Father-Son Inter-Generational Transmission of Authoritarian Paternal Attitudes.

Science.gov (United States)

Peretti, Peter O.; Statum, Jo Ann

1984-01-01

Attempted to determine authoritarian paternal attitude inter-generational transmission in fathers and sons (N=75). Results suggested that authoritarian paternal attitudes could be indicated in terms of five factors: Dominant, Rigidity, Conformity, Intolerant, and Uncreative; and that the sons expressed strongly the authoritarian attitudes of their…

The Transmission of Parenting from Fathers to Sons

Science.gov (United States)

Hofferth, Sandra L.; Pleck, Joseph H.; Vesely, Colleen K.

2012-01-01

SYNOPSIS Objective We address the extent to which parenting practices of fathers and mothers are associated with their sons’ parenting behaviors as young adults and whether adolescent behavior explains this association. Design Data come from 409 young men interviewed in the 2006 Young Adult study of the 1979 National Longitudinal Survey of Youth. Results Men whose fathers were positively involved with them when growing up report more positive parenting of their own children, a direct effect. Less harsh mothering and more positive fathering are associated with reduced adolescent behavior problems, and positive mothering is associated with positive adjustment of these young men as adolescents. However, neither adolescent problem behavior nor positive adjustment is associated with young men’s fathering of their own children, and thus does not explain the association between the fathering young men received and their own fathering behavior. Conclusions Men’s parenting of their sons can have a long-term direct effect on how their sons parent their own children. Although parenting is associated with both positive and negative behaviors of sons during adolescence, these adolescent behaviors are not directly linked to later parenting behavior when sons have their own children. More research is needed to examine mediation mechanisms for the intergenerational transmission of parenting. PMID:23284271

Parent-son decision-making about human papillomavirus vaccination: a qualitative analysis

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Alexander Andreia B

2012-12-01

Full Text Available Abstract Background Licensed for use in males in 2009, Human Papillomavirus (HPV vaccination rates in adolescent males are extremely low. Literature on HPV vaccination focuses on females, adult males, or parents of adolescent males, without including adolescent males or the dynamics of the parent-son interaction that may influence vaccine decision-making. The purpose of this paper is to examine the decision-making process of parent-son dyads when deciding whether or not to get vaccinated against HPV. Methods Twenty-one adolescent males (ages 13–17, with no previous HPV vaccination, and their parents/guardians were recruited from adolescent primary care clinics serving low to middle income families in a large Midwestern city. Dyad members participated in separate semi-structured interviews assessing the relative role of the parent and son in the decision regarding HPV vaccination. Interviews were recorded, transcribed, and coded using inductive content analysis. Results Parents and sons focused on protection as a reason for vaccination; parents felt a need to protect their child, while sons wanted to protect their own health. Parents and sons commonly misinterpreted the information about the vaccine. Sons were concerned about an injection in the penis, while some parents and sons thought the vaccine would protect them against other sexually transmitted infections including Herpes, Gonorrhea, and HIV. Parents and sons recalled that the vaccine prevented genital warts rather than cancer. The vaccine decision-making process was rapid and dynamic, including an initial reaction to the recommendation for HPV vaccine, discussion between parent and son, and the final vaccine decision. Provider input was weighed in instances of initial disagreement. Many boys felt that this was the first health care decision that they had been involved in. Dyads which reported shared decision-making were more likely to openly communicate about sexual issues than those

Ethics issues in security hospitals.

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Weinstein, Henry C

2002-01-01

The term 'security hospital' is used for a variety of facilities including forensic hospitals and prison hospitals, which, because of their mission, the nature of their work, and the populations they serve-or because of the authority under which they operate-place the staff at considerable risk of ethical violations related to either clinical care or to forensic activities. The problem of divided loyalties is of special concern in security hospitals. Ethics principles particularly at risk are confidentiality and informed consent. Where there are cultural disparities between the staff and the patients, differences in background, socioeconomic class, education, and other types of diversity, cultural awareness is required and must be reflected in appropriate treatment and evaluation. To counteract the risks of ethical violations, a security hospital should create an ethical climate and develop means to anticipate, prevent, and deal with ethical violations. These might include detailed and specific policies and procedures, programs of orientation, education, consultation, and liaison as well as its own ethics committee. Copyright 2002 John Wiley & Sons, Ltd.

Coupling coefficients of SO(n) and integrals involving Jacobi and Gegenbauer polynomials

International Nuclear Information System (INIS)

Alisauskas, Sigitas

2002-01-01

The expressions for the coupling coefficients (3j-symbols) for most degenerate (symmetric) representations of orthogonal groups SO(n) in a canonical basis (with SO(n) restricted to SO(n-1) and different semicanonical or tree bases (with SO(n) restricted to SO(n')xSO(n''), n'+n''=n) are considered, respectively, in context of integrals involving triplets of the Gegenbauer and the Jacobi polynomials. Since the directly derived triple-hypergeometric series do not reveal the apparent triangle conditions of the 3j-symbols, they are rearranged, using their relation with semistretched isofactors of the second kind for the complementary chain Sp(4) contains SU(2)xSU(2) and analogy with the stretched 9j coefficients of SU(2), into formulae with more rich limits for summation intervals and obvious triangle conditions. The isofactors of class-one representations of orthogonal groups or class-two representations of unitary groups (and, of course, the related integrals involving triplets of the Gegenbauer and the Jacobi polynomials) turn into double sums in the cases of canonical SO(n) contains SO(n-1) or U(n) contains U(n-1) and semicanonical SO(n) contains SO(n-2)xSO(2) chains, as well as into the 4 F 3 (1) series under more specific conditions. Some ambiguities of the phase choice of the complementary group approach are adjusted, as well as problems with an alternating sign parameter of SO(2) representations in the SO(3) contains SO(2) and SO(n) contains SO(n-2)xSO(2) chains. (author)

Lean healthcare in developing countries: evidence from Brazilian hospitals.

Science.gov (United States)

Costa, Luana Bonome Message; Filho, Moacir Godinho; Rentes, Antonio Freitas; Bertani, Thiago Moreno; Mardegan, Ronaldo

2017-01-01

The present study evaluates how five sectors of two Brazilian hospitals have implemented lean healthcare concepts in their operations. The main characteristics of the implementation process are analyzed in the present study: the motivational factor for implementation, implementation time, form (consultancy or internal), team (hospital and consultants), lean implementation continuity/sustainability, lean healthcare tools and methods implemented, problems/improvement opportunities, lean healthcare barriers faced during the implementation process, and critical factors that affected the implementation and the results obtained in each case. The case studies indicate that reducing patient lead times and costs and making financial improvements were the primary factors that motivated lean healthcare implementation in the hospitals studied. Several tools and methods were used in the cases studied, especially value stream mapping and DMAIC. The barriers found in both hospitals are primarily associated with the human factor. Additionally, the results obtained after implementation were analyzed and improvements in financial aspects, productivity and capacity, and lead time reduction of the analyzed sectors were observed. Further, this study also exhibited four propositions elaborated from the results obtained from the cases that highlighted barriers and challenges to lean healthcare implementation in developing countries. Two of these barriers are hospital organizational structure (and, consequently, how the senior management works with medical staff), and outsourcing hospital activities. This study also concluded that the initialization and maintenance of lean healthcare implementation rely heavily on external support because lean healthcare subject knowledge is not yet available in the healthcare organization, which represents a challenge. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

A Letter from a Black Mom to Her Son

Science.gov (United States)

Watson, Dyan

2012-01-01

An African American mother and teacher educator uses examples from her own childhood to describe how she hopes her child will be treated by teachers, and what she fears. In her letter to her son, the African American mom expresses how she want teachers to know her son's journey to school--metaphorically and physically. She wants them to know that…

Crustal thickness mapping in Raipur–Katni area of Narmada–Son ...

Indian Academy of Sciences (India)

The Narmada–Son lineament (NSL) is one of the most prominent tectonic features which divides the .... fault at Red Sea area (Bhattacharjee and Koide. 1978). The Son and .... relationship between SI and number of infinite dimension of the ...

Plantilla de enfermería y demanda de cuidados de ancianos hospitalizados, ¿son suficientes los recursos? Nursing staff and care needs in hospitalized elders, are there enough resources?

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Alfonso Jesús Cruz Lendínez

2007-12-01

Full Text Available Introducción: El aumento de la población de personas mayores de 65 años hace cada vez más frecuente su ingreso en los hospitales. El tiempo de estancia hospitalaria de los ancianos suele ser más prolongado que el del resto de pacientes. Objetivo: Analizar la capacidad de prestación de cuidados de 3 unidades de hospitalización de un hospital público y compararla con la demanda de cuidados de los ancianos. Métodos: Estudio prospectivo observacional en 3 unidades de hospitalización de medicina interna de un hospital universitario de la red pública de Andalucía (España. Se ha incluido una muestra de 190 pacientes ancianos hospitalizados. Las variables recogidas fueron: demográficas, relacionadas con la hospitalización, demanda de cuidados y capacidad de prestación de cuidados de la plantilla de enfermería. Los datos se han obtenido del sistema de información del hospital, del conjunto mínimo básico de datos de pacientes y por observación directa mediante el método de nivel de cuidados (MNC. Resultados: La edad media de los ancianos hospitalizados fue de 77,4 años, con 21,1% de mayores de 85 años. La estancia media fue de 15,68 días. La estimación de la capacidad de prestación de cuidados de la plantilla de enfermería fue de 2,8 horas/paciente/día (con un índice de enfermeras tituladas del 60%. A partir de la medición de niveles de dependencia, la demanda de cuidados media de los ancianos fue de 4,9 horas/paciente/día. Esta diferencia supone un déficit anual de 51 profesionales de enfermería en la plantilla de las 3 unidades de hospitalización. Los factores que influyen en la demanda de cuidados de los ancianos son la edad, días de estancia hospitalaria, el diagnóstico médico y el destino del paciente al alta. También se encuentra una relación con la presencia de un familiar acompañando al paciente (cuidador familiar. Los cuidados básicos representan un 65,7% del total de cuidados requeridos. Conclusiones: La

Benefits of Self-Organizing Networks (SON for Mobile Operators

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Olav Østerbø

2012-01-01

Full Text Available Self-Organizing Networks (SON is a collection of functions for automatic configuration, optimization, diagnostisation and healing of cellular networks. It is considered to be a necessity in future mobile networks and operations due to the increased cost pressure. The main drivers are essentially to reduce CAPEX and OPEX, which would otherwise increase dramatically due to increased number of network parameters that has to be monitored and set, the rapidly increasing numbers of base stations in the network and parallel operation of 2G, 3G and Evolved Packet Core (EPC infrastructures. This paper presents evaluations on the use of some of the most important SON components. Mobile networks are getting more complex to configure, optimize and maintain. Many SON functions will give cost savings and performance benefits from the very beginning of a network deployment and these should be prioritized now. But even if many functions are already available and can give large benefits, the field is still in its infancy and more advanced functions are either not yet implemented or have immature implementations. It is therefore necessary to have a strategy for how and when different SON functions should be introduced in mobile networks.

Prevalencia del tabaquismo en los trabajadores de un hospital

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Arévalo Alonso José Miguel

1997-01-01

Full Text Available FUNDAMENTO: Sobre tabaquismo se han realizado muchos estudios tanto en España como en otros países. El objetivo de esta encuesta es valorar la prevalencia de tabaquismo en una muestra representativa de trabajadores del hospital y su asociación con la edad, sexo, estamento profesional y actitudes. MÉTODOS: Después de un estudio piloto, se realizó una encuesta en una muestra representativa y aleatoria (n=360 de trabajadores del hospital, a los que se les preguntó por sus actitudes al hábito tabáquico, clasificados por edad, sexo y estamentos. RESULTADOS: El porcentaje total de fumadores es de 36.4%, pero no se han encontrado diferencias estadísticamente significativas ni por sexo ni grupo de edad. Los estamentos con mayor porcentaje de fumadores son ATS/DUE y Administrativos. El 42.8% de los no fumadores declaran haberlo hecho antes, siendo los estamentos de ATS/DUE, Administrativos y Facultativos los que mostraron el mayor porcentaje. Un 40.5% de fumadores declaran estar dispuestos a dejar el hábito, mientras el grupo de personas mayores de 50 años se muestran más resistentes. La mayoría de fumadores de cigarrillos señalan que fuman en el hospital. La mayor parte de ellos son fumadores intermedios (10-20 cigarrillos/día y lo llevan haciendo muchos años. La mayor parte de los exfumadores declaran haber dejado el hábito en los últimos años. CONCLUSIONES: Estos resultados demuestran que un gran porcentaje de trabajadores del hospital son fumadores. Sin embargo, existe un importante número que está dispuestos a dejarlo. Por ello, animamos a estas personas a que dejen de fumar y ayudarles por medio de diversas acciones tales como: consulta de tratamiento del tabaquismo, consejo médico y educación para la salud. Proponemos declarar al hospital como "HOSPITAL SIN TABACO" para el año 2000, lo cual incluye a trabajadores, pacientes y visitas, de acuerdo con la estrategia de la OMS "Salud para todos".

SON is a spliceosome-associated factor required for mitotic progression.

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Huen, Michael S Y; Sy, Shirley M H; Leung, Ka Man; Ching, Yick-Pang; Tipoe, George L; Man, Cornelia; Dong, Shuo; Chen, Junjie

2010-07-01

The eukaryotic RNA splicing machinery is dedicated to the daunting task of excising intronic sequences on the many nascent RNA transcripts in a cell, and in doing so facilitates proper translation of its transcriptome. Notably, emerging evidence suggests that RNA splicing may also play direct roles in maintaining genome stability. Here we report the identification of the RNA/DNA-binding protein SON as a component of spliceosome that plays pleiotropic roles during mitotic progression. We found that SON is essential for cell proliferation, and that its inactivation triggers a MAD2-dependent mitotic delay. Moreover, SON deficiency is accompanied by defective chromosome congression, compromised chromosome segregation and cytokinesis, which in turn contributes to cellular aneuploidy and cell death. In summary, our study uncovers a specific link between SON and mitosis, and highlights the potential of RNA processing as additional regulatory mechanisms that govern cell proliferation and division. © 2010 Landes Bioscience

THE MOTIF OF THE PRODIGAL SON IN IVAN TURGENEV'S NOVELS

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Valentina Ivanovna Gabdullina

2013-11-01

Full Text Available The author questions the perception of Ivan Turgenev as a “non- Christian writer” and studies the problem of the prodigal son motif functioning in a series of his novels. In his novels, Turgenev pictured different phases of the archetypal story, originating from the Gospel parable of the prodigal son. In the novel Rudin he depicted the phase of spiritual wanderings of the hero who had lost touch with his native land — Russia. In his next novels (Home of the Gentry, Fathers and Sons and Smoke, after leading his hero in circles and sending him back to his paternal home, Turgenev reconstructs the model of human behavior, represented in the parable, thereby recognizing the immutability of the idea formalized in the Gospel. The motif of the return to Russian land gets its completion in Turgenev's last novel Virgin Soil, in which the author paradoxically connects the Westernist idea with the Gospel imperative. Solomin, the son of a deacon, sent by his wise father out to Europe “to get education”, studies in England, masters the European knowledge and returns back “to his native land” to establish his own business in inland Russia. Thus, a series of Turgenev's novels, in which he portrayed different phases of social life, are interlinked with the motif of the prodigal son, who is represented by novels' main characters.

HPV vaccine for teen boys: Dyadic analysis of parents' and sons' beliefs and willingness.

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Moss, Jennifer L; Reiter, Paul L; Brewer, Noel T

2015-09-01

Parents and adolescents often decide together whether the child should receive human papillomavirus (HPV) vaccine. However, few studies have investigated the dyadic nature of beliefs that affect this process. Data came from the 2010 HPV Immunization in Sons (HIS) Study, a national sample of 412 parents and their adolescent sons. We conducted dyadic multivariate logistic regression to examine the relationships between parents' and sons' HPV vaccine beliefs and their willingness to have the son receive the vaccine. Less than half of parents and sons were willing to have the sons receive HPV vaccine (43% and 29%, respectively). Willing parents and sons anticipated greater regret if the son did not receive HPV vaccine but later contracted an HPV infection (parent odds ratio [OR]=1.72, 95% confidence interval [CI]=1.24-2.40; son OR=1.51, 95% CI=1.04-2.19) (both pCommunication campaigns may be able to target these beliefs to increase parents' and sons' willingness to seek HPV vaccination. Copyright © 2015 Elsevier Inc. All rights reserved.

Quality competition and hospital mergers-An experiment.

Science.gov (United States)

Han, Johann; Kairies-Schwarz, Nadja; Vomhof, Markus

2017-12-01

On the basis of a Salop model with regulated prices, we investigate quality provision behaviour of competing hospitals before and after a merger. For this, we use a controlled laboratory experiment where subjects decided on the level of treatment quality as head of a hospital. We find that the post-merger average quality is significantly lower than the average pre-merger quality. However, for merger insiders and outsiders, average quality choices are significantly higher than predicted for pure profit-maximising hospitals. This upward deviation is potentially driven by altruistic behaviour towards patients. Furthermore, we find that in the case where sufficient cost synergies are realised by the merged hospitals, there is a significant increase in average quality choices compared to the scenario without synergies. Finally, we find that our results do not change when comparing individual decisions to team decisions. Copyright © 2017 John Wiley & Sons, Ltd.

Supersymmetric vector multiplets in nonadjoint representations of SO(N)

International Nuclear Information System (INIS)

Nishino, Hitoshi; Rajpoot, Subhash

2007-01-01

In the conventional formulation of N=1 supersymmetry, a vector multiplet is supposed to be in the adjoint representation of a given gauge group. We present a new formulation with a vector multiplet in the nonadjoint representation of SO(N) gauge group. Our basic algebra is [T I ,T J ]=f IJK T K , [T I ,U i ]=-(T I ) ij U j , [U i ,U j ]=-(T I ) ij T I , where T I are the generators of SO(N), while U i are the new ''generators'' in certain nonadjoint real representation R of SO(N). We use here the word generator in the broader sense of the word. Such a representation can be any real representation of SO(N) with the positive definite metric, satisfying (T I ) ij =-(T I ) ji and (T I ) [ij| (T I ) |k]l ≡0. The first nontrivial examples are the spinorial 8 S and conjugate spinorial 8 C representations of SO(8) consistent with supersymmetry. We further couple the system to chiral multiplets and show that a Higgs mechanism can give positive definite (mass) 2 to the new gauge fields for U i . We show an analogous system working with N=1 supersymmetry in 10D, and thereby N=4 system in 4D interacting with extra multiplets in the representation R. We also perform superspace reformulation as an independent confirmation

Some relevant properties of SO(n) representations for Grand unified theories

International Nuclear Information System (INIS)

Girardi, G.; Sorba, P.; Sciarrino, A.

1980-05-01

General properties of the SO(n) groups are examined, with emphasis on the usefulness of the Gel'fand-Zetlin basis for explicit calculations. The SO(n) representations containing a vector stabilized by subgroups of the type S[O(n-p) x O(p)], SU(k) x U(1) or SU(k) if n=2k, are characterized in view of selecting Higgs representations in SO(n) gauge models. Some useful properties of the SU(n) Gel'fand-Zetlin basis are given in the appendices

The association of hospital governance with innovation in Taiwan.

Science.gov (United States)

Yang, Chen-Wei; Yan, Yu-Hua; Fang, Shih-Chieh; Inamdar, Syeda Noorein; Lin, Hsien-Cheng

2018-01-01

Hospitals in Taiwan are facing major changes and innovation is increasingly becoming a critical factor for remaining competitive. One determinant that can have a significant impact on innovation is hospital governance. However, there is limited prior research on the relationship between hospital governance and innovation. The purpose of this study is to propose a conceptual framework to hypothesize the relationship between governance mechanisms and innovation and to empirically test the hypotheses in hospital organizations. We examine the relationship between governance mechanisms and innovation using data on 102 hospitals in Taiwan from the Taiwan Joint Commission on Hospital Accreditation and Quality Improvement. We model governance mechanisms using board structure, information transparency and strategic decision-making processes. For our modeling and data analysis we use measurement and structural models. We find that in hospital governance, information transparency and strategic decision making did impact innovation. However, governance structure did not. To facilitate innovation, hospital boards can increase information transparency and improve the decision-making process when considering strategic investments in innovative initiatives. To remain competitive, hospital boards need to develop and monitor indices that measure hospital innovation to ensure ongoing progress. Copyright © 2017 John Wiley & Sons, Ltd.

Views of Astronaut (Col.) Joe Engle and son Jon with L-5 Piper Cub

Science.gov (United States)

1981-01-01

Views of Astronaut (Col.) Joe Engle and son Jon with L-5 Piper Cub at Clover Airport. Photos include Engle turning propeller while his son sits in the cockpit (34323); both Engle and son examine propeller (34324); Engle works on engine while his son sits in cockpit (34325).

[Epilepsy treatment in Serbian medieval monastery hospitals].

Science.gov (United States)

Ilić-Tasić, Slobodanka; Pantović, Mihailo; Jović, Nebojsa; Ravanić, Dragan; Obradović, Dejan; Sretenović, Srdjan; Pantović, Maja; Pantović, Vesna

2009-01-01

Emperor John III Ducas Vatatzes (ruled from 1222-1254) and his son Theodore II Lascaris (ruled from 1254-1258) both suffered from epilepsy. On his journeys to Nicaea, St Sava visited emperors Theodore I Lascaris (ruled from 1204-1222) and John II Vatatzes, who richly rewarded him, which was probably of crucial importance for the foundation of hospitals in the Monastery of Hilandar and the Monastery of Studenica These hospitals had special departments for the treatment of patints with epilepsy. According to researches conducted up-to-date, these departments are considered to be the oldest institutions for epilepsy treatment. Monastery hospitals in the West served primarily as a shelter for the poor and patients with chronic incurable diseases. The development of Serbian monastery hospitals was a long process and it included institutions that lasted for a long time (for over two centuries) in which, among others, those affected by epilepsy were cured.

Influência das vogais na estimulabilidade dos sons líquidos

OpenAIRE

Castro,Márcia Mathias de; Wertzner,Haydée Fizbein

2009-01-01

OBJETIVO: verificar o número de crianças, entre 5:0 e 11:6 anos, com e sem Transtorno Fonológico, falantes do Português Brasileiro que imitaram corretamente os sons líquidos no teste de estimulabilidade considerando cada uma das vogais subsequentes. MÉTODOS: a estimulabilidade foi medida por uma prova de imitação de 63 sílabas com os sons com as sete vogais orais, em três repetições. Foi analisada a porcentagem de sujeitos que produziu corretamente os sons em função da vogal subsequente. RESU...

In the Pursuit of Sons: Additional Births or Sex-Selective Abortion in Pakistan?

Science.gov (United States)

Zaidi, Batool; Morgan, S Philip

2016-12-01

Even though Pakistan is a highly patriarchal society, it has not featured prominently in studies focusing on sex-selective abortion and sex ratios at birth. But with fertility declining and existing strong son preference-Pakistan has one of the highest desired sex ratios in the world-how will Pakistani families respond? In the pursuit of sons, will they have additional children or resort to sex-selective abortions? Or is there evidence that the pursuit of sons is weakening? Using data from three rounds of the demographic and health survey, we show clear evidence of son preference in fertility intentions, patterns of contraceptive use and parity progression ratios. More specifically, we find pervasive evidence that Pakistanis continue childbearing to have a son, to have more than one son and to have at least one daughter. We do not find consistent and convincing evidence that sex ratios at birth (which indicate sex-selective abortion) are increasing.

My Son 22.10.11

Directory of Open Access Journals (Sweden)

Rebecca Baillie

2013-01-01

Full Text Available 'My Son 22.10.11' was made immediately following a miscarriage 8 weeks into pregnancy. After bleeding lightly for a couple of hours, I went to the toilet and a large bloody mass fell from within me. I knew that I could not flush this away, and that to retrieve the mass was my only chance to connect with the unborn foetus. I fished the contents from the bottom of the toilet bowl using my hands and carried them into my small studio. I found some paper and began to dissect the mass. At the centre, I found the tiny, cold, hard foetus. I kissed it and then began to use it as a kind of painting tool, drawing the outline of the lost child using its very own flesh and blood. I knew that to create a lasting and tangible portrait of 'my son' was the best way to understand the somewhat unreal and fleeting experience of miscarriage. I thought of Frida Kahlo while making the work, thinking 'thank God' that I had a reference to miscarriage before it happened to me. I also thought of my childhood days spent on our family pig farm, and of all the dead pig foetuses that I had seen at various stages of development. Before the miscarriage, I thought little about the subject; afterwards, I recognise the profundity of the creation of a life that is never born. The experience is so common, yet so very rarely discussed or depicted.

Preliminary Characterization of the Liquid Discharge of the Mexico Hospital; Caracterizacion Preliminar de la Descarga Liquida del Hospital Mexico

Energy Technology Data Exchange (ETDEWEB)

Hernandez Rojas, A

2001-07-01

constituye un grave problema a nivel nacional. En este trabajo se realiza una caracterizacion preliminar de la descarga liquida del Hospital Mexico. Para ello se analizaron diferentes puntos de vertido dentro de la institucion, ellos son : Lavanderia, cocina central, Laboratorio Clinico, Rayos X, Laboratorio de Biomasa, Morgue y la descarga final del hospital. Esto con el fin de conocer el manejo de los desechos liquidos en el centro de salud, la calidad sanitaria de estos vertidos y su influencia en las aguas crudas del Hospital Mexico en el cuerpo receptor. Para este estudio primero se coordino con el personal de cada departamento para conocer sobre el manejo y tipo de residuos liquidos que son descargados al sistema de tuberias. Posteriormente se realizaron las pruebas fisico-quimicas y biologicas con base en dos muestreos compuestos realizados los dias 26 de octubre y 4 de noviembre de 1998. Entre las pruebas realizadas se tienen: pH, DBO, DQO, SAAM, Grasas y Aceites, Temperatura, Nitrogeno y Coliformes Fecales, dependiendo de las caracteristicas de su punto de procedencia. Al final del estudio, se evaluaron los resultados obtenidos para cada punto de vertido estudiado y luego se analizo la influencia de estos focos sobre la calidad de las aguas crudas del hospital, las cuales descargan en una quebrada localizada al costado noroeste de las instalaciones. Los resultados obtenidos permiten conocer preliminarmente la caracterizacion de la descarga liquida del Hospital Mexico y lo catalogan como una fuente de contaminacion. El Hospital requiere de una planta de tratamiento biologica para aquellos vertidos biodegradables, y de un sistema de tratamiento quimico para tratar ese tipo de productos, que son utilizados en los procesos propios de cada departamento; ademas se requiere tomar en cuenta medidas de reduccion de contaminacion que disminuyan la cantidad de desechos desde la fuente. (Author)

Son Preference and Family Limitation in Pakistan: A Parity- and Contraceptive Method-Specific Analysis.

Science.gov (United States)

Channon, Melanie Dawn

2017-09-01

Son preference exerts a strong influence over contraceptive and fertility decisions in many South Asian countries. In Pakistan, where fertility remains high and contraceptive use low, research on son preference has been limited. Data from Pakistan Demographic and Health Surveys conducted in 1990-1991, 2006-2007 and 2012-2013 were used to examine potential indicators and outcomes of son preference. Descriptive analyses looked at sex composition preferences of men and women, as well as the sex ratio at last birth. Multivariate logistic regression analyses examined parity progression by birth order, while multinomial logistic regression was used to identify associations between sex composition and use of permanent, temporary and traditional contraceptive methods. Parity progression and choice of contraceptive method are increasingly associated with the sex composition of children. Many respondents wanted at least two sons, though most also wanted at least one daughter. Analyses suggest that the prevalence of modern contraceptive use among parous women would have been 19% higher in 2012-2013 in the absence of son preference. Permanent method use was extremely low among women with no sons and increased significantly with number of sons. The association between number of sons and use of temporary methods was weaker, while son preference had little relationship with traditional method use. The association of son preference with parity progression and modern contraceptive use has become stronger in Pakistan. Continuation of the fertility transition may be difficult unless the degrees of differential stopping behavior and differential contraceptive use decline.

Having a Son Promotes Clean Cooking Fuel Use in Urban India: Women's Status and Son Preference

OpenAIRE

Avinash Kishore; Dean Spears

2014-01-01

Urban Indian households with a male first child are approximately 2 percentage points more likely to use clean cooking fuel than comparable households with a female first child. Given Indian son preference, there are at least two mechanisms by which child sex could affect fuel choice: by improving the intrahousehold status of women, who bear more of the costs of traditional fuels, or by presenting an opportunity to invest in children's health, in the context of a preference for healthier boys...

Mothers' Predictions of Their Son's Executive Functioning Skills: Relations to Child Behavior Problems

Science.gov (United States)

Johnston, Charlotte

2011-01-01

This study examined mothers' ability to accurately predict their sons' performance on executive functioning tasks in relation to the child's behavior problems. One-hundred thirteen mothers and their 4-7 year old sons participated. From behind a one-way mirror, mothers watched their sons perform tasks assessing inhibition and planning skills.…

The institutionalization of Jesus' charismatic authority: "Son of Man" as case study1

Directory of Open Access Journals (Sweden)

Yolanda Dreyer

2000-12-01

Full Text Available This article argues that Jesus used the expression "son of man" not in a titular way, but genetically, meaning "humankind". This use of "son of man" developed into a titular usage in which Jesus is identified with "Son of Man". The study shows that Jesus' use of the expression "son of man" should be understood in the context of the "little tradition" which was reinterpreted in terms of the "great tradition" in a titular way. It is argued that this transition from "litle tradition" to "great tradition"can be seen as "false attribution". After Jesus' death when his followers reorganized themselves into a cultic community, they gave Jesus the position "founder of the cult". They did this by making use of honorary titles. The use of the title "Son of Man" for Jesus is interpreted in terms of the social theory of the institutionalization of charismatic authority. The focus is on the title "Son of Man" as it appears in legal sayings or church rules, wisdom sayings and prophetic and apocalyptic sayings.

Lifestyle in pregnancy and cryptorchidism in sons: a study within two large Danish birth cohorts

Directory of Open Access Journals (Sweden)

Kjersgaard C

2018-03-01

Full Text Available Camilla Kjersgaard,1 Linn Håkonsen Arendt,1,2 Andreas Ernst,1 Morten Søndergaard Lindhard,2 Jørn Olsen,1,3 Tine Brink Henriksen,2 Katrine Strandberg-Larsen,4 Cecilia Høst Ramlau-Hansen1 1Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, 2Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Aarhus, 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 4Department of Public Health, Section of Social Medicine, Copenhagen University, Copenhagen, Denmark Purpose: Cryptorchidism is the most frequent congenital malformation in boys and is associated with low sperm count, infertility and testicular cancer. Unhealthy maternal lifestyle during pregnancy such as smoking, high prepregnancy body mass index (BMI as well as alcohol and caffeine intake may constitute possible risk factors for cryptorchidism, but results from the few previous studies are conflicting. We aimed to explore the association between maternal lifestyle factors and occurrence of cryptorchidism in sons.Patients and methods: The Danish National Birth Cohort and the Aarhus Birth Cohort provided information on maternal lifestyle from early pregnancy. Data were linked to several Danish health registers, multiple imputation was used to handle missing data and Cox proportional hazards models were used to adjust for potential confounders.Results: In total, 85,923 boys were included, and of them, 2.2% were diagnosed with cryptorchidism. We observed the strongest associations between maternal tobacco smoking and prepregnancy BMI and cryptorchidism. Sons of women who smoked 10–14 cigarettes/day had the highest hazard ratio (HR for cryptorchidism (1.37; 95% CI: 1.06–1.76, and for maternal BMI ≥30 kg/m2, the HR was 1.32 (95% CI: 1.06–1.65. Binge drinking was associated with an HR <1, if the women had one or two episodes in pregnancy (HR: 0.81; 95% CI: 0.67–0.98. Average maternal alcohol intake

Readiness for hospital discharge: A concept analysis.

Science.gov (United States)

Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice

2017-11-01

To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.

Suh Yang Park, who Became a Doctor as a Son of a Butcher

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PARK Hyoung Woo

2006-12-01

Full Text Available Dr. Suh Yang Park was born in 1885 as a son of a butcher, which was the lowest class at that time in Korea. However, contact with western missionaries, including Dr. O. R. Avison, provided him with an understanding of western civilization. After entering Chejungwon Medical School in 1900, Dr. Park learned basic sciences, basic medical sciences like anatomy and physiology, and other Western medical specialties such as internal medicine and surgery. He graduated from medical school in 1908 and received Government Certificate from Home Office, the first in Korea in this field, which granted the right to practice medicine. His certificate number was 4th overall. As both a doctor and a talented musician, Dr. Park actively participated in the social enlightenment movement. He was quite progressive in his time, having surpassed the social limitations as a son of a butcher, as well as actively propagating his knowledge of Western civilization onto others. After graduation, he had served as a professor at the school he graduated from, until he went into exile in Manchuria in 1917 due to the annexation of Korea by Japan in 1910. There, he opened a hospital and provided medical treatment for Koreans. He also established a school for young Koreans, inspiring them with a sense of nationalism. Also, Dr. Park was an active member of various Independence Movement Organizations in Manchuria. Then in 1932, at the time when Japan took control of Manchuria, his school was closed down. As a result, Dr. Park couldn't help but stop his anti-Japanese activities. In 1936, he returned to his homeland and passed away in 1940, just five years before the liberation of Korea from Japanese occupation.

[Suh Yang Park, who became a doctor as a son of a butcher].

Science.gov (United States)

Park, Hyoung Woo; Hong, Jung Wan

2006-12-01

Dr. Suh Yang Park was born in 1885 as a son of a butcher, which was the lowest class at that time in Korea. However, contact with western missionaries, including Dr. 0. R. Avison, provided him with an understanding of western civilization. After entering Chejungwon Medical School in 1900, Dr. Park learned basic sciences, basic medical sciences like anatomy and physiology, and other Western medical specialties such as internal medicine and surgery. He graduated from medical school in 1908 and received Government Certificate from Home Office, the first in Korea in this field, which granted the right to practice medicine. His certificate number was 4th overall. As both a doctor and a talented musician, Dr. Park actively participated in the social enlightenment movement. He was quite progressive in his time, having surpassed the social limitations as a son of a butcher, as well as actively propagating his knowledge of Western civilization onto others. After graduation, he had served as a professor at the school he graduated from, until he went into exile in Manchuria in 1917 due to the annexation of Korea by Japan in 1910. There, he opened a hospital and provided medical treatment for Koreans. He also established a school for young Koreans, inspiring them with a sense of nationalism. Also, Dr. Park was an active member of various Independence Movement Organizations in Manchuria. Then in 1932, at the time when Japan took control of Manchuria, his school was closed down. As a result, Dr. Park couldn't help but stop his anti-Japanese activities. In 1936, he returned to his homeland and passed away in 1940, just five years before the liberation of Korea from Japanese occupation.

Public Hospital Spending in England: Evidence from National Health Service Administrative Records

OpenAIRE

Kelly, E.; Stoye, G.; Vera-Hernández, M.

2016-01-01

© 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spendi...

Son, Sent, and Servant

Directory of Open Access Journals (Sweden)

Truls Åkerlund

2015-11-01

Full Text Available This study challenges the claim that Jesus is the archetypical servant leader as described in contempo-rary leadership literature. Based on a theological reading of the Fourth Gospel, the paper suggests that, as a servant, Jesus cannot be understood apart from his mission and obedience to God. Consequently, Jesus was not primarily a servant leader but rather the Son who was sent to the world to enact the Fa-ther’s will. In this regard, the Fourth Gospel provides a unique perspective that is barely noted in the current discourse on servant leadership modelled on the example of Christ. Although certain aspects of servant leadership theory correspond to John’s portrayal of Jesus, the study concludes that other de-scriptions of him as a servant leader suffer from a one-sided and reductionist Christology. Implications of this view for Christian ministry are briefly sketched out.

The experience of sons caring for a parent with dementia.

Science.gov (United States)

McDonnell, Eilis; Ryan, Assumpta A

2014-11-01

This study explored the experiences of sons caring for a parent with dementia. Individual, semi-structured interviews were conducted with a purposeful sample of sons (n = 13) in a rural part of Ireland. Interviews were audiotaped, transcribed verbatim and analysed for common themes. The key themes that emerged were 'the parental bond', 'a binding role', 'coordinating care and support' and a 'getting on with it' approach to care. The study highlighted the commitment of sons to their caregiving role and the strong sense of duty that motivated them to provide care. The findings suggested that while many aspects of the caregiving experience such as lack of information and support are gender neutral, there are differences in the caregiving experiences of men and women in how they view their relationship with their parent and in the management of their caregiving role that merit further investigation. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

De Novo Truncating Variants in SON Cause Intellectual Disability, Congenital Malformations, and Failure to Thrive.

Science.gov (United States)

Tokita, Mari J; Braxton, Alicia A; Shao, Yunru; Lewis, Andrea M; Vincent, Marie; Küry, Sébastien; Besnard, Thomas; Isidor, Bertrand; Latypova, Xénia; Bézieau, Stéphane; Liu, Pengfei; Motter, Connie S; Melver, Catherine Ward; Robin, Nathaniel H; Infante, Elena M; McGuire, Marianne; El-Gharbawy, Areeg; Littlejohn, Rebecca O; McLean, Scott D; Bi, Weimin; Bacino, Carlos A; Lalani, Seema R; Scott, Daryl A; Eng, Christine M; Yang, Yaping; Schaaf, Christian P; Walkiewicz, Magdalena A

2016-09-01

SON is a key component of the spliceosomal complex and a critical mediator of constitutive and alternative splicing. Additionally, SON has been shown to influence cell-cycle progression, genomic integrity, and maintenance of pluripotency in stem cell populations. The clear functional relevance of SON in coordinating essential cellular processes and its presence in diverse human tissues suggests that intact SON might be crucial for normal growth and development. However, the phenotypic effects of deleterious germline variants in SON have not been clearly defined. Herein, we describe seven unrelated individuals with de novo variants in SON and propose that deleterious variants in SON are associated with a severe multisystem disorder characterized by developmental delay, persistent feeding difficulties, and congenital malformations, including brain anomalies. Copyright © 2016 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

Informal caregivers in hospitals: Opportunities and threats.

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Amiresmaili, Mohammadreza; Emrani, Zahra

2018-05-20

High hospital costs are a challenge that health system face. Additionally, studies identified manpower deficiency as a problem in health system. Hospital is a place where patients with different physical and mental conditions come to. Their families and friends' companionship can facilitate this situation for them. This study illustrates the roles of informal caregivers in hospital. This is a phenomenological qualitative study. Data were gathered through semistructured interviews. We interviewed 22 informal caregivers and 9 nurse staffs from different departments of hospital. They were selected through purposeful and snowball sampling approach. The framework method was used for data analysis. We found 3 main themes including (a) roles of informal caregivers, (b) opportunities of presence of the informal caregivers in the hospital, and (c) threats of presence of informal caregivers. This study shows some roles for informal caregivers including mental supports, consultation, decision-making, and care roles. Concerning the shortage of manpower in Iran's hospitals, nurses have less time to take care of each patient; therefore, using informal caregivers as an implicit strategy to overcome nursing shortage and to reduce hospital costs seems to be beneficial. We suggest that an appropriate plan is necessary to make use of them for filling this gap to some extent, as well as providing training sessions and facilities for companions acting as informal caregivers. Copyright © 2018 John Wiley & Sons, Ltd.

SON connects the splicing-regulatory network with pluripotency in human embryonic stem cells.

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Lu, Xinyi; Göke, Jonathan; Sachs, Friedrich; Jacques, Pierre-Étienne; Liang, Hongqing; Feng, Bo; Bourque, Guillaume; Bubulya, Paula A; Ng, Huck-Hui

2013-10-01

Human embryonic stem cells (hESCs) harbour the ability to undergo lineage-specific differentiation into clinically relevant cell types. Transcription factors and epigenetic modifiers are known to play important roles in the maintenance of pluripotency of hESCs. However, little is known about regulation of pluripotency through splicing. In this study, we identify the spliceosome-associated factor SON as a factor essential for the maintenance of hESCs. Depletion of SON in hESCs results in the loss of pluripotency and cell death. Using genome-wide RNA profiling, we identified transcripts that are regulated by SON. Importantly, we confirmed that SON regulates the proper splicing of transcripts encoding for pluripotency regulators such as OCT4, PRDM14, E4F1 and MED24. Furthermore, we show that SON is bound to these transcripts in vivo. In summary, we connect a splicing-regulatory network for accurate transcript production to the maintenance of pluripotency and self-renewal of hESCs.

Risk of cryptorchidism among sons of horticultural workers and farmers in Denmark

DEFF Research Database (Denmark)

Jørgensen, Kristian Tore; Jensen, Morten Søndergaard; Toft, Gunnar Vase

2014-01-01

on occupation and cryptorchidism. METHODS: The cohort consisted of >600 000 boys born in Denmark from 1980-2007 with a parent in employment during pregnancy. These boys were followed for cryptorchidism from 1980-2009 comparing risks among sons of horticultural workers and farmers with sons of parents in other...... occupations. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated using Cox regression adjusting for parental age, birth years, parity, and geographical region. RESULTS: Sons of maternal farmers were at increased risk of cryptorchidism (157 cases; HR 1.31, 95% CI 1.12-1.53) compared to boys...... of mothers in other occupations (15 511 cases). Paternal occupation as farmer was unrelated to the risk among sons. Maternal occupation as a horticultural worker was associated with a non-significantly increased risk (72 cases; HR 1.20, 95% CI 0.95-1.52). A similar association was found for paternal...

Public hospital autonomy in China in an international context.

Science.gov (United States)

Allen, Pauline; Cao, Qi; Wang, Hufeng

2014-01-01

Following decades of change in health care structures and modes of funding, China has recently been making pilot reforms to the governance of its public hospitals, primarily by increasing the autonomy of public hospitals and redefining the roles of the health authorities. In this paper, we analyse the historical evolution and current situation of public hospital governance in China, focussing the range of governance models being tried out in pilot cities across China. We then draw on the experiences of public hospital governance reform in a wide range of other countries to consider the nature of the Chinese pilots. We find that the key difference in China is that the public hospitals in the pilot schemes do not receive sufficient funding from government and are able to distribute profits to staff. This creates incentives to charge patients for excessive treatment. This situation has undermined public service orientation in Chinese public hospitals. We conclude that the pilot reforms of governance will not be sufficient to remedy all the problems facing these hospitals, although they are a step in the right direction. Copyright © 2013 John Wiley & Sons, Ltd.

Travailler loin de son domicile

OpenAIRE

Bonnet, Estelle; Verley, Elise; Ries, Tammy

2017-01-01

Résumé : La mobilité géographique liée à un lieu de travail éloigné du domicile – supposant soit de longs trajets quotidiens, soit de dormir en dehors du domicile – s’inscrit à l’articulation de la sphère professionnelle et de la sphère privée. Elle met à l’épreuve le couple et la distribution des rôles sexués en son sein. Cet article interroge les divisions sexuées inhérentes à cette articulation selon que l’on se place du point de vue d’une mobilité féminine ou masculine. Il examine en quoi...

African-American Fathers' Perspectives on Facilitators and Barriers to Father-Son Sexual Health Communication.

Science.gov (United States)

Randolph, Schenita D; Coakley, Tanya; Shears, Jeffrey; Thorpe, Roland J

2017-06-01

African-American males ages 13 through 24 are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), accounting for over half of all HIV infections in this age group in the United States. Clear communication between African-American parents and their youth about sexual health is associated with higher rates of sexual abstinence, condom use, and intent to delay initiation of sexual intercourse. However, little is known about African-American fathers' perceptions of what facilitates and inhibits sexual health communication with their preadolescent and adolescent sons. We conducted focus groups with 29 African-American fathers of sons ages 10-15 to explore perceived facilitators and barriers for father-son communication about sexual health. Participants were recruited from barbershops in metropolitan and rural North Carolina communities highly affected by STIs and HIV, and data were analyzed using content analysis. Three factors facilitated father-son communication: (a) fathers' acceptance of their roles and responsibilities; (b) a positive father-son relationship; and (c) fathers' ability to speak directly to their sons about sex. We also identified three barriers: (a) fathers' difficulty in initiating sexual health discussions with their sons; (b) sons' developmental readiness for sexual health information; and (c) fathers' lack of experience in talking with their own fathers about sex. These findings have implications for father-focused prevention interventions aimed at reducing risky sexual behaviors in adolescent African-American males. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Do private hospitals outperform public hospitals regarding efficiency, accessibility, and quality of care in the European Union? A literature review.

Science.gov (United States)

Kruse, Florien M; Stadhouders, Niek W; Adang, Eddy M; Groenewoud, Stef; Jeurissen, Patrick P T

2018-03-02

European countries have enhanced the scope of private provision within their health care systems. Privatizing services have been suggested as a means to improve access, quality, and efficiency in health care. This raises questions about the relative performance of private hospitals compared with public hospitals. Most systematic reviews that scrutinize the performance of the private hospitals originate from the United States. A systematic overview for Europe is nonexisting. We fill this gap with a systematic realist review comparing the performance of public hospitals to private hospitals on efficiency, accessibility, and quality of care in the European Union. This review synthesizes evidence from Italy, Germany, the United Kingdom, France, Greece, Austria, Spain, and Portugal. Most evidence suggests that public hospitals are at least as efficient as or are more efficient than private hospitals. Accessibility to broader populations is often a matter of concern in private provision: Patients with higher social-economic backgrounds hold better access to private hospital provision, especially in private parallel systems such as the United Kingdom and Greece. The existing evidence on quality of care is often too diverse to make a conclusive statement. In conclusion, the growth in private hospital provision seems not related to improvements in performance in Europe. Our evidence further suggests that the private (for-profit) hospital sector seems to react more strongly to (financial) incentives than other provider types. In such cases, policymakers either should very carefully develop adequate incentive structures or be hesitant to accommodate the growth of the private hospital sector. Copyright © 2018 John Wiley & Sons, Ltd.

Selection of asset investment models by hospitals: examination of influencing factors, using Switzerland as an example.

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Eicher, Bernhard

2016-10-01

Hospitals are responsible for a remarkable part of the annual increase in healthcare expenditure. This article examines one of the major cost drivers, the expenditure for investment in hospital assets. The study, conducted in Switzerland, identifies factors that influence hospitals' investment decisions. A suggestion on how to categorize asset investment models is presented based on the life cycle of an asset, and its influencing factors defined based on transaction cost economics. The influence of five factors (human asset specificity, physical asset specificity, uncertainty, bargaining power, and privacy of ownership) on the selection of an asset investment model is examined using a two-step fuzzy-set Qualitative Comparative Analysis. The research shows that outsourcing-oriented asset investment models are particularly favored in the presence of two combinations of influencing factors: First, if technological uncertainty is high and both human asset specificity and bargaining power of a hospital are low. Second, if assets are very specific, technological uncertainty is high and there is a private hospital with low bargaining power, outsourcing-oriented asset investment models are favored too. Using Qualitative Comparative Analysis, it can be demonstrated that investment decisions of hospitals do not depend on isolated influencing factors but on a combination of factors. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Contribution of case-mix classification to profiling hospital characteristics and productivity.

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Kuwabara, Kazuaki; Matsuda, Shinya; Fushimi, Kiyohide; Ishikawa, Koichi B; Horiguchi, Hiromasa; Hayashida, Kenshi; Fujimori, Kenji

2011-01-01

Case-mix classification has made it possible to analyze acute care delivery case volumes and resources. Data arising from observed differences have a role in planning health policy. Aggregated length of hospital stay (LOS) and total charges (TC) as measures of resource use were calculated from 34 case-mix groups at 469 hospitals (1,721,274 eligible patients). The difference between mean resource use of all hospitals and the mean resource use of each hospital was subdivided into three components: amount of variation attributable to hospital practice behavior (efficiency); amount attributable to hospital case-mix (complexity); and amount attributable to the interaction. Hospital characteristics were teaching status (academic or community), ownership, disease coverage, patients, and hospital volume. Multivariate analysis was employed to determine the impact of hospital characteristics on efficiency. Mean LOS and TC were greater for academic than community hospitals. Academic hospitals were least associated with LOS and TC efficiency. Low disease coverage was a predictor of TC efficiency while low patient volume was a predictor of unnecessarily long hospital stays. There was an inverse correlation between complexity and efficiency for both LOS and TC. Policy makers should acknowledge that differentiation of hospital function needs careful consideration when measuring efficiency. Copyright © 2010 John Wiley & Sons, Ltd.

Hospitalization and other risk factors for depressive and anxious symptoms in oncological and non-oncological patients.

Science.gov (United States)

De Fazio, Pasquale; Cerminara, Gregorio; Ruberto, Stefania; Caroleo, Mariarita; Puca, Maurizio; Rania, Ornella; Suffredini, Elina; Procopio, Leonardo; Segura-Garcìa, Cristina

2017-04-01

Depression and anxiety are common in hospitalized patients. In particular, oncological patients might be vulnerable to depression and anxiety. The aim of this study is to assess and compare different variables and the prevalence of anxiety and depression symptoms between oncological and medically ill inpatients and to identify variables that can influence depressive and anxious symptoms during hospitalization of patients. A total of 360 consecutive hospitalized patients completed the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Patients Health Questionnaire-9, General Health Questionnaire (GHQ-12), 12-Item Short-Form Survey: physical component summary (PCS), and mental component summary (MCS). Patients were divided into oncological patients and non-oncological patients: groups 1 and 2. Only two significant differences were evident between the groups: the PCS of 12-item Short-form Survey was higher in non-oncological patient (p < 0.000), and the GHQ total score was higher in oncological patients. Variables significantly associated with HADS-D ≥ 8 were lower MCS, higher GHQ-12 score, lower PCS, more numerous previous hospitalizations, longer duration of hospitalization, and positive psychiatric family history. Variables significantly associated with HADS-A ≥ 8 were lower MCS, higher GHQ-12 score, positive psychiatric family history, longer duration of hospitalization, and younger age. Anxiety and depression symptoms in concurrent general medical conditions were associated with a specific sociodemographic profile, and this association has implications for clinical care. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Aditivos alimentarios: ¿qué son, cómo actúan, por qué son tan necesarios?

