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Sample records for hospitalization study flu

  1. A study of the swine flu (H1N1 epidemic among health care providers of a medical college hospital of Delhi

    Directory of Open Access Journals (Sweden)

    Om Prakash Rajoura

    2011-01-01

    Full Text Available Background: Influenza viruses cause annual epidemics and occasional pandemics that have claimed the lives of millions. Understanding the role of specific perceptions in motivating people to engage in precautionary behavior may help health communicators to improve their messages about outbreaks of new infectious disease generally and swine flu specifically. Objectives: To study the knowledge and practices of health care providers regarding swine flu and to study the attitudes and practices of health care providers toward the prevention of the swine flu epidemic. Materials and Methods: The present study was a cross-sectional (descriptive study and was conducted in the month of September, 2009, among doctors and nurses. A maximum of 40% of the total health care providers of GTB Hospital were covered because of feasibility and logistics, and, therefore, the sample size was 334. Results: Around 75% of the health care providers were aware about the symptoms of swine flu. Mostly, all study subjects were aware that it is transmitted through droplet infection. Correct knowledge of the incubation period of swine flu was known to 80% of the doctors and 69% of the nurses. Knowledge about high-risk groups (contacts, travelers, health care providers was observed among 88% of the doctors and 78.8% of the nurses. Practice of wearing mask during duty hours was observed among 82.6% of doctors and 85% of nurses, whereas of the total study population, only 40% were correctly using mask during duty hours. Conclusions: Significant gaps observed between knowledge and actual practice of the Health Care Provider regarding swine flu need to be filled by appropriate training. Data indicate that the health care providers are very intellectual, but they do not themselves practice what they preach.

  2. Surveillance of illness associated with pandemic (H1N1) 2009 virus infection among adults using a global clinical site network approach: the INSIGHT FLU 002 and FLU 003 studies

    DEFF Research Database (Denmark)

    Dwyer, Dominic E; Gerstoft, Jan

    2011-01-01

    , with 1049 enrollments into the FLU 002 outpatient study and 316 into the FLU 003 hospitalization study. These 'in progress' INSIGHT influenza observational studies may act as a model for obtaining epidemiological, clinical and laboratory information in future international disease outbreaks....

  3. The Flu (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... for Educators Search English Español Flu KidsHealth / For Kids / Flu What's in this article? What's the Flu? ...

  4. Promotion of flu vaccination among healthcare workers in an Italian academic hospital: An experience with tailored web tools.

    Science.gov (United States)

    Conte, Alessandro; Quattrin, Rosanna; Filiputti, Elisa; Cocconi, Roberto; Arnoldo, Luca; Tricarico, Pierfrancesco; Delendi, Mauro; Brusaferro, Silvio

    2016-10-02

    Influenza causes significant mortality particularly among the elderly and high-risk groups. Healthcare workers (HCWs) are at risk of occupational exposure due to contact with patients. Aims of this study was to promote flu shot among HCWs through a multimedia campaign in a large North-Eastern Italian Hospital. The 2013/2014 flu vaccination multimedia campaign addressed to HCWs was developed by maintaining pre-existing tools (letters in pay slip and poster displayed in wards) and creating 4 on-line spots (30") delivered trough the hospital intranet. Campaign effectiveness was assessed in terms of changes in knowledge, attitude and practice comparing data of pre (10 items) and post test (20 items) survey on a randomized sample of HCWs. Response rates were 92.6% (464/501) in pre-test and 83.2% (417/501) in post-test. 93.8% (391/417) of HCWs reported to awareness of the campaign to promote vaccination. Spots were seen by 59.6% (233/391) of HCWs. Some reasons for vaccine denial, "not believing in vaccine efficacy" (34.7% to 14.9%), "not considering flu as a serious problem" (from 24% to 12.6%), "thinking not to get sick" (28.7% to 18.2%) or "being against the vaccine" (32.7% to 21%), showed a statistically significant reduction after the exposure to the campaign. The "intention to get vaccinated in the next year" instead, raised effectively (13.1% to 36.6%). Vaccinated HCWs rate in 2013-2014 season was 7.6% (221/2910), and 5.6% (164/2910) in 2012-2013 (pweb tools deserve to be better studied as effective approach to convey health information among HCWs.

  5. Diagnosing Flu

    Science.gov (United States)

    ... Types Seasonal Avian Swine Variant Pandemic Other Diagnosing Flu Questions & Answers Language: English (US) Español Recommend on ... How do I know if I have the flu? Your respiratory illness might be the flu if ...

  6. Planning for avian flu disruptions on global operations: a DMAIC case study.

    Science.gov (United States)

    Kumar, Sameer

    2012-01-01

    The author aims to assess the spread of avian flu, its impact on businesses operating in the USA and overseas, and the measures required for corporate preparedness. Six Sigma DMAIC process is used to analyze avian flu's impact and how an epidemic could affect large US business operations worldwide. Wal-Mart and Dell Computers were chosen as one specializes in retail and the other manufacturing. The study identifies avian flu pandemic risks including failure modes on Wal-Mart and Dell Computers global operations. It reveals the factors that reinforce avian-flu pandemic's negative impact on company global supply chains. It also uncovers factors that balance avian-flu pandemic's impact on their global supply chains. Avian flu and its irregularity affect the research outcomes because its spread could fluctuate based on so many factors that could come into play. Further, the potential cost to manufacturers and other supply chain partners is relatively unknown. As a relatively new phenomenon, quantitative data were not available to determine immediate costs. In this decade, the avian influenza H5N1 virus has killed millions of poultry in Asia, Europe and Africa. This flu strain can infect and kill humans who come into contact with this virus. An avian influenza H5N1 outbreak could lead to a devastating effect on global food supply, business services and business operations. The study provides guidance on what global business operation managers can do to prepare for such events, as well as how avian flu progression to a pandemic can disrupt such operations. This study raises awareness about avian flu's impact on businesses and humans and also highlights the need to create contingency plans for corporate preparedness to avoid incurring losses.

  7. "Stomach Flu" (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Educators Search English Español "Stomach Flu" KidsHealth / For Kids / "Stomach Flu" Print Many people talk about the " ...

  8. Antibiotic Use in Cold and Flu Season and Prescribing Quality: A Retrospective Cohort Study.

    Science.gov (United States)

    Alsan, Marcella; Morden, Nancy E; Gottlieb, Joshua D; Zhou, Weiping; Skinner, Jonathan

    2015-12-01

    Excessive antibiotic use in cold and flu season is costly and contributes to antibiotic resistance. The study objective was to develop an index of excessive antibiotic use in cold and flu season and determine its correlation with other indicators of prescribing quality. We included Medicare beneficiaries in the 40% random sample denominator file continuously enrolled in fee-for-service benefits for 2010 or 2011 (7,961,201 person-years) and extracted data on prescription fills for oral antibiotics that treat respiratory pathogens. We collapsed the data to the state level so they could be merged with monthly flu activity data from the Centers for Disease Control and Prevention. Linear regression, adjusted for state-specific mean antibiotic use and demographic characteristics, was used to estimate how antibiotic prescribing responded to state-specific flu activity. Flu-activity associated antibiotic use varied substantially across states-lowest in Vermont and Connecticut, highest in Mississippi and Florida. There was a robust positive correlation between flu-activity associated prescribing and use of medications that often cause adverse events in the elderly (0.755; Pantibiotic use was positively correlated with prescribing high-risk medications to the elderly and negatively correlated with beta-blocker use after myocardial infarction. These findings suggest that excessive antibiotic use reflects low-quality prescribing. They imply that practice and policy solutions should go beyond narrow, antibiotic specific, approaches to encourage evidence-based prescribing for the elderly Medicare population.

  9. Flu Shot

    Science.gov (United States)

    Flu is a respiratory infection caused by a number of viruses. Most people with the flu get better on their own. But it can ... cause complications and sometimes even death. Getting the flu vaccine every year is the best way to ...

  10. Swine-Flu Scare Offers Lessons for Study-Abroad Programs

    Science.gov (United States)

    Fischer, Karin

    2009-01-01

    Reports of swine flu have led some colleges to pull students and faculty members out of Mexico, the epicenter of the outbreak, and to cancel study-abroad programs there. But even as the number of new cases appears to be falling, the health scare offers some lasting lessons for colleges, says Gary Rhodes, director of the Center for Global Education…

  11. Fighting the Flu

    Centers for Disease Control (CDC) Podcasts

    2011-03-08

    Wes Studi, Hollywood actor, urges Native peoples to know the facts about the flu.  Created: 3/8/2011 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 3/8/2011.

  12. Pandemic Flu

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other Pandemic Influenza Language: English (US) Español Recommend on Facebook ... Planning State and Local Government Planning More 1918 Pandemic Flu Commemoration 100 years later, read about the ...

  13. Flu Facts

    Science.gov (United States)

    ... severe cases. These large-scale outbreaks are called epidemics . If they spread worldwide, they're called pandemics . ... before you even know you're sick. Flu epidemics often start in schools and then move quickly ...

  14. Flu Vaccine Safety Information

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other Flu Vaccine Safety Information Questions & Answers Language: English (US) ... safety of flu vaccines monitored? Egg Allergy Are flu vaccines safe? Flu vaccines have good safety record. ...

  15. Flued head replacement alternatives

    International Nuclear Information System (INIS)

    Smetters, J.L.

    1987-01-01

    This paper discusses flued head replacement options. Section 2 discusses complete flued head replacement with a design that eliminates the inaccessible welds. Section 3 discusses alternate flued head support designs that can drastically reduce flued head installation costs. Section 4 describes partial flued head replacement designs. Finally, Section 5 discusses flued head analysis methods. (orig./GL)

  16. FluView National Flu Activity Map

    Data.gov (United States)

    U.S. Department of Health & Human Services — The FluView National Flu Activity Map is a complementary widget to the state-by-state flu map widget introduced in the 2007-2008 flu season. This interactive map...

  17. STUDY OF FACTORS INFLUENCING EARLY SYMPTOMATIC IMPROVEMENT, RETURN TO NORMOXIA AND RADIOLOGICAL RESOLUTION IN SWINE FLU PATIENTS WITH RESPIRATORY FAILURE IN RICU

    Directory of Open Access Journals (Sweden)

    Vamsidhar Reddy Manne

    2017-05-01

    Full Text Available BACKGROUND Since 2009, swine influenza outbreaks have been recorded virtually every year, although their extent and severity have varied widely. Localised outbreaks are taking place at variable intervals, usually every 1-3 years. The most recent outbreak has been from December 2016 through April 2017. We still are in the midst of one. This study of factors influencing early clinical and radiological improvement and reversion to normoxia in swine flu patients with respiratory failure helps in saving precious lives. MATERIALS AND METHODS This is a cross-sectional study conducted at RICU, Department of Pulmonary Medicine, S.V.R.R. Government General Hospital/S.V. Medical College, Tirupathi, Andhra Pradesh, between January 2017 and April 2017. Study sample was the total number of swine flu patients admitted to the RICU of the Department of Pulmonary Medicine with respiratory failure. RESULTS Out of 42 patients who tested positive for swine flu, 37 had respiratory failure and were immediately admitted in RICU. Oxygen support, oseltamivir and higher antibiotics were immediately started, injectable steroids given where necessary. Comorbidities were meticulously managed. 19 were males and 18 were females. 21 patients (>50% were above 50 years. Cough and breathlessness were present in all patients (100%. At admission, all 37 showed SpO2 <85% and at discharge all of them were normoxic. 18 patients had either multilobar pneumonia or ARDS on CXR, which had resolved by the time of discharge. The shortest duration of stay was 7 days and the longest duration of stay was 11 days. 35 patients were discharged and 2 patients died. CONCLUSION Good oxygenation, starting of oseltamivir on day 1 of admission prevents further complications and hastens recovery. Swine flu patients with normal chest x-ray and no comorbidities can still end up with respiratory failure. Steroids decrease cough and breathlessness, but have no role in hastening recovery. No residual symptoms

  18. Flu season and trehalose

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2018-01-01

    Full Text Available Most of us who are practicing medicine know that we are in a very active flu season. This was brought home to me when last week trying to admit a patient to the hospital from the office. She was a bone marrow transplant patient who had severe diarrhea and dehydration probably secondary to C. difficile. Hospital admissions said the patient had to be sent to the Emergency Room because the hospital was full due to the flu epidemic. Nationwide there has been a dramatic increase in the number of hospitalizations due to influenza over the past week from 13.7 to 22.7 per 100,000 (1. Influenza A(H3N2 has been the most common form of influenza reported this season. These viruses are often linked to more severe illness, especially in children and people age 65 years and older. Fortunately, the CDC also says that the flu cases may be peaking. However, at ...

  19. Avian Flu

    International Nuclear Information System (INIS)

    Eckburg, Paul

    2006-01-01

    Since 2003, a severe form of H5N1 avian influenza has rapidly spread throughout Asia and Europe, infecting over 200 humans in 10 countries. The spread of H5N1 virus from person-to-person has been rare, thus preventing the emergence of a widespread pandemic. However, this ongoing epidemic continues to pose an important public health threat. Avian flu and its pandemic potential in humans will be discussed.

  20. Flu Symptoms & Complications

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other Flu Symptoms & Complications Language: English (US) Español Recommend on ... not everyone with flu will have a fever. Flu Complications Most people who get influenza will recover ...

  1. Thimerosal in Flu Vaccine

    Science.gov (United States)

    ... Seasonal Avian Swine Variant Pandemic Other Thimerosal in Flu Vaccine Questions & Answers Language: English (US) Español Recommend ... and/or fungi from contaminating the vaccine. Do flu vaccines contain thimerosal? Flu vaccines in multi-dose ...

  2. First Aid: Influenza (Flu)

    Science.gov (United States)

    ... for Educators Search English Español First Aid: The Flu KidsHealth / For Parents / First Aid: The Flu Print ... tiredness What to Do If Your Child Has Flu Symptoms: Call your doctor. Encourage rest. Keep your ...

  3. Key Facts about Influenza (Flu) and Flu Vaccine

    Science.gov (United States)

    ... Swine Variant Pandemic Other Key Facts About Influenza (Flu) Language: English (US) Español Recommend on Facebook Tweet ... Flu Treating Flu What is Influenza (also called Flu)? The flu is a contagious respiratory illness caused ...

  4. Your baby and the flu

    Science.gov (United States)

    Babies and the flu; Your infant and the flu; Your toddler and the flu ... FLU SYMPTOMS IN INFANTS AND TODDLERS The flu is an infection of the nose, throat, and (sometimes) lungs. Call your baby's provider if ...

  5. Misconceptions about Seasonal Flu and Flu Vaccines

    Science.gov (United States)

    ... Vaccine (LAIV) Misconceptions about Flu Vaccines Vaccine Supply & Distribution Vaccine Supply for 2017-2018 Season Frequently Asked ... conditions. Flu vaccination has been associated with lower rates of some cardiac ... a baby after birth from flu. (Mom passes antibodies onto the developing ...

  6. MP-AzeFlu provides rapid and effective allergic rhinitis control: results of a non-interventional study in Romania.

    Science.gov (United States)

    Agache, I; Doros, I C; Leru, P M; Bucur, I; Poenaru, M; Sarafoleanu, C

    2018-03-01

    Allergic Rhinitis and its Impact on Asthma (ARIA) and the European Union (EU) recommend a shift to guide allergic rhinitis (AR) treatment decisions from symptom severity to disease control, using a simple visual analogue scale (VAS). Using this VAS we assessed, in a real-life study in Romania, the effectiveness of MP-AzeFlu nasal spray. In this multi-centre, prospective, non-interventional study, 253 patients (over 11 years old) with moderate-to-severe AR were prescribed MP-AzeFlu and assessed their symptoms on a VAS (0 (not at all bothersome) to 100 mm (very bothersome)) on Days 0, 1, 3, 7 and 14. The proportion of patients who achieved a defined VAS score cut-off for well-controlled (38 mm) AR were also calculated. Patients perception of disease control was assessed on Day 3. MP-AzeFlu use was associated with a mean (standard deviation) VAS score reduction from 78.4 (15.1) mm at baseline to 14.7 (15.1) mm on the last day. Effectiveness was consistent irrespective of disease severity, phenotype or patient age. 83.4% of patients achieved the smaller than 39 mm well-controlled VAS score cut-off by last day and 95.2% considered their symptoms to be well- or partly controlled at Day 3. MP-AzeFlu provided rapid, effective and sustained AR symptom control in a real-life setting in Romania, irrespective of severity, phenotype or patient age, aligning with ARIA and EU recommendations and supporting the position of MP-AzeFlu as the drug of choice for the treatment of moderate-to-severe AR.

  7. Swine flu

    Directory of Open Access Journals (Sweden)

    Manish Sinha

    Full Text Available Summary: The recent outbreak of human infection with a novel Swine-Origin Influenza A (H1N1 virus is spreading rapidly through sustained human-to-human transmission in multiple countries. Human-to-human transmission occurs by inhalation of infectious droplets and droplet nuclei, and by direct contact, which is facilitated by air and land travel and social gatherings. The most frequently reported symptoms are fever, cough, myalgia, and sore throat. Detailed contact and travel histories and knowledge of viral activity in community are essential for prompt case detection by the health personnel. Real-time Reverse Transcriptase-Polymerase Chain Reaction analysis of throat swabs or lower respiratory samples is a sensitive means of diagnosis. Use of oral oseltamivir may be warranted for the treatment of severe illness. Keywords: Swine influenza, H1N1, Swine flu, Oseltamivir

  8. A rapid method for assessing social versus independent interest in health issues: a case study of 'bird flu' and 'swine flu'.

    Science.gov (United States)

    Bentley, R Alexander; Ormerod, Paul

    2010-08-01

    Effective communication strategies regarding health issues are affected by the way in which the public obtain their knowledge, particularly whether people become interested independently, or through their social networks. This is often investigated through localized ethnography or surveys. In rapidly-evolving situations, however, there may also be a need for swift, case-specific assessment as a guide to initial strategy development. With this aim, we analyze real-time online data, provided by the new 'Google Trends' tool, concerning Internet search frequency for health-related issues. To these data we apply a simple model to characterise the effective degree of social transmission versus decisions made individually. As case examples, we explore two rapidly-evolved issues, namely the world-wide interest in avian influenza, or 'bird flu', in 2005, and in H1N1, or 'swine flu', from late April to early May 2009. The 2005 'bird flu' scare demonstrated almost pure imitation for two months initially, followed by a spike of independent decision that corresponded with an announcement by US president George Bush. For 'swine flu' in 2009, imitation was the more prevalent throughout. Overall, the results show how interest in health scares can spread primarily by social means, and that engaging more independent decisions at the population scale may require a dramatic announcement to push a populace over the 'tipping point'. Copyright 2010 Elsevier Ltd. All rights reserved.

  9. How Does Seasonal Flu Differ From Pandemic Flu?

    Science.gov (United States)

    ... Past Issues How Does Seasonal Flu Differ From Pandemic Flu? Past Issues / Fall 2006 Table of Contents ... this page please turn Javascript on. Seasonal Flu Pandemic Flu Outbreaks follow predictable seasonal patterns; occurs annually, ...

  10. Flu Vaccine Safety and Pregnancy

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other Flu Vaccine Safety and Pregnancy Questions & Answers Language: English ( ... flu vaccine? Why should pregnant women get a flu shot? Flu is more likely to cause severe ...

  11. Cancer, the Flu, and You

    Science.gov (United States)

    ... Flu Publications Stay Informed Cancer Home Cancer, the Flu, and You What Cancer Patients, Survivors, and Caregivers ... Spanish) Recommend on Facebook Tweet Share Compartir Prevent Flu! Get a Flu Vaccine and Take Preventive Actions ...

  12. Grid attacks avian flu

    CERN Multimedia

    2006-01-01

    During April, a collaboration of Asian and European laboratories analysed 300,000 possible drug components against the avian flu virus H5N1 using the EGEE Grid infrastructure. Schematic presentation of the avian flu virus.The distribution of the EGEE sites in the world on which the avian flu scan was performed. The goal was to find potential compounds that can inhibit the activities of an enzyme on the surface of the influenza virus, the so-called neuraminidase, subtype N1. Using the Grid to identify the most promising leads for biological tests could speed up the development process for drugs against the influenza virus. Co-ordinated by CERN and funded by the European Commission, the EGEE project (Enabling Grids for E-sciencE) aims to set up a worldwide grid infrastructure for science. The challenge of the in silico drug discovery application is to identify those molecules which can dock on the active sites of the virus in order to inhibit its action. To study the impact of small scale mutations on drug r...

  13. Influenza (Flu) Viruses

    Science.gov (United States)

    ... Types Seasonal Avian Swine Variant Pandemic Other Influenza (Flu) Viruses Language: English (US) Español Recommend on Facebook ... influenza circulate and cause illness. More Information about Flu Viruses Types of Influenza Viruses Influenza A and ...

  14. Colds and the Flu

    Science.gov (United States)

    ... disease (COPD). What medicines can I give my child? There is no cure for the cold or the flu, and antibiotics do not work against the viruses that cause colds and the flu. Pain relievers such as ...

  15. Treating Influenza (Flu)

    Science.gov (United States)

    ... Diabetes (type 1 and 2) can make the immune system less able to fight the flu. Also, flu illness can raise blood sugar levels. ... of age on long-term aspirin therapy • Weakened immune system due to disease or ... risk from the flu: • Adults 65 years and older • Children younger than ...

  16. Avoiding the Flu

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Flu Avoiding the Flu Past Issues / Fall 2009 Table of Contents Children ... should still get the 2009 H1N1 vaccine. H1N1 Flu: Who Should Be Vaccinated First The Centers for ...

  17. Tracking and visualization of space-time activities for a micro-scale flu transmission study.

    Science.gov (United States)

    Qi, Feng; Du, Fei

    2013-02-07

    Infectious diseases pose increasing threats to public health with increasing population density and more and more sophisticated social networks. While efforts continue in studying the large scale dissemination of contagious diseases, individual-based activity and behaviour study benefits not only disease transmission modelling but also the control, containment, and prevention decision making at the local scale. The potential for using tracking technologies to capture detailed space-time trajectories and model individual behaviour is increasing rapidly, as technological advances enable the manufacture of small, lightweight, highly sensitive, and affordable receivers and the routine use of location-aware devices has become widespread (e.g., smart cellular phones). The use of low-cost tracking devices in medical research has also been proved effective by more and more studies. This study describes the use of tracking devices to collect data of space-time trajectories and the spatiotemporal processing of such data to facilitate micro-scale flu transmission study. We also reports preliminary findings on activity patterns related to chances of influenza infection in a pilot study. Specifically, this study employed A-GPS tracking devices to collect data on a university campus. Spatiotemporal processing was conducted for data cleaning and segmentation. Processed data was validated with traditional activity diaries. The A-GPS data set was then used for visual explorations including density surface visualization and connection analysis to examine space-time activity patterns in relation to chances of influenza infection. When compared to diary data, the segmented tracking data demonstrated to be an effective alternative and showed greater accuracies in time as well as the details of routes taken by participants. A comparison of space-time activity patterns between participants who caught seasonal influenza and those who did not revealed interesting patterns. This study

  18. Should we fear "flu fear" itself? Effects of H1N1 influenza fear on ED use.

    Science.gov (United States)

    McDonnell, William M; Nelson, Douglas S; Schunk, Jeff E

    2012-02-01

    Surges in patient volumes compromise emergency departments' (EDs') ability to deliver care, as shown by the recent H1N1 influenza (flu) epidemic. Media reports are important in informing the public about health threats, but the effects of media-induced anxiety on ED volumes are unclear. The aim of this study is to examine the effect of widespread public concern about flu on ED use. We reviewed ED data from an integrated health system operating 18 hospital EDs. We compared ED visits during three 1-week periods: (a) a period of heightened public concern regarding flu before the disease was present ("Fear Week"), (b) a subsequent period of active disease ("Flu Week"), and (c) a week before widespread concern ("Control Week"). Fear Week was identified from an analysis of statewide Google electronic searches for "swine flu" and from media announcements about flu. Flu Week was identified from statewide epidemiological data. Data were reviewed from 22 608 visits during the study periods. Fear Week (n = 7712) and Flu Week (n = 7687) were compared to Control Week (n = 7209). Fear Week showed a 7.0% increase in visits (95% confidence interval, 6-8). Pediatric visits increased by 19.7%, whereas adult visits increased by 1%. Flu Week showed an increase over Control Week of 6.6% (95% confidence interval, 6-7). Pediatric visits increased by 10.6%, whereas adult visits increased by 4.8%. At a time of heightened public concern regarding flu but little disease prevalence, EDs experienced substantial increases in patient volumes. These increases were significant and comparable to the increases experienced during the subsequent epidemic of actual disease. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Influenza (Flu) Vaccine (Inactivated or Recombinant): What You Need to Know

    Science.gov (United States)

    ... people with certain health conditions or a weakened immune system are at greatest risk. Each year thousands of people in the United States die from flu , and many more are hospitalized. Flu vaccine can: • ...

  20. Flu (Influenza): Information for Parents

    Science.gov (United States)

    ... PARENTS | DISEASES and the VACCINES THAT PREVENT THEM | Flu (Influenza) and the Vaccine to Prevent It Last updated October 2017 The best way to protect against flu is by getting a flu vaccine. Doctors recommend ...

  1. [Differentiation of influenza (Flu) type A, type B, and respiratory syncytial virus (RSV) by QuickNavi™-Flu+RSV].

    Science.gov (United States)

    Kohiyama, Risa; Miyazawa, Takashi; Shibano, Nobuko; Inano, Koichi

    2014-01-01

    Because it is not easy to differentiate Influenza virus (Flu) from RS virus (RSV) just by clinical symptoms, to accurately diagnose those viruses in conjunction with patient's clinical symptoms, rapid diagnostic kits has been used separately for each of those viruses. In our new study, we have developed a new rapid diagnostic kit, QuickNavi™-Flu+RSV. The kit can detect Flu A, Flu B, and RSV antigens with a single sample collection and an assay. Total of 2,873 cases (including nasopharyngeal swabs and nasopharyngeal aspirates specimens) in 2010/2011 and 2011/2012 seasons were evaluated with QuickNavi™-Flu+RSV and a commercially available kit. Sensitivity, specificity, and accuracy of Flu type A, type B, and RSV were above 95% when compared to commercially available kits (QuickNavi™-Flu and QuickNavi™-RSV) and considered to be equivalent to the commercially available kits. In 2011/2012 season, RSV infections increased prior to Flu season and continued during the peak of the Flu season. The kit can contribute to accurate diagnosis of Flu and RSV infections since co-infection cases have also been reported during the 2011/2012 season. QuickNavi™-Flu+RSV is useful for differential diagnosis of respiratory infectious diseases since it can detect Flu type A, type B, and RSV virus antigens with a single sample collection.

  2. Bird Flu (Avian Influenza)

    Science.gov (United States)

    Bird flu (avian influenza) Overview Bird flu is caused by a type of influenza virus that rarely infects humans. More than a ... for Disease Control and Prevention estimates that seasonal influenza is responsible for ... heat destroys avian viruses, cooked poultry isn't a health threat. ...

  3. Randomised active programs on healthcare workers' flu vaccination in geriatric health care settings in France: the VESTA study.

    Science.gov (United States)

    Rothan-Tondeur, M; Filali-Zegzouti, Y; Golmard, J-L; De Wazieres, B; Piette, F; Carrat, F; Lejeune, B; Gavazzi, G

    2011-02-01

    Because of a lack of efficacy of influenza vaccination in elderly population, there are still numerous outbreaks in geriatric health care settings. The health care workers (HCW) flu vaccination is known to get herd immunity and decrease the impact of influenza in elderly population living in geriatric health care settings. However, the rates of vaccinated HCWs are still low in France. The French Geriatric Infection Risk Institute (ORIG) performed the VESTA study, a three-phase multicentre to identify factors limiting vaccination in HCWs, and to develop and implement active programs promoting HCWs influenza vaccination. To implement multicenter programs to enhance HCW influenza vaccination. It was a cluster randomised interventional studies. 43 geriatric health care settings (GHCSs), long term care and rehabilitation care settings in France. 1814 Health care workers from 20 GHCSs in the interventional group and 2,435 health care workers in 23 GHCSs in the control group. After the failure of a first educational program giving scientific information and. tested during the 2005-06 flu season in 43 HCSs, a second program was designed with the help of marketing experts, one year after Program 1. The objectives were to involve HCWs in the creation of "safety zones", and to give personal satisfaction. Program 2 was tested during the 2006-07 season. 20 of the 24 HCSs from the Program 1 cluster were included in the Program 2 cluster (1,814 HCWs), and 16 of the 19 HCSs from the Control 1 cluster, plus 7 new HCSs with interest in participating, were included in the Control 2 cluster (23 HCSs; 2,435 HCWs). The efficacy of each program was assessed by calculating and comparing the percentage of vaccinated HCWs, from all HCSs taken together, in the program and control clusters. Program 1 failed to increase the HCW vaccination coverage rate (VCR) (Program 1: 34%; Control 1: 32%; p > 0.05),). Program 2 increased the VCR in HCWs (Program 2: 44%; Control 2: 27%; Chi2 test, p active

  4. Vaccination against seasonal flu

    CERN Multimedia

    2015-01-01

    The Medical Service once again recommends you to get your annual flu vaccination for the year.   Vaccination is the most effective way of avoiding the illness and any serious consequences and protecting those around you. The flu can have especially serious consequences for people with chronic conditions (diabetes, cardio-vascular disease, etc.), pregnant women, infants, and people over 65 years of age. Remember, anyone working on the CERN site who wishes to be vaccinated against seasonal flu should go to the Infirmary (Building 57, ground floor) with their vaccine. The Medical Service will issue a prescription on the day of the vaccination for the purposes of reimbursement by UNIQA. NB: The Medical Service cannot provide this vaccination service for family members or retired members of the personnel. For more information: • The "Seasonal flu" flyer by the Medical Service • Recommendations of the Swiss Federal Office of Public...