OpenAIRE

Blanco de Alvarado-Ortiz, Teresa

2014-01-01

Para John M. deMan, en su obra PrincipIes of Food Chemistry a los aditivos alimentarios con frecuencia se les asocia a algo químico, otorgándose erradamente a lo quimico características de artificial, no siempre bueno para la salud.Dicen bien erradamente, porque hombres, animales, plantas, microorganismos, alimentos, aire, cerros, minas y todo lo que nos rodea en la maravillosa naturaleza, es químico. Los aditivos alimentarios,todos químicos, naturales o artificiales son extraordinarias susta...

Gender gap in parents' financing strategy for hospitalization of their children: evidence from India.

Science.gov (United States)

Asfaw, Abay; Lamanna, Francesca; Klasen, Stephan

2010-03-01

The 'missing women' dilemma in India has sparked great interest in investigating gender discrimination in the provision of health care in the country. No studies, however, have directly examined discrimination in health-care financing strategies in the case of severe illness of sons versus daughters. In this paper, we hypothesize that households who face tight budget constraints are more likely to spend their meager resources on hospitalization of boys rather than girls. We use the 60th round of the Indian National Sample Survey (2004) and a multinomial logit model to test this hypothesis and to throw some light on this important but overlooked issue. The results reveal that boys are much more likely to be hospitalized than girls. When it comes to financing, the gap in the usage of household income and savings is relatively small, while the gender gap in the probability of hospitalization and usage of more onerous financing strategies is very high. Ceteris paribus, the probability of boys to be hospitalized by financing from borrowing, sale of assets, help from friends, etc. is much higher than that of girls. Moreover, in line with our theoretical framework, the results indicate that the gender gap intensifies as we move from the richest to poorest households. (c) 2009 John Wiley & Sons, Ltd.

The Role of Learning in Health Technology Assessments: An Empirical Assessment of Endovascular Aneurysm Repairs in German Hospitals.

Science.gov (United States)

Varabyova, Yauheniya; Blankart, Carl Rudolf; Schreyögg, Jonas

2017-02-01

Changes in performance due to learning may dynamically influence the results of a technology evaluation through the change in effectiveness and costs. In this study, we estimate the effect of learning using the example of two minimally invasive treatments of abdominal aortic aneurysms: endovascular aneurysm repair (EVAR) and fenestrated EVAR (fEVAR). The analysis is based on the administrative data of over 40,000 patients admitted with unruptured abdominal aortic aneurysm to more than 500 different hospitals over the years 2006 to 2013. We examine two patient outcomes, namely, in-hospital mortality and length of stay using hierarchical regression models with random effects at the hospital level. The estimated models control for patient and hospital characteristics and take learning interdependency between EVAR and fEVAR into account. In case of EVAR, we observe a significant decrease both in the in-hospital mortality and length of stay with experience accumulated at the hospital level; however, the learning curve for fEVAR in both outcomes is effectively flat. To foster the consideration of learning in health technology assessments of medical devices, a general framework for estimating learning effects is derived from the analysis. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

Implementing hospital innovation in Taiwan: the perspectives of institutional theory and social capital.

Science.gov (United States)

Yang, Chen-Wei

2015-01-01

The main purpose of this study is to develop an innovation model for hospital organisations. For this purpose, this study explores and examines the determinants, capabilities and performance in the hospital sector. First, this discusses three categories of determinants that affect hospitals' innovative capability studies: (1) knowledge stock; (2) social ties; and (3) institutional pressures. Then, this study examines the idea of innovative hospital capabilities, defined as the ability of the hospital organisation to innovate their knowledge. Finally, the hospital evaluation rating, which identifies performance in the hospital sector, was examined. This study empirically tested the theoretical model at the organisation level. The findings suggest that a hospital's innovative capabilities are influenced by its knowledge stock, social ties, institutional pressures and the impact of hospital performance. However, in attempts to keep hospitals aligned with their highly institutionalised environments, it may prove necessary for hospital administrators to pay more attention to both existing knowledge stock and the process of innovation if the institutions are to survive. Finally, implications for theory and practitioners complete this study. Copyright © 2014 John Wiley & Sons, Ltd.

Impaired Reproductive Development in Sons of Women Occupationally Exposed to Pesticides during Pregnancy

DEFF Research Database (Denmark)

Andersen, Helle Raun; Schmidt, Ida M.; Grandjean, Philippe

2008-01-01

OBJECTIVES: The aim of this prospective study was to investigate whether occupational pesticide exposure during pregnancy causes adverse effects on the reproductive development in the male infants. DESIGN AND MEASUREMENTS: Pregnant women employed in greenhouses in Denmark were consecutively...... recruited, and 113 mother-son pairs were included. The mothers were categorized as occupationally exposed (91 sons) or unexposed (22 sons) to pesticides during pregnancy. Testicular position and volume, penile length, and position of urethral opening were determined at 3 months of age using standardized...

Disability in the Family: John and Alice Dewey Raising Their Son Sabino

Science.gov (United States)

Danforth, Scot

2018-01-01

Background/Context: The current biographic understanding of John Dewey's experience adopting and raising an Italian boy named Sabino emphasizes the theme of finding an emotional replacement for Morris and Gordon, two young sons who had tragically died on family trips to Europe. Lacking is substantive attention to the fact that John Dewey's son had…

The Telephone Connection: An Interview with Ernest Hemingway's Son.

Science.gov (United States)

Workman, Brooke

1979-01-01

Relates how a conference call to Ernest Hemingway's son, Gregory, resolved questions and brought understanding and excitement to a group of Iowa high school students enrolled in a 12-week Hemingway seminar. (FL)

Reproductive Rights and Son Preference in India : Mobilizing ...

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

This project is concerned with two overlapping manifestations of gender inequality in India : limited access to reproductive rights on the one hand, and practices associated with son preference on the other. Work that brings together these two issues is urgently needed, particularly in the context of declining funding for ...

Short-lived radiopharmaceutical development at E.R. Squibb and Sons, Inc

International Nuclear Information System (INIS)

Loberg, M.D.

1985-01-01

This paper describes the present status and future plans of E.R. Squibb and Sons, Inc. as they relate to the development of short-lived radiopharmaceuticals. The advantages of short-lived radiopharmaceuticals are summarized as are the problems inherent in their manufacture, quality control, and distribution. The nuclear generator is advocated as the best means of distributing short-lived radiopharmaceuticals. The E.R. Squibb and Sons work with the 82 Sr → 82 Rb generator is summarized

Trust-based or performance-based management: a study of employment contracting in hospitals.

Science.gov (United States)

Pettersen, Inger Johanne

2011-01-01

Hospitals are frequently changing managerial practices due to numerous public sector reforms taking place. In general, these reforms include the making and monitoring of contracts that regulate relations between the hospitals and their professional staffs. The aim of this paper is to discuss some main characteristics of the contracts that regulate the perceived relations between physicians as employees and the public hospital as employer. The theoretical framework is based on a contract theory approach. The empirical data is based on survey data from full-time employed physicians in the medical and surgical divisions in one of the largest university hospitals in Norway. This study shows that perceived obligations and psychological contracts indicate high degree of relational contracts between the hospital and the physicians. These socio-cultural elements should be recognized as important mechanisms of coordination and communication when policy makers and hospital managers are designing hospital management control systems. Copyright © 2009 John Wiley & Sons, Ltd.

L'astronomie et son histoire

CERN Document Server

Roy, Jean-René

1982-01-01

Le livre de Jean-René Roy nous présente une vaste synthèse des connaissances présentes en astronomie. Le grand mérite du livre est de dérouler son sujet en parallèle avec une histoire de l'astronomie. Le côté historique est ici beaucoup plus qu'un luxe. Il redonne leurs dimensions vraies aux réponses qu'apporte l'astronomie. Pour bien sentir la nature d'une étape franchie, il faut aussi avoir vécu la situation telle qu'elle se présentait avant. Et les fiches personnelles incluses dans le livre ont l'intérêt de nous rapprocher encore plus du "" feu de l'action "". Écrit dans un style direct et

The institutionalization of Jesus' charismatic authority: "Son of Man" as case study¹

OpenAIRE

Yolanda Dreyer

2000-01-01

This article argues that Jesus used the expression "son of man" not in a titular way, but genetically, meaning "humankind". This use of "son of man" developed into a titular usage in which Jesus is identified with "Son of Man". The study shows that Jesus' use of the expression "son of man" should be understood in the context of the "little tradition" which was reinterpreted in terms of the "great tradition" in a titular way. It is argued that this transition from "litle tradition" to "great t...

The effect of hospital-physician integration on health information technology adoption.

Science.gov (United States)

Lammers, Eric

2013-10-01

The US federal government has recently made a substantial investment to enhance the US health information technology (IT) infrastructure. Previous literature on the impact of IT on firm performance across multiple industries has emphasized the importance of a process of co-invention whereby organizations develop complementary practices to achieve greater benefit from their IT investments. In health care, employment of physicians by hospitals can confer greater administrative control to hospitals over physicians' actions and resources and thus enable the implementation of new technology and initiatives aimed at maximizing benefit from use of the technology. In this study, I tested for the relationship between hospital employment of physicians and hospitals' propensity to use health IT. I used state laws that prohibit hospital employment of physicians as an instrument to account for the endogenous relationship with hospital IT use. Hospital employment of physicians is associated with significant increases in the probability of hospital health IT use. Therefore, subsidization of health IT among hospitals not employing physicians may be less efficient. Furthermore, state laws prohibiting hospitals from employing physicians may inhibit adoption of health IT, thus working against policy initiatives aimed at promoting use of the technology. Copyright © 2012 John Wiley & Sons, Ltd.

Types of sons/siblings, fraternal function and peers

Directory of Open Access Journals (Sweden)

Luisa Brunori

2013-12-01

Full Text Available In this article, the author starts by exploring family dynamics using the psychodynamic-groupanalytic paradigm to explore the intertwined relationships amongst the family figures like son, daughter, parents and sibling. The work focuses on the analysis of the psychological aspects related to siblings in the family, birth order and their consequences.

Girl adoption in China-A less-known side of son preference.

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Chen, Yuyu; Ebenstein, Avraham; Edlund, Lena; Li, Hongbin

2015-01-01

In 1987, 4 per cent of girls were adopted within China. Why? Unlike infanticide, abandonment rids parents of daughters while preserving the supply of potential brides. In fact, an erstwhile tradition common in Fujian and Jiangxi provinces had parents of sons adopting an infant girl to serve as a future daughter-in-law and household help. Analysing a nationally representative 1992 survey of children, we found that: (1) girl adoptions were concentrated in the above-mentioned provinces; (2) girls were predominantly adopted by families with sons; (3) adopted girls faced substantial disadvantage as measured by school attendance at ages 8-13. In the 1990s, as the sex ratio at birth climbed, were girls aborted rather than abandoned? Observing that in the 2000 census too many girls appear in families with older sons, we estimated that at least 1/25 girls were abandoned in the 1990s, a proportion that in Fujian and Jiangxi may have peaked at 1/10 in 1994.

Preparing for the introduction of hospital autonomy in Laos: an assessment of current situation and suggestions for policy-making.

Science.gov (United States)

Geng, Jinsong; Yu, Hao; Chen, Yingyao

2016-04-01

The National Assembly of Lao People's Democratic Republic (Laos) approved the Health Sector Reform Strategy in 2012, which called for an assessment as to whether Laos should introduce hospital autonomy, and if so, in which ways. The purpose of this study is to assess the status quo of hospital governance in Laos and propose policy suggestions for hospital autonomy in the country. We formulated an analytic framework for hospital autonomy based on previous work by other researchers, collected qualitative data through key informant interviews and focus group discussions, and also performed secondary data analysis. Public hospitals in Laos enjoyed some informal autonomy with little accountability and Laos is facing key challenges of hospital governance. As a result, introducing hospital autonomy in Laos could bring risks, benefits and debates. Before Laos decides on granting autonomy to its public hospitals, we strongly suggest that the government do pilot in selected public hospitals with well-regulated governance framework first and conduct rigorous evaluations to examine whether the granted autonomy leads to the intended social goals of equity, quality, efficiency and sustainability. We recommend residual claimants should be monitored by the government and by the society with open and transparent approach, and active measures should be taken to improve performance and ensure social functions. The study findings may also provide some suggestions for low- and middle-income countries, which are contemplating the introduction of hospital autonomy in the public sector. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Reliability of P mode event classification using contemporaneous BiSON and GOLF observations

International Nuclear Information System (INIS)

Simoniello, R; Chaplin, W J; Elsworth, Y P; Garcia, R A

2008-01-01

We carried out a comparison of the signals seen in contemporaneous BiSON and GOLF data sets. Both instruments perform Doppler shift velocity measurements in integrated sunlight, although BiSON perform measurements from the two wings of potassium absorption line and GOLF from one wing of the NaD1 line. Discrepancies between the two datasets have been observed. We show,in fact, that the relative power depends on the wing in which GOLF data observes. During the blue wing period, the relative power is mugh higher than in BiSON datasets, while a good agreement has been observed during the red period.

Major ion chemistry of the Son River, India

Indian Academy of Sciences (India)

The chemistry of major ions in the surface water of the Son River was studied in detail to determine various source(s) and processes controlling its water chemistry, seasonal and spatial variations in water chemistry, dissolved fluxes and chemical denudation rate (CDR). The study shows that Ca2+, Mg2+ and HCO 3 − are ...

Breaking the ice! Predictors about communication between nonresident African American fathers and sons about sex.

Science.gov (United States)

Burns, Jade C; Caldwell, Cleopatra H

2016-02-01

Research on communication between resident and nonresident African American fathers and their sons about sex has been understudied. The purpose of this study is to determine the influence of parenting variables, specifically, racial socialization and father involvement on nonresident African American father-son communication about sex. Data for this study are from the Fathers and Sons Project. This intervention study is designed to enhance relationships between nonresident African American fathers and their 8-12 year old sons and to prevent risky health behaviors among sons. The present study is based on 345 African American boys who completed baseline face-to-face interviews. The average age of the sons was 10.2 years old (SD = 1.4), with an average of two siblings (SD = 1.53). Age and sons' perceptions of more parental monitoring by their fathers were predictive of increased communication about sex. Racial socialization messages explained additional variance in communication about sex above other parenting variables and controls. Findings suggest when working with African American families, providers who counsel parents, and in particular provide outreach to fathers regarding communication about sex, are in a unique position to enhance parenting communication skills about sexuality. ©2015 American Association of Nurse Practitioners.

Associations Between Fathers' and Sons' Sexual Risk in Rural Kenya: The Potential for Intergenerational Transmission.

Science.gov (United States)

Giusto, Ali M; Green, Eric P; Puffer, Eve S

2017-08-01

Despite high rates of HIV in areas of Sub-Saharan Africa and men's role in driving the epidemic, little is known about whether or how sexual risk-both behaviors and beliefs-may be passed down through generations of males. This study examined associations between sexual risk behaviors and sex-related beliefs of adolescent males and those of their male caregivers in Kenya, as well as the potential moderating effects of parenting characteristics and father-son relationship quality. Cross-sectional linear regression analysis was applied to baseline data from a trial of a family- and church-based intervention for families in rural Kenya that followed a stepped-wedge cluster randomized design. Our subsample consisted of 79 male caregiver and son (aged 10-16 years) dyads. Results demonstrated a direct relationship between fathers' and sons' sex-related beliefs that was not moderated by parenting or quality of father-son relationship. Parenting/relationship characteristics did moderate the relationship between fathers' and sons' sexual behavior; if fathers did not engage in high-risk sex and exhibited more positive parenting/higher relationship quality, their sons were less likely to be sexually active. Among fathers having high-risk sex, parenting was unrelated to sons' behavior except at very high levels of positive parenting/relationship quality; at these levels, sons were actually more likely to have had sex. Findings support recommendations to include male caregivers in youth HIV prevention efforts, potentially by targeting fathers' parenting strategies and their individual risk. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Has Their Son Been Vaccinated? Beliefs About Other Parents Matter for Human Papillomavirus Vaccine.

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Schuler, Christine L; Coyne-Beasley, Tamera

2016-07-01

The goal of this study was to determine if parents' beliefs about social norms of human papillomavirus (HPV) vaccination for sons were associated with knowledge of HPV, intention to vaccinate sons, or beliefs about side effects. A cross-sectional, survey-based study of parents with sons was performed in 2010. Fisher's exact tests were used to examine associations between demographics and responses about social norms. Multivariate logistic regression models examined beliefs about social norms of male HPV vaccination and primary outcomes. Few parents agreed that others were vaccinating sons (n = 31/267, 12%), including 1% responding strongly agree and 11% responding agree. Most parents, 52%, disagreed that others were vaccinating (40% disagree, 11% strongly disagree), and 37% chose prefer not to answer regarding others' vaccination practices. Hispanic parents and those with a high school education or less were significantly more likely to choose prefer not to answer than their respective counterparts regarding vaccination norms. In multivariate models, parents agreeing others were vaccinating sons had greater odds of having high knowledge of HPV (adjusted odds ratio [aOR] high vs low knowledge 3.15, 95% confidence interval [CI] 1.13, 8.77) and increased intention to vaccinate sons (n = 243, aOR = 4.41, 95% CI = 1.51, 12.89). Beliefs about side effects were not significantly associated with beliefs about social norms. Parents' beliefs about others' vaccination practices are important with regard to knowledge of HPV and intention to vaccinate sons. Studying how various public messages about HPV vaccine may influence normative beliefs could be relevant to improving vaccination coverage. © The Author(s) 2015.

Deterioro funcional en ancianos ingresados en un hospital sin unidades geriátricas Functional impairment in elderly inpatients in a hospital without geriatric units

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Alfonso Jesús Cruz Lendínez

2010-03-01

Full Text Available Introducción: El aumento de la población de personas mayores de 65 años hace cada vez más frecuente su ingreso en los hospitales. La estancia hospitalaria en unidades de hospitalización convencionales puede llevar aparejado el deterioro de la capacidad funcional en los ancianos. Objetivos: Establecer el perfil del paciente anciano atendido en las Unidades de Medicina Interna del Complejo Hospitalario de Jaén. Analizar los resultados de la hospitalización en personas mayores en términos de variación de la capacidad funcional al alta respecto del ingreso. Identificar qué variables influyen en la variación de esa capacidad funcional de los ancianos hospitalizados en un centro sin unidades geriátricas. Métodos: Estudio prospectivo observacional en tres unidades de hospitalización de medicina interna de un hospital universitario de la red pública de Andalucía. Se ha incluido una muestra de 190 pacientes ancianos hospitalizados. Las variables recogidas fueron: demográficas, relacionadas con la hospitalización y con la capacidad funcional. Los datos se han obtenido mediante el uso del Índice de valoración de dependencia de Barthel. Resultados: La hospitalización en las unidades de medicina interna no contribuye a la mejora de la capacidad funcional de las personas mayores, más bien tiene un efecto negativo, favoreciendo el deterioro en un importante grupo de estos pacientes. En función de la edad, de entre los pacientes analizados (65-85 años y más, los pacientes de menor edad son los que obtienen mejores resultados de recuperación funcional al alta, mientras que los mayores de 85 años son los que peor resultado presentan. Observamos cómo pierden capacidad funcional el 16% de los menores de 85 años y el 67,5% de los mayores de 85. Conclusiones: La edad, la capacidad funcional al ingreso, la capacidad funcional al alta, la presencia de acompañantes durante la hospitalización y el destino al alta son los factores que m

Explaining turnover intention in Korean public community hospitals: occupational differences.

Science.gov (United States)

Hwang, Jee-In; Chang, Hyejung

2008-01-01

Personnel in public hospitals had relatively low job satisfaction despite of tenure employment. High turnover rates degrade hospital image and incur additional costs related to recruitment and training. The purposes of this study were to describe the occupational differences and to identify factors affecting turnover intention among public hospital personnel. A questionnaire survey was conducted as part of Administrative Services Quality Evaluation Program by Seoul metropolitan municipality from 1 November to 1 December in 2003. The subjects were 1251 entire hospital personnel in four hospitals. The questionnaire was designed to measure job satisfaction, organizational commitment, turnover intention, and demographic characteristics. Logistic regression analysis was performed to determine factors influencing turnover intention. There were significant differences in job satisfaction, organizational commitment, and turnover intention according to the occupations. The turnover intention rates were highest among physicians, followed by paramedicals and nursing staffs and then administrators. The significant factors affecting turnover intention were involvement and loyalty among physicians, hospital type, satisfaction with systems and loyalty among nursing staffs, satisfaction with relationship and loyalty among administrators, and loyalty among paramedicals. There were different moderators that influence turnover intentions of hospital personnel. Loyalty had the most important effect upon turnover intention in all occupations. 2007 John Wiley & Sons, Ltd

The rise of the daughter-in-law: Why son preference is weakening in ...

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

2012-11-13

Nov 13, 2012 ... Millions of women are 'missing' because they die in much larger ... This means that the population of Bangladesh, along with that of India and Pakistan, ... Sons, on the other hand, were considered insurance against poverty in old age. ... sons would defy child mortality rates to look after their aged parents.

La croissance demographique et son impact sur le developpement ...

African Journals Online (AJOL)

La croissance demographique et son impact sur le developpement des grandes villes au ... La ville de Porto-Novo au Bénin n'est pas en marge de cette réalité que ... and the need for improving its framework of life through its development.

Andrew Wyeth and N.C. Wyeth: a psychodynamic perspective on father and son.

Science.gov (United States)

Shaw, Jon A

2013-01-01

This paper examines the relationship between two extraordinary artists, father and son--N.C. Wyeth (1882-1945) and Andrew Wyeth (1917-2009)--and their art. N.C. Wyeth, the father, the most famous illustrator of his day, painted scenes full of drama and action, often of men engaged in violent life and death struggles. N.C. was unable to separate from his powerful mother and yearned for his iconic father. He thought himself an artistic failure and dedicated himself to raising his children to be geniuses. The youngest son, Andrew Wyeth, who lived a "secret life," painted scenes often characterized by pathos: bleak and barren landscapes, leaden skies, tire tracks, gray framed houses, desiccated fields, and circling buzzards. In the father-son relationship, we often seen three themes perpetuated developmentally: (1) the son's identification with the innermost conflicts of his father; (2) the yearning for the iconic father of his youth; and (3) a continuation and disavowal of his father's life. These themes are played out in the relationship between Andrew Wyeth and his father.

Older Parents Benefit More in Health Outcome From Daughters' Than Sons' Emotional Care in China.

Science.gov (United States)

Zeng, Yi; Brasher, Melanie Sereny; Gu, Danan; Vaupel, James W

2016-12-01

To examine whether older parents in China would benefit more from daughters' care than from sons' emotional care. Analysis of the unique data sets of the Chinese Longitudinal Healthy Longevity Survey conducted in 2002, 2005, and 2008-2009 in 22 provinces. As compared with having son(s), having daughter(s) is significantly more beneficial at older ages in China, with regard to maintaining higher cognitive capacity and reducing mortality risk. Such daughter advantages in providing emotional care to older parents are more profound among the oldest-old aged 80+ as compared with the young-old aged 65 to 79 and surprisingly more profound in rural areas as compared with urban areas, even though son preference is much more common among rural residents. We describe how educational campaigns aimed at informing the public about the benefits of daughter(s) for older parents' health outcome could help promote gender equality and reduce traditional son preference, especially in rural China.

The Son Jarocho and Fandango Amidst Struggle and Social Movements: Migratory Transformation and Reinterpretation of the Son Jarocho in La Nueva Espa�a, M�xico, and the United States

OpenAIRE

Hern�ndez, Alexandro David

2014-01-01

This dissertation is a study on the son jarocho and its fandango as a migratory and transformative musical culture between nations and social circumstances. The son jarocho embodies tradition in many cultural practices of society, such as its presence at social rites and at fandangos. However, there exist hidden histories, transcripts of resistance not accounted for in M�xico's official history, of the son jarocho as music of struggle and protest. From censorship, punishment, and imprisonme...

SON68 glass alteration enhanced by magnetite

Energy Technology Data Exchange (ETDEWEB)

Godon, Nicole; Gin, Stephane; Rebiscoul, Diane; Frugier, Pierre [CEA, DEN-Marcoule, F30207, Bagnols-sur-Ceze (France)

2013-07-01

This paper reports experimental and modeling results of SON68 glass / magnetite interactions while in contact with synthetic groundwater from a clay environment. It is shown that magnetite enhances glass alteration, first by the sorption of Si released from the glass onto magnetite surfaces, then by a second process that could be the precipitation of an iron silicate mineral or the transformation of magnetite into a more reactive phase like hematite or goethite. This study globally suggests a detrimental effect of magnetite on the long-term durability of nuclear glass in geological disposal conditions. (authors)

The Power of a Single Mother: The Influence of Black Women on Their Sons' Academic Performance

Science.gov (United States)

Robinson, Quintin L.; Werblow, Jacob

2013-01-01

This study examines the ways single Black mothers contribute to the educational success of their 11th-grade sons, despite the fact that their sons are enrolled in "failing schools." Data from five interviews and one focus group reveal common characteristics of how single-Black mothers help their sons beat the odds.

Sexy sons: a dead end for cytoplasmic genes.

Science.gov (United States)

Zeh, Jeanne A

2004-08-07

Critics of sexual conflict theory argue that females may gain a net reproductive benefit from mating with manipulative males because the direct costs that they suffer may be offset by the production of sexy, i.e. manipulative, sons. However, this exclusive focus on nuclear gene effects represents an incomplete view of female fitness. Females differ fundamentally from males in transmitting not only nuclear genes but also a wide range of cytoplasmic genetic elements (CGEs) that can have profound effects, from male killing to influencing development of the nervous system and cognitive ability. Maternal transmission of CGEs has two major implications for sexual selection. First, the evolution of male fitness traits, such as sperm competitive ability, may be constrained because response to selection on mitochondrial genomes can occur only through the female line. Second, CGEs bear the direct costs of male manipulation but gain no indirect benefits when females produce sexy sons. This should result in perpetual antagonistic coevolution between nuclear genes involved in male manipulation and CGEs that promote female resistance to male sexually selected traits. Explicit consideration of the consequences of selection acting on CGEs is therefore necessary for a better understanding of the relationship between sexual selection and sexual conflict.

Accounting for quality in the measurement of hospital performance: evidence from Costa Rica.

Science.gov (United States)

Arocena, Pablo; García-Prado, Ariadna

2007-07-01

This paper provides insights into how Costa Rican public hospitals responded to the pressure for increased efficiency and quality introduced by the reforms carried out over the period 1997-2001. To that purpose we compute a generalized output distance function by means of non-parametric mathematical programming to construct a productivity index, which accounts for productivity changes while controlling for quality of care. Our results show an improvement in hospital performance mainly driven by quality increases. The adoption of management contracts seems to have contributed to such enhancement, more notably for small hospitals. Further, productivity growth is primarily due to technical and scale efficiency change rather than technological change. A number of policy implications are drawn from these results. Copyright (c) 2006 John Wiley & Sons, Ltd.

Like daughter, like son? Fertility decline and the transformation of gender systems in the family

Directory of Open Access Journals (Sweden)

Keera Allendorf

2012-10-01

Full Text Available BACKGROUND An important question for population research is whether fertility decline transforms gender systems. OBJECTIVE This paper contributes to answering this broad question by examining how fertility decline may change the relative value and roles of daughters versus sons in families. First, I outline theoretical pathways, suggesting that a key factor is the gender composition of families. As fertility declines, the proportion of families with children of only one gender increases, which may facilitate greater gender symmetry between daughters and sons. Second, I explore how fertility decline may be transforming the relative value and roles of sons and daughters in practice in one place. METHODS The analysis draws primarily on semi-structured interviews with 30 respondents living in one Indian village. RESULTS In recent decades, fertility has declined to at least replacement levels. Respondents also perceive changes in the gender system, including less son preference, more equal schooling for sons and daughters, more freedom in marriage and pre-marital relationships, and perhaps greater daughter support of parents in old age. CONCLUSIONS The results describe changes in the relative value, treatment, and behavior of sons and daughters that are consistent with the theorized effects of fertility decline. Future research is needed, however, to determine whether fertility decline makes a unique causal contribution to changes in the gender system.

Delirium after lung transplantation: Association with recipient characteristics, hospital resource utilization, and mortality.

Science.gov (United States)

Sher, Yelizaveta; Mooney, Joshua; Dhillon, Gundeep; Lee, Roy; Maldonado, José R

2017-05-01

Delirium is associated with increased morbidity and mortality. The factors associated with post-lung transplant delirium and its impact on outcomes are under characterized. The medical records of 163 consecutive adult lung transplant recipients were reviewed for delirium within 5 days (early-onset) and 30 hospital days (ever-onset) post-transplantation. A multivariable logistic regression model assessed factors associated with delirium. Multivariable negative binomial regression and Cox proportional hazards models assessed the association of delirium with ventilator duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, and one-year mortality. Thirty-six percent of patients developed early-onset, and 44% developed ever-onset delirium. Obesity (OR 6.35, 95% CI 1.61-24.98) and bolused benzodiazepines within the first postoperative day (OR 2.28, 95% CI 1.07-4.89) were associated with early-onset delirium. Early-onset delirium was associated with longer adjusted mechanical ventilation duration (P=.001), ICU LOS (Pdelirium was associated with longer ICU (Pdelirium was not significantly associated with one-year mortality (early-onset HR 1.65, 95% CI 0.67-4.03; ever-onset HR 1.70, 95% CI 0.63-4.55). Delirium is common after lung transplant surgery and associated with increased hospital resources. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Putative Son's Attractiveness Alters the Perceived Attractiveness of the Putative Father.

Science.gov (United States)

Prokop, Pavol

2015-08-01

A body of literature has investigated female mate choice in the pre-mating context (pre-mating sexual selection). Humans, however, are long-living mammals forming pair-bonds which sequentially produce offspring. Post-mating evaluations of a partner's attractiveness may thus significantly influence the reproductive success of men and women. I tested herein the theory that the attractiveness of putative sons provides extra information about the genetic quality of fathers, thereby influencing fathers' attractiveness across three studies. As predicted, facially attractive boys were more frequently attributed to attractive putative fathers and vice versa (Study 1). Furthermore, priming with an attractive putative son increased the attractiveness of the putative father with the reverse being true for unattractive putative sons. When putative fathers were presented as stepfathers, the effect of the boy's attractiveness on the stepfather's attractiveness was lower and less consistent (Study 2). This suggests that the presence of an attractive boy has the strongest effect on the perceived attractiveness of putative fathers rather than on non-fathers. The generalized effect of priming with beautiful non-human objects also exists, but its effect is much weaker compared with the effects of putative biological sons (Study 3). Overall, this study highlighted the importance of post-mating sexual selection in humans and suggests that the heritable attractive traits of men are also evaluated by females after mating and/or may be used by females in mate poaching.

?Cuales son las amenazas o peligros volcanicos?

Science.gov (United States)

Myers, Bobbie; Brantley, Steven R.; Stauffer, Peter; Hendley, James W.

2000-01-01

Los volcanes son capaces de producir numerosos peligros geologicos e hidrologicos. Los cientificos del Servicio Geologico de los EE. UU. (USGS, por sus siglas en ingles) y de otras instituciones alrededor del mundo estan estudiando los peligros de muchos de los centenares de volcanes activos y potencialmente activos del mundo. Estos cientificos vigilan muy de cerca la actividad de algunos de los volcanes mas peligrosos, por lo que estan preparados para alertar a las autoridades y/o a la poblacion en caso de que aumente sustancialmente la probabilidad de que ocurra una erupcion u otro evento peligroso.

"There is such a thing as too many daughters, but not too many sons": A qualitative study of son preference and fetal sex selection among Indian immigrants in the United States.

Science.gov (United States)

Puri, Sunita; Adams, Vincanne; Ivey, Susan; Nachtigall, Robert D

2011-04-01

In response to concerns from feminists, demographers, bioethicists, journalists, and health care professionals, the Indian government passed legislation in 1994 and 2003 prohibiting the use of sex selection technology and sex-selective abortion. In contrast, South Asian families immigrating to the United States find themselves in an environment where reproductive choice is protected by law and technologies enabling sex selection are readily available. Yet there has been little research exploring immigrant Indian women's narratives about the pressure they face to have sons, the process of deciding to utilize sex selection technologies, and the physical and emotional health implications of both son preference and sex selection. We undertook semi-structured, in-depth interviews with 65 immigrant Indian women in the United States who had pursued fetal sex selection on the East and West coasts of the United States between September 2004 and December 2009. Women spoke of son preference and sex selection as separate though intimately related phenomena, and the major themes that arose during interviews included the sociocultural roots of son preference; women's early socialization around the importance of sons; the different forms of pressure to have sons that women experienced from female in-laws and husbands; the spectrum of verbal and physical abuse that women faced when they did not have male children and/or when they found out they were carrying a female fetus; and the ambivalence with which women regarded their own experience of reproductive "choice." We found that 40% of the women interviewed had terminated prior pregnancies with female fetuses and that 89% of women carrying female fetuses in their current pregnancy pursued an abortion. These narratives highlight the interaction between medical technology and the perpetuation of this specific form of violence against women in an immigrant context where women are both the assumed beneficiaries of reproductive choice

Independent Contributions of Early Positive Parenting and Mother-Son Coercion on Emerging Social Development.

Science.gov (United States)

Akcinar, Berna; Shaw, Daniel S

2018-06-01

In the current study, we explored associations between parent-child coercion and positive parenting in the toddler period in relation to children's social-behavioral development during the school-age period. The data were drawn from the Pitt Mother & Child Project, a sample of 310 low-income, ethnically diverse boys. Drawing on tenets of both attachment and social learning theory, it was hypothesized that coercive mother-son interaction would lead to reductions in positive maternal parenting in the toddler period, and that both positive parenting and mother-son coercion in the toddler period would contribute to children's conduct problems at school entry and lower social skills and peer rejection in middle childhood. The results were largely confirmed, such that mother-son coercive interaction at 18 months was related to decreases in positive parenting at 24 months. Additionally, mother-son coercive interaction and positive parenting at 24 months were linked to child conduct problems at age 5, which in turn predicted child social skills and peer rejection during middle childhood. In addition to indirect effects through child conduct problems, mother-son coercion continued to be independently related to school-age peer rejection. The findings are discussed with respect to the importance of early coercive interactions in the growth of child social-behavioral development from early to middle childhood.

Sons fricativos surdos Voiceless fricatives sounds

Directory of Open Access Journals (Sweden)

Carla Aparecida Cielo

2008-01-01

Full Text Available TEMA: características dos sons fricativos surdos. OBJETIVO: propor uma revisão da literatura pertinente às características acústicas, fonéticas e fonológicas dos fonemas fricativos surdos que integram o sistema fonológico do Português. Além disso, são descritas suas aplicações na terapia vocal. CONCLUSÕES: os fricativos são fonemas agudos, abrangendo de 2500 a 8000Hz; são plenamente adquiridos até os 3:7 anos de idade; o /s/ que também é o mais afetado em casos de frênulo lingual curto; a omissão do /s/ é uma das ocorrências mais freqüentes na alfabetização; sendo que, no desvio fonológico e na fissura lábio-palatina, freqüentemente ocorre comprometimento de toda a classe de fricativos. Na avaliação de voz, os fricativos são mencionados com as medidas de TMF e relação s/z, bem como seu uso como sons de apoio na fonoterapia.BACKGROUND: characteristics of voiceless fricative sounds PURPOSE: to review the literature related to acoustic, phonetics and phonological characteristics of voiceless fricative sounds that are part of the phonological system of the Portuguese Language. Furthermore, it describes the use of these sounds in voice therapy. CONCLUSIONS: fricatives are acute phonemes comprised between 2500 and 8000 Hz; they are fully acquired up to the age of 3:7 years; the /s/, which is the most affected in cases of short lingual frenum; omission of the /s/ is one of the most frequent occurrences during literacy education; and in the phonological deviation and labial-palatine fissure the entire class of fricatives is frequently affected. In voice assessment, fricative sounds are mentioned as TMF measurements and s/z relationship, and their use as support sounds in speech therapy.

Major ion chemistry of the Son River, India: Weathering processes ...

Indian Academy of Sciences (India)

solute flux and CDR values. The water chemistry indicates that the Son River water is good to excellent .... to separate suspended sediments and preserved at. 4◦C for further ...... and waste water, 20th edn; American Public Health. Association ...

Factors Associated with Review Board Dispositions following Re-hospitalization among Discharged Persons found Not Criminally Responsible.

Science.gov (United States)

Wilson, Catherine M; Nicholls, Tonia L; Charette, Yanick; Seto, Michael C; Crocker, Anne G

2016-03-01

In the Canadian forensic mental health system, a person found Not Criminally Responsible on account of Mental Disorder (NCRMD) and given a conditional discharge returns to the community while remaining under the jurisdiction of a provincial/territorial Review Board. However, the individual can be re-hospitalized while on conditional discharge, for reasons such as substance use, violation of conditions, or violence. We investigated whether being re-hospitalized has an impact on the factors associated with the subsequent Review Board disposition. Persons found NCRMD from the three largest Canadian provinces who were conditionally discharged at least once during the observation period were included in the sample (N = 1,367). These individuals were involved in 2,920 disposition hearings; nearly one-third of patients (30%) were re-hospitalized after having been conditionally discharged by the Review Board. The factors examined included the scales of the Historical Clinical Risk Management-20 and salient behavior that occurred since the previous hearing, such as substance use or violence. The greater presence of clinical items resulted in a greater likelihood of a hospital detention decision at the next hearing. The effect was larger for the re-hospitalized group than for the group who successfully remained in the community since the last hearing. The results suggest that dynamic factors, specifically indicators of mental health, are heavily weighted by the Review Boards, consistent with the literature on imminent risk and in line with the NCRMD legislation. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Paternal antisocial behavior and sons' cognitive ability: a population-based quasiexperimental study.

Science.gov (United States)

Latvala, Antti; Kuja-Halkola, Ralf; Långström, Niklas; Lichtenstein, Paul

2015-01-01

Parents' antisocial behavior is associated with developmental risks for their offspring, but its effects on their children's cognitive ability are unknown. We used linked Swedish register data for a large sample of adolescent men (N = 1,177,173) and their parents to estimate associations between fathers' criminal-conviction status and sons' cognitive ability assessed at compulsory military conscription. Mechanisms behind the association were tested in children-of-siblings models across three types of sibling fathers with increasing genetic relatedness (half-siblings, full siblings, and monozygotic twins) and in quantitative genetic models. Sons whose fathers had a criminal conviction had lower cognitive ability than sons whose fathers had no conviction (any crime: Cohen's d = -0.28; violent crime: Cohen's d = -0.49). As models adjusted for more genetic factors, the association was gradually reduced and eventually eliminated. Nuclear-family environmental factors did not contribute to the association. Our results suggest that the association between men's antisocial behavior and their children's cognitive ability is not causal but is due mostly to underlying genetic factors. © The Author(s) 2014.

Perfectionism Group Treatment for Eating Disorders in an Inpatient, Partial Hospitalization, and Outpatient Setting.

Science.gov (United States)

Levinson, Cheri A; Brosof, Leigh C; Vanzhula, Irina A; Bumberry, Laura; Zerwas, Stephanie; Bulik, Cynthia M

2017-11-01

Perfectionism is elevated in individuals with eating disorders and is posited to be a risk factor, maintaining factor, and treatment barrier. However, there has been little literature testing the feasibility and effectiveness of perfectionism interventions in individuals specifically with eating disorders in an open group format. In the current study, we tested the feasibility of (a) a short cognitive behavioural therapy for perfectionism intervention delivered in an inpatient, partial hospitalization, and outpatient for eating disorders setting (combined N = 28; inpatient n = 15; partial hospital n = 9; outpatient n = 4), as well as (b) a training for disseminating the treatment in these settings (N = 9). Overall, we found that it was feasible to implement a perfectionism group in each treatment setting, with both an open and closed group format. This research adds additional support for the implementation of perfectionism group treatment for eating disorders and provides information on the feasibility of implementing such interventions across multiple settings. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Closing Italian Forensic Psychiatry Hospitals in Favor of Treating Insanity Acquittees in the Community.

Science.gov (United States)

Carabellese, Felice; Felthous, Alan R

2016-03-01

Originally a hedge against the death penalty, the insanity defense came to offer hospitalization as an alternative to imprisonment. In the late 19th century Italy opened inpatient services first for mentally ill prisoners and then for offenders found not guilty by reason of insanity. Within the past decade, a series of decrees has resulted in transferring the responsibility for treating NGRI acquittees and "dangerous" mentally ill prisoners from the Department of Justice to the Department of Health, and their treatment from Italy's high security forensic psychiatric hospitals (OPGs) to community regional facilities (REMSs, Residences for the Execution of Security Measures), community mental health facilities, one of which is located in each region of Italy. Today community REMSs provide the treatment and management of socially dangerous offenders. The dynamic evolution of Italy's progressive mental health system for insanity acquittees, to our knowledge the most libertarian, community oriented approach of any country, is retraced. Discussion includes cautionary concerns as well as potential opportunities for improvements in mental health services. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Major ion chemistry of the Son River, India: Weathering processes ...

Indian Academy of Sciences (India)

Major ion chemistry of the Son River, India: Weathering processes, dissolved fluxes and water quality assessment. Chinmaya Maharana, Sandeep Kumar Gautam,. Abhay Kumar Singh and Jayant K Tripathi. J. Earth Syst. Sci. 124(6) cO Indian Academy of Sciences. Supplementary data ...

...And Kronos Ate His Sons

Science.gov (United States)

Vitiello, Giuseppe

In closed systems, energy is conserved. The origin of the time axis is completely arbitrary due to the invariance under continuous time-translations. The flowing of time swallows those fictitious origins one might assign on its axis, as Kronos ate his sons. Dissipation breaks such a scenario. It implies a non-forgettable origin of time. Open systems need their complement (their "double") in order to become, together, a closed system. Time emerges as an observable measured by the evolution of the open system complement, which acts as a clock. The conservation of the energy-momentum tensor in electrodynamics is considered and its relation with dissipative systems and self-similar fractal structures is discussed. The isomorphism with coherent states in quantum field theory (QFT) is established and the generator of transitions among unitarily inequivalent representations of the canonical commutation relations (CCR) is shown to provide sequences in time of phases, which defines the arrow of time. Merging properties of electrodynamics, fractal self-similarity, dissipation and coherent states point to an integrated vision of Nature.

Trigeneración en un hospital en Madrid

OpenAIRE

Stoica, Geany Mark Antonio

2014-01-01

En el presente proyecto se tiene como finalidad determinar de forma precisa las posibilidades de trigeneración de un hospital concreto. Basando los cálculos y simulaciones en datos reales facilitados por el propio centro, que analizándolos posteriormente se podrá decidir sobre el tipo de planta y potencia más adecuada a su configuración energética actual. Los objetivos a cumplir en el presente proyecto por tanto son: Estudio de la viabilidad de implantar un sistema de trigeneració...

Les Ilenti ou maudire son prochain en turc

Directory of Open Access Journals (Sweden)

Altan Gokalp

2009-05-01

Full Text Available La langue turque contemporaine dispopse d’un nombre important de formules d’invective et de malédiction qui relèvent d’un genre appelé ilenç ou ilenti, forme qui est connue depuis les premières inscriptions turques runiques de la Haute Asie. Bien que l’islam réprouve le fait de maudire son prochain, le genre issu d’une grande tradition turque ancienne est d’un usage commun chez les Turcs. Plus encore, la manière de maudire relève d’une tradition savante, d’un « Grand Parler » qui s’apparente aux genres littéraires les plus classiques comme l’épopée, le conte ou la poésie lyrique : la métrique, les rimes, l’usage des assonances obéissent aux mêmes règles que la grande tradition littéraire turque. En cela, le fait d’user de l’invective et de la malédiction est d’une certaine manière une prétention à la distinction et à la domination de l’autre. Les cibles de l’invective éclairent bien cette volonté de dominer et de détruire son ennemi (le corps, la famille, la maladie, une mort peu digne, etc..

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

Science.gov (United States)

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

2014-12-01

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

Lost in hospital: a qualitative interview study that explores the perceptions of NHS inpatients who spent time on clinically inappropriate hospital wards.

Science.gov (United States)

Goulding, Lucy; Adamson, Joy; Watt, Ian; Wright, John

2015-10-01

Prior research suggests that the placement of patients on clinically inappropriate hospital wards may increase the risk of experiencing patient safety issues. To explore patients' perspectives of the quality and safety of the care received during their inpatient stay on a clinically inappropriate hospital ward. Qualitative study using semi-structured interviews. Nineteen patients who had spent time on at least one clinically inappropriate ward during their hospital stay at a large NHS teaching hospital in England. Patients would prefer to be treated on the correct specialty ward, but it is generally accepted that this may not be possible. When patients are placed on inappropriate wards, they may lack a sense of belonging. Participants commented on potential failings in communication, medical staff availability, nurses' knowledge and the resources available, each of which may contribute to unsafe care. Patients generally acknowledge the need for placement on inappropriate wards due to demand for inpatient beds, but may report dissatisfaction in terms of preference and belonging. Importantly, patients recount issues resulting from this placement that may compromise their safety. Hospital managers should be encouraged to appreciate this insight and potential threat to safe practice and where possible avoid inappropriate ward transfers and admissions. Where such admissions are unavoidable, staff should take action to address the gaps in safety of care that have been identified. © 2013 John Wiley & Sons Ltd.

'SON-GO-KU' : a dream of automated library

Science.gov (United States)

Sato, Mamoru; Kishimoto, Juji

In the process of automating libraries, the retrieval of books through the browsing of shelves is being overlooked. The telematic library is a document based DBMS which can deliver the content of books by simulating the browsing process. The retrieval actually simulates the process a person would use in selecting a book in a real library, where a visual presentation using a graphic display is substituted. The characteristics of prototype system "Son-Go-Ku" for such retrieval implemented in 1988 are mentioned.

The relation of son preference and religion to induced abortion: the case of South Korea.

Science.gov (United States)

Chung, Woojin

2007-09-01

This paper explores the factors that influence the practice of induced abortion in a very low fertility society, with particular emphasis on son preference and three distinct religions: Confucianism, Buddhism and Christianity. Using multivariate logistic regression models fitted by the generalized estimating equation (GEE) method, this paper analysed the data collected by the 2000 Korea National Fertility and Family Health Survey of 6348 married women aged 15-49 years with a total of 1217 pregnancy outcomes. The results showed that the likelihood of induced abortions in women with two or more children, compared with those with one child, was significantly influenced by the sex composition of the previous children: odds ratio (OR)=12.71 (95% CI=5.49, 29.42) for women with only son(s), and OR=3.91 (95% CI=1.67, 9.14) for women with only daughter(s). At parity two, women with two sons were much more likely to have induced abortions than women with two daughters (OR=5.88, 95% CI=2.70, 12.85). Although Buddhist women were not significantly different from Confucian women in induced abortion practice, Christian women were much less likely than Confucian women to have an induced abortion (OR=0.39, 95% CI=0.18, 0.88 for women with only sons and OR=0.44, 95% CI=0.24, 0.81 for women with two children). This suggests that even in this very low fertility society, son preference and religious affiliation are significant predictors of women's practice of induced abortion.

Older parents enjoy better filial piety and care from daughters than sons in China

DEFF Research Database (Denmark)

Zeng, Yi; George, Linda; Sereny, Melanie

2016-01-01

OBJECTIVE: To examine whether older parents in China would benefit more from daughters' care than from sons' emotional care. METHOD: Analysis of the unique data sets of the Chinese Longitudinal Healthy Longevity Survey conducted in 2002, 2005, and 2008-2009 in 22 provinces. RESULTS: As compared......' health outcome could help promote gender equality and reduce traditional son preference, especially in rural China....

A case of aneurysmal bone cyst in father and son

International Nuclear Information System (INIS)

Leithner, A.; Windhager, R.; Kainberger, F.; Lang, S.

1998-01-01

The authors report a familial case of primary aneurysmal bone cyst in father and son, affecting both at the same location at nearly the same age. This fact again raises the speculation of a genetic link as another factor in the pathogenesis of aneurysmal bone cyst

Mother-son discrepant reporting on parenting practices: The contribution of temperament and depression.

Science.gov (United States)

Shishido, Yuri; Latzman, Robert D

2017-06-01

Despite low to moderate convergent correlations, assessment of youth typically relies on multiple informants for information across a range of psychosocial domains including parenting practices. Although parent-youth informant discrepancies have been found to predict adverse youth outcomes, few studies have examined contributing factors to the explanation of informant disagreements on parenting practices. The current study represents the first investigation to concurrently examine the role of mother and son's self-reported affective dimensions of temperament and depression as pathways to informant discrepancies on parenting practices. Within a community sample of 174 mother-son dyads, results suggest that whereas mother's self-reported temperament evidenced no direct effects on discrepancies, the association between the product term of mother's negative and positive temperament and discrepancies on positive parenting was fully mediated by mother's depression (a mediated moderation). In contrast, son's self-reported temperament evidenced both direct and indirect effects, partially mediated by depression, on rating discrepancies for positive parenting. All told, both son's self-reported affective dimensions of temperament and depression contributed to the explanation of discrepant reporting on parenting practices; only mother's self-reported depression, but not temperament, uniquely contributed. Results highlight the importance of considering both parent and youth's report in the investigation of informant discrepancies on parenting practices. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Hospital charitable lotteries: taking a gamble on systems thinking.

Science.gov (United States)

Reynolds, Jennifer

2013-12-01

The presence of lotteries can be witnessed worldwide. Charitable lotteries are often portrayed as 'good works', and recently, hospitals have utilized them as a popular fundraising vehicle to raise necessary funds to help achieve organizational goals and objectives. Research indicates that lotteries contribute to gambling-related harms; however, research into charitable lotteries has been underdeveloped. Both the gambling and the health care industries are complex and evolving, consisting of many interacting stakeholders with often different and competing interests. This article seeks to present systems thinking as a conceptual framework to help fill the gap in understanding the use of gambling within hospitals and its possible benefits and unforeseen negative consequences. Addressing the gap in knowledge is important to help inform decision making aimed at reducing gambling-related harms. This article proposes how the school of systems thinking, specifically framing hospitals as complex adaptive systems and system dynamics modelling, can be utilized to understand the policy implications of the adoption of lotteries as a revenue source for hospitals. Hospitals have a duty to care, inform and protect. Hospital charitable lotteries have become big business; however, its incorporation into critical funding strategies needs to be carefully understood. Systems thinking theory and methodologies provide an integrated approach to examine this dynamic and evolving fundraising initiative. Findings from this article can inform the development of action strategies, including policy development at multiple levels. © 2013 John Wiley & Sons Ltd.

Influence of Internet dissemination on hospital selection for benign surgical disease: A single center retrospective study.

Science.gov (United States)

Lee, Sung Ryul; Koo, Bum Hwan; Byun, Geon Young; Lee, Seung Geun; Kim, Myoung Jin; Hong, Soo Kyung; Kim, Su Yeon; Lee, Yu Jin

2018-05-17

The Internet is used worldwide, but its effect on hospital selection of minor surgical disease has not hitherto been thoroughly studied. To investigate the effect of the Internet dissemination on hospital selection of minor surgical disease and information affecting selection, we conducted a survey of patients who underwent laparoscopic surgery from January 2016 to April 2017. We analyzed the questionnaire responses of 1916 patients. Over 80% of patients in all groups selected the hospital based on Internet information. Among patients aged over 60 years, 65.1% selected the hospital based on Internet information. With regard to hospital selection factors, the highest number of responses was for sophisticated surgical treatment (93.1%). The second highest was for a simplified medical care system (33.0%); third was a comprehensive nursing care system (18.1%). Among responses about surgical treatment, the most were obtained for short operation time and fewer hospitalization days (81.5%). Copyright © 2018 John Wiley & Sons, Ltd.

Having a son or daughter with Down syndrome: perspectives from mothers and fathers.

Science.gov (United States)

Skotko, Brian G; Levine, Susan P; Goldstein, Richard

2011-10-01

This study asks parents who have children with Down syndrome (DS) how they feel about their lives so that such information could be shared with expectant couples during prenatal counseling sessions. A valid and reliable survey instrument was mailed to 4,924 households on the mailing lists of six non-profit DS organizations. Of the 2,044 respondents, 99% reported that they love their son or daughter; 97% were proud of them; 79% felt their outlook on life was more positive because of them; 5% felt embarrassed by them; and 4% regretted having them. The parents report that 95% of their sons or daughters without DS have good relationships with their siblings with DS. The overwhelming majority of parents surveyed report that they are happy with their decision to have their child with DS and indicate that their sons and daughters are great sources of love and pride. Copyright © 2011 Wiley-Liss, Inc.

Values that Fathers Communicate to Sons about Sex, Sexuality, Relationships, and Marriage.

Science.gov (United States)

Coakley, Tanya M; Randolph, Schenita D; Shears, Jeffrey; Collins, Patrick

2017-01-01

African American males between ages 13 and 24 are disproportionately affected by unintended pregnancy and sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV/AIDS; indeed, they account for 50% of HIV infections among all youth. Clear communication between parents and their youth about sex is associated with higher rates of sexual abstinence, condom use, and intent to delay initiation of sexual intercourse, which can prevent STIs and unintended pregnancy. However, barriers exist for parents to educate their youth about sexual health. The purpose of this article is to explore the values fathers communicate to their sons to prevent their risky sexual behaviors that lead to STIs, HIV, and adolescent parenthood. This was a qualitative study conducted from May and June 2015. African American fathers (N = 29) who had sons, ages 10 to 15 years, participated in five focus groups across metropolitan and rural North Carolina communities in barbershops. A qualitative content analysis revealed four themes regarding areas that fathers imparted their values onto their sons to protect them from sexual health risks: (a) sex, (b) sexuality, (c) relationships, and (d) marriage. The findings have implications for social work and public health practice.

Lo que son mujeres en los escenarios

Directory of Open Access Journals (Sweden)

González Cañal, Rafael

2007-06-01

Full Text Available In this article I review the publishing and stage trajectory of one of Rojas Zorrilla’s most significant plays: Lo que son mujeres. As well as collecting a list of the different editions, I emphasize the 1822 version by the Mexican Manuel Eduardo de Gorostiza, which started a new renaissance period for this play on stage. I also analyze the 1899 one-act version by Emilio Bobadilla. Finally, I include all the different productions between the 17th and the 19th centuries, and address the little interest aroused in the 20th century–suffice to say that it has not been staged even during these early years of the 21st century when the centenary of Rojas Zorrilla is being celebrated.En este artículo se hace un repaso detallado de la fortuna editorial y escénica de una de las obras más significativas de Rojas Zorrilla: Lo que son mujeres. Aparte de recoger las diferentes ediciones de la misma, se hace hincapié en la refundición del mexicano Manuel Eduardo de Gorostiza, estrenada en 1822, que abrió un período de cierta recuperación de este texto dramático en los escenarios. Se analiza también la refundición que llevó a cabo en un solo acto Emilio Bobadilla en 1899. Finalmente, se registran todas las representaciones conocidas de la obra desde el siglo XVII hasta el siglo XIX y se constata el poco interés que ha despertado en los escenarios del siglo XX. Incluso en los últimos años, en los que los montajes de obras de Rojas comienzan a ser más frecuentes, esta obra no ha sido todavía llevada a escena.

O campo magnético e a massa dos mésons

OpenAIRE

Camila Sampaio Machado

2013-01-01

Neste trabalho buscamos explorar os efeitos do campo magnético, criado em colisões de íons pesados não-centrais, em estados ligados. Motivados pelo caso do átomo de hidrogênio, onde a presença do campo magnético deixa o estado mais ligado,estudamos o caso dos mésons B e D. Inicialmente trabalhamos com a equação de Schrödinger e utilizamos o modelo de potencial de Cornell que faz uma boa descrição da espectroscopoia de mésons pesados. Em seguida, utilizando as regras de soma da QCD, procuram...

Do hospitals respond to rivals' quality and efficiency? A spatial panel econometric analysis.

Science.gov (United States)

Longo, Francesco; Siciliani, Luigi; Gravelle, Hugh; Santos, Rita

2017-09-01

We investigate whether hospitals in the English National Health Service change their quality or efficiency in response to changes in quality or efficiency of neighbouring hospitals. We first provide a theoretical model that predicts that a hospital will not respond to changes in the efficiency of its rivals but may change its quality or efficiency in response to changes in the quality of rivals, though the direction of the response is ambiguous. We use data on eight quality measures (including mortality, emergency readmissions, patient reported outcome, and patient satisfaction) and six efficiency measures (including bed occupancy, cancelled operations, and costs) for public hospitals between 2010/11 and 2013/14 to estimate both spatial cross-sectional and spatial fixed- and random-effects panel data models. We find that although quality and efficiency measures are unconditionally spatially correlated, the spatial regression models suggest that a hospital's quality or efficiency does not respond to its rivals' quality or efficiency, except for a hospital's overall mortality that is positively associated with that of its rivals. The results are robust to allowing for spatially correlated covariates and errors and to instrumenting rivals' quality and efficiency. Copyright © 2017 John Wiley & Sons, Ltd.

Is a {mu}mol a {mu}mol? Growth and development of chrysanthemum cultivated under SON-T lighting and under LED-lighting; Is a {mu}mol a {mu}mol? Groei en ontwikkeling van chrysant geteeld onder SON-T belichting en onder LED verlichting

Energy Technology Data Exchange (ETDEWEB)

Meinen, E.; Marcelis, L.F.M.; Steenhuizen, J.W.; Dueck, T.A.

2009-12-15

Description of an experiment that was conducted, comparing LED lamps and SON-T (high pressure sodium) lamps. In climate rooms with LED (96% red sodium lamps) or SON-T lamps (without daylight), chrysanthemums were cultivated at two light intensities. Although the air temperature was the same in both treatments, the leaf temperature was clearly higher in the case of SON-T as a result of heat radiation. In the case of LED a more round leaves were observed. Plants cultivated under SON-T light developed closed crops much quicker and required a shorter reaction time (10 to 14 days at high and low light intensity). Yet, the harvest weight of the branches was the same. The net leaf photosynthesis was lower in chrysanthemums cultivated under LED lighting compared to plants cultivated under SON-T lighting. This is probably due to long-term cultivation under a spectrum of almost exclusively red light. The differences between SON-T and LED with regard to light color and heat radiation have significant consequences for growth and development. [Dutch] Een experiment is uitgevoerd om LED lampen en SON-T (hogedruk natriumlampen) lampen te vergelijken. In klimaatkamers met LED (96% rood en 4% blauw) of SON-T lampen (zonder daglichttoetreding) werden chrysanten geteeld bij 2 lichtintensiteiten. Hoewel de luchttemperatuur identiek was bij beide behandelingen was de bladtemperatuur duidelijk hoger bij SON-T als gevolg van warmtestraling. Onder LED belichting werd meer 'bol blad' waargenomen. Planten geteeld onder SON-T belichting ontwikkelden sneller een gesloten gewas en hadden een kortere reactietijd (10 tot 14 dagen bij hoge en lage lichtintensiteit). Maar het oogstgewicht van de takken was gelijk. De netto actuele bladfotosynthese was lager bij chrysanten geteeld onder LED belichting vergeleken met planten geteeld onder SON-T belichting. Dit is waarschijnlijk toe te schrijven aan langdurige teelt onder een spectrum met vrijwel alleen rood licht. De verschillen tussen SON

Son huasteco e identidad regional

Directory of Open Access Journals (Sweden)

Rosa María Bonilla Burgos

2013-04-01

Full Text Available La población de la región Huasteca es partícipe de manifestaciones musicales en diferentes ámbitos, lo cual permite reconocer que entre todos los géneros utilizados destaca el son huasteco y su correspondiente bailable llamado huapango. Dichas expresiones musicales se impregnan de los ambientes tanto físico como social que viven constantemente. Es a través de las letras de los sones huastecos que se desarrolla el mecanismo para reflejar el mundo natural que perciben, y los acontecimientos que les suceden, cobrando una importancia que deriva en una identificación que trasciende. Conciben su entorno y lo refieren con sentido de pertenencia-apropiación, que les permite recrear su vida y fundirse en una identificación cultural a la que se le llamará “identidad regional”. La relevancia de considerar una expresión musical de estas características radica en que se preserva y enriquece constantemente unificando un área de México que no necesariamente corresponde a límites políticos establecidos en las diferentes etapas históricas.

Por qué todas las cuentas son falsas

OpenAIRE

Aerde, Michel van

1994-01-01

Los principales criterios para evaluación y decisión, en la sociedad actual, son inspirados por cálculos económicos. Mucho nos preocupamos de cuentas pero muy poco nos preguntamos de lo que es el dinero. Muy poco reflexionamos filosóficamente, ontológicamente, sobre la naturaleza misma del dinero. ¿Qué es esto que pretende ser la base de nuestra sociedad? El dinero es mentiroso por naturaleza. Es una representación de mucha vida, que no puede ser representada. El dinero es peligroso, se convi...

The 6-Item Cognitive Impairment Test as a bedside screening for dementia in general hospital patients: results of the General Hospital Study (GHoSt).

Science.gov (United States)

Hessler, Johannes Baltasar; Schäufele, Martina; Hendlmeier, Ingrid; Nora Junge, Magdalena; Leonhardt, Sarah; Weber, Joshua; Bickel, Horst

2017-07-01

The objective of this study was to examine the psychometric quality of the 6-Item Cognitive Impairment Test (6CIT) as a bedside screening for the detection of dementia in general hospital patients. Participants (N = 1,440) were inpatients aged ≥65 of 33 randomly selected general hospitals in Southern Germany. The 6CIT was conducted at bedside, and dementia was diagnosed according to DSM-IV. Nursing staff was asked to rate the patients' cognitive status, and previous diagnoses of dementia were extracted from medical records. Completion rates and validity statistics were calculated. Two-hundred seventy patients had dementia. Cases with delirium but no dementia were excluded. Feasibility was 97.9% and 83.3% for patients without and with dementia, respectively, and decreased from moderate (93.8%) to severe dementia (53%). The area under the curve of the 6CIT was 0.98. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated for the cutoffs 7/8 (0.96, 0.82, 0.85, 0.52, 0.99) and 10/11 (0.88, 0.95, 0.94, 0.76, 0.98). The nurse ratings and medical records information had lower validity statistics. Logistic regression analyses revealed that the 6CIT statistically significantly provided information above nurse ratings and medical records. Twenty-five and 37 additional patients were correctly classified by the 7/8 and 10/11 cutoffs, respectively. The 6CIT is a feasible and valid screening tool for the detection of dementia in older general hospital patients. The 6CIT outperformed the nurse ratings of cognitive status and dementia diagnoses from medical records, suggesting that standardized screening may have benefits with regard to case finding. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Understanding Motherhood as Maturation: Maternity Scripts in Lois Lowry's "Son"

Science.gov (United States)

Deszcz-Tryhubczak, Justyna; Marecki, Mateusz

2015-01-01

When put together with the other parts of The Giver Quartet, "Son" (2012), Lowry's recently published concluding book, emerges as an odd exception to the focus on young adult protagonists since it foregrounds the mother's perspective and addresses the issue of motherhood. It presents the reader with at least three conceptual models of…

Confidence in delegation and leadership of registered nurses in long-term-care hospitals.

Science.gov (United States)

Yoon, Jungmin; Kim, Miyoung; Shin, Juhhyun

2016-07-01

Effective delegation improves job satisfaction, responsibility, productivity and development. The ageing population demands more nurses in long-term-care hospitals. Delegation and leadership promote cooperation among nursing staff. However, little research describes nursing delegation and leadership style. We investigated the relationship between registered nurses' delegation confidence and leadership in Korean long-term-care hospitals. Our descriptive correlational design sampled 199 registered nurses from 13 long-term-care hospitals in Korea. Instruments were the Confidence and Intent to Delegate Scale and Multifactor Leadership Questionnaire. Confidence in delegation significantly aligned with current-unit clinical experience, length of total clinical-nursing experience, delegation-training experience and leadership. Transformational leadership was the most statistically significant factor influencing delegation confidence. When effective delegation integrates with efficient leadership, staff can deliver optimal care to long-term-care patients. © 2016 John Wiley & Sons Ltd.

Experiences of parents whose sons or daughters have (had) attempted suicide

DEFF Research Database (Denmark)

Buus, Niels; Caspersen, Jimmy; Hansen, Rasmus

2014-01-01

problem and relatives are understood as playing an important role in suicide prevention; however, suicide and suicidal behaviour affect the relatives' lives profoundly, both emotionally and socially, and the psychosocial impact on families is underresearched. DESIGN: Focus groups with parents of sons......AIM: The aim of this exploratory study was to gain further insights into the experiences of parents of sons or daughters who have attempted suicide and how these parents respond to the increased psychosocial burden following the suicide attempt(s). BACKGROUND: Suicide is a major public health...... or daughters who have attempted suicide. METHODS: In January and February 2012, we interviewed two groups of parents recruited at a counselling programme for relatives of persons who have attempted suicide. The analysis combined a thematic analysis with a subsequent analysis of how the themes were negotiated...

Self-Organizing Networks (SON) Self-Planning, Self-Optimization and Self-Healing for GSM, UMTS and LTE

CERN Document Server

Ramiro, Juan

2011-01-01

With the current explosion in network traffic, and mounting pressure on operators' business case, Self-Organizing Networks (SON) play a crucial role. They are conceived to minimize human intervention in engineering processes and at the same time improve system performance to maximize Return-on-Investment (ROI) and secure customer loyalty. Written by leading experts in the planning and optimization of Multi-Technology and Multi-Vendor wireless networks, this book describes the architecture of Multi-Technology SON for GSM, UMTS and LTE, along with the enabling technologies for SON planning, opti

Léon Bardalès: Sa vie et son œuvre

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Ilias Taxidis

2011-07-01

Full Text Available Cette étude comprend la présentation et l’édition critique de deux lettres et six poèmes de Léon Bardalès qui fut l’un des dignitaires impériaux byzantins de la fin du XIIIe et du début du XIVe siècle. Pour l’occasion, toutes les données concernant l’auteur et son activité politique et littéraire sont réévaluées conformément aux informations fournies par les lettres que Bardalès a reçues d’épistoliers connus de son époque, comme Maxime Planude, Nicéphore Choumnos et Nicéphore Grégoras. Dans l’édition, les erreurs et fautes d’inattention des éditeurs précédents sont corrigées, et un apparat des sources est ajouté.

Quem são os egressos de internação psiquiátrica? ¿Quiénes son los pacientes que obtuvieron el alta de la internación psiquiátrica? Who are the patients who have been discharged from psychiatric hospital care recently?

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Lucilene Cardoso

2009-12-01

átrica anterior 62,5% de ellos. Conclusiones: Conocer quienes son esos pacientes posibilita identificar características que pueden ayudar a determinar el mejor tratamiento, el soporte profesional y la elaboración de intervenciones psicoeducativas que demuestran ser necesarias en esa población.Objective: To describe the characteristics of persons with mental illnesses who have been discharged from psychiatric hospital care recently. Methods: Descriptive study conducted with a sample of 48 patients between December 17 2007 and April 17 2008. Data were collected through the economic and social questionnaire that gathers socio-demographic information including psychiatric hospitalizations and patient's knowledge of diagnosis and psychopharmacological treatment. Results: The mean age of the participants was 39 years. The majority were women (n = 39, had at least one previous hospitalization (62.5%, and did not know the diagnosis of their mental illness. Schizophrenia and/or Schizotypic Disorders were the most common types of mental illnesses (33.3%. Less than half of participants (43.8% were able to verbalize the name and dosage of their medications correctly. Conclusion: Knowing those patients characteristics may be helpful in planning and implementing the best mental health treatment that includes professional support and effective psycho educational intervention.

URGENCIAS PSIQUIÁTRICAS EN EL HOSPITAL GENERAL

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Dr. Rodrigo Nieto

2017-11-01

Full Text Available Las urgencias psiquiátricas pueden presentarse en diversos escenarios clínicos, incluyendo la consulta ambulatoria, el servicio de urgencias, o el hospital general. Por este motivo, es importante que tanto psiquiatras como médicos de otras especialidades estén capacitados para su reconocimiento y manejo inicial. Especialmente en el contexto del hospital general, es importante considerar la relación entre enfermedades médicas y psiquiátricas, desde los síntomas físicos que pueden presentarse producto de un trastorno psiquiátrico, hasta los síntomas psiquiátricos que son el resultado de enfermedades orgánicas, medicamentos o abuso de sustancias. Adicionalmente, en este artículo se entregan elementos para el manejo de algunas urgencias psiquiátricas particularmente relevantes, tales como la ideación suicida, la agitación psicomotora o el delirium, donde las intervenciones iniciales pueden ser de gran importancia para la evolución y el pronóstico del paciente.

La arquitectura del pleno barroco en Granada: el hospital del Corpus Christi

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Barrios Rozúa, Juan Manuel

2011-03-01

Full Text Available The Corpus Christi hospital of Granada was a victim of prejudices against the baroque on the part of influential historians. Nevertheless, the building is an interesting example of hospital architecture with a frankly original temple. Thanks to the exhaustive analysis of the institution’s very complete archive, it can be determined that some thirty artists worked there, including Alonso Cano and his disciple Juan Luis de Ortega, whose architectural works are evaluated here.

El hospital del Corpus Christi de Granada fue víctima de los prejuicios contra el barroco de influyentes historiadores. Sin embargo, el edificio constituye un interesante ejemplo de arquitectura hospitalaria con un templo francamente original. Gracias al análisis exhaustivo de su completo archivo, puede detectarse la labor de una treintena de artífices, entre ellos Alonso Cano y su discípulo Juan Luis de Ortega, cuyas obras arquitectónicas son valoradas aquí.

Communication satisfaction of professional nurses working in public hospitals.

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Wagner, J-D; Bezuidenhout, M C; Roos, J H

2015-11-01

This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire (CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members. © 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd.

Que son las Cochinillas de los Cotrus (Naranjos, Limoneros, Mandarinos, etc. y como se Combaten.

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Posada Sinisterra. Belisario

1942-04-01

Full Text Available Las cochinillas son insectos de aspecto variado. Son llamados también insectos-escamas porque la mayoría de ellos viven protegidos por una concha o escama de forma y coloración diversa. Las especies que en seguida se describen tienen un ciclo biológico muy similar. Se reproducen por medio de huevos que depositan las hembras bajo la escama.

Like father, like son: the intergenerational cycle of adolescent fatherhood.

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Sipsma, Heather; Biello, Katie Brooks; Cole-Lewis, Heather; Kershaw, Trace

2010-03-01

Strong evidence exists to support an intergenerational cycle of adolescent fatherhood, yet such a cycle has not been studied. We examined whether paternal adolescent fatherhood (i.e., father of study participant was age 19 years or younger when his first child was born) and other factors derived from the ecological systems theory predicted participant adolescent fatherhood. Data included 1496 young males who were interviewed annually from the National Longitudinal Survey of Youth 1997. Cox regression survival analysis was used to determine the effect of paternal adolescent fatherhood on participant adolescent fatherhood. Sons of adolescent fathers were 1.8 times more likely to become adolescent fathers than were sons of older fathers, after other risk factors were accounted for. Additionally, factors from each ecological domain-individual (delinquency), family (maternal education), peer (early adolescent dating), and environment (race/ethnicity, physical risk environment)-were independent predictors of adolescent fatherhood. These findings support the need for pregnancy prevention interventions specifically designed for young males who may be at high risk for continuing this cycle. Interventions that address multiple levels of risk will likely be most successful at reducing pregnancies among partners of young men.

THE EPITHESIS IN THE LOAN WORDS ALINTI KELİMELERDE SON TÜREME

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Gülden SAĞOL YÜKSEKKAYA

2010-01-01

Full Text Available Anaptyxis is a sound appearing that is not found in the original structure of the word. There are three types of anaptyxis: prothesis, epenthesis and epithesis. Epithesis is a vowel or consonant appearing at the end of a word which is not found in the original structure of it. Although, there isn’t not so much example, both vowel and consonant reproduction is seen even in the last sound of the word; but the derivative sound isn’t the same, standard in the whole dialects and accents. Nevertheless some derivative sounds have an intense in a specific region, they aren’t seen in the other areas or has rare example. In this study, the epithesis in the loan words in Turkish will be emphasized. Bir kelimede aslında bulunmayan bir sesin sonradan ortaya çıkmasına ses türemesi denir. Ses türemesinin üç çeşidi vardır: ön türeme, iç türeme, son türeme. Son türeme, kelimenin aslında bulunmayan bir ünlü veya ünsüzün kelime sonunda belirmesidir. Örneği fazla olmamakla birlikte son seste de hem ünlü hem de ünsüz türemesi görülür. Ancak türeyen sesler standart olarak bütün lehçe ve ağızlarda ortak değildir. Türeyen bazı sesler belli bir bölge içerisinde yoğunlaşırken, bazı bölgelerde görülmemekte veya sadece birkaç, hatta bir örnekle sınırlı kalabilmektedir. Bu çalışmada Türkçede alıntı kelimelerdeki son türeme örnekleri üzerinde durulacaktır.

‘To refer, not to characterise’: A synchronic look at the Son-of-Man logia in the Sayings Gospel Q

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Llewellyn

2013-03-01

Full Text Available The article intends to address the Son-of-Man problem by applying Delbert Burkett’s ‘question of reference’ to those Son-of-Man logia that appear in the Sayings Gospel Q. A position is taken that recent philological approaches to the Son-of-Man problem have not been overly convincing, successful or helpful. Similarly, attempting to determine the authenticity of individual Son-of-Man sayings has not led to any form of scholarly consensus. In place of these approaches, a synchronic approach is defended and applied to the Son-of-Man sayings in Q, with interesting results.

Strategic planning processes and financial performance among hospitals in Lebanon.

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Saleh, Shadi; Kaissi, Amer; Semaan, Adele; Natafgi, Nabil Maher

2013-01-01

Strategic planning has been presented as a valuable management tool. However, evidence of its deployment in healthcare and its effect on organizational performance is limited in low-income and middle-income countries (LMICs). The study aimed to explore the use of strategic planning processes in Lebanese hospitals and to investigate its association with financial performance. The study comprised 79 hospitals and assessed occupancy rate (OR) and revenue-per-bed (RPB) as performance measures. The strategic planning process included six domains: having a plan, plan development, plan implementation, responsibility of planning activities, governing board involvement, and physicians' involvement. Approximately 90% of hospitals have strategic plans that are moderately developed (mean score of 4.9 on a 1-7 scale) and implemented (score of 4.8). In 46% of the hospitals, the CEO has the responsibility for the plan. The level of governing board involvement in the process is moderate to high (score of 5.1), whereas physician involvement is lower (score of 4.1). The OR and RPB amounted to respectively 70% and 59 304 among hospitals with a strategic plan as compared with 62% and 33 564 for those lacking such a plan. No statistical association between having a strategic plan and either of the two measures was detected. However, the findings revealed that among hospitals that had a strategic plan, higher implementation levels were associated with lower OR (p plans allow organizations to better cope with environmental turbulence. Copyright © 2012 John Wiley & Sons, Ltd.

Integrating Equality - Globalization, Women's Rights, Son Preference and Human Trafficking

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Cho, Seo-Young

2011-01-01

Employing economic and social globalization indicators, we empirically analyze whether globalization affects women’s rights in the economic and social dimensions. Using panel data from 150 countries over the 1981-2008 period, we find that social globalization positively affects both women’s economic and social rights, while the impact of economic globalization disappears when controlling for social globalization. Furthermore, we find that social globalization also reduces ‘son preference’ pro...

Fathers Are Important People: A Study of Father-Son Sexual Communication

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DiIorio, Colleen; Lehr, Sally; Wasserman, Jill L.; Eichler, Michelle; Cherry, Chauncey; Denzmore, Pamela

2006-01-01

The purpose of this study was to examine the perceived role of African-American fathers in educating their sons about sex and HIV prevention. Given that some studies have shown a relationship between parent-adolescent sexual communication and adolescent sexual behavior, and the disproportionately high rates of teen pregnancy and HIV (and other…

Power and trust in organizational relations: an empirical study in Turkish public hospitals.

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Bozaykut, Tuba; Gurbuz, F Gulruh

2015-01-01

Given the salience of the interplay between trust and power relations in organizational settings, this paper examines the perceptions of social power and its effects on trust in supervisors within the context of public hospitals. Following the theoretical background from which the study model is developed, the recent situation of hospitals within Turkish healthcare system is discussed to further elucidate the working conditions of physicians. Sample data were collected employing a structured questionnaire that was distributed to physicians working at seven different public hospitals. The statistical analyses indicate that perceptions of supervisors' social power affect subordinates' trust in supervisors. Although coercive power is found to have the greatest impact on trust in supervisors, the influence of the power base is weak. In addition, the results show that perceptions of social power differ between genders. However, the results do not support any of the hypotheses regarding the relations between trust in supervisors and the examined demographic variables. Copyright © 2014 John Wiley & Sons, Ltd.

The role of God in the father/son relationship during identity formation – a Gestalt theoretical perspective

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H.B. Grobler

2010-07-01

Full Text Available This article is based on research done within the Afrikaansspeaking community in the area of the Drakenstein Municipality, Western Cape province, South Africa. The focus falls specifically on one concept that was outlined during the research, namely the perceptions of fathers and adolescent sons on identity formation within their relationship as well as the role that God plays. Combined qualitative/quantitative research was conducted with emphasis on semi-structured interviews with fathers (n=4 and adolescent boys (n=4 and an auto-ethnography of the author as the dominant component. The lessdominant quantitative component consisted of questionnaires completed by fathers (n=42 and adolescent boys (n=180. Metatheoretical assumptions and theoretical assumptions as grounding for the male identity are discussed as part of the author’s paradigmatic perspective. Furthermore, empirical findings are discussed and recommendations are made. From the discussions with fathers and their sons it was clear that both fathers and sons have a need to stand in close relationship to each other and to God. It is within this relationship where their identities are formed. However, fathers seemed to be resistant of transferring their beliefs to their sons. Adolescent boys also indicated no need to one day transfer learned behaviour from their fathers to their sons.

Bilateral effects of hospital patient-safety procedures on nurses' job satisfaction.

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Inoue, T; Karima, R; Harada, K

2017-09-01

nurses' job satisfaction. In addition, policymakers in the hospitals should consider that chief nurses' leadership styles may reduce autonomy and suppress nurses' job satisfaction. © 2017 The Authors International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

Barriers to medication error reporting among hospital nurses.

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Rutledge, Dana N; Retrosi, Tina; Ostrowski, Gary

2018-03-01

errors, especially errors where patient harm is not apparent or where an error might be hidden. Such under-reporting impedes collection of accurate medication error data and prevents hospitals from changing harmful practices. © 2018 John Wiley & Sons Ltd.

Violence experienced by nurses at six university hospitals in Turkey.

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Ünsal Atan, S; Baysan Arabaci, L; Sirin, A; Isler, A; Donmez, S; Unsal Guler, M; Oflaz, U; Yalcinkaya Ozdemir, G; Yazar Tasbasi, F

2013-12-01

This research was conducted to analyse the violence experienced by nurses employed at six university hospitals. A descriptive and cross-sectional study was conducted. The research sample consisted of 441 nurses who worked in the emergency, intensive care and psychiatry units of six university hospitals in Turkey between June 2008 and June 2009 and who voluntarily agreed to participate. It was found that 60.8% of the nurses were subjected to verbal violence and/or physical violence from patients, visitors or health staff. Of the nurses who were subjected to workplace violence, 42.9% stated that their experience of verbal and/or physical violence had a negative impact on their physical and/or psychological health, and 42.9% stated that their work performance was negatively affected. Of these nurses, 1.8% stated that they received professional help, 13.6% stated that a report was made and 9.5% stated that they contacted the hospital police in some way. According to the findings of this research, similar to the situation worldwide, nurses in Turkey are subjected to verbal and/or physical violence from patients, visitors and health staff. © 2012 John Wiley & Sons Ltd.

¡Son notables… los desaciertos y los vacíos!

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Manuel Argüello Rodríguez

2007-10-01

Full Text Available Son notables las ausencias y los equilibrios forzados en el informe de los cinco ciudadanos costarricenses sobre el TLC. Ausencias y seudoequilibrios que han sido ya utilizados para fortalecer la campaña de propaganda arrebatadora contra la oposición al TLC indicando que ‘los notables’ desnudaron los fantasmas (con lo cual, a decir verdad no se vería nada, sería la total transparencia.

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

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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.

Building hospital capacity planning mechanisms in Poland: The impact of 2016/2017 regulatory changes.

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Dubas-Jakóbczyk, Katarzyna; Sowada, Christoph; Domagała, Alicja; Więckowska, Barbara

2018-02-07

Capacity planning is a crucial component of modern health care governance. The aim of this paper is to analyze the requirements that need to be met to build effective hospital capacity planning mechanisms in Poland. In this context, the recent regulatory changes strongly influencing hospital sector functioning, including introduction of health care needs maps, capital investment assessment, and hospital network regulations, are analyzed. Some possible ways forward, based on review of international experiences in hospital capacity planning, are discussed. Applied methods include literature review and analysis of statistical data as well as desk analysis of key national regulations related to hospital sector. Results indicate that at the system level, the process of capacity planning involves 4 elements: capital investment in facilities, equipment, and technology; service delivery; allocation of staff; and financial resources. For hospital capacity planning to be effective, the strategic decision at the macrolevel must be complemented by appropriate management of individual hospitals. The major challenge of building hospital capacity planning mechanism in Poland is imbedding it into the overall health system strategy. Because of the lack of such a strategy, the practical implementation of the ad hoc changes, which have been introduced, shows some inconsistencies. The regulations implemented between 2016 and 2017 provided a basis for hospital capacity planning, yet still need evaluation and adjustments. Also, including a mechanism for human resources planning is of crucial importance. The regulations should provide incentives for reducing oversized hospital infrastructure with simultaneous development of the long-term and coordinated care models. Copyright © 2018 John Wiley & Sons, Ltd.

Hospital decentralisation in Romania: stakeholders' perspectives in the newsprint media.

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Popa, Adela Elena

2014-01-01

In the summer of 2010, Romania undertook a process of hospital decentralisation as part of the reform in the healthcare sector. The national newsprint media covered the process thoroughly. This paper is a study of how key stakeholders' views, attitudes, beliefs and attitudes towards decentralisation are represented in print media. 106 articles, published between June and September 2010, retrieved from the online databases of six leading national dailies were analysed. A mixed methodology was used in the data analysis stage. The qualitative data exploration identified five voices belonging to stakeholders involved directly or indirectly in the process: the representatives of central government, the local authorities (district and local councils, municipal mayors), health professionals (managers and physicians in hospitals), the media (journalists, analysts) and finally voices from civil society, professional associations and advocacy groups. These were the main actors negotiating the subjective meanings of the decentralisation process. An imbalance between these key actors were observed in the frequency, content and tone of the messages delivered in media during the four months. Central government and the local authorities were the most active voices, but the respective discourses differed significantly. An analysis of the accounts identified three main themes: the financial problem (hospitals liabilities and future spending), human resource in hospitals (the impact of decentralisation upon it) and the political character of the decentralisation. Copyright © 2013 John Wiley & Sons, Ltd.

Does procedure profitability impact whether an outpatient surgery is performed at an ambulatory surgery center or hospital?

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Plotzke, Michael Robert; Courtemanche, Charles

2011-07-01

Ambulatory surgery centers (ASCs) are small (typically physician owned) healthcare facilities that specialize in performing outpatient surgeries and therefore compete against hospitals for patients. Physicians who own ASCs could treat their most profitable patients at their ASCs and less profitable patients at hospitals. This paper asks if the profitability of an outpatient surgery impacts where a physician performs the surgery. Using a sample of Medicare patients from the National Survey of Ambulatory Surgery, we find that higher profit surgeries do have a higher probability of being performed at an ASC compared to a hospital. After controlling for surgery type, a 10% increase in a surgery's profitability is associated with a 1.2 to 1.4 percentage point increase in the probability the surgery is performed at an ASC. Copyright © 2010 John Wiley & Sons, Ltd.

Autosomal-dominant Leber Congenital Amaurosis Caused by a Heterozygous CRX Mutation in a Father and Son.

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Arcot Sadagopan, Karthikeyan; Battista, Robert; Keep, Rosanne B; Capasso, Jenina E; Levin, Alex V

2015-06-01

Leber congenital amaurosis (LCA) is most often an autosomal recessive disorder. We report a father and son with autosomal dominant LCA due to a mutation in the CRX gene. DNA screening using an allele specific assay of 90 of the most common LCA-causing variations in the coding sequences of AIPL1, CEP290, CRB1, CRX, GUCY2D, RDH12 and RPE65 was performed on the father. Automated DNA sequencing of his son examining exon 3 of the CRX gene was subsequently performed. Both father and son have a heterozygous single base pair deletion of an adenine at codon 153 in the coding sequence of the CRX gene resulting in a frameshift mutation. Mutations involving the CRX gene may demonstrate an autosomal dominant inheritance pattern for LCA.

Structural characteristics of hospitals and nurse-reported care quality, work environment, burnout and leaving intentions.

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Lindqvist, Rikard; Smeds Alenius, Lisa; Griffiths, Peter; Runesdotter, Sara; Tishelman, Carol

2015-03-01

To investigate whether hospital characteristics not readily susceptible to change (i.e. hospital size, university status, and geographic location) are associated with specific self-reported nurse outcomes. Research often focuses on factors within hospitals (e.g. work environment), which are susceptible to change, rather than on structural factors in their own right. However, numerous assumptions exist about the role of structural factors that may lead to a sense of pessimism and undermine efforts at constructive change. Data was derived from survey questions on assessments of work environment and satisfaction, intention to leave, quality of care and burnout (measured by the Maslach Burnout Inventory), from a population-based sample of 11 000 registered nurses in Sweden. Mixed model regressions were used for analysis. Registered nurses in small hospitals were slightly more likely to rank their working environment and quality of nursing care better than others. For example 23% of staff in small hospitals were very satisfied with the work environment compared with 20% in medium-sized hospitals and 21% in large hospitals. Registered nurses in urban areas, who intended to leave their job, were more likely to seek work in another hospital (38% vs. 32%). While some structural factors were related to nurse-reported outcomes in this large sample, the associations were small or of questionable importance. The influence of structural factors such as hospital size on nurse-reported outcomes is small and unlikely to negate efforts to improve work environment. © 2013 John Wiley & Sons Ltd.

Should I stay or should I go? Hospital emergency department waiting times and demand.

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Sivey, Peter

2018-03-01

In the absence of the price mechanism, hospital emergency departments rely on waiting times, alongside prioritisation mechanisms, to restrain demand and clear the market. This paper estimates by how much the number of treatments demanded is reduced by a higher waiting time. I use variation in waiting times for low-urgency patients caused by rare and resource-intensive high-urgency patients to estimate the relationship. I find that when waiting times are higher, more low-urgency patients are deterred from treatment and leave the hospital during the waiting period without being treated. The waiting time elasticity of demand for low-urgency patients is approximately -0.25 and is highest for the lowest-urgency patients. Copyright © 2017 John Wiley & Sons, Ltd.

Is nurse managers' leadership style related to Japanese staff nurses' affective commitment to their hospital?

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Kodama, Yoshimi; Fukahori, Hiroki; Sato, Kana; Nishida, Tomoko

2016-10-01

To determine if nurse managers' leadership style is related to Japanese staff nurses' affective commitment to their hospital. In Western countries, nurse managers' transformational leadership style has been found to increase staff nurses' affective commitment to their hospital. However, there are few studies examining this relationship in the context of acute care hospitals in Japan. Staff nurses completed measures of their nurse managers' perceived leadership style and factors related to their own affective commitment. The association between affective commitment and perception of leadership style was assessed with multiple logistic regression. Of 736 questionnaires distributed, 579 (78.9%) were returned, and data from 396 (53.8%) fully completed questionnaires were analysed. The intellectual stimulation aspect of transformational leadership positively increased staff nurses' affective commitment (odds ratio: 2.23). Nurse managers' transactional and laissez-faire leadership styles were not related to affective commitment among staff nurses. The intellectual stimulation aspect of transformational leadership may increase the retention of staff nurses through enhanced affective commitment. To increase staff nurses' affective commitment to their hospital, we suggest that hospital administrators equip nurse managers with intellectual stimulation skills. © 2016 John Wiley & Sons Ltd.

Selecting sex: the effect of preferring sons.

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Hesketh, Therese

2011-11-01

Son preference remains common in countries from East Asia through South Asia to the Middle East and North Africa. Where sex selective technology and abortion are readily available, such as in China, South Korea and India, this has led to a marked excess in male births. Worst excesses are seen in parts of rural China where there are 140 male births for every 100 female. This leads to large numbers of unmarriageable men. Concerns about the consequences centre around the propensity to aggression and violence of these men with increased levels of crime and antisocial behaviour, threatening societal stability and security. But recent studies do not support these assumptions, but rather suggest that these men are marginalised, lonely, withdrawn and prone to psychological problems. Measures to reduce sex selection should include enforcement of existing legislation on sex-selection, and public awareness campaigns about the dangers of late abortion and gender imbalance. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Why Are Indian Children So Short? The Role of Birth Order and Son Preference.

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Jayachandran, Seema; Pandi, Rohini

2017-09-01

Child stunting in India exceeds that in poorer regions like sub-Saharan Africa. Data on over 168,000 children show that, relative to Africa, India's height disadvantage increases sharply with birth order. We posit that India’s steep birth order gradient is due to favoritism toward eldest sons, which affects parents' fertility decisions and resource allocation across children. We show that, within India, the gradient is steeper for high-son-preference regions and religions. The gradient also varies with sibling gender as predicted. A back-of-the-envelope calculation suggests that India's steeper birth order gradient can explain over one-half of the India-Africa gap in average child height.

Clinical presentation at first heart failure hospitalization does not predict recurrent heart failure admission.

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Kosztin, Annamaria; Costa, Jason; Moss, Arthur J; Biton, Yitschak; Nagy, Vivien Klaudia; Solomon, Scott D; Geller, Laszlo; McNitt, Scott; Polonsky, Bronislava; Merkely, Bela; Kutyifa, Valentina

2017-11-01

There are limited data on whether clinical presentation at first heart failure (HF) hospitalization predicts recurrent HF events. We aimed to assess predictors of recurrent HF hospitalizations in mild HF patients with an implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator. Data on HF hospitalizations were prospectively collected for patients enrolled in MADIT-CRT. Predictors of recurrent HF hospitalization (HF2) after the first HF hospitalization were assessed using Cox proportional hazards regression models including baseline covariates and clinical presentation or management at first HF hospitalization. There were 193 patients with first HF hospitalization, and 156 patients with recurrent HF events. Recurrent HF rate after the first HF hospitalization was 43% at 1 year, 52% at 2 years, and 55% at 2.5 years. Clinical signs and symptoms, medical treatment, or clinical management of HF at first HF admission was not predictive for HF2. Baseline covariates predicting recurrent HF hospitalization included prior HF hospitalization (HR = 1.59, 95% CI: 1.15-2.20, P = 0.005), digitalis therapy (HR = 1.58, 95% CI: 1.13-2.20, P = 0.008), and left ventricular end-diastolic volume >240 mL (HR = 1.62, 95% CI: 1.17-2.25, P = 0.004). Recurrent HF events are frequent following the first HF hospitalization in patients with implanted implantable cardioverter defibrillator or cardiac resynchronization therapy with defibrillator. Neither clinical presentation nor clinical management during first HF admission was predictive of recurrent HF. Prior HF hospitalization, digitalis therapy, and left ventricular end-diastolic volume at enrolment predicted recurrent HF hospitalization, and these covariates could be used as surrogate markers for identifying a high-risk cohort. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

BAKUNIN'S SON, A DIALOGIC NOVEL BY SERGIO ATZENI

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Masina Depperu (Universidade de Lisboa

2013-10-01

Full Text Available Bakunin’s Son, a short novel by Sergio Atzeni, is the perfect embodiment of Bakhtin’s theory of the dialogic novel. The author sets his stories and characters - mostly humble outcast defeated people - in his own homeland, Sardinia. The accurately planned structure as an interview to thirty-two people reflects a multifarious reality with its complex rules and mentality expressed through different points of view, languages and ideologies. The protagonist’s story may result contradictory according to the different opinions of people who met him. Also the choice of a hybrid language contributes to create a highly connoted cultural context. In Bakunin’s Son, in fact, the Italian and the Sardinian overlap in a manner that cannot be distinguished or graphically marked, since form and meaning are fused together.Key words: dialogic novel, hybrid language.O filho de Bakunin, um romance polifónico de Sergio AtzeniO romance breve de Sergio Atzeni, O filho de Bakunin, è a perfeita exemplificação da teoria bachtininana do romance polifónico. O autor insere as histórias e as persona gens, geralmente abatidas, pessoas humildes e marginalizadas, na sua terra natal, a Sardenha. A história è estruturada na forma de entrevista a trinta e duas persona gens que com os seus pontos de vista criam una realidade multi-facetada e subjectiva. A vida de Tullio Saba, o protagonista, está narrada às vezes em modo contraditório e, por isso, os factos podem ser divergentes nas opiniões de quem esteve mais ou menos em contacto directo com ele. O uso característico de um instrumento linguístico híbrido, a meio caminho entre o italiano e o sardo, conota não somente o léxico mas também a estruturação inteira do discurso que atinge o efeito final pretendido pelo autor de descrever uma diversa ealidade antropológico-cultural.Palavras chave: romance polifónico, instrumento linguístico híbrido

THE APOCOPE IN THE LOAN WORDS ALINTI KELİMELERDE SON SES DÜŞMESİ

Directory of Open Access Journals (Sweden)

Aylin KOÇ

2010-10-01

Full Text Available Disappearance is the loss of a sound in structure of the word with some reasons. There are three types of disappearance: apheresis, syncope and apocope. The apocope is disappearance of a vowel or consonant at the end of a word. This situation isn’t standard in whole dialects and accents. Some dropping sounds, have an intense in a spesific region, they aren’t seen in the other areas or have rare examples. This is rather common in the dialects. In this study will be handled the apocope in the loan words with the examples in Turkey Turkish and contemporary Turkish dialects. Bir kelimedeki seslerden birinin, çeşitli nedenlerle düşmesine ses düşmesi denir. Ses düşmesi üç çeşittir: ön ses düşmesi, iç ses düşmesi ve son ses düşmesi. Son ses düşmesi, kelimede son ses durumunda olan ünlü veya ünsüzün düşmesidir. Bu durum, bütün lehçelerde ve ağızlarda standart değildir. Düşen bazı sesler, belli bir bölge içinde yoğunlaşırken, bazı bölgelerde görülmemekte ve hatta birkaç ya da bir örnekle sınırlı kalabilmektedir. Bu daha çok ağızlarda görülür. Çalışmada, Türkiye Türkçesinde ve Çağdaş Türk Lehçelerinde alıntı kelimelerde son ses düşmesi bahsi örnekleriyle ele alınacaktır.

Plantilla de enfermería y demanda de cuidados de ancianos hospitalizados, ¿son suficientes los recursos?

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Alfonso Jesús Cruz Lendínez

Full Text Available Introducción: El aumento de la población de personas mayores de 65 años hace cada vez más frecuente su ingreso en los hospitales. El tiempo de estancia hospitalaria de los ancianos suele ser más prolongado que el del resto de pacientes. Objetivo: Analizar la capacidad de prestación de cuidados de 3 unidades de hospitalización de un hospital público y compararla con la demanda de cuidados de los ancianos. Métodos: Estudio prospectivo observacional en 3 unidades de hospitalización de medicina interna de un hospital universitario de la red pública de Andalucía (España. Se ha incluido una muestra de 190 pacientes ancianos hospitalizados. Las variables recogidas fueron: demográficas, relacionadas con la hospitalización, demanda de cuidados y capacidad de prestación de cuidados de la plantilla de enfermería. Los datos se han obtenido del sistema de información del hospital, del conjunto mínimo básico de datos de pacientes y por observación directa mediante el método de nivel de cuidados (MNC. Resultados: La edad media de los ancianos hospitalizados fue de 77,4 años, con 21,1% de mayores de 85 años. La estancia media fue de 15,68 días. La estimación de la capacidad de prestación de cuidados de la plantilla de enfermería fue de 2,8 horas/paciente/día (con un índice de enfermeras tituladas del 60%. A partir de la medición de niveles de dependencia, la demanda de cuidados media de los ancianos fue de 4,9 horas/paciente/día. Esta diferencia supone un déficit anual de 51 profesionales de enfermería en la plantilla de las 3 unidades de hospitalización. Los factores que influyen en la demanda de cuidados de los ancianos son la edad, días de estancia hospitalaria, el diagnóstico médico y el destino del paciente al alta. También se encuentra una relación con la presencia de un familiar acompañando al paciente (cuidador familiar. Los cuidados básicos representan un 65,7% del total de cuidados requeridos. Conclusiones: La

Cryptorchidism and hypospadias in sons of gardeners and farmers

DEFF Research Database (Denmark)

Weidner, I S; Møller, H; Jensen, Tina Kold

1998-01-01

Cryptorchidism and hypospadias have been related to prenatal estrogen exposure in animal models. Some chemicals used in farming and gardening have been shown to possess estrogenic and other hormone-disrupting effects. Earlier studies have indicated increased risks of urogenital malformations...... in the sons of pesticide appliers. In the present study, parental occupation in the farming and gardening industry among 6,177 cases of cryptorchidism, 1,345 cases of hypospadias, and 23,273 controls, born live from 1983 to 1992 in Denmark, was investigated in a register-based case-control study...... of female gardeners could suggest an association with prenatal exposure to occupationally related chemicals....

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

Science.gov (United States)

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

2014-05-01

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

Strategic interaction among hospitals and nursing facilities: the efficiency effects of payment systems and vertical integration.

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Banks, D; Parker, E; Wendel, J

2001-03-01

Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by initiating prospective payments to nursing facilities, and are exploring the bundling of payments to hospitals. This paper develops a static profit-maximization model of the strategic interaction between the transferring hospital and a receiving nursing facility. This model suggests that the post-1984 system of prospective payment for hospital care, coupled with nursing facility payments that reimburse for services performed, induces inefficient under-provision of hospital services and encourages vertical integration. It further indicates that the extension of prospective payment to nursing facilities will not eliminate the incentive to vertically integrate, and will not result in efficient production unless such integration takes place. Bundling prospective payments for hospitals and nursing facilities will neither remove the incentive for vertical integration nor induce production efficiency without such vertical integration. However, bundled payment will induce efficient production, with or without vertical integration, if nursing facilities are reimbursed for services performed. Copyright 2001 John Wiley & Sons, Ltd.

The Impact of Birth Order on Intergenerational Transmission of Attitudes from Parents to Adolescent Sons: The Israeli Case

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Kulik, Liat

2004-01-01

This study deals with birth order and its impact on intergenerational transmission of parental attitudes to adolescent sons in Israeli society. The sample included 294 participants (including 98 mothers, 98 fathers, and 98 sons). The attitudes chosen were key issues of concern in Israeli society: gender role attitudes, ethnic stereotypes, and…

Son Excellence Madame Elisabeth Laurin Ambassadeur Représentant permanent de la France auprès de l’Office des Nations Unies et des autres organisations internationales en Suisse République française Son Excellence Monsieur Roberto Balzaretti Ambassadeur Directeur

CERN Multimedia

AUTHOR|(CDS)2099575

2016-01-01

Son Excellence Madame Elisabeth Laurin Ambassadeur Représentant permanent de la France auprès de l’Office des Nations Unies et des autres organisations internationales en Suisse République française Son Excellence Monsieur Roberto Balzaretti Ambassadeur Directeur,

'Being a conduit' between hospital and home: stakeholders' views and perceptions of a nurse-led Palliative Care Discharge Facilitator Service in an acute hospital setting.