  5. Avian Influenza (Bird Flu)

    Science.gov (United States)

    ... type="submit" value="Submit" /> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Information on Avian Influenza Language: English (US) Español Recommend on Facebook Tweet ...

  6. Bat Influenza (Flu)

    Science.gov (United States)

    ... currently known to carry bat flu are not native to the continental United States, but are common ... by: Office of the Associate Director for Communication, Digital Media Branch, Division of Public Affairs Email Recommend ...

  7. Vaccine Effectiveness - How Well Does the Seasonal Flu Vaccine Work?

    Science.gov (United States)

    ... work. CDC has been working with researchers at universities and hospitals since the 2003-2004 flu season ... maintained by: Office of the Associate Director for Communication, Digital Media Branch, Division of Public Affairs Email ...

  8. Comparison of Xpert Flu rapid nucleic acid testing with rapid antigen testing for the diagnosis of influenza A and B.

    Science.gov (United States)

    DiMaio, Michael A; Sahoo, Malaya K; Waggoner, Jesse; Pinsky, Benjamin A

    2012-12-01

    Influenza infections are associated with thousands of hospital admissions and deaths each year. Rapid detection of influenza is important for prompt initiation of antiviral therapy and appropriate patient triage. In this study the Cepheid Xpert Flu assay was compared with two rapid antigen tests, BinaxNOW Influenza A & B and BD Directigen EZ Flu A+B, as well as direct fluorescent antibody testing for the rapid detection of influenza A and B. Using real-time, hydrolysis probe-based, reverse transcriptase PCR as the reference method, influenza A sensitivity was 97.3% for Xpert Flu, 95.9% for direct fluorescent antibody testing, 62.2% for BinaxNOW, and 71.6% for BD Directigen. Influenza B sensitivity was 100% for Xpert Flu and direct fluorescent antibody testing, 54.5% for BinaxNOW, and 48.5% for BD Directigen. Specificity for influenza A was 100% for Xpert Flu, BinaxNOW, and BD Directigen, and 99.2% for direct fluorescent antibody testing. All methods demonstrated 100% specificity for influenza B. These findings support the use of the Xpert Flu assay in settings requiring urgent diagnosis of influenza A and B. Copyright © 2012 Elsevier B.V. All rights reserved.

  9. Flu Vaccine Skin Patch Tested

    Science.gov (United States)

    ... Subscribe September 2017 Print this issue Health Capsule Flu Vaccine Skin Patch Tested En español Send us ... Each year, millions of people nationwide catch the flu. The best way to protect yourself is to ...

  10. Flublok Seasonal Influenza (Flu) Vaccination

    Science.gov (United States)

    ... type="submit" value="Submit" /> Archived Flu Emails Influenza Types Seasonal Avian Swine Variant Pandemic Other Flublok Seasonal Influenza (Flu) Vaccine Questions & Answers Language: English (US) Español ...

  11. Flu Surveillance: Department of Health

    Science.gov (United States)

    Health & Wellness Food, Water & Environment Birth, Death & Marriage Records Laboratory Healthcare facility managers Schools & child care providers Rhode Island Data Flu Surviellance Healthcare Management Agency Centers for Disease Control &amo; Prevention Flu.gov World Health Organization We can

  12. Flu and People with Asthma

    Science.gov (United States)

    ... Swine Variant Pandemic Other Flu and People with Asthma Language: English (US) Español Recommend on Facebook Tweet ... Take Steps to Fight the Flu What is Asthma? Asthma is a lung disease that is caused ...

  13. Flu shots and the characteristics of unvaccinated elderly Medicare beneficiaries.

    Science.gov (United States)

    Lochner, Kimberly A; Wynne, Marc

    2011-12-21

    Data from the Medicare Current Beneficiary Survey, 2009. • Overall, 73% of Medicare beneficiaries aged 65 years and older reported receiving a flu shot for the 2008 flu season, but vaccination rates varied by socio-demographic characteristics. Flu vaccination was lowest for beneficiaries aged 65-74 years old, who were non-Hispanic Blacks and Hispanics, were not married, had less than a high school education, or who were eligible for Medicaid (i.e., dual eligibles). • Healthcare utilization and personal health behavior were also related to vaccination rates, with current smokers and those with no hospitalizations or physician visits being less likely to be vaccinated. • Among those beneficiaries who reported receiving a flu shot, 59% received it in a physician's office or clinic, with the next most common setting being in the community (21%); e.g., grocery store, shopping mall, library, or church. • Among those beneficiaries who did not receive a flu shot, the most common reasons were beliefs that the shot could cause side effects or disease (20%), that they didn't think the shot could prevent the flu (17%), or that the shot wasn't needed (16%). Less than 1% reported that they didn't get the flu shot because of cost. Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths occurring among the elderly (Fiore et al., 2010). Most physicians recommend their elderly patients get a flu shot each year, and many hospitals inquire about elderly patient's immunization status upon admission, providing a vaccination if requested. The importance of getting a flu shot is underscored by the Department of Health and Human Services' Healthy People initiative, which has set a vaccination goal of 90% for the Nation's elderly by the year 2020 (Department of Health and Human Services [DHHS], 2011). Although all costs related to flu shots are covered by Medicare, requiring

  14. Antiviral Drugs: Seasonal Flu

    Centers for Disease Control (CDC) Podcasts

    2010-09-29

    In this podcast, Dr. Joe Bresee explains the nature of antiviral drugs and how they are used for seasonal flu.  Created: 9/29/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/29/2010.

  15. Warning Signs: Seasonal Flu

    Centers for Disease Control (CDC) Podcasts

    2010-09-29

    In this podcast, Dr. Joe Bresee describes the main symptoms of seasonal flu and when it is serious enough to seek medical help.  Created: 9/29/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/29/2010.

  16. Take Three: Seasonal Flu

    Centers for Disease Control (CDC) Podcasts

    2010-09-29

    In this podcast, Dr. Joe Bresee describes how to keep from getting seasonal flu and spreading it to others by taking these three steps.  Created: 9/29/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/29/2010.

  17. Flu and Holiday Travel

    Centers for Disease Control (CDC) Podcasts

    2010-12-13

    This podcast explains the ways people can stay healthy and avoid the flu when traveling this winter.  Created: 12/13/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 12/13/2010.

  18. Oseltamivir-Resistant Flu

    Centers for Disease Control (CDC) Podcasts

    2012-04-13

    Dr. Aaron Storms, an Epidemic Intelligence Service (EIS) officer at CDC, discusses his paper about oseltamivir-resistant H1N1flu.  Created: 4/13/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/17/2012.

  19. Comparison of Directigen Flu A+B with Real Time PCR in the Diagnosis of Influenza.

    Science.gov (United States)

    Bosevska, Golubinka; Panovski, Nikola; Janceska, Elizabeta; Mikik, Vladimir; Topuzovska, Irena Kondova; Milenkovik, Zvonko

    2015-01-01

    Early diagnosis and treatment of patients with influenza is the reason why physicians need rapid high-sensitivity influenza diagnostic tests that require no complex lab equipment and can be performed and interpreted within 15 min. The Aim of this study was to compare the rapid Directigen Flu A+B test with real time PCR for detection of influenza viruses in the Republic of Macedonia. One-hundred-eight respiratory samples (combined nose and throat swabs) were routinely collected for detection of influenza virus during influenza seasons. Forty-one patients were pediatric cases and 59 were adult. Their mean age was 23 years. The patients were allocated into 6 age groups: 0-4 yrs, 5-9 yrs, 10-14 yrs, 15-19 yrs, 20-64 yrs and > 65 yrs. Each sample was tested with Directigen Flu A+B and CDC real time PCR kit for detection and typisation/subtypisation of influenza according to the lab diagnostic protocol. Directigen Flu A+B identified influenza A virus in 20 (18.5%) samples and influenza B virus in two 2 (1.9%) samples. The high specificity (100%) and PPV of Directigen Flu A+B we found in our study shows that the positive results do not need to be confirmed. The overall sensitivity of Directigen Flu A+B is 35.1% for influenza A virus and 33.0% for influenza B virus. The sensitivity for influenza A is higher among children hospitalized (45.0%) and outpatients (40.0%) versus adults. Directigen Flu A+B has relatively low sensitivity for detection of influenza viruses in combined nose and throat swabs. Negative results must be confirmed.

  20. Key Facts about Seasonal Flu Vaccine

    Science.gov (United States)

    ... Swine Variant Pandemic Other Key Facts About Seasonal Flu Vaccine Language: English (US) Español Recommend on Facebook ... the flu is to get vaccinated each year. Flu Vaccination Why should people get vaccinated against the ...

  1. Performance of the inFLUenza Patient-Reported Outcome (FLU-PRO) diary in patients with influenza-like illness (ILI)

    Science.gov (United States)

    Bacci, Elizabeth D.; Leidy, Nancy K.; Poon, Jiat-Ling; Stringer, Sonja; Memoli, Matthew J.; Han, Alison; Fairchok, Mary P.; Coles, Christian; Owens, Jackie; Chen, Wei-Ju; Arnold, John C.; Danaher, Patrick J.; Lalani, Tahaniyat; Burgess, Timothy H.; Millar, Eugene V.; Ridore, Michelande; Hernández, Andrés; Rodríguez-Zulueta, Patricia; Ortega-Gallegos, Hilda; Galindo-Fraga, Arturo; Ruiz-Palacios, Guillermo M.; Pett, Sarah; Fischer, William; Gillor, Daniel; Moreno Macias, Laura; DuVal, Anna; Rothman, Richard; Dugas, Andrea; Guerrero, M. Lourdes

    2018-01-01

    Background The inFLUenza Patient Reported Outcome (FLU-PRO) measure is a daily diary assessing signs/symptoms of influenza across six body systems: Nose, Throat, Eyes, Chest/Respiratory, Gastrointestinal, Body/Systemic, developed and tested in adults with influenza. Objectives This study tested the reliability, validity, and responsiveness of FLU-PRO scores in adults with influenza-like illness (ILI). Methods Data from the prospective, observational study used to develop and test the FLU-PRO in influenza virus positive patients were analyzed. Adults (≥18 years) presenting with influenza symptoms in outpatient settings in the US, UK, Mexico, and South America were enrolled, tested for influenza virus, and asked to complete the 37-item draft FLU-PRO daily for up to 14-days. Analyses were performed on data from patients testing negative. Reliability of the final, 32-item FLU-PRO was estimated using Cronbach’s alpha (α; Day 1) and intraclass correlation coefficients (ICC; 2-day reproducibility). Convergent and known-groups validity were assessed using patient global assessments of influenza severity (PGA). Patient report of return to usual health was used to assess responsiveness (Day 1–7). Results The analytical sample included 220 ILI patients (mean age = 39.3, 64.1% female, 88.6% white). Sixty-one (28%) were hospitalized at some point in their illness. Internal consistency reliability (α) of FLU-PRO Total score was 0.90 and ranged from 0.72–0.86 for domain scores. Reproducibility (Day 1–2) was 0.64 for Total, ranging from 0.46–0.78 for domain scores. Day 1 FLU-PRO scores correlated (≥0.30) with the PGA (except Gastrointestinal) and were significantly different across PGA severity groups (Total: F = 81.7, pFLU-PRO scores are reliable, valid, and responsive in adults with influenza-like illness. PMID:29566007

  2. The Spanish flu in Denmark

    DEFF Research Database (Denmark)

    Kolte, Ida Viktoria; Skinhøj, Peter; Keiding, Niels

    2008-01-01

    The spread of H5N1 influenza and the similarity between this avian virus and the Spanish flu virus causes fear of a new influenza pandemic, but data from the Spanish flu may also be of guidance in planning for preventive measures. Using data on influenza cases, influenza deaths and total deaths...

  3. [Estimation of the population attributable fraction due to obesity in hospital admissions for flu valued according to Body Mass Index (BMI) and CUN-BAE].

    Science.gov (United States)

    Dávila-Batista, V; Carriedo, D; Díez, F; Pueyo Bastida, A; Martínez Durán, B; Martin, V

    2018-03-01

    The obesity pandemic together with the influenza pandemic could lead to a significant burden of disease. The body mass index (BMI) does not discriminate obesity appropriately. The CUN-BAE has recently been used as an estimate of body fatness for Caucasians, including BMI, gender, and age. The aim of this study is to assess the population attributable fraction of hospital admissions due to influenza, due to the body fatness measured with the BMI, and the CUN-BAE. A multicentre study was conducted using matched case-controls. Cases were hospital admissions with the influenza confirmed by the RT-PCR method between 2009 and 2011. The risk of hospital admission and the population attribuible fraction were calculated using the BMI or the CUN-BAE for each adiposity category in a conditional logical regression analysis adjusted for confounding variables. The analyzes were estimated in the total sample, in unvaccinated people, and those less than 65 years-old. A total of 472 hospitalised cases and 493 controls were included in the study. Compared to normal weight, the aOR of influenza hospital admissions increases with each level of BMI (aOR=1.26; 2.06 and 11.64) and CUN-BAE (aOR=2.78; 4.29; 5.43 and 15.18). The population attributable fraction of influenza admissions using CUN-BAE is 3 times higher than that estimated with BMI (0,72 vs. 0,27), with the differences found being similar the non-vaccinated and under 65 year-olds. The BMI could be underestimating the burden of disease attributable to obesity in individuals hospitalised with influenza. There needs to be an appropriate assessment of the impact of obesity and vaccine recommendation criteria. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Impact of pandemic flu training on ability of medical personnel to recognize an index case of avian influenza.

    Science.gov (United States)

    Adini, Bruria; Goldberg, Avishay; Cohen, Robert; Bar-Dayan, Yaron

    2012-04-01

    This study investigated the relationship between training programmes for pandemic flu and level of knowledge of health-care professionals with performance in an avian flu exercise. Training programmes of all general hospitals in Israel for managing a pandemic influenza were evaluated. Spearman's ρ correlation was used to analyse the relationship between training scores and level of knowledge of medical personnel with performance in an avian flu exercise. Hospital preparedness levels were evaluated at two time points and Wilcoxon signed-rank test was used to determine if overall preparedness scores improved over time. Evaluation of training programmes for pandemic influenza showed high to very high scores in most hospitals (mean 85, SD 22). Significant correlations between training and performance in the exercise were noted for: implementation of training programmes 0.91, P = 0.000; designating personnel for training 0.87, P = 0.000; content of training 0.61, P = 0.001; and training materials 0.36, P = 0.05. Overall reliability of the evaluation scores was 0.82 and reliability for two of the sub-scales was: implementation of the programme 0.78; and designating personnel for training 0.37. No significant correlation was found between level of knowledge and performance in the exercise. Training programmes for hospital personnel for pandemic flu have a significant role in improving performance in case of pandemic flu. The key component of the training programme appears to be the implementation of the programme. Use of knowledge tests should be further investigated, as they do not appear to correlate with the level of emergency preparedness for pandemic influenza.

  5. H1N1 influenza (Swine flu)

    Science.gov (United States)

    Swine flu; H1N1 type A influenza ... The H1N1 virus is now considered a regular flu virus. It is one of the three viruses included in the regular (seasonal) flu vaccine . You cannot get H1N1 flu virus from ...

  6. Recognizing flu-like symptoms from videos.

    Science.gov (United States)

    Thi, Tuan Hue; Wang, Li; Ye, Ning; Zhang, Jian; Maurer-Stroh, Sebastian; Cheng, Li

    2014-09-12

    Vision-based surveillance and monitoring is a potential alternative for early detection of respiratory disease outbreaks in urban areas complementing molecular diagnostics and hospital and doctor visit-based alert systems. Visible actions representing typical flu-like symptoms include sneeze and cough that are associated with changing patterns of hand to head distances, among others. The technical difficulties lie in the high complexity and large variation of those actions as well as numerous similar background actions such as scratching head, cell phone use, eating, drinking and so on. In this paper, we make a first attempt at the challenging problem of recognizing flu-like symptoms from videos. Since there was no related dataset available, we created a new public health dataset for action recognition that includes two major flu-like symptom related actions (sneeze and cough) and a number of background actions. We also developed a suitable novel algorithm by introducing two types of Action Matching Kernels, where both types aim to integrate two aspects of local features, namely the space-time layout and the Bag-of-Words representations. In particular, we show that the Pyramid Match Kernel and Spatial Pyramid Matching are both special cases of our proposed kernels. Besides experimenting on standard testbed, the proposed algorithm is evaluated also on the new sneeze and cough set. Empirically, we observe that our approach achieves competitive performance compared to the state-of-the-arts, while recognition on the new public health dataset is shown to be a non-trivial task even with simple single person unobstructed view. Our sneeze and cough video dataset and newly developed action recognition algorithm is the first of its kind and aims to kick-start the field of action recognition of flu-like symptoms from videos. It will be challenging but necessary in future developments to consider more complex real-life scenario of detecting these actions simultaneously from

  7. Flu and People with Diabetes

    Science.gov (United States)

    ... Seasonal Avian Swine Variant Pandemic Other Flu and People with Diabetes Language: English (US) Español Recommend on Facebook Tweet Share Compartir People with diabetes (type 1 or type 2), even ...

  8. Pregnant Women and Influenza (Flu)

    Science.gov (United States)

    ... risk of serious flu complications, such as pregnant women. Treatment should begin as soon as possible because antiviral drugs work best when started early (within 48 hours after symptoms start). Antiviral drugs can make your ...

  9. Caring for Someone Sick (Flu)

    Science.gov (United States)

    ... 2018 Season Frequently Asked Questions on Vaccine Supply Historical Reference of Seasonal Influenza Vaccine Doses Distributed Other ... Seizures Flu-like symptoms that improve but then return with fever and worse cough Steps to Take ...

  10. Hospitality Studies: Escaping the Tyranny?

    Science.gov (United States)

    Lashley, Conrad

    2015-01-01

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

  11. A review of the clinical efficacy and safety of MP-AzeFlu, a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate, in clinical studies conducted during different allergy seasons in the US

    Directory of Open Access Journals (Sweden)

    Prenner BM

    2016-07-01

    Full Text Available Bruce M Prenner Allergy Associates Medical Group, Inc., San Diego, CA, USA Abstract: A novel intranasal formulation of azelastine HCl (AZE, an antihistamine and fluticasone propionate (FP, a corticosteroid in a single spray (MP-AzeFlu [Dymista®] was studied in four randomized, double-blind, placebo-controlled trials of patients with seasonal allergic rhinitis conducted in the US. Study sites were distributed so that all major US geographic regions and the prevalent pollens within these regions were represented. Spring and summer studies included patients aged 12 years and older with allergy to grass and tree pollens. Fall studies enrolled patients with allergy to weeds, in particular ragweed. In addition, a study was conducted during the winter months in patients with allergy to mountain cedar pollen in TX, USA. Regardless of allergy season or prevalent pollen, MP-AzeFlu improved nasal symptoms of allergic rhinitis (AR to a significantly greater degree than AZE or FP, two treatments that currently are recommended as the first-line AR therapy. MP-AzeFlu improved all individual AR symptoms and was significantly better than FP and AZE for nasal congestion relief, which is generally accepted as the most bothersome symptom for AR patients. The onset of action was within 30 minutes. MP-AzeFlu also provided clinically important improvement in the overall Rhinoconjunctivitis Quality of Life Questionnaire score and significantly improved ocular symptoms of rhinitis compared to placebo. Favorable characteristics of the MP-AzeFlu formulation as well as superior clinical efficacy make it an ideal intranasal therapy for AR. Keywords: Dymista, seasonal allergic rhinitis, grass pollen, ragweed, Texas mountain cedar, intranasal therapy

  12. FluBreaks: early epidemic detection from Google flu trends.

    Science.gov (United States)

    Pervaiz, Fahad; Pervaiz, Mansoor; Abdur Rehman, Nabeel; Saif, Umar

    2012-10-04

    The Google Flu Trends service was launched in 2008 to track changes in the volume of online search queries related to flu-like symptoms. Over the last few years, the trend data produced by this service has shown a consistent relationship with the actual number of flu reports collected by the US Centers for Disease Control and Prevention (CDC), often identifying increases in flu cases weeks in advance of CDC records. However, contrary to popular belief, Google Flu Trends is not an early epidemic detection system. Instead, it is designed as a baseline indicator of the trend, or changes, in the number of disease cases. To evaluate whether these trends can be used as a basis for an early warning system for epidemics. We present the first detailed algorithmic analysis of how Google Flu Trends can be used as a basis for building a fully automated system for early warning of epidemics in advance of methods used by the CDC. Based on our work, we present a novel early epidemic detection system, called FluBreaks (dritte.org/flubreaks), based on Google Flu Trends data. We compared the accuracy and practicality of three types of algorithms: normal distribution algorithms, Poisson distribution algorithms, and negative binomial distribution algorithms. We explored the relative merits of these methods, and related our findings to changes in Internet penetration and population size for the regions in Google Flu Trends providing data. Across our performance metrics of percentage true-positives (RTP), percentage false-positives (RFP), percentage overlap (OT), and percentage early alarms (EA), Poisson- and negative binomial-based algorithms performed better in all except RFP. Poisson-based algorithms had average values of 99%, 28%, 71%, and 76% for RTP, RFP, OT, and EA, respectively, whereas negative binomial-based algorithms had average values of 97.8%, 17.8%, 60%, and 55% for RTP, RFP, OT, and EA, respectively. Moreover, the EA was also affected by the region's population size

  13. Get Your Flu Shot!| NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Flu Shot Get Your Flu Shot! Past Issues / Winter 2011 Table of Contents ... failure, or lung disease "For the 2010–2011 flu season, the flu vaccine provides protection against the ...

  14. Fluência verbal e variáveis sociodemográficas no processo de envelhecimento: um estudo epidemiológico Verbal fluency and sociodemographic variables in the aging process: an epidemiological study

    Directory of Open Access Journals (Sweden)

    Thaís Bento Lima da Silva

    2011-01-01

    Full Text Available A fluência verbal é um marcador das funções executivas, envolvendo a capacidade de busca e recuperação de dados, habilidades de organização, autorregulação e memória operacional. Objetivou-se identificar a existência de diferenças em fluência verbal (número de animais, categorias, grupos e alternância de categorias entre sexo, faixas etárias, faixas de escolaridade e renda. Trezentos e oitenta e três idosos (60 anos ou mais participaram de estudo epidemiológico de corte transversal. Foram aplicadas questões sociodemográficas e o teste de fluência verbal categoria animais. As variáveis do teste de fluência verbal foram influenciadas por sexo, idade e escolaridade, com melhor desempenho a favor dos homens, dos participantes mais jovens e mais escolarizados. Os resultados confirmam que o desempenho em fluência verbal deve ser interpretado à luz das informações sociodemográficas.Verbal fluency is a marker of executive functions which involves the ability of searching and retrieving information, organizational skills, self-regulation and working memory. The objective of this paper was to identify differences in verbal fluency (number of animals, categories, clusters and category switching associated with gender, age, education and income. Three hundred eighty three elderly (60 or older participated in an epidemiological cross-sectional study. Participants answered sociodemographic questions and completed the verbal fluency animal category test. Verbal fluency variables were influenced by gender, age, and education. Higher performance was reported for men and participants with lower age and higher education. Results confirm that performance in verbal fluency must be interpreted in the light of sociodemographic information.

  15. Swine Flu -A Comprehensive View

    Science.gov (United States)

    Singh, Vandana; Sood, Meenakshi

    2012-07-01

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

  16. flu, a metastable gene controlling surface properties of Escherichia coli.

    OpenAIRE

    Diderichsen, B

    1980-01-01

    flu, a gene of Escherichia coli K-12, was discovered and mapped between his and shiA. It is shown that flu is a metastable gene that changes frequently between the flu+ and flu states. flu+ variants give stable homogeneous suspensions, are piliated, and form glossy colonies. flu variants aggregate, fluff and sediment from suspensions, are nonpiliated, and form frizzy colonies. flu+ and flu variants can be isolated from most strains. Implications of these observations are discussed, and it is ...

  17. Flu Vaccine and People with Egg Allergies

    Science.gov (United States)

    ... Pandemic Other Flu Vaccine and People with Egg Allergies Language: English (US) Español Recommend on Facebook Tweet ... for Recommendations This page contains information about egg allergy and flu vaccination. Summary: CDC and its Advisory ...

  18. Caring for Your Child's Cold or Flu

    Science.gov (United States)

    ... Print Share Caring for Your Child’s Cold or Flu Page Content ​Unfortunately, there's no cure for the ... or spoon) that is marked in milliliters. Prevention: Flu vaccine Children 6 months or older should get ...

  19. Surveillance of illness associated with pandemic (H1N1) 2009 virus infection among adults using a global clinical site network approach: the INSIGHT FLU 002 and FLU 003 studies

    DEFF Research Database (Denmark)

    Dwyer, Dominic E; Nielsen, Henrik Ib

    2011-01-01

    The novel pandemic influenza A (H1H1) 2009 virus spread rapidly around the world in 2009. The paucity of prospective international epidemiologic data on predictors of clinical outcomes with pandemic (H1N1) 2009 virus infection stimulated the INSIGHT network, an international network of community...... and hospital-based investigators, to commence two worldwide clinical observational studies to describe pandemic (H1N1) 2009 virus activity. The purpose of these two studies was to estimate the percent of adult patients with illness due to laboratory-confirmed pandemic (H1N1) 2009 virus infection...

  20. Knowledge, Attitude and Practices regarding Swine Flu among adult population

    Directory of Open Access Journals (Sweden)

    Harjot Kaur

    2015-09-01

    Full Text Available Introduction: Prevention is the most appropriate measure to control H1N1 flu pandemic and awareness of H1N1 flu is ranked very high in preventive measures. Keeping this in view, study was designed to assess the awareness level and to compare it among urban and rural participants. Aims and objectives: To assess the knowledge, attitude and practices regarding swine flu among adult population, to assess whether there is any difference among rural and urban population and to assess the response generated by the media coverage and the Government efforts.Methods: This cross-sectional study was done from April to July 2015 on 300 houses from the urban area and 150 houses from rural area, chosen from study population by random sampling. Mean and standard deviation for continuous variables and percentages for categorical were calculated. Results: 94% of urban and 91.3% of the rural participants had previously heard about swine flu, main source being TV. 46% of urban and 74% of rural participants had myth about spread of swine flu by eating pork. 41.3% of urban and 8.7% of rural population thought that government measures are sufficient for controlling swine flu. Conclusion: Knowledge regarding swine flu pandemic is good among study participants but role of health care providers is minimal and requires more dedicated effort. Lack of awareness among study population regarding some key focus areas like health promoting habits, vaccination and myths regarding the spread is of serious concern and needs to be addressed by the media, health workers and the Government efforts

  1. Determinants of individuals' risks to 2009 pandemic influenza virus infection at household level amongst Djibouti city residents--a CoPanFlu cross-sectional study.