Science.gov (United States)

Venkatasalu, Munikumar Ramasamy; Clarke, Amanda; Atkinson, Joanne

2015-06-01

To explore and critically examine stakeholders' views and perceptions concerning the nurse-led Palliative Care Discharge Service in an acute hospital setting and to inform sustainability, service development and future service configuration. The drive in policy and practice is to enable individuals to achieve their preferred place of care during their last days of life. However, most people in UK die in acute hospital settings against their wishes. To facilitate individuals' preferred place of care, a large acute hospital in northeast England implemented a pilot project to establish a nurse-led Macmillan Palliative Care Discharge Facilitator Service. A pluralistic evaluation design using qualitative methods was used to seek stakeholders' views and perceptions of this service. In total, 12 participants (five bereaved carers and seven health professionals) participated in the evaluation. Semi-structured interviews were conducted with bereaved carers who used this service for their relatives. A focus group and an individual interview were undertaken with health professionals who had used the service since its inception. Individual interviews were also conducted with the Discharge Facilitator and service manager. Analysis of all data was guided by Framework Analysis. Four key themes emerged relating to the role of the Discharge Facilitator Service: achieving preferred place of care; the Discharge Facilitator as the 'conduit' between hospital and community settings; delays in hospital discharge and stakeholders' perceptions of the way forward for the service. The Discharge Facilitator Service acted as a reliable resource and support for facilitating the fast-tracking of end-of-life patients to their preferred place of care. Future planning for hospital-based palliative care discharge facilitating services need to consider incorporating strategies that include: increased profile of the service, expansion of service provision and the Discharge Facilitator's earlier

A Stylistic Analysis of D.H. Lawrence’s ‘Sons and Lovers’

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Nozar Niazi

2013-05-01

Full Text Available This paper aims at analyzing D.H. Lawrence’s ‘Sons and Lovers’ using a stylistic approach. Stylistics is a study of the amalgamation of form with content. The stylistic analysis of a novel goes beyond the traditional, intuitive interpretation, because it combines intuition and detailed linguistic analysis of the text. The defining elements of modern language are within the text itself, not prescribed from outside. With modernist texts, usually understanding comes from close study of the language system defined within the text itself. Form, technique and style are considered not as a mere vehicle of the content of the story, but an integral part of the work’s meaning and value. In our analysis of ‘Sons and Lovers’ the resources of language: lexis, syntax, phonology, figurative language, cohesion and coherence, are discussed in relation to the style of discourse in order to explore hidden meanings in the text. The resources of language are shown to be an essential part of the meaning of the novel.

Representations of the algebra Uq'(son) related to quantum gravity

International Nuclear Information System (INIS)

Klimyk, A.U.

2002-01-01

The aim of this paper is to review our results on finite dimensional irreducible representations of the nonstandard q-deformation U q ' (so n ) of the universal enveloping algebra U(so(n)) of the Lie algebra so(n) which does not coincide with the Drinfeld-Jimbo quantum algebra U q (so n ).This algebra is related to algebras of observables in quantum gravity and to algebraic geometry.Irreducible finite dimensional representations of the algebra U q ' (so n ) for q not a root of unity and for q a root of unity are given

Effects of oral nutritional supplementation in the management of malnutrition in hospital and post-hospital discharged patients in India: a randomised, open-label, controlled trial.

Science.gov (United States)

Huynh, D T T; Devitt, A A; Paule, C L; Reddy, B R; Marathe, P; Hegazi, R A; Rosales, F J

2015-08-01

Hospital malnutrition is a significant problem that still remains under-recognised and under-treated in India. The present study assessed the effects of oral nutritional supplementation (ONS) in conjunction with dietary counselling versus dietary counselling (control) alone in malnourished patients when given in hospital and post-hospital discharge. The present study was conducted in nine private and four public hospitals. Patients from various medical wards were screened for malnutrition using modified Subjective Global Assessment (mSGA) and randomised to control (n = 106) or ONS (n = 106) for 12 weeks. Two servings (460 mL) of ONS were prescribed daily, providing 432 kcal, 16 g of protein and 28 micronutrients. The primary outcome was weight gain over 12 weeks. Other outcomes included change in body mass index (BMI), serum pre-albumin, albumin and C-reactive protein levels, energy and nutrient intakes, and handgrip strength at weeks 4, 8 and 12, as well as mSGA score at week 12. The mean age of patients was 39 years. Fifty-five percent were males and 90.3% were moderately malnourished (mSGA score B) at baseline. At week 12, ONS significantly improved certain parameters compared to control: weight (2.0 versus 0.9 kg; P energy intake per day (560 versus 230 kcal; P energy intake and weight in malnourished Indian patients. Those patients with poorer functional status at baseline demonstrated the most benefit. © 2014 The Authors Maternal & Child Nutrition Published by John Wiley & Sons Ltd.

The (un) making of a man: fathers and sons in the African novel

African Journals Online (AJOL)

Lipenga

Things Fall Apart (1958), Zakes Mda's The Sculptors of. Mapungubwe ... The important thing to note in his analysis is his highlighting of the various ... to this discussion – of a farmer (strong, hard-working, strict) who is contrasted with his son ...

6j-symbols for symmetric representations of SO(n) as the double series

International Nuclear Information System (INIS)

Alisauskas, Sigitas

2002-01-01

The corrected triple sum expression of Alisauskas (1987 J. Phys. A: Math. Gen. 20 35) for the recoupling (Racah) coefficients (6j-symbols) of the symmetric (most degenerate) representations of the orthogonal groups SO(n) (previously derived from the fourfold sum expression of Alisauskas also related to the result of Hormess and Junker (1999 J. Phys. A: Math. Gen. 32 4249) is rearranged into three new different double sum expressions (related to the hypergeometric Kampe de Feriet type series) and a new triple sum expression with preferable summation condition. The Regge type symmetry of special 6j-symbols of the orthogonal groups SO(n) in terms of special Kampe de Feriet F 1:4 1:3 series is revealed. The recoupling coefficients for antisymmetric representations of symplectic group Sp(2n) are derived using their relation with the recoupling coefficients of the formal orthogonal group SO(-2n)

Assessing managerial information needs: Modification and evaluation of the Hospital Shift Leaders' Information Needs Questionnaire.

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Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Siirala, Eriikka; Löyttyniemi, Eliisa; Aantaa, Riku; Salanterä, Sanna

2018-03-01

The aims were (1) to evaluate the modified version of the Intensive Care Unit Information Need Questionnaire for the broader hospital setting, and (2) to describe the differences in respondents' managerial activities and information needs according to the position held by the respondent and the type of hospital unit. Information systems do not support managerial decision-making sufficiently and information needed in the day-to-day operations management in hospital units is unknown. An existing questionnaire was modified and evaluated. Shift leaders, that is, the nurses and physicians responsible for the day-to-day operations management in hospital units were reached using purposive sampling (n = 258). The questionnaire ascertained the importance of information. Cronbach's α ranged from .85-.96 for the subscales. Item - total correlations showed good explanatory power. Managerial activities and information needs differed between respondents in different positions, although all shared about one-third of important information needs. The response rate was 26% (n = 67). The validity and reliability of the questionnaire were good. Attention should be paid to the positions of shift leaders when developing information systems. The questionnaire can be used to determine important information when developing information systems to support day-to-day operations management in hospitals. © 2018 John Wiley & Sons Ltd.

Mate-sampling costs and sexy sons.

Science.gov (United States)

Kokko, H; Booksmythe, I; Jennions, M D

2015-01-01

Costly female mating preferences for purely Fisherian male traits (i.e. sexual ornaments that are genetically uncorrelated with inherent viability) are not expected to persist at equilibrium. The indirect benefit of producing 'sexy sons' (Fisher process) disappears: in some models, the male trait becomes fixed; in others, a range of male trait values persist, but a larger trait confers no net fitness advantage because it lowers survival. Insufficient indirect selection to counter the direct cost of producing fewer offspring means that preferences are lost. The only well-cited exception assumes biased mutation on male traits. The above findings generally assume constant direct selection against female preferences (i.e. fixed costs). We show that if mate-sampling costs are instead derived based on an explicit account of how females acquire mates, an initially costly mating preference can coevolve with a male trait so that both persist in the presence or absence of biased mutation. Our models predict that empirically detecting selection at equilibrium will be difficult, even if selection was responsible for the location of the current equilibrium. In general, it appears useful to integrate mate sampling theory with models of genetic consequences of mating preferences: being explicit about the process by which individuals select mates can alter equilibria. © 2014 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2014 European Society For Evolutionary Biology.

Capilla del Hospital Municipal de Mannheim, Alemania

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Mutschler, C.

1969-07-01

Full Text Available This building was completed when the Municipal Hospital of Mannheim was enlarged and became a Faculty of Medicine. It serves equally well for catholic and protestant religious services. The visitor reaches the church after traversing a gently inclined path: the main feature that holds his attention on entering is the altar and sacristy zone. Advancing up a ramp a gallery is reached, which enables sick people on wheelchairs, or in beds, to participate in the liturgical acts. The main materials utilised have been untreated brick and concrete.Construida a raíz de la ampliación del Hospital Municipal de Mannheim y su conversión en Facultad de Medicina, sirve indistintamente para la celebración de los actos litúrgicos de ambas confesiones. El visitante, por un camino suavemente inclinado, ingresa en el interior del edificio, cuyo núcleo focal está constituido por la zona del altar y las sacristías. Subiendo por una rampa se accede a una galería que permite el que los enfermos, en sillones con ruedas, o en Ja cama, etc., puedan participar desde allí en los actos litúrgicos. Los materiales fundamentales empleados son: ladrillo a cara vista y hormigón, igualmente visto.

Literature as an exploration of the phenomenology of schizophrenia: disorder and recovery in Denis Johnson's Jesus' Son.

Science.gov (United States)

Hamm, Jay A; Leonhardt, Bethany L; Fogley, Rebecca L; Lysaker, Paul H

2014-12-01

When read as a fictional psychosis narrative, Jesus' Son, a collection of short stories by Denis Johnson, reveals important elements of the phenomenology of schizophrenia and recovery. It is possible that Jesus' Son, as a work of fiction, may be able to uniquely add depth and nuance to an understanding of the phenomenology of schizophrenia involving a state of psychological fragmentation, an ever-changing interpersonal field and a loss of personal agency. In addition, by following the protagonist in Jesus' Son as he begins to resolve some of his difficulties, the book also offers an individualised account of recovery. The authors detail how the book reveals these insights about schizophrenia and recovery and suggest that these elements are intertwined in such a manner that leads to a profound disruption of self-experience, characterised by a collapse of metacognitive processes. Jesus' Son may add depth to our understanding of the subjective experience of schizophrenia and recovery, and also may serve as one example in which the study of humanities offers an opportunity to explore the human elements in the most profound forms of suffering. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Bayreuth Productivity Analysis-a method for ascertaining and improving the holistic service productivity of acute care hospitals.

Science.gov (United States)

Pfannstiel, Mario Alexander

2016-01-01

The healthcare sector is lacking a method with which hospitals can measure the extent to which they achieve their goals in terms of aggregate productivity from both patients' and employees' perspectives. The Bayreuth Productivity Analysis (BPA) provides a solution to this problem because it uses two standardized questionnaires-one for patients and one for employees-to ascertain productivity at hospitals. These questionnaires were developed in several steps according to the principles of classical test theory, and they consist of six dimensions (information, organization, climate, methods, infrastructure and equipment) of five items each. One item describes a factual situation relevant to productivity and services so that it makes a contribution to the overall productivity of a hospital. After individualized evaluation of these items, the dimensions are subjectively weighted in the two questionnaires. The productivity index thus ascertained can be considered "holistic" when all patients and employees in a hospital make a differentiated assessment and weigh off each of the dimensions. In conclusion, the BPA constitutes a simple yet practicable method to ascertain and improve the holistic service productivity of hospitals. Copyright © 2014 John Wiley & Sons, Ltd.

Managerial performance and cost efficiency of Japanese local public hospitals: a latent class stochastic frontier model.

Science.gov (United States)

Besstremyannaya, Galina

2011-09-01

The paper explores the link between managerial performance and cost efficiency of 617 Japanese general local public hospitals in 1999-2007. Treating managerial performance as unobservable heterogeneity, the paper employs a panel data stochastic cost frontier model with latent classes. Financial parameters associated with better managerial performance are found to be positively significant in explaining the probability of belonging to the more efficient latent class. The analysis of latent class membership was consistent with the conjecture that unobservable technological heterogeneity reflected in the existence of the latent classes is related to managerial performance. The findings may support the cause for raising efficiency of Japanese local public hospitals by enhancing the quality of management. Copyright © 2011 John Wiley & Sons, Ltd.

Factors associated with job satisfaction among district hospital health workers in Northern Vietnam: a cross-sectional study.

Science.gov (United States)

Nguyen, Huy Van; Duong, Huong Thao; Vu, Toan Thinh

2017-04-01

In many developing countries, including Vietnam, little is known about job satisfaction among lower level-health staff. The purpose of this study was to assess job satisfaction and its determinants among district hospital health staff. In a cross-sectional quantitative study, 128 health staff from a rural district hospital in Northern Vietnam were approached for data collection. Regression techniques were adopted to assess factors associated with several types of job satisfaction. Overall job satisfaction was moderately high, ranging from 69% to 91%. Across all dimensions, health workers showed their highest satisfaction with co-worker relationships, while, in comparison, it was much lower for their supervisor's style and relationship. However, they claimed their lowest satisfaction with compensation and benefits. In final multivariate models, females and those satisfied with knowledge, skills and job performance were most likely to be satisfied with relationships with co-workers. Staff who were married, received a low pay, who were not satisfied with supervisor style and relationships and who were not satisfied with staff training, development opportunities were least likely to be satisfied with compensation and benefits. The study findings highlight an important need for designing an intervention program that considers organizational factors. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Adoption of high technology medical imaging and hospital quality and efficiency: Towards a conceptual framework.

Science.gov (United States)

Sandoval, Guillermo A; Brown, Adalsteinn D; Wodchis, Walter P; Anderson, Geoffrey M

2018-05-17

Measuring the value of medical imaging is challenging, in part, due to the lack of conceptual frameworks underlying potential mechanisms where value may be assessed. To address this gap, this article proposes a framework that builds on the large body of literature on quality of hospital care and the classic structure-process-outcome paradigm. The framework was also informed by the literature on adoption of technological innovations and introduces 2 distinct though related aspects of imaging technology not previously addressed specifically in the literature on quality of hospital care: adoption (a structural hospital characteristic) and use (an attribute of the process of care). The framework hypothesizes a 2-part causality where adoption is proposed to be a central, linking factor between hospital structural characteristics, market factors, and hospital outcomes (ie, quality and efficiency). The first part indicates that hospital structural characteristics and market factors influence or facilitate the adoption of high technology medical imaging within an institution. The presence of this technology, in turn, is hypothesized to improve the ability of the hospital to deliver high quality and efficient care. The second part describes this ability throughout 3 main mechanisms pointing to the importance of imaging use on patients, to the presence of staff and qualified care providers, and to some elements of organizational capacity capturing an enhanced clinical environment. The framework has the potential to assist empirical investigations of the value of adoption and use of medical imaging, and to advance understanding of the mechanisms that produce quality and efficiency in hospitals. Copyright © 2018 John Wiley & Sons, Ltd.

Everything moves on: referral trends to a leavers' group in a high secure hospital and trial leave progress of group graduates.

Science.gov (United States)

Adshead, Gwen; Pyszora, Natalie; Wilson, Claire; Gopie, Ramesh; Thomas, Deryk; Smith, Julia; Glorney, Emily; Moore, Estelle; Tapp, James

2017-04-01

Moving on from high secure psychiatric care can be a complex and potentially stressful experience, which may hinder progression. A leavers' group in a UK high secure hospital is offered to support patients with this transition. The aims of this study are to investigate characteristics of patients referred for the leavers' group and compare outcomes for leavers' group graduates with those for patients who never attended a leavers' group for any reason. A retrospective quasi-experimental design was applied to data extracted from various records sources - within and outside the high security hospital. About one-fifth of patients who left the hospital on trial leave during the study were referred to the leavers' group (N = 109). Referred patients were significantly more likely to have either been admitted from another high-security hospital or transferred from prison for treatment and have a diagnosis of paranoid schizophrenia. Patients not referred had a significantly higher rate of previously refusing to participate in groups. There was a tendency for rate of return from trial leave for group graduates to be lower than that of patients who did not attend the leavers' group, but this just failed to reach statistical significance (rate ratio [RR] = 1.04; CI 0.97-1.11). A leavers' group appeared to be a valued therapy option for people who had spent a long time in high secure psychiatric care, or those who continued to require hospital treatment beyond prison tariffs. There was a low return rate from trial leave, which made the evaluation of this outcome difficult. A detailed study into both the reasons for return from trial leave and successes would provide further information on ideal preparation for moving on. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Parents' perceptions of their adolescent sons' recovery in a therapeutic community for addicted clients.

Science.gov (United States)

Chen, Gila; Elisha, Ety; Timor, Uri; Ronel, Natti

2013-11-01

A qualitative phenomenological study of parents of addicted male adolescents who were residents of a Jewish therapeutic community (TC) describes and interprets the parents' perceptions of the recovery process. Deep, semistructured interviews with 14 parents provided the data. The parents' perceptions were clustered into three main themes of meaning: (a) the process of change, (b) the experiences of family members in the course of the son's recovery process, and (c) the parents' perception of the treatment at Retorno. According to the parents, the admission of their sons into the TC brought notable relief to the family life, which enabled the whole family to begin a recovery process. The findings support the positive criminology perspective that emphasizes the disintegration-integration vector as significant in the recovery process. Recommendations for intervention planning are provided.

The Quest for the Whole in D. H. Lawrence’s Sons and Lovers

Directory of Open Access Journals (Sweden)

Nesar Uddin

2013-10-01

Full Text Available David Herbert Lawrence portrays a complex husband-wife, mother-son, and man-woman relationship in his novel Sons and Lovers. This article studied the relational motifs of the major character Paul Morel with other characters and the dire upshot resulting from this relation. The study found that Paul strove for happiness through the concerted entertainment of body and soul with his beloved people, but he failed because his mother’s unusual attachment to him negatively impacted on his building up a normal relation with others. Mother’s failure to find happiness in her conjugal life led her to pouring her love into Paul, exploiting him, making him sub-serve her own need and denying him the right to his own independent life. As a result, the son’s relation with other women proved a disastrous failure. The women with whom Paul had relation underwent part of the sufferings somehow or other. Finally, Mother’s death made him hopeless and left his life in nothingness.

Borgring sæson 1 - Vold, brand og ødelæggelse

DEFF Research Database (Denmark)

Ulriksen, Jens; Christensen, Jonas; Holm, Nanna

2017-01-01

Sæson 1 af Borgringprojektet er overstået – i hvert fald i marken. Efter måneders planlægning, både blandt arkæologer og formidlingsfolk, kunne Hendes Majestæt Dronningen officielt åbne den publikumsorienterede del af forskningsprojektet den sidste dag i maj 2016. Gennem de følgende tre måneder bl...

Do diagnosis-related group-based payments incentivise hospitals to adjust output mix?

Science.gov (United States)

Liang, Li-Lin

2015-04-01

This study investigates whether the diagnosis-related group (DRG)-based payment method motivates hospitals to adjust output mix in order to maximise profits. The hypothesis is that when there is an increase in profitability of a DRG, hospitals will increase the proportion of that DRG (own-price effects) and decrease those of other DRGs (cross-price effects), except in cases where there are scope economies in producing two different DRGs. This conjecture is tested in the context of the case payment scheme (CPS) under Taiwan's National Health Insurance programme over the period of July 1999 to December 2004. To tackle endogeneity of DRG profitability and treatment policy, a fixed-effects three-stage least squares method is applied. The results support the hypothesised own-price and cross-price effects, showing that DRGs which share similar resources appear to be complements rather substitutes. For-profit hospitals do not appear to be more responsive to DRG profitability, possibly because of their institutional characteristics and bonds with local communities. The key conclusion is that DRG-based payments will encourage a type of 'product-range' specialisation, which may improve hospital efficiency in the long run. However, further research is needed on how changes in output mix impact patient access and pay-outs of health insurance. Copyright © 2014 John Wiley & Sons, Ltd.

In-hospital costs associated with chronic constipation in Belgium: a retrospective database study.

Science.gov (United States)

Chevalier, P; Lamotte, M; Joseph, A; Dubois, D; Boeckxstaens, G

2014-03-01

Real-life data on the economic burden of chronic idiopathic constipation are scarce. The objectives of this study were to assess hospitalization resource use and costs associated with chronic constipation and its complications in Belgium. This was a single country, retrospective study using the IMS Hospital Disease Database (2008), which comprises data on 34% of acute hospital beds in Belgium and contains information on patient demographics, length of stay (LOS), billed costs, drug use, diagnoses, and procedures. Stays with a primary diagnosis of constipation, or a secondary diagnosis of constipation and a concomitant diagnosis of a constipation-related complication, were selected. Patients with diagnoses of colorectal cancer, ulcerative colitis or Crohn's disease, or who had stays involving potentially constipation-inducing procedures, were excluded as having secondary constipation. Patients receiving opioids, calcium-antagonists, antipsychotics or antidepressants were excluded as having drug-induced constipation. In total, 1541 eligible patients were identified. The average unadjusted cost per day in hospital for idiopathic constipation was €441 (€311 ± 1.4 in day clinic visits without overnight stays; €711 ± 14.0 in full hospitalizations with complications). The average LOS in a full hospitalization setting was 7.0 and 4.0 days in stays with and without complications, respectively. The most frequent drug and procedural treatments were osmotically acting laxatives (with complications: 42.61%; without complications: 35.69%), and transanal enema (2.32% and 2.03%), respectively. The burden of constipation is often underestimated; it is a condition reflected by hospital-related costs comparable to such indications as migraine, which increase when associated with complications. © 2013 The Authors. Neurogastroenterology & Motility Published by John Wiley & Sons Ltd.

Power and resistance within the hospital's hierarchical system: the experiences of chronically ill patients.

Science.gov (United States)

Griscti, Odette; Aston, Megan; Warner, Grace; Martin-Misener, Ruth; McLeod, Deborah

2017-01-01

To explore experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings. Specifically, we explored how social and institutional discourses shape power relations during the negotiation process. The hospital system is embedded in a hierarchical structure where the voice of the healthcare provider as expert is often given more importance than the patient. This system has been criticised as being oppressive to patients who are perceived to be lower in the hierarchy. In this study, we illustrate how the hospital's hierarchical system is not always oppressing but can also create moments of empowerment for patients. A feminist poststructuralist approach informed by the teaching of Foucault was used to explore power relations between nurses and patients when negotiating patient care in hospital settings. Eight individuals who suffered from chronic illness shared their stories about how they negotiated their care with nurses in hospital settings. The interviews were tape-recorded. Discourse analysis was used to analyse the data. Patients recounted various experiences when their voices were not heard because the current hospital system privileged the healthcare provider experts' advice over the patients' voice. The hierarchical structure of hospital supported these dynamics by privileging nurses as gatekeepers of service, by excluding the patients' input in the nursing notes and through a process of self-regulation. However, patients in this study were not passive recipients of care and used their agency creatively to resist these discourses. Nurses need to be mindful of how the hospital's hierarchical system tends to place nurses in a position of power, and how their authoritative position may positively or adversely affect the negotiation of patient care. © 2016 John Wiley & Sons Ltd.

Disclosing discourses: biomedical and hospitality discourses in patient education materials.

Science.gov (United States)

Öresland, Stina; Friberg, Febe; Määttä, Sylvia; Öhlen, Joakim

2015-09-01

Patient education materials have the potential to strengthen the health literacy of patients. Previous studies indicate that readability and suitability may be improved. The aim of this study was to explore and analyze discourses inherent in patient education materials since analysis of discourses could illuminate values and norms inherent in them. Clinics in Sweden that provided colorectal cancer surgery allowed access to written information and 'welcome letters' sent to patients. The material was analysed by means of discourse analysis, embedded in Derrida's approach of deconstruction. The analysis revealed a biomedical discourse and a hospitality discourse. In the biomedical discourse, the subject position of the personnel was interpreted as the messenger of medical information while that of the patients as the carrier of diagnoses and recipients of biomedical information. In the hospitality discourse, the subject position of the personnel was interpreted as hosts who invite and welcome the patients as guests. The study highlights the need to eliminate paternalism and fosters a critical reflective stance among professionals regarding power and paternalism inherent in health care communication. © 2015 John Wiley & Sons Ltd.

Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010.

Science.gov (United States)

Bhuiyan, Mejbah U; Luby, Stephen P; Alamgir, Nadia I; Homaira, Nusrat; Mamun, Abdullah A; Khan, Jahangir A M; Abedin, Jaynal; Sturm-Ramirez, Katharine; Gurley, Emily S; Zaman, Rashid U; Alamgir, A S M; Rahman, Mahmudur; Widdowson, Marc-Alain; Azziz-Baumgartner, Eduardo

2014-07-01

Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh. From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010. We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010. In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons

Multivariate Multiple Regression Models for a Big Data-Empowered SON Framework in Mobile Wireless Networks

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Yoonsu Shin

2016-01-01

Full Text Available In the 5G era, the operational cost of mobile wireless networks will significantly increase. Further, massive network capacity and zero latency will be needed because everything will be connected to mobile networks. Thus, self-organizing networks (SON are needed, which expedite automatic operation of mobile wireless networks, but have challenges to satisfy the 5G requirements. Therefore, researchers have proposed a framework to empower SON using big data. The recent framework of a big data-empowered SON analyzes the relationship between key performance indicators (KPIs and related network parameters (NPs using machine-learning tools, and it develops regression models using a Gaussian process with those parameters. The problem, however, is that the methods of finding the NPs related to the KPIs differ individually. Moreover, the Gaussian process regression model cannot determine the relationship between a KPI and its various related NPs. In this paper, to solve these problems, we proposed multivariate multiple regression models to determine the relationship between various KPIs and NPs. If we assume one KPI and multiple NPs as one set, the proposed models help us process multiple sets at one time. Also, we can find out whether some KPIs are conflicting or not. We implement the proposed models using MapReduce.

BALTIMORE’S M.S. LEVY AND SONS: Straw Hat Makers to the World, 1870-1960

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Jessica I. Elfenbein

2008-01-01

Full Text Available From 1860 to 1960, Baltimore was an important center of the men’s ready-to- wear clothing industries. German-speaking Jews created many businesses that manufactured and sold underwear, men’s suits, and specialty items like hats and umbrellas. The straw hat making firm started by M.S. Levy is an interesting example of a Baltimore-based, family-owned niche business that existedfor 90 years, through three generations ofa singlefamily. The M.S. Levy and Sons story has two main chapters. The first covers the period from its founding by Michael Simon Levy in the 1870s through his son Julius’ death in 1926. This is the story of ascension. A premonition about the coming popularity of straw hats, together with a small but important technological breakthrough, positioned a family and a small industry for significant expansion. The second period began in 1930 with the introduction of wool felt hats and the death of William, M.S. Levy’s oldest son, and includes the Great Depression, unionization, merger, third generation leadership, and finally, in 1959, the family’s withdrawal from the industry. This later period, as told by grandsons of the founder, is the story of struggle followed by decline.

The iron swords from the necropolis of Son Pellisser; preliminary advance

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Agustín Fernández Mártinez

2016-11-01

Full Text Available This paper submits the iron swords from the necropolis of Son Pellisser (Calvià-Majorca. Although the materials that we find are numerous and still under research offer a preliminary study about three imported swords, found in burial objects, also their possible origin and way of introduction on the island. These weapons could be the first archaeological evidence that the Balearic mercenaries participated in the Wars of Sicily, between Carthaginians and Greeks, from the fifth century BC.

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%.

From Here to There and Back Again: The Story of a Mother, Her Son, Disability, and School Choice

Science.gov (United States)

Mann, Glenys

2016-01-01

Nelly and her children live in Queensland, Australia. When it came time for her second youngest son to start school, Nelly was not prepared for the difficulty that she had enrolling him at the school of her choice. In spite of her son's disability, Nelly thought that it was natural that he would go to his local school with his sister. It is not…

Designing a balanced scorecard for a tertiary care hospital in Pakistan: a modified Delphi group exercise.

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Rabbani, Fauziah; Jafri, Syed M Wasim; Abbas, Farhat; Shah, Mairaj; Azam, Syed Iqbal; Shaikh, Babar Tasneem; Brommels, Mats; Tomson, Goran

2010-01-01

Balanced Scorecards (BSC) are being implemented in high income health settings linking organizational strategies with performance data. At this private university hospital in Pakistan an elaborate information system exists. This study aimed to make best use of available data for better performance management. Applying the modified Delphi technique an expert panel of clinicians and hospital managers reduced a long list of indicators to a manageable size. Indicators from existing documents were evaluated for their importance, scientific soundness, appropriateness to hospital's strategic plan, feasibility and modifiability. Panel members individually rated each indicator on a scale of 1-9 for the above criteria. Median scores were assigned. Of an initial set of 50 indicators, 20 were finally selected to be assigned to the four BSC quadrants. These were financial (n = 4), customer or patient (n = 4), internal business or quality of care (n = 7) and innovation/learning or employee perspectives (n = 5). A need for stringent definitions, international benchmarking and standardized measurement methods was identified. BSC compels individual clinicians and managers to jointly work towards improving performance. This scorecard is now ready to be implemented by this hospital as a performance management tool for monitoring indicators, addressing measurement issues and enabling comparisons with hospitals in other settings. Copyright 2010 John Wiley & Sons, Ltd.

The (un) making of a man: fathers and sons in the African novel

African Journals Online (AJOL)

Lipenga

This perspective enables a reading of the texts as not merely depicting ... level, these texts reveal a structural trend where the relationship between the .... recipient of the teaching of masculinity, as Okonkwo's adopted son. .... from a feminist point of view, but in Mapungubwe, the norm is that a woman ..... critical dualism.

Le glaive et la chair : le pouvoir et son incarnation au temps des derniers Valois

OpenAIRE

Roux, Nicolas Le

2014-01-01

Au xvie siècle, pouvait-on concevoir la monarchie autrement qu’incarnée ? Servir le roi, c’était servir un prince auquel on était lié personnellement, et non une institution abstraite. Le monarque devait apparaître comme un compagnon pour la noblesse militaire. Henri II représentait le modèle du roi chevalier. Contrairement à son père, Charles IX ne faisait pas la guerre, mais il épuisait son corps dans d’interminables chasses. Henri III a tenu dans sa jeunesse le rôle de chef de guerre. Deve...

Female babies and risk-aversion: Causal evidence from hospital wards.

Science.gov (United States)

Pogrebna, Ganna; Oswald, Andrew J; Haig, David

2018-03-01

Using ultrasound scan data from paediatric hospitals, and the exogenous 'shock' of learning the gender of an unborn baby, the paper documents the first causal evidence that offspring gender affects adult risk-aversion. On a standard Holt-Laury criterion, parents of daughters, whether unborn or recently born, become almost twice as risk-averse as parents of sons. The study demonstrates this in longitudinal and cross-sectional data, for fathers and mothers, for babies in the womb and new-born children, and in a West European nation and East European nation. These findings may eventually aid our understanding of risky health behaviors and gender inequalities. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

Knowledge, compliance with good clinical practices and barriers to effective control of postoperative pain among nurses from hospitals with and without a "Hospital without Pain" certificate.

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Tomaszek, Lucyna; Dębska, Grażyna

2018-04-01

(i) To compare knowledge and compliance with good clinical practices regarding control of postoperative pain among nurses employed at hospitals with and without a "Hospital without Pain" certificate, (ii) to identify the determinants of nurses' knowledge and (iii) to define barriers to effective control of postoperative pain. Only a slight improvement in postoperative pain control has been observed recently, if any. Implementation of good clinical practices in the control of postoperative pain requires involvement of nurses. A cross-sectional study. The study included 257 nurses from hospitals with a "Hospital without Pain" certificate and 243 nurses from noncertified hospitals, with mean job seniority of 17.6 ± 9.6 years. All respondents answered 26 questions regarding postoperative pain control-related issues. Based on the answers, overall scores were calculated for (i) nurses' knowledge, (ii) compliance with good clinical practices and (iii) barriers to effective control of postoperative pain. Nurses from the certified hospitals presented with significantly higher levels of knowledge and compliance with good clinical practices and identified significantly more barriers to effective control of postoperative pain. Apart from certification of a hospital, better knowledge of postoperative pain control was determined by higher education, participation in postgraduate training programmes and other relevant courses, self-education from medical journals, employment at paediatric ward or intensive care unit. The most commonly reported barriers to effective control of pain included too low doses of painkillers prescribed by physicians and inability to modify the protocol of pain treatment by the nurse. Control of postoperative pain can be improved by enrolling nurses in various forms of continuous training and by providing them with greater autonomy in administering painkillers to surgical patients. Better quality of care offered to patients with postoperative pain

The consumers' social media use in choosing physicians and hospitals: the case study of the province of Izmir.

Science.gov (United States)

Tengilimoglu, Dilaver; Sarp, Nilgün; Yar, Cemre Eda; Bektaş, Meral; Hidir, Mehmet Nil; Korkmaz, Esin

2017-01-01

Manifested as a reflection of the Internet technology progress, web 2.0 has transformed communication among people to different dimensions while increasing the social use of Internet. Thus, the concept of social media has entered our lives. Blogs, forums, Facebook, Twitter and YouTube applications are but few of the social media platforms with active users exceeding millions. As in many other subjects, these and others are also environments where people share information and their positive or negative experiential views with respect to healthcare issues and services. Hence, the social media communication and exchange of information are deemed influential on the process of receiving health services. In the present study that aims to determine social media use of individuals in their choice of physicians, dentists and hospitals, a survey, as a data collection instrument, has been carried out to 947 residents of the province of Izmir. Individuals participating in the study have stated that they have used social media in choosing a physician (41.9% of the participants), dentist (34.1% of the participants) and hospitals (41.7% of the participants). The study has revealed that individuals are affected by social media in their healthcare choices. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Transgenerational effects of nutrition are different for sons and daughters.

Science.gov (United States)

Zizzari, Z V; van Straalen, N M; Ellers, J

2016-07-01

Food shortage is an important selective factor shaping animal life-history trajectories. Yet, despite its role, many aspects of the interaction between parental and offspring food environments remain unclear. In this study, we measured developmental plasticity in response to food availability over two generations and tested the relative contribution of paternal and maternal food availability to the performance of offspring reared under matched and mismatched food environments. We applied a cross-generational split-brood design using the springtail Orchesella cincta, which is found in the litter layer of temperate forests. The results show adverse effects of food limitation on several life-history traits and reproductive performance of both parental sexes. Food conditions of both parents contributed to the offspring phenotypic variation, providing evidence for transgenerational effects of diet. Parental diet influenced sons' age at maturity and daughters' weight at maturity. Specifically, being born to food-restricted parents allowed offspring to alleviate the adverse effects of food limitation, without reducing their performance under well-fed conditions. Thus, parents raised on a poor diet primed their offspring for a more efficient resource use. However, a mismatch between maternal and offspring food environments generated sex-specific adverse effects: female offspring born to well-fed mothers showed a decreased flexibility to deal with low-food conditions. Notably, these maternal effects of food availability were not observed in the sons. Finally, we found that the relationship between age and size at maturity differed between males and females and showed that offspring life-history strategies in O. cincta are primed differently by the parents. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

Nurse-physician collaboration impacts job satisfaction and turnover among nurses: A hospital-based cross-sectional study in Beijing.

Science.gov (United States)

Zhang, Lin; Huang, Lei; Liu, Meng; Yan, Hong; Li, Xiue

2016-06-01

This study aims to explore the impact of physician-nurse collaboration on nurse job satisfaction and turnover in a dental hospital. Physician-nurse collaboration is important for the stability of the entire nursing team. Few studies have shown the impact on job satisfaction and turnover among nurses working in Chinese dental hospitals. This was a prospective, cross-sectional study and investigated nurses from a tertiary dental hospital in Beijing using convenience non-randomized sampling. A structured questionnaire was used to collect data, which included general information, the Index of Work Satisfaction, the Nurse-Physician Collaboration Scale and the Turnover Intention Scale. The scores of physician-nurse collaboration correlated positively with those for job satisfaction and negatively with the stated likelihood of turnover intention. Physician-nurse collaboration scores positively predicted job satisfaction and negatively predicted the likelihood of quitting the current job. In conclusion, improving the level of physician-nurse collaboration is helpful to enhance job satisfaction and reduce turnover among nurses in a dental hospital. © 2016 John Wiley & Sons Australia, Ltd.

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.

Water immersion during labor and birth: is there an extra cost for hospitals?

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Poder, Thomas G

2017-06-01

Water immersion during labor and birth is growing in popularity, and many hospitals are now considering offering this service to laboring women. Some advantages of water immersion are demonstrated, but others remain uncertain, and particularly, few studies have examined the financial impact of such a device on hospitals. This study simulated what could be the extra cost of water immersion for hospitals. Clinical outcomes were drawn from the results of systematic reviews already published, and cost units were those used in the Quebec health network. A decision tree was used with microsimulations of representative laboring women. Sensitivity analyses were performed as regards analgesic use and labor duration. Microsimulations indicated an extra cost between $166.41 and $274.76 (2014 Canadian dollars) for each laboring woman as regards the scenario considered. The average extra cost was $221.12 (95% confidence interval, 219.97-222.28). While water immersion allows better clinical outcomes, implementation and other costs are higher than the savings generated, which leads to a small extra cost to allow women to potentially have more relaxation and less pain. © 2016 John Wiley & Sons, Ltd.

Perinatal outcomes and travel time from home to hospital: Welsh data from 1995 to 2009.

Science.gov (United States)

Paranjothy, Shantini; Watkins, W John; Rolfe, Kim; Adappa, Roshan; Gong, Yi; Dunstan, Frank; Kotecha, Sailesh

2014-12-01

To study the association between travel time from home to hospital and birth outcomes. For all registrable births to women resident in Wales (1995-2009), we calculated the travel time between the mother's residence and the postcode-based location for both the birth hospital and all hospitals with maternity services that were open. Using logistic regression, we obtained odds ratios for the association between travel time and each birth outcome, adjusted for confounders. In our analysis of 412 827 singleton births, for every 15-min increase in travel time to the birth hospital, there was an increased risk of early (n = 609; OR: 1.13; 95%CI: 1.07, 1.20) and late neonatal death (n = 251; OR: 1.15; 95%CI: 1.05, 1.26). Results for intrapartum stillbirth were inconclusive (n = 135; OR: 1.13; 95%CI: 0.98, 1.30). For the above-combined (n = 995) results, we get OR: 1.15, 95%CI: 1.09, 1.20. No association was found with travel time to the nearest hospital (OR: 1.01; 95%CI: 0.90, 1.13 per 15-min increase in travel time) for the composite outcome of intrapartum stillbirth and neonatal deaths. Longer travel time to the birth hospital was associated with increased risk of neonatal deaths, but there was no strong evidence of association with the geographical location of maternity services. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

When the Least Restrictive Environment is Residential: Meeting the Needs of Our Son

Science.gov (United States)

Morris, Djenne-Amal

2013-01-01

In this article, the author, a parent of Malik, a special needs child with CHARGE Syndrome, describes the difficulties she encountered with her local educational agency (LEA) in transitioning her son from the Perkins School for the Blind in Watertown, Massachusetts to the Eastern North Carolina School for the Deaf (ENCSD). At ENCSD, Malik now…

Ahn and Son Afr J Tradit Complement Altern Med. (2014) 11(1):28 ...

African Journals Online (AJOL)

cadewumi

Ahn and Son Afr J Tradit Complement Altern Med. (2014) 11(1):28-29 ... The comparisons of the frequency and choice of functional supplements were analysed using Chi-square test with. SPSS (SPSSs 18.0K for ... Significant difference of choice for functional supplements was observed between male and female (p < 0.01) ...

Down syndrome as risk factor for respiratory syncytial virus hospitalization: A prospective multicenter epidemiological study.

Science.gov (United States)

Sánchez-Luna, Manuel; Medrano, Constancio; Lirio, Julián

2017-03-01

Respiratory syncytial virus (RSV) infection in childhood, particularly in premature infants, is associated with significant morbidity and mortality. To compare the hospitalization rates due to RSV infection and severity of disease between infants with and without Down syndrome (DS) born at term and without other associated risk factors for severe RSV infection. In a prospective multicentre epidemiological study, 93 infants were included in the DS cohort and 68 matched by sex and data of birth (±1 week) and were followed up to 1 year of age and during a complete RSV season. The hospitalization rate for all acute respiratory infection was significantly higher in the DS cohort than in the non-DS cohort (44.1% vs 7.7%, P<.0001). Hospitalizations due to RSV were significantly more frequent in the DH cohort than in the non-DS cohort (9.7% vs 1.5%, P=.03). RSV prophylaxis was recorded in 33 (35.5%) infants with DS. The rate of hospitalization according to presence or absence of RSV immunoprophylaxis was 3.0% vs 15%, respectively. Infants with DS showed a higher rate of hospitalization due to acute lower respiratory tract infection and RSV infection compared to non-DS infants. Including DS infants in recommendations for immunoprophylaxis of RSV disease should be considered. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Young Children’s Risk-Taking: Mothers’ Authoritarian Parenting Predicts Risk-Taking by Daughters but Not Sons

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Erin E. Wood

2017-01-01

Full Text Available We investigated how mothers’ parenting behaviors and personal characteristics were related to risk-taking by young children. We tested contrasting predictions from evolutionary and social role theories with the former predicting higher risk-taking by boys compared to girls and the latter predicting that mothers would influence children’s gender role development with risk-taking occurring more in children parented with higher levels of harshness (i.e., authoritarian parenting style. In our study, mothers reported their own gender roles and parenting styles as well as their children’s risk-taking and activities related to gender roles. The results were only partially consistent with the two theories, as the amount of risk-taking by sons and daughters did not differ significantly and risk-taking by daughters, but not sons, was positively related to mothers’ use of the authoritarian parenting style and the girls’ engagement in masculine activities. Risk-taking by sons was not predicted by any combination of mother-related variables. Overall, mothers who were higher in femininity used more authoritative and less authoritarian parenting styles. Theoretical implications as well as implications for predicting and reducing children’s risk-taking are discussed.

The impact of single and shared rooms on family-centred care in children's hospitals.

Science.gov (United States)

Curtis, Penny; Northcott, Andy

2017-06-01

To explore whether and how spatial aspects of children's hospital wards (single and shared rooms) impact upon family-centred care. Family-centred care has been widely adopted in paediatric hospitals internationally. Recent hospital building programmes in many countries have prioritised the provision of single rooms over shared rooms. Limited attention has, however, been paid to the potential impact of spatial aspects of paediatric wards on family-centred care. Qualitative, ethnographic. Phase 1; observation within four wards of a specialist children's hospital. Phase 2; interviews with 17 children aged 5-16 years and 60 parents/carers. Sixty nursing and support staff also took part in interviews and focus group discussions. All data were subjected to thematic analysis. Two themes emerged from the data analysis: 'role expectations' and 'family-nurse interactions'. The latter theme comprised three subthemes: 'family support needs', 'monitoring children's well-being' and 'survey-assess-interact within spatial contexts'. Spatial configurations within hospital wards significantly impacted upon the relationships and interactions between children, parents and nurses, which played out differently in single and shared rooms. Increasing the provision of single rooms within wards is therefore likely to directly affect how family-centred care manifests in practice. Nurses need to be sensitive to the impact of spatial characteristics, and particularly of single and shared rooms, on families' experiences of children's hospital wards. Nurses' contribution to and experience of family-centred care can be expected to change significantly when spatial characteristics of wards change and, as is currently the vogue, hospitals maximise the provision of single rather than shared rooms. © 2016 John Wiley & Sons Ltd.

The Son's Fault: Martin Luther King, Jr.'s Search for and Recovery of Sonship.

Science.gov (United States)

Hinds, Jay-Paul

2018-04-01

This article examines the role of sonship in the psychological and spiritual development of men. In using the methodology of psychobiography, I explore the life history of Martin Luther King, Jr. to analyze his search for and recovery of sonship. I propose that sonship helps men rebel against and, in the end, overcome the feelings of inadequacy that are experienced in their struggles to achieve manhood, particularly within the father-son dyad. The scholarship of pastoral theologian Donald Capps is instructive in this regard, in that he suggests that sons should be allowed to search for a male figure, a father-substitute, who can affirm, not disdain or reject, this state of sonship. In the end, what is often viewed as a negative act of regression-i.e., the recovery of and return to sonship-is recognized instead as a positive one that assists a man in his journey toward wholeness.

Hospital nurses' wellbeing at work: a theoretical model.

Science.gov (United States)

Utriainen, Kati; Ala-Mursula, Leena; Kyngäs, Helvi

2015-09-01

To develop a theoretical model of hospital nurses' wellbeing at work. The concept of wellbeing at work is presented without an exact definition and without considering different contents. A model was developed in a deductive manner and empirical data collected from nurses (n = 233) working in a university hospital. Explorative factor analysis was used. The main concepts were: patients' experience of high-quality care; assistance and support among nurses; nurses' togetherness and cooperation; fluent practical organisation of work; challenging and meaningful work; freedom to express diverse feelings in the work community; well-conducted everyday nursing; status related to the work itself; fair and supportive leadership; opportunities for professional development; fluent communication with other professionals; and being together with other nurses in an informal way. Themes included: collegial relationships; enhancing high-quality patient care; supportive and fair leadership; challenging, meaningful and well organised work; and opportunities for professional development. Object-dependent wellbeing was supported. Managers should focus on strengthening the positive aspect of wellbeing at work, focusing on providing fluently organised work practices, fair and supportive leadership and togetherness while allowing nurses to implement their own ideas and promote the experience of meaningfulness. © 2014 John Wiley & Sons Ltd.

A Female Patient with FMR1 Premutation and Mosaic X Chromosome Aneuploidy and Two Sons with Intellectual Disability.

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Galanina, Ekaterina M; Tulupov, Andrey A; Lemskaya, Natalya A; Korostyshevskaya, Aleksandra M; Maksimova, Yuliya V; Shorina, Asia R; Savelov, Andrey A; Sergeeva, Irina G; Isanova, Evgeniya R; Grishchenko, Irina V; Yudkin, Dmitry V

2017-03-01

In this report, we describe a molecular cytogenetic study of a family burdened with intellectual disability (ID) and suicide. Our study revealed that the mother has a heterozygous premutation in the FMR1 gene and supernumerary X chromosomes as well as X-derived marker chromosomes. Both of her sons have ID and a normal chromosome number. One of the sons has fragile X syndrome, and the other has ID of an unclear nature.

LA PREPARACIÓN HOSPITALARIA PARA ENFRENTAR HURACANES.LA EXPERIENCIA DE UN HOSPITAL CUBANO.

OpenAIRE

Marcos D. Iraola Ferrer; Pedro Ordúñez García

2005-01-01

RESUMEN:Este trabajo resumen los puntos clave de la preparación para enfrentar los desastres solo en el ámbito hospitalario específicamente la preparación para enfrentar huracanes desde la perspectiva de un hospital situado en un país del Caribe. En Cuba, estos fenómenos se han venido incrementando en número e intensidad. Los puntos que se describen de la preparación son: la evacuación, la expansión, la clasificación y previsión para el caso de interrupción de servicios exteriores, entre otro...

"Fathers and Sons" in Xenophon's Teaching of the Man Taking Care of Himself

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Pichugina, Victoria; Bezrogov, Vitaly

2017-01-01

This article considers the oeuvre of Xenophon (c.430-354 bc) as providing an insight into the concept of "care of the self" in Greek education. In many of his works the leading characters are men who take care of themselves through education. Addressing the theme of "fathers and sons," Xenophon aimed to show that "care of…

A companionship between strangers - the hospital environment as a challenge in patient-patient interaction in oncology wards.

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Larsen, Lene Søndergård; Larsen, Birte Hedegaard; Birkelund, Regner

2014-02-01

To present an identification and discussion of the impact of the hospital environment on interaction among people with cancer. In recent years, researchers have focused on identifying and describing features of the hospital environment that promote healing, recovery and well-being. It has been discovered that architectural features affect hospitalized patients both positively and negatively. But the research has failed to include fellow patients as part of the hospital environment. A qualitative approach influenced by ethnography. Participant observation and individual qualitative interviews were used to collect data. From a total of 85 observed people with cancer 10 men and 10 women were interviewed. Data were collected over 6 months in 2010-2011 and analysed using inductive thematic analysis. Patients had ambiguous views regarding their fellow patients and the hospital environment. The hospital environment imposed conditions that caused stress factors such as the loss of personal privacy and control, but it also offered the possibility of good company and support from fellow patients. Refuge from fellow patients was hard to achieve and the fact that personal conversations might be overheard by fellow patients caused patients to withhold important information from healthcare professionals. Nevertheless, patients accepted the hospital environment uncritically, with resignation or with silent rebellion. Despite the challenges, 18 of 20 patients preferred multiple-bed rooms with the company of fellow patients. The influence of the hospital environment on hospitalized people with cancer and their interpersonal interaction needs to be acknowledged by healthcare professionals. In addition, evidence-based hospital design must include research into patient preferences and arguments. Further investigation is needed. © 2013 John Wiley & Sons Ltd.

À chacun son puzzle

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Jean-Noël Ferrié

2012-05-01

Full Text Available Le texte soutient que le « tournant naturaliste » que l’on nous invite à négocier ne donne aucun moyen supplémentaire pour parvenir à une description perspicace de ce que les gens font dans des circonstances précises, l’existence humaine pouvant être considérée comme une collection de circonstances précises. Sans doute le naturalisme nous permet-il de comprendre comment certaines actions humaines sont possibles, mais cela ne nous dit pas pourquoi et comment elles font sens pour tout un chacun. La méthodologie nécessaire pour éclaircir le premier point obscurcit généralement le second. Le mieux est donc de considérer que les deux approches ne vont pas de pair. Ce point de vue est soutenu à partir d’exemple tirés de l’anthropologie de la religion.To each one his puzzle. For a serene methodological pluralismThe text argues that the « naturalistic turn » that we are invited to negotiate does not give any additional means to achieve an insightful description of what people do in specific circumstances, and human existence can be considered as a collection of specific circumstances. Probably naturalism allows us to understand how some human actions are possible, but that does not tell us why and how they make sense for everyone. The methodology needed to clarify the first point usually obscures the second one. The best way is to consider that the two approaches do not go together. The text supports this view from an example drawn from the anthropology of religion.A cada uno su rompecabezas. En favor de un pluralismo metodológico serenoEl texto argumenta que la inflexión naturalista a la que se nos invita a participar no proporciona ningún medio suplementario que desemboque en una descripción perspicaz de lo que la gente hace en circunstancias concretas ya que la existencia humana puede ser considerada como una concatenación de circunstancias concretas. Sin duda el naturalismo nos permite comprender como son

Factors associated with recommitment of NGRI acquittees to a forensic hospital.

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Green, Debbie; Belfi, Brian; Griswold, Hali; Schreiber, Jeremy M; Prentky, Robert; Kunz, Michal

2014-09-01

The current archival study assesses risk factors associated with recommitment of 142 individuals adjudicated Not Guilty by Reason of Insanity (NGRI) from civil settings to a forensic hospital in New York State. Within 10 years of transfer from a forensic hospital, 40 (28.2%) were recommitted. Using survival analyses to account for the wide range in opportunity for recommitment, period of transfer (i.e., pre versus post the 1995 case of George L, which clarified factors related to assessments of dangerousness) and the Historical scale and specific items of the HCR-20 emerged as important risk factors for recommitment. Specifically, hazard of recommitment was 2.9 times higher for those with high Historical scores as compared to those with low scores. However, few individual risk factors were associated with recommitment. Prior supervision failure, negative attitude, problems with substance use, and absent or less serious major mental illness and relationship problems were informative in predicting recommitment over 10 and 3 year follow-up periods. Copyright © 2014 John Wiley & Sons, Ltd.