    Science.gov (United States)

    Andayi, Fred; Crepey, Pascal; Kieffer, Alexia; Salez, Nicolas; Abdo, Ammar A; Carrat, Fabrice; Flahault, Antoine; de Lamballerie, Xavier

    2014-01-27

    Following the 2009 swine flu pandemic, a cohort for pandemic influenza (CoPanFlu) study was established in Djibouti, the Horn of Africa, to investigate its case prevalence and risk predictors' at household level. From the four city administrative districts, 1,045 subjects from 324 households were included during a face-to-face encounter between 11th November 2010 and 15th February 2011. Socio-demographic details were collected and blood samples were analysed in haemagglutination inhibition (HI) assays. Risk assessments were performed in a generalised estimating equation model. In this study, the indicator of positive infection status was set at an HI titre of ≥ 80, which was a relevant surrogate to the seroconversion criterion. All positive cases were considered to be either recent infections or past contact with an antigenically closely related virus in humans older than 65 years. An overall sero-prevalence of 29.1% and a geometrical mean titre (GMT) of 39.5% among the residents was observed. Youths, ≤ 25 years and the elderly, ≥65 years had the highest titres, with values of 35.9% and 29.5%, respectively. Significantly, risk was high amongst youths ≤ 25 years, (OR 1.5-2.2), residents of District 4(OR 2.9), students (OR 1.4) and individuals living near to river banks (OR 2.5). Belonging to a large household (OR 0.6), being employed (OR 0.5) and working in open space-outdoor (OR 0.4) were significantly protective. Only 1.4% of the cohort had vaccination against the pandemic virus and none were immunised against seasonal influenza. Despite the limited number of incident cases detected by the surveillance system, A(H1N1)pdm09 virus circulated broadly in Djibouti in 2010 and 2011. Age-group distribution of cases was similar to what has been reported elsewhere, with youths at the greatest risk of infection. Future respiratory infection control should therefore be tailored to reach specific and vulnerable individuals such as students and those working

  2. Determinants of individuals’ risks to 2009 pandemic influenza virus infection at household level amongst Djibouti city residents - A CoPanFlu cross-sectional study

    Science.gov (United States)

    2014-01-01

    Background Following the 2009 swine flu pandemic, a cohort for pandemic influenza (CoPanFlu) study was established in Djibouti, the Horn of Africa, to investigate its case prevalence and risk predictors’ at household level. Methods From the four city administrative districts, 1,045 subjects from 324 households were included during a face-to-face encounter between 11th November 2010 and 15th February 2011. Socio-demographic details were collected and blood samples were analysed in haemagglutination inhibition (HI) assays. Risk assessments were performed in a generalised estimating equation model. Results In this study, the indicator of positive infection status was set at an HI titre of ≥ 80, which was a relevant surrogate to the seroconversion criterion. All positive cases were considered to be either recent infections or past contact with an antigenically closely related virus in humans older than 65 years. An overall sero-prevalence of 29.1% and a geometrical mean titre (GMT) of 39.5% among the residents was observed. Youths, ≤ 25 years and the elderly, ≥65 years had the highest titres, with values of 35.9% and 29.5%, respectively. Significantly, risk was high amongst youths ≤ 25 years, (OR 1.5-2.2), residents of District 4(OR 2.9), students (OR 1.4) and individuals living near to river banks (OR 2.5). Belonging to a large household (OR 0.6), being employed (OR 0.5) and working in open space-outdoor (OR 0.4) were significantly protective. Only 1.4% of the cohort had vaccination against the pandemic virus and none were immunised against seasonal influenza. Conclusion Despite the limited number of incident cases detected by the surveillance system, A(H1N1)pdm09 virus circulated broadly in Djibouti in 2010 and 2011. Age-group distribution of cases was similar to what has been reported elsewhere, with youths at the greatest risk of infection. Future respiratory infection control should therefore be tailored to reach specific and vulnerable

  3. Swine flu (H1N1 influenza): awareness profile of visitors of swine flu screening booths in Belgaum city, Karnataka.

    Science.gov (United States)

    Viveki, R G; Halappanavar, A B; Patil, M S; Joshi, A V; Gunagi, Praveena; Halki, Sunanda B

    2012-06-01

    The 2009 flu pandemic was a global outbreak of a new strain of H1N1 influenza virus often referred colloquially as "swine flu". The objectives of the study were: (1) To know the sociodemographic and awareness profile of visitors attending swine flu screening booths. (2) To reveal sources of information. The present cross-sectional study was undertaken among the visitors (18 years and above) attending swine flu screening booths organised within the Belgaum city during Ganesh festival from 28-08-2009 to 03-09-2009 by interviewing them using predesigned, pretested structured questionnaire on swine flu. The data was collected and analysed using SPSS software programme for windows (version 16). Chi-square test was applied. Out of 206 visitors, 132 (64.1%) were males and 107 (51.9%) were in the age group of 30-49 years; 183 (88.8%) had heard about swine flu. More than a third of the visitors (38.3%) disclosed that there was a vaccine to prevent swine flu. Majority responded that it could be transmitted by being in close proximity to pigs (49.0%) and by eating pork (51.5%). Newspaper/magazine (64.6%), television (61.7%), and public posters/pamphlets (44.2%) were common sources of information. The present study revealed that doctors/public health workers have played little role in creating awareness in the community. The improved communication between doctors and the community would help to spread correct information about the disease and the role that the community can play in controlling the spread of the disease.

  4. Much ado about flu: A mixed methods study of parental perceptions, trust and information seeking in a pandemic.

    Science.gov (United States)

    King, Catherine L; Chow, Maria Y K; Wiley, Kerrie E; Leask, Julie

    2018-02-13

    Effective public health messaging is essential in both the planning phase and duration of a pandemic. This study aimed to gain an understanding of parental information seeking, trusted sources and needs in relation to pandemic influenza A 2009 (pH1N1) to inform future policy planning and resource development. We conducted a mixed methods study; parents from 16 childcare centres in Sydney, Australia, were surveyed between 16 November and 9 December 2009, and interviews were conducted with participants from six childcare centres between June 2009 and May 2011. From 972 surveys distributed, 431 were completed; a response rate of 44%. Most parents (90%) reported that doctors were "trusted a lot" as a source of influenza information, followed by nurses (59%), government (56%) and childcare centres (52%). Less trusted sources included media (7% selected "trusted a lot"), antivaccination groups (6%) and celebrities (1%). Parents identified a range of key search terms for influenza infection and vaccine. From 42 in-depth interviews, key themes were as follows: "Action trigger," "In an emergency, think Emergency," "Fright to hype" and "Dr Google and beyond." Parents relied heavily on media messages, but cynicism emerged when the pandemic was milder than expected. Parents viewed a range of information sources as trustworthy, including doctors, authoritative hospital or government websites, and childcare centres and schools. A user-centred orientation is vital for pandemic communications including tailored information provision, via trusted sources based on what parents want to know and how they can find it. © 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  5. Stained Glass and Flu

    Centers for Disease Control (CDC) Podcasts

    2017-02-01

    Dr. Robert Webster, an Emeritus member of the Department of Infectious Diseases at St. Jude Children's Research Hospital, discusses his cover art story on stained glass and influenza.  Created: 2/1/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/1/2017.

  6. Hospital Waste Management - Case Study

    Directory of Open Access Journals (Sweden)

    Beatriz Edra

    2017-07-01

    Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.

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

    African Journals Online (AJOL)

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

  8. A Multicenter Retrospective Review of Prone Position Ventilation (PPV) in Treatment of Severe Human H7N9 Avian Flu.

    Science.gov (United States)

    Xu, Yuanda; Deng, Xilong; Han, Yun; Zhou, Lixin; He, Weiqun; Chen, Sibei; Nong, Lingbo; Huang, Huang; Zhang, Yan; Yu, Tieou; Li, Yimin; Liu, Xiaoqing

    2015-01-01

    Patients with H7N9 avian flu concurrent with severe acute respiratory distress syndrome (ARDS) usually have a poor clinical outcome. Prone position ventilation (PPV) has been shown to improve the prognosis of patients with severe ARDS. This study explored the effects of PPV on the respiratory and circulatory mechanics of H7N9-infected patients with severe ARDS. Individuals admitted to four hospitals designated for H7N9 patients in Guangdong province were treated with PPV, and their clinical data were recorded before and after receiving PPV. Six of 20 critically ill patients in the ICU received PPV. After treatment with 35 PPV sessions, the oxygenation index (OI) values of the six patients when measured post-PPV and post-supine position ventilation (SPV) were significantly higher than those measured pre-PPV (P protective ventilation strategy for use in patients with H7N9 avian flu concurrent with severe ARDS.

  9. Using EGEE against avian flu

    CERN Multimedia

    2006-01-01

    During April 2006 avian flu was spreading across the world with the potential of turning into a pandemic, a drug to treat the deadly H5N1 strain was needed. Such a task required the huge processing power provided by EGEE, which analysed 300 000 possible drug components for their suitability. This map shows the network of computer centres and their activity during this time.

  10. Swine flu - A pandemic outbreak

    Directory of Open Access Journals (Sweden)

    Jini George

    Full Text Available Hippocrates had described influenza like outbreak in 412 B.C. and since then repeated influenza like epidemics and pandemics have been recorded in recent times. One of the greatest killers of all time was the pandemic of swine flu (Spanish flu of 1918-1919, when 230 million people died. Annual influenza epidemics are estimated to affect 5–15% of the global population, resulting in severe illness in 3–5 million patients causing 250,000–500,000 deaths worldwide. Severe illness and deaths occur mainly in the high-risk populations of infants, the elderly and chronically ill patients. The 2009 outbreak of swine flu is thought to be a mutation more specifically a reassortment of four known strains of influenza A virus subtype H1N1; one endemic in humans, one endemic in birds, and two endemic in pigs. WHO officially declared the outbreak to be a pandemic on June 11, 2009, but stressed that the new designation was a result of the global "spread of the virus," not its severity. [Vet World 2009; 2(12.000: 472-474

  11. Design and methods of a social network isolation study for reducing respiratory infection transmission: The eX-FLU cluster randomized trial.

    Science.gov (United States)

    Aiello, Allison E; Simanek, Amanda M; Eisenberg, Marisa C; Walsh, Alison R; Davis, Brian; Volz, Erik; Cheng, Caroline; Rainey, Jeanette J; Uzicanin, Amra; Gao, Hongjiang; Osgood, Nathaniel; Knowles, Dylan; Stanley, Kevin; Tarter, Kara; Monto, Arnold S

    2016-06-01

    Social networks are increasingly recognized as important points of intervention, yet relatively few intervention studies of respiratory infection transmission have utilized a network design. Here we describe the design, methods, and social network structure of a randomized intervention for isolating respiratory infection cases in a university setting over a 10-week period. 590 students in six residence halls enrolled in the eX-FLU study during a chain-referral recruitment process from September 2012-January 2013. Of these, 262 joined as "seed" participants, who nominated their social contacts to join the study, of which 328 "nominees" enrolled. Participants were cluster-randomized by 117 residence halls. Participants were asked to respond to weekly surveys on health behaviors, social interactions, and influenza-like illness (ILI) symptoms. Participants were randomized to either a 3-Day dorm room isolation intervention or a control group (no isolation) upon illness onset. ILI cases reported on their isolation behavior during illness and provided throat and nasal swab specimens at onset, day-three, and day-six of illness. A subsample of individuals (N=103) participated in a sub-study using a novel smartphone application, iEpi, which collected sensor and contextually-dependent survey data on social interactions. Within the social network, participants were significantly positively assortative by intervention group, enrollment type, residence hall, iEpi participation, age, gender, race, and alcohol use (all Pisolation from social networks in a university setting. These data provide an unparalleled opportunity to address questions about isolation and infection transmission, as well as insights into social networks and behaviors among college-aged students. Several important lessons were learned over the course of this project, including feasible isolation durations, the need for extensive organizational efforts, as well as the need for specialized programmers and server

  12. Integrative study of pandemic A/H1N1 influenza infections: design and methods of the CoPanFlu-France cohort

    Directory of Open Access Journals (Sweden)

    Lapidus Nathanael

    2012-06-01

    Full Text Available Abstract Background The risk of influenza infection depends on biological characteristics, individual or collective behaviors and the environmental context. The Cohorts for Pandemic Influenza (CoPanFlu France study was set up in 2009 after the identification of the novel swine-origin A/H1N1 pandemic influenza virus. This cohort of 601 households (1450 subjects representative for the general population aims at using an integrative approach to study the risk and characteristics of influenza infection as a complex combination of data collected from questionnaires regarding sociodemographic, medical, behavioral characteristics of subjects and indoor environment, using biological samples or environmental databases. Methods/Design Households were included between December 2009 and July 2010. The design of this study relies on systematic follow-up visits between influenza seasons and additional visits during influenza seasons, when an influenza-like illness is detected in a household via an active surveillance system. During systematic visits, a nurse collects individual and environmental data on questionnaires and obtains blood samples from all members of the household. When an influenza-like-illness is detected, a nurse visits the household three times during the 12 following days, and collects data on questionnaires regarding exposure and symptoms, and biological samples (including nasal swabs from all subjects in the household. The end of the follow-up period is expected in fall 2012. Discussion The large amount of data collected throughout the follow-up will permit a multidisciplinary study of influenza infections. Additional data is being collected and analyzed in this ongoing cohort. The longitudinal analysis of these households will permit integrative analyses of complex phenomena such as individual, collective and environmental risk factors of infection, routes of transmission, or determinants of the immune response to infection or vaccination.

  13. 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) ...

  14. Initial psychological responses to Influenza A, H1N1 ("Swine flu"

    Directory of Open Access Journals (Sweden)

    Neto Felix

    2009-10-01

    Full Text Available Abstract Background The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork. We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu" in the six days following the WHO pandemic alert level 5, and regional differences in these responses. Methods 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180 or Europe (N = 148. Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption Results 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p Conclusion Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation.

  15. Self-other differences in H1N1 flu risk perception in a global context: a comparative study between the United States and China.

    Science.gov (United States)

    Han, Gang Kevin; Zhang, Jueman Mandy; Chu, Kejun Rebecca; Shen, Guolin

    2014-01-01

    Extending research on self-other differences in perception to a global health risk, this study compares U.S. and Chinese college students' perceived H1N1 flu risk at four levels: personal, group, societal, and global. It also examines how personal experience, interpersonal communication, traditional and Internet-based media, and self-efficacy affect perception at four levels, as well as the self-other differences between the personal level and each of the other three levels. An online survey in both countries reveals an "ascending pattern," showing higher perceived risk for others than for selves. Chinese respondents perceive higher risk than U.S. respondents at all levels. Interpersonal communication predicts risk perception at four levels in the United States and at the group and societal levels in China. New media exposure exerts influence on all but the group level in China, while social networking sites (SNS) exposure predicts group- and societal-level risk perception in the United States. The overall attention paid to H1N1 information in the media affects all levels in both countries. Interaction between media exposure and attention is influential at all levels in the United States. Self-efficacy is negatively associated with risk perception in China except at the global level. Attention to media in the United States, and SNS exposure in China, explain the self-other differences in three comparisons, along with self-efficacy, which decreases the self-other gap in the United States while increasing the gap in China.

  16. Protecting Against Influenza (Flu): Advice for Caregivers of Young Children

    Science.gov (United States)

    ... Avian Swine Variant Pandemic Other Protecting Against Influenza (Flu): Advice for Caregivers of Young Children Language: English ( ... from the flu. Advice on How to Prevent Flu for Caregivers of Young Children 1. Take Time ...

  17. How to be a good visitor during flu season

    Science.gov (United States)

    ... consumers How to be a good visitor during flu season 11/20/2017 Access a printer-friendly ... of infection prevention. This is especially true during flu season. According to the CDC, influenza (the flu) ...

  18. Help Stop the Flu | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Flu Shot Help Stop the Flu Past Issues / Winter 2011 Table ... CDC recommends that Americans do the following to help stop the flu: Cover nose and mouth with ...

  19. Flu (Influenza) Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/fluinfluenzatest.html Flu (Influenza) Test To use the sharing features on this page, please enable JavaScript. What is a Flu (Influenza) Test? Influenza, known as the flu , is ...

  20. Flu Shots, Mammogram, and the Perception of Probabilities

    NARCIS (Netherlands)

    Carman, K.G.; Kooreman, P.

    2010-01-01

    We study individuals’ decisions to decline or accept preventive health care interventions such as flu shots and mammograms. In particular, we analyze the role of perceptions of the effectiveness of the intervention, by eliciting individuals' subjective probabilities of sickness and survival, with

  1. Outbreak of a New Strain of Flu at a Fair

    Centers for Disease Control (CDC) Podcasts

    2013-02-28

    Dr. Karen Wong, an EIS officer with the Centers for Disease Control and Prevention, discusses her study about flu outbreaks at agricultural fairs.  Created: 2/28/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 3/4/2013.

  2. Does Work Stress Predict the Occurrence of Cold, Flu and Minor Illness Symptoms in Clinical Psychology Trainees?

    OpenAIRE

    Phillips, Anna C.; Sheffield, David

    2005-01-01

    Objectives: The present study examined the three/four-day lagged relationship between daily work stress and upper respiratory tract infection (URTI) and other minor illness symptoms. Methods: Twenty-four postgraduate clinical psychology trainees completed work stress, cold/flu symptoms and somatic symptoms checklists daily for four weeks. Results: Increases in work stress were observed two days prior to a cold/flu episode but not three or four days preceding a cold/flu episode. Work stress wa...

  3. The flu fighters

    Science.gov (United States)

    Colizza, Vittoria; Vespignani, Alessandro

    2010-02-01

    The Black Death was one of the most devastating pandemics in history. Beginning in 1347, the plague took just three years to spread from Constantinople in western Turkey to Italy and then on to the rest of Europe, leaving nearly a quarter of the continent's population dead in its wake. Historical studies confirm that the disease diffused smoothly, generating an epidemic front that travelled through the continent as a continuous wave at a rate of about 200-400 miles per year.

  4. Natural T Cell-mediated Protection against Seasonal and Pandemic Influenza. Results of the Flu Watch Cohort Study.

    Science.gov (United States)

    Hayward, Andrew C; Wang, Lili; Goonetilleke, Nilu; Fragaszy, Ellen B; Bermingham, Alison; Copas, Andrew; Dukes, Oliver; Millett, Elizabeth R C; Nazareth, Irwin; Nguyen-Van-Tam, Jonathan S; Watson, John M; Zambon, Maria; Johnson, Anne M; McMichael, Andrew J

    2015-06-15

    A high proportion of influenza infections are asymptomatic. Animal and human challenge studies and observational studies suggest T cells protect against disease among those infected, but the impact of T-cell immunity at the population level is unknown. To investigate whether naturally preexisting T-cell responses targeting highly conserved internal influenza proteins could provide cross-protective immunity against pandemic and seasonal influenza. We quantified influenza A(H3N2) virus-specific T cells in a population cohort during seasonal and pandemic periods between 2006 and 2010. Follow-up included paired serology, symptom reporting, and polymerase chain reaction (PCR) investigation of symptomatic cases. A total of 1,414 unvaccinated individuals had baseline T-cell measurements (1,703 participant observation sets). T-cell responses to A(H3N2) virus nucleoprotein (NP) dominated and strongly cross-reacted with A(H1N1)pdm09 NP (P < 0.001) in participants lacking antibody to A(H1N1)pdm09. Comparison of paired preseason and post-season sera (1,431 sets) showed 205 (14%) had evidence of infection based on fourfold influenza antibody titer rises. The presence of NP-specific T cells before exposure to virus correlated with less symptomatic, PCR-positive influenza A (overall adjusted odds ratio, 0.27; 95% confidence interval, 0.11-0.68; P = 0.005, during pandemic [P = 0.047] and seasonal [P = 0.049] periods). Protection was independent of baseline antibodies. Influenza-specific T-cell responses were detected in 43%, indicating a substantial population impact. Naturally occurring cross-protective T-cell immunity protects against symptomatic PCR-confirmed disease in those with evidence of infection and helps to explain why many infections do not cause symptoms. Vaccines stimulating T cells may provide important cross-protective immunity.

  5. Natural T Cell–mediated Protection against Seasonal and Pandemic Influenza. Results of the Flu Watch Cohort Study

    Science.gov (United States)

    Wang, Lili; Goonetilleke, Nilu; Fragaszy, Ellen B.; Bermingham, Alison; Copas, Andrew; Dukes, Oliver; Millett, Elizabeth R. C.; Nazareth, Irwin; Nguyen-Van-Tam, Jonathan S.; Watson, John M.; Zambon, Maria; Johnson, Anne M.; McMichael, Andrew J.

    2015-01-01

    Rationale: A high proportion of influenza infections are asymptomatic. Animal and human challenge studies and observational studies suggest T cells protect against disease among those infected, but the impact of T-cell immunity at the population level is unknown. Objectives: To investigate whether naturally preexisting T-cell responses targeting highly conserved internal influenza proteins could provide cross-protective immunity against pandemic and seasonal influenza. Methods: We quantified influenza A(H3N2) virus–specific T cells in a population cohort during seasonal and pandemic periods between 2006 and 2010. Follow-up included paired serology, symptom reporting, and polymerase chain reaction (PCR) investigation of symptomatic cases. Measurements and Main Results: A total of 1,414 unvaccinated individuals had baseline T-cell measurements (1,703 participant observation sets). T-cell responses to A(H3N2) virus nucleoprotein (NP) dominated and strongly cross-reacted with A(H1N1)pdm09 NP (P < 0.001) in participants lacking antibody to A(H1N1)pdm09. Comparison of paired preseason and post-season sera (1,431 sets) showed 205 (14%) had evidence of infection based on fourfold influenza antibody titer rises. The presence of NP-specific T cells before exposure to virus correlated with less symptomatic, PCR-positive influenza A (overall adjusted odds ratio, 0.27; 95% confidence interval, 0.11–0.68; P = 0.005, during pandemic [P = 0.047] and seasonal [P = 0.049] periods). Protection was independent of baseline antibodies. Influenza-specific T-cell responses were detected in 43%, indicating a substantial population impact. Conclusions: Naturally occurring cross-protective T-cell immunity protects against symptomatic PCR-confirmed disease in those with evidence of infection and helps to explain why many infections do not cause symptoms. Vaccines stimulating T cells may provide important cross-protective immunity. PMID:25844934

  6. Comparative community burden and severity of seasonal and pandemic influenza: results of the Flu Watch cohort study.

    Science.gov (United States)

    Hayward, Andrew C; Fragaszy, Ellen B; Bermingham, Alison; Wang, Lili; Copas, Andrew; Edmunds, W John; Ferguson, Neil; Goonetilleke, Nilu; Harvey, Gabrielle; Kovar, Jana; Lim, Megan S C; McMichael, Andrew; Millett, Elizabeth R C; Nguyen-Van-Tam, Jonathan S; Nazareth, Irwin; Pebody, Richard; Tabassum, Faiza; Watson, John M; Wurie, Fatima B; Johnson, Anne M; Zambon, Maria

    2014-06-01

    Assessment of the effect of influenza on populations, including risk of infection, illness if infected, illness severity, and consultation rates, is essential to inform future control and prevention. We aimed to compare the community burden and severity of seasonal and pandemic influenza across different age groups and study years and gain insight into the extent to which traditional surveillance underestimates this burden. Using preseason and postseason serology, weekly illness reporting, and RT-PCR identification of influenza from nasal swabs, we tracked the course of seasonal and pandemic influenza over five successive cohorts (England 2006-11; 5448 person-seasons' follow-up). We compared burden and severity of seasonal and pandemic strains. We weighted analyses to the age and regional structure of England to give nationally representative estimates. We compared symptom profiles over the first week of illness for different strains of PCR-confirmed influenza and non-influenza viruses using ordinal logistic regression with symptom severity grade as the outcome variable. Based on four-fold titre rises in strain-specific serology, on average influenza infected 18% (95% CI 16-22) of unvaccinated people each winter. Of those infected there were 69 respiratory illnesses per 100 person-influenza-seasons compared with 44 per 100 in those not infected with influenza. The age-adjusted attributable rate of illness if infected was 23 illnesses per 100 person-seasons (13-34), suggesting most influenza infections are asymptomatic. 25% (18-35) of all people with serologically confirmed infections had PCR-confirmed disease. 17% (10-26) of people with PCR-confirmed influenza had medically attended illness. These figures did not differ significantly when comparing pandemic with seasonal influenza. Of PCR-confirmed cases, people infected with the 2009 pandemic strain had markedly less severe symptoms than those infected with seasonal H3N2. Seasonal influenza and the 2009 pandemic

  7. SERO SURVEI DAN ANALISA PENGETAHUAN SIKAP PENJAMAH UNGGAS TERHADAP PENYAKIT FLU BURUNG DI INDONESIA TAHUN 2008

    Directory of Open Access Journals (Sweden)

    Noer Endah Pracoyo

    2013-02-01

    Full Text Available Abstract The bird flu in Indonesia actually is Avian Influenza Virus H5N1 type. Is known bird flu virus in Humans occur if direct contact with infected poultry or through contact with environmental enclosure, and the carcasses of infected poultry products. The absence of the data if the handlers of poultry in the cases of bird flu virus has been exposed to the research conducted sero survey of bird flu antibody titers in handlers poultry  attitudes and knowledge of poultry against bird flu incident. The research objective measure antibodies against respondents tirer AI H5N1 virus, assess knowledge and attitudes against bird flu handlers through the interview. The study design was cross sectional. Handlers of poultry population in the region is ever going Extraordinary Cases of bird flu. Samples were responders/poultry handlers venous blood taken for H5N1 antibody titer by Ellisa, H5N1 conducted interviews using a questionnaire. The study used the respondents informed consent agreement. Research time in February to November 2007 in the island of Java. The number of samples of 80 samples of respondents. The results obtained are not found of H5N1 avian influenza antibody titer in responders. The results of the interview most of the handlers to wash Their hands after doing Their job (82.1%. A total of 52.9% residential handlers is more than a mile from where the management of poultry, (69% lived outside market handlers/Abattoir of poultry.Handler to act entered correctly (53.3%% and almost all handlers (97% would bring the patient/patient ill with signs of bird flu infection to health facilities. Keywords: poultry handlers, bird flu virus, knowledge and attitudes of poultry handlers Abstrak Yang dimaksud Flu burung di Indonesia sebetulnya adalah Virus Avian Influenza dengan tipe H5N1. Selama ini diketahui penularan virus flu burung pada manusia terjadi jika kontak langsung dengan unggas yang terinfeksi atau melalui kontak dengan lingkungan kandang

  8. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all.

    Science.gov (United States)

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to €51-€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries.

  9. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all.

    Directory of Open Access Journals (Sweden)

    Joke Bilcke

    Full Text Available This is one of the first studies to (1 describe the out-of-hospital burden of influenza-like-illness (ILI and clinically diagnosed flu, also for patients not seeking professional medical care, (2 assess influential background characteristics, and (3 formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever, a longer duration of illness, more use of medication (especially antibiotics and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to €51-€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries.

  10. What You Can Do to Stop the Flu

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Flu What You Can Do to Stop the Flu Past Issues / Fall 2009 Table of Contents To ... Health and Human Services: http://flu.gov NIH Flu Research to Results Scientists at the National Institute ...

  11. 2009 H1N1 Flu Vaccine Facts

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Flu 2009 H1N1 Flu Vaccine Facts Past Issues / Fall 2009 Table of ... the H1N1 flu vaccine. 1 The 2009 H1N1 flu vaccine is safe and well tested. Clinical trials ...

  12. The Evaluations of Swine Flu Magnitudes in TV News: A Comparative Analysis of Paired Influenza Pandemics.

    Science.gov (United States)

    Pan, Po-Lin; Meng, Juan

    2015-01-01

    This study examined how major TV news networks covered two flu pandemics in 1976 and 2009 in terms of news frames, mortality exemplars, mortality subject attributes, vaccination, evaluation approaches, and news sources. Results showed that the first pandemic was frequently framed with the medical/scientific and political/legal issues, while the second pandemic was emphasized with the health risk issue in TV news. Both flu pandemics were regularly reported with mortality exemplars, but the focus in the first pandemic was on the flu virus threat and vaccination side effects, while the vaccination shortage was frequently revealed in the second outbreak.

  13. [Prospective study in 2 hospitals].

    Science.gov (United States)

    Jiménez-Buñuales, M T; Martínez-Sáenz, M S; González-Diego, P; Vallejo-García, M; Gallardo-Anciano, J; Cestafe-Martínez, A

    2016-06-01

    The purpose of this study is to know the incidence rate of medication reconciliation at admission and discharge in patients of La Rioja and to improve the patient safety on medication reconciliation. An observational prospective study, part of the Joint Action PaSQ, Work Package 5, European Union Network for Patient Safety and Quality of Care. The study has taken into account the definitions of the Institute for Safe Medication Practices. Any unintended discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a reconciliation error. A total of 750 patients were included, 9 (1.2%) of whom showed at least one discrepancy. The patients had a total of 3,156 mediations registered: 2,313 prescriptions (73.4%) showed no differences, while 821 prescriptions (26%) were intended discrepancies and 21 prescriptions (0.6%) unintended discrepancies were considered by the physician as reconciliation errors. A percentage of 1.2 of the patients, which represents 0.6% of the medicines (one in 166 medications registered) had reconciliation errors during their hospital stay. A proceeding has been implemented by means of the physician doing the medication reconciliation and reviewing it with the help of a medication reconciliation form. The medication reconciliation is a priority strategic objective to improve the safety of patients. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

  14. FluReF, an automated flu virus reassortment finder based on phylogenetic trees.

    Science.gov (United States)

    Yurovsky, Alisa; Moret, Bernard M E

    2011-01-01

    Reassortments are events in the evolution of the genome of influenza (flu), whereby segments of the genome are exchanged between different strains. As reassortments have been implicated in major human pandemics of the last century, their identification has become a health priority. While such identification can be done "by hand" on a small dataset, researchers and health authorities are building up enormous databases of genomic sequences for every flu strain, so that it is imperative to develop automated identification methods. However, current methods are limited to pairwise segment comparisons. We present FluReF, a fully automated flu virus reassortment finder. FluReF is inspired by the visual approach to reassortment identification and uses the reconstructed phylogenetic trees of the individual segments and of the full genome. We also present a simple flu evolution simulator, based on the current, source-sink, hypothesis for flu cycles. On synthetic datasets produced by our simulator, FluReF, tuned for a 0% false positive rate, yielded false negative rates of less than 10%. FluReF corroborated two new reassortments identified by visual analysis of 75 Human H3N2 New York flu strains from 2005-2008 and gave partial verification of reassortments found using another bioinformatics method. FluReF finds reassortments by a bottom-up search of the full-genome and segment-based phylogenetic trees for candidate clades--groups of one or more sampled viruses that are separated from the other variants from the same season. Candidate clades in each tree are tested to guarantee confidence values, using the lengths of key edges as well as other tree parameters; clades with reassortments must have validated incongruencies among segment trees. FluReF demonstrates robustness of prediction for geographically and temporally expanded datasets, and is not limited to finding reassortments with previously collected sequences. The complete source code is available from http://lcbb.epfl.ch/software.html.

  15. I strong administrative buy-in, firm mandates can push flu vaccination rates up to more than 99% among health care workers.

    Science.gov (United States)

    2014-11-01

    While flu vaccination rates are inching up among health care workers, there is still room for improvement. The Centers for Disease Control and Prevention reports that slightly more than 75% of health care workers received the flu vaccination during the 2013-14 season--an increase of roughly 3% over the 2012-13 season. However, some hospitals have been able to achieve vaccination rates in excess of 99%. The apparent key to these efforts is a firm mandate that all personnel receive a flu shot as a condition of employment. There is always pushback to such policies, but hospitals report that most personnel eventually come around. While flu vaccination rates are on the increase among health, care personnel, data from the Centers for Medicare and Medicaid Services (CMS) note that rates vary widely from state to state. For example, the vaccination rate for health care workers in New Jersey stood at just 62% last year. In contrast, more than 95% of health care workers in Maryland received the shot during the 2013-14 flu season. Both Loyola University Medical Center and Henry Ford Hospital have been able to boost flu vaccination rates among their health care workers to more than 99% with the implementation of policies that require flu shots as a condition of employment. Experts say successful flu vaccination campaigns require strong administration buy-in and physician leadership.

  16. HIV/AIDS and the Flu

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other HIV/AIDS and the Flu Questions & Answers Language: English ( ... people with HIV and AIDS. Should people with HIV/AIDS receive the inactivated influenza vaccine? People with ...

  17. Swine Influenza (Swine Flu) in Pigs

    Science.gov (United States)

    ... Address What's this? Submit What's this? Submit Button Influenza Types Seasonal Avian Swine Variant Pandemic Other Key Facts about Swine Influenza (Swine Flu) in Pigs Language: English (US) Español ...

  18. Flu and Heart Disease and Stroke

    Science.gov (United States)

    ... Seasonal Avian Swine Variant Pandemic Other Flu and Heart Disease & Stroke Language: English (US) Español Recommend on Facebook Tweet Share Compartir People with Heart Disease* and Those Who Have Had a Stroke Are ...

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

    Science.gov (United States)

    Pan, Zhi Xiong; Pokharel, Shaligram

    2007-01-01

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

  20. A case study of hospital operations management.

    Science.gov (United States)

    Cheng, T C

    1987-12-01

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

  1. 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.

  2. The German hospital malnutrition study.

    Science.gov (United States)

    Pirlich, Matthias; Schütz, Tatjana; Norman, Kristina; Gastell, Sylvia; Lübke, Heinrich Josef; Bischoff, Stephan C; Bolder, Ulrich; Frieling, Thomas; Güldenzoph, Helge; Hahn, Kristian; Jauch, Karl-Walter; Schindler, Karin; Stein, Jürgen; Volkert, Dorothee; Weimann, Arved; Werner, Hansjörg; Wolf, Christiane; Zürcher, Gudrun; Bauer, Peter; Lochs, Herbert

    2006-08-01

    Malnutrition is frequently observed in chronic and severe diseases and associated with impaired outcome. In Germany general data on prevalence and impact of hospital malnutrition are missing. Nutritional state was assessed by subjective global assessment (SGA) and by anthropometric measurements in 1,886 consecutively admitted patients in 13 hospitals (n=1,073, university hospitals; n=813, community or teaching hospitals). Risk factors for malnutrition and the impact of nutritional status on length of hospital stay were analyzed. Malnutrition was diagnosed in 27.4% of patients according to SGA. A low arm muscle area and arm fat area were observed in 11.3% and 17.1%, respectively. Forty-three % of patients 70 years old were malnourished compared to only 7.8% of patients malnutrition was observed in geriatric (56.2%), oncology (37.6%), and gastroenterology (32.6%) departments. Multivariate analysis revealed three independent risk factors: higher age, polypharmacy, and malignant disease (all PMalnutrition was associated with an 43% increase of hospital stay (PMalnutrition is associated with increased length of hospital stay. Higher age, malignant disease and major comorbidity were found to be the main contributors to malnutrition. Adequate nutritional support should be initiated in order to optimize the clinical outcome of these patients.

  3. Controlling pandemic flu: the value of international air travel restrictions.

    OpenAIRE

    Joshua M Epstein; D Michael Goedecke; Feng Yu; Robert J Morris; Diane K Wagener; Georgiy V Bobashev

    2007-01-01

    Background Planning for a possible influenza pandemic is an extremely high priority, as social and economic effects of an unmitigated pandemic would be devastating. Mathematical models can be used to explore different scenarios and provide insight into potential costs, benefits, and effectiveness of prevention and control strategies under consideration. Methods and Findings A stochastic, equation-based epidemic model is used to study global transmission of pandemic flu, including the effects ...

  4. Guillain-Barré Syndrome (GBS) and Flu Vaccine

    Science.gov (United States)

    ... Swine Variant Pandemic Other Guillain-Barré syndrome and Flu Vaccine Questions & Answers Language: English (US) Español Recommend ... it among people who have been vaccinated against flu? The background rate for GBS in the Unites ...

  5. What You Should Know about Flu Antiviral Drugs

    Science.gov (United States)

    ... Other What You Should Know About Flu Antiviral Drugs Language: English (US) Español Recommend on Facebook Tweet ... used to treat flu illness. What are antiviral drugs? Antiviral drugs are prescription medicines (pills, liquid, an ...

  6. Preventing Flu During Pregnancy (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    During the influenza season, pregnant women and infants under 6 months old are especially susceptible to severe complications from the flu. This podcast discusses the importance of pregnant women receiving the flu vaccine.

  7. Cold, Flu, or Allergy? Know the Difference for Best Treatment

    Science.gov (United States)

    ... October 2014 Print this issue Cold, Flu, or Allergy? Know the Difference for Best Treatment En español ... Peanut Allergy Therapy Wise Choices Cold, Flu, or Allergy? Treatment depends on which you have. A health ...

  8. Is It a Cold or the Flu (For Parents)?

    Science.gov (United States)

    ... English Español Is It a Cold or the Flu? KidsHealth / For Parents / Is It a Cold or the Flu? Print en español ¿Es un resfriado o una ... cough, and high fever — could it be the flu that's been going around? Or just a common ...

  9. Preventing Flu During Pregnancy (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    During the influenza season, pregnant women and infants under 6 months old are especially susceptible to severe complications from the flu. The seasonal flu vaccination is the best way to protect both mother and baby. In this podcast Dr. Stacie Greby discusses the importance of pregnant women receiving the flu vaccine.

  10. Continue to Vaccinate Patients and Staff Against the Flu

    Centers for Disease Control (CDC) Podcasts

    This podcast is a reminder to health care providers about the importance of annual flu vaccination—it’s not too late! Health care providers should get their flu vaccine and continue offering and encouraging flu vaccination among their staff, colleagues, and patients.

  11. Effects of seasonal and pandemic influenza on health-related quality of life, work and school absence in England: Results from the Flu Watch cohort study.

    Science.gov (United States)

    Fragaszy, Ellen B; Warren-Gash, Charlotte; White, Peter J; Zambon, Maria; Edmunds, William J; Nguyen-Van-Tam, Jonathan S; Hayward, Andrew C

    2018-01-01

    Estimates of health-related quality of life (HRQoL) and work/school absences for influenza are typically based on medically attended cases or those meeting influenza-like-illness (ILI) case definitions and thus biased towards severe disease. Although community influenza cases are more common, estimates of their effects on HRQoL and absences are limited. To measure quality-adjusted life days and years (QALDs and QALYs) lost and work/school absences among community cases of acute respiratory infections (ARI), ILI and influenza A and B and to estimate community burden of QALY loss and absences from influenza. Flu Watch was a community cohort in England from 2006 to 2011. Participants were followed up weekly. During respiratory illness, they prospectively recorded daily symptoms, work/school absences and EQ-5D-3L data and submitted nasal swabs for RT-PCR influenza testing. Average QALD lost was 0.26, 0.93, 1.61 and 1.84 for ARI, ILI, H1N1pdm09 and influenza B cases, respectively. 40% of influenza A cases and 24% of influenza B cases took time off work/school with an average duration of 3.6 and 2.4 days, respectively. In England, community influenza cases lost 24 300 QALYs in 2010/11 and had an estimated 2.9 million absences per season based on data from 2006/07 to 2009/10. Our QALDs and QALYs lost and work and school absence estimates are lower than previous estimates because we focus on community cases, most of which are mild, may not meet ILI definitions and do not result in healthcare consultations. Nevertheless, they contribute a substantial loss of HRQoL on a population level. © 2017 The Authors. Influenza and Other Respiratory Viruses. Published by John Wiley & Sons Ltd.

  12. Deck Yourself with Flu Protection Song

    Centers for Disease Control (CDC) Podcasts

    2009-12-22

    This song (sung to the tune of Deck the Halls) describes actions you can take to protect yourself and others from the flu. Sing along!  Created: 12/22/2009 by National Center for Preparedness, Detection, and Control of Infectious Diseases (NCPDCID), Division of Global Migration and Quarantine (DGMQ).   Date Released: 12/22/2009.

  13. Personal Stories: Why Flu Vaccination Matters

    Centers for Disease Control (CDC) Podcasts

    2008-12-08

    In this podcast, moving personal stories help inform parents about the dangers of flu to children and the benefits of vaccination.  Created: 12/8/2008 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 12/8/2008.

  14. Public views of the uk media and government reaction to the 2009 swine flu pandemic

    Directory of Open Access Journals (Sweden)

    Smith Emily

    2010-11-01

    Full Text Available Abstract Background The first cases of influenza A/H1N1 (swine flu were confirmed in the UK on 27th April 2009, after a novel virus first identified in Mexico rapidly evolved into a pandemic. The swine flu outbreak was the first pandemic in more than 40 years and for many, their first encounter with a major influenza outbreak. This study examines public understandings of the pandemic, exploring how people deciphered the threat and perceived they could control the risks. Methods Purposive sampling was used to recruit seventy three people (61 women and 12 men to take part in 14 focus group discussions around the time of the second wave in swine flu cases. Results These discussions showed that there was little evidence of the public over-reacting, that people believed the threat of contracting swine flu was inevitable, and that they assessed their own self-efficacy for protecting against it to be low. Respondents assessed a greater risk to their health from the vaccine than from the disease. Such findings could have led to apathy about following the UK Governments recommended health protective behaviours, and a sub-optimal level of vaccine uptake. More generally, people were confused about the difference between seasonal influenza and swine flu and their vaccines. Conclusions This research suggests a gap in public understandings which could hinder attempts to communicate about novel flu viruses in the future. There was general support for the government's handling of the pandemic, although its public awareness campaign was deemed ineffectual as few people changed their current hand hygiene practices. There was less support for the media who were deemed to have over-reported the swine flu pandemic.

  15. Influenza forecasting with Google Flu Trends.

    Science.gov (United States)

    Dugas, Andrea Freyer; Jalalpour, Mehdi; Gel, Yulia; Levin, Scott; Torcaso, Fred; Igusa, Takeru; Rothman, Richard E

    2013-01-01

    We developed a practical influenza forecast model based on real-time, geographically focused, and easy to access data, designed to provide individual medical centers with advanced warning of the expected number of influenza cases, thus allowing for sufficient time to implement interventions. Secondly, we evaluated the effects of incorporating a real-time influenza surveillance system, Google Flu Trends, and meteorological and temporal information on forecast accuracy. Forecast models designed to predict one week in advance were developed from weekly counts of confirmed influenza cases over seven seasons (2004-2011) divided into seven training and out-of-sample verification sets. Forecasting procedures using classical Box-Jenkins, generalized linear models (GLM), and generalized linear autoregressive moving average (GARMA) methods were employed to develop the final model and assess the relative contribution of external variables such as, Google Flu Trends, meteorological data, and temporal information. A GARMA(3,0) forecast model with Negative Binomial distribution integrating Google Flu Trends information provided the most accurate influenza case predictions. The model, on the average, predicts weekly influenza cases during 7 out-of-sample outbreaks within 7 cases for 83% of estimates. Google Flu Trend data was the only source of external information to provide statistically significant forecast improvements over the base model in four of the seven out-of-sample verification sets. Overall, the p-value of adding this external information to the model is 0.0005. The other exogenous variables did not yield a statistically significant improvement in any of the verification sets. Integer-valued autoregression of influenza cases provides a strong base forecast model, which is enhanced by the addition of Google Flu Trends confirming the predictive capabilities of search query based syndromic surveillance. This accessible and flexible forecast model can be used by

  16. Mitigation approaches to combat the flu pandemic.

    Science.gov (United States)

    Chawla, Raman; Sharma, Rakesh Kumar; Madaan, Deepali; Dubey, Neha; Arora, Rajesh; Goel, Rajeev; Singh, Shefali; Kaushik, Vinod; Singh, Pankaj Kumar; Chabbra, Vivek; Bhardwaj, Janak Raj

    2009-07-01

    Management of flu pandemic is a perpetual challenge for the medical fraternity since time immemorial. Animal to human transmission has been observed thrice in the last century within an average range of 11-39 years of antigenic recycling. The recent outbreak of influenza A (H1N1, also termed as swine flu), first reported in Mexico on April 26, 2009, occurred in the forty first year since last reported flu pandemic (July 1968). Within less than 50 days, it has assumed pandemic proportions (phase VI) affecting over 76 countries with 163 deaths/35,928 cases (as on 15(th) June 2009). It indicated the re-emergence of genetically reassorted virus having strains endemic to humans, swine and avian (H5N1). The World Health Organisation (WHO) member states have already pulled up their socks and geared up to combat such criticalities. Earlier outbreaks of avian flu (H5N1) in different countries led WHO to develop pandemic preparedness strategies with national/regional plans on pandemic preparedness. Numerous factors related to climatic conditions, socio-economic strata, governance and sharing of information/logistics at all levels have been considered critical indicators in monitoring the dynamics of escalation towards a pandemic situation.The National Disaster Management Authority (NDMA), Government of India, with the active cooperation of UN agencies and other stakeholders/experts has formulated a concept paper on role of nonhealth service providers during pandemics in April 2008 and released national guidelines - management of biological disasters in July 2008. These guidelines enumerate that the success of medical management endeavors like pharmaceutical (anti-viral Oseltamivir and Zanamivir therapies), nonpharmaceutical interventions and vaccination development etc., largely depends on level of resistance offered by mutagenic viral strain and rationale use of pharmaco therapeutic interventions. This article describes the mitigation approach to combat flu pandemic with

  17. Mitigation Approaches to Combat the Flu Pandemic

    Science.gov (United States)

    Chawla, Raman; Sharma, Rakesh Kumar; Madaan, Deepali; Dubey, Neha; Arora, Rajesh; Goel, Rajeev; Singh, Shefali; Kaushik, Vinod; Singh, Pankaj Kumar; Chabbra, Vivek; Bhardwaj, Janak Raj

    2009-01-01

    Management of flu pandemic is a perpetual challenge for the medical fraternity since time immemorial. Animal to human transmission has been observed thrice in the last century within an average range of 11-39 years of antigenic recycling. The recent outbreak of influenza A (H1N1, also termed as swine flu), first reported in Mexico on April 26, 2009, occurred in the forty first year since last reported flu pandemic (July 1968). Within less than 50 days, it has assumed pandemic proportions (phase VI) affecting over 76 countries with 163 deaths/35,928 cases (as on 15th June 2009). It indicated the re-emergence of genetically reassorted virus having strains endemic to humans, swine and avian (H5N1). The World Health Organisation (WHO) member states have already pulled up their socks and geared up to combat such criticalities. Earlier outbreaks of avian flu (H5N1) in different countries led WHO to develop pandemic preparedness strategies with national/regional plans on pandemic preparedness. Numerous factors related to climatic conditions, socio-economic strata, governance and sharing of information/logistics at all levels have been considered critical indicators in monitoring the dynamics of escalation towards a pandemic situation. The National Disaster Management Authority (NDMA), Government of India, with the active cooperation of UN agencies and other stakeholders/experts has formulated a concept paper on role of nonhealth service providers during pandemics in April 2008 and released national guidelines - management of biological disasters in July 2008. These guidelines enumerate that the success of medical management endeavors like pharmaceutical (anti-viral Oseltamivir and Zanamivir therapies), nonpharmaceutical interventions and vaccination development etc., largely depends on level of resistance offered by mutagenic viral strain and rationale use of pharmaco therapeutic interventions. This article describes the mitigation approach to combat flu pandemic with its

  18. Spreading Of Avian Flu On Duck And Its Impact On Social Economy: Lesson Learnt From Avian Flu Cases On Chicken

    OpenAIRE

    Nyak Ilham

    2013-01-01

    Bird flu disease that attacks duck dismissed the notion of duck immune to bird flu disease. Learning from the experience of bird flu disease that attacks poultry in the year of 2004-2005, necessary to measure the spread of disease prevention bird flu in ducks. This paper aims to describe the business and trade patterns of duck associated with the spread of avian influenza and predict the socio-economic impact of bird flu on duck farms in Indonesia. Duck rearing patterns mostly are in the e...

  19. Comparison: Flu prescription sales data from a retail pharmacy in the US with Google Flu trends and US ILINet (CDC) data as flu activity indicator.

    Science.gov (United States)

    Patwardhan, Avinash; Bilkovski, Robert

    2012-01-01

    The potential threat of bioterrorism along with the emergence of new or existing drug resistant strains of influenza virus, added to expanded global travel, have increased vulnerability to epidemics or pandemics and their aftermath. The same factors have also precipitated urgency for having better, faster, sensitive, and reliable syndromic surveillance systems. Prescription sales data can provide surrogate information about the development of infectious diseases and therefore serve as a useful tool in syndromic surveillance. This study compared prescription sales data from a large drug retailing pharmacy chain in the United States with Google Flu trends surveillance system data as a flu activity indicator. It was found that the two were highly correlated. The correlation coefficient (Pearson 'r') for five years' aggregate data (2007-2011) was 0.92 (95% CI, 0.90-0.94). The correlation coefficients for each of the five years between 2007 and 2011 were 0.85, 0.92, 0.91, 0.88, and 0.87 respectively. Additionally, prescription sales data from the same large drug retailing pharmacy chain in the United States were also compared with US Outpatient Influenza-like Illness Surveillance Network (ILINet) data for 2007 by Centers for Disease Control and Prevention (CDC). The correlation coefficient (Pearson 'r') was 0.97 (95% CI, 0.95-0.98).

  20. Comparison: Flu prescription sales data from a retail pharmacy in the US with Google Flu trends and US ILINet (CDC data as flu activity indicator.

    Directory of Open Access Journals (Sweden)

    Avinash Patwardhan

    Full Text Available The potential threat of bioterrorism along with the emergence of new or existing drug resistant strains of influenza virus, added to expanded global travel, have increased vulnerability to epidemics or pandemics and their aftermath. The same factors have also precipitated urgency for having better, faster, sensitive, and reliable syndromic surveillance systems. Prescription sales data can provide surrogate information about the development of infectious diseases and therefore serve as a useful tool in syndromic surveillance. This study compared prescription sales data from a large drug retailing pharmacy chain in the United States with Google Flu trends surveillance system data as a flu activity indicator. It was found that the two were highly correlated. The correlation coefficient (Pearson 'r' for five years' aggregate data (2007-2011 was 0.92 (95% CI, 0.90-0.94. The correlation coefficients for each of the five years between 2007 and 2011 were 0.85, 0.92, 0.91, 0.88, and 0.87 respectively. Additionally, prescription sales data from the same large drug retailing pharmacy chain in the United States were also compared with US Outpatient Influenza-like Illness Surveillance Network (ILINet data for 2007 by Centers for Disease Control and Prevention (CDC. The correlation coefficient (Pearson 'r' was 0.97 (95% CI, 0.95-0.98.

  1. Analysing Twitter and web queries for flu trend prediction.

    Science.gov (United States)

    Santos, José Carlos; Matos, Sérgio

    2014-05-07

    Social media platforms encourage people to share diverse aspects of their daily life. Among these, shared health related information might be used to infer health status and incidence rates for specific conditions or symptoms. In this work, we present an infodemiology study that evaluates the use of Twitter messages and search engine query logs to estimate and predict the incidence rate of influenza like illness in Portugal. Based on a manually classified dataset of 2704 tweets from Portugal, we selected a set of 650 textual features to train a Naïve Bayes classifier to identify tweets mentioning flu or flu-like illness or symptoms. We obtained a precision of 0.78 and an F-measure of 0.83, based on cross validation over the complete annotated set. Furthermore, we trained a multiple linear regression model to estimate the health-monitoring data from the Influenzanet project, using as predictors the relative frequencies obtained from the tweet classification results and from query logs, and achieved a correlation ratio of 0.89 (puser-generated content have mostly focused on the english language. Our results further validate those studies and show that by changing the initial steps of data preprocessing and feature extraction and selection, the proposed approaches can be adapted to other languages. Additionally, we investigated whether the predictive model created can be applied to data from the subsequent flu season. In this case, although the prediction result was good, an initial phase to adapt the regression model could be necessary to achieve more robust results.

  2. Modelling the Growth of Swine Flu

    Science.gov (United States)

    Thomson, Ian

    2010-01-01

    The spread of swine flu has been a cause of great concern globally. With no vaccine developed as yet, (at time of writing in July 2009) and given the fact that modern-day humans can travel speedily across the world, there are fears that this disease may spread out of control. The worst-case scenario would be one of unfettered exponential growth.…

  3. Hospitality as lens for migration studies

    DEFF Research Database (Denmark)

    Greve, Anni

    there are limits to its financial resources. What is more, the focus on claim-making and extended rights of the migrant produces a tendency for the language and practice of hospitality to ‘turn’ against the guest today, and notably the construction of the figure of guests who not only fail to fulfil their duties...... (welfare ‘parasites’) but even betray the host. Next, an enquiry of the concept of hospitality as possible lens for migration studies; it implies a twofold analyses with two levels, a macro level, to focus our attention to the modalities of hospitality given by the juridical status of the stranger and its...... influence on civil inclusion (Sassen 2007; Brenner 2011); and a meso level, to focus instead upon hospitality as an inter-subjective relationship between the host and the guest as a way to relate, as an experience and as an ethics (Derrida 2001). Finally the paper gives a short introduction into an on...

  4. Cold And Flu: Conventional vs Botanical & Nutritional Therapy

    OpenAIRE

    KALRA M; KHATAK M; KHATAK S

    2011-01-01

    Cold and flu (or Influenza) are both respiratory illnesses and the terms are used interchangeably. However, they are both caused by different viruses. There are two main types of flu viruses: influenza A and influenza B. The most serious and deadly flu outbreaks are caused by influenza A because of its ability to genetically shift into new forms against which no person has developed immunity. Influenza B generally causes less severe infection. Outbreaks of influenza B commonly occur in school...

  5. Preventing Flu During Pregnancy (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-09-26

    During the influenza season, pregnant women and infants under 6 months old are especially susceptible to severe complications from the flu. The seasonal flu vaccination is the best way to protect both mother and baby. In this podcast Dr. Stacie Greby discusses the importance of pregnant women receiving the flu vaccine.  Created: 9/26/2013 by MMWR.   Date Released: 9/26/2013.

  6. Continue to Vaccinate Patients and Staff Against the Flu

    Centers for Disease Control (CDC) Podcasts

    2012-02-08

    This podcast is a reminder to health care providers about the importance of annual flu vaccination—it’s not too late! Health care providers should get their flu vaccine and continue offering and encouraging flu vaccination among their staff, colleagues, and patients.  Created: 2/8/2012 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 2/14/2012.

  7. Applying lessons from behavioral economics to increase flu vaccination rates.

    Science.gov (United States)

    Chen, Frederick; Stevens, Ryan

    2017-12-01

    Seasonal influenza imposes an enormous burden on society every year, yet many people refuse to obtain flu shots due to misconceptions of the flu vaccine. We argue that recent research in psychology and behavioral economics may provide the answers to why people hold mistaken beliefs about flu shots, how we can correct these misconceptions, and what policy-makers can do to increase flu vaccination rates. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2008-01-01

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

  9. It's Not Too Late to Get Vaccinated Against Flu | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Flu Vaccination It's Not Too Late to Get Vaccinated Against Flu ... older should get the flu vaccine each year. It usually takes two weeks after you are vaccinated ...

  10. Time to Get Your Seasonal Flu Shot | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn JavaScript on. Feature: Flu Season Time to Get Your Seasonal Flu Shot Past Issues / ... able to infect others for an even longer time. How serious is the flu? Certain people are ...

  11. Mitigation approaches to combat the flu pandemic

    Directory of Open Access Journals (Sweden)

    Raman Chawla

    2009-01-01

    The National Disaster Management Authority (NDMA, Government of India, with the active cooperation of UN agencies and other stakeholders/experts has formulated a concept paper on role of nonhealth service providers during pandemics in April 2008 and released national guidelines - management of biological disasters in July 2008. These guidelines enumerate that the success of medical management endeavors like pharmaceutical (anti-viral Oseltamivir and Zanamivir therapies, nonpharmaceutical interventions and vaccination development etc., largely depends on level of resistance offered by mutagenic viral strain and rationale use of pharmaco therapeutic interventions. This article describes the mitigation approach to combat flu pandemic with its effective implementation at national, state and local levels.

  12. Age and Ethnic Differences in Cold Weather and Contagion Theories of Colds and Flu

    Science.gov (United States)

    Sigelman, Carol K.

    2012-01-01

    Age and ethnic group differences in cold weather and contagion or germ theories of infectious disease were explored in two studies. A cold weather theory was frequently invoked to explain colds and to a lesser extent flu but became less prominent with age as children gained command of a germ theory of disease. Explanations of how contact with…

  13. Too Late for a Flu Shot (For Parents)?

    Science.gov (United States)

    ... have recently given birth, or are breastfeeding during flu season anyone whose immune system is weakened from medications or illnesses (like HIV ... has ever had a severe reaction to a flu vaccination has Guillain-Barré ... affects the immune system and nerves) In the past, it was recommended ...

  14. 42 CFR 410.57 - Pneumococcal vaccine and flu vaccine.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Pneumococcal vaccine and flu vaccine. 410.57 Section 410.57 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 410.57 Pneumococcal vaccine and flu vaccine. (a) Medicare Part B pays for pneumococcal vaccine and its...

  15. OHS Helps Protect Employees During Flu Season | Poster

    Science.gov (United States)

    Flu season is in full swing, bringing a host of symptoms like congestion, coughs, fever, chills, muscle aches, and fatigue. To help NCI at Frederick employees stay healthy this year, Occupational Health Services (OHS) is offering two types of flu vaccines for free.

  16. Know and Share the Facts about Flu Vaccination

    Science.gov (United States)

    Grohskopf, Lisa

    2012-01-01

    Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. It can cause mild to severe illness, and sometimes can lead to death. Symptoms of flu can include fever or a feverish feeling, cough, sore throat, runny or stuffy nose, muscle or body aches, headache, fatigue, vomiting, and diarrhea. Flu…

  17. E-Learning's Potential Scrutinized in Flu Crisis

    Science.gov (United States)

    Ash, Katie; Davis, Michelle R.

    2009-01-01

    The closing of hundreds of U.S. schools in recent weeks because of concerns about swine flu underscores the need for administrators to make plans for continuing their students' education during any extended shutdown, emergency experts and federal officials say. Fears about a severe flu pandemic had eased as of late last week, but experts say…

  18. Limit Asthma Attacks Caused by Colds or Flu

    Science.gov (United States)

    Asthma: Limit asthma attacks caused by colds or flu A cold or the flu can trigger an asthma attack. Here's why — and how to keep your sneeze ... plan. If you notice warning signs of an asthma attack — such as coughing, wheezing, chest tightness or shortness ...

  19. Preventing Flu During Pregnancy (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2013-09-26

    During the influenza season, pregnant women and infants under 6 months old are especially susceptible to severe complications from the flu. This podcast discusses the importance of pregnant women receiving the flu vaccine.  Created: 9/26/2013 by MMWR.   Date Released: 9/26/2013.