Comparing performance of 30-day readmission risk classifiers among hospitalized primary care patients.

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Garrison, Gregory M; Robelia, Paul M; Pecina, Jennifer L; Dawson, Nancy L

2017-06-01

Hospital readmission within 30 days of discharge occurs in almost 20% of US Medicare patients and may be a marker of poor quality inpatient care, ineffective hospital to home transitions, or disease severity. Within a patient centered medical home, care transition interventions may only be practical from cost and staffing perspectives if targeted at patients with the greatest risk of readmission. Various scoring algorithms attempt to predict patients at risk for 30-day readmission, but head-to-head comparison of performance is lacking. Compare published scoring algorithms which use generally available electronic medical record data on the same set of hospitalized primary care patients. The LACE index, the LACE+ index, the HOSPITAL score, and the readmission risk score were computed on a consecutive cohort of 26,278 hospital admissions. Classifier performance was assessed by plotting receiver operating characteristic curves comparing the computed score with the actual outcome of death or readmission within 30 days. Statistical significance of differences in performance was assessed using bootstrapping techniques. Correct readmission classification on this cohort was moderate with the following c-statistics: Readmission risk score 0.666; LACE 0.680; LACE+ 0.662; and HOSPITAL 0.675. There was no statistically significant difference in performance between classifiers. Logistic regression based classifiers yield only moderate performance when utilized to predict 30-day readmissions. The task is difficult due to the variety of underlying causes for readmission, nonlinearity, and the arbitrary time period of concern. More sophisticated classification techniques may be necessary to increase performance and allow patient centered medical homes to effectively focus efforts to reduce readmissions. © 2016 John Wiley & Sons, Ltd.

Potential barriers to the application of multi-factor portfolio analysis in public hospitals: evidence from a pilot study in the Netherlands.

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Pavlova, Milena; Tsiachristas, Apostolos; Vermaeten, Gerhard; Groot, Wim

2009-01-01

Portfolio analysis is a business management tool that can assist health care managers to develop new organizational strategies. The application of portfolio analysis to US hospital settings has been frequently reported. In Europe however, the application of this technique has received little attention, especially concerning public hospitals. Therefore, this paper examines the peculiarities of portfolio analysis and its applicability to the strategic management of European public hospitals. The analysis is based on a pilot application of a multi-factor portfolio analysis in a Dutch university hospital. The nature of portfolio analysis and the steps in a multi-factor portfolio analysis are reviewed along with the characteristics of the research setting. Based on these data, a multi-factor portfolio model is developed and operationalized. The portfolio model is applied in a pilot investigation to analyze the market attractiveness and hospital strengths with regard to the provision of three orthopedic services: knee surgery, hip surgery, and arthroscopy. The pilot portfolio analysis is discussed to draw conclusions about potential barriers to the overall adoption of portfolio analysis in the management of a public hospital. Copyright (c) 2008 John Wiley & Sons, Ltd.

Pre-hospital emergency anaesthesia in awake hypotensive trauma patients: beneficial or detrimental?

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Crewdson, K; Rehn, M; Brohi, K; Lockey, D J

2018-04-01

The benefits of pre-hospital emergency anaesthesia (PHEA) are controversial. Patients who are hypovolaemic prior to induction of anaesthesia are at risk of severe cardiovascular instability post-induction. This study compared mortality for hypovolaemic trauma patients (without major neurological injury) undergoing PHEA with a patient cohort with similar physiology transported to hospital without PHEA. A retrospective database review was performed to identify patients who were hypotensive on scene [systolic blood pressure (SBP) < 90 mmHg], and GCS 13-15. Patient records were reviewed independently by two pre-hospital clinicians to identify the likelihood of hypovolaemia. Primary outcome measure was mortality defined as death before hospital discharge. Two hundred and thirty-six patients were included; 101 patients underwent PHEA. Fifteen PHEA patients died (14.9%) compared with six non-PHEA patients (4.4%), P = 0.01; unadjusted OR for death was 3.73 (1.30-12.21; P = 0.01). This association remained after adjustment for age, injury mechanism, heart rate and hypovolaemia (adjusted odds ratio 3.07 (1.03-9.14) P = 0.04). Fifty-eight PHEA patients (57.4%) were hypovolaemic prior to induction of anaesthesia, 14 died (24%). Of 43 PHEA patients (42.6%) not meeting hypovolaemia criteria, one died (2%); unadjusted OR for mortality was 13.12 (1.84-578.21). After adjustment for age, injury mechanism and initial heart rate, the odds ratio for mortality remained significant at 9.99 (1.69-58.98); P = 0.01. Our results suggest an association between PHEA and in-hospital mortality in awake hypotensive trauma patients, which is strengthened when hypotension is due to hypovolaemia. If patients are hypovolaemic and awake on scene it might, where possible, be appropriate to delay induction of anaesthesia until hospital arrival. © 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Las computadoras ¿son buenas o malas para los niños?

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Revista Chasqui

2015-01-01

Full Text Available Se trabaja sobre un estudio del Instituo Argentino de Computación. Sobre las computadoras hay criterios opuestos unos las defienden y otros las atacan, pero lo cierto es que éstas no son ni buenas ni malas para los niños. Da a los padres y maestros advertencias sobre los riesgos. Informa sobre el programa Kidkey que ayuda a fijar el tiempo de conexión a Internet.

Detection de la fin de la compaction des anodes par le son

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Sanogo, Bazoumana

L'objectif de ce projet etait de developper un outil de controle en temps reel du temps de compaction en se servant du son genere par le vibrocompacteur pendant le formage des anodes crues. Ainsi, une application a ete developpee pour l'analyse des sons enregistres. Des essais ont ete realises avec differents microphones pour une meilleure qualite des mesures et un a ete choisi pour la suite du projet. De meme, differents tests ont ete realises sur des anodes de laboratoire ainsi que des anodes a l'echelle industrielle afin de mettre en place une methode pour la detection du temps optimal necessaire au formage des anodes. Les travaux au laboratoire de carbone a l'Universite du Quebec a Chicoutimi (UQAC) ont consiste a l'enregistrement de son des anodes fabriquees sur place avec differentes configurations; et a la caracterisation de certaines anodes de l'usine. Les anodes fabriquees au laboratoire sont reparties en deux groupes. Le premier regroupe les anodes pour la validation de notre methode. Ce sont des anodes produites avec des temps de compaction differents. Le laboratoire de carbone a l'UQAC est unique et il est possible de produire des anodes avec les memes proprietes que celles des anodes industrielles. Par consequent, la validation initialement prevue a l'usine a ete effectuee avec les anodes de laboratoire. Le deuxieme groupe a servi a etudier les effets des matieres premieres sur le temps de compaction. Le type de coke et le type de brai ont constitue les differentes variations dans ce deuxieme groupe. Quant aux tests et mesures a l'usine, ils ont ete realises en trois campagnes de mesure. La premiere campagne en juin 2014 a servi a standardiser et a trouver le meilleur positionnement des appareils pour les mesures, a regler le logiciel et a faire les premieres mesures. Une deuxieme campagne en mai 2015 a fait l'objet d'enregistrement de son en classant les anodes selon differents temps de compaction. La troisieme et derniere campagne en decembre 2015 a

Defining the patient safety attitudes and influencing factors of health professionals working at maternity hospitals.

Science.gov (United States)

Tunçer Ünver, Gamze; Harmanci Seren, Arzu Kader

2018-02-27

To determine patient safety attitudes of midwives, nurses and physicians and to examine the difference or correlation in patient safety attitudes of midwives, nurses and physicians working in maternity hospitals. It has been suggested that it is necessary to define the factors affecting patient safety attitudes of health professionals working in maternity hospitals. A descriptive and correlational design was employed.The sample comprised 58 midwives, 134 nurses and 63 physicians (255) in two maternity hospitals in Istanbul, Turkey. The data were collected using an 'information form' and a 'Patient Safety Attitude Questionnaire'. The safety attitudes of participants were generally found to be negative. However, midwives had more positive patient safety attitudes and the age, unit, adequacy of patient safety training and the importance of patient safety were the most effective variables. As health professionals working in maternity hospitals generally have negative patient safety attitudes and because patient safety training provided better attitudes among the participants, these training programmes should be developed and implemented considering the differences among age groups and units. Health professionals have different views on the patient safety culture; therefore, training needs to involve everyone to create a shared vision for patient safety. © 2018 John Wiley & Sons Ltd.

Necesidad de subsistencia de la puerpera y su recién nacido en el hospital San José de Popayán 1992

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Muñoz B. Sandra Felisa

1994-11-01

Full Text Available

Con el fin de investigar que hacen las puérperas que son atendidas en el Hospital San José de Popayán para auto cuidarse durante el puerperio y cuidar a su recién nacido y para satisfacer su necesidad de subsistencia, se eligió un modelo socioeconómico denominado desarrollo a escala humana, planteado por Manfred Max-Neef y otros, puesto que este modelo tiene en cuenta tanto las necesidades existenciales como las necesidades axiológicas que son presentadas en una matriz de necesidades. Este modelo además fomenta y estimula la toma de decisiones creativas por parte de las personas involucradas en el proceso de autocuidado.

Meaning of becoming mother and son/daughter through massage

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Francisca Márquez Doren

2014-06-01

Full Text Available Objective: Revealing the experience of mothers when massaging their children to know the phenomenon in the context of a mother-child healthy development. Method: This is a qualitative study with a phenomenological approach carried out with 11 women who massaged their children and answered the guiding question: What did the experience of massaging your child mean to you? Results: The experience of massaging their children meant the development of their being a mother and of being a son/daughter, in addition to developing the attachment relationship between them. The massage can operationalize this integrality, become a tool of communication, stimulation and promotion of secure attachment, by promoting the loving interaction between mother and child. Conclusion: This practice should be considered as an option in the programs that promote the comprehensive health of the mother and child.

Compared study of the local structure of alteration products of SON 68 glass and natural gels; Etude comparee de la structure locale des produits d'alteration du verre SON 68 et de gels naturels

Energy Technology Data Exchange (ETDEWEB)

Pellegrin, E

2000-07-01

This study is a contribution in the understanding of the long time behavior of alteration products of the glass SON 68, used to simulate the nuclear glass R7T7. The local structure around Zirconium and iron has been probed using X-ray absorption spectroscopy in altered surface layer of glass SON 68. Alteration products of this glass have been prepared for short (3 hours to 7 days) and long (17 months) time, using various indexes of saturation for the leaching solution with respect to the Si content of the glass (from 0 to 90 %). The evolution of the local structure around Fe has also been studied in recent and old natural ferric gels. Zr, Fe- L{sub 2,3} XANES and Zr, Fe-K EXAFS spectroscopies have shown that, in the pristine glass, these elements are connected to the polymeric network. Zr is found in an environment close to that of a zircon-silicate containing Na and Ca. Trivalent Fe is a network former. The leached layer of glass SON 68 is constituted of poorly ordered Zr-and Fe-(oxi-hydr)oxides that may have been formed by a mechanism of dissolution/precipitation; a relict phase with the same Zr local structure as that observed in the pristine glass, probably obtained thanks to in-situ solid condensation. The structural characteristics of the leached layer are observed from the first steps of alteration for Zr and Fe. Conversely to Fe, the structural status of Zr depends on the leaching kinetic as well as the contents of Ca and Si in the solid. Fe-K EXAFS results in recent natural ferri-hydrides present a clear structural similarity with that determined in glass SON 68 leached products. The study of old paleosols (between 1,800 and 200,000 years) has demonstrated the long time stability of ferric gels, although an increase of medium range order around Fe is seen. (author)

Death of a son is associated with risk of suicide among parous women in Taiwan: a nested case-control study.

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Chen, Chih-Cheng; Kuo, Chien-Chun; Wu, Trong-Neng; Yang, Chun-Yuh

2012-01-01

The impact of the sex of a deceased child on maternal suicide has not been studied. We examined whether the death of a child, especially a son, increased the risk of suicide among parous Taiwanese women. This matched case-control study was done within a cohort of 1 292 462 Taiwanese women who experienced a first and singleton childbirth between 1 January 1978 and 31 December 1987 and were followed up until 31 December 2008. From the cohort, 2701 suicide cases were identified and 2701 controls were randomly selected. Multiple logistic regression was used to estimate the risk of suicide associated with the death of a child. The adjusted odds ratios (ORs) for suicide among mothers whose son had died were 2.60 (95% CI = 1.18-5.73), 2.58 (1.28-5.20), and 4.20 (0.79-22.45) for death of a son aged younger than 1 year, 1 to 17 years, and 18 years or older. The ORs for suicide associated with the death of a daughter were not statistically significant: the respective adjusted ORs were 1.86 (0.82-4.62), 1.38 (0.54-3.49), and 2.48 (0.40-15.51). The death of a child, especially a son, increased the risk of maternal suicide, which supports the notion that preference for a son is firmly rooted in traditional Chinese culture.

State supervision of SONS in the mammographic departments

International Nuclear Information System (INIS)

Jursikova, E.; Kodl, O.

2008-01-01

State Office for Nuclear Safety has been performed the state supervision over radiation protection at all mammographic centres in the Czech Republic. Inspections are carried out on the basis of requirements of: Act No. 18/1997 Coll., Atomic Act, subsequently amended; Act No. 552/1991 Coll., Supervision Act, subsequently amended; Decree No. 307 /2002 Coll., On radiation protection, as amended by Decree No. 499/2005 Coll. 137 mammography X-ray units have been used actively by 108 independent licensees since 1 September 2008. The mammography screening program started in September 2002. The screening program was carried out at 59 working places last year and already at 66 workplaces with accreditation from 1 up to 3 years this year. The activity of the centres is monitored and inspected continuously (not only by SONS). Inspections at 35 workplaces were carried out last year .The doses are significantly below guidance levels at major part of working places. Most of detected defects were eliminated after inspections. The quality of mammographic workplaces in the Czech Republic has been gradually increased and improved. (authors)

First, keep it safe: Integration of a complementary medicine service within a hospital.

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Schiff, Elad; Levy, Ilana; Arnon, Zahi; Ben-Arye, Eran; Attias, Samuel

2018-05-01

This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety-related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment-associated adverse effects, which were documented in an obligatory field on treatment reports. After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice-director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety-related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty-nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety-related incidents and continuous adaptation of the CM service safety protocols. © 2018 John Wiley & Sons Ltd.

From job stress to intention to leave among hospital nurses: A structural equation modelling approach.

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Lo, Wen-Yen; Chien, Li-Yin; Hwang, Fang-Ming; Huang, Nicole; Chiou, Shu-Ti

2018-03-01

The aim of this study was to examine the structural relationships linking job stress to leaving intentions through job satisfaction, depressed mood and stress adaptation among hospital nurses. High turnover among nurses is a global concern. Structural relationships linking job stress to leaving intentions have not been thoroughly examined. Two nationwide cross-sectional surveys of full-time hospital staff in 2011 and 2014. The study participants were 26,945 and 19,386 full-time clinical nurses in 2011 and 2014 respectively. Structural equation modelling was used to examine the interrelationships among the study variables based on the hypothesized model. We used cross-validation procedures to ensure the stability and validity of the model in the two samples. There were five main paths from job stress to intention to leave the hospital. In addition to the direct path, job stress directly affected job satisfaction and depressed mood, which in turn affected intention to leave the hospital. Stress adaptation mitigated the effects of job stress on job satisfaction and depressed mood, which led to intention to leave the hospital. Intention to leave the hospital preceded intention to leave the profession. Those variables explained about 55% of the variance in intention to leave the profession in both years. The model fit was good for both samples, suggesting validity of the model. Strategies to decrease turnover intentions among nurses could focus on creating a less stressful work environment, increasing job satisfaction and stress adaptation and decreasing depressed mood. Hospitals should cooperate in this issue to decrease nurse turnover. © 2017 John Wiley & Sons Ltd.

The risk of cryptorchidism among sons of women working in horticulture in Denmark

DEFF Research Database (Denmark)

Gabel, Pernille; Jensen, Morten Søndergaard; Andersen, Helle Raun

2011-01-01

Androgens are crucial for normal testicular descent. Studies show that some pesticides have estrogenic or antiandrogenic effects, and that female workers exposed to pesticides have increased risk of having a boy with cryptorchidism. The main objective of the present study was to investigate wheth...... pregnant women exposed to pesticides due to their work in horticulture experience excess risk of having sons with cryptorchidism....

Can hospitals compete on quality? Hospital competition.

Science.gov (United States)

Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

2015-09-01

In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

Applying the Balanced Scorecard approach in teaching hospitals: a literature review and conceptual framework.

Science.gov (United States)

Trotta, Annarita; Cardamone, Emma; Cavallaro, Giusy; Mauro, Marianna

2013-01-01

Teaching hospitals (THs) simultaneously serve three different roles: offering medical treatment, teaching future doctors and promoting research. The international literature recognises such organisations as 'peaks of excellence' and highlights their economic function in the health system. In addition, the literature describes the urgent need to manage the complex dynamics and inefficiency issues that threaten the survival of teaching hospitals worldwide. In this context, traditional performance measurement systems that focus only on accounting and financial measures appear to be inadequate. Given that THs are highly specific and complex, a multidimensional system of performance measurement, such as the Balanced Scorecard (BSC), may be more appropriate because of the multitude of stakeholders, each of whom seek a specific type of accountability. The aim of the paper was twofold: (i) to review the literature on the BSC and its applications in teaching hospitals and (ii) to propose a scorecard framework that is suitable for assessing the performance of THs and serving as a guide for scholars and practitioners. In addition, this research will contribute to the ongoing debate on performance evaluation systems by suggesting a revised BSC framework and proposing specific performance indicators for THs. Copyright © 2012 John Wiley & Sons, Ltd.

Visualizing variations in organizational safety culture across an inter-hospital multifaceted workforce.

Science.gov (United States)

Kobuse, Hiroe; Morishima, Toshitaka; Tanaka, Masayuki; Murakami, Genki; Hirose, Masahiro; Imanaka, Yuichi

2014-06-01

To develop a reliable and valid questionnaire that can distinguish features of organizational culture for patient safety across subgroups such as hospitals, professions, management/non-management positions and units/wards. We developed a Hospital Organizational Culture Questionnaire based on a conceptual framework incorporating items from a review of existing literature. The questionnaire was administered to hospital staff including doctors, nurses, allied health personnel, and administrative staff at six public hospitals in Japan. Reliability and validity were assessed through exploratory factor analysis, multitrait scaling analysis, Cronbach's alpha coefficient and multiple regression analysis using staff-perceived achievement of safety as the response variable. Discriminative power across subgroups was assessed with radar chart profiling. Of the 3304 hospital staff surveyed, 2924 (88.5%) responded. After exploratory factor analysis and multitrait analysis, the finalized questionnaire was composed of 24 items in the following eight dimensions: improvement orientation, passion for mission, professional growth, resource allocation prioritization, inter-sectional collaboration, responsibility and authority, teamwork, and information sharing. Construct validity and internal consistency of dimensions were confirmed with multitrait analysis and Cronbach's alpha coefficients, respectively. Multiple regression analysis showed that improvement orientation, passion for mission, resource allocation prioritization and information sharing were significantly associated with higher achievement in safety practices. Our questionnaire tool was able to distinguish features of safety culture among different subgroups. Our questionnaire demonstrated excellent validity and reliability, and revealed distinct cultural patterns among different subgroups. Quantitative assessment of organizational safety culture with this tool may further the understanding of associated characteristics of

Rethinking family-centred care for the child and family in hospital.

Science.gov (United States)

Tallon, Mary M; Kendall, Garth E; Snider, Paul D

2015-05-01

This paper presents and discusses an alternative model of family-centred care (FCC) that focuses on optimising the health and developmental outcomes of children through the provision of appropriate support to the child's family. The relevance, meaning and effectiveness of FCC have been challenged recently. Studies show that parents in hospital often feel unsupported, judged by hospital staff and uncertain about what care they should give to their child. With no convincing evidence relating FCC to improved child health outcomes, it has been suggested that FCC should be replaced with a new improved model to guide the care of children in hospital. This integrative review discusses theory and evidence-based literature that supports the practice of an alternative model of FCC that is focused on the health and developmental outcomes of children who are seriously ill, rather than the organisational requirements of children's hospitals. Theories and research findings in a wide range of disciplines including epidemiology, psychology, sociology, anthropology and neuroscience were accessed for this discussion. Nursing literature regarding partnership building, communication and FCC was also accessed. This paper discusses the benefits of applying a bioecological model of human development, the family and community resource framework, the concepts of allostatic load and biological embedding, empowerment theory, and the nurse-family partnership model to FCC. While there is no direct evidence showing that the implementation of this alternative model of FCC in the hospital setting improves the health and developmental outcomes of children who are seriously ill, there is a great deal of evidence from community nursing practice that suggests it is very likely to do so. Application of these theoretical concepts to practice has the potential to underpin a theory of nursing that is relevant for all nurses irrespective of the age of those they care for and the settings within which they

Histerosonografía experiencia en el Hospital Universitario de Santander Hysterosonography experience in University Hospital of Santander

Directory of Open Access Journals (Sweden)

Janer Sepúlveda Agudelo

2010-12-01

Full Text Available Introducción: La histerosonografía consiste en la evaluación por ultrasonido de la cavidad uterina después de la insuflación de solución salina. La indicación más común de la histerosonografía es la hemorragia uterina anormal. Objetivo: Los objetivos del presente trabajo son describir los hallazgos de la histerosonografía durante el periodo estudiado en el Hospital Universitario de Santander e incentivar el uso de la histerosonografía en nuestro medio, mediante la enseñanza de la técnica a los nuevos profesionales de ginecología. Materiales y métodos: Se realizó un estudio de serie de casos con pacientes programadas para histerosonografía en el Hospital Universitario de Santander entre Febrero de 2007 y Junio de 2008, a quienes se les evaluó la cavidad uterina mediante histerosonografía, presentando una modificación a la técnica. Las variables a medir son la edad, indicación de histerosonografía, hallazgos intracavitarios, efectos secundarios. Resultados: Las indicaciones de histerosonografía fueron: Hemorragia uterina anormal 43,3%, miomatosis uterina 21,6%, lesión endometrial tipo pólipo 27,0%, infertilidad 5,4% y anomalías müllerianas 2,7%. Los hallazgos intracavitarios más comunes: Histerosonografía Normal 51,4%, pólipo endometrial 32,4% y mioma submucoso 16,2%. Se presentó como efectos secundarios dolor pélvico, episodio de lipotimia y sangrado genital moderado sin compromiso hemodinámico. Conclusión: La histerosonografía es un procedimiento seguro que permite una evaluación de la cavidad uterina, sin efectos secundarios importantes como lo demuestra nuestra experiencia. La modificación a la técnica puede evitar la incomodidad de la paciente, al realizar en una sola ocasión la introducción del transductor transvaginal, pero requiere de estudios aleatorizados controlados para confirmar esta aseveración. Salud UIS 2010; 42: 256-260Introduction: Sonohysterography is an ultrasound evaluation of the

Job satisfaction of Slovenian hospital nursing workforce.

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Prosen, Mirko; Piskar, Franka

2015-03-01

To test the psychometric properties of the McCloskey-Mueller Satisfaction Scale and to assess which of the McCloskey-Mueller Satisfaction Scale dimensionalities have a considerable impact on job satisfaction of nursing employees in three public Slovenian hospitals. Job satisfaction of nurses is linked to productivity, turnover, absenteeism and patient outcomes. Little is known about the factors contributing to job satisfaction among Slovenian hospital nurses. Understanding the contributing factors could help nurse managers to take appropriate measures. A cross-sectional survey study was used to obtain a sample of 169 registered nursing assistants and 74 registered nurses working in three public hospitals in Slovenia, from which data was obtained using the McCloskey-Mueller Satisfaction Scale. Dimensionality was tested using exploratory factor analysis. A seven-factor structure of 29 items was obtained, which accounted for 54.3% of the total variance in job satisfaction, and was internally consistent (Cronbach's alpha coefficient of the instrument was 0.78). The first factor 'Satisfaction with Interaction Opportunities', which is a component of the social rewards dimension in the McCloskey-Mueller Satisfaction Scale, explained 30.6% of the variation. The registered nursing assistants' job dissatisfaction was higher than that of the registered nurses. Both were mostly dissatisfied with professional opportunities. Using the factor analysis, a seven-factor structure was found instead of the originally introduced eight-factor model, which suggests a need for further redevelopment of the McCloskey-Mueller Satisfaction Scale. The results suggest that operational management needs to revitalize the work environment by ensuring proactive leadership and allowing participation in the decision-making process, while health-care organisations need to support the professional development of registered nursing assistants and registered nurses in order to achieve sustainable effects

Does state budget pressure matter for uncompensated care spending in hospitals? Findings from Texas and California.

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Chang, Jongwha; Patel, Isha; Suh, Won S; Lin, Hsien-Chang; Kim, Sunjung; Balkrishnan, Rajesh

2012-01-01

This study examined the impact of state budget cuts on uncompensated care at general acute care hospital organizations. This study capitalized on the variations in the states of Texas and California to form a natural experiment testing the joint impact of budget cut status on uncompensated care costs, as well as specific charity care costs and bad debt expenses from indigent patients. Budget cuts in the state of Texas occurred in the year 2004. Information was obtained from the Texas Department of Health and the California Department of Health Services regarding financial characteristics of hospitals and from the American Hospital Directory annual survey regarding organizational characteristics of hospitals. We created three dependent variables: R(UC) (the ratio of total uncompensated care costs to gross patient revenue), R(CC) (the ratio of charity care to total patient revenue) and R(BD) (the ratio of bad debt expenses to gross patient revenue). Using a two-period panel data set and individual hospital fixed effects, we captured hospital uncompensated care spending that could also have influenced budget cut status. Additionally, the impact of the state budget cut status on hospitals' uncompensated care spending, charity care spending and bad debt expenses was also estimated using the similar methodology. In this study, we included 416 (in Texas) and 352 (in California) public, not-for-profit (NFP) and for-profit (FP) hospitals that completed the annual survey during the study period 2002-2005. For the state of Texas, results from the fixed effect model confirmed that the year 2005 was directly related to increased R(UC) and R(CC) . The coefficients of 2005 were significantly and positively associated with R(UC) (0.43, p budget cut pressure on uncompensated care provided in Texas general acute care hospitals. Copyright © 2012 John Wiley & Sons, Ltd.

DOLOR Y SUFRIMIENTO NO SON SINÓNIMOS PERO SON INTRÍNSECOS A LA NATURALEZA HUMANA:UNA VISIÓN DEL DOLOR Y EL SUFRIMIENTO HUMANO

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Rubén Darío Camargo

2012-01-01

Full Text Available El dolor y el sufrimiento no tienen un referente histórico en el hombre. Solo desde que el hombre es consciente de su humanidad se presenta el dolor y el sufrimiento. El hombre y el dolor siempre han existido, se sufre cuando se nace y se siente dolor, proceso que se repite en cada respiración celular, en cada reacción de oxireducción. Bioló-gicamente en Latín PATIOR = SUFRIR-PADECER es el esfuerzo energético de todo ser vivo para su integración factorial celular.En la medicina el dolor tiene su explicación anatómica y fisiológica, el dolor hace referencia a lo somático y a lo fisiológico. El Dolor agudo es la consecuencia inmediata de la activación del siste-ma nociceptivo, generalmente por un daño tisular somático o visceral, desapareciendo habitualmente con la lesión que lo originó. El Dolor crónico es aquel que persiste en ausencia de la lesión perifé-rica inicial. En la esencia de la filosofía el dolor es impensable e inteligible, se siente, se maneja se tolera pero no se piensa en dolor. Dolor y sufrimiento no son sinónimos pero son intrínsecos a la naturaleza humana. El hombre cuando experimenta el dolor se encuentra con su propio límite, con su propia impotencia de no poder cambiar un hecho real. El sufrimiento humano en la atención diaria del paciente enfermo no lo maneja-mos por ser este algo intangible no monitorizable y mucho menos medible y cuantificable.El dolor del enfermo no es libre ni voluntario, es producto de la fragilidad de su materia, el dolor del que sufre despierta en sus familiares la solidaridad y Tolerancia.

Using BiSON to detect solar internal g-modes

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Kuszlewicz J.

2015-01-01

Full Text Available The unambiguous detection of individual solar internal g modes continues to elude us. With the aid of new additions to calibration procedures, as well as updated methods to combine multi-site time series more effectively, the noise and signal detection threshold levels in the low-frequency domain (where the g modes are expected to be found have been greatly improved. In the BiSON 23-year dataset these levels now rival those of GOLF, and with much greater frequency resolution available, due to the long time series, there is an opportunity to place more constraints on the upper limits of individual g mode amplitudes. Here we detail recent work dedicated to the challenges of observing low-frequency oscillations using a ground-based network, including the role of the window function as well as the effect of calibration on the low frequency domain.

Dombey and Son: An Inverted Maid's Tragedy

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Taher Badinjki

2015-06-01

Full Text Available Ross Dabney, J. Butt & K. Tillotson, and others think that Dickens revised the role of Edith in the original plan of Dombey and Son upon the advice of a friend. I tend to believe that Dickens's swerve from his course was prompted by two motives, his relish for grand scenes, and his endeavour to engage the reader's sympathies for a character who was a victim of a social practice which he was trying to condemn. Dickens's humanitarian attitude sought to redeem the sinner and condemn the sin. In engaging the reader's sympathies,  Dickens  had entrapped his own.  Both Edith and Alice are shown as victims of rapacious mothers who sell anything, or anybody for money. While Good Mrs Brown sells Alice's virtue and innocence for cash, Mrs Skewton trades on Edith's beauty in the marriage market to secure fortune and a good establishment. Edith and Alice's maturity and moral growth and their scorn and anger at their mothers' false teaching come in line with public prudery. Moreover, their educators in the principles of Mammonism have not succeeded altogether in stifling their innate feminine tenderness and capacity for affection, the thing that draws them near their reader's heart and wins them love and sympathy. Keywords: Money,  transaction,  victims,  saleable,  Mormonism,  greedy, rapacious

Nursing students' perceptions of their clinical learning environment in placements outside traditional hospital settings.

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Bjørk, Ida T; Berntsen, Karin; Brynildsen, Grethe; Hestetun, Margrete

2014-10-01

To explore students' opinions of the learning environment during clinical placement in settings outside traditional hospital settings. Clinical placement experiences may influence positively on nursing students attitudes towards the clinical setting in question. Most studies exploring the quality of clinical placements have targeted students' experience in hospital settings. The number of studies exploring students' experiences of the learning environment in healthcare settings outside of the hospital venue does not match the growing importance of such settings in the delivery of health care, nor the growing number of nurses needed in these venues. A survey design was used. The Clinical Learning Environment Inventory was administered to two cohorts of undergraduate nursing students (n = 184) after clinical placement in mental health care, home care and nursing home care. Nursing students' overall contentment with the learning environment was quite similar across all three placement areas. Students in mental health care had significantly higher scores on the subscale individualisation, and older students had significantly higher scores on the total scale. Compared with other studies where the Clinical Learning Environment Inventory has been used, the students' total scores in this study are similar or higher than scores in studies including students from hospital settings. Results from this study negate the negative views on clinical placements outside the hospital setting, especially those related to placements in nursing homes and mental healthcare settings. Students' experience of the learning environment during placements in mental health care, home care and nursing homes indicates the relevance of clinical education in settings outside the hospital setting. © 2014 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

¿Quién habla de las mujeres en las noticias donde ellas son las protagonistas?

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Ana Tamarit

2011-01-01

Full Text Available Este artículo presenta un análisis de las fuentes que los periodistas utilizan en las informaciones donde las mujeres son protagonistas de las noticias. La investigación -cuantitativa y cualitativa- se ha realizado en los periódicos de ámbito nacional y local de Castilla y León. Con los resultados obtenidos observamos cómo en los periódicos las noticias que hablan de las mujeres en la mayoría de las ocasiones no se firman. Comprobamos cuáles son las fuentes más utilizadas para la elaboración de esas noticias y las diferentes formas de citar a la fuente cuando se trata de un hombre o de una mujer.

Inactive nurses in Taiwan: human capital, intention to return to hospital nursing, and incentives for returning.

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Yu, Hsing-Yi; Tang, Fu-In; Chen, I-Ju; Yin, Teresa J C; Chen, Chu-Chieh; Yu, Shu

2016-04-01

To investigate inactive nurses' human capital, intention to return to hospital nursing and incentives for returning. Few studies have discussed the loss of human capital with regard to inactive nurses and how to attract them to return to clinical work. Systematic random sampling was used, with 328 subjects completing the mailed questionnaires, resulting in a response rate of 25.4%. Inactive nurses not only had moderate to high human capital (average years of nursing experience was 10.29, with moderate to high levels of nursing professional commitment and nursing competence) and were young. Forty-three percent of subjects reported intending to return to hospital nursing. Sufficient nurse staffing, greater safety in the working environment, and re-entry preparation programmes were incentives for returning. Recruiting inactive nurses back to hospital work is vital and feasible as inactive nurses had a moderate to high degree of human capital. The most feasible way is offering reasonable working conditions, in particular, providing sufficient staffing, a safe working environment and re-entry preparation programmes. The findings confirm the human capital of inactive nurses and provide concrete directions for nursing managers to follow when recruiting inactive nurses to hospital nursing. © 2015 John Wiley & Sons Ltd.

Mothers, fathers, sons, and daughters: gender differences in factors associated with parent-child communication about sexual topics.

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Wilson, Ellen K; Koo, Helen P

2010-12-14

In the United States, nearly half of high school students are sexually active, and adolescents experience high rates of unintended pregnancy and sexually transmitted diseases. Parents can have an important influence on their children's sexual behaviour, but many parents do not talk with their children about sexual topics. Research has shown significant differences in parent-child communication about sexual topics depending on the gender of both the parent and the child. Little is known, however, about the reasons for these gender differences. The purpose of this paper is to describe how factors associated with parent-child communication about sexual topics differ by gender. Data are from a nationwide online survey with 829 fathers and 1,113 mothers of children aged 10 to 14. For each of the four gender groups (fathers of sons, fathers of daughters, mothers of sons, mothers of daughters), we calculated the distribution of responses to questions assessing (1) parent-child communication about sex-related topics, and (2) factors associated with that communication. We used chi-square tests to determine whether the distributions differed and the false discovery rate control to reduce the likelihood of type I errors. With both sons and daughters, fathers communicated less about sexual topics than mothers did. Fathers also had lower levels of many characteristics that facilitate communication about sex (e.g., lower self-efficacy and lower expectations that talking to their children about sex would have positive outcomes). Compared with parents of sons, parents of daughters (both mothers and fathers) talked more about sexual topics, were more concerned about potential harmful consequences of sexual activity, and were more disapproving of their child having sex at an early age. Using a large national sample, this study confirms findings from previous studies showing gender differences in parent-child communication about sexual topics and identifies gender differences in

Mothers, fathers, sons, and daughters: gender differences in factors associated with parent-child communication about sexual topics

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Koo Helen P

2010-12-01

Full Text Available Abstract Background In the United States, nearly half of high school students are sexually active, and adolescents experience high rates of unintended pregnancy and sexually transmitted diseases. Parents can have an important influence on their children's sexual behaviour, but many parents do not talk with their children about sexual topics. Research has shown significant differences in parent-child communication about sexual topics depending on the gender of both the parent and the child. Little is known, however, about the reasons for these gender differences. The purpose of this paper is to describe how factors associated with parent-child communication about sexual topics differ by gender. Methods Data are from a nationwide online survey with 829 fathers and 1,113 mothers of children aged 10 to 14. For each of the four gender groups (fathers of sons, fathers of daughters, mothers of sons, mothers of daughters, we calculated the distribution of responses to questions assessing (1 parent-child communication about sex-related topics, and (2 factors associated with that communication. We used chi-square tests to determine whether the distributions differed and the false discovery rate control to reduce the likelihood of type I errors. Results With both sons and daughters, fathers communicated less about sexual topics than mothers did. Fathers also had lower levels of many characteristics that facilitate communication about sex (e.g., lower self-efficacy and lower expectations that talking to their children about sex would have positive outcomes. Compared with parents of sons, parents of daughters (both mothers and fathers talked more about sexual topics, were more concerned about potential harmful consequences of sexual activity, and were more disapproving of their child having sex at an early age. Conclusions Using a large national sample, this study confirms findings from previous studies showing gender differences in parent

Positioning matrix of economic efficiency and complexity: a case study in a university hospital.

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Ippolito, Adelaide; Viggiani, Vincenzo

2014-01-01

At the end of 2010, the Federico II University Hospital in Naples, Italy, initiated a series of discussions aimed at designing and applying a positioning matrix to its departments. This analysis was developed to create a tool able to extract meaningful information both to increase knowledge about individual departments and to inform the choices of general management during strategic planning. The name given to this tool was the positioning matrix of economic efficiency and complexity. In the matrix, the x-axis measures the ratio between revenues and costs, whereas the y-axis measures the index of complexity, thus showing "profitability" while bearing in mind the complexity of activities. By using the positioning matrix, it was possible to conduct a critical analysis of the characteristics of the Federico II University Hospital and to extract useful information for general management to use during strategic planning at the end of 2010 when defining medium-term objectives. Copyright © 2013 John Wiley & Sons, Ltd.

Manejo de morbimortalidad del paciente pediátrico quemado en el hospital "Baca Ortiz" de Quito, Ecuador Handling of morbi-mortality of pediatric burned patient at "Baca Ortiz" hospital, Quito, Ecuador

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P. Dávalos Dávalos

2007-09-01

Full Text Available En la unidad de quemados del Hospital de Niños "Baca Ortiz" de la ciudad de Quito (Ecuador se ha realizado un estudio de la morbimortalidad de pacientes pediátricos ingresados durante el año 2005. La principal causa de quemaduras en nuestro medio son los líquidos hirvientes, con una mayor mortalidad en varones que en mujeres: 2,55% frente a 1,7%. La mortalidad global fue de 4,25% durante el año 2005, notablemente inferior al 17 % que teníamos como media hace 5 años. Existen muchos factores que agravan el pronóstico evolutivo de estos pacientes como son: la edad, superficie corporal quemada, estado nutricional y antecedentes personales. El proceso infeccioso se detecta mediante la clínica; realizamos cultivos de biopsias de piel con un alto porcentaje de positividad de 67,64%. Detectamos resistencia bacteriana y empezamos a utilizar Quinolonas (Ciprofloxacina.We present a study of morbi-mortality of burned children who entered in Burned Unit at "Baca Ortiz" Children Hospital in Quito (Ecuador during 2005. Burns main cause are boiling liquids and mortality is higher in men than in women: 2,55% vs 1,7%. Global mortality during 2005 was of 4,25% with a noted decrease than the one obtained five years ago, which was 17%. There are many factors aggravating patients' evolutional prognosis, such as: age, burned body surface, nutritional status and personal backgrounds. Infectious process is detected by the clinic and tissue biopsies cultivations are made, with a highly positive percentage (67,64%. Antibacterial resistance was detected and we began to use Quinolones (Ciprofloxacin.

Psychological effects of relational job characteristics: validation of the scale for hospital nurses.

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Santos, Alda; Castanheira, Filipa; Chambel, Maria José; Amarante, Michael Vieira; Costa, Carlos

2017-07-01

This study validates the Portuguese version of the psychological effects of the relational job characteristics scale among hospital nurses in Portugal and Brazil. Increasing attention has been given to the social dimension of work, following the transition to a service economy. Nevertheless, and despite the unquestionable relational characteristics of nursing work, scarce research has been developed among nurses under a relational job design framework. Moreover, it is important to develop instruments that study the effects of relational job characteristics among nurses. We followed Messick's framework for scale validation, comprising the steps regarding the response process and internal structure, as well as relationships with other variables (work engagement and burnout). Statistical analysis included exploratory factor analysis and confirmatory factor analysis. The psychological effects of the relational job characteristics scale provided evidence of good psychometric properties with Portuguese and Brazilian hospital nurses. Also, the psychological effects of the relational job characteristics are associated with nurses' work-related well-being: positively with work engagement and negatively concerning burnout. Hospitals that foster the relational characteristics of nursing work are contributing to their nurses' work-related well-being, which may be reflected in the quality of care and patient safety. © 2017 John Wiley & Sons Ltd.

Sociosexually unrestricted parents have more sons: a further application of the generalized Trivers-Willard hypothesis (gTWH).

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Kanazawa, Satoshi; Apari, Péter

2009-01-01

The generalized Trivers-Willard hypothesis (gTWH) proposes that parents who possess any heritable trait which increases male reproductive success at a greater rate than female reproductive success in a given environment will have a higher-than-expected offspring sex ratio, and parents who possess any heritable trait which increases the female reproductive success at a greater rate than male reproductive success in a given environment will have a lower-than-expected offspring sex ratio. One heritable trait which increases the reproductive success of sons much more than that of daughters is unrestricted sociosexual orientation. We therefore predict that parents with unrestricted sociosexual orientation (measured by the number of sexual partners, frequency of sex, and attitudes toward relationship commitment and sexual exclusivity) have a higher-than-expected offspring sex ratio (more sons). We analyse the US General Social Surveys and the National Longitudinal Study of Adolescent Health (Add Health), both with large nationally representative samples. Our analyses support the prediction from the gTWH. One standard deviation increase in unrestrictedness of sociosexual orientation increases the odds of having a son by 12-19% in the representative American samples.

Complicated grief and manic comorbidity in the aftermath of the loss of a son.

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Carmassi, Claudia; Shear, M Katherine; Socci, Chiara; Corsi, Martina; Dell'osso, Liliana; First, Michael B

2013-09-01

Based on the recommendations of the sub-workgroup on trauma and dissociative disorders, the American Psychiatric Association (APA) removed the "bereavement exclusion" from the criteria for major depression in DSM-5. In addition, proposed DSM-5 research criteria for persistent complex bereavement disorder (PCBD) were included in the new manual in a section for conditions and criteria needing further research. We describe a case that warranted such a diagnosis. The patient was a 52- year-old woman who was admitted to the inpatient unit of our clinic on the birthday of her son who had died 18 months earlier. She was diagnosed with a manic episode with psychotic symptoms according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and was treated accordingly. Three months after discharge, she made a suicide attempt and was admitted and re-assessed. During this admission, she completed the Inventory of Complicated Grief (ICG), the Mood-Spectrum Rating Scale (MOODS-SR), and the Trauma and Loss Spectrum questionnaire (TALS-SR). She endorsed symptoms of intense yearning for her son, feelings of shock and disbelief, anger and bitterness related to his death, estrangement from others, auditory, tactile and visual hallucinations of the deceased, and intense emotional reactivity to memories of her son. These symptoms were sufficiently prolonged and severe to meet criteria for complicated grief. While complicated grief appeared to be the primary diagnosis for this patient, when she was diagnosed using only DSMIV-TR criteria, her treatment failed to address herprimary problem. This case draws attention to the occurrence of manic-like symptoms as well as depression-like manifestations following bereavement and highlights the importance of including the syndrome of complicated grief in the diagnostic nomenclature.

Environmental contamination and hospital-acquired infection: factors that are easily overlooked.

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Beggs, C; Knibbs, L D; Johnson, G R; Morawska, L

2015-10-01

There is an ongoing debate about the reasons for and factors contributing to healthcare-associated infection (HAI). Different solutions have been proposed over time to control the spread of HAI, with more focus on hand hygiene than on other aspects such as preventing the aerial dissemination of bacteria. Yet, it emerges that there is a need for a more pluralistic approach to infection control; one that reflects the complexity of the systems associated with HAI and involves multidisciplinary teams including hospital doctors, infection control nurses, microbiologists, architects, and engineers with expertise in building design and facilities management. This study reviews the knowledge base on the role that environmental contamination plays in the transmission of HAI, with the aim of raising awareness regarding infection control issues that are frequently overlooked. From the discussion presented in the study, it is clear that many unknowns persist regarding aerial dissemination of bacteria, and its control via cleaning and disinfection of the clinical environment. There is a paucity of good-quality epidemiological data, making it difficult for healthcare authorities to develop evidence-based policies. Consequently, there is a strong need for carefully designed studies to determine the impact of environmental contamination on the spread of HAI. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of Callovo-Oxfordian clay rock on the dissolution rate of the SON68 simulated nuclear waste glass

Energy Technology Data Exchange (ETDEWEB)

Neeway, James J., E-mail: James.Neeway@pnnl.gov [SUBATECH, Unité Mixte de Recherche 6457, École des Mines de Nantes, CNRS/IN2P3, Université de Nantes, BP 20722, 44307 Nantes cedex 3 (France); Abdelouas, Abdesselam; Ribet, Solange; El Mendili, Yassine [SUBATECH, Unité Mixte de Recherche 6457, École des Mines de Nantes, CNRS/IN2P3, Université de Nantes, BP 20722, 44307 Nantes cedex 3 (France); Schumacher, Stéphan [ANDRA, Parc de la Croix Blanche, 1/7 rue Jean Monnet, 92298 Châtenay-Malabry (France); Grambow, Bernd [SUBATECH, Unité Mixte de Recherche 6457, École des Mines de Nantes, CNRS/IN2P3, Université de Nantes, BP 20722, 44307 Nantes cedex 3 (France)

2015-04-15

Long-term storage of high-level nuclear waste glass in France is expected to occur in an engineered barrier system (EBS) located in a subsurface Callovo-Oxfordian (COx) clay rock formation in the Paris Basin in northeastern France. Understanding the behavior of glass dissolution in the complex system is critical to be able to reliably model the performance of the glass in this complex environment. To simulate this multi-barrier repository scenario in the laboratory, several tests have been performed to measure glass dissolution rates of the simulated high-level nuclear waste glass, SON68, in the presence of COx claystone at 90 °C. Experiments utilized a High-Performance Liquid Chromatography (HPLC) pump to pass simulated Bure site COx pore water through a reaction cell containing SON68 placed between two COx claystone cores for durations up to 200 days. Silicon concentrations at the outlet were similar in all experiments, even the blank experiment with only the COx claystone (∼4 mg/L at 25 °C and ∼15 mg/L at 90 °C). The steady-state pH of the effluent, measured at room temperature, was roughly 7.1 for the blank and 7.3–7.6 for the glass-containing experiments demonstrating the pH buffering capacity of the COx claystone. Dissolution rates for SON68 in the presence of the claystone were elevated compared to those obtained from flow-through experiments conducted with SON68 without claystone in silica-saturated solutions at the same temperature and similar pH values. Additionally, through surface examination of the monoliths, the side of the monolith in direct contact with the claystone was seen to have a corrosion thickness 2.5× greater than the side in contact with the bulk glass powder. Results from one experiment containing {sup 32}Si-doped SON68 also suggest that the movement of Si through the claystone is controlled by a chemically coupled transport with a Si retention factor, K{sub d}, of 900 mL/g.

Quality-quantity decomposition of income elasticity of U.S. hospital care expenditure using state-level panel data.

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Chen, Weiwei; Okunade, Albert; Lubiani, Gregory G

2014-11-01

Economic theory suggests that income growth could lead to changes in consumption quantity and quality as the spending on a commodity changes. Similarly, the volume and quality of healthcare consumption could rise with incomes because of demographic changes, usage of innovative medical technologies, and other factors. Hospital healthcare spending is the largest component of aggregate US healthcare expenditures. The novel contribution of our paper is estimating and decomposing the income elasticity of hospital care expenditures (HOCEXP) into its quantity and quality components. By using a 1999-2008 panel dataset of the 50 US states, results from the seemingly unrelated regressions model estimation reveal the income elasticity of HOCEXP to be 0.427 (std. error=0.044), with about 0.391 (calculated std. error=0.044) arising from care quality improvements and 0.035 (std. error=0.050) emanating from the rise in usage volume. Our novel research findings suggest the following: (i) the quantity part of hospital expenditure is inelastic to income change; (ii) almost the entire income-induced rise in hospital expenditure comes from care quality changes; and (iii) the 0.427 income elasticity of HOCEXP, the largest component of total US healthcare expenditure, makes hospital care a normal commodity and a much stronger technical necessity than aggregate healthcare. Policy implications are discussed. Copyright © 2013 John Wiley & Sons, Ltd.

Son preference, number of children, education and occupational choice in rural Nepal

OpenAIRE

Hatlebakk, Magnus

2012-01-01

A unique family survey was conducted in Nepal to investigate the economic consequences of having a first-born girl. Women get more children, but we find no causal effect of number of children on economic outcomes. But independently of the number of children there is a positive effect on boys' education of having a first born sister, who presumably takes care of household work so the boys can focus on school. This indicates a stronger son-preference in Nepal than what is found in studies from ...

Jean Alesi and his son Giuliano visited CERN

CERN Multimedia

Emma Jones

2010-01-01

Jean Alesi, former F1 racing driver, and his kids visited CERN on Monday 1st February 2010. The Bulletin and the Video productions team had the opportunity to meet him. The video interview is transcribed for your convenience. What attracted you to CERN, what was it that made you want to come? We talked at home with the children about places to see close to us, like CERN, where they are seeking to reproduce the origins of the world. These things are so far removed from what we ordinarily think and talk about, that they captured our imagination and made us want to come see for ourselves. We know that your son (Giuliano, 9 years) is interested in what is happening at CERN, so we'd like to ask him: how did he find out about it? Giuliano: I am very interested in the technologies used in laboratories, and the exploration of the Universe. Plus, I wanted to see some of the incredible machines. I enjoyed my visit a lot. I found out about CERN from my mother. She showed me a video that I really liked, so I wanted to...

The risk of cryptorchidism among sons of women working in horticulture in Denmark: a cohort study.