  20. Long term serious olfactory loss in colds and/or flu.

    Science.gov (United States)

    de Haro-Licer, Josep; Roura-Moreno, Jordi; Vizitiu, Anabella; González-Fernández, Adela; González-Ares, Josep Antón

    2013-01-01

    In the general population, we can find 2-3% of lifelong olfactory disorders (from hyposmia to anosmia). Two of the most frequent aetiologies are the common cold and flu. The aim of this study was to show the degree of long-term olfactory dysfunction caused by a cold or flu. This study was based on 240 patients, with olfactory loss caused only by flu or a cold. We excluded all patients with concomitant illness (66 patients), the rest of patients (n=174) consisted of 51 men (29.3%) and 123 women (70.7%). They all underwent olfactometry study (i and v cranial nerve) and a nasal sinus computed tomography scan, as well as magnetic resonance imaging of the brain. Results were compared with a control group (n=120). Very significant differences in levels of olfactory impairment for the olfactory nerve (P<.00001) and trigeminal nerve (P<.0001) were confirmed. People that suffer olfactory dysfunction for more than 6 months, from flu or a cold, present serious impairment of olfactory abilities. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  1. Mayaro virus: the jungle flu

    Directory of Open Access Journals (Sweden)

    Izurieta RO

    2018-04-01

    Full Text Available Ricardo O Izurieta,1 David A DeLacure,1 Andres Izurieta,2 Ismael A Hoare,1 Miguel Reina Ortiz,1,3 1Department of Global Health, College of Public Health, University of South Florida, Tampa, FL, USA; 2Department of Computer Science and Engineering, College of Engineering, University of South Florida, Tampa, FL, USA; 3Fundación Raíces, Esmeraldas, Ecuador Abstract: Mayaro fever is an emerging acute viral disease endemic in Central and South America. Mayaro virus (MAYV is classified in the Semliki Forest virus antigenic complex and shares similarities with the alphavirus Chikungunya virus and the flavivirus Dengue virus. MAYV is an arbovirus transmitted by Haemagogus janthinomys, with competence also demonstrated in Aedes aegypti, Aedes scapularis, and Anopheles quadrimaculatus. Outbreaks and small epidemics of Mayaro fever have occurred in several countries in northern South America and the Caribbean. In addition, travel-associated cases have been reported in European nationals returning from endemic areas. Clinical features of Mayaro fever include fever, chills, persistent arthralgia, retro-orbital pain, maculopapular rash, itching, dizziness, and, rarely, lymphadenopathy. Methods of control for MAYV are similar to those used for other sylvatic arboviruses. Although MAYV was discovered as long ago as the 1950s and continues to be prevalent in the tropical areas of the Americas, it remains neglected and under-studied. This paper provides a thorough and current review of the published MAYV literature ranging from its original description to modern outbreaks, and from the basic virus characteristics to the clinical and epidemiological aspects of this disease. Keywords: Mayaro virus, emerging arbovirus, dengue-like virus, arthrogenic virus

  2. Spreading Of Avian Flu On Duck And Its Impact On Social Economy: Lesson Learnt From Avian Flu Cases On Chicken

    Directory of Open Access Journals (Sweden)

    Nyak Ilham

    2013-06-01

    Full Text Available Bird flu disease that attacks duck dismissed the notion of duck immune to bird flu disease. Learning from the experience of bird flu disease that attacks poultry in the year of 2004-2005, necessary to measure the spread of disease prevention bird flu in ducks. This paper aims to describe the business and trade patterns of duck associated with the spread of avian influenza and predict the socio-economic impact of bird flu on duck farms in Indonesia. Duck rearing patterns mostly are in the extensive and semi-intensive system, that have large potential disease transmission occured between duck and wild. Illegal trade in the crossborder region and imports from countries that re-export it, ias alo become potential as well as the entry point to the bird flu virus in Indonesia. Ducks trade between regions by land transportation is difficult to control as well becomes the potential media to spread of the virus to a wider area. The economic impact of bird flu on duck business occured due to the death of ducks, decline in production and loss of job opportunities, while that on demand reduction was not significant. Small scale farmers that were bankrupt as a result of bird flu outbreaks may require technical assistance and access to capital for recovery. In the future, development of ducks business should be directed at duck farms into a semi-intensive and intensive system to facilitate the control of epidemic diseases

  3. Strategi Pesan Promosi Kesehatan Cegah Flu Burung

    Directory of Open Access Journals (Sweden)

    Tuti Widiastuti

    2012-12-01

    Full Text Available Avian influenza health disaster has attacked many countries in the world, includes Indonesia. An effort have been done by government through Health Department RI publish health promotion communication on public services advertising (PSA version “Cegah Flu Burung dengan B3K”. In a way to criticize this PSA is used theoretical framework social construction of reality and health promotion. This research use descriptive qualitative method, whereas data is collected with literature review from television PSA, and data analysis technique is used framing analysis from Zhondang Pan and Gerald M. Kosicki. Based on research finding has been found that avian influenza prevention health promotion message not yet “enabling” (ability people to act healthy life, but it only “desiring” (willingness. From this we can say that health promotion still prioritize in giving information, whereas message toward new attitude and behavior changes through learning process still not visible.

  4. Design and methods of a social network isolation study for reducing respiratory infection transmission: The eX-FLU cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Allison E. Aiello

    2016-06-01

    Conclusions/significance: We identified a feasible study design for testing the impact of isolation from social networks in a university setting. These data provide an unparalleled opportunity to address questions about isolation and infection transmission, as well as insights into social networks and behaviors among college-aged students. Several important lessons were learned over the course of this project, including feasible isolation durations, the need for extensive organizational efforts, as well as the need for specialized programmers and server space for managing survey and smartphone data.

  5. Early warning: Avian flu and nuclear science

    International Nuclear Information System (INIS)

    Belak, S.

    2006-01-01

    Avian flu has spread to 51 countries, 36 this year alone, many of which are densely populated and deprived. The joint FAO/IAEA programme is working on the rapid detection of emerging diseases, including bird flu, and using nuclear and radiation techniques in the process. The problems are serious and challenging, but nuclear technologies may offer a solution. For most developing countries, TAD (transboundary animal diseases) detection is still vital. The bottleneck is their inability to rapidly detect the virus and to determine early enough whether it is H5N1 or another subtype, so that authorities can take appropriate control measures. Serious efforts are focused on the early detection of the agents. Timely recognition of such viral infections would prevent the spread of the diseases to large animal populations in huge geographic areas. Thus, the development of novel, powerful diagnostic nuclear and nuclear-related assays is a crucial issue today in veterinary research and animal health care. Molecular virology offers a range of new methods, which are able to accelerate and improve the diagnosis of infectious diseases in animals and in man. The molecular detection assays, like the polymerase chain reaction (PCR) technologies, provide possibilities for a very rapid diagnosis. The detection of viruses can be completed within hours or hopefully even within minutes with a sensitivity level of less than one pathogenic organism. Molecular approaches have contributed significantly to the rapid detection of well-established, as well as newly emerging, infectious agents such as Nipah and Hendra viruses or corona viruses in the SARS scenario and the detection and molecular characterisation of the highly pathogenic avian influenza H5N1 subtype that threatens the world today. The nucleic acid amplification assays, although they were at first expensive and cumbersome, have become relatively cheap and user-friendly tools in the diagnostic laboratories

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

    Science.gov (United States)

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

    2008-04-01

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

  7. Nudges or mandates? The ethics of mandatory flu vaccination.

    Science.gov (United States)

    Dubov, Alex; Phung, Connie

    2015-05-21

    According to the CDC report for the 2012-2013 influenza season, there was a modest increase in the vaccination coverage rate among healthcare workers from 67% in 2011-2012, to 72% in 2012-2013 to the current 75% coverage. This is still far from reaching the US National Healthy People 2020 goal of 90% hospitals vaccination rates. The reported increase in coverage is attributed to the growing number of healthcare facilities with vaccination requirements with average rates of 96.5%. However, a few other public health interventions stir so much controversy and debate as vaccination mandates. The opposition stems from the belief that a mandatory flu shot policy violates an individual right to refuse unwanted treatment. This article outlines the historic push to achieve higher vaccination rates among healthcare professionals and a number of ethical issues arising from attempts to implement vaccination mandates. It then turns to a review of cognitive biases relevant in the context of decisions about influenza vaccination (omission bias, ambiguity aversion, present bias etc.) The article suggests that a successful strategy for policy-makers and others hoping to increase vaccination rates is to design a "choice architecture" that influences behavior of healthcare professionals without foreclosing other options. Nudges incentivize vaccinations and help better align vaccination intentions with near-term actions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals.

    Science.gov (United States)

    Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz

    2018-03-01

    The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

  9. Management of flu-like syndrome with cetirizine in patients with relapsing-remitting multiple sclerosis during therapy with interferon beta: Results of a randomized, cross-over, placebo-controlled pilot study.

    Directory of Open Access Journals (Sweden)

    Doriana Landi

    Full Text Available Flu-like syndrome (FLS is a common adverse event experienced by patients with relapsing-remitting multiple sclerosis (RRMS treated with interferon beta (IFNβ. FLS can lead to poor treatment adherence and early IFNβ discontinuation. The involvement of interleukin-6 (IL-6 in the occurrence of FLS has been suggested. We hypothesized that cetirizine, a second-generation histamine H1 receptor antagonist able to reduce the levels of IL-6, might improve IFNβ-induced FLS.We conducted a pilot, cross-over, randomized, placebo-controlled, double-blind study to evaluate the efficacy of cetirizine 10 mg added after each IFNβ injection to the standard of care for FLS (acetaminophen or nonsteroidal anti-inflammatory drugs on FLS in patients with RRMS treated with IFNβ. Patients were randomized to two treatment sequences: 1 4-week treatment with placebo added to the standard treatment for FLS, followed by 4-week treatment with cetirizine added to the standard of care, and 2 first addition of cetirizine, then of placebo. The primary efficacy endpoint was the mean change of FLS severity [11-point visual analog scale (VAS] after 4 weeks of treatment within each sequence.Forty-five patients (71.1% female, mean age 39.1 years, mean time from RRMS diagnosis 5.8 years were randomized to treatment sequences 1 and 2. The differences between cetirizine and placebo in the intensity of FLS were not statistically significant: total mean VAS scores at 4 hours from IFNβ injection were 3.57 and 3.42 for cetirizine and placebo, respectively (difference -0.15; 95% confidence interval: from -0.74 to 0.44; p = 0.6029. The two treatments were similar also with regard to other efficacy measures considered and to the safety/tolerability profile.The addition of cetirizine to the standard of care for IFNβ-induced FLS in patients with RRMS does not seem to provide significant benefits compared with placebo. Further effort is required to understand the mechanisms underlying IFN

  10. A Multicenter Retrospective Review of Prone Position Ventilation (PPV in Treatment of Severe Human H7N9 Avian Flu.

    Directory of Open Access Journals (Sweden)

    Yuanda Xu

    Full Text Available Patients with H7N9 avian flu concurrent with severe acute respiratory distress syndrome (ARDS usually have a poor clinical outcome. Prone position ventilation (PPV has been shown to improve the prognosis of patients with severe ARDS. This study explored the effects of PPV on the respiratory and circulatory mechanics of H7N9-infected patients with severe ARDS.Individuals admitted to four hospitals designated for H7N9 patients in Guangdong province were treated with PPV, and their clinical data were recorded before and after receiving PPV.Six of 20 critically ill patients in the ICU received PPV. After treatment with 35 PPV sessions, the oxygenation index (OI values of the six patients when measured post-PPV and post-supine position ventilation (SPV were significantly higher than those measured pre-PPV (P < 0.05.The six patients showed no significant differences in their values for respiratory rate (RR, peak inspiratory pressure (PIP, tidal volume (TV or arterial partial pressure of carbon dioxide (PaCO2 when compared pre-PPV, post-PPV, and post-SPV. Additionally, there were no significant differences in the mean values for arterial pressure (MAP, cardiac index (CI, central venous pressure (CVP, heart rate (HR, lactic acid (LAC levels or the doses of norepinephrine (NE administered when compared pre-PPV, post-PPV, and post-SPV.PPV provided improved oxygenation that was sustained after returning to a supine position, and resulted in decreased carbon dioxide retention. PPV can thus serve as an alternative lung protective ventilation strategy for use in patients with H7N9 avian flu concurrent with severe ARDS.

  11. Avian Flu (H7N9) in China

    Science.gov (United States)

    ... Mobile Apps RSS Feeds Avian Flu (H7N9) in China Recommend on Facebook Tweet Share Compartir Warning - Level ... of H7N9 have been reported outside of mainland China but most of these infections have occurred among ...

  12. People at High Risk of Developing Flu-Related Complications

    Science.gov (United States)

    ... Influenza Types Seasonal Avian Swine Variant Pandemic Other People at High Risk of Developing Flu–Related Complications ... related complications if they get sick with influenza. People at High Risk for Developing Flu-Related Complications ...

  13. Flu: What to Do If You Get Sick

    Science.gov (United States)

    ... 2018 Season Frequently Asked Questions on Vaccine Supply Historical Reference of Seasonal Influenza Vaccine Doses Distributed Other ... be held Flu-like symptoms improve but then return with fever and worse cough Fever with a ...

  14. Influenza (Flu) vaccine (Live, Intranasal): What you need to know

    Science.gov (United States)

    ... is taken in its entirety from the CDC Influenza Live, Intranasal Flu Vaccine Information Statement (VIS): www.cdc.gov/vaccines/ ... flulive.html . CDC review information for Live, Intranasal Influenza VIS: Vaccine Information Statement Influenza Page last reviewed: ...

  15. Situation Update: Summary of Weekly FluView

    Science.gov (United States)

    ... reported by the District of Columbia, the U.S. Virgin Islands, and 37 states (Alaska, Arkansas, California, Colorado, ... rates for all ages (cumulative) and all age-group specific rates for the 2014-2015 flu season. ...

  16. 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.

  17. Attitudes and expectations regarding exercise in the hospital of hospitalized older adults: a qualitative study.

    Science.gov (United States)

    So, Cynthia; Pierluissi, Edgar

    2012-04-01

    To describe expectations of, and perceived motivators and barriers to, in-hospital exercise of hospitalized older adults. Qualitative study using the framework theory. Public hospital general medical wards. Twenty-eight English- or Spanish-speaking inpatients aged 65 to 103. Semistructured interviews were conducted at the bedside. Questions explored attitudes and expectations regarding in-hospital exercise. Interviews were tape recorded and transcribed, and content analysis was performed to identify major themes. For most participants (71%), exercise in the hospital meant walking. Only 29% of participants expected to be exercising in the hospital, although three-quarters perceived it to be appropriate. Major themes included motivating factors and barriers to in-hospital exercise. Motivating factors included avoiding the negative effects of prolonged bed rest, promoting a sense of well-being, promoting functional recovery, and being asked to exercise. Barriers included symptoms related to one's illness, institutional barriers, and fear of injury. Most respondents (85%) felt that if the physician suggested exercise, it would influence their decision to do so, yet few (27%) reported that they had spoken to their physician about exercise. Hospitalized older adults have positive perceptions about in-hospital exercise, although they must overcome significant barriers to do so. Medical professionals have a strong influence over the exercise behavior of elderly adults in the hospital yet infrequently address the issue. Incorporating motivating factors and removing barriers may increase the effectiveness of in-hospital exercise programs. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  18. Bird flu, influenza and 1918: the case for mutant Avian tuberculosis.

    Science.gov (United States)

    Broxmeyer, Lawrence

    2006-01-01

    Influenza is Italian for "influence", Latin: influentia. It used to be thought that the disease was caused by a bad influence from the heavens. Influenza was called a virus long, long before it was proven to be one. In 2005, an article in the New England Journal of Medicine estimated that a recurrence of the 1918 influenza epidemic could kill between 180 million and 360 million people worldwide. A large part of the current bird-flu hysteria is fostered by a distrust among the lay and scientific community regarding the actual state of our knowledge regarding the bird flu or H5N1 and the killer "Influenza" Pandemic of 1918 that it is compared to. And this distrust is not completely unfounded. Traditionally, "flu" does not kill. Experts, including Peter Palese of the Mount School of Medicine in Manhattan, remind us that even in 1992, millions in China already had antibodies to H5N1, meaning that they had contracted it and that their immune system had little trouble fending it off. Dr. Andrew Noymer and Michel Garenne, UC Berkely demographers, reported in 2000 convincing statistics showing that undetected tuberculosis may have been the real killer in the 1918 flu epidemic. Aware of recent attempts to isolate the "Influenza virus" on human cadavers and their specimens, Noymer and Garenne summed that: "Frustratingly, these findings have not answered the question why the 1918 virus was so virulent, nor do they offer an explanation for the unusual age profile of deaths". Bird flu would certainly be diagnosed in the hospital today as Acute Respiratory Distress Syndrome (ARDS). Roger and others favor suspecting tuberculosis in all cases of acute respiratory failure of unknown origin. By 1918, it could be said, in so far as tuberculosis was concerned, that the world was a supersaturated sponge ready to ignite and that among its most vulnerable parts was the very Midwest where the 1918 unknown pandemic began. It is theorized that the lethal pig epidemic that began in Kansas

  19. A comparative study of the costliness of Manitoba hospitals.

    Science.gov (United States)

    Shanahan, M; Loyd, M; Roos, N P; Brownell, M

    1999-06-01

    In light of ongoing discussions about health care policy, this study offered a method of calculating costs at Manitoba hospitals that compared relative costliness of inpatient care provided in each hospital. This methodology also allowed comparisons across types of hospitals-teaching, community, major rural, intermediate and small rural, as well as northern isolated facilities. Data used in this project include basic hospital information, both financial and statistical, for each of the Manitoba hospitals, hospital charge information by case from the State of Maryland, and hospital discharge abstract information for Manitoba. The data from Maryland were used to create relative cost weights (RCWs) for refined diagnostic related groups (RDRGs) and were subsequently adjusted for Manitoba length of stay. These case weights were then applied to cases in Manitoba hospitals, and several other adjustments were made for nontypical cases. This case mix system allows cost comparisons across hospitals. In general, hospital case mix costing demonstrated variability in hospital costliness, not only across types of hospitals but also within hospitals of the same type and size. Costs at the teaching hospitals were found to be considerably higher than the average, even after accounting for acuity and case mix.

  20. CTL epitopes for influenza A including the H5N1 bird flu; genome-, pathogen-, and HLA-wide screening

    DEFF Research Database (Denmark)

    Wang, M.J.; Lamberth, K.; Harndahl, M.

    2007-01-01

    are present in the emerging bird flu isolates. Our study demonstrates that present technology enables a fast global screening for T cell immune epitopes of potential diagnostics and vaccine interest. This technology includes immuno-bioinformatics predictors with the capacity to perform fast genome-, pathogen......-, and HLA-wide searches for immune targets. To exploit this new potential, a coordinated international effort to analyze the precious source of information represented by rare patients, such as the current victims of bird flu, would be essential....

  1. Clinical accuracy of a PLEX-ID flu device for simultaneous detection and identification of influenza viruses A and B.

    Science.gov (United States)

    Tang, Yi-Wei; Lowery, Kristin S; Valsamakis, Alexandra; Schaefer, Virginia C; Chappell, James D; White-Abell, Jill; Quinn, Criziel D; Li, Haijing; Washington, Cicely A; Cromwell, Jenna; Giamanco, Chantel M; Forman, Michael; Holden, Jeffery; Rothman, Richard E; Parker, Michelle L; Ortenberg, Elaine V; Zhang, Lei; Lin, Yea-Lin; Gaydos, Charlotte A

    2013-01-01

    Respiratory tract infections caused by influenza A and B viruses often present nonspecifically, and a rapid, high-throughput laboratory technique that can identify influenza viruses is clinically and epidemiologically desirable. The PLEX-ID Flu assay (Abbott Molecular Inc., Des Plaines, IL) incorporates multilocus PCR and electrospray ionization-mass spectrometry to detect and differentiate influenza A 2009 H1N1 (H1N1-p), seasonal H1N1 (H1N1-s), influenza A H3N2, and influenza B viruses in nasopharyngeal swab (NPS) specimens. The clinical performance characteristics of the PLEX-ID Flu assay in symptomatic patients were determined in this multicenter trial. A total of 2,617 prospectively and retrospectively collected NPS specimens from patients with influenza-like illness between February 2008 and 28 May 2010 were eligible for inclusion in the study. Each specimen was tested in parallel by the PLEX-ID Flu assay and by the Prodesse ProFLU+ assay (Prodesse Inc., Madison, WI), to detect influenza A and B viruses. Specimens testing positive for influenza A virus by ProFLU+ were subtyped as H1N1-p, H1N1-s, or H3N2 by using the ProFAST+ assay (Gen-Probe Prodesse Inc.). The reproducibility of the PLEX-ID Flu assay ranged from 98.3 to 100.0%, as determined by testing a nine-specimen panel at three clinical sites on each of 5 days. Positive percent agreements (PPAs) and negative percent agreements (NPAs) of the PLEX-ID Flu assay were 94.5% and 99.0% for influenza A virus and 96.0% and 99.9% for influenza B virus, respectively. For the influenza A virus subtyping characterization, the PLEX-ID Flu assay had PPAs and NPAs of 98.3% and 97.5% for H1N1-p, 88.6% and 100.0% for H1N1-s, and 98.0% and 99.9% for H3N2, respectively. The overall agreements between the PLEX-ID and Prodesse ProFLU+/ProFAST+ assays were 97.1 to 100.0%. Bidirectional Sanger sequencing analysis revealed that 87.5% of 96 discrepant results between the PLEX-ID Flu and ProFLU+/ProFAST+ assays were found upon

  2. Medicinal plants indicated for flu and colds in the South of Brazil

    Directory of Open Access Journals (Sweden)

    Marjoriê da Costa Mendieta

    2015-09-01

    Full Text Available We sought to know the medicinal plants used for flu and colds by farmers from the South of Rio Grande do Sul State and to compare it with scientific evidence. This descriptive study was conducted with 12 farmers living at Ilha dos Marinheiros, in the city of Rio Grande, Rio Grande do Sul, Brazil. We used descriptive analysis, comparing the results with the scientific literature. Thirteen plants were cited as used for cold and flu: Achyrocline satureioides, Allium sativum, Cinnamomum zeylanicum, Citrus limon, Citrus reticulata, Citrus sinensis, Gochnatia polymorpha, Illicium verum, Mentha piperita, Mikania sp., Ocimum selloi, Origanum majorana and Verbena sp. Results show popular knowledge meeting scientific evidence for most indications, seen that 84,6% of cited plants are in agreement with the literature. Thus, we emphasize the richness of popular knowledge, the need of its appreciation and constant approximation of health professionals to this knowledge, integrated with science.

  3. ERP implementation in hospitals: a case study.

    Science.gov (United States)

    Agarwal, Divya; Garg, Poonam

    2012-01-01

    In a competitive healthcare sector, hospitals have to focus on their processes in order to deliver high-quality care while at the same time reducing costs. Many hospitals have decided to adopt one or another Enterprise Resource Planning (ERP) system to improve their businesses, but implementing an ERP system can be a demanding endeavour. The systems are so difficult to implement that some are successful; many have failed, causing multimillion dollar losses. The challenge of ERP solutions lie in implementation because they are complex, time consuming and expensive too. This paper describes the various process workflows and phases of ERP implementation at Fortis Hospital Cunningham Road, Bangalore, India. This knowledge will provide valuable insights for the researchers and practitioners to understand the different process workflows and to make informed decisions when implementing ERP in any hospital.

  4. Synthetic Influenza vaccine (FLU-v) stimulates cell mediated immunity in a double-blind, randomised, placebo-controlled Phase I trial.

    Science.gov (United States)

    Pleguezuelos, Olga; Robinson, Stuart; Stoloff, Gregory A; Caparrós-Wanderley, Wilson

    2012-06-29

    Current Influenza vaccines elicit antibody mediated prophylactic immunity targeted to viral capsid antigens. Despite their global use these vaccines must be administered yearly to the population, cannot be manufactured until the circulating viral strain(s) have been identified and have limited efficacy. A need remains for Influenza vaccines addressing these issues and here we report the results of a Phase Ib trial of a novel synthetic Influenza vaccine (FLU-v) targeting T cell responses to NP, M1 and M2. Forty-eight healthy males aged 18-40 were recruited for this single-centre, randomised, double blind study. Volunteers received one single low (250 μg) or high (500 μg) dose of FLU-v, either alone or adjuvanted. Safety, tolerability and basic immunogenicity (IgG and IFN-γ responses) parameters were assessed pre-vaccination and for 21 days post-vaccination. FLU-v was found to be safe and well tolerated with no vaccine associated severe adverse events. Dose-dependent IFN-γ responses >2-fold the pre-vaccination level were detected in 80% and 100% of volunteers receiving, respectively, the low and high dose adjuvanted FLU-v formulations. No formulation tested induced any significant FLU-v antibody response. FLU-v is safe and induces a vaccine-specific cellular immunity. Cellular immune responses are historically known to control and mitigate infection and illness during natural infection. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. 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...

  6. Perfluoroalkyl substance serum concentrations and immune response to FluMist vaccination among healthy adults.

    Science.gov (United States)

    Stein, Cheryl R; Ge, Yongchao; Wolff, Mary S; Ye, Xiaoyun; Calafat, Antonia M; Kraus, Thomas; Moran, Thomas M

    2016-08-01

    Perfluoroalkyl substances (PFAS) were shown to be immunotoxic in laboratory animals. There is some epidemiological evidence that PFAS exposure is inversely associated with vaccine-induced antibody concentration. We examined immune response to vaccination with FluMist intranasal live attenuated influenza vaccine in relation to four PFAS (perfluorooctanoate, perfluorononanoate, perfluorooctane sulfonate, perfluorohexane sulfonate) serum concentrations among 78 healthy adults vaccinated during the 2010-2011 influenza season. We measured anti-A H1N1 antibody response and cytokine and chemokine concentrations in serum pre-vaccination, 3 days post-vaccination, and 30 days post-vaccination. We measured cytokine, chemokine, and mucosal IgA concentration in nasal secretions 3 days post-vaccination and 30 days post-vaccination. Adults with higher PFAS concentrations were more likely to seroconvert after FluMist vaccination as compared to adults with lower PFAS concentrations. The associations, however, were imprecise and few participants seroconverted as measured either by hemagglutination inhibition (9%) or immunohistochemical staining (25%). We observed no readily discernable or consistent pattern between PFAS concentration and baseline cytokine, chemokine, or mucosal IgA concentration, or between PFAS concentration and change in these immune markers between baseline and FluMist-response states. The results of this study do not support a reduced immune response to FluMist vaccination among healthy adults in relation to serum PFAS concentration. Given the study's many limitations, however, it does not rule out impaired vaccine response to other vaccines or vaccine components in either children or adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Influenza vaccine effectiveness among adult patients in a University of Lyon hospital (2004-2009).

    Science.gov (United States)

    Amour, Sélilah; Voirin, Nicolas; Regis, Corinne; Bouscambert-Duchamp, Maude; Comte, Brigitte; Coppéré, Brigitte; Pires-Cronenberger, Silene; Lina, Bruno; Vanhems, Philippe

    2012-01-20

    The aim of this study was to estimate influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza among hospitalized patients. A case-control investigation was based on the prospective surveillance of influenza-like illness (ILI) during five flu seasons. We compared influenza-positive cases and influenza-negative controls. Unadjusted overall IVE was 62% (95% confidence interval 24% to 81%). We found that IVE was lower during the 2004-05 flu season (11%; 95% CI -232% to 76%) when the vaccine and circulating viruses were mismatched. Expansion of the study to other hospitals could provide IVE estimates earlier in the season, for different age groups and emerging virus strains. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

    Science.gov (United States)

    Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

    2014-09-01

    Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data

  9. DYSELECTROLYTEMIA IN ELDERLY: A HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Tanushree

    2016-03-01

    Full Text Available INTRODUCTION Dyselectrolytemia is a common problem affecting elderly hospitalised patients. Although hypo/hypernatremia is the most common electrolyte abnormality found in elderly, abnormalities in other electrolytes may also occur in various settings. Information regarding the pattern of electrolyte abnormalities in elderly is lacking in this part of the country. With this background the following case control study was taken up with the following aims and objectives. OBJECTIVES • To study the various patterns of dyselectrolytemia in elderly and compare them with young. • To evaluate and compare the various aetiological factors and comorbid conditions involved in the occurrence of electrolyte abnormalities in these groups of patients. RESULTS The mean age of the study population was 66.174 years (SD- 6.512 years and of the control group was 41.94 years (SD - 10.924 years. Hyponatraemia was the most common electrolyte abnormality encountered in both the groups (57% vs. 60%, p- 0.61. The incidence of hyperkalaemia was significantly higher in the older age group (19.5% vs. 11.5%, p-0.03. Also, in the elderly, the presence of abnormalities in more than one electrolyte level was significantly higher than the young (25.5% vs. 14%, p -0.005. The average length of hospital stay in the elderly was 10.05 days (SD- 4.40 days whereas in the young was 6.35 days (SD- 3.27 days, p <0.0001. The mortality rate was also significantly higher in the elderly group (16% vs. 3.5%, p<0.0001. CONCLUSION Dyselectrolytemia is a common pathological condition encountered in the elderly population which is associated with a very high morbidity and mortality when compared with the young. Hence, elderly patients particularly with associated comorbid conditions should be screened routinely for the presence of associated electrolyte disturbances.

  10. Breaking down the monolith: Understanding flu vaccine uptake among African Americans

    Directory of Open Access Journals (Sweden)

    Sandra Crouse Quinn

    2018-04-01

    Full Text Available Black adults are significantly less likely to be immunized for seasonal influenza when compared to Whites. This persistent disparity contributes to increased influenza-related morbidity and mortality in the African American population. Most scholarship on vaccine disparities has compared Whites and Blacks. Employing Public Health Critical Race Praxis, this study seeks to shift the focus to explore differences within the Black population. Utilizing a nationally-representative 2015 survey of US Black adults (n = 806, we explore differences by gender, age, income, and education across vaccine-related measures (e.g., perceived risk, knowledge, attitudes and racial factors (e.g. racial salience, racial fairness, perceived discrimination. We also explore differences by vaccine behavior in the past five years among those who vaccinate every year, most years but not all, once or twice, and never. Greater frequency of flu vaccine uptake was associated with better self-reported vaccine knowledge, more positive vaccine attitudes, more trust in the flu vaccine and the vaccine process, higher perceived disease risk, lower perceived risk of vaccine side effects, stronger subjective and moral norms, lower general vaccine hesitancy, higher confidence in the flu vaccine, and lower perceived barriers. Logistic regression results highlighted other significant differences among the groups, emphasizing areas to target for improved vaccination rates. We find great diversity within the Black community related to influenza immunization decisions, highlighting the need to “break down the monolith” in future research.

  11. Crying wolf? Biosecurity and metacommunication in the context of the 2009 swine flu pandemic.

    Science.gov (United States)

    Nerlich, Brigitte; Koteyko, Nelya

    2012-07-01

    This article explores how the 2009 pandemic of swine flu (H1N1) intersected with issues of biosecurity in the context of an increasing entanglement between the spread of disease and the spread of information. Drawing on research into metacommunication, the article studies the rise of communication about ways in which swine flu was communicated, both globally and locally, during the pandemic. It examines and compares two corpora of texts, namely UK newspaper articles and blogs, written between 28 March and 11 June 2009, that is, the period from the start of the outbreak till the WHO announcement of the pandemic. Findings show that the interaction between traditional and digital media as well as the interaction between warnings about swine flu and previous warnings about other epidemics contributed to a heightened discourse of blame and counter-blame but also, more surprisingly, self-blame and reflections about the role the media in pandemic communication. The consequences of this increase in metacommunication for research into crisis communication are explored. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Are comparisons of patient experiences across hospitals fair? A study in Veterans Health Administration hospitals.

    Science.gov (United States)

    Cleary, Paul D; Meterko, Mark; Wright, Steven M; Zaslavsky, Alan M

    2014-07-01

    Surveys are increasingly used to assess patient experiences with health care. Comparisons of hospital scores based on patient experience surveys should be adjusted for patient characteristics that might affect survey results. Such characteristics are commonly drawn from patient surveys that collect little, if any, clinical information. Consequently some hospitals, especially those treating particularly complex patients, have been concerned that standard adjustment methods do not adequately reflect the challenges of treating their patients. To compare scores for different types of hospitals after making adjustments using only survey-reported patient characteristics and using more complete clinical and hospital information. We used clinical and survey data from a national sample of 1858 veterans hospitalized for an initial acute myocardial infarction (AMI) in a Department of Veterans Affairs (VA) medical center during fiscal years 2003 and 2004. We used VA administrative data to characterize hospitals. The survey asked patients about their experiences with hospital care. The clinical data included 14 measures abstracted from medical records that are predictive of survival after an AMI. Comparisons of scores across hospitals adjusted only for patient-reported health status and sociodemographic characteristics were similar to those that also adjusted for patient clinical characteristics; the Spearman rank-order correlations between the 2 sets of adjusted scores were >0.97 across 9 dimensions of inpatient experience. This study did not support concerns that measures of patient care experiences are unfair because commonly used models do not adjust adequately for potentially confounding patient clinical characteristics.

  13. How to Boost Flu Vaccination Rates among Employees in Your Program

    Science.gov (United States)

    de Perio, Marie A.; Wiegand, Douglas M.; Evans, Stefanie M.; Niemeier, Maureen T.

    2012-01-01

    Flu viruses are typically spread by droplets, when people who are sick with flu cough, sneeze, or talk. Less often, a person may get flu from touching a surface or object that has the virus on it and then touching his own mouth, eyes, or nose. Flu can cause mild to severe illness and may even lead to death. Child care providers are at risk of…

  14. Population versus hospital controls for case-control studies on cancers in Chinese hospitals.

    Science.gov (United States)

    Li, Lin; Zhang, Min; Holman, D'Arcy

    2011-12-15

    Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using conditional logistic regression analyses. The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93). For exposure of green tea drinking, the adjusted ORs (95% CIs) comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83) and 0.21 (0.27, 0.74) for three cancers combined, 0.06 (0.01, 0.61) and 0.07 (0.01, 0.47) for breast cancer, 0.52 (0.29, 0.94) and 0.45 (0.25, 0.82) for colorectal cancer, 0.65 (0.08, 5.63) and 0.57 (0.07, 4.79) for leukemia using hospital and population controls respectively. The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

  15. Population versus hospital controls for case-control studies on cancers in Chinese hospitals

    Directory of Open Access Journals (Sweden)

    Li Lin

    2011-12-01

    Full Text Available Abstract Background Correct control selection is crucial to the internal validity of case-control studies. Little information exists on differences between population and hospital controls in case-control studies on cancers in Chinese hospital setting. Methods We conducted three parallel case-control studies on leukemia, breast and colorectal cancers in China between 2009 and 2010, using population and hospital controls to separately match 540 incident cases by age, gender and residency at a 1:1 ratio. Demographic and lifestyle factors were measured using a validated questionnaire in face-to-face interview. Odds ratios (ORs and 95% confidence intervals (CIs were obtained using conditional logistic regression analyses. Results The two control groups had closely similar exposure distributions of 15 out of 16 factors, with the only exception being that hospital controls were less likely to have a BMI ≥ 25 (OR = 0.71, 95% CI: 0.54, 0.93. For exposure of green tea drinking, the adjusted ORs (95% CIs comparing green tealeaves intake ≥ 1000 grams annually with non-drinkers were 0.51 (0.31, 0.83 and 0.21 (0.27, 0.74 for three cancers combined, 0.06 (0.01, 0.61 and 0.07 (0.01, 0.47 for breast cancer, 0.52 (0.29, 0.94 and 0.45 (0.25, 0.82 for colorectal cancer, 0.65 (0.08, 5.63 and 0.57 (0.07, 4.79 for leukemia using hospital and population controls respectively. Conclusions The study found that hospital controls were comparable with population controls for most demographic characteristics and lifestyle factors measured, but there was a slight difference between the two control groups. Hospital outpatients provide a satisfactory control group in hospital-based case-control study in the Chinese hospital setting.

  16. What You Should Know and Do This Flu Season If You Are 65 Years and Older

    Science.gov (United States)

    ... Pandemic Other What You Should Know and Do this Flu Season If You Are 65 Years and Older Language: English (US) Español Recommend on ... for people 65 and older. Actions To Take This Flu Season: Get Your ... get a seasonal flu vaccine each year by the end of October if possible. However, ...

  17. Flu shots and unvaccinated elderly Medicare beneficiaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — Elderly persons (aged 65 years and older) are at increased risk of complications from influenza, with the majority of influenza-related hospitalizations and deaths...

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

    OpenAIRE

    Mardiana, Ria; Djabir Hamzah; Syamsul Bahri

    2013-01-01

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

  19. A study on building data warehouse of hospital information system.

    Science.gov (United States)

    Li, Ping; Wu, Tao; Chen, Mu; Zhou, Bin; Xu, Wei-guo

    2011-08-01

    Existing hospital information systems with simple statistical functions cannot meet current management needs. It is well known that hospital resources are distributed with private property rights among hospitals, such as in the case of the regional coordination of medical services. In this study, to integrate and make full use of medical data effectively, we propose a data warehouse modeling method for the hospital information system. The method can also be employed for a distributed-hospital medical service system. To ensure that hospital information supports the diverse needs of health care, the framework of the hospital information system has three layers: datacenter layer, system-function layer, and user-interface layer. This paper discusses the role of a data warehouse management system in handling hospital information from the establishment of the data theme to the design of a data model to the establishment of a data warehouse. Online analytical processing tools assist user-friendly multidimensional analysis from a number of different angles to extract the required data and information. Use of the data warehouse improves online analytical processing and mitigates deficiencies in the decision support system. The hospital information system based on a data warehouse effectively employs statistical analysis and data mining technology to handle massive quantities of historical data, and summarizes from clinical and hospital information for decision making. This paper proposes the use of a data warehouse for a hospital information system, specifically a data warehouse for the theme of hospital information to determine latitude, modeling and so on. The processing of patient information is given as an example that demonstrates the usefulness of this method in the case of hospital information management. Data warehouse technology is an evolving technology, and more and more decision support information extracted by data mining and with decision-making technology is

  20. Incidences and variations of hospital acquired venous thromboembolism in Australian hospitals: a population-based study.

    Science.gov (United States)

    Assareh, Hassan; Chen, Jack; Ou, Lixin; Hillman, Ken; Flabouris, Arthas

    2016-09-22

    Data on hospital-acquired venous thromboembolism (HA-VTE) incidence, case fatality rate and variation amongst patient groups and health providers is lacking. We aim to explore HA-VTE incidences, associated mortality, trends and variations across all acute hospitals in New South Wales (NSW)-Australia. A population-based study using all admitted patients (aged 18-90 with a length of stay of at least two days and not transferred to another acute care facility) in 104 NSW acute public and private hospitals during 2002-2009. Poisson mixed models were used to derive adjusted rate ratios (IRR) in presence of patient and hospital characteristics. Amongst, 3,331,677 patients, the incidence of HA-VTE was 11.45 per 1000 patients and one in ten who developed HA-VTE died in hospital. HA-VTE incidence, initially rose, but subsequently declined, whereas case fatality rate consistently declined by 22 % over the study period. Surgical patients were 128 % (IRR = 2.28, 95 % CI: 2.19-2.38) more likely to develop HA-VTE, but had similar case fatality rates compared to medical patients. Private hospitals, in comparison to public hospitals had a higher incidence of HA-VTE (IRR = 1.76; 95 % CI: 1.42-2.18) for medical patients. However, they had a similar incidence (IRR = 0.91; 95 % CI: 0.75-1.11), but a lower mortality (IRR = 0.59; 95 % CI: 0.47-0.75) amongst surgical patients. Smaller public hospitals had a lower HA-VTE incidence rate compared to larger hospitals (IRR  1.71). Hospitals with a lower reported HA-VTE incidence tended to have a higher HA-VTE case fatality rate. Despite the decline in HA-VTE incidence and case fatality, there were large variations in incidents between medical and surgical patients, public and private hospitals, and different hospital groups. The causes of such differences warrant further investigation and may provide potential for targeted interventions and quality improvement initiatives.

  1. [Adverse events self-declaration system and influenza vaccination coverage of healthcare workers in a tertiary hospital].

    Science.gov (United States)

    Velasco Munoz, Cesar; Sequera, Víctor-Guillermo; Vilajeliu, Alba; Aldea, Marta; Mena, Guillermo; Quesada, Sebastiana; Varela, Pilar; Olivé, Victoria; Bayas, José M; Trilla, Antoni

    2016-02-19

    During the influenza vaccination campaign 2011-2012 we established a self-declaration system of adverse events (AEs) in healthcare workers (HCW). The aim of this study is to describe the vaccinated population and analyse vaccination coverage and self-declared AEs after the voluntary flu vaccination in a university hospital in Barcelona. Observational study. We used the HCW immunization record to calculate the vaccination coverage. We collected AEs using a voluntary, anonymous, self-administered survey during the 2011-2012 flu vaccination campaign. We performed a logistic regression model to determine the associated factors to declare AEs. The influenza vaccination coverage in HCW was 30.5% (n=1,507/4,944). We received completed surveys from 358 vaccinated HCW (23.8% of all vaccinated). We registered AEs in 186 respondents to the survey (52.0% of all respondents). Of these, 75.3% (n=140) reported local symptoms after the flu vaccination, 9.7% (n=18) reported systemic symptoms and 15.1% (n=28) both local and systemic symptoms. No serious AEs were self-reported. Female sex and aged under 35 were both factors associated with declaring AEs. Our self-reporting system did not register serious AEs in HCW, resulting in an opportunity to improve HCW trust in flu vaccination. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  2. Guidance for Schools on the Recent Flu Outbreak

    Science.gov (United States)

    US Department of Education, 2009

    2009-01-01

    The document provides a transcript of a conference call moderated by Bill Modzeleski, Director of the Office of Safe and Drug-Free Schools. The focus of the call was the recent outbreak of swine flu in Mexico and the United States. Centers for Disease Control (CDC) actions and recommendations to the education community were discussed. A comparison…

  3. Science and Security Clash on Bird-Flu Papers

    Science.gov (United States)

    Fischman, Josh

    2012-01-01

    Censored papers on bird flu, which could help terrorists, have critics wondering if academic scientists can police their own work. The near-publication has brought out general critics of the federal panel, the National Science Advisory Board for Biosecurity, and the voluntary self-policing approach that it embraces instead of regulation. Members…

  4. Use of Protective Gear in Bird Flu Outbreak Response

    Centers for Disease Control (CDC) Podcasts

    CDC's Dr. Oliver Morgan discusses how the use of masks and other protective gear impacted whether workers dealing with an outbreak of bird flu in England became sick. The paper is published in the January 2009 issue of CDC’s journal, Emerging Infectious Diseases.

  5. Strategies for Fighting Pandemic Flu in Developing Countries

    Centers for Disease Control (CDC) Podcasts

    Countries throughout the world are preparing for the next influenza pandemic. Developing countries face special challenges because they don't have antiviral drugs or vaccines that more developed countries have. In this podcast, CDC's Dr. Dan Jernigan discusses new and innovative approaches that may help developing countries fight pandemic flu when it emerges.

  6. Pregnant Women: Know the Signs and Symptoms of Flu

    Centers for Disease Control (CDC) Podcasts

    This podcast is targeted to pregnant women and explains 1) the signs and symptoms of the flu, and 2) what to do if you experience and signs and symptoms. This podcast is NOT a substitute for the advice of your doctor or health care provider. It is intended for educational purposes only.

  7. Don't Get, Don't Spread: Seasonal Flu

    Centers for Disease Control (CDC) Podcasts

    2010-09-29

    In this podcast, Dr. Joe Bresee describes how to keep from getting the seasonal flu and spreading it to others.  Created: 9/29/2010 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 9/29/2010.

  8. Pandemics and networks : The case of the Mexican flu

    NARCIS (Netherlands)

    Omic, J.; Van Mieghem, P.

    2010-01-01

    The recent widespread of the new Mexican flu and SARS show the high dependency on contemporary traveling patterns. The air transport network is recognized as an important channel of epidemic propagation for different diseases. In order to predict epidemic spreading and the influence of protection

  9. Colds and flu – an overview of the management

    African Journals Online (AJOL)

    However, the flu is a viral illness that is caused by the influenza virus and has a high mortality .... However, not enough high-quality trials support the .... action and are combined in cold medicines to help patients sleep. Literature has stated that ...

  10. "FluSpec": A Simulated Experiment in Fluorescence Spectroscopy

    Science.gov (United States)

    Bigger, Stephen W.; Bigger, Andrew S.; Ghiggino, Kenneth P.

    2014-01-01

    The "FluSpec" educational software package is a fully contained tutorial on the technique of fluorescence spectroscopy as well as a simulator on which experiments can be performed. The procedure for each of the experiments is also contained within the package along with example analyses of results that are obtained using the software.

  11. Flu Diagnosis System Using Jaccard Index and Rough Set Approaches

    Science.gov (United States)

    Efendi, Riswan; Azah Samsudin, Noor; Mat Deris, Mustafa; Guan Ting, Yip

    2018-04-01

    Jaccard index and rough set approaches have been frequently implemented in decision support systems with various domain applications. Both approaches are appropriate to be considered for categorical data analysis. This paper presents the applications of sets operations for flu diagnosis systems based on two different approaches, such as, Jaccard index and rough set. These two different approaches are established using set operations concept, namely intersection and subset. The step-by-step procedure is demonstrated from each approach in diagnosing flu system. The similarity and dissimilarity indexes between conditional symptoms and decision are measured using Jaccard approach. Additionally, the rough set is used to build decision support rules. Moreover, the decision support rules are established using redundant data analysis and elimination of unclassified elements. A number data sets is considered to attempt the step-by-step procedure from each approach. The result has shown that rough set can be used to support Jaccard approaches in establishing decision support rules. Additionally, Jaccard index is better approach for investigating the worst condition of patients. While, the definitely and possibly patients with or without flu can be determined using rough set approach. The rules may improve the performance of medical diagnosis systems. Therefore, inexperienced doctors and patients are easier in preliminary flu diagnosis.

  12. Thermal comfort study of hospital workers in Malaysia.

    Science.gov (United States)

    Yau, Y H; Chew, B T

    2009-12-01

    This article presents findings of the thermal comfort study in hospitals. A field survey was conducted to investigate the temperature range for thermal comfort in hospitals in the tropics. Thermal acceptability assessment was conducted to examine whether the hospitals in the tropics met the ASHRAE Standard-55 80% acceptability criteria. A total of 114 occupants in four hospitals were involved in the study. The results of the field study revealed that only 44% of the examined locations met the comfort criteria specified in ASHRAE Standard 55. The survey also examined the predicted percentage of dissatisfied in the hospitals. The results showed that 49% of the occupants were satisfied with the thermal environments in the hospitals. The field survey analysis revealed that the neutral temperature for Malaysian hospitals was 26.4 degrees C. The comfort temperature range that satisfied 90% of the occupants in the space was in the range of 25.3-28.2 degrees C. The results from the field study suggested that a higher comfort temperature was required for Malaysians in hospital environments compared with the temperature criteria specified in ASHRAE Standard (2003). In addition, the significant deviation between actual mean vote and predicted mean vote (PMV) strongly implied that PMV could not be applied without errors in hospitals in the tropics. The new findings on thermal comfort temperature range in hospitals in the tropics could be used as an important guide for building services engineers and researchers who are intending to minimize energy usage in heating, ventilating and air conditioning systems in hospitals operating in the tropics with acceptable thermal comfort level and to improve the performance and well-being of its workers.

  13. Hospital disaster emergency preparedness: A study of Onandjokwe ...

    African Journals Online (AJOL)

    This study explored disaster emergency preparedness at Onandjokwe Lutheran Hospital in Northern Namibia. It utilized quantitative and qualitative research methods, using a self-administered questionnaire, semi-structured key informant interviews, and a hospital disaster plan checklist. A stratified sample of 120 ...

  14. FluG affects secretion in colonies of Aspergillus niger.

    Science.gov (United States)

    Wang, Fengfeng; Krijgsheld, Pauline; Hulsman, Marc; de Bekker, Charissa; Müller, Wally H; Reinders, Marcel; de Vries, Ronald P; Wösten, Han A B

    2015-01-01

    Colonies of Aspergillus niger are characterized by zonal heterogeneity in growth, sporulation, gene expression and secretion. For instance, the glucoamylase gene glaA is more highly expressed at the periphery of colonies when compared to the center. As a consequence, its encoded protein GlaA is mainly secreted at the outer part of the colony. Here, multiple copies of amyR were introduced in A. niger. Most transformants over-expressing this regulatory gene of amylolytic genes still displayed heterogeneous glaA expression and GlaA secretion. However, heterogeneity was abolished in transformant UU-A001.13 by expressing glaA and secreting GlaA throughout the mycelium. Sequencing the genome of UU-A001.13 revealed that transformation had been accompanied by deletion of part of the fluG gene and disrupting its 3' end by integration of a transformation vector. Inactivation of fluG in the wild-type background of A. niger also resulted in breakdown of starch under the whole colony. Asexual development of the ∆fluG strain was not affected, unlike what was previously shown in Aspergillus nidulans. Genes encoding proteins with a signal sequence for secretion, including part of the amylolytic genes, were more often downregulated in the central zone of maltose-grown ∆fluG colonies and upregulated in the intermediate part and periphery when compared to the wild-type. Together, these data indicate that FluG of A. niger is a repressor of secretion.

  15. Development of the Flu-PRO: a patient-reported outcome (PRO) instrument to evaluate symptoms of influenza.

    Science.gov (United States)

    Powers, John H; Guerrero, M Lourdes; Leidy, Nancy Kline; Fairchok, Mary P; Rosenberg, Alice; Hernández, Andrés; Stringer, Sonja; Schofield, Christina; Rodríguez-Zulueta, Patricia; Kim, Katherine; Danaher, Patrick J; Ortega-Gallegos, Hilda; Bacci, Elizabeth Dansie; Stepp, Nathaniel; Galindo-Fraga, Arturo; St Clair, Kristina; Rajnik, Michael; McDonough, Erin A; Ridoré, Michelande; Arnold, John C; Millar, Eugene V; Ruiz-Palacios, Guillermo M

    2016-01-05

    To develop content validity of a comprehensive patient-reported outcome (PRO) measure following current best scientific methodology to standardize assessment of influenza (flu) symptoms in clinical research. Stage I (Concept Elicitation): 1:1 telephone interviews with influenza-positive adults (≥18 years) in the US and Mexico within 7 days of diagnosis. Participants described symptom type, character, severity, and duration. Content analysis identified themes and developed the draft Flu-PRO instrument. Stage II (Cognitive Interviewing): The Flu-PRO was administered to a unique set of influenza-positive adults within 14 days of diagnosis; telephone interviews addressed completeness, respondent interpretation of items and ease of use. Samples: Stage I: N = 46 adults (16 US, 30 Mexico); mean (SD) age: 38 (19), 39 (14) years; % female: 56%, 73%; race: 69% White, 97% Mestizo. Stage II: N = 34 adults (12 US, 22 Mexico); age: 37 (14), 39 (11) years; % female: 50%, 50%; race: 58% White, 100% Mestizo. Symptoms identified by >50%: coughing, weak or tired, throat symptoms, congestion, headache, weakness, sweating, chills, general discomfort, runny nose, chest (trouble breathing), difficulty sleeping, and body aches or pains. No new content was uncovered during Stage II; participants easily understood the instrument. Results show the 37-item Flu-PRO is a content valid measure of influenza symptoms in adults with a confirmed diagnosis of influenza. Research is underway to evaluate the suitability of the instrument for children and adolescents. This work can form the basis for future quantitative tests of reliability, validity, and responsiveness to evaluate the measurement properties of Flu-PRO for use in clinical trials and epidemiology studies.

  16. Monitoring influenza activity in the United States: a comparison of traditional surveillance systems with Google Flu Trends.

    Directory of Open Access Journals (Sweden)

    Justin R Ortiz

    2011-04-01

    Full Text Available Google Flu Trends was developed to estimate US influenza-like illness (ILI rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections.Influenza activity data from 2003-04 through 2007-08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance, and US Influenza Virologic Surveillance System (CDC Virus Surveillance. Pearson's correlation coefficients with 95% confidence intervals (95% CI were calculated to compare surveillance data. An analysis was performed to investigate outlier observations and determine the extent to which they affected the correlations between surveillance data. Pearson's correlation coefficient describing Google Flu Trends and CDC Virus Surveillance over the study period was 0.72 (95% CI: 0.64, 0.79. The correlation between CDC ILI Surveillance and CDC Virus Surveillance over the same period was 0.85 (95% CI: 0.81, 0.89. Most of the outlier observations in both comparisons were from the 2003-04 influenza season. Exclusion of the outlier observations did not substantially improve the correlation between Google Flu Trends and CDC Virus Surveillance (0.82; 95% CI: 0.76, 0.87 or CDC ILI Surveillance and CDC Virus Surveillance (0.86; 95%CI: 0.82, 0.90.This analysis demonstrates that while Google Flu Trends is highly correlated with rates of ILI, it has a lower correlation with surveillance for laboratory-confirmed influenza. Most of the outlier observations occurred during the 2003-04 influenza season that was characterized by early and intense influenza activity, which potentially altered health care seeking behavior, physician testing practices, and internet search behavior.

  17. Monitoring Influenza Activity in the United States: A Comparison of Traditional Surveillance Systems with Google Flu Trends

    Science.gov (United States)

    Ortiz, Justin R.; Zhou, Hong; Shay, David K.; Neuzil, Kathleen M.; Fowlkes, Ashley L.; Goss, Christopher H.

    2011-01-01

    Background Google Flu Trends was developed to estimate US influenza-like illness (ILI) rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections. Methods and Findings Influenza activity data from 2003–04 through 2007–08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance), and US Influenza Virologic Surveillance System (CDC Virus Surveillance). Pearson's correlation coefficients with 95% confidence intervals (95% CI) were calculated to compare surveillance data. An analysis was performed to investigate outlier observations and determine the extent to which they affected the correlations between surveillance data. Pearson's correlation coefficient describing Google Flu Trends and CDC Virus Surveillance over the study period was 0.72 (95% CI: 0.64, 0.79). The correlation between CDC ILI Surveillance and CDC Virus Surveillance over the same period was 0.85 (95% CI: 0.81, 0.89). Most of the outlier observations in both comparisons were from the 2003–04 influenza season. Exclusion of the outlier observations did not substantially improve the correlation between Google Flu Trends and CDC Virus Surveillance (0.82; 95% CI: 0.76, 0.87) or CDC ILI Surveillance and CDC Virus Surveillance (0.86; 95%CI: 0.82, 0.90). Conclusions This analysis demonstrates that while Google Flu Trends is highly correlated with rates of ILI, it has a lower correlation with surveillance for laboratory-confirmed influenza. Most of the outlier observations occurred during the 2003–04 influenza season that was characterized by early and intense influenza activity, which potentially altered health care seeking behavior, physician testing practices, and internet search behavior. PMID:21556151

  18. Use of social media by Western European hospitals: longitudinal study.

    Science.gov (United States)

    Van de Belt, Tom H; Berben, Sivera A A; Samsom, Melvin; Engelen, Lucien J L P G; Schoonhoven, Lisette

    2012-05-01

    Patients increasingly use social media to communicate. Their stories could support quality improvements in participatory health care and could support patient-centered care. Active use of social media by health care institutions could also speed up communication and information provision to patients and their families, thus increasing quality even more. Hospitals seem to be becoming aware of the benefits social media could offer. Data from the United States show that hospitals increasingly use social media, but it is unknown whether and how Western European hospitals use social media. To identify to what extent Western European hospitals use social media. In this longitudinal study, we explored the use of social media by hospitals in 12 Western European countries through an Internet search. We collected data for each country during the following three time periods: April to August 2009, August to December 2010, and April to July 2011. We included 873 hospitals from 12 Western European countries, of which 732 were general hospitals and 141 were university hospitals. The number of included hospitals per country ranged from 6 in Luxembourg to 347 in Germany. We found hospitals using social media in all countries. The use of social media increased significantly over time, especially for YouTube (n = 19, 2% to n = 172, 19.7%), LinkedIn (n =179, 20.5% to n = 278, 31.8%), and Facebook (n = 85, 10% to n = 585, 67.0%). Differences in social media usage between the included countries were significant. Social media awareness in Western European hospitals is growing, as well as its use. Social media usage differs significantly between countries. Except for the Netherlands and the United Kingdom, the group of hospitals that is using social media remains small. Usage of LinkedIn for recruitment shows the awareness of the potential of social media. Future research is needed to investigate how social media lead to improved health care.

  19. Preparing for the Flu (Including 2009 H1N1 Flu): A Communication Toolkit for Schools (Grades K-12)

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2010

    2010-01-01

    The purpose of "Preparing for the Flu: A Communication Toolkit for Schools" is to provide basic information and communication resources to help school administrators implement recommendations from CDC's (Centers for Disease Control and Prevention) Guidance for State and Local Public Health Officials and School Administrators for School (K-12)…

  20. Optimizing antibiotic usage in hospitals: a qualitative study of the perspectives of hospital managers.

    Science.gov (United States)

    Broom, A; Gibson, A F; Broom, J; Kirby, E; Yarwood, T; Post, J J

    2016-11-01

    Antibiotic optimization in hospitals is an increasingly critical priority in the context of proliferating resistance. Despite the emphasis on doctors, optimizing antibiotic use within hospitals requires an understanding of how different stakeholders, including non-prescribers, influence practice and practice change. This study was designed to understand Australian hospital managers' perspectives on antimicrobial resistance, managing antibiotic governance, and negotiating clinical vis-à-vis managerial priorities. Twenty-three managers in three hospitals participated in qualitative semi-structured interviews in Australia in 2014 and 2015. Data were systematically coded and thematically analysed. The findings demonstrate, from a managerial perspective: (1) competing demands that can hinder the prioritization of antibiotic governance; (2) ineffectiveness of audit and monitoring methods that limit rationalization for change; (3) limited clinical education and feedback to doctors; and (4) management-directed change processes are constrained by the perceived absence of a 'culture of accountability' for antimicrobial use amongst doctors. Hospital managers report considerable structural and interprofessional challenges to actualizing antibiotic optimization and governance. These challenges place optimization as a lower priority vis-à-vis other issues that management are confronted with in hospital settings, and emphasize the importance of antimicrobial stewardship (AMS) programmes that engage management in understanding and addressing the barriers to change. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. Development of processes allowing near real-time refinement and validation of triage tools during the early stage of an outbreak in readiness for surge: the FLU-CATs Study.