Science.gov (United States)

Gabel, Pernille; Jensen, Morten Søndergaard; Andersen, Helle Raun; Baelum, Jesper; Thulstrup, Ane Marie; Bonde, Jens Peter; Toft, Gunnar

2011-11-14

Androgens are crucial for normal testicular descent. Studies show that some pesticides have estrogenic or antiandrogenic effects, and that female workers exposed to pesticides have increased risk of having a boy with cryptorchidism. The main objective of the present study was to investigate whether pregnant women exposed to pesticides due to their work in horticulture experience excess risk of having sons with cryptorchidism. We conducted a cohort study of pregnant women working in horticulture using four cohorts including one cohort established with data from the departments of occupational medicine in Jutland and Funen and three existing mother-child cohorts (n=1,468). A reference group was established from the entire Danish population of boys born in the period of 1986-2007 (n=783,817). Nationwide Danish health registers provided information on birth outcome, cryptorchidism diagnosis and orchiopexy. The level of occupational exposure to pesticides was assessed by expert judgment blinded towards outcome status. Risk of cryptorchidism among exposed horticulture workers compared to the background population and to unexposed horticulture workers was assessed by Cox regression models. Pesticide exposed women employed in horticulture had a hazard ratio (HR) of having cryptorchid sons of 1.39 (95% CI 0.84; 2.31) and a HR of orchiopexy of 1.34 (0.72; 2.49) compared to the background population. Analysis divided into separate cohorts revealed a significantly increased risk of cryptorchidism in cohort 2: HR 2.58 (1.07;6.20) and increased risk of orchiopexy in cohort 4: HR 2.76 (1.03;7.35), but no significant associations in the other cohorts. Compared to unexposed women working in horticulture, pesticide exposed women had a risk of having sons with cryptorchidism of 1.34 (0.30; 5.96) and of orchiopexy of 1.93 (0.24;15.4). The data are compatible with a slightly increased risk of cryptorchidism in sons of women exposed to pesticides by working in horticulture.

La Mycorhize à arbuscules : quels bénéfices pour l'homme et son ...

African Journals Online (AJOL)

La Mycorhize à arbuscules : quels bénéfices pour l'homme et son ... et quantitative de la production végétale mais aussi pour une gestion et une remédiation ... Mycorrhizal symbiosis, and specifically arbuscular mycorrhization, which occurs ...

Hospital waste management in nonteaching hospitals of Lucknow City, India

Directory of Open Access Journals (Sweden)

Manish Kumar Manar

2014-01-01

Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.

The Tragedy of Hamlet, Son of an Organic Chemist of Denmark

Science.gov (United States)

Brisbois, Ronald G.

2004-04-01

Once faced with structure reactivity relationships in the context of nucleophilic substitution at sp 3 carbon, introductory organic chemistry students must compare and contrast the various attributes and ramifications of S N 2 versus S N 1 reaction pathways. The dramatic (even melodramatic) way in which some students ask such comparative questions inspired a parody of Hamlet's famous to be or not to be soliloquy. Herein, Hamlet (the son of an organic chemist of Denmark) is the surrogate of any and every student as he uses a thoroughly Shakespearian approach to sorting out some of the key distinguishing features of S N 2 versus S N 1 reactions.

The application of hospitality elements in hospitals.

Science.gov (United States)

Wu, Ziqi; Robson, Stephani; Hollis, Brooke

2013-01-01

In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

Parental mental health after the accidental death of a son during military service: 23-year follow-up study.

Science.gov (United States)

Kristensen, Pål; Heir, Trond; Herlofsen, Pål H; Langsrud, Øyvind; Weisæth, Lars

2012-01-01

We prospectively studied parental mental health after suddenly losing a son in a military training accident. Parents (N = 32) were interviewed at 1, 2 and 23 years after the death of their son. The General Health Questionnaire and Expanded Texas Inventory of Grief were self-reported at 1, 2, 5, and 23 years; the Inventory of Complicated Grief was self-reported at 23 years. We observed a high prevalence of psychiatric disorders at 1- and 2-year follow-ups (57% and 45%, respectively), particularly major depression (43% and 31%, respectively). Only one mental disorder was diagnosed at the 23-year follow-up. Grief and psychological distress were highest at 1- and 2-year follow-ups. Spouses exhibited a high concordance of psychological distress. Mothers reported more intense grief reactions than did fathers. The loss of a son during military service may have a substantial impact on parental mental health particularly during the first 2 years after death. Spouses' grief can be interrelated and may contribute to their psychological distress.

Are severely injured trauma victims in Norway offered advanced pre-hospital care? National, retrospective, observational cohort.

Science.gov (United States)

Wisborg, T; Ellensen, E N; Svege, I; Dehli, T

2017-08-01

Studies of severely injured patients suggest that advanced pre-hospital care and/or rapid transportation provides a survival benefit. This benefit depends on the disposition of resources to patients with the greatest need. Norway has 19 Emergency Helicopters (HEMS) staffed by anaesthesiologists on duty 24/7/365. National regulations describe indications for their use, and the use of the national emergency medical dispatch guideline is recommended. We assessed whether severely injured patients had been treated or transported by advanced resources on a national scale. A national survey was conducted collecting data for 2013 from local trauma registries at all hospitals caring for severely injured patients. Patients were analysed according to hospital level; trauma centres or acute care hospitals with trauma functions. Patients with an Injury Severity Score (ISS) > 15 were considered severely injured. Three trauma centres (75%) and 17 acute care hospitals (53%) had data for trauma patients from 2013, a total of 3535 trauma registry entries (primary admissions only), including 604 victims with an ISS > 15. Of these 604 victims, advanced resources were treating and/or transporting 51%. Sixty percent of the severely injured admitted directly to trauma centres received advanced services, while only 37% of the severely injured admitted primarily to acute care hospitals received these services. A highly developed and widely distributed HEMS system reached only half of severely injured trauma victims in Norway in 2013. © 2017 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Repeat HIV testing during pregnancy and delivery: missed opportunities in a rural district hospital in Zambia.

Science.gov (United States)

Heemelaar, Steffie; Habets, Nicole; Makukula, Ziche; van Roosmalen, Jos; van den Akker, Thomas

2015-03-01

To assess coverage of repeat HIV testing among women who delivered in a Zambian hospital. HIV testing of pregnant women and repeat testing every 3 months during pregnancy and breastfeeding is the recommended policy in areas of high HIV prevalence. A prospective implementation study in a second-level hospital in rural Zambia. Included were all pregnant women who delivered in hospital during May and June 2012. Data regarding antenatal visits and HIV testing were collected by two investigators using a standardised form. Of 401 women who delivered in hospital, sufficient antenatal data could be retrieved for 322 (80.3%) women. Of these 322 women, 301 (93.5%) had attended antenatal care (ANC) at least once. At the time of discharge after delivery in hospital, 171 (53.1%) had an unclear HIV status because their negative test result was more than 3 months ago or of an unknown date, or because they had not been tested at all during pregnancy or delivery. An updated HIV status was present for 151 (46.9%) women: 25 (7.8%) were HIV positive and 126 (39.1%) had tested negative within the last 3 months. In this last group, 79 (24.5%) had been tested twice or more during pregnancy. During the study period, none of the women was tested during admission for delivery. Despite high ANC coverage, opportunities for repeat HIV testing were missed in almost half of all women who delivered in this hospital in a high-prevalence HIV setting. © 2014 John Wiley & Sons Ltd.

Mandatory internal mobility in French hospitals: the results of imposed management practices.

Science.gov (United States)

van Schingen, Edith; Dariel, Odessa; Lefebvre, Hélène; Challier, Marie-Pierre; Rothan-Tondeur, Monique

2017-01-01

To describe the impact of a mandatory internal mobility policy on nurses working in French state-funded health establishments. Public hospitals in France rely on the internal mobility of nursing staff to respond to organisational needs, to reduce costs and to increase productivity. However, there is very little data on the impact of such management practices on the nurses themselves. A cross-sectional study, including 3077 nurses from 35 hospitals in the region of Paris, was conducted. Data were collected using a validated self-assessment questionnaire. Forty per cent of French nurses are required to work in different units. This mobility differs according to individual characteristics [age (P = 0.04), length of service (P = 0.017)] and type of environment [hospital (P < 0.0001), specialty (P < 0.0001)]. We can distinguish two types of approaches for implementing a mandatory staff nurse mobility policy. The first is an event that is regular, planned and lasts for several days. The second is an event that is irregular, short and organised the day before or the day of the change. Overall, while nurses are dissatisfied with all types of mandatory unit changes, this dissatisfaction is primarily a result of the irregular mobility events. This study demonstrates the importance of implementing a planned inter-unit mobility event and proposes recommendations for this type of implementation. © 2016 John Wiley & Sons Ltd.

Catalysts of worker-to-worker violence and incivility in hospitals.

Science.gov (United States)

Hamblin, Lydia E; Essenmacher, Lynnette; Upfal, Mark J; Russell, Jim; Luborsky, Mark; Ager, Joel; Arnetz, Judith E

2015-09-01

used to educate hospital staff. © 2015 John Wiley & Sons Ltd.

Atmospheric Extinction Coefficients in the Ic Band for Several Major International Observatories: Results from the BiSON Telescopes, 1984-2016

Science.gov (United States)

Hale, S. J.; Chaplin, W. J.; Davies, G. R.; Elsworth, Y. P.; Howe, R.; Lund, M. N.; Moxon, E. Z.; Thomas, A.; Pallé, P. L.; Rhodes, E. J., Jr.

2017-09-01

Over 30 years of solar data have been acquired by the Birmingham Solar Oscillations Network (BiSON), an international network of telescopes used to study oscillations of the Sun. Five of the six BiSON telescopes are located at major observatories. The observational sites are, in order of increasing longitude: Mount Wilson (Hale) Observatory (MWO), California, USA; Las Campanas Observatory, Chile; Observatorio del Teide, Izaña, Tenerife, Canary Islands; the South African Astronomical Observatory, Sutherland, South Africa; Carnarvon, Western Australia; and the Paul Wild Observatory, Narrabri, New South Wales, Australia. The BiSON data may be used to measure atmospheric extinction coefficients in the {{{I}}}{{c}} band (approximately 700-900 nm), and presented here are the derived atmospheric extinction coefficients from each site over the years 1984-2016.

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

Science.gov (United States)

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

2017-10-01

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

The Impact of Hospital Size on CMS Hospital Profiling.

Science.gov (United States)

Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J

2016-04-01

The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.

Elaboración de un Modelo de Gestión de Mantenimiento en el Hospital Básico Baños

OpenAIRE

Lobato Inca, Franklin Geovanny

2015-01-01

La investigación tuvo como objetivo la elaboración de un modelo de gestión de mantenimiento en el “Hospital Básico Baños”. Se realizaron auditorias cualitativas, semicuantitativas y cuantitativas del mantenimiento, para escenificar la problemática del mantenimiento hospitalario desde varios puntos de vista, determinando el grado de desarrollo del departamento de mantenimiento y su forma de gestionar, para poder determinar puntos de mejora y establecer que acciones son necesar...

«¿Quién soy yo? ¿Quiénes son ellos/as?». Personajes en busca de identidad

Directory of Open Access Journals (Sweden)

Caretti, Laura

2006-12-01

Full Text Available Who am I? Who are they? These are the questions haunting the characters, created by writers such as Ibsen, Pirandello, Beckett and others, whose emblematic search for identity is explored in the article. The complex interconnections between subjectivity and alterity are focused within the coordinates of space (society and time (memory in their outward and inward movement. The characters are seen on stage relating also to the otherness of actors and spectators. Particular relief is given to the difference between the female and male search for identity in the light of contemporary historical changes.¿Quién soy yo? ¿Quiénes son ellos/as? Estas son las cuestiones que obsesionan a los personajes creados por escritores como Ibsen, Pirandello, Beckett y otros, cuya emblemática búsqueda de identidad se explora a lo largo de este artículo. Las complejas interconexiones entre subjetividad y alteridad son analizadas con las coordenadas del espacio (sociedad y el tiempo (memoria en su movimiento interno y externo. Los personajes son vistos en el escenario desde la alteridad de actores y espectadores. Un particular relieve se otorga a la diferencia entre la búsqueda de la identidad femenina y masculina a la luz de los cambios históricos contemporáneos.

Polyandrous females provide sons with more competitive sperm: Support for the sexy-sperm hypothesis in the rattlebox moth (Utetheisa ornatrix).

Science.gov (United States)

Egan, Andrea L; Hook, Kristin A; Reeve, H Kern; Iyengar, Vikram K

2016-01-01

Given the costs of multiple mating, why has female polyandry evolved? Utetheisa ornatrix moths are well suited for studying multiple mating in females because females are highly polyandrous over their life span, with each male mate transferring a substantial spermatophore with both genetic and nongenetic material. The accumulation of resources might explain the prevalence of polyandry in this species, but another, not mutually exclusive, possibility is that females mate multiply to increase the probability that their sons will inherit more-competitive sperm. This latter "sexy-sperm" hypothesis posits that female multiple mating and male sperm competitiveness coevolve via a Fisherian runaway process. We tested the sexy-sperm hypothesis by using competitive double matings to compare the sperm competition success of sons of polyandrous versus monandrous females. In accordance with sexy-sperm theory, we found that in 511 offspring across 17 families, the male whose polyandrous mother mated once with each of three different males sired significantly more of all total offspring (81%) than did the male whose monandrous mother was mated thrice to a single male. Interestingly, sons of polyandrous mothers had a significantly biased sex ratio of their brood toward sons, also in support of the hypothesis. © 2015 The Author(s). Evolution © 2015 The Society for the Study of Evolution.

Bioavailability of suppository acetaminophen in healthy and hospitalized ill dogs.

Science.gov (United States)

Sikina, E R; Bach, J F; Lin, Z; Gehring, R; KuKanich, B

2018-05-13

To determine the plasma pharmacokinetics of suppository acetaminophen (APAP) in healthy dogs and clinically ill dogs. This prospective study used six healthy client-owned and 20 clinically ill hospitalized dogs. The healthy dogs were randomized by coin flip to receive APAP orally or as a suppository in crossover study design. Blood samples were collected up to 10 hr after APAP dosing. The hospitalized dogs were administered APAP as a suppository, and blood collected at 2 and 6 hr after dosing. Plasma samples were analyzed by ultra-performance liquid chromatography with triple quadrupole mass spectrometry. In healthy dogs, oral APAP maximal concentration (C MAX =2.69 μg/ml) was reached quickly (T MAX =1.04 hr) and eliminated rapidly (T1/2 = 1.81 hr). Suppository APAP was rapidly, but variably absorbed (C MAX =0.52 μg/ml T MAX =0.67 hr) and eliminated (T 1/2  = 3.21 hr). The relative (to oral) fraction of the suppository dose absorbed was 30% (range <1%-67%). In hospitalized ill dogs, the suppository APAP mean plasma concentration at 2 hr and 6 hr was 1.317 μg/ml and 0.283 μg/ml. Nonlinear mixed-effects modeling did not identify significant covariates affecting variability and was similar to noncompartmental results. Results supported that oral and suppository acetaminophen in healthy and clinical dogs did not reach or sustain concentrations associated with efficacy. Further studies performed on different doses are needed. © 2018 John Wiley & Sons Ltd.

Perceived organisational support, organisational commitment and self-competence among nurses: a study in two Italian hospitals.

Science.gov (United States)

Battistelli, Adalgisa; Galletta, Maura; Vandenberghe, Christian; Odoardi, Carlo

2016-01-01

This study examined the contributions of perceived organisational support (POS) and organisational commitment (i.e. affective, continuance and normative) to self-competence among nurses. In high-POS environments, workers benefit from socio-emotional resources to improve their skills, while positive forms of commitment (e.g. affective commitment) create a fertile context for developing one's competencies. A cross-sectional study was conducted among the nursing staff of two Italian urban hospitals (hospital A, n = 160; hospital B, n = 192). A structured questionnaire was administered individually to the nurses. Data analysis was conducted through multi-group analysis and supplemented by a bootstrapping approach. The results showed that POS was positively related to self-competence through affective commitment. In contrast, continuance and normative commitment did not mediate this relationship. This study shows that supporting employees through caring about their well-being as well as fostering positive forms of organisational commitment increases nurses' self-competence. Nurse managers may increase support perceptions and commitment among their staff by rewarding their contributions and caring about their well-being, as well as concentrating on training strategies that improve work-related skills. © 2015 John Wiley & Sons Ltd.

Like father, like son: periventricular nodular heterotopia and nonverbal learning disorder.

Science.gov (United States)

McCann, Marcia V; Pongonis, Stephen J; Golomb, Meredith R; Edwards-Brown, Mary; Christensen, Celanie K; Sokol, Deborah K

2008-08-01

Periventricular nodular heterotopia is a common malformation of cortical development in which the migration of developing neurons destined for the cerebral cortex is abbreviated. Bilateral periventricular nodular heterotopia is most commonly an X-linked disorder that involves mutations in the filamin A (FLNA) gene, but an autosomal recessive form and sporadic forms have been identified. To our knowledge, autosomal dominant transmission of isolated periventricular nodular heterotopia has not been reported. Periventricular nodular heterotopia has a heterogeneous phenotype, associated commonly with seizure disorder, and more recently with reading deficits and visual-spatial deficits in some patients. We present a father and son with bilateral periventricular nodular heterotopia and similar visual-spatial learning deficits, consistent with nonverbal learning disability.

Thermodynamic and structural models compared with the initial dissolution rates of SON glass samples

International Nuclear Information System (INIS)

Tovena, I.; Advocat, T.; Ghaleb, D.; Vernaz, E.

1993-01-01

The experimentally determined initial dissolution rate R 0 of nuclear glass was correlated with thermodynamic parameters and structural parameters. The initial corrosion rates of six ''R7T7'' glass samples measured at 100 deg C in a Soxhlet device were correlated with the glass free hydration energy and the glass formation enthalpy. These correlations were then tested with a group of 26 SON glasses selected for their wide diversity of compositions. The thermodynamic models provided a satisfactory approximation of the initial dissolution rate determined under Soxhlet conditions for SON glass samples that include up to 15 wt% of boron and some alumina. Conversely, these models are inaccurate if the boron concentration exceeds 15 wt% and the glass contains no alumina. Possible correlations between R 0 and structural parameters, such as the boron coordination number and the number of nonbridging oxygen atoms, were also investigated. The authors show that R 0 varies inversely with the number of 4-coordinate boron atoms; conversely, the results do not substantiate published reports of a correlation between R 0 and the number of nonbridging oxygen atoms. (authors). 13 refs., 2 figs., 4 tabs

The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States.

Science.gov (United States)

Okubo, Yusuke; Nochioka, Kotaro; Testa, Marcia A

2018-04-01

Obesity is the most common public health problem and is a clinically complicating risk factor among hospitalized children. The impact of pediatric obesity on the severity and morbidity of lower respiratory tract infections remains unclear. We conducted a retrospective cohort study of bronchitis and pneumonia among children aged 2-20 years using hospital discharge records. The data were obtained from the Kid's Inpatient Database in 2003, 2006, 2009, and 2012, and were weighted to estimate the number of hospitalizations in the United States. We used the International Classification of Diseases, Ninth Revision, Clinical Modification code (278.0×) to classify whether the patient was obese or not. We investigated the associations between pediatric obesity and use of mechanical ventilation using multivariable logistic regression model. In addition, we ascertained the relationships between pediatric obesity, comorbid blood stream infections, mean healthcare cost, and length of hospital stay. We estimated a total of 133 602 hospitalizations with pneumonia and bronchitis among children aged between 2 and 20 years. Obesity was significantly associated with use of mechanical ventilation (adjusted OR 2.90, 95% CI 2.15-3.90), comorbid bacteremia or septicemia (adjusted OR 1.58, 95% CI 1.03-2.44), elevated healthcare costs (adjusted difference $383, 95%CI $276-$476), and prolonged length of hospital stay (difference 0.32 days, 95%CI 0.23-0.40 days), after adjusting for patient and hospital characteristics using multivariable logistic regression models. Pediatric obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. These findings suggest the importance of obesity prevention for pediatric populations. © 2017 John Wiley & Sons Ltd.

The impact of total quality service (TQS) on healthcare and patient satisfaction: an empirical study of Turkish private and public hospitals.

Science.gov (United States)

Bakan, Ismail; Buyukbese, Tuba; Ersahan, Burcu

2014-01-01

This paper attempts to measure patients' perceptions of the quality of services in public and private healthcare centers in Turkey. The main aim was to examine the impact of the dimensions of patient-perceived total quality service (TQS) on patients' satisfaction. The research framework and hypotheses are derived from a literature review of service quality and quality in the healthcare industry. The research data were collected through questionnaires and then statistically analyzed using descriptive statistics, Pearson product moment correlation and linear regression. The results suggest that service quality perceptions positively influence patient satisfaction with overall hospital care (SOHC). The most important factors identified in the regression model regarding patient SOHC are the quality of the hospital's social responsibility, administrative processes and overall experience of medical care received. These factors explain 74% of the variance in SOHC. The findings of the study can be used to improve TQS in both private and public hospitals. Copyright © 2013 John Wiley & Sons, Ltd.

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

Science.gov (United States)

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

2008-10-01

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

THE OCCURRENCE OF THE CARE ‘OF US’ IN THE MOVEMENTS AND FLUCTUATIONS OF THE INTERACTIVE PROCESSES IN THE HOSPITAL ENVIRONMENT

Directory of Open Access Journals (Sweden)

Maria Aparecida Baggio

2016-01-01

Full Text Available La finalidad fue comprender como los profesionales de enfermería y salud viven y significan las relaciones en el proceso de cuidado de “lo nosotros”, utilizando la Teoría Fundamentada en los Datos como método. Participaron 25 profesionales de enfermería y salud de un hospital universitario, distribuidos en cuatro grupos de muestreo. Los datos fueron recolectados mediante entrevista semiestructurada, en el período de marzo a julio del 2011. La contextualización de la institución y gestión forma el contexto, los movimientos de las relaciones/ interacciones humanas y la salud del profesional son condiciones causales, mientras el avance de la tecnología, el declive del cuidado humano y el vivir social son condiciones intervinientes. Las relaciones/interacciones humanas de cuidado procesadas son estrategias para que ocurra el cuidado de “lo nosotros” en la circularidad del proceso de cuidar y ser cuidado. En los movimientos y ondulaciones de los procesos de interacción humana, los profesionales construyen en su práctica el cuidado de “lo nosotros”, entendido como relacional y procesual.

Compte rendu critique du livre Voir son steak comme un animal mort, de Martin Gibert

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Drolet, Marie-Josée

2016-10-01

Full Text Available This critical review provides, first, a step-by-step synthesis of the arguments presented in each chapter of Martin Gibert’s bookVoir son steak comme un animal mort (Seeing your steak as a dead animal. Second, a critical perspective of the book and a personal reflection are presented.

Nursing magnet hospitals have better CMS hospital compare ratings

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Robbins RA

2017-11-01

Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.

¿Son Fiables las Estimaciones de Pobreza en América Latina?

OpenAIRE

Sanjay G. Reddy

2008-01-01

¿Cuál es el nivel de pobreza de ingresos en América Latina? ¿Ha estado disminuyendo? ¿Son fiables las estimaciones actuales? El enfoque más influyente para medir la pobreza de ingresos a nivel regional y mundial es él utilizado por el Banco Mundial, que establece líneas internacionales de pobreza de ?un dólar al día? y ?dos dólares al día? por persona. El banco utiliza factores de ?paridad del poder adquisitivo? (PPA) para transformar estas líneas internacionales en monedas locales. (...)...

Pre-implementation studies of a workforce planning tool for nurse staffing and human resource management in university hospitals.

Science.gov (United States)

van Oostveen, Catharina J; Ubbink, Dirk T; Mens, Marian A; Pompe, Edwin A; Vermeulen, Hester

2016-03-01

To investigate the reliability, validity and feasibility of the RAFAELA workforce planning system (including the Oulu patient classification system - OPCq), before deciding on implementation in Dutch hospitals. The complexity of care, budgetary restraints and demand for high-quality patient care have ignited the need for transparent hospital workforce planning. Nurses from 12 wards of two university hospitals were trained to test the reliability of the OPCq by investigating the absolute agreement of nursing care intensity (NCI) measurements among nurses. Validity was tested by assessing whether optimal NCI/nurse ratio, as calculated by a regression analysis in RAFAELA, was realistic. System feasibility was investigated through a questionnaire among all nurses involved. Almost 67 000 NCI measurements were performed between December 2013 and June 2014. Agreement using the OPCq varied between 38% and 91%. For only 1 in 12 wards was the optimal NCI area calculated judged as valid. Although the majority of respondents was positive about the applicability and user-friendliness, RAFAELA was not accepted as useful workforce planning system. Nurses' performance using the RAFAELA system did not warrant its implementation. Hospital managers should first focus on enlarging the readiness of nurses regarding the implementation of a workforce planning system. © 2015 John Wiley & Sons Ltd.

Do daily ward interviews improve measurement of hospital quality and safety indicators? A prospective observational study.

Science.gov (United States)

Sarkies, Mitchell N; Bowles, Kelly-Ann; Skinner, Elizabeth H; Haas, Romi; Mitchell, Deb; O'Brien, Lisa; May, Kerry; Ghaly, Marcelle; Ho, Melissa; Haines, Terry P

2016-10-01

The aim of this study was to determine if the addition of daily ward interview data improves the capture of hospital quality and safety indicators compared with incident reporting systems alone. An additional aim was to determine the potential characteristics influencing under-reporting of hospital quality and safety indicators in incident reporting systems. A prospective, observational study was performed at two tertiary metropolitan public hospitals. Research assistants from allied health backgrounds met daily with the nurse in charge of the ward and discussed the occurrence of any falls, pressure injuries and rapid response medical team calls. Data were collected from four general medical wards, four surgical wards, an orthopaedic, neurosciences, plastics, respiratory, renal, sub-acute and acute medical assessment unit. An estimated total of 303 falls, 221 pressure injuries and 884 rapid response medical team calls occurred between 15 wards across two hospitals, over a period of 6 months. Hospital incident reporting systems underestimated falls by 30.0%, pressure injuries by 59.3% and rapid response medical team calls by 17.0%. The use of ward interview data collection in addition to hospital incident reporting systems improved data capture of falls by 23.8% (n = 72), pressure injuries by 21.7% (n = 48) and rapid response medical team calls by 12.7% (n = 112). Falls events were significantly less likely to be reported if they occurred on a Monday (P = 0.04) and pressure injuries significantly more likely to be reported if they occurred on a Wednesday (P = 0.01). Hospital quality and safety indicators (falls, pressure injuries and rapid response medical team calls) were under-reported in incident reporting systems, with variability in under-reporting between wards and the day of event occurrence. The use of ward interview data collection in addition to hospital incident reporting systems improved reporting of hospital quality and safety

A retrospective study of oral and maxillofacial injuries in Seremban Hospital, Malaysia.

Science.gov (United States)

Ramli, Roszalina; Rahman, Normastura Abdul; Rahman, Roslan Abdul; Hussaini, Haizal Mohd; Hamid, Abdul Latif Abdul

2011-04-01

Aetiology of oral and maxillofacial injuries in this country includes motorvehicle accident (MVA), fall, industrial accidents and others. Among these causes, MVA accident is the predominant cause of injury in Malaysia. A retrospective record review was carried out using hospital records of all patients who sustained oral and maxillofacial injury at the Department of Oral Surgery, Seremban Hospital, Negeri Sembilan, Malaysia between 1998 and 2002. Information related to demographics, aetiology of trauma, vehicles involved in collision, location of injuries and treatment modalities were reviewed. Two thousand nine hundred and eighty-six patients sustained oral and maxillofacial injuries. Of these patients, 79.2% were men and the remaining were women. Among all the races, Malays had the highest involvement (50.6%) followed by Indians (24.5%), Chinese (19.6%) and others (5.3%). There were statistically significant results on the association of aetiology and the ethnic groups, in the age group of 30 years or less and male gender (P < 0.001). The most common injury was the soft-tissue injury followed by dental and dentoalveolar injuries and bony fracture. Among all facial fractures, 66.3% were managed conservatively, 13% were treated surgically and 19.7% did not have any intervention. In relation to dental and dentoalveolar injuries, 64.8% had treatment in the form of splinting, restorations or dental extraction. The rest of the patients (35.2%) were referred to their dentists or did not have any active treatment at Seremban Hospital. Most of the dental and facial injuries in Seremban Hospital were caused by MVA and were predominantly managed using conservative methods. © 2011 John Wiley & Sons A/S.

77 FR 72906 - Chessie Logistics Co., LLC-Acquisition and Operation Exemption-J. Emil Anderson & Son, Inc.

Science.gov (United States)

2012-12-06

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. FD 35700] Chessie Logistics Co., LLC--Acquisition and Operation Exemption-- J. Emil Anderson & Son, Inc. Chessie Logistics Co... served on Ariel A. Erbacher, Legal Counsel, Chessie Logistics Co., LLC, 1001 Green Bay Rd., Unit 204...

Mothers’ Academic Gender Stereotypes and Education-Related Beliefs About Sons and Daughters in African American Families

Science.gov (United States)

Wood, Dana; Kurtz-Costes, Beth; Okeke-Adeyanju, Ndidi; Rowley, Stephanie J.

2010-01-01

The role of African American mothers’ academic gender stereotype endorsement in shaping achievement-related expectations for and perceptions of their own children was examined. Mothers (N = 334) of 7th and 8th graders completed measures of expectations for their children’s future educational attainment, perceptions of their children’s academic competence, and academic gender stereotypes. Consistent with hypotheses, mothers held less favorable expectations for sons and perceived sons to be less academically competent than daughters. In addition, mothers reported stereotypes favoring girls over boys in academic domains; stereotype endorsement, in turn, was related to mothers’ educational expectations for and beliefs about the academic competence of their own children, even with youths’ actual achievement controlled. Negative stereotypes about the academic abilities of African American boys may create a negative feedback loop, thereby contributing to the maintenance of the gender gap in African Americans’ educational outcomes. PMID:20648228

Modelado del proceso de esterilización del hospital clínico universitario de Valladolid mediante diagramas IDEF

OpenAIRE

Viñas del Hoyo, Víctor

2015-01-01

El principal objetivo de este trabajo de fin de grado es elaborar mediante diagramas IDEF, más concretamente el IDEFO, cuál sería el funcionamiento de la central de esterilización de nueva construcción del Hospital Clínico Universitario de Valladolid, mediante la gestión por procesos. Otros objetivos secundarios pero no menos importantes de este proyecto son:comprender el modelo de gestión por procesos e identificar los pasos que hay que seguir para implantarla correctamente. Ver y aprender ...

Poesía y filosofía son de palabra

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Santamaría Pargada, Antonio

2006-04-01

Full Text Available The imaginary and sinister concentration-camp chief Otto Friedrich Zur Linde was conceived by Jorge-Luis Borges as an example of misunderstanding philosophy and life, by seeing in them only the power of fight. This conception is compared with a dynamic understanding of philosophy. For Mr. Zur Linde Aristotle and Plato represent this confrontation, and each philosophical debate in history could be considered as a moment in it. But now, in the last fight, the will to power of man has gone beyond all the limits, even of morality. However some modern techniques of appropriation of ancient philosophy are completely opposed to this conception, namely Paul Ricoeur’s theory of fiction and Heidegger’s Sein und Schein,. Ultimately, the close relationship between poetry and philosophy since its origins speak against this thesis. A closer analysis of Nietzsche and Hölderlin will help to enlighten how wrong Zur Linde´s conception is..El siniestro jefe de un campo de concentración Otto Friedrich Zur Linde, concebido por Borges como ejemplo de una interpretación de la filosofía y la vida en la que la lucha es el único motor, es confrontado con una concepción de la filosofía dinámica. Zur Linde mantiene que Aristóteles y Platón son el enfrentamiento filosófico paradigmático. En el último momento del enfrentamiento la voluntad de poder de un nuevo superhombre ha rebasado todos los límites, incluso el de la conciencia. A esto se oponen las técnicas de apropiación filosófica del mundo griego por parte de la modernidad, a saber: el poder de la ficción, el Schein y el Sein así como el nacimiento de la filosofía, tan cercano a la poesía. Bajo este prisma cabe un análisis de Nietzsche y Hölderlin, que reniega de la interpretación de Zur Linde y clarifica que ante todo poetas y filósofos son seres de palabra.

The clinical effectiveness and cost-effectiveness of clinical nurse specialist-led hospital to home transitional care: a systematic review.

Science.gov (United States)

Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Donald, Faith; Martin-Misener, Ruth; Kilpatrick, Kelley; Harbman, Patricia; Kaasalainen, Sharon; Marshall, Deborah; Charbonneau-Smith, Renee; DiCenso, Alba

2015-10-01

Clinical nurse specialists (CNSs) are major providers of transitional care. This paper describes a systematic review of randomized controlled trials (RCTs) evaluating the clinical effectiveness and cost-effectiveness of CNS transitional care. We searched 10 electronic databases, 1980 to July 2013, and hand-searched reference lists and key journals for RCTs that evaluated health system outcomes of CNS transitional care. Study quality was assessed using the Cochrane Risk of Bias and Quality of Health Economic Studies tools. The quality of evidence for individual outcomes was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. We pooled data for similar outcomes. Thirteen RCTs of CNS transitional care were identified (n = 2463 participants). The studies had low (n = 3), moderate (n = 8) and high (n = 2) risk of bias and weak economic analyses. Post-cancer surgery, CNS care was superior in reducing patient mortality. For patients with heart failure, CNS care delayed time to and reduced death or re-hospitalization, improved treatment adherence and patient satisfaction, and reduced costs and length of re-hospitalization stay. For elderly patients and caregivers, CNS care improved caregiver depression and reduced re-hospitalization, re-hospitalization length of stay and costs. For high-risk pregnant women and very low birthweight infants, CNS care improved infant immunization rates and maternal satisfaction with care and reduced maternal and infant length of hospital stay and costs. There is low-quality evidence that CNS transitional care improves patient health outcomes, delays re-hospitalization and reduces hospital length of stay, re-hospitalization rates and costs. Further research incorporating robust economic evaluation is needed. © 2015 John Wiley & Sons, Ltd.

Nurses caring for ENT patients in a district general hospital without a dedicated ENT ward score significantly less in a test of knowledge than nurses caring for ENT patients in a dedicated ENT ward in a comparable district general hospital.

Science.gov (United States)

Foxton, C R; Black, D; Muhlschlegel, J; Jardine, A

2014-12-01

To assess whether there is a difference in ENT knowledge amongst nurses caring for patients on a dedicated ENT ward and nurses caring for ENT patients in a similar hospital without a dedicated ENT ward. A test of theoretical knowledge of ENT nursing care was devised and administered to nurses working on a dedicated ENT ward and then to nurses working on generic non-subspecialist wards regularly caring for ENT patients in a hospital without a dedicated ENT ward. The test scores were then compared. A single specialist ENT/Maxillo-Facial/Opthalmology ward in hospital A and 3 generic surgical wards in hospital B. Both hospitals are comparable district general hospitals in the south west of England. Nursing staff working in hospital A and hospital B on the relevant wards were approached during the working day. 11 nurses on ward 1, 10 nurses on ward 2, 11 nurses on ward 3 and 10 nurses on ward 4 (the dedicated ENT ward). Each individual test score was used to generate an average score per ward and these scores compared to see if there was a significant difference. The average score out of 10 on ward 1 was 6.8 (+/-1.6). The average score on ward two was 4.8 (+/-1.6). The average score on ward three was 5.5 (+/-2.1). The average score on ward 4, which is the dedicated ENT ward, was 9.7 (+/-0.5). The differences in average test score between the dedicated ENT ward and all of the other wards are statistically significant. Nurses working on a dedicated ENT ward have an average higher score in a test of knowledge than nurses working on generic surgical wards. This difference is statistically significant and persists despite banding or training. © 2014 John Wiley & Sons Ltd.

The prodigal son: some psychological aspects of Augustine's conversion to Christianity.

Science.gov (United States)

Nauta, Rein

2008-03-01

Augustine's conversion is considered exemplary for its Christian testimony. However, the psychological aspects are also relevant, for Augustine's conversion to Christianity was as much inspired by personal and cultural ambitions as by religious convictions. For Augustine, the conversion to the Christian faith spelled a life of asceticism--a life of celibacy, a virtuous and chaste existence, which also offered him a means of escape from the threatening ambiguity of parental relations and a chance to realize the cultural ideal of the civilized philosopher who has subjugated the passions of the flesh. In this paper we explore the psychological dynamics of the absent father, the suffering mother and the prodigal son and the role they played in Augustine's conversion to Christianity.

Trends in stroke admissions to a Tanzanian hospital over four decades: a retrospective audit.

Science.gov (United States)

Walker, Richard W; Viney, Rachel; Green, Laura; Mawanswila, Manasseh; Maro, Venance P; Gjertsen, Charlotte; Godfrey, Hannah; Smailes, Rosanna; Gray, William K

2015-10-01

The aim of this study was to record stroke admissions to a tertiary referral hospital in Tanzania over four decades. We audited the medical records held at a large teaching and tertiary referral hospital in northern Tanzania over four decades. We collected records for the years 1974-1976, 1984-1986, 1994-1995 and 2008. All patients admitted as inpatients with a primary diagnosis of stroke were included in the study. Data collected included age, sex, stroke subtype, predominant side of symptoms and survival to discharge. The number of stroke admissions rose from just four in the three-year period 1974-1976 (mean 1.3 cases annually) to 153 cases annually in 2008. The mean age of those admitted rose steadily during this period, as did the proportion of females admitted. The burden of stroke on health services in Tanzania appears to have increased rapidly. If this increase is to be slowed, then sustainable primary preventative measures to target known stroke risk factors will be required. © 2015 John Wiley & Sons Ltd.

Learning to care for older patients: hospitals and nursing homes as learning environments.

Science.gov (United States)

Huls, Marije; de Rooij, Sophia E; Diepstraten, Annemie; Koopmans, Raymond; Helmich, Esther

2015-03-01

specific benefits and challenges associated with learning in the nursing home, may further inform the implementation of geriatric medicine clerkships in hospitals and nursing homes. © 2015 John Wiley & Sons Ltd.

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

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Jaquelyn Poma

2012-03-01

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

HCAHPS - Hospital

Data.gov (United States)

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

Latino Parents' Awareness and Receipt of the HPV Vaccine for Sons and Daughters in a State with Low Three-Dose Completion.

Science.gov (United States)

Kepka, Deanna; Ding, Qian; Bodson, Julia; Warner, Echo L; Mooney, Kathi

2015-12-01

Latinos suffer a disproportionate burden of human papillomavirus (HPV)-preventable cancers, yet uptake and completion of the HPV vaccine among Latinos is below recommendations. Reasons for low HPV vaccine uptake among Latinos in Utah are unknown. We surveyed Latino parents of HPV vaccine age-eligible adolescents (N=118). Univariable analyses identified sociodemographic characteristics associated with HPV vaccine awareness, interest, and uptake for daughter(s) and/or son(s) using chi-square tests or Fisher's exact tests. More parents who had lived in the USA for 15 years or more had vaccinated their daughter (43.6 vs. 32.5%, p=0.035) compared to those living in the USA for shorter time periods. Parents born in Mexico reported their son had not received the HPV vaccine (74.6 vs. 58.3%, p=0.049) more than those born elsewhere. Parents with Mexican birthplace and ancestry reported not knowing about the HPV vaccine as the main barrier to vaccinating daughters (47.1 vs. 5.9%, p=0.002 for both) and sons (birthplace 38.3 vs. 10.3%, p=0.007; ancestry 37.1 vs. 11.1%, p=0.013) compared to those born or descending elsewhere. Non-acculturated parents with a son were more likely to report not knowing about the HPV vaccine as the main barrier to vaccine receipt (47.6 vs. 12.5%, pLatinos in an understudied region and complement prior research in other regions. This study may have implications for designing culturally tailored interventions to improve uptake of the HPV vaccine among the growing population of Latinos in Utah, and other states in the Intermountain West.

¿Son las mujeres una minoría?

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Osborne, Raquel

1996-10-01

Full Text Available Not available.

El clásico tratamiento de las mujeres como minoría desde la sociología se halla contemporáneamente interrelacionado con las políticas de igualdad tejidas en torno a las mujeres. Pasado y presente, teoría y práctica se unen para mostrar que las teorías no son accidentales ni fortuitas sino que acarrean importantes consecuencias en la acción, pudiendo dar lugar a intervenciones en la vida pública, que es lo que, a mi entender, confiere su sentido a la. sociología y, en particular, a la sociología del género. El título alude a la existencia de un importante desarrollo en sociología de la temática de las minorías, que traemos a colación por cuanto desde muy temprano dicha ciencia refirió este tema a las mujeres, desarrollo que seguiremos en este artículo. La conceptualización de las mujeres como minoría se traducirá, en términos de políticas públicas, en lo que se conoce como medidas de acción o discriminación positiva impulsadas, en lo que a las mujeres atañe, por el movimiento feminista.

Eventos adversos derivados del cuidado brindado en la Unidad de Cuidados Intensivos Adultos del Hospital Universidad del Norte. Barranquilla (Colombia

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Elizabeth Villarreal Cantillo

2014-01-01

Full Text Available Objetivo: Determinar los eventos adversos derivados del cuidado brindado en la Unidad de Cuidados Intensivos del Hospital Universidad del Norte (en Barranquilla en el periodo enero-diciembre de 2012. Materiales y métodos: Estudio descriptivo transversal retrospectivo. La muestra se obtuvo mediante un muestreo sistemático, a partir de un listado ordenado de todas las personas ingresadas al Hospital Universidad del Norte (HUN en los servicios de Urgencias, Hospitalización, Cirugía, UCI Adultos, UCI Neonatal, Gineco-Obstetricia, Consulta Externa, Radiología y Laboratorio que hubieran sufrido algún evento adverso ocurrido entre enero a diciembre de 2012. La información se obtuvo mediante la base de datos del Hospital Universidad del Norte. Para el análisis se utilizó Microsoft Excel 2010. Resultados: Durante 2012 se presentaron 130 (25 % casos de eventos adversos; siendo el segundo servicio con mayor número de eventos, después de Hospitalización. Las tres primeras causas de eventos adversos fueron: la infección nosocomial, con un 25 %; las úlceras por presión, con en un 18 %, y la neumonía asociada a ventilación mecánica, con un 16 %. Conclusiones: Los eventos adversos que más son reportados en las unidades de cuidados intensivos adultos son aquellos que ocurren cuando hay una mayor intervención en el paciente. Condiciona la aparición de eventos adversos un personal sanitario con déficit de conocimientos y falta de preparación. La ocurrencia de estos eventos adversos pone en peligro la vida de los seres humanos, debido a que empeoran su condición, produce sobrecosto y al profesional le genera sobrecarga laboral y afectiva.

Hospital Compare

Data.gov (United States)

U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

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

Science.gov (United States)

Anbäcken, O

1994-01-01

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

The management of hospital waste products in hospitals of Bushehr Province

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kamran Mirzaie

2008-02-01

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

ABRAM ET LA MAISON DE SON PÈRE (GN 11,26-32)

OpenAIRE

Misenga Dituanya, Marie-Anne; Abram et la maison de son père (Gn 11,26-32)

2015-01-01

L’élection et l’alliance sont des concepts fondamentaux dans l’Ancien Testament. Cette initiative divine commence avec Abraham par qui Dieu promet de bénir tous les clans de la terre (Gn 12,1-4; 15; 17). Cependant, on néglige souvent le point de départ d’Abraham qui n’est pas l’appel de Dieu, mais la situation de la famille de son père que Dieu demande à Abraham de quitter (Gn 11,26-32). Il est donc important d’étudier cette partie de plus près pour voir s’il est possible de préciser ce qu’es...

Hospitals

Data.gov (United States)

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

Consentimento informado em laringectomizados: estudo em um hospital escola Consentimiento informado en laringectomias: estudio en un hospital escolar Informed consent for laryngectomies: a university hospital case study

Directory of Open Access Journals (Sweden)

Alessandra de Oliveira Paixão

2001-04-01

Full Text Available O presente estudo teve como objetivo identificar como os pacientes submetidos à laringectomia parcial ou total tem compreendido as informações referentes ao procedimento cirúrgico. Utilizamos a técnica de entrevista através de questões abertas com pacientes de um hospital governamental, voltado para a assistência, o ensino e a pesquisa. Através das cinco categorias temáticas identificadas, podemos concluir que o respeito pela autonomia do paciente não está sendo exercido pela equipe médica e de enfermagem, pois as informações são processadas de forma inadequada por esses profissionais e não se considera a autonomia do paciente em alguns casos.El presente estudio tuvo como objetivo identificar como los pacientes sometidos laringectomía total o parcial han comprendido las informaciones sobre el procedimiento quirúrgico. Utilizamos la técnica de entrevista a través de preguntas abiertas con pacientes de un hospital gubernamental, orientado a la asistencia, la enseñanza y la investigación. A través de las cinco categorías temáticas identificadas, concluimos que el respeto por la autonomía del paciente no está siendo ejercido de manera correcta por el equipo médico y de enfermería, pues las informaciones son procesadas de forma inadecuada por estos profesionales y no se considera la autonomía del paciente en algunos casos.This study aimed at identifying how patients submitted to partial or total laryngectomy understand the information on the surgical procedure. Authors used the technique of semi-structured interview through open questions with patients admitted at a government hospital characterized by the development of activities centered on the care, teaching and research. Based on the identified five thematic categories, authors concluded that the respect for patient's autonomy is not being correctly performed by the medical and nursing team, as information are being processed in an inadequate way and they are not

Why patients may not exercise their choice when referred for hospital care. An exploratory study based on interviews with patients.

Science.gov (United States)

Victoor, Aafke; Delnoij, Diana; Friele, Roland; Rademakers, Jany

2016-06-01

Various north-western European health-care systems encourage patients to make an active choice of health-care provider. This study explores, qualitatively, patients' hospital selection processes and provides insight into the reasons why patients do or do not make active choices. Semi-structured individual interviews were conducted with 142 patients in two departments of three Dutch hospitals. Interviews were recorded, transcribed and analysed in accordance with the grounded theory approach. Three levels of choice activation were identified - passive, semi-active and active. The majority of the patients, however, visited the default hospital without having used quality information or considered alternatives. Various factors relating to patient, provider and health-care system characteristics were identified that influenced patients' level of choice activation. On the whole, the patients interviewed could be classified into five types with regard to how they chose, or 'ended up at' a hospital. These types varied from patients who did not have a choice to patients who made an active choice. A large variation exists in the way patients choose a hospital. However, most patients tend to visit the default without being concerned about choice. Generally, they do not see any reason to choose another hospital. In addition, barriers exist to making choices. The idea of a patient who actively makes a choice originates from neoclassical microeconomic theory. However, policy makers may try in vain to bring principles originating from this theory into health care. Even so, patients do value the opportunity of attending 'their' own hospital. © 2014 The Authors Health Expectations Published by John Wiley & Sons Ltd.

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

Data.gov (United States)

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

Patient Survey (PCH - HCAHPS) PPS-exempt Cancer Hospital - Hospital

Data.gov (United States)

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

A case study of conflict management in bonobos: how does a bonobo (Pan paniscus) mother manage conflicts between her sons and her female coalition partner?

Science.gov (United States)

Legrain, L; Stevens, J; Alegria Iscoa, J; Destrebecqz, A

2011-01-01

Female coalitions are an important part of the social organization of bonobos. The strength of the mother-son relationship is another essential part of this social structure. A bonobo mother is therefore facing a dilemma when a conflict arises between her sons and her female coalition partners. Will she take her coalition partner's side and favour the social organization of the group or support her son in order to defend her offspring? In order to address this issue, we performed an observational study of the captive group at Planckendael (Belgium) and used social grooming and proximity to assess the relationship between individuals. As a case study, we focused on the relationships between Hortense, one of the group's mothers, her 3 sons Redi, Vifijo and Zamba, and her coalition partner Hermien. Surprisingly, we observed that Hortense preferentially supported her female coalition partner. For Hortense's social status in the group, it may be more important to maintain the strong relationship with her higher-ranking female coalition partner than to support her sons. Copyright © 2012 S. Karger AG, Basel.

Isolation of Enterobacter aerogenes carrying blaTEM-1 and blaKPC-3 genes recovered from a hospital Intensive Care Unit.

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Pulcrano, Giovanna; Pignanelli, Salvatore; Vollaro, Adriana; Esposito, Matilde; Iula, Vita Dora; Roscetto, Emanuela; Soriano, Amata Amy; Catania, Maria Rosaria

2016-06-01

Enterobacter aerogenes has recently emerged as an important hospital pathogen. In this study, we showed the emergence of E. aerogenes isolates carrying the blaKPC gene in patients colonized by carbapenem-resistant Klebsiella pneumoniae strains. Two multiresistant E. aerogenes isolates were recovered from bronchial aspirates of two patients hospitalized in the Intensive Care Unit at the "Santa Maria della Scaletta" Hospital, Imola. The antimicrobial susceptibility test showed the high resistance to carbapenems and double-disk synergy test confirmed the phenotype of KPC and AmpC production. Other investigation revealed that ESBL and blaKPC genes were carried on the conjugative pKpQIL plasmid. This is a relevant report in Italy that describes a nosocomial infection due to the production of KPC beta-lactamases by an E. aerogenes isolate in patients previously colonized by K. pneumoniae carbapenem-resistant. In conclusion, it's necessary a continuous monitoring of multidrug-resistant strains for the detection of any KPC-producing bacteria that could expand the circulation of carbapenem-resistant pathogens. © 2016 APMIS. Published by John Wiley & Sons Ltd.

Poetics of Narrative: A Study on the "Sons of the Wind" by Laila Al Atrash

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Al Zuraigat, Asma M.; Zeidanin, Hussein Hasan

2015-01-01

This study aims at identifying the poetic devices overlapping with the genre of fiction in Laila Al Atrash's novel "The Sons of the Wind". The devices the study explores are the poetics of the title, poetics of the prologue and poetics of the language upon which the writer relies to support her point of view about the topics and issues…

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

Science.gov (United States)

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

2018-01-29

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

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

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Motomura Noboru

2008-11-01

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

Participatory redesign of work organisation in hospital nursing: A study of the implementation process.

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Stab, Nicole; Hacker, Winfried

2018-05-01

The main goal of the study was to apply and analyse a moderated participatory small-group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small-group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Registered nurses of 22 wards actively took part in the small-group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Participatory small-group activities may be successfully applied in hospital nursing in order to improve work organisation. Participatory assessment and redesign of nurses' work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. © 2018 John Wiley & Sons Ltd.

¿Qué son los modelos físicos?