    Science.gov (United States)

    Venkatesan, Sudhir; Myles, Puja R; McCann, Gerard; Kousoulis, Antonis A; Hashmi, Maimoona; Belatri, Rabah; Boyle, Emma; Barcroft, Alan; van Staa, Tjeerd Pieter; Kirkham, Jamie J; Nguyen Van Tam, Jonathan S; Williams, Timothy J; Semple, Malcolm G

    2015-10-01

    During pandemics of novel influenza and outbreaks of emerging infections, surge in health-care demand can exceed capacity to provide normal standards of care. In such exceptional circumstances, triage tools may aid decisions in identifying people who are most likely to benefit from higher levels of care. Rapid research during the early phase of an outbreak should allow refinement and validation of triage tools so that in the event of surge a valid tool is available. The overarching study aim is to conduct a prospective near real-time analysis of structured clinical assessments of influenza-like illness (ILI) using primary care electronic health records (EHRs) during a pandemic. This abstract summarises the preparatory work, infrastructure development, user testing and proof-of-concept study. (1) In preparation for conducting rapid research in the early phase of a future outbreak, to develop processes that allow near real-time analysis of general practitioner (GP) assessments of people presenting with ILI, management decisions and patient outcomes. (2) As proof of concept: conduct a pilot study evaluating the performance of the triage tools 'Community Assessment Tools' and 'Pandemic Medical Early Warning Score' to predict hospital admission and death in patients presenting with ILI to GPs during inter-pandemic winter seasons. Prospective near real-time analysis of structured clinical assessments and anonymised linkage to data from EHRs. User experience was evaluated by semistructured interviews with participating GPs. Thirty GPs in England, Wales and Scotland, participating in the Clinical Practice Research Datalink. All people presenting with ILI. None. Study outcome is proof of concept through demonstration of data capture and near real-time analysis. Primary patient outcomes were hospital admission within 24 hours and death (all causes) within 30 days of GP assessment. Secondary patient outcomes included GP decision to prescribe antibiotics and/or influenza

  2. 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...

  3. Controlling pandemic flu: the value of international air travel restrictions.

    Directory of Open Access Journals (Sweden)

    Joshua M Epstein

    2007-05-01

    Full Text Available Planning for a possible influenza pandemic is an extremely high priority, as social and economic effects of an unmitigated pandemic would be devastating. Mathematical models can be used to explore different scenarios and provide insight into potential costs, benefits, and effectiveness of prevention and control strategies under consideration.A stochastic, equation-based epidemic model is used to study global transmission of pandemic flu, including the effects of travel restrictions and vaccination. Economic costs of intervention are also considered. The distribution of First Passage Times (FPT to the United States and the numbers of infected persons in metropolitan areas worldwide are studied assuming various times and locations of the initial outbreak. International air travel restrictions alone provide a small delay in FPT to the U.S. When other containment measures are applied at the source in conjunction with travel restrictions, delays could be much longer. If in addition, control measures are instituted worldwide, there is a significant reduction in cases worldwide and specifically in the U.S. However, if travel restrictions are not combined with other measures, local epidemic severity may increase, because restriction-induced delays can push local outbreaks into high epidemic season. The per annum cost to the U.S. economy of international and major domestic air passenger travel restrictions is minimal: on the order of 0.8% of Gross National Product.International air travel restrictions may provide a small but important delay in the spread of a pandemic, especially if other disease control measures are implemented during the afforded time. However, if other measures are not instituted, delays may worsen regional epidemics by pushing the outbreak into high epidemic season. This important interaction between policy and seasonality is only evident with a global-scale model. Since the benefit of travel restrictions can be substantial while

  4. Impact of 2015 earthquakes on a local hospital in Nepal: A prospective hospital-based study.

    Science.gov (United States)

    Giri, Samita; Risnes, Kari; Uleberg, Oddvar; Rogne, Tormod; Shrestha, Sanu Krishna; Nygaard, Øystein Petter; Koju, Rajendra; Solligård, Erik

    2018-01-01

    Natural disasters pose a great challenge to the health systems and individual health facilities. In low-resource settings, disaster preparedness systems are often limited and not been well described. Two devastating earthquakes hit Nepal within a 17-days period in 2015. This study aims to describe the burden and distribution of emergency cases to a local hospital. This is a prospective observational study of patients presenting to a local hospital for a period of 21 days following the earthquake on April 25, 2015. Demographic and clinical information was prospectively registered for all patients in the systematic emergency registry. Systematic telephone interviews were conducted in a random sample of the patients 90 days after admission to the hospital. A total of 2,003 emergency patients were registered during the period. The average daily number of emergency patients during the first five days was almost five times higher (n = 150) than the pre-incident daily average (n = 35). The majority of injuries were fractures (58%), 348 (56%) in the lower extremities. A total of 345 surgical procedures were performed and the hospital treated 111 patients with severe injuries related to the earthquake (compartment syndrome, crush injury, and internal injury). Among those with follow-up interviews, over 90% reported that they had been severely affected by the earthquakes; complete house damage, living in temporary shelter, or loss of close family member. The hospital experienced a very high caseload during the first days, and the majority of patients needed orthopaedic services. The proportion of severely injured and in-hospital deaths were relatively low, probably indicating that the most severely injured did not reach the hospital in time. The experiences underline the need for robust and easily available local health services that can respond to disasters.

  5. Study on waste from hospital and clinics in Phitsanulok

    Directory of Open Access Journals (Sweden)

    Suwannee Adsavakulchai

    2002-10-01

    Full Text Available Waste generation depends on numerous factors such as established waste management methods, type of hospital establishment, hospital specialization, proportion of reusable items employed in hospital, and proportion of patients treated on a day-care basis. This study surveyed the waste from hospital and clinics in Phitsanulok and found the average daily waste generated as general, medical and hazardous waste from all hospitals in Phitsanulok Province at 1.751, 0.284 and 0.013 kg/bed respectively and at 0.323, 0.041 and 0.002 kg/bed respectively from all clinics in Phitsanulok Province. Medical waste from all hospitals consisted of needles, gloves, drain tubes, cottons and gauze, napkins, plastic syringes, swap and body parts with total daily generation at 0.452, 0.480, 0.390, 0.404, 0.018, 0.355, 0.004 and 0.382 kg/bed respectively. Information about proper waste management process is needed to improve hospital waste management. Hospital waste management is an important and necessary component of environmental health protection.

  6. How hospitalized children and parents perceive nurses and hospital amenities: A qualitative descriptive study in Poland.

    Science.gov (United States)

    Marcinowicz, Ludmiła; Abramowicz, Paweł; Zarzycka, Danuta; Abramowicz, Magdalena; Konstantynowicz, Jerzy

    2016-03-01

    A qualitative descriptive design using an interview guide approach was adopted to investigate the patient-nurse relationship and paediatric ward amenities from the perspective of parents and hospitalised children in Poland. The study included 26 parents or caregivers of hospitalised children (between 13 months and 15 years old) and 22 children (from 10 to 16 years old). Qualitative content analysis was used to analyse the recorded verbal data. Data from patients' transcripts were coded and classified in terms of topics on the patient-nurse relationship and hospital care. We identified five main topics. 1. Nurse qualities; 2. Nurse verbal behaviour; 3. Nurse tone of voice and non-verbal behaviour; 4. Hospital amenities; 5. Parents' expectations towards nurses. Our study contributes to increased understanding of parents' and children's experiences of paediatric hospital care. © The Author(s) 2014.

  7. Variations in renal morphometry: A hospital-based Indian study

    Directory of Open Access Journals (Sweden)

    Ranjeet S Rathore

    2016-01-01

    Conclusions: Our study revealed that there exist differences in various morphometric parameters of the kidney and ureter in different subsets of the Indian population attending our hospital as compared with the standard values quoted in the world literature.

  8. Determining symptoms for chest radiographs in patients with swine flu (H1N1)

    International Nuclear Information System (INIS)

    Al-Nakshabandi, Nizar A.

    2011-01-01

    The question arises about the chest X-ray findings and clinical symptoms in swine flu and about the most important clinical finding when correlated with the chest radiograph. Should physicians order a chest X-ray in each patient suspected of having swine flu? There were 179 patients with a high suspicion of swine flu. All 179 patients had an initial chest radiograph. As many as 65 males (representing 56% of the projected study population) had a normal chest radiograph, while 35 males (representing 55.6% of the study population) had an abnormal chest X-ray. As many as 51 females (representing 44% of the population) had a normal chest X-ray, while 20 females (representing 44% of the study population) had abnormal chest X-rays. Polymerase chain reaction (PCR) was not a determining factor for normal vs. abnormal chest X-ray (CXR). Rapid antigen test was not a determining factor for normal vs. abnormal CXR. Fever was not a determining factor for normal vs. abnormal CXR. Cough appears to be a determining factor for normal vs. abnormal CXR. Sore throat appears to be a determining factor for normal vs. abnormal CXR. Chest pain was not a determining factor for normal vs. abnormal CXR. Presence of cough with PCR was statistically significant. In my opinion, chest radiographs in patients with suspected H1N1 should only be obtained if there is a cough or sore throat. Other symptoms associated with H1N1 do not warrant a chest radiograph unless absolutely necessary

  9. Male factor in infertility: study from a tertiary care hospital

    OpenAIRE

    Kalavathi D. Biradar

    2016-01-01

    Background: Infertility is a condition with important psychological, economic, demographic and medical implications. Male infertility refers to a male's inability to result pregnancy in a fertile female. Methods: The present hospital based study was conducted in the Department of Obstetrics and Gynaecology, East Point Hospital, Bangalore. Duration of the study was for 6 months from October 2015 to March 2016. A total of 250 infertile couples couple coming for evaluation to the outpatient d...

  10. Canadian Acute Respiratory Illness and Flu Scale (CARIFS) for clinical detection of influenza in children.

    Science.gov (United States)

    Fischer, Jason B; Prasad, Priya A; Coffin, Susan E; Alpern, Elizabeth R; Mistry, Rakesh D

    2014-10-01

    Validated clinical scales, such as the Canadian Acute Respiratory Illness and Flu Scale (CARIFS), have not been used to differentiate influenza (FLU) from other respiratory viruses. Secondary analysis of a prospective cohort presenting to the emergency department (ED) with an influenza-like infection from 2008 to 2010. Subjects were children aged 0 to 19 years who had a venipuncture and respiratory virus polymerase chain reaction. Demographics and CARIFS items were assessed during the ED visit; comparisons were made between FLU and non-FLU subjects. The 203 subjects had median age 30.5 months; 61.6% were male. Comorbid conditions (51.2%) were common. FLU was identified in 26.6%, and were older than non-FLU patients (69.7 vs 47.9 months, P = .02). Demographic, household factors, and mean CARIFS score did not differ between FLU (33.7), and non-FLU (32.0) (mean difference 1.6, 95% CI: -2.0 to 5.2) groups. CARIFS cannot discriminate between FLU and non-FLU infection in ED children with influenza-like infection. © The Author(s) 2014.

  11. FLU AS PROBLEM COMMON TO ALL MANKIND. FUTURE DIRECTIONS FOR PREVENTION AND TREATMENT OF INFLUENZA

    Directory of Open Access Journals (Sweden)

    Korovaeva I.V

    2014-06-01

    Full Text Available This article discusses the flu, as one of the most common infectious diseases affecting humanity throughout its history. The data on the structure of A influenza virus and its variability is given historical background for most famous of the pandemics, which inflicted irreparable damage to the population of the Earth, are shown the basic stages of the study for influenza virus. Are considered the types of variability of the A virus influenza, its ability to overcome interspecies barriers that form the basis of pathogen escape from the immune response. The article shows the promising areas of modern prevention and treatment of this disease

  12. Spanish flu, Asian flu, Hong Kong flu, and seasonal influenza in Japan under social and demographic influence: review and analysis using the two-population model.

    Science.gov (United States)

    Yoshikura, Hiroshi

    2014-01-01

    When cumulative numbers of patients (X) and deaths (Y) associated with an influenza epidemic are plotted using the log-log scale, the plots fall on an ascending straight line generally expressed as logY = k(logX - logN0). For the 2009 H1N1 influenza pandemic, the slope k was ~0.6 for Mexico and ~2 for other countries. The two-population model was proposed to explain this phenomenon (Yoshikura H. Jpn J Infect Dis. 2012;65:279-88; Yoshikura H. Jpn J Infect Dis. 2009;62:411-2; and Yoshikura H. Jpn J Infect Dis. 2009;62:482-4). The current article reviews and analyzes previous influenza epidemics in Japan to examine whether the two-population model is applicable to them. The slope k was found to be ~2 for the Spanish flu during 1918-1920 and the Asian flu during 1957-1958, and ~1 for the Hong Kong flu and seasonal influenza prior to 1960-1961; however, k was ~0.6 for seasonal influenza after 1960-1961. This transition of the slope k of seasonal influenza plots from ~1 to ~0.6 corresponded to the shift in influenza mortality toward the older age groups and a drastic reduction in infant mortality rates due to improvements in the standard of living during the 1950s and 1960s. All the above observations could be well explained by reconstitution of the influenza epidemic based on the two-population model.

  13. Kebijakan Pemerintah Dalam Rangka Pemulihan Ekonomi Dan Keterkaitannya Dengan Merebaknya Flu Burung

    Directory of Open Access Journals (Sweden)

    Muryani Muryani

    2015-11-01

    Full Text Available The negative impact of the outbreak of bird flu on economic sectors in the sectoral and macro aspect is analized using Computable General Equilibrium (CGE models. Base on SNSE 2008 dataand some disagregation data sectors, two simulations are conducted. The result of the simulation studies indicate that there is the decrease in the production of poultry meat sector (traditional and medium-large and egg sectors impact on the micro and macro aspects of the economy. This research is the second step of my research deal with Avian flu and the economy.The first step was the negative impact of avian flu on economy which was already published on Asian Social Economic Journal by last year. The result of this research are : On the micro level in domestic market there are decresed production and increased prices in the poultry sector, eggs, other farms, restaurants and services. While in the foreign market there are decresed exports as well as imports. Similarly, there is a decline in consumption by the entire group of household due to a decline in the acceptance by all groups of households and firms. Government revenue also declined due to a decrease in taxes from households and firms.At the macro level there are a decline in GDP and a decline in the investment. The last  simulation illustrate  the increase of production and the impact of government policy on the micro aspects and the overall economy.  On the micro level in domestic market there are increased production and falling prices in the sector of poultry, eggs, other farms, restaurants and services. While in foreign market there are  increased exports and  decreased imports in almost all sectors. Similarly, there are an increase in consumption by the entire group of households due to an increse in the acceptance by all groups of households and firms. Government revenue also increased due to an increse in taxes from household and firms.

  14. Pregnant Women: Know the Signs and Symptoms of Flu

    Centers for Disease Control (CDC) Podcasts

    2010-11-17

    This podcast is targeted to pregnant women and explains 1) the signs and symptoms of the flu, and 2) what to do if you experience and signs and symptoms. This podcast is NOT a substitute for the advice of your doctor or health care provider. It is intended for educational purposes only.  Created: 11/17/2010 by National Center for Immunization and Respiratory Diseases (NCIRD), Office of the Director (OD).   Date Released: 11/17/2010.

  15. Strategies for Fighting Pandemic Flu in Developing Countries

    Centers for Disease Control (CDC) Podcasts

    2009-03-04

    Countries throughout the world are preparing for the next influenza pandemic. Developing countries face special challenges because they don't have antiviral drugs or vaccines that more developed countries have. In this podcast, CDC's Dr. Dan Jernigan discusses new and innovative approaches that may help developing countries fight pandemic flu when it emerges.  Created: 3/4/2009 by Emerging Infectious Diseases.   Date Released: 3/4/2009.

  16. Use of Protective Gear in Bird Flu Outbreak Response

    Centers for Disease Control (CDC) Podcasts

    2008-12-29

    CDC's Dr. Oliver Morgan discusses how the use of masks and other protective gear impacted whether workers dealing with an outbreak of bird flu in England became sick. The paper is published in the January 2009 issue of CDC’s journal, Emerging Infectious Diseases.  Created: 12/29/2008 by Emerging Infectious Diseases.   Date Released: 12/29/2008.

  17. Avian influenza (bird flu) outbreak news scare and its economic ...

    African Journals Online (AJOL)

    Avian influenza (bird flu) outbreak news scare and its economic implication on poultry enterprises in Adamawa state, Nigeria. MR Ja'afar-Furo, HG Balla, B Yakubu. Abstract. No Abstract. Global Journal of Agricultural Sciences Vol. 6 (1) 2007: pp. 61-68. http://dx.doi.org/10.4314/gjass.v6i1.2302 · AJOL African Journals ...

  18. A National Study of Wellbeing of Hospital Doctors in Ireland

    OpenAIRE

    Hayes, Blanaid

    2016-01-01

    The working environment for hospital doctors in Ireland has undergone radical change in recent years with hospital posts becoming unattractive to doctors in training and to consultants. For young medical graduates, the tensions between training requirements and service demands have contributed to a ‘brain drain’ with over half leaving to work abroad after graduation. Many consultant posts are vacant or are filled on a temporary basis, impacting on the quality of patient care. This study se...

  19. Deciphering the Swine-Flu Pandemics of 1918 and 2009

    Science.gov (United States)

    Goldstein, Richard; Dos Reis, Mario; Tamuri, Asif; Hay, Alan

    The devastating "Spanish flu" of 1918 killed an estimated 50 million people worldwide, ranking it as the deadliest pandemic in recorded human history. It is generally believed that the virus transferred from birds directly to humans shortly before the start of the pandemic, subsequently jumping from humans to swine. By developing 'non-homogeneous' substitution models that consider that substitution patterns may be different in human, avian, and swine hosts, we can determine the timing of the host shift to mammals. We find it likely that the Spanish flu of 1918, like the current 2009 pandemic, was a 'swine-origin' influenza virus. Now that we are faced with a new pandemic, can we understand how influenza is able to change hosts? Again by modelling the evolutionary process, considering the different selective constraints for viruses in the different hosts, we can identify locations that seem to be under different selective constraints in humans and avian hosts. This allows us to identify changes that may have facilitated the establishment of the 2009 swine-origin flu in humans.

  20. Study of Marketing Components Affecting Health Care Services in Hospitals

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Akbarian Bafghi

    2016-10-01

    Full Text Available Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.

  1. Hospital solid waste management practices in Limpopo Province, South Africa: A case study of two hospitals

    International Nuclear Information System (INIS)

    Nemathaga, Felicia; Maringa, Sally; Chimuka, Luke

    2008-01-01

    The shortcomings in the management practices of hospital solid waste in Limpopo Province of South Africa were studied by looking at two hospitals as case studies. Apart from field surveys, the generated hospital waste was weighed to compute the generation rates and was followed through various management practices to the final disposal. The findings revealed a major policy implementation gap between the national government and the hospitals. While modern practices such as landfill and incineration are used, their daily operations were not carried according to minimum standards. Incinerator ash is openly dumped and wastes are burned on landfills instead of being covered with soil. The incinerators used are also not environmentally friendly as they use old technology. The findings further revealed that there is no proper separation of wastes according to their classification as demanded by the national government. The mean percentage composition of the waste was found in the following decreasing order: general waste (60.74%) > medical waste (30.32%) > sharps (8.94%). The mean generation rates were found to be 0.60 kg per patient per day

  2. Introducing Namaste Care to the hospital environment: a pilot study.

    Science.gov (United States)

    St John, Kimberley; Koffman, Jonathan

    2017-10-01

    The rising prevalence of dementia is impacting on acute hospitals and placing increased expectations on health and social care professionals to improve the support and services they are delivering. It has been recommended that good practice in dementia care relies on adopting a palliative approach to care and meeting people's physical, psychological, social and spiritual needs. Increased dementia training for staff that includes initiatives that promote dignity; enhancing communication skills and recognizing that a person with dementia may be approaching the end of their lives are needed. Our study aim was to explore whether Namaste Care is an acceptable and effective service for people with advanced dementia being cared for on an acute hospital ward. This was an exploratory qualitative interview, pilot study. Individual, semi-structured, face-to-face interviews were conducted with hospital healthcare staff working in an area of the hospital where Namaste Care had been implemented. Data were analysed using the framework approach. Eight interviews were completed with members of the multidisciplinary ward team. Two themes were identified: (I) difficulties establishing relationships with people with dementia in hospital (subthemes: lack of time and resources, lack of confidence leading to fear and anxiety); (II) the benefits of a Namaste Care service in an acute hospital setting (subthemes: a reduction in agitated behavior; connecting and communicating with patients with dementia using the senses; a way of showing people with dementia they are cared for and valued). This small-scale study indicates that Namaste Case has the potential to improve the quality of life of people with advanced dementia being cared for in an acute hospital setting. However, further research is required to explore more specifically its benefits in terms of improved symptom management and wellbeing of people with dementia on acute hospitals wards.

  3. Human resource crises in German hospitals--an explorative study.

    Science.gov (United States)

    Schermuly, Carsten C; Draheim, Michael; Glasberg, Ronald; Stantchev, Vladimir; Tamm, Gerrit; Hartmann, Michael; Hessel, Franz

    2015-05-28

    The complexity of providing medical care in a high-tech environment with a highly specialized, limited labour force makes hospitals more crisis-prone than other industries. An effective defence against crises is only possible if the organizational resilience and the capacity to handle crises become part of the hospitals' organizational culture. To become more resilient to crises, a raised awareness--especially in the area of human resource (HR)--is necessary. The aim of this paper is to contribute to the process robustness against crises through the identification and evaluation of relevant HR crises and their causations in hospitals. Qualitative and quantitative methods were combined to identify and evaluate crises in hospitals in the HR sector. A structured workshop with experts was conducted to identify HR crises and their descriptions, as well as causes and consequences for patients and hospitals. To evaluate the findings, an online survey was carried out to rate the occurrence (past, future) and dangerousness of each crisis. Six HR crises were identified in this study: staff shortages, acute loss of personnel following a pandemic, damage to reputation, insufficient communication during restructuring, bullying, and misuse of drugs. The highest occurrence probability in the future was seen in staff shortages, followed by acute loss of personnel following a pandemic. Staff shortages, damage to reputation, and acute loss of personnel following a pandemic were seen as the most dangerous crises. The study concludes that coping with HR crises in hospitals is existential for hospitals and requires increased awareness. The six HR crises identified occurred regularly in German hospitals in the past, and their occurrence probability for the future was rated as high.

  4. Factors Influencing Hospital Stay for Pulmonary Embolism. A Cohort Study.

    Science.gov (United States)

    Rodríguez-Núñez, Nuria; Ruano-Raviña, Alberto; Abelleira, Romina; Ferreiro, Lucía; Lama, Adriana; González-Barcala, Francisco J; Golpe, Antonio; Toubes, María E; Álvarez-Dobaño, José M; Valdés, Luis

    2017-08-01

    The aim of this study was to identify factors influencing hospital stay due to pulmonary embolism. We performed a retrospective cohort study of patients hospitalized between 2010 and 2015. Patients were identified using information recorded in hospital discharge reports (ICD-9-CM codes 415.11 and 415.19). We included 965 patients with a median stay of 8 days (IQR 6-13 days). Higher scores on the simplified Pulmonary Embolism Severity Index (sPESI) were associated with increased probability of longer hospital stay. The probability of a hospital stay longer than the median was 8.65 (95% CI 5.42-13.79) for patients referred to the Internal Medicine Department and 1.54 (95% CI 1.07-2.24) for patients hospitalized in other departments, compared to those referred to the Pneumology Department. Patients with grade 3 on the modified Medical Research Council dyspnea scale had an odds ratio of 1.63 (95% CI: 1.07-2.49). The likelihood of a longer than median hospital stay was 1.72 (95% CI: 0.85-3.48) when oral anticoagulation (OAC) was initiated 2-3 days after admission, and 2.43 (95% CI: 1.16-5.07) when initiated at 4-5 days, compared to OAC initiation at 0-1 days. sPESI grade, the department of referral from the Emergency Department, the grade of dyspnea and the time of initiating OAC were associated with a longer hospital stay. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. [Burnout syndrome in pre-hospital and hospital emergency. Cognitive study in two cohorts of nurses].

    Science.gov (United States)

    Cicchitti, Chiara; Cannizzaro, Giorgia; Rosi, Fabrizio; Maccaroni, Roberto; Menditto, Vincenzo G

    2014-01-01

    Burnout syndrome (BOS) associated with stress has been documented in health care professionals in many specialties. The emergency department and the pre-hospital healthcare services are highly stressful environments. Little is known about the BOS in critical care nursing staff. The objective of the study is to compare the incidence of BOS and its three domains, namely, emotional exhaustion, depersonalization and reduced professional accomplishment, in two cohorts of critical care nurses: a pre-hospital and a hospital emergency service. A survey using a questionnaire (the Maslach Burnout Inventory-General Survey, MBI-GS), among nurses of two Italian emergency services has been performed: a hospital emergency service (HES, Emergency Department or "Pronto Soccorso") and a pre-hospital emergency service (PHES, territorial healthcare service or "Centrale Operativa 118"). All 60 nurses surveyed (82% female) filled the questionnaires. BOS-related symptoms have been identified in at least 50% of the nurses in the HES: 50% suffered a medium-high emotional exhaustion, 75% had a medium-high depersonalization and 92.5% had a medium-high reduced professional accomplishment. Among the PEHS nurses, BOS-related symptoms have been identified in at least 60% of the respondents: 60% had a medium-high emotional exhaustion, 70% had a medium-high depersonalization and 95% had a medium-high reduced professional accomplishment. Moreover, the likelihood that a nurse has a severe BOS, that is at least one degree of high burnout or ≥2 degrees of medium burnout, is significantly higher in the group of the PHES than in the HES (90% vs 60%, p nursing staff had a severe BOS. The incidence of BOS appeared to be similar among PHES and HES nurses with a higher trend for the former. Further interventional studies are needed to investigate the determinants of BOS among critical care nurses and the potentially preventive strategies.

  6. Surgical site infections in Italian Hospitals: a prospective multicenter study

    Directory of Open Access Journals (Sweden)

    Ippolito Giuseppe

    2008-03-01

    Full Text Available Abstract Background Surgical site infections (SSI remain a major clinical problem in terms of morbidity, mortality, and hospital costs. Nearly 60% of SSI diagnosis occur in the postdischarge period. However, literature provides little information on risk factors associated to in-hospital and postdischarge SSI occurrence. A national prospective multicenter study was conducted with the aim of assessing the incidence of both in-hospital and postdisharge SSI, and the associated risk factors. Methods In 2002, a one-month, prospective national multicenter surveillance study was conducted in General and Gynecological units of 48 Italian hospitals. Case ascertainment of SSI was carried out using standardized surveillance methodology. To assess potential risk factors for SSI we used a conditional logistic regression model. We also reported the odds ratios of in-hospital and postdischarge SSI. Results SSI occurred in 241 (5.2% of 4,665 patients, of which 148 (61.4% during in-hospital, and 93 (38.6% during postdischarge period. Of 93 postdischarge SSI, sixty-two (66.7% and 31 (33.3% were detected through telephone interview and questionnaire survey, respectively. Higher SSI incidence rates were observed in colon surgery (18.9%, gastric surgery (13.6%, and appendectomy (8.6%. If considering risk factors for SSI, at multivariate analysis we found that emergency interventions, NNIS risk score, pre-operative hospital stay, and use of drains were significantly associated with SSI occurrence. Moreover, risk factors for total SSI were also associated to in-hospital SSI. Additionally, only NNIS, pre-operative hospital stay, use of drains, and antibiotic prophylaxis were associated with postdischarge SSI. Conclusion Our study provided information on risk factors for SSI in a large population in general surgery setting in Italy. Standardized postdischarge surveillance detected 38.6% of all SSI. We also compared risk factors for in-hospital and postdischarge SSI

  7. Qualitative Performance Evaluation of Hospitals Using DEA, Balanced Scorecard and Servqual; A Case Study of General Hospitals of Yazd

    Directory of Open Access Journals (Sweden)

    M Asadi

    2011-02-01

    Full Text Available Introduction: Evaluation is an important factor in productivity context, and acts as a control system for other areas of productivity. Hospitals are large organizations incurring heavy expenses in every country. The level of efficiency in a hospital is a good criterion to understand how hospitals consume their resources. The goal of this research was to determine relative efficiency of 13 public hospitals in Yazd province by using integrated DEA, BSC and SERVQUAL model. Methods: In this study, relative efficiency of 13 public hospitals of Yazd province was calculated using data envelopment analysis technique(DEA and balanced score card and servqual. BSC was used as a tool for designing of performance evaluation indexes, while DEA was used as a tool of evaluating performance and ranking. Results: The mean relative efficiency of hospitals under study was about 0.945 in the Persian calendar year 2008-9. The efficiency levels of nine hospitals were borderline and the efficiency of four hospitals was less than 1. Hospital no.3 had the highest efficiency levels and hospital no.10 had the lowest efficiency level. Conclusion: In this stage, on the basis of references presented by the DEA model, solutions for increasing the quality performance levels of inefficient hospitals in fourth dimensions were determined and some suggestions were proposed. Although all performance indices of the inefficient hospitals need to be addressed, priorities have to be determined by the respective managers.