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José Luis Rolleri

2013-01-01

Full Text Available En este artículo analizamos los principales conceptos propuestos de modelo con el propósito de resaltar el carácter idealizado y abstracto de los modelos físicos, que generalmente es pasado por alto en la literatura filosófica relevante desde diversas posiciones, como el instrumentalismo y el pragmatismo; el cual, sin embargo tiene importantes implicaciones en problemas filosóficos como el del realismo científico. Desde una posición conceptualista, sostenemos que los modelos desidealizados son los vehículos para conceptualizar los sistemas físicos desde la perspectiva de una teoría. In this paper we analyze the main intended concepts of model in order to underline the idealized and abstract character of physical models, that generally is overpass in the relevant philosophical literature from diverse positions on the scientific knowledge, such as instrumentalism and pragmatism, which however has important implications on philosophical problems such as that of scientific realism. From a conceptualistic position we hold that the de-idealized models are the vehicles to conceptualized physical systems from the perspective of a theory

Superselection sectors of SO(N) Wess-Zumino-Witten models

International Nuclear Information System (INIS)

Boeckenhauer, J.

1996-06-01

The superselection structure of so(N) WZW models is investigated form the point of view of algebraic quantum field theory. At level 1 it turns out that the observable algebras of the WZW theory can be constructed in terms of even CAR algebras. This fact allows to give a formulation of these models close to the DHR framework. Localized endomorphisms are constructed explicitly in terms of Bogoliubov transformations, and the WZW fusion rules are proven using the DHR sector product. At level 2 it is shown that most of the sectors are realized in H NS =H NS x H NS where H NS is the Neveu-Schwarz sector of the level 1 theory. The level 2 charcters are derived and H NS is decomposed completely into tensor products of the sectors of the WZW chiral algebra and irreducible representation spaces of the coset Virasoro algebra. Crucial for this analysis is the DHR decomposition of H NS into sectors of a gauge invariant fermion algebra since the WZW chiral algebra as well as the coset Virasoro algebra are invariant under the gauge group O(2). (orig.)

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.

Estimating adverse selection and moral hazard effects with hospital invoices data in a government-controlled healthcare system.

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Liu, Xiangping; Nestic, Danijel; Vukina, Tomislav

2012-08-01

We use invoices for hospital services from a regional hospital in Croatia to test for adverse selection and moral hazard. There are three categories of patients: with no supplemental insurance, who bought it, and who are entitled to it for free. Our identification procedure relies on the premise that the difference in the observed medical care consumption between the patients who bought the insurance and those entitled to free insurance is caused by pure selection effect, whereas the difference in healthcare consumption between the group that received the free insurance and the group that has no insurance is due to moral hazard. Results show favorable selection for patients in 20- to 30-year-old cohort and significant moral hazard for all age cohorts. The selection effect reverses its sign in older cohorts explained by the differences in risk aversion across cohorts caused by the timing of transition from socialism to market economy. Copyright © 2011 John Wiley & Sons, Ltd.

La experiencia del Hospital Clínic de Barcelona: integración Facultad de Medicina - IDIBAPS - Hospital Universitario

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Juan Rodés

Full Text Available La investigación traslacional es una nueva disciplina que incorpora aspectos de ciencia básica e investigación clínica y, por tanto, requiere entrenamiento y recursos que no se suelen encontrar en los laboratorios o en departamentos clínicos. Es por ello que los institutos donde se combinan ambos tipos de investigación como universidades, centros de investigación básica y hospitales de alto nivel asistencial, son las instituciones ideales para realizar este tipo de investigación. En el Hospital Clínic de Barcelona se ha producido un cambio en el transcurso de los últimos 40 años. Este cambio ha venido marcado por varios hechos, a destacar la creación de los servicios clínicos que substituyeron a las antiguas cátedras, la creación de los servicios de medicina, las becas post-residencia, los años sabáticos, la Fundación Clínic para la Investigación Biomédica y finalmente la puesta en marcha del Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS. En los últimos años es importante destacar también la reorganización del hospital en institutos y centros. La producción científica en estos últimos años se ha mantenido en alza, tanto en número de publicaciones como del impacto de las revistas en las que se publica. El IDIBAPS ha alcanzado unos resultados similares a los obtenidos por los mejores institutos de investigación del mundo occidental.

Hospital Outpatient PPS Partial Hospitalization Program LDS

Data.gov (United States)

U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

Work values and their association with burnout/work engagement among nurses in long-term care hospitals.

Science.gov (United States)

Saito, Yumiko; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Takai, Yukari; Yamamoto-Mitani, Noriko

2018-05-01

To examine burnout and work engagement among nurses in Japanese long-term care hospitals and their relation to nurses' and organisational work values, and nurse-organisation congruence of such values. Nursing managers must help improve nurses' well-being; however, no research has considered strategies to improve staff outcomes in long-term care hospitals. We propose that individual nurse's work values and the congruence of these values with those of their organisations may influence burnout and work engagement. We conducted a cross-sectional survey of nurses in long-term care hospitals. Multiple regression analyses were conducted to examine the effects of nurses' work values and nurse-organisation congruence in these values on burnout and work engagement. Higher individual intrinsic and altruistic work values were associated with improvements in nurses' burnout and work engagement. Nurse-organisation non-congruence in altruistic values was associated with lower work engagement, whereas that of intrinsic work values was not associated with either outcome variable. Promoting intrinsic and altruistic work values among nurses could be effective for improving both burnout and work engagement. Opportunities such as case conferences could foster intrinsic and altruistic work values through the review of good care practices and communication between managers/colleagues about feelings and thoughts. © 2018 John Wiley & Sons Ltd.

Longitudinal associations of nursing staff turnover with patient outcomes in long-term care hospitals in Korea.

Science.gov (United States)

Kim, Yoonseo; Han, Kihye

2018-01-10

To describe the characteristics of long-term care hospitals in 2010-2013 and to examine the longitudinal associations of nursing staff turnover with patient outcomes. The number of long-term care hospitals has exploded in Korea since the national long-term care insurance was launched in 2008. The care quality deviation across long-term care hospitals is large. This was a longitudinal secondary data analysis using the Health Insurance Review and Assessment Service's data. From 2010 to 2013, the nursing staff turnover rate decreased. The number of patients per registered nurse increased while that per total nursing staff and skill mix decreased. All adverse patient outcomes decreased. Higher nursing staff turnover and lower RN proportions were associated with adverse patient outcomes. Since the launch of the long-term care insurance, total nursing staffing, turnover rate and patient outcomes have improved, while the skill mix has decreased. Systematic efforts to decrease nursing staff turnover should be implemented for better long-term care patient outcomes. In addition to maintaining high levels of nurse staffing and skill mix, supportive work environments and competitive wages and benefits could reduce turnover, and ultimately adverse patient outcomes. Health care policy should separate nursing staffing levels for registered nurses and certified nursing assistants. © 2018 John Wiley & Sons Ltd.

Incidence and etiology of hospitalized acute respiratory infections in the Egyptian Delta.

Science.gov (United States)

Rowlinson, Emily; Dueger, Erica; Mansour, Adel; Azzazy, Nahed; Mansour, Hoda; Peters, Lisa; Rosenstock, Summer; Hamid, Sarah; Said, Mayar M; Geneidy, Mohamed; Abd Allah, Monier; Kandeel, Amr

2017-01-01

Acute Respiratory Infections (ARI) are responsible for nearly two million childhood deaths worldwide. A limited number of studies have been published on the epidemiology of viral respiratory pathogens in Egypt. A total of 6113 hospitalized patients >1 month of age with suspected ARI were enrolled between June 23, 2009 and December 31, 2013. Naso- and oropharyngeal specimens were collected and tested for influenza A and B, respiratory syncytial virus, human metapneumovirus, adenovirus, and parainfluenza viruses 1-3. Blood specimens from children 1-11 months were cultured and bacterial growth was identified by polymerase chain reaction. Results from a healthcare utilization survey on the proportion of persons seeking care for ARI was used to calculate adjusted ARI incidence rates in the surveillance population. The proportion of patients with a viral pathogen detected decreased with age from 67% in patients age 1-11 months to 19% in patients ≥65 years of age. Influenza was the dominant viral pathogen detected in patients ≥1 year of age (13.9%). The highest incidence rates for hospitalized ARI were observed in children 1-11 months (1757.9-5537.5/100 000 population) and RSV was the most commonly detected pathogen in this age group. In this study population, influenza is the largest viral contributor to hospitalized ARIs and children 1-11 months of age experience a high rate of ARI hospitalizations. This study highlights a need for surveillance of additional viral pathogens and alternative detection methods for bacterial pathogens, which may reveal a substantial proportion of as yet unidentified etiologies in adults. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Defining the role of a forensic hospital registered nurse using the Delphi method.

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Newman, Claire; Patterson, Karen; Eason, Michelle; Short, Ben

2016-11-01

A Delphi survey was undertaken to refine the position description of a registered nurse working in a forensic hospital, in New South Wales, Australia. Prior to commencing operation in 2008, position descriptions were developed from a review of legislation, as well as policies and procedures used by existing forensic mental health services in Australia. With an established workforce and an evolving model of care, a review of the initial registered nurse position description was required. An online Delphi survey was undertaken. Eight executive (88.9%) and 12 (58.3%) senior nursing staff participated in the first survey round. A total of four survey rounds were completed. At the final round, there was consensus (70%) that the revised position description was either very or somewhat suitable. There were a total of nine statements, from 31 originally produced in round 1, that did not reach consensus. The Delphi survey enabled a process for refining the Forensic Hospital registered nurse position description. Methods that facilitate executive and senior nursing staff consensus in the development and review of position descriptions should be considered in nursing management. © 2016 John Wiley & Sons Ltd.

Exploring staff perceptions and experiences of volunteers and visitors on the hospital ward at mealtimes using an ethnographic approach.

Science.gov (United States)

Ottrey, Ella; Palermo, Claire; Huggins, Catherine E; Porter, Judi

2018-04-01

the importance of nutrition. The working relationship between hospital staff, volunteers and visitors should be strengthened to improve nutritional care. © 2018 John Wiley & Sons Ltd.

The impact of economic crisis on the Greek hospitals' productivity.

Science.gov (United States)

Mitropoulos, Panagiotis; Mitropoulos, Ioannis; Karanikas, Haralampos; Polyzos, Nikolaos

2018-01-01

During the recent economic crisis, Greece implemented a comprehensive reform in the health care system. The 2010 health reform occurred under the constraints imposed by the memorandum of understanding that the Greek Government signed with its EU/International Monetary Fund creditors to control its deficit. The objective of the study is to examine the impact of the reform on the efficiency and productivity of public hospitals in Greece. We use the Malmquist productivity index to comparatively examine the potential changes before and after the reform years. We compare productivity, efficiency, and technological changes using panel data of 111 public acute hospitals operating in Greece throughout the recession period of 2009 to 2012. Bootstrapping methods are applied to allow for uncertainty owing to sampling error and for statistical inference for the Malmquist productivity index and its decompositions. The analysis indicates that the productivity has been increased following the policy changes. It appears that the expected benefits from the reform in general have been achieved, at least in the short-term. This result is examined in the light of management and operations activities, which are related with the reform process. Therefore, at a second stage, the Malmquist index is regressed on variables that may potentially be statistically associated with productivity growth. Copyright © 2017 John Wiley & Sons, Ltd.

Hospitals look to hospitality service firms to meet TQM goals.

Science.gov (United States)

Hard, R

1992-05-20

Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

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

Science.gov (United States)

Rivers, P A; Fottler, M D

2004-11-01

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

Differences in hospital attendance for anaphylaxis between immigrants and non-immigrants: a cohort study.

Science.gov (United States)

Norredam, M; Sheikh, A; Dynnes Svendsen, K; Holm Petersen, J; Garvey, L H; Kristiansen, M

2016-07-01

The impact of migration on the risk of anaphylaxis remains unknown. We hypothesized that non-Western immigrants have a lower incidence of anaphylaxis compared to Danish-born. We investigated variations in hospital attendance for anaphylaxis between immigrants and Danish-born including time- and age- trends. A register-based, historical prospective cohort design. Refugees or family reunified immigrants (n = 127 250) who, between January 1, 1994 and December 31, 2010, obtained residency permits in Denmark were included and matched in a 1 : 6 ratio on age and sex with Danish-born individuals (n = 740 600). Personal identification numbers were cross-linked to the Danish National Patient Registry identifying all first-time hospital attendances for anaphylaxis from January 1, 1994 and December 31, 2010. Incidence rate ratios were estimated, stratified for sex and region of birth, adjusting for age using a Cox regression model including the influence of duration of residence and age when residence was obtained. In total 1053 hospital attendances for anaphylaxis were identified: 89 among non-Western immigrants, 9 among Western immigrants and 955 among Danish-born patients. Both male (RR = 0.65; 95%CI: 0.46;0.90) and female (RR = 0.64; 95%CI: 0.48;0.85) non-Western immigrants had a significantly lower risk ratio of hospital attendance for anaphylaxis compared to Danish-born. Compared to Danish-born, non-Western immigrants living in Denmark during the entire follow-up period also showed a decreased risk (RR = 0.65; 95%CI: 0.34;1.25). Compared to Danish-born, non-Western immigrants who obtained residence permission as children had a decreased risk of hospital attendance for anaphylaxis (RR = 0.48; 95%CI: 0.25;0.91). This Danish register-based study using nationwide data revealed fewer hospital attendances for anaphylaxis among non-Western immigrants compared to Danish-born; however this protection was lost over time. © 2016 John Wiley & Sons Ltd.

Experiences of family carers of older people with mental health problems in the acute general hospital: a qualitative study.

Science.gov (United States)

Clissett, Philip; Porock, Davina; Harwood, Rowan H; Gladman, John R F

2013-12-01

To explore the experiences of family carers of people with cognitive impairment during admission to hospital. Providing appropriate care in acute hospitals for people with co-morbid cognitive impairment, especially dementia or delirium or both, is challenging to healthcare professionals. One key element is close working with family members. Qualitative interview study. Semi-structured interviews with family carers of 34 older people who had been admitted to a UK general hospital and had co-morbid cognitive impairment. Interviews conducted in 2009 and 2010. Analysis was undertaken using Strauss and Corbin's framework. The findings elaborate a core problem, 'disruption from normal routine' and a core process, 'gaining or giving a sense of control to cope with disruption'. Family carers responded to disruption proactively by trying to make sense of the situation and attempting to gain control for themselves or the patient. They tried to stay informed, communicate with staff about the patient and plan for the future. The interaction of the core problem and the core process resulted in outcomes where family members either valued the support of hospital staff and services or were highly critical of the care provided. Family carers are not passive in the face of the disruption of hospitalization and respond both by trying to involve themselves in the care and support of their relative and by trying to work in partnership with members of staff. Nurses need to foster this relationship conscientiously. © 2013 John Wiley & Sons Ltd.

Impact of leadership styles adopted by head nurses on job satisfaction: a comparative study between governmental and private hospitals in Jordan.

Science.gov (United States)

Abdelhafiz, Ibrahim Mbarak; Alloubani, Aladeen Mah'D; Almatari, Mohammad

2016-04-01

Previous studies demonstrated that leadership styles are the basis of daily interactions between leaders and employees and facilitate and enhance work processes. This study aimed to explore how the leadership styles of nurse leaders affect job satisfaction among working nurses. Quantitative, descriptive and comparative methods were used. Three main Ministry of Health hospitals in different areas of Jordan and three private hospitals in Amman were selected. Among the leadership styles measured by the Multi-factor Leadership Questionnaire 5X, transformational leadership had been used by head nurse managers in both settings more than transactional leadership and passive-avoidant leadership. The level of job satisfaction among nursing staff was higher in public hospitals than in private hospitals in this study. A positive relationship was found between the overall score for transformational leadership and job satisfaction (r = 0.374**). The overall transactional leadership score correlated positively with job satisfaction (r = 0.391**). Conversely, the overall correlation between passive-avoidant leadership and job satisfaction was negative (r = -0.240). The increased development of transformational leadership behaviours increases nurses' job satisfaction and thus contributes to an increased retention of nurses. The ability of hospitals to address the leadership styles of head nurses and their impacts on job satisfaction will be strengthened. © 2015 John Wiley & Sons Ltd.

The Hospital Information Planning Study at Groote Schuur Hospital ...

African Journals Online (AJOL)

Information is an increasingly important resource in an academic hospital. Effective planning and control of this resource are essential in order to maximize its usefulness. Tile HOspital Information Planning Study (HIPS) undertaken at Groote Schuur Hospital, and based on. the Business Systems Planning (BSP) ...

Exploring hospitality within hospital meals by means of visual methodologies

DEFF Research Database (Denmark)

Justesen, Lise

2016-01-01

ABSTRACT This paper reflects the application of visual methodologies adapted in an explorative study on hospitality and hospital meals. It takes point of departure in a multi-sited ethnographic fieldwork placed at a general hospital in 2012. Visual methodologies were applied in multiple ways....... This includes visual methodologies as part of observation and interview strategies. The paper presents and discusses how the application of different visual methodologies can contribute to the construction of ethnographical knowledge on hospitality and hospital meals. Finally ethical considerations as well...

On Hospital Design – Identifying Building Attributes of Hospital Design

DEFF Research Database (Denmark)

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

The present paper surveys the input parameters in hospital design and describes them formally as building attributes in preparation for facilitating planning and designing of hospitals with the aim of a more optimal design process. The overview of the hospital functionalities, bonds, logistics...... and needs is based on an approach of understanding the complexity of the hospital functionalities based on capacities, qualities and times beforehand specific department or units are described. This approach attempts to create an overview of the hospital functionalities respecting capacities, qualities...

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

Science.gov (United States)

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

2010-10-01

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

Percepción del personal de enfermería hacia la cultura de seguridad en un hospital pediátrico en México

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Concepción Mélendez Méndez

2014-11-01

Full Text Available Introducción: La seguridad del paciente es un tema que en los últimos años ha mostrado pleno desarrollo. Ya que en, 2004 la Organización Mundial de la Salud (OMS creó la Alianza Mundial para la Seguridad del paciente. La alianza promueve la sensibilización y el compromiso político para mejorar la seguridad de la atención y apoya a los estados miembros en la formulación de políticas y prácticas para la seguridad de los pacientes en todo el mundo. Objetivo: Determinar las Fortalezas y oportunidades de mejora hacia la cultura de la seguridad con que cuenta el personal de enfermería que labora en los diferentes servicios y turnos del Hospital de Pediatría de México y el grado global  de seguridad percibido. Materiales y Métodos: Diseño descriptivo y transversal en una muestra de 247 enfermeras del hospital de pediatría. Resultados: La media de edad de los encuestados fue de 49 años el 91 % fueron mujeres y el 70 son enfermeras generales, las dimensiones que calificaron como fortalezas fueron cuatro y ocho de las doce calificaron como oportunidad de mejora, el grado global de seguridad lo calificaron en el rango de 7-8 que significa muy buena. Discusión: Los resultados del estudio difieren de lo reportado por: diversos autores ya que ellos en sus investigaciones reportaron como fortaleza las dimensiones que en este estudio calificaron como oportunidad de mejora y son similares con lo reportado por otros autores en lo que se refiere a la notificación de eventos adversos y dotación de personal, que en este estudio también calificaron como fortalezas. Conclusiones: El personal de enfermeria considera que las fortalezas con que se cuenta en el hospital son pocas y que faltan muchas cosas por mejorar para garantizar la seguridad del paciente.Palabras clave: Seguridad, Cultura, Percepción. (Fuente: DeCs BIREME.Cómo citar este artículo: Meléndez C, Garza R, González JF, Castillo S, González S, Ruiz E. Percepción del personal de

Like father, Like Son? Collective decisions taking into account family relations

Directory of Open Access Journals (Sweden)

Ariádne Scalfoni Rigo

2018-01-01

Full Text Available This teaching case aims to promote reflection on other possible economic actions and alternative management models based on proximity relations. It presents a real situation in a community in the interior of Bahia, experienced by a Community Development Bank, which is an innovative experience on solidarity financing in Brazil and worldwide, related to a credit request by a certain Mr. Francisco. In order to protect his son, Pedro, Francisco created a dilemma that Ms. Marta, the credit agent of the Community Development Bank, sought to solve within the Credit Analysis Committee, a collective decision-making structure based on neighborhood relations.  The decision was not easy and involved many variables. This case allows to discuss the influence of community relations on solidarity finances, in collective management structures, and in the dynamics of Community Development Banks.

Parents' experience of living with and caring for an adult son or daughter with schizophrenia at home in Ireland: a qualitative study.

Science.gov (United States)

McAuliffe, R; O'Connor, L; Meagher, D

2014-03-01

This study explored the experience of parents living with, and caring for, an adult son or daughter with schizophrenia. There is increasing emphasis on the involvement of carers and users in the care for people with schizophrenia. 'A Vision for Change' highlights the need for a partnership approach and emphasizes that carers are an integral part in the planning and delivery of mental health services. In order to meet such requests, it was necessary to explore the meaning of caregiving for Irish families. A descriptive qualitative design was used to enable parents to describe their experiences. Semi-structured, in-depth interviews with a convenience sample of six parents in Ireland were carried out in 2007. The study encompassed four major themes: psychological tsunami, caring activities, coping with enduring illness and an uncertain pathway. Parents reported severe psychological distress when their son or daughter was diagnosed with schizophrenia. Their deep sense of loss was followed by acceptance of the situation. Feelings of love and a sense of responsibility helped to give meaning to their caring role. This study gave a voice to some parents of a son or daughter with schizophrenia. A family-centred approach should be at the core of care planning for this vulnerable population. © 2013 John Wiley & Sons Ltd.

Mitochondrial DNA analysis on remains of a putative son of Louis XVI, King of France and Marie-Antoinette.

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Jehaes, E; Decorte, R; Peneau, A; Petrie, J H; Boiry, P A; Gilissen, A; Moisan, J P; Van den Berghe, H; Pascal, O; Cassiman, J J

1998-01-01

Carl Wilhelm Naundorff was buried in 1845 in Delft as Louis Charles, Duc de Normandie, 'Louis XVII'. However, the son of Louis XVI and Marie-Antoinette-Louis XVII--officially died in the Temple of Paris in 1795. In order to resolve the identity of Naundorff, mitochondrial DNA (mtDNA) D-loop sequences of his remains were compared with the sequences obtained from the hairs of two sisters of Marie-Antoinette, Marie-Antoinette herself, and with the sequences obtained from DNA samples of two living maternal relatives. The mtDNA sequence of a bone sample from Naundorff showed two nucleotide differences from the sequences of the three sisters and four differences from the sequences of living maternal relatives. Based on this evidence it becomes very unlikely that Naundroff is the son of Marie-Antoinette.

Acceptability of the human papillomavirus vaccine and reasons for non-vaccination among parents of adolescent sons.

Science.gov (United States)

Donahue, Kelly L; Stupiansky, Nathan W; Alexander, Andreia B; Zimet, Gregory D

2014-06-30

Routine administration of the quadrivalent human papillomavirus (HPV) vaccine has been recommended for 11-12-year-old males since 2011, but coverage remains low. In a U.S. national sample of parents of 11-17-year-old males (n=779), 78.6% of parents reported their sons had not received the HPV vaccine. The most common reason for non-vaccination (56.7%) was "My doctor or healthcare provider has not recommended it." Parents citing only logistical reasons for non-vaccination (e.g., lack of recommendation, access, or education, n=384) reported significantly higher vaccine acceptability than parents reporting a combination of attitudinal (e.g., concerns about vaccine safety or efficacy) and logistical barriers (n=92), while parents citing only attitudinal barriers (n=73) reported the lowest level of vaccine acceptability. In sum, many parents are willing but have not vaccinated sons due to logistical barriers, most commonly lack of healthcare provider recommendation. These findings have important implications for increasing HPV vaccination coverage among adolescent males. Copyright © 2014 Elsevier Ltd. All rights reserved.

LA SABIDURIA DEL SILENCIO. HACIA EL DIÁLOGO... ¡OTROS MUNDOS SON POSIBLES!

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Juan Carlos Valverde Campos

2012-05-01

Full Text Available A Occidentales y Orientales nos cobija un mismo techo. Sin embargo, la manera de concebir el mundo y, por ende, de actuar, es diferente. La sociedad globalizada en la que vivimos quiere hacer de este mundo uno solo, con un solo corazón y una sola manera de actuar y pensar. Occidente ha impuesto su mundo cuando en realidad son muchos y debemos conocerlos. El pensamiento oriental tiene mucho qué decirnos a los occidentales. En todo caso, el silencio que impone la escucha es fundamental en eso que tantos llaman hoy el diálogo.

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

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Li, Yongjun; Lei, Xiyang; Morton, Alec

2018-02-14

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

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

African Journals Online (AJOL)

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

Hospital diversification strategy.

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Eastaugh, Steven R

2014-01-01

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

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

Science.gov (United States)

Rees, Tom

2002-01-01

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

Turning frequency in adult bedridden patients to prevent hospital-acquired pressure ulcer: A scoping review.

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Jocelyn Chew, H-S; Thiara, Emelia; Lopez, Violeta; Shorey, Shefaly

2018-04-01

The aim of this study was to identify current research on turning frequencies of adult bed-bound patients and inform future turning practices for hospitals based on evidence-based practice. We undertook a scoping review framework that provided a transparent and systematic methodology using 8 electronic databases (CINAHL, PubMed, Cochrane Library, ScienceDirect, PsycINFO, Scopus, ProQuest, and Web of Science) to identify articles published from 2000 to 2016. Articles were included if they focused on the prevention of hospital-acquired pressure ulcers related to the frequency of turning or repositioning of bed-bound patients. Literature search and data extraction were performed independently by 3 authors. The study followed the PRISMA guidelines. In total, 911 articles were identified, of which 10 were eligible. Of the eligible articles, 8 studies could not reach a conclusion on the effective frequency of turning and duration for repositioning patients to prevent the development of pressure ulcers. Only 2 studies found significant differences among the intervention and control groups. Results regarding turning and repositioning schedules are inconclusive; however, the topic needs further exploration to improve the outdated guidelines surrounding pressure ulcer prevention. This may, in turn, make the work of nurses more efficient and make treatment cost-effective for both the patients and the hospitals. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Hospital 360°.

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Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia

2015-01-01

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

Constipation--prevalence and incidence among medical patients acutely admitted to hospital with a medical condition.

Science.gov (United States)

Noiesen, Eline; Trosborg, Ingelise; Bager, Louise; Herning, Margrethe; Lyngby, Christel; Konradsen, Hanne

2014-08-01

To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients. Constipation is a common medical problem with severe consequences, and most people suffer from constipation at some point in their lives. In the general population, constipation is one of the most common complaints and is a significant personal and public health burden. Alteration in patients' patterns of elimination while in hospital has long been identified as either a potential or an actual problem that requires attention. Knowledge of the prevalence and incidence of constipation during hospitalisation is only sporadic. The study was descriptive and a prospective cohort design was chosen. The Constipation Assessment Scale was translated into Danish and was used for the assessment of patient-reported bowel function. Five nurses made the assessments at admission to the acute medical ward and three days after admission. Three hundred and seventy-three patients participated in this study. Thirty-nine percent of the patients showed symptoms of constipation at admission. Of the patients who did not have the symptoms at admission, 43% developed the symptoms during the first three days of their stay in hospital. Significantly more of the older patients developed symptoms of moderate constipation. The incidence rate was 143 new cases per 1000 patient days. In this study, symptoms of constipation were common among patients acutely admitted to hospital due to different medical conditions. Symptoms of constipation were also developed during the first three days of the stay in hospital. The study highlights the need to develop both clinical guidelines towards treating constipation, and preventive measures to ensure that patients do not become constipated while staying in hospital. © 2013 John Wiley & Sons Ltd.

Assisted autogenic drainage in infants and young children hospitalized with uncomplicated pneumonia, a pilot study.

Science.gov (United States)

Corten, Lieselotte; Jelsma, Jennifer; Human, Anri; Rahim, Sameer; Morrow, Brenda M

2018-01-01

Pneumonia is the most important respiratory problem in low-to-middle income countries. Airway clearance therapy continues to be used in children with pneumonia and secretion retention; however, there is lack of evidence to support or reject this treatment. This study aimed to investigate the feasibility of a randomized controlled trial (RCT) on the efficacy and safety of assisted autogenic drainage (AAD) compared to standard nursing care in children hospitalized with uncomplicated pneumonia. A single-blinded pilot RCT was conducted on 29 children (median age 3.5 months, IQR 1.5-9.4) hospitalized with uncomplicated pneumonia. The intervention group received standard nursing care with additional bi-daily AAD, for 10 to 30 min. The control group only received standard nursing care, unless otherwise deemed necessary by the physician or physiotherapist. The primary outcome measure was duration of hospitalization. The secondary outcome measures included days of fever and supplemental oxygen support; respiratory rate (RR) and heart rate adjusted for age; RR and oxygen saturation pre-, post-, and 1-hr post-treatment; oxygen saturation; adverse events; and mortality. No difference was found for duration of hospitalization (median 7.5 and 7.0 days for the control and intervention groups, respectively); however, Kaplan-Meier analysis revealed a strong tendency towards a shorter time to discharge in the intervention group (p = .06). No significant differences were found for the other outcome measures at time of discharge. No adverse events were reported. Within the intervention group, a significant reduction in RR adjusted for age was found. As no adverse events were reported, and AAD did not prolong hospitalization; AAD might be considered as safe and effective in young children with uncomplicated pneumonia. However, a larger multicentred RCT is warranted to determine the efficacy of AAD compared to standard nursing care. Copyright © 2017 John Wiley & Sons, Ltd.

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

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Tjibbe Donker

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

Hospital turnaround strategies.

Science.gov (United States)

Langabeer, James

2008-01-01

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

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

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

2015-06-01

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

Hospitals; hospitals13

Data.gov (United States)

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

Meaning Reconstruction Process After Suicide: Life-Story of a Japanese Woman Who Lost Her Son to Suicide.

Science.gov (United States)

Kawashima, Daisuke; Kawano, Kenji

2017-09-01

Although Japan has a high suicide rate, there is insufficient research on the experiences of suicide-bereaved individuals. We investigated the qualitative aspects of the meaning reconstruction process after a loss to suicide. We conducted a life-story interview using open-ended questions with one middle-aged Japanese woman who lost her son to suicide. We used a narrative approach to transcribe and code the participant's narratives for analysis. The analysis revealed three meaning groups that structured the participant's reactions to the suicide: making sense of her son's death and life, relationships with other people, and reconstruction of a bond with the deceased. The belief that death is not an eternal split and that there is a connection between the living and the deceased reduced the pain felt by our participant. Furthermore, the narratives worked as scaffolds in the meaning reconstruction process. We discuss our results in the light of cross-cultural differences in the grieving process.

[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.

Factors related to burnout among Chinese female hospital nurses: cross-sectional survey in Liaoning Province of China.

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Wu, Hui; Liu, Li; Sun, Wei; Zhao, Xue; Wang, Jiana; Wang, Lie

2014-07-01

To explore the factors associated with burnout among female hospital nurses in China. Burnout has been a major concern in the field of occupational health, and yet there has been little research exploring the factors related to burnout among Chinese nurses. Exploring the factors associated with burnout is important in improving nurses' health and the quality of health care services in China. The study population consisted of 1845 female hospital nurses in the Liaoning Province of China. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey; occupational stress was measured using the Chinese versions of the Job Content Questionnaire and Effort-Reward Imbalance Questionnaire. A general linear regression model was applied to analyse the factors associated with burnout. Mean scores (±SD) were 11.74 (7.14) for emotional exhaustion, 7.12 (5.67) for cynicism and 23.34 (9.60) for self-efficacy. Strong extrinsic effort was the most powerful predictor of emotional exhaustion and cynicism; strong psychological job demands were the most robust predictor of low self-efficacy. The findings suggest that occupational stress was strongly related to burnout among female hospital nurses in China. Occupational stress was identified as the most robust predictor of burnout among Chinese female hospital nurses. Reducing burnout among nurses working in China may require health education, health promotion and occupational training programmes aimed at improving work situations and reducing occupational stress. © 2012 John Wiley & Sons Ltd.

Cinematic narratives of Sonderkommando: Son of saul or narrating the victim, perpetrator, trauma and death

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Daković Nevena

2016-01-01

Full Text Available The aim of this paper is to map out - by analysing the film Son of Saul, but also by its comparison with two other films dealing with the topic, Himmelkommando and The Grey Zone, the narrative mechanism that satisfies the complex ethical and aesthetical demands imposed by the theme of Sonderkommando as the particular episode of the Holocaust. The key element of the narrative structure is the construction of the Levi’s “dead and drowned” witness who “resurrected” through the narrative intervention becomes the only reliable and credible narrator of the historical trauma. The prerequisite for his emergence is the narration and representation of the death which makes but also solves the traumatised - understood as multiple, fragmented, opposed - identities of the members of the special squad. Their entangled identity involves the simultaneous presence of a victim, perpetrator, witness and the authentic narrator of the trauma of the death camp. The death of the perpetrator is the condition sina qua non for the emergence of the figure of the victim-witness narrator but also for making of narrative which overcomes the initial trauma of the Holocaust. The detailed analysis of the film Son of Saul confirms and identifies these narratives as the modernist narration of the post-traumatic film.

CUENTOS QUE NO SON CUENTOS...UN RECORRIDO POR SAN ZENÓN (MAGDALENA

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Tania Ximena Salcedo Goméz

2013-07-01

Full Text Available Es de tarde y el sol inclemente de febrero se refleja sobre Las cálidas aguas del río Magdalena; sus visos en naranja y rojo se inmortalizan en el tapiz del cielo, mientras en tierra, esta gama de luz iridescente se forja en la piel de los hombres y mujeres de San Zenón. Los árboles desnudos han sido bañados por el frío invierno. Las ciénagas y el río han dejado sus marcas a través del marrón 330 de sus cortezas. Las pocas hojas que quedan son solo un breve recuerdo de un amanecer con sombra. El asfalto y la pasividad del viento, quienes amenazan la lucidez.

Hypoxaemia in Mozambican children <5 years of age admitted to hospital with clinical severe pneumonia: clinical features and performance of predictor models.

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Bassat, Quique; Lanaspa, Miguel; Machevo, Sónia; O'Callaghan-Gordo, Cristina; Madrid, Lola; Nhampossa, Tacilta; Acácio, Sozinho; Roca, Anna; Alonso, Pedro L

2016-09-01

To determine the prevalence of hypoxaemia among under-five children admitted to hospital with clinical severe pneumonia and to assess the performance to diagnose hypoxaemia of models based on clinical signs. We conducted a hospital-based survey in a district hospital from Southern Mozambique. A total of 825 children were recruited after obtaining an informed consent. The prevalence of hypoxaemia on admission was 27.9%, and 19.8% of these children died (OR compared with non-hypoxaemic children 3.22, 95% CI 1.98-5.21, P < 0.001). The model with larger area under the ROC curve (AUC-ROC) to predict hypoxaemia included cyanosis or thoracoabdominal breathing or respiratory rate ≥70 breaths per minute. None of the models performed well when tested in different case scenarios of oxygen availability through mathematical modelling, with over 50% of hypoxaemic children not receiving oxygen even in favourable case scenarios. Clinical signs alone or in combination are not suitable to diagnose hypoxaemia. The use of pulse oximeters should be strongly encouraged. © 2016 John Wiley & Sons Ltd.

Calidad del llenado del certificado de defunción y muerte fetal en un hospital de segundo nivel en México

OpenAIRE

Henández Mier, C.

2014-01-01

l os certificados de defunción y muerte fetal son de valor legal, epidemiológico y es tadístico, el objetivo del presente estudio es proponer un modelo objetivo y evaluar la calidad del llenado en un hospital de segundo nivel en México. Metodologí a: Se realizó un estudio observacional, descriptivo, retrospectivo, tomando como variables los requisitos establecidos en la Guía Para el Llenado del Certificado de Defunción y del Certificado de Muerte Fetal. La evaluación de l...

Diarrhoea in slum children: observation from a large diarrhoeal disease hospital in Dhaka, Bangladesh.

Science.gov (United States)

Ferdous, Farzana; Das, Sumon Kumar; Ahmed, Shahnawaz; Farzana, Fahmida Dil; Malek, Mohammad Abdul; Das, Jui; Latham, Jonathan Ross; Faruque, Abu Syed Golam; Chisti, Mohammod Jobayer

2014-10-01

To determine and compare socio-demographic, nutritional and clinical characteristics of children under five with diarrhoea living in slums with those of children who do not live in slums of Dhaka, Bangladesh. From 1993 to 2012, a total of 28 948 under fives children with diarrhoea attended the Dhaka Hospital of icddr,b. Data were extracted from the hospital-based Diarrhoea Disease Surveillance System, which comprised 17 548 under fives children from slum and non-slum areas of the city. Maternal illiteracy [aOR = 1.57; 95% confidence interval (1.36, 1.81), P-value slum-dwelling children after controlling for co-variates. Measles immunisation [0.52 (0.47, 0.59) P slum dwellers than other children in univarate analysis only. Slum-dwelling children are more malnourished, have lower immunisation rates (measles vaccination and vitamin A supplementation) and higher rates of measles, are more susceptible to diarrhoeal illness due to V. cholerae and suffer from severe dehydration more often than children from non-slum areas. Improved health and nutrition strategies should give priority to children living in urban slums. © 2014 John Wiley & Sons Ltd.

The effects of interactive music therapy on hospitalized children with cancer: a pilot study.

Science.gov (United States)

Barrera, Maru E; Rykov, Mary H; Doyle, Sandra L

2002-01-01

The use of music therapy with children in health settings has been documented, but its effectiveness has not yet been well established. This pilot study is a preliminary exploration of the effectiveness of interactive music therapy in reducing anxiety and increasing the comfort of hospitalized children with cancer. Pre- and post-music therapy measures were obtained from children (N = 65) and parents. The measures consisted of children's ratings of mood using schematic faces, parental ratings of the child's play performance, and satisfaction questionnaires completed by parents, children and staff. There was a significant improvement in children's ratings of their feelings from pre- to post-music therapy. Parents perceived an improved play performance after music therapy in pre-schoolers and adolescents but not in school-aged children. Qualitative analyses of children's and parents' comments suggested a positive impact of music therapy on the child's well-being. These preliminary findings are encouraging and suggest beneficial effects of interactive music therapy with hospitalized pediatric hematology/oncology patients. In future studies replicating these findings should be conducted in a randomized control trial. Copyright 2002 John Wiley & Sons, Ltd.

A multilevel model of patient safety culture: cross-level relationship between organizational culture and patient safety behavior in Taiwan's hospitals.

Science.gov (United States)

Chen, I-Chi; Ng, Hui-Fuang; Li, Hung-Hui

2012-01-01

As health-care organizations endeavor to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. The main objective of this study was to investigate the cross-level influences of organizational culture on patient safety behavior in Taiwan's hospitals. The authors measured organizational culture (bureaucratic, supportive and innovative culture), patient safety culture and behavior from 788 hospital workers among 42 hospitals in Taiwan. Multilevel analysis was applied to explore the relationship between organizational culture (group level) and patient safety behavior (individual level). Patient safety culture had positive impact on patient safety behavior in Taiwan's hospitals. The results also indicated that bureaucratic, innovative and supportive organizational cultures all had direct influence on patient safety behavior. However, only supportive culture demonstrated significant moderation effect on the relationship between patient safety culture and patient safety behavior. Furthermore, organizational culture strength was shown correlated negatively with patient safety culture variability. Overall, organizational culture plays an important role in patient safety activities. Safety behaviors of hospital staff are partly influenced by the prevailing cultural norms in their organizations and work groups. For management implications, constructed patient priority from management commitment to leadership is necessary. For academic implications, research on patient safety should consider leadership, group dynamics and organizational learning. These factors are important for understanding the barriers and the possibilities embedded in patient safety. Copyright © 2011 John Wiley & Sons, Ltd.

Hospital Library Administration.

Science.gov (United States)

Cramer, Anne

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

Evaluación de anemia ferropénica en la primera infancia del Municipio de Sonsón-Antioquia, 2007

OpenAIRE

Castillo Salgado, Tulia Isabel; Pérez Escobar, Rocío

2014-01-01

Objetivo: Determinar la prevalencia de anemia por deficiencia de hierro en niños de la primera infancia del municipio de Sonsón – Antioquia, en el año 2007. Metodología: Se realizó un estudio descriptivo transversal en 391 niños de 0 a 84 meses de edad del Municipio de Sonsón, Antioquia. Se estudiaron los parámetros de hemoglobina y ferritina sérica utilizando puntos de corte de la Organización Mundial de la Salud (OMS). Se calcularon las medidas de frecuencia y de resumen y los intervalos de...

Alexander Falconer Sr Seamen's missionary in New Zealand, son Alexander Falconer medical superintendent for mentally ill, grandson Murray Falconer neurosurgeon.

Science.gov (United States)

Hawgood, Barbara J

2016-08-01

Alexander Falconer Sr (1843-1915) came from Scotland to New Zealand. A practical Christian, he set up places of relaxation for miners, sailors and soldiers; he became the Seamen's Missionary. Son, Dr Alexander Falconer (1874-1955) trained at Otago University Medical School. As medical superintendent for the mentally ill, he urged the early introduction of psychotherapy. His son, Murray Falconer (1910-1977) was the first Nuffield Dominions Clinical Fellow, training in neurosurgery in Oxford. He was the first director of the Guy's-Maudsley Neurosurgical Unit in London and was internationally known for the surgical management of temporal lobe epilepsy in adults and children. © The Author(s) 2016.

La riqueza y la pobreza de las naciones. ¿Por qué algunas son tan ricas y otras tan pobres?

Directory of Open Access Journals (Sweden)

Abel Ignacio López

2001-01-01

Full Text Available Landes, David. La riqueza y la pobreza de las naciones. ¿Por qué algunas son tan ricas y otras son tan pobres?, Barcelona, Editorial Crítica, 1999, 604 páginas. ¿Porqué hay naciones pobres y naciones ricas y cuál es la contribución de la historia en la comprensión de esta cuestión? El autor entiende por cultura el espíritu de empresa, el conjunto de valores que guían la conducta de una población, el dominio de la ciencia, la tecnología y el espíritu racional.

La riqueza y la pobreza de las naciones. ¿Por qué algunas son tan ricas y otras tan pobres?

OpenAIRE

Abel Ignacio López

2010-01-01

Landes, David. La riqueza y la pobreza de las naciones. ¿Por qué algunas son tan ricas y otras son tan pobres?, Barcelona, Editorial Crítica, 1999, 604 páginas. ¿Porqué hay naciones pobres y naciones ricas y cuál es la contribución de la historia en la comprensión de esta cuestión? El autor entiende por cultura el espíritu de empresa, el conjunto de valores que guían la conducta de una población, el dominio de la ciencia, la tecnología y el espíritu racional.

Hospital marketing revisited.

Science.gov (United States)

Costello, M M

1987-05-01

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

Hospital in the Home nurses' recognition and response to clinical deterioration.

Science.gov (United States)

Gray, Erika; Currey, Judy; Considine, Julie

2018-05-01

To obtain an understanding of how Hospital in the Home (HITH) nurses recognise and respond to clinical deterioration in patients receiving care at home or in their usual place of residence. Recognising and responding to clinical deterioration is an international safety priority and a key nursing responsibility. Despite an increase in care delivery in home environments, how HITH nurses recognise and respond to clinical deterioration is not yet fully understood. A prospective, descriptive exploratory design was used. A survey containing questions related to participant characteristics and 10 patient scenarios was used to collect data from 47 nurses employed in the HITH units of three major health services in Melbourne, Australia. The 10 scenarios reflected typical HITH patients and included medical history and clinical assessment findings (respiratory rate, oxygen saturation, heart rate, blood pressure, temperature, conscious state and pain score). The three major findings from this study were that: (i) nurse and patient characteristics influenced HITH nurses' assessment decisions; (ii) the cues used by HITH nurses to recognise clinical deterioration varied according to the clinical context; and (iii) although HITH nurses work in an autonomous role, they engage in collaborative practice when responding to clinical deterioration. Hospital in the Home nurses play a fundamental role in patient assessment, and the context in which they recognise and respond to deterioration is markedly different to that of hospital nurses. The assessment, measurement and interpretation of clinical data are a nursing responsibility that is crucial to early recognition and response to clinical deterioration. The capacity of HITH services to care for increasing numbers of patients in their home environment, and to promptly recognise and respond to clinical deterioration should it occur, is fundamental to safety within the healthcare system. Hospital in the Home nurses are integral to a

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

Science.gov (United States)

Thibodeau, Patricia L; Funk, Carla J

2009-10-01

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

Failed Mothers, Monster Sons. Reading Shakespeare’S Richard Iii as a Fairy Tale

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Percec Dana

2014-03-01

Full Text Available The paper looks at Shakespeare’s historical play Richard III and its fairy tale-like character given by the configuration of the main character as an arch-villain and the presence of motifs and patterns typically associated with the fairy tale genre. More specifically, it considers the mother-son relationship between the Duchess of York and Richard in the light of the motif of monstrous birth. It is not a coincidence that the emergence of such motifs coincides with the historical contexts of the early modern period. Reading Richard III in this key is related to the revisionist approach to chronicle plays.

Developing and testing the patient-centred innovation questionnaire for hospital nurses.

Science.gov (United States)

Huang, Ching-Yuan; Weng, Rhay-Hung; Wu, Tsung-Chin; Lin, Tzu-En; Hsu, Ching-Tai; Hung, Chiu-Hsia; Tsai, Yu-Chen

2018-03-01

Develop the patient-centred innovation questionnaire for hospital nurses and establish its validity and reliability. Patient-centred care has been adopted by health care managers in their efforts to improve health care quality. It is regarded as a core concept for developing innovation. A cross-sectional study was employed to collect data from hospital nurses in Taiwan. This study was divided into two stages: pilot study and main study. In the main study, 596 valid responses were collected. This study adopted reliability analysis, exploratory factor analysis, confirmatory factor analysis and selected nurse innovation scale as a criterion to test criterion-related validity. Five-dimension patient-centred innovation questionnaire was proposed: access and practicability, co-ordination and communication, sharing power and responsibility, care continuity, family and person focus. Each dimension demonstrated a reliability of 0.89-0.98. All dimensions had acceptable convergent and discriminate validity. The patient-centred innovation questionnaire and nurse innovation scale exhibited a significantly positive correlation. Patient-centred innovation questionnaire not only had a good theoretical basis but also had sufficient reliability and construct validity, and criterion-related validity. Patient-centred innovation questionnaire could give a measure for evaluating the implementation of patient-centred care and could be used as a management tool during the process of nurse innovation. © 2017 John Wiley & Sons Ltd.

Hospitable Classrooms: Biblical Hospitality and Inclusive Education

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Anderson, David W.

2011-01-01

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

¿Son efectivas las intervenciones para reducir el consumo de sodio en la dieta?

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Gabriel Rada

2015-09-01

Full Text Available Las personas que consumen más sodio tienen cifras de presión arterial más alta, lo cual aumenta su morbimortalidad cardiovascular. El consumo de sodio en países latinoamericanos duplica o triplica lo recomendado, lo que ha llevado a redoblar los esfuerzos por abordar este problema. Los cambios de conducta y modificación de estilos de vida son difíciles de conseguir y mantener en el tiempo, por lo que las intervenciones a este nivel suelen precisar un abordaje desde múltiples perspectivas.

The impact of HMO and hospital competition on hospital costs.

Science.gov (United States)

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

2005-01-01

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

Motivos de licenças médicas em um hospital de urgência-emergência Razones de licencias médicas en un hospital de urgencia-emergencia Reason of medical licenses in an emergency hospital

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Marília Alves

2006-04-01

Full Text Available Trata-se de um estudo descritivo sobre o absenteísmo-doença entre os trabalhadores de um hospital de grande porte especializado em atendimento de urgência e emergência de Belo Horizonte. Foi analisado o absenteísmo-doença abordando a prevalência, motivo (CID10, tempo de afastamento e risco por categoria profissional. As categorias profissionais foram: serviços de apoio, auxiliares administrativos, enfermagem e medicina. O índice de absentismo-doença no hospital foi de 2,06. A chance de ocorrência de licenças médicas por profissional é 4,7. Este índice foi influenciado pela alta razão prevalente apresentada pela enfermagem (8,48. Os principais motivos de licenças médicas são doenças do sistema osteomuscular e do tecido conjuntivo (14,68%, fatores que influenciam o estado de saúde (13,59% e doenças do aparelho respiratório (13,32%.Se trata de un estudio descriptivo de la absenteísmo-enfermedad entre los obreros de un hospital de gran carga especializada en la asistencia de urgencia emergencia de Belo Horizonte, en 2002. La absenteísmo-enfermedad que se acercó él prevalecía se analizó, razón (CID10, tiempo y se arriesga para la categoría profesional. Las categorías profesionales eran: servicios de apoyo, administrativo, enfermería y medicina. El índice de absentismo-enfermedad en el hospital era de 2,06. la oportunidad de ocurrencia de licencias médicas para el profesional es 4,7. Este índice se influenció por el prevalente de razón de descarga presentado por la enfermería (8,48. Las razones principales de licencias médicas son enfermedades del osteomuscular del sistema y del tejido conjunto (14,68%, factores que influyen en la condición de salud (13,59% y enfermedades de la ropa respiratoria (13,32%.This is a descriptive study about the illness-absenteism process among workers in a large emergency hospital in the city of Belo Horizonte, in 2002. The illness- absenteeism process was analyzed considering

A new family of N dimensional superintegrable double singular oscillators and quadratic algebra Q(3) ⨁ so(n) ⨁ so(N-n)

Science.gov (United States)

Fazlul Hoque, Md; Marquette, Ian; Zhang, Yao-Zhong

2015-11-01

We introduce a new family of N dimensional quantum superintegrable models consisting of double singular oscillators of type (n, N-n). The special cases (2,2) and (4,4) have previously been identified as the duals of 3- and 5-dimensional deformed Kepler-Coulomb systems with u(1) and su(2) monopoles, respectively. The models are multiseparable and their wave functions are obtained in (n, N-n) double-hyperspherical coordinates. We obtain the integrals of motion and construct the finitely generated polynomial algebra that is the direct sum of a quadratic algebra Q(3) involving three generators, so(n), so(N-n) (i.e. Q(3) ⨁ so(n) ⨁ so(N-n)). The structure constants of the quadratic algebra itself involve the Casimir operators of the two Lie algebras so(n) and so(N-n). Moreover, we obtain the finite dimensional unitary representations (unirreps) of the quadratic algebra and present an algebraic derivation of the degenerate energy spectrum of the superintegrable model.

¿Qué hogares colombianos son pobres? una aproximación desde la ECV del 2003

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Adriana Carolina Silva Arias

2007-01-01

Full Text Available Este artículo analizó los conceptos y medidas de pobreza. A partir de esta perspectiva, se estudió quiénes son pobres en Colombia y qué características de los hogares determinan dicha condición para el 2003. A partir de la Encuesta de Calidad de Vida, se realizó un análisis logit para identifi car y medir la incidencia de algunos factores en la probabilidad de que un hogar sea clasifi cado como pobre. Estas estimaciones mostraron que los hogares que tienen más probabilidad de considerarse como pobres son aquellos en los que los jefes de hogar eran analfabetas, mujeres, los que se ocuparon en labores agrícolas o que hacían parte de alguna etnia. Adicionalmente, se encontró que los hogares que tenían menores de 12 años tuvieron más de probabilidad de ser pobres. Finalmente, los hogares cuyo jefe de hogar tenía mayor nivel educativo, tenían menor probabilidad de ser pobres, siendo mayor el efecto educativo de su cónyuge.

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

Science.gov (United States)

Palangkaraya, Alfons; Yong, Jongsay

2013-06-01

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

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

Job satisfaction and horizontal violence in hospital staff registered nurses: the mediating role of peer relationships.

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Purpora, Christina; Blegen, Mary A

2015-08-01

foster hospital staff registered nurses' job satisfaction in the presence of horizontal violence. © 2015 John Wiley & Sons Ltd.

Factors influencing nurse-assessed quality nursing care: A cross-sectional study in hospitals.

Science.gov (United States)

Liu, Ying; Aungsuroch, Yupin

2018-04-01

To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care. Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programmes to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model. A cross-sectional survey. The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model. The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient-to-nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout. This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses' work conditions of work environment and patient-to-nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programmes to improve quality nursing care. © 2017 John Wiley & Sons Ltd.

The role of hospice in the transition from hospital to home for technology-dependent children-A qualitative study.

Science.gov (United States)

Price, Jayne; McCloskey, Sharon; Brazil, Kevin

2018-01-01

To report parent and professional perspectives of step-down care in assisting the transition from hospital to home, within one children's hospice in a constituent country of the United Kingdom. In recent years, increasing numbers of children-dependent on long term assisted ventilation have been noted. Meeting the complex physical, emotional and social needs of the child and family is challenging. Many of these children spend extended periods in hospital even when medically stable. This was a qualitative study using an inductive, semantic analytic approach within a realist epistemology. Data collection was carried out in 2013. Interviews took place with parents (n = 5) and focus groups with professionals (n = 26) who had experience of step-down care. Multiple benefits of step-down in the hospice were clear. Both sets of accounts suggested that for children and families life was "on hold" in hospital. Hospice was considered a home-like environment where the child and family could "live again". Parents reflected that, in hospice they were "living, not existing" while professionals highlighted hospice as nurturing and empowering the whole family, promoting the child's development while safely meeting their clinical needs. The study highlights a number of crucial benefits to the child and family both in the immediate and longer terms. The collective perspectives therefore endorse hospice as a potential viable choice for these children and their families during the always difficult, usually protracted transition from hospital to home. © 2017 John Wiley & Sons Ltd.

Evolution of the uranium local environment during alteration of SON68 glass

International Nuclear Information System (INIS)

Jollivet, Patrick; Auwer, Christophe Den; Simoni, Eric

2002-01-01

The speciation of uranium in SON68 glass specimens doped with 0.75-3.5 wt% uranium and in the gels formed by alteration of the specimens was investigated by X-ray absorption spectroscopy. In the glasses, uranium is present at oxidation state VI and coordination number 6 with the same average distances than those found in a UO 3 type environment. The U-O distances and uranium coordination numbers are identical throughout the uranium concentration range. During glass alteration the uranium remains at oxidation state VI in the gels, but was found in the uranyl form. An increase in the equatorial distances (from 2.20 and 2.32 A in the glass to respectively 2.22 and 2.39 A in the gel) and coordination numbers (to about 7 and 8, respectively) was observed

The global tantalum industry and Sons of Gwalia Ltd

International Nuclear Information System (INIS)

Paull, D.

2002-01-01

Sons of Gwalia Ltd., in Perth Australia is a long-term supplier of tantalum (Ta), a valuable rare metal with adequate supply. Tantalum is soft and ductile with high melting and boiling points and a low co-efficient of thermal expansion. It has excellent capacity to store and release electrical charge and offers exceptional resistance to corrosion. Its' main use is in consumer electronics such as mobile phones, laptop computers, DVD players, personal video recorders and MP-3 players. For automotive electronics, tantalum is used for air-bags, audio systems, navigation systems, anti-lock break systems and under the hood vehicle management systems. The super alloy is also in demand by the aerospace industry and for turbine blades for power stations. The total demand of Tantalum in 2000 was 5 million lbs. Demand growth has increased steadily since 1993 with perhaps a slight increase in the past 5 years. Resources are estimated at a 125 year supply based on year 2000 production rates. 41 per cent of the world supply of tantalum is obtained from Australia, 13 per cent from Africa, 16 per cent from America, 22 per cent from Asia. The Greenbushes mine in Australia is the world's largest tantalum mine with 80 million lbs Ta, followed by Australia's Wodgina Mine with 50 million lbs Ta. Both mines are expected to be operational for the next 25 years. 12 figs

QCD Precision Measurements and Structure Function Extraction at a High Statistics, High Energy Neutrino Scattering Experiment: NuSOnG

International Nuclear Information System (INIS)

Adams, T.; Batra, P.; Bugel, Leonard G.; Camilleri, Leslie Loris; Conrad, Janet Marie; Fisher, Peter H.; Formaggio, Joseph Angelo; Karagiorgi, Georgia S.; )

2009-01-01

We extend the physics case for a new high-energy, ultra-high statistics neutrino scattering experiment, NuSOnG (Neutrino Scattering On Glass) to address a variety of issues including precision QCD measurements, extraction of structure functions, and the derived Parton Distribution Functions (PDFs). This experiment uses a Tevatron-based neutrino beam to obtain a sample of Deep Inelastic Scattering (DIS) events which is over two orders of magnitude larger than past samples. We outline an innovative method for fitting the structure functions using a parameterized energy shift which yields reduced systematic uncertainties. High statistics measurements, in combination with improved systematics, will enable NuSOnG to perform discerning tests of fundamental Standard Model parameters as we search for deviations which may hint of 'Beyond the Standard Model' physics

Incidencia del neumotórax en el Hospital "Julio Trigo López" Incidence of pneumothorax in "Julio Trigo" Hospital

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Germán Brito Sosa

2012-03-01

Full Text Available Objetivos: determinar el comportamiento del neumotórax como urgencia en el Hospital "Julio Trigo López", en el período comprendido entre 1995-2004. Métodos: se realizó un estudio descriptivo, retrospectivo de corte transversal. Se analizaron las historias clínicas de los 555 pacientes con neumotórax en el Hospital "Julio Trigo López" en el período comprendido entre 1995 a 2004. El universo estuvo constituido por los 555 pacientes con diagnóstico de neumotórax, que fueron atendidos en nuestro hospital durante el período señalado. Resultados: el neumotórax es más frecuente en el sexo masculino (75,1 %, y los grupos de edades afectados con más frecuencia se encontraron entre 21 y 40 años (52 %. El 78 % de los pacientes con neumotórax espontáneo son fumadores, y de los 43 pacientes que no tienen hábito de fumar, 37 de ellos tienen antecedentes de afecciones respiratorias, con predominio del enfisema, el asma bronquial y la bronquiectasia. Los neumotórax espontáneos fueron menos frecuentes en 195 pacientes (35,1 % en relación con los neumotórax traumáticos, que se presentaron en 360 pacientes (64,9 %, y de ellos, 127 presentaron hemoneumotórax. Hubo 62 pacientes (11 % con complicaciones, y fueron las más frecuentes: la persistencia del cuadro (4,7 % y el shock hipovolémico (3,4 %. Conclusiones: existe una relación directa entre las enfermedades crónicas respiratorias y los neumotórax espontáneos. Los neumotórax espontáneos recidivantes están relacionados con el hábito de fumar, la edad avanzada y con las afecciones respiratorias crónicas.Objectives: to determine the behavior of pneumothorax as emergency in "Julio trigo" Hospital from 1995 to 2004. Methods: a cross-sectional, retrospective and descriptive study was conducted. The medical records from 555 patients with pneumothorax admitted in above mentioned hospital between 1995-2004. Universe included 555 patients diagnosed with pneumothorax, seen in our hospital

CONDUTAS APÓS EXPOSIÇÃO OCUPACIONAL A MATERIAL BIOLÓGICO EM UM HOSPITAL ESPECIALIZADO EM ONCOLOGIA

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Paula Batista Luize

2015-01-01

Full Text Available Accidentes de trabajo con material biológico son una preocupación para las instituciones de salud. Es un estudio transversal, el objetivo fue evaluar las condutas reportadas por lo profesionales de enfermeria en un hospital especializado en oncología de São Paulo después de la exposición a material biológico. La población fue compuesta por 441 profesionales. El proyecto fue aprobado por el Comité Ético de Investigación del hospital. De los 441 entrevistados, 82 (18.6% reportaron la exposición en los últimos doce meses. Es de destacar que 47 (57,3% profesionales reportaron oficialmente el accidente y buscaron atención clínica especializada. La razón dada con mayor frecuencia por los sujetos que no tomaron conducta (72,1% fue considerar la notificación innecesaria. Las estrategias dirigidas a incrementar la adherencia a las prácticas profesionales recomendadas después de la exposición pueden contribuir a la mejora de la seguridad profesional.

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

Science.gov (United States)

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

2017-11-01

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

¿Son los MOOC una alternativa de aprendizaje?

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Antonio Ramón Bartolomé Pina

2015-01-01

Full Text Available Este trabajo reflexiona sobre los MOOC como entornos de aprendizaje. El número de cursos masivos abiertos y en línea (MOOC ha crecido exponencialmente en pocos años desde que fueron introducidos. Los MOOC son considerados una nueva forma de entornos virtuales de aprendizaje potenciados por la tecnología. Se consideran dos tipos de MOOC: unos los organizados por Siemens y Downes (cMOOC y otros los desarrollados en lugares como Stanford, con muchos estudiantes y loables objetivos (xMOOC; estos tienen también sus debilidades. Aunque han sido recibidos con altas expectativas, también han encontrado una fuerte oposición que está aumentando con el tiempo, lo que nos permite estudiar este fenómeno en profundidad. Aunque todavía hay pocas investigaciones empíricas sobre los efectos de los MOOC en el aprendizaje, este estudio trata de arrojar luz sobre el tema desde un punto de vista teórico. En primer lugar exploraremos las expectativas positivas y negativas generadas. Los MOOC pueden constituir una buena propuesta a gran escala, lo que solo es posible para unas pocas grandes instituciones. No hay estudio de mercado, ni modelo de negocio, ni investigaciones empíricas que permitan confirmar los anuncios de sus efectos positivos. Revisaremos las teorías del aprendizaje recientes y clásicas respecto a su capacidad para explicar el proceso de aprendizaje y compararemos los cursos en línea tradicionales, los xMOOC y los cMOOC en relación a su potencial para apoyar el aprendizaje y su auto-regulación.

Similarities of Variant Creutzfeldt-Jakob Disease Strain in Mother and Son in Spain to UK Reference Case.

Science.gov (United States)

Diack, Abigail B; Boyle, Aileen; Ritchie, Diane; Plinston, Chris; Kisielewski, Dorothy; de Pedro-Cuesta, Jesús; Rábano, Alberto; Will, Robert G; Manson, Jean C

2017-09-01

We investigated transmission characteristics of variant Creutzfeldt-Jakob disease in a mother and son from Spain. Despite differences in patient age and disease manifestations, we found the same strain properties in these patients as in UK vCJD cases. A single strain of agent appears to be responsible for all vCJD cases to date.

Determinants of Hospital Pharmacists’ Job Satisfaction in Romanian Hospitals

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Magdalena Iorga

2017-12-01

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

Determinants of Hospital Pharmacists' Job Satisfaction in Romanian Hospitals.

Science.gov (United States)

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

2017-12-11

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

The work engagement of nurses in multiple hospital sectors in Saudi Arabia: a comparative study.

Science.gov (United States)

Aboshaiqah, Ahmad E; Hamadi, Hanadi Y; Salem, Olfat A; Zakari, Nazik M A

2016-05-01

To examine the differences in work engagement among nurses in Saudi Arabia and its relationship with personal characteristics across different hospital affiliations. Quality care requires an adequate supply of engaged nurses who are dedicated, energised and absorbed in their work. In the nursing profession, work engagement is of considerable importance, owing to the shortage of nurses and the continuing reduction in healthcare costs. An analytic comparative cross-sectional design was used. Eight hospitals from three provinces and different affiliation types participated in the study. The Utrecht work engagement scale (UWES) was used to measure 980 nurses' work engagement. The findings indicate that nurses' total engagement scores were closer to the higher end of the Likert scale. The findings indicate generally high levels of work engagement, particularly regarding the element of dedication. Furthermore, the study shows significant differences in nurses' engagement among the various work settings and in nurses' age and experience. A number of nurses' personal characteristics have independent influences on their work engagement. Nurse leaders should acknowledge that a statement of professional nursing scope of practice is a necessity to encourage and fulfil engagement. © 2016 John Wiley & Sons Ltd.

[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

Candiduria in hospitalized patients in teaching hospitals of Ahvaz.

Science.gov (United States)

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

2012-12-01

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

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

Directory of Open Access Journals (Sweden)

Amin Talebpour

2016-06-01

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

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

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McCarthy, Aidan; Maor, Dorit; McConney, Andrew

2017-01-01

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

Two decades of external peer review of cancer care in general hospitals; the Dutch experience.

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Kilsdonk, Melvin J; Siesling, Sabine; Otter, Rene; van Harten, Wim H

2016-03-01

External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews were held with clinicians, oncology nurses, and managers from fifteen general hospitals that participated in three rounds of peer review over a period of 16 years. Interviewees reflected on the goals and expectations, experiences, perceived impact, and future role of external peer review. Transcriptions of the interviews were coded to discover recurrent themes. Improving clinical care and organization were the main motives for participation. Positive impact was perceived on multiple aspects of care such as shared responsibilities, internal prioritization of cancer care, improved communication, and a clear structure and position of cancer care within general hospitals. Establishing a direct relationship between the external peer review and organizational or clinical impact proved to be difficult. Criticism was raised on the content of the program being too theoretical and organization-focussed after three rounds. According to most stakeholders, external peer review can improve multidisciplinary team work in cancer care; however, the acceptance is threatened by a perceived disbalance between effort and visible clinical impact. Leaner and more clinically focused programs are needed to keep repeated peer reviews challenging and worthwhile. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Unanticipated hospital admission in pediatric patients with congenital heart disease undergoing ambulatory noncardiac surgical procedures.

Science.gov (United States)

Yuki, Koichi; Koutsogiannaki, Sophia; Lee, Sandra; DiNardo, James A

2018-05-18

An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken. The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission. This is a retrospective study of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis in a single center. Using the electronic preoperative anesthesia evaluation form, we identified 3010 patients with congenital heart disease who underwent noncardiac procedures of which 1028 (34.1%) were scheduled to occur on an ambulatory basis. Demographic, echocardiographic and functional status data, cardiovascular and respiratory adverse events, and reasons for postprocedure admission were recorded. Univariable analysis was conducted. The unplanned hospital admission was 2.7% and univariable analysis demonstrated that performance of an echocardiogram within 6 mo of the procedure and procedures performed in radiology were associated with postoperative admission. Cardiovascular adverse event incidence was 3.9%. Respiratory adverse event incidence was 1.8%. Ambulatory, noncomplex procedures can be performed in pediatric patients with congenital heart disease and good functional status with a relatively low unanticipated hospital admission rate. © 2018 John Wiley & Sons Ltd.

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

Science.gov (United States)

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

2016-09-01

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

Hospitality and hostility in hospitals

DEFF Research Database (Denmark)

Jensen, Tina Blegind; Aanestad, Margunn

2007-01-01

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

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

Science.gov (United States)

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

2011-12-01

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

Linking objects in the process of mourning for sons disappeared in war: Croatia 2001.

Science.gov (United States)

Jurcević, Slavica; Urlić, Ivan

2002-04-01

Mothers use linking object to externalize the complex aspects of their relationship to the loss of their child. We analyzed the linking objects that mothers kept in memory of their sons who disappeared in the 1991-1995 war in Croatia or whose remains were uncovered and identified long time after they had gone missing. The case study of disturbed mourning included 26 mothers of Croatian soldiers from Croatian Osijek-Baranja County who went missing in war or whose remains were recovered and identified long after they had gone missing. The mothers were selected independently by the president of the Association of Families of Missing and Detained Croatian Soldiers and agreed to participate in the study in 2001. They were interviewed in their homes, their testimonies were recorded, and photographs of the linking objects taken. Linking objects were classified according to the Volkan's four-group classification. Out of four Volkan's groups of linking objects, we identified the objects belonging to the first three. Those were 1) objects that had been worn by the deceased (clothes, wrist-watch, ring, or glasses), (6/26); 2) objects that could be viewed in the psychoanalytic sense as an extension of the body of the disappeared or dead person, such as a camera (4/26); and 3) objects with realistic or symbolic resemblance to the deceased, usually a photograph (8/26). None of the examined objects belonged to the fourth Volkan's group (objects at hand when the news of the death came or objects present at the funeral, things that could be considered last-minute objects, ie, related to the moment when the deceased was last seen alive). However, 8/26 objects formed a new hitherto undescribed group. Mothers used such objects to create a memorial shrine to their sons. A photograph of the missing person or person whose remains were identified long after he had gone missing occupied a central place at the shrine, and was surrounded by other symbols of the Catholic iconography (Virgin

Mixed-method research protocol: defining and operationalizing patient-related complexity of nursing care in acute care hospitals.

Science.gov (United States)

Huber, Evelyn; Kleinknecht-Dolf, Michael; Müller, Marianne; Kugler, Christiane; Spirig, Rebecca

2017-06-01

To define the concept of patient-related complexity of nursing care in acute care hospitals and to operationalize it in a questionnaire. The concept of patient-related complexity of nursing care in acute care hospitals has not been conclusively defined in the literature. The operationalization in a corresponding questionnaire is necessary, given the increased significance of the topic, due to shortened lengths of stay and increased patient morbidity. Hybrid model of concept development and embedded mixed-methods design. The theoretical phase of the hybrid model involved a literature review and the development of a working definition. In the fieldwork phase of 2015 and 2016, an embedded mixed-methods design was applied with complexity assessments of all patients at five Swiss hospitals using our newly operationalized questionnaire 'Complexity of Nursing Care' over 1 month. These data will be analysed with structural equation modelling. Twelve qualitative case studies will be embedded. They will be analysed using a structured process of constructing case studies and content analysis. In the final analytic phase, the quantitative and qualitative data will be merged and added to the results of the theoretical phase for a common interpretation. Cantonal Ethics Committee Zurich judged the research programme as unproblematic in December 2014 and May 2015. Following the phases of the hybrid model and using an embedded mixed-methods design can reach an in-depth understanding of patient-related complexity of nursing care in acute care hospitals, a final version of the questionnaire and an acknowledged definition of the concept. © 2016 John Wiley & Sons Ltd.

Development, implementation and outcome analysis of semi-automated alerts for metformin dose adjustment in hospitalized patients with renal impairment.

Science.gov (United States)

Niedrig, David; Krattinger, Regina; Jödicke, Annika; Gött, Carmen; Bucklar, Guido; Russmann, Stefan

2016-10-01

Overdosing of the oral antidiabetic metformin in impaired renal function is an important contributory cause to life-threatening lactic acidosis. The presented project aimed to quantify and prevent this avoidable medication error in clinical practice. We developed and implemented an algorithm into a hospital's clinical information system that prospectively identifies metformin prescriptions if the estimated glomerular filtration rate is below 60 mL/min. Resulting real-time electronic alerts are sent to clinical pharmacologists and pharmacists, who validate cases in electronic medical records and contact prescribing physicians with recommendations if necessary. The screening algorithm has been used in routine clinical practice for 3 years and generated 2145 automated alerts (about 2 per day). Validated expert recommendations regarding metformin therapy, i.e., dose reduction or stop, were issued for 381 patients (about 3 per week). Follow-up was available for 257 cases, and prescribers' compliance with recommendations was 79%. Furthermore, during 3 years, we identified eight local cases of lactic acidosis associated with metformin therapy in renal impairment that could not be prevented, e.g., because metformin overdosing had occurred before hospitalization. Automated sensitive screening followed by specific expert evaluation and personal recommendations can prevent metformin overdosing in renal impairment with high efficiency and efficacy. Repeated cases of metformin-associated lactic acidosis in renal impairment underline the clinical relevance of this medication error. Our locally developed and customized alert system is a successful proof of concept for a proactive clinical drug safety program that is now expanded to other clinically and economically relevant medication errors. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

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

Science.gov (United States)

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

2014-11-01

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

The Hospitable Meal Model

DEFF Research Database (Denmark)

Justesen, Lise; Overgaard, Svend Skafte

2017-01-01

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

ELEMENTAL FORMS OF HOSPITALITY

Directory of Open Access Journals (Sweden)

Maximiliano Emanuel Korstanje

2010-11-01

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

Fraud in Hospitals

OpenAIRE

Musau, Steve; Vian, Taryn

2008-01-01

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

Impact of an antimicrobial stewardship programme on antibiotic usage and resistance in a tertiary hospital in China.

Science.gov (United States)

Zhang, Z-G; Chen, F; Ou, Y

2017-10-01

Antimicrobial misuse has been commonly observed in China. This phenomenon can cause antibiotic resistance. This study was designed to evaluate the impact of an antimicrobial stewardship programme implemented in a tertiary hospital in China from 2011 to 2014. The antimicrobial stewardship programme began in 2011. Data on the consumption of antibiotics and antimicrobial resistance between 2011 and 2014 were collected. Comparison of the 2011 data with those of 2014 showed that antibiotic defined daily doses/per 100 patient-days decreased from 92.5±2.8 to 35.8±1.2 (Padministrative management, especially information management, was effective in reducing antibiotic consumption and lessening antibiotic resistance. © 2017 John Wiley & Sons Ltd.

"I have nine specialists. They need to swap notes!" Australian patients' perspectives of medication-related problems following discharge from hospital.

Science.gov (United States)

Eassey, Daniela; McLachlan, Andrew J; Brien, Jo-Anne; Krass, Ines; Smith, Lorraine

2017-10-01

Research has shown that patients are most susceptible to medication-related problems (MRPs) when transitioning from hospital to home. Currently, the literature in this area focuses on interventions, which are mainly orientated around the perspective of the health-care professional and do not take into account patient perspectives and experiences. To capture the experiences and perceptions of Australian patients regarding MRPs following discharge from hospital. A cross-sectional study was conducted using a questionnaire collecting quantitative and qualitative data. Thematic analysis was conducted of the qualitative data. Survey participants were recruited through The Digital Edge, an online market research company. Five hundred and six participants completed the survey. A total of 174 participants self-reported MRPs. Two concepts and seven subthemes emerged from the analysis. The first concept was types of MRPs and patient experiences. Three themes were identified: unwanted effects from medicines, confusion about medicines and unrecognized medicines. The second concept was patient engagement in medication management, of which four themes emerged: informing patients, patient engagement, communication amongst health-care professionals and conflicting advice. This study provides an important insight into patients' experiences and perceptions of MRPs following discharge from hospital. Future direction for practice and research should look into implementing patient-centred care at the time of hospital discharge to ensure the provision of clear and consistent information, and developing ways to support and empower patients to ensure a smooth transition post-discharge from hospital. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Orodental status and medical problems of stroke inpatients undergoing rehabilitation at a rehabilitation hospital in Japan.

Science.gov (United States)

Asahi, Yoshinao; Omichi, Shiro; Ono, Takahiro

2015-09-01

Many stroke patients may have oral problems and systemic diseases, but clinical information on treatment provided to stroke patients for dental problems during inpatient rehabilitation is rare. The objective of this study was to research stroke inpatients' requirements for dental treatment and the accompanying risks. We included 165 stroke patients undergoing inpatient rehabilitation at Morinomiya Hospital during the year 2010 and researched the causes of stroke and the patients' orodental status, underlying diseases, antithrombotic drugs prescribed and special considerations or difficulties in the treatment. Cerebral infarction was the most common causes of stroke. Many patients had hypertension, heart disease or diabetes mellitus, and 54.5% had been prescribed antithrombotic drugs. Dentists diagnosed 57.0% patients with untreated dental cavities. Approximately 30% did not use dentures despite having a requirement. In total, 142 patients underwent dental treatment including periodontal treatment, prosthetic treatment and tooth extraction under management of circulation and haemostasis such as monitoring vital signs and surgical splints in cases of the difficult extraction. The current study revealed a high requirement for dental treatment among stroke patients and demonstrated the effectiveness of performing dental treatment during inpatient rehabilitation of these patients. © 2014 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.

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...

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

Science.gov (United States)

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

2014-10-01

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

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

Science.gov (United States)

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

1992-01-01

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

Bad Boys Meet the Swan of Avon: A Re-Visioning of Hamlet in Sons of Anarchy

Directory of Open Access Journals (Sweden)

Burzyńska Katarzyna

2017-12-01

Full Text Available This article investigates the intersections between Shakespeare’s Hamlet and a popular TV series Sons of Anarchy (SOA, loosely based on the Shakespearean original. The crime drama series revolves around an outlaw motorcycle club that literally “rules” a fictional town in California like an old royal family with its own brutal dynastic power squabbles and dark family secrets. The club is governed by an unscrupulous President Clay and an equally violent, though more conflicted, Vice President Jax Teller, the son of the late President, who had died in mysterious circumstances. In the article I argue that the popularity of the series lies not in its graphic scenes of violence, over-the-top Harley chases, and sex intrigues, but rather in its Shakespearean and Renaissance structure. SOA, dubbed as “Hamlet on Harleys”1, is an appropriation rather than an adaptation of Shakespeare’s tragedy, which makes it a truly transmedial phenomenon. The article investigates a fascinating blend of seemingly marginal elements of modern American culture and the canonical British tragedy. It also addresses the connections between the lifestyles of the so called outlaw MC clubs and the early modern family structure as presented in Hamlet, focusing on the issues of power and gender relations.

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

NARCIS (Netherlands)

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

2015-01-01

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

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

African Journals Online (AJOL)

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

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

Science.gov (United States)

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

2015-11-01

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

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

Science.gov (United States)

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

2018-06-01

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

Afastamentos do trabalho na enfermagem: ocorrências com trabalhadores de um hospital de ensino Retiros del trabajo en la enfermaría: ocurrencias en trabajadores en un hospital de enseñanza Nursing absenteeism: occurrences at a university hospital

Directory of Open Access Journals (Sweden)

Denise Beretta Barboza

2003-03-01

Full Text Available As condições laborais da equipe de enfermagem freqüentemente são marcadas por riscos, os quais repercutem em elevado absenteísmo e licenças-saúde. O objetivo deste estudo foi caracterizar os afastamentos entre trabalhadores de enfermagem de um hospital geral de ensino da cidade de São José do Rio Preto-SP, registrados durante o ano de 1999. Trata-se de uma investigação epidemiológica censitária, cuja coleta de dados foi efetuada por meio de consulta aos registros do Centro de Atendimento ao Trabalhador do hospital estudado. Os resultados indicaram que, no período, 333 trabalhadores envolveram-se em 662 episódios de afastamento. As licenças-saúde ocorreram, principalmente, por problemas geniturinário e doenças mal definidas entre enfermeiros, técnicos e auxiliares de enfermagem; e doenças dos órgãos dos sentidos, doenças infecta-parasitárias e doenças respiratórias entre os atendentes de enfermagem. Os dados obtidos subsidiam melhor análise dessa situação neste hospital e intervenções para melhoria das condições de trabalho vigentes.Las condiciones laborales del equipo de enfermería son frecuentemente marcadas por riesgos, situación que se refleja en un alto ausentismo e incapacidades médicas. El objetivo de este estudio fué caracterizar los retiros entre los trabajadores del equipo de enfermería de un hospital general de enseñanza de la ciudad de São José do Rio Preto-SP registrados durante el año de 1999. Se trató de una investigación por censo epidemiológico, cuya recolección de datos fue efectuada a través de la consulta a los registros del Centro de Atención al Trabajador del hospital estudiado. Los resultados indicaron que en este período 333 trabajadores estuvieron involucrados en 662 episodios de retiros. Las incapacidades ocurrieron principalmente por problemas génitourinarios y enfermedades mal definidas entre enfermeros, técnicos y auxiliares de enfermería; enfermedades de los �

Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

Science.gov (United States)

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

2012-01-01

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

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

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

2010-10-01

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

ELEMENTAL FORMS OF HOSPITALITY

OpenAIRE

Maximiliano Emanuel Korstanje

2010-01-01

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

The role of pH in the vapor hydration at 175 °C of the French SON68 glass

International Nuclear Information System (INIS)

Ait Chaou, Abdelouahed; Abdelouas, Abdesselam; El Mendili, Yassine; Martin, Christelle

2017-01-01

The French simulated nuclear waste SON68 glass was altered in the presence of water vapor at 175 °C and 98% of relative humidity under several atmospheres (NH_3, H_2S, CO_2 and argon). The objectives were to study the role of pH on hydration kinetics and secondary phases formation. The hydration was followed by infrared spectroscopy and the nature and extent of alteration products were determined by characterizing the reacted glass surface with scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), μ-Raman spectroscopy and X-ray diffraction (XRD). The glass hydration/alteration rate clearly increased with increasing pH, that is controlled by the gas atmosphere, as the following: NH_3 > Ar > CO_2 > H_2S. This can directly be linked to the secondary phases precipitated on the glass surface. Hence, the major alteration products observed at high pH (under NH_3 and Ar) are analcime and Ca-silicates hydrates (CSH) while at low pH (under CO_2 and H_2S) only a hydrated gel layer was identified. - Highlights: • The vapor hydration study of the SON68 glass under geological conditions. • The secondary phases formation in the alteration of SON68 glass. • The pH effect on the alteration kinetics of glass.

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

Science.gov (United States)

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

2016-04-01

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

Seismic Interpretation of the Nam Con Son Basin and its Implication for the Tectonic Evolution

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Nguyen Quang Tuan

2016-06-01

Full Text Available DOI:10.17014/ijog.3.2.127-137The Nam Con Son Basin covering an area of circa 110,000 km2 is characterized by complex tectonic settings of the basin which has not fully been understood. Multiple faults allowed favourable migration passageways for hydrocarbons to go in and out of traps. Despite a large amount of newly acquired seismic and well data there is no significant update on the tectonic evolution and history of the basin development. In this study, the vast amount of seismic and well data were integrated and reinterpreted to define the key structural events in the Nam Con Son Basin. The results show that the basin has undergone two extentional phases. The first N - S extensional phase terminated at around 30 M.a. forming E - W trending grabens which are complicated by multiple half grabens filled by Lower Oligocene sediments. These grabens were reactivated during the second NW - SE extension (Middle Miocene, that resulted from the progressive propagation of NE-SW listric fault from the middle part of the grabens to the margins, and the large scale building up of roll-over structure. Further to the SW, the faults of the second extentional phase turn to NNE-SSW and ultimately N - S in the SW edge of the basin. Most of the fault systems were inactive by Upper Miocene except for the N - S fault system which is still active until recent time.

Hospitality and Institutional Meals

DEFF Research Database (Denmark)

Justesen, Lise; Strøjer, Anna-Lise

2017-01-01

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

"Daughter and son: a completely different story”? Gender as a moderator of the relationship between sexism and parental attitudes

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Małgorzata Lipowska

2016-09-01

Full Text Available Background During childhood, parents are the first and most important individuals who form the base of the content of gender stereotypes in children. A parent’s expectations about the extent a child’s behaviour should be line with gender stereotypes also depends on the intensity of a parent’s sexism. A parent’s sexism may be exhibited in parental attitudes. Hence, in our study we analysed the relationship between parental ambivalent sexism and parental attitudes within dyads of mothers and fathers with a special focus on the role of the gender of both parents and children. Participants and procedure Two hundred and ninety-four couples of parents of five-year-olds (153 girls, 141 boys participated. The Ambivalent Sexism Inventory (ASI was used to measure levels of sexism, and the Parental Attitudes Scale (SPR was used to assess parental attitudes. Results In terms of the profile of parental attitudes, regardless of the child’s sex, mothers and fathers scored highest for inconsequent and demanding attitudes, and lowest for overprotective and autonomy attitudes. The child’s sex is also not important for the overall levels of parents’ sexism – fathers exhibit higher levels of hostile sexism in comparison to mothers. Only the mothers’ education level is important for levels of sexism – women with higher education exhibited the lowest levels of hostile sexism. The child’s sex moderates relationships between parents’ sexism and parental attitudes. In the case of mothers of sons, the intensity of benevolent sexism is negatively related to overprotective and demanding attitudes. The more educated the mothers of sons, the more demanding they were. For fathers of sons, the inconsequence attitude increases under the influence of both hostile and benevolent sexism. Among fathers of daughters, hostile sexism strengthens the overprotective attitude, while levels of both benevolent and hostile sexism as well as education influence the

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

Science.gov (United States)

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

2018-05-03

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

A família e o doente mental usuário do hospital-dia: estudo de um caso La familia y el enfermo mental usuário del hospital/día: estudo de un caso The family and the mentally-ill user of day-hospitals: a case study

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Ana Ruth Macêdo Monteiro

2000-12-01

este estudio son bastante significativas para la construcción de nuevas posibilidades en la atención a la familia del enfermo mental.The day-hospital, as a modality of psychiatric care, provides families with the possibility to experience greater contact with their mentally-ill relative during treatment and leads them to searching, together with such relative, for ways to facilitate the adaptation process of interaction in the family. This study aims at understanding how families and the users of day-hospitals interact out of their homes and at describing the experience narrated by a family. The family in this study was selected from one of the users of a day-hospital who had a previous history of hospital admissions for psychiatric treatment. Five members of the family under study were interviewed. Based on the experiences described by the subjects, two great thematic categories emerged: the family experiencing the day-hospital with its family member and the family-user relationships. The experiences narrated by the subjects in this study are rather significant for the construction of new possibilities in caring for the mentally-ill person's family.

[Sociodemographic characteristics of the pregnant adolescent in a high specialty hospital].

Science.gov (United States)

Blanquet-García, Jaime; Montoya-Cázarez, Aminta; Carranza-Lira, Sebastián

2016-01-01

The adolescents' pregnancy is a public health problem related to sociocultural and economic factors which compromise the mother-son binomial. The aim of this paper is to identify the socio-demographic characteristics of pregnant adolescents from the hospital. Retrospective, descriptive and observational study, in which all pregnant patients between 10 and 19 years from the Hospital, during June 2012 and January 2014, were studied. The following data were collected: age, scholarship, occupation, marital status, age at beginning of sexual relations, number of sexual partners, contraceptive use and type of contraceptive method, pregnancies, parturition, cesarean section and abortions. Statistical analysis: Descriptive statistic was used, consistent in central tendency and dispersion measures. 608 adolescent were studied, age was 16.7 ± 1.2 years, 50.2% were students, 35.1% unemployed, 29.5% were single and 25.2% married. In 79% was its first pregnancy. The age at beginning of sexual relations was at 15.0 ± 1.3 years; 39% didn't use contraceptive method and 24.5% hadn't addictions. The pregnancy wasn't planned nor wished in 78.1%. Gestational age was between 8 and 44 weeks, this latter due to no confident amenorrhea and 56.7% had associated pathology. The mean age of the couple was 20.6 ± 3.8 years, 84.1% worked and 64.2% hadn't addictions. The opportune detection of risk factors will allow the prevention and attention of the teenage pregnancy.

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

Science.gov (United States)

Carter, Mary W

2003-08-01

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

FACTORES DE RIESGO QUE INCIDEN EN LA RETINOPATÍA DEL PREMATURO EN EL SERVICIO DE NEONATOLOGÍA EN UN HOSPITAL DEL MINISTERIO DE SALUD

OpenAIRE

Guerrero Sausa, Mirella Raquel; Universidad Señor de Sipán; Sánchez Saavedra, Sandra Del Pilar; Universidad Señor de Sipán; Lizárraga De Maguiña, Isabel Graciela; Hospital Regional Docente Las Mercedes

2016-01-01

Este estudio tiene como objetivo: Determinar los Factores de Riesgo que Inciden en la Retinopatía del Prematuro en el Servicio de Neonatología del Hospital Regional Docente las Mercedes - Chiclayo 2014, es de tipo cuantitativo, diseño no experimental, descriptivo y retrospectivo, la población muestral fue de 136 recién nacidos prematuros según criterios de inclusión y exclusión. Las técnicas de recolección de datos son de análisis documental y bibliográfico, teniendo como fuentes primarias la...

La comprensión del relato periodístico: ¿qué son los hechos?

OpenAIRE

Saharrea, Juan Manuel

2013-01-01

El objetivo de este trabajo echar luz acerca de la comprensión del relato periodístico planteando el debate filosófico acerca del estatus de los hechos. Tomando algunas distinciones de la filosofía del lenguaje y la epistemología contemporáneas definimos nuestra propia posición en relación con los hechos. De acuerdo con nuestra perspectiva los hechos, no son, bajo ningún aspecto, independientes de descripción. Planteamos las tesis del realismo y el relativismo en torno a los hechos y de cada ...

Examination of the Film "My Father and My Son" According to the Basic Concepts of Multigenerational Family Therapy

Science.gov (United States)

Acar, Tulin; Voltan-Acar, Nilufer

2013-01-01

The aim of this study was to evaluate the basic concepts of multigenerational Family Therapy and to evaluate the scenes of the film ''My Father and My Son'' according to these concepts. For these purposes firstly basic concepts of Multigenerational Family Therapy such as differentiation of self, triangles/triangulation, nuclear family emotional…

Ehlers-Danlos syndrome type IV : unusual congenital anomalies in a mother and son with a COL3A1 mutation and a normal collagen III protein profile

NARCIS (Netherlands)

Kroes, HY; Pals, G; van Essen, AJ

A mother and son with Ehlers-Danlos syndrome (EDS) type IV and unusual congenital anomalies are described. The congenital anomalies include, in the mother, amniotic band-like constrictions on one hand, a unilateral clubfoot, and macrocephaly owing to normal-pressure hydrocephaly and, in the son, an

Mid- to late Holocene climate-driven regime shifts inferred from diatom, ostracod and stable isotope records from Lake Son Kol (Central Tian Shan, Kyrgyzstan)

Science.gov (United States)

Schwarz, Anja; Turner, Falko; Lauterbach, Stefan; Plessen, Birgit; Krahn, Kim J.; Glodniok, Sven; Mischke, Steffen; Stebich, Martina; Witt, Roman; Mingram, Jens; Schwalb, Antje

2017-12-01

Arid Central Asia represents a key region for understanding climate variability and interactions in the Northern Hemisphere. Patterns and mechanisms of Holocene climate change in arid Central Asia are, however, only partially understood. Multi-proxy data combining diatom, ostracod, sedimentological, geochemical and stable isotope analyses from a ca. 6000-year-old lake sediment core from Son Kol (Central Kyrgyzstan) show distinct and repeated changes in species assemblages. Diatom- and ostracod-inferred conductivity shifts between meso-euhaline and freshwater conditions suggest water balance and regime shifts. Organism-derived data are corroborated by stable isotope, mineralogical and geochemical records, underlining that Son Kol was affected by strong lake level fluctuations of several meters. The δ13Ccarb/δ18Ocarb correlation shows repeated switchovers from a closed to an open lake system. From 6000 to 3800 and 3250 to 1950 cal. yr BP, Son Kol was a closed basin lake with higher conductivities, increased nutrient availability and a water level located below the modern outflow. Son Kol became again a hydrologically open lake at 3800 and 1950 cal. yr BP. Comparisons to other local and regional paleoclimate records indicate that these regime shifts were largely controlled by changing intensity and position of the Westerlies and the Siberian Anticyclone that triggered changes in the amount of winter precipitation. A strong influence of the Westerlies ca. 5000-4400, 3800-3250 and since 1950 cal. yr BP enhanced the amount of precipitation during spring, autumn and winter, whereas cold and dry winters prevailed during phases with a strong Siberian Anticyclone and southward shifted Westerlies at ca. 6000-5000, 4400-3800 and 3250-1950 cal. yr BP. Similarities between variations in winter precipitation at Son Kol and records of the predominant NAO-mode further suggest a teleconnection between wet (dry) winter climate in Central Asia and a positive (negative) NAO

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.

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

Science.gov (United States)

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

2012-01-01

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

Sex on show. Issues of privacy and dignity in a Forensic mental health hospital: Nurse and patient views.

Science.gov (United States)

Quinn, Chris; Happell, Brenda

2015-08-01

To explore perceptions of privacy and dignity for sexual relationships in a Forensic mental health hospital. The role of nurses in forensic mental health hospitals is frequently complicated by opposing expectations of therapeutic relationships and maintaining security. What can result is an over-emphasis on risk reduction by controlling patient behaviour, which can extend to patient intimacy and sexual relationships. An exploratory, qualitative approach. Individual interviews were conducted with 12 nurses and 10 patients in a forensic mental health hospital. Thematic data analysis was undertaken to identify the main themes. The need for a private and dignified place for patient intimacy was one major theme to emerge from this research from both nurse and patient participants and is the focus of this article. A disparity is reported between the level of support reported by nurse participants with the experience of the patient participants. Sexual intimacy and sexual relationships are important components of normal human behaviour. Institutional rules and rule adherence create barriers for patients, forcing their intimacy and sexual relationships into secrecy. There is a need for further research to consider the benefits and risks of patient intimacy and sexual relationships for long-term patients in forensic mental health settings. Patients in forensic hospitals are sexually active and seek support from nurses. Nurses are in an ideal role to recognise the important part they can play in supporting the intimacy and sexual relationship needs of patients. Strategies to assist in developing confidence in responding to normal human behaviour is a matter of priority. © 2015 John Wiley & Sons Ltd.

How complete is the information on preadmission psychotropic medications in inpatients with dementia? A comparison of hospital medical records with dispensing data.

Science.gov (United States)

Pisa, Federica Edith; Palese, Francesca; Romanese, Federico; Barbone, Fabio; Logroscino, Giancarlo; Riedel, Oliver

2018-06-05

Reliable information on preadmission medications is essential for inpatients with dementia, but its quality has hardly been evaluated. We assessed the completeness of information and factors associated with incomplete recording. We compared preadmission medications recorded in hospital electronic medical records (EMRs) with community-pharmacy dispensations in hospitalizations with discharge code for dementia at the University Hospital of Udine, Italy, 2012-2014. We calculated: (a) prevalence of omissions (dispensed medication not recorded in EMRs), additions (medication recorded in EMRs not dispensed), and discrepancies (any omission or addition); (b) multivariable logistic regression odds ratio, with 95% confidence interval (95% CI), of ≥1 omission. Among 2,777 hospitalizations, 86.1% had ≥1 discrepancy for any medication (Kappa 0.10) and 33.4% for psychotropics. When psychotropics were recorded in EMR, antipsychotics were added in 71.9% (antidepressants: 29.2%, antidementia agents: 48.2%); when dispensed, antipsychotics were omitted in 54.4% (antidepressants: 52.7%, antidementia agents: 41.5%). Omissions were 92% and twice more likely in patients taking 5 to 9 and ≥10 medications (vs. 0 to 4), 17% in patients with psychiatric disturbances (vs. none), and 41% with emergency admission (vs. planned). Psychotropics, commonly used in dementia, were often incompletely recorded. To enhance information completeness, both EMRs and dispensations should be used. Copyright © 2018 John Wiley & Sons, Ltd.

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

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

2017-10-01

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

Hospitals

DEFF Research Database (Denmark)

Mullins, Michael

2013-01-01

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

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

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

2016-01-01

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

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

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

2017-04-01

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

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.

The Quest of Father and Son: Illuminating Character Identity, Motivation, and Conflict in Cormac McCarthy's "The Road"

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Gilbert, Chris

2012-01-01

"The Road" has been an important part of the author's English IV Honors course for several years now. Undeniably bleak, it details a father and son's journey through a seared, post-apocalyptic wasteland. As they travel through the burnt remains of America, they are threatened by starvation, dehydration, and scattered, hostile humans. Although his…

Giving Birth to Life--Again!: Bereaved Parents' Experiences with Children Born Following the Death of an Adult Son

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Hamama-Raz, Yaira; Rosenfeld, Sarah; Buchbinder, Eli

2010-01-01

This article is based on a qualitative study examining the experiences of parents that lost a son during military service in Israel and consequently choose to give birth to another child. Seven couples and 3 mothers were interviewed for the study, and their interviews were analyzed using a phenomenological-hermeneutic approach. Three main themes…

Service Robots for Hospitals

DEFF Research Database (Denmark)

Özkil, Ali Gürcan

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

Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia.

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Ho, Gwendolyn; Jonas, Brian A; Li, Qian; Brunson, Ann; Wun, Ted; Keegan, Theresa H M

2017-06-01

Few studies have evaluated the impact of complications, sociodemographic and clinical factors on early mortality (death ≤60 days from diagnosis) in acute myeloid leukaemia (AML) patients. Using data from the California Cancer Registry linked to hospital discharge records from 1999 to 2012, we identified patients aged ≥15 years with AML who received inpatient treatment (N = 6359). Multivariate logistic regression analyses were used to assess the association of complications with early mortality, adjusting for sociodemographic factors, comorbidities and hospital type. Early mortality decreased over time (25·3%, 1999-2000; 16·8%, 2011-2012) across all age groups, but was higher in older patients (6·9%, 15-39, 11·4%, 40-54, 18·6% 55-65, and 35·8%, >65 years). Major bleeding [Odds ratio (OR) 1·5, 95% confidence interval (CI) 1·3-1·9], liver failure (OR 1·9, 95% CI 1·1-3·1), renal failure (OR 2·4, 95% CI 2·0-2·9), respiratory failure (OR 7·6, 95% CI 6·2-9·3) and cardiac arrest (OR 15·8, 95% CI 8·7-28·6) were associated with early mortality. Higher early mortality was also associated with single marital status, low neighbourhood socioeconomic status, lack of health insurance and comorbidities. Treatment at National Cancer Institute-designated cancer centres was associated with lower early mortality (OR 0·5, 95% CI 0·4-0·6). In conclusion, organ dysfunction, hospital type and sociodemographic factors impact early mortality. Further studies should investigate how differences in healthcare delivery affect early mortality. © 2017 John Wiley & Sons Ltd.

Sexual imprinting on continuous variation: do female zebra finches prefer or avoid unfamiliar sons of their foster parents?

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Schielzeth, H; Burger, C; Bolund, E; Forstmeier, W

2008-09-01

Sexual imprinting on discrete variation that serves the identification of species, morphs or sexes is well documented. By contrast, sexual imprinting on continuous variation leading to individual differences in mating preferences within a single species, morph and sex has been studied only once (in humans). We measured female preferences in a captive population of wild-type zebra finches. Individual cross-fostering ensured that all subjects grew up with unrelated foster parents and nest mates. Females from two cohorts (N = 113) were given a simultaneous choice between (two or four) unfamiliar males, one of which was a genetic son of their foster parents (SFP). We found no significant overall preference for the SFP (combined effect size d = 0.14 +/- 0.15). Additionally, we tested if foster parent traits could potentially explain between-female variation in preferences. However, neither the effectiveness of cooperation between the parents nor male contribution to parental care affected female preferences for the son of the foster father. We conclude that at least in zebra finches sexual imprinting is not a major source of between-individual variation in mating preferences.

Son preference among the historical Sandžak Muslim population

Directory of Open Access Journals (Sweden)

Čvorović Jelena

2012-01-01

Full Text Available This paper attempts to explain parental son preferences among historical Muslim population in the Sandžak region, southwestern Serbia. The paper draws upon data collected in the course of anthropological fieldwork studies in the region. The fieldwork was performed among Muslim and Christian families in Serbian rural area of Sandžak, measuring maternal fitness in relation to several variables. The data set comes from 120 women born between 1880-1924, representing so a historical demographic data based on individual and lineage records. These data were complemented with official records from Archive of Novi Pazar, whenever possible. In this Serbian rural area, land is still considered as an abundant resource, useful in establishing a family, livestock or agriculture. In the past, in spite of yearly fluctuations in production, lands and labor constituted a stable source of wealth from generation to generation. In this study, the data include the socio-economic status of each woman, assigned according to her husband’s family economic status: land-ownership vs. landless. This represents differences in resource availability in terms of nutrition, wealth and workload among these women. As the results show, the Muslim families, on average, left more surviving descendants through sons, in contrast with their Christian counterparts. The basic research question, then, is why? Furthermore, what were the impacts of particular behaviors on reproductive and lineage success, under particular social and ecological conditions? In this sample, regarding the Muslim families, the family structure was/is traditional and stratified, characterized by a large disparity in the status of males and females. Patrilineal inheritance, the concentration of wealth and power in males and the social restriction of women all characterize even today this patriarchal family arrangement. This supports the Trivers-Willard hypothesis, especially in terms of sex-biased parental

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

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

2015-02-01

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

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

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Saeid Nazemi

2012-08-01

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

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

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Hocquet, D; Muller, A; Bertrand, X

2016-08-01

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

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

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

2013-02-01

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

The founding of Zemun Hospital

Directory of Open Access Journals (Sweden)

Milanović Jasmina

2014-01-01

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

Development of a methodology for the detection of hospital financial outliers using information systems.

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Okada, Sachiko; Nagase, Keisuke; Ito, Ayako; Ando, Fumihiko; Nakagawa, Yoshiaki; Okamoto, Kazuya; Kume, Naoto; Takemura, Tadamasa; Kuroda, Tomohiro; Yoshihara, Hiroyuki

2014-01-01

Comparison of financial indices helps to illustrate differences in operations and efficiency among similar hospitals. Outlier data tend to influence statistical indices, and so detection of outliers is desirable. Development of a methodology for financial outlier detection using information systems will help to reduce the time and effort required, eliminate the subjective elements in detection of outlier data, and improve the efficiency and quality of analysis. The purpose of this research was to develop such a methodology. Financial outliers were defined based on a case model. An outlier-detection method using the distances between cases in multi-dimensional space is proposed. Experiments using three diagnosis groups indicated successful detection of cases for which the profitability and income structure differed from other cases. Therefore, the method proposed here can be used to detect outliers. Copyright © 2013 John Wiley & Sons, Ltd.

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