  8. The fluG-BrlA pathway contributes to the initialisation of autolysis in submerged Aspergillus nidulans cultures.

    Science.gov (United States)

    Emri, Tamás; Molnár, Zsolt; Pusztahelyi, Tünde; Varecza, Zoltán; Pócsi, István

    2005-07-01

    The fluG gene proved to be essential in the initialisation of autolysis in Aspergillus nidulans (teleomorph Emericella nidulans) cultures, while a loss-of-function mutation in only one out of the flbB-E genes had only minor effects on autolysis. In contrast to its important role in sporulation, brlA regulated only some, but not all, elements of the autolytic process. The tightly coupled autolytic events (chitinase and proteinase production, hyphal fragmentation, disorganisation of pellets, autolytic loss of biomass) observable in ageing cultures of A. nidulans were disconnected by loss-of-function mutations in some genes of the FluG-BrlA regulatory network. The tight correlation between pellet morphology and size and hydrolase production was also erased by these mutations. On the other hand, the mutations studied did not affect the glutathione metabolism of the fungus.

  9. Study of cluster headache: A hospital-based study

    Directory of Open Access Journals (Sweden)

    Amita Bhargava

    2014-01-01

    Full Text Available Introduction: Cluster headache (CH is uncommon and most painful of all primary headaches, and continues to be managed suboptimally because of wrong diagnosis. It needs to be diagnosed correctly and specifically treated. There are few studies and none from this region on CH. Materials and Methods: To study the detailed clinical profile of CH patients and to compare them among both the genders. Study was conducted at Mahatma Gandhi hospital, Jodhpur (from January 2011to December 2013. Study comprises 30 CH patients diagnosed according to International Headache Society guidelines (ICHD-II. Routine investigations and MRI brain was done in all patients. All measurements were reported as mean ± SD. Categorical variables were compared using the Chi-square test, and continuous variables were compared using Student′s t-test. SPSS for Windows, Version 16.0, was used for statistical analyses with the significance level set at P = 0.05. Results: M: F ratio was 9:1. Age at presentation was from 22-60 years (mean - 38 years. Latency before diagnosis was 3 months-12 years (mean - 3.5 years. All suffered from episodic CH and aura was found in none. Pain was strictly unilateral (right-19, left-11, predominantly over temporal region-18 (60%. Pain intensity was severe in 27 (90% and moderate in 3 (10%. Pain quality was throbbing in 12 (40%. Peak intensity was reached in 5 minutes-30 minutes and attack duration varied from 30 minutes to 3 hours (mean - 2.45 hours. Among autonomic features, conjunctival injection-23 (76.6% and lacrimation-25 (83.3% were most common. Restlessness during episode was found in 80%. CH duration varied from 10 days to 12 weeks. Circadian periodicity for attacks was noted in 24 (80%. Conclusion: Results are consistent with other studies on many accounts, but is different from Western studies with respect to low frequency of family history, chronic CH, restlessness and aura preceeding the attack. Detailed elicitation of history is

  10. Setting healthcare priorities in hospitals: a review of empirical studies.

    Science.gov (United States)

    Barasa, Edwine W; Molyneux, Sassy; English, Mike; Cleary, Susan

    2015-04-01

    Priority setting research has focused on the macro (national) and micro (bedside) level, leaving the meso (institutional, hospital) level relatively neglected. This is surprising given the key role that hospitals play in the delivery of healthcare services and the large proportion of health systems resources that they absorb. To explore the factors that impact upon priority setting at the hospital level, we conducted a thematic review of empirical studies. A systematic search of PubMed, EBSCOHOST, Econlit databases and Google scholar was supplemented by a search of key websites and a manual search of relevant papers' reference lists. A total of 24 papers were identified from developed and developing countries. We applied a policy analysis framework to examine and synthesize the findings of the selected papers. Findings suggest that priority setting practice in hospitals was influenced by (1) contextual factors such as decision space, resource availability, financing arrangements, availability and use of information, organizational culture and leadership, (2) priority setting processes that depend on the type of priority setting activity, (3) content factors such as priority setting criteria and (4) actors, their interests and power relations. We observe that there is need for studies to examine these issues and the interplay between them in greater depth and propose a conceptual framework that might be useful in examining priority setting practices in hospitals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  11. Assessing and responding in real time to online anti-vaccine sentiment during a flu pandemic.

    Science.gov (United States)

    Seeman, Neil; Ing, Alton; Rizo, Carlos

    2010-01-01

    The perceived safety of vaccination is an important explanatory factor for vaccine uptake and, consequently, for rates of illness and death. The objectives of this study were (1) to evaluate Canadian attitudes around the safety of the H1N1 vaccine during the fall 2009 influenza pandemic and (2) to consider how public health communications can leverage the Internet to counteract, in real time, anti-vaccine sentiment. We surveyed a random sample of 175,257 Canadian web users from October 27 to November 19, 2009, about their perceptions of the safety of the HINI vaccine. In an independent analysis, we also assessed the popularity of online flu vaccine-related information using a tool developed for this purpose. A total of 27,382 unique online participants answered the survey (15.6% response rate). Of the respondents, 23.4% considered the vaccine safe, 41.4% thought it was unsafe and 35.2% reported ambivalence over its safety. Websites and blog posts with anti-vaccine sentiment remained popular during the course of the pandemic. Current public health communication and education strategies about the flu vaccine can be complemented by web analytics that identify, track and neutralize anti-vaccine sentiment on the Internet, thus increasing perceived vaccine safety. Counter-marketing strategies can be transparent and collaborative, engaging online "influencers" who spread misinformation.

  12. Study of Development for RFID System to Hospital Environment.

    Science.gov (United States)

    Hong, Seung Kwon; Sung, Myung-Whun

    2015-01-01

    RFID/USN develops information systems for anytime, anywhere to anybody access Electronic Medical Records (EMR). The goal of the present study is to develop a RFID/USN-based information system for the hospital environment. First, unable to recognize, second, able to recognize as a pursuit of place and suppose the time of medical examination. A retrospective analysis of 235 RFID monitoring results, from four ENT ambulatory clinics of Seoul National University Hospital were extracted by a reader program and monitoring of RFID tag (2006.11.16~2006.12.16). RFID detection for sensing reader of this study has been put into representing "place" and "spending time" of patients for medical history taking and examination. Through the RFID of detection for specific place and spending time of medical examination, RFID/USN develops information system progressing in the EMR of hospital system.

  13. Novel Use of Flu Surveillance Data: Evaluating Potential of Sentinel Populations for Early Detection of Influenza Outbreaks.

    Science.gov (United States)

    Daughton, Ashlynn R; Velappan, Nileena; Abeyta, Esteban; Priedhorsky, Reid; Deshpande, Alina

    2016-01-01

    Influenza causes significant morbidity and mortality each year, with 2-8% of weekly outpatient visits around the United States for influenza-like-illness (ILI) during the peak of the season. Effective use of existing flu surveillance data allows officials to understand and predict current flu outbreaks and can contribute to reductions in influenza morbidity and mortality. Previous work used the 2009-2010 influenza season to investigate the possibility of using existing military and civilian surveillance systems to improve early detection of flu outbreaks. Results suggested that civilian surveillance could help predict outbreak trajectory in local military installations. To further test that hypothesis, we compare pairs of civilian and military outbreaks in seven locations between 2000 and 2013. We find no predictive relationship between outbreak peaks or time series of paired outbreaks. This larger study does not find evidence to support the hypothesis that civilian data can be used as sentinel surveillance for military installations. We additionally investigate the effect of modifying the ILI case definition between the standard Department of Defense definition, a more specific definition proposed in literature, and confirmed Influenza A. We find that case definition heavily impacts results. This study thus highlights the importance of careful selection of case definition, and appropriate consideration of case definition in the interpretation of results.

  14. Comparative Transcriptomic and Proteomic Analyses Reveal a FluG-Mediated Signaling Pathway Relating to Asexual Sporulation of Antrodia camphorata.

    Science.gov (United States)

    Li, Hua-Xiang; Lu, Zhen-Ming; Zhu, Qing; Gong, Jin-Song; Geng, Yan; Shi, Jin-Song; Xu, Zheng-Hong; Ma, Yan-He

    2017-09-01

    Medicinal mushroom Antrodia camphorata sporulate large numbers of arthroconidia in submerged fermentation, which is rarely reported in basidiomycetous fungi. Nevertheless, the molecular mechanisms underlying this asexual sporulation (conidiation) remain unclear. Here, we used comparative transcriptomic and proteomic approaches to elucidate possible signaling pathway relating to the asexual sporulation of A. camphorata. First, 104 differentially expressed proteins and 2586 differential cDNA sequences during the culture process of A. camphorata were identified by 2DE and RNA-seq, respectively. By applying bioinformatics analysis, a total of 67 genes which might play roles in the sporulation were obtained, and 18 of these genes, including fluG, sfgA, SfaD, flbA, flbB, flbC, flbD, nsdD, brlA, abaA, wetA, ganB, fadA, PkaA, veA, velB, vosA, and stuA might be involved in a potential FluG-mediated signaling pathway. Furthermore, the mRNA expression levels of the 18 genes in the proposed FluG-mediated signaling pathway were analyzed by quantitative real-time PCR. In summary, our study helps elucidate the molecular mechanisms underlying the asexual sporulation of A. camphorata, and provides also useful transcripts and proteome for further bioinformatics study of this valuable medicinal mushroom. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Hospital information system utilization in Iran: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Abbasi Moghadam

    2014-11-01

    Full Text Available Hospital information system (HIS should ideally allow different forms of data to be stored and used for decision making by clinicians and managers alike. This system has been developed since the early 1980's, and many hospitals gradually converted from an unrelated system into an integrated one. In successful implementation of HIS plans, the role of human factors, either individually or as a group, is expected to be very important and decisive. In this phenomenological qualitative research, in-depth personal interviews were conducted with the hospital's senior managers, and discussions were conducted in six to eight member focus groups. To include participants for interviews, purposive sampling was used in an Iranian hospital among doctors, nurses and other healthcare providers who had experience in using HIS. Data collection continued until saturation stage. The meetings took about 90 to 120 minutes, in which the participants were asked about discovering needs as well as facilitating and inhibiting factors regarding HIS application. Two members of the research team independently analyzed the interview transcripts.  As a result, problems in HIS isolation were reported to be related to the following: software, hardware, manpower, management and training. About the last point, it was stated that adequate continuing professional development programs did not exist for proper use of computers in the hospital. To achieve the ultimate goal of HISs (e.g. increasing patient satisfaction and decreasing hospital costs, it is necessary to create basic changes in the training system, and to get feedback from hospital personnel. Other steps include addressing software and hardware shortcomings as well as moving towards reinforcing the facilitating factors and refraining from inhibiting ones discovered in this study.

  16. A Functional Food Mixture “Protector” Reinforces the Protective Immune Parameters against Viral Flu Infection in Mice

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    Kenza A. Mansoor

    2018-06-01

    Full Text Available Background: Viral influenza infection causes serious health issues especially when an outbreak occurs. Although influenza virus vaccines are available and each year manufactures modify the vaccine depending on the expected mutated strain, it is still far from satisfactory, mainly in young children and older adults. Therefore, a product that can support and shape the immune system to protect against viral flu infections is highly essential. Methods: A functional food water-soluble mixture of pomegranate, red grape, dates, olive fruit, figs, and ginger extracts, termed herein “Protector”, was prepared and tested in stimulating/modulating the production of specific cytokines, and hemagglutinin inhibition (HAI antibodies following viral flu vaccination in mice. Results: A single intraperitoneal or multiple oral administration for 1–7 days of “Protector” significantly increased the production of interferon (IFN-γ and interleukin (IL-12 in blood, spleen, and lungs of mice. When “Protector” was orally administered for one week following a single vaccine injection (primary immunization or for two weeks (one week apart following double vaccine injections (secondary immunization, mice significantly produced higher titers of HAI antibodies. This increase in HAI antibodies was associated with Pillow-inducing significant and different changes in vaccine-induced IFN-γ, IL-12, IL-6 and IL-22 following primary and secondary immunizations. Conclusions: “Protector” administration reinforces the protective immune parameters against viral flu infection. Therefore, after performing preclinical toxicology studies and ensuring its safety, “Protector” should be considered a potential product to be tested in clinical trials to conclude its efficacy in reducing the devastating effects of flu infection in humans and its outbreaks.

  17. Hospital waste management and toxicity evaluation: A case study

    International Nuclear Information System (INIS)

    Tsakona, M.; Anagnostopoulou, E.; Gidarakos, E.

    2007-01-01

    Hospital waste management is an imperative environmental and public safety issue, due to the waste's infectious and hazardous character. This paper examines the existing waste strategy of a typical hospital in Greece with a bed capacity of 400-600. The segregation, collection, packaging, storage, transportation and disposal of waste were monitored and the observed problematic areas documented. The concentrations of BOD, COD and heavy metals were measured in the wastewater the hospital generated. The wastewater's toxicity was also investigated. During the study, omissions and negligence were observed at every stage of the waste management system, particularly with regard to the treatment of infectious waste. Inappropriate collection and transportation procedures for infectious waste, which jeopardized the safety of staff and patients, were recorded. However, inappropriate segregation practices were the dominant problem, which led to increased quantities of generated infectious waste and hence higher costs for their disposal. Infectious waste production was estimated using two different methods: one by weighing the incinerated waste (880 kg day -1 ) and the other by estimating the number of waste bags produced each day (650 kg day -1 ). Furthermore, measurements of the EC 50 parameter in wastewater samples revealed an increased toxicity in all samples. In addition, hazardous organic compounds were detected in wastewater samples using a gas chromatograph/mass spectrograph. Proposals recommending the application of a comprehensive hospital waste management system are presented that will ensure that any potential risks hospital wastes pose to public health and to the environment are minimized

  18. STUDY ON WASTEWATER TREATMENT SYSTEMS IN HOSPITALS OF IRAN

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    M. Majlesi Nasr, A. R. Yazdanbakhsh

    2008-07-01

    Full Text Available Nowadays, water resources shortage is one of the most important issues for environmental engineers and managers as well as its conservation due to population growth and ever-increasing water demands. Besides, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components. In this paper, physical and chemical specifications of produced wastewater in hospitals of Iran were investigated experiments. Results were compared with the effluent parameters of wastewater standards of Iranian Department of the Environment. 70 governmental hospitals from different provinces of Iran were selected by purposive (non-random sampling method. For data analysis, SPSS and EXCEL softwares were applied. The findings of the study showed that 52% of the surveyed hospitals were not equipped and 48% were equipped with wastewater treatment systems. The mean of Biochemical Oxygen Demand, Chemical Oxygen Demand and Total Suspended Solids of the effluent of wastewater treatment systems were reported as 113, 188 and 99 mg/L respectively. Comparison of the indicators between effluents of wastewater treatment systems and the standards of Departments of the Environment, showed the inefficiency in these systems and it was concluded that despite the recent improvements in hospital wastewater treatment systems, they should be upgraded based on the remarks in this paper.

  19. Motivating factors in hospital environmental management programs: a multiple case study in four private Brazilian hospitals

    Directory of Open Access Journals (Sweden)

    Jan Krüger

    Full Text Available Abstract Environmental responsibility has been a widespread and relatively recent research theme in the healthcare sector. Considering that the greater life expectancy increases the need for healthcare services and that these services produce negative environmental externalities on human health, it is important to understand the relationship between environmental responsibility and the healthcare sector. This article aims to investigate what motivates hospital managers to adopt environmental responsibility programs and to identify the actions implemented by them. A multiple case study was conducted involving four Brazilian hospitals based in Rio de Janeiro and São Paulo. The results indicate that the main drivers are competitive, ethical and regulatory and that the competitive and regulatory motivators have the potential to establish a baseline for environmental performance that varies across ownership type (public or private. The results also indicate that the comprehensiveness of environmental actions is related to organizational resilience and to the motivators that drive hospitals to adopt those actions. Two conceptual models are proposed to illustrate these findings and offer bases for further research.

  20. Pathogens gone wild? Medical anthropology and the "swine flu" pandemic.

    Science.gov (United States)

    Singer, Merrill

    2009-07-01

    Beginning in April 2009, global attention began focusing on the emergence in Mexico of a potentially highly lethal new influenza strain of porcine origin that has successfully jumped species barriers and is now being transmitted around the world. Reported on extensively by the mass media, commented on by public health and government officials across the globe, and focused on with nervous attention by the general public, the so-called swine flu pandemic raises important questions, addressed here, concerning the capacity of medical anthropology to respond usefully to such disease outbreaks and their health and social consequences.

  1. A Study of Hospital Waste Generation and Management Practice in ...

    African Journals Online (AJOL)

    This study was carried out in Akure, the capital of Ondo State, Nigeria to assess the current practice of hospital wastes management, the magnitude and variety of wastes and the awareness of the stakeholders on the implications of their activities. The composition of wastes found in the 20 healthcare facilities visited ...

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

    Science.gov (United States)

    Burda, D

    1991-10-07

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

  3. Knee osteoarthritis prevalence in hospitalized elderly patients: a retrospective study.

    Science.gov (United States)

    Huang, Ke Qiang; Li, Chuan Silvia; Lin, Zhong Qiu; Feng, Guo Fei; Wang, Xiao Hui; Fu, Wen Zhe; Xie, Zhi Quan

    2013-01-01

    This study aimed to determine the prevalence rate of knee osteoarthritis (OA) and the risk factors for OA in hospitalized elderly patients. We conducted this retrospective study in elderly patients (aged 65 years and older) who were hospitalized in the Geriatric Ward of General Hospital of Guangzhou Military Command of the People's Liberation Army between January 2011 and June 2013, including general condition, present history, past history, physical examination, X-ray results, and disease diagnosis. The prevalence, awareness, and treatment rates of knee OA in hospitalized elderly patients were calculated. Risk factors were computed using multiple logistic regression analysis. Of a total of 267 (17.4%) hospitalized elderly patients diagnosed with knee OA, the prevalence rate of OA was 9.95% in males and 37.76% in females. The rate of awareness among those with OA was 51.68%; the rate of treatment was 83.33%; and the rate of control was 77.39%. The medical expenses for both females (1143±315 yuan month-1) and males (1192±357 yuan month-1) in knee OA patients are higher than that of the non-knee OA group (989±274 yuan month-1, 1038±295 yuan month-1). The risk factors for knee OA include gender (OR=2.448), age (OR=1.124), transportation mode (OR= 8.972), exercise (OR=7.374), bowel evacuation position (OR=5.767), family history of knee OA (OR=2.195), and body mass index (OR=2.469). The prevalence of knee OA is unexpectedly high in hospitalized elderly patients, and the rates of awareness and treatment are less than desirable. Prevention and control measures should be taken in patients with concomitant risk factors.

  4. assessment of the economic and social implications of the avian flu ...

    African Journals Online (AJOL)

    Admin

    2006-01-22

    Jan 22, 2006 ... KEYWORDS: Assessment, Economic, Social Implications, Avian Flu, Nigerian Poultry. INTRODUCTION. Avian flu is a highly infectious, contagious and zoonotic disease of man, poultry and other birds caused by the avian influenza type A virus, Emmanuel et.al. (2006). The avian influenza virus belongs to ...

  5. Who Takes Advantage of Free Flu Shots? Examining the Effects of an Expansion in Coverage

    NARCIS (Netherlands)

    Carman, K.G.; Mosca, I.

    2011-01-01

    Because of the high risk of costly complications (including death) and the externalities of contagious diseases, many countries provide free flu shots to certain populations free of charge. This paper examines the expansion of the free flu shot program in the Netherlands. This program expanded in

  6. H1N1 Flu & U.S. Schools: Answers to Frequently Asked Questions

    Science.gov (United States)

    US Department of Education, 2009

    2009-01-01

    A severe form of influenza known as H1N1, commonly being called swine flu, has health officials around the world concerned. In the United States, the outbreak of H1N1 has prompted school closures and cancellation of school-related events. As the flu spreads, the Department of Education encourages school leaders, parents and students to know how to…

  7. An econometric analysis of SARS and Avian flu on international tourist arrivals to Asia

    NARCIS (Netherlands)

    M.J. McAleer (Michael); B-W. Huang (Bing-Wen); H-I. Kuo (Hsiao-I); C-C. Chen (Chi-Chung); C-L. Chang (Chia-Lin)

    2008-01-01

    textabstractThis paper compares the impacts of SARS and human deaths arising from Avian Flu on international tourist arrivals to Asia. The effects of SARS and human deaths from Avian Flu will be compared directly according to human deaths. The nature of the short run and long run relationship is

  8. Swine-Flu Plans Put E-Learning in the Spotlight

    Science.gov (United States)

    Davis, Michelle R.; Ash, Katie

    2009-01-01

    Last school year, many educators were caught unprepared when schools closed in response to cases of swine flu. This time around, both the federal government and school districts are putting specific online-learning measures in place to get ready for possible closures or waves of teacher and student absences because of a flu outbreak. To prepare…

  9. ‘Tis the Season for Flu Vaccine (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2015-12-10

    Flu season typically runs from late fall through early spring. In this podcast, Dr. Lisa Grohskopf discusses the importance of getting vaccinated against the flu.  Created: 12/10/2015 by MMWR.   Date Released: 12/10/2015.

  10. Flu: A Guide for Parents of Children or Adolescents with Chronic Health Conditions

    Science.gov (United States)

    ... should get a flu shot. If possible, pregnant women should not be the main caregivers of a child with the flu until they recover. When can my child go back to school after being sick? Usually, your child should stay home for at least 24 hours after the fever ...

  11. Colds and flu – an overview of the management | Ismail | South ...

    African Journals Online (AJOL)

    The common cold and flu are two very different viruses that share very similar symptoms. The common cold is a self-limiting upper respiratory tract infection and it is caused by the rhinovirus, coronavirus or the adenovirus. It usually resolves within 7-10 days. The flu is caused by the influenza virus and usually presents with ...

  12. Study of Psychological Empowerment in Hospitals of Qom Province, Iran

    Directory of Open Access Journals (Sweden)

    Amir Ashkan Nasiripour

    2013-09-01

    Full Text Available Background and Objectives: It is necessary to study employees’ empowerment components to realize the empowerment process and enhance the organization's capacity to make empowerment atmosphere. Employee's viewpoints and attitudes affect organizational decision making and also their cooperation, partnership, and job satisfaction. Current research was done to study the empowerment components of the employees of the hospitals of Medical University of Qom in year 2011.Methods: This study was done using descriptive cross-sectional method on 365 employees of the hospitals of Qom University of Medical Sciences. The samples were equally selected from the hospitals using a stratified random method. The research tool was a questionnaire consisting of 15 closed-answer questions plus demographic characteristics. Data analysis was done using descriptive and analytical statistics. Independent t-test and analysis of variance was used to determine the intergroup differences. Results: The amount of the hospital employees’ empowerment components with a mean of 3.89 was in good condition. Also, the employees' attitude toward this category was different. There was a significant difference between men and women's attitude toward job meaningfulness. There was no significant association between psychological empowerment indices and age, academic discipline, education level, and the type of unit or ward's activity with confidence interval of 95% (p>0.05. There was also a statistically significant association between employees' work experience and the component of sense of effectiveness.Conclusion: According to the results of this study, the amount of empowerment components in the employees of hospitals of the Qom University of Medical Sciences was in acceptable level. Therefore, it is suggested that university managers pay more attention to employees' capabilities for assigning more responsibilities to them, and make much effort by their programming to make an

  13. The swine flu vaccine, public attitudes, and researcher interpretations: a systematic review of qualitative research.

    Science.gov (United States)

    Carlsen, Benedicte; Glenton, Claire

    2016-06-24

    During pandemics, health authorities may be uncertain about the spread and severity of the disease and the effectiveness and safety of available interventions. This was the case during the swine flu (H1N1) pandemic of 2009-2010, and governments were forced to make decisions despite these uncertainties. While many countries chose to implement wide scale vaccination programmes, few accomplished their vaccination goals. Many research studies aiming to explore barriers and facilitators to vaccine uptake have been conducted in the aftermath of the pandemic, including several qualitative studies. 1. To explore public attitudes to the swine flu vaccine in different countries through a review of qualitative primary studies. 2. To describe and discuss the implications drawn by the primary study authors. Systematic review of qualitative research studies, using a broadly comparative cross case-study approach. Study quality was appraised using an adaptation of the Critical Appraisal Skills Programme (CASP) quality assessment tool. The review indicates that the public had varying opinions about disease risk and prevalence and had concerns about vaccine safety. Most primary study authors concluded that participants were uninformed, and that more information about the disease and the vaccine would have led to an increase in vaccine uptake. We find these conclusions problematic. We suggest instead that people's questions and concerns were legitimate given the uncertainties of the situation at the time and the fact that the authorities did not have the necessary information to convince the public. Our quality assessment of the included studies points to a lack of reflexivity and a lack of information about study context. We suggest that these study weaknesses are tied to primary study authors' lack of acknowledgement of the uncertainties surrounding the disease and the vaccine. While primary study authors suggest that authorities could increase vaccine uptake through increased

  14. Technological aspects of hospital communication challenges: an observational study.

    Science.gov (United States)

    Popovici, Ilinca; Morita, Plinio P; Doran, Diane; Lapinsky, Stephen; Morra, Dante; Shier, Ashleigh; Wu, Robert; Cafazzo, Joseph A

    2015-06-01

    To gain insights into how technological communication tools impact effective communication among clinicians, which is critical for patient safety. This multi-site observational study analyzes inter-clinician communication and interaction with information technology, with a focus on the critical process of patient transfer from the Emergency Department to General Internal Medicine. Mount Sinai Hospital, Sunnybrook Health Sciences Centre and Toronto General Hospital. At least five ED and general internal medicine nurses and physicians directly involved in patient transfers were observed on separate occasions at each institution. N/A. N/A. The study provides insight into clinician workflow, evaluates current hospital communication systems and identifies key issues affecting communication: interruptions, issues with numeric pagers, lack of integrated communication tools, lack of awareness of consultation status, inefficiencies related to the paper chart, unintuitive user interfaces, mixed use of electronic and paper systems and lack of up-to-date contact information. It also identifies design trade-offs to be negotiated: synchronous communication vs. reducing interruptions, notification of patient status vs. reducing interruptions and speed vs. quality of handovers. The issues listed should be considered in the design of new technology for hospital communications. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  15. The impact of communications about swine flu (influenza A H1N1v) on public responses to the outbreak: results from 36 national telephone surveys in the UK.

    Science.gov (United States)

    Rubin, G J; Potts, H W W; Michie, S

    2010-07-01

    To assess the association between levels of worry about the possibility of catching swine flu and the volume of media reporting about it; the role of psychological factors in predicting likely uptake of the swine flu vaccine; and the role of media coverage and advertising in predicting other swine flu-related behaviours. Data from a series of random-digit-dial telephone surveys were analysed. A time series analysis tested the association between levels of worry and the volume of media reporting on the start day of each survey. Cross-sectional regression analyses assessed the relationships between likely vaccine uptake or behaviour and predictor variables. Thirty-six surveys were run at, on average, weekly intervals across the UK between 1 May 2009 and 10 January 2010. Five surveys (run between 14 August and 13 September) were used to assess likely vaccine uptake. Five surveys (1-17 May) provided data relating to other behaviours. Between 1047 and 1173 people aged 16 years or over took part in each survey: 5175 participants provided data about their likely uptake of the swine flu vaccine; 5419 participants provided data relating to other behaviours. All participants were asked to state how worried they were about the possibility of personally catching swine flu. Subsets were asked how likely they were to take up a swine flu vaccination if offered it and whether they had recently carried tissues with them, bought sanitising hand gel, avoided using public transport or had been to see a general practitioner, visited a hospital or called NHS Direct for a flu-related reason. The percentage of 'very' or 'fairly' worried participants fluctuated between 9.6% and 32.9%. This figure was associated with the volume of media reporting, even after adjusting for the changing severity of the outbreak [chi2(1) = 6.6, p = 0.010, coefficient for log-transformed data = 2.6]. However, this effect only occurred during the UK's first summer wave of swine flu. In total, 56.1% of

  16. Selection of medicines in Chilean public hospitals: an exploratory study

    Directory of Open Access Journals (Sweden)

    Collao Juan F

    2013-01-01

    Full Text Available Abstract Background There is a growing interest in high income countries to control expenditure on medicines by improving the rationale for their selection. However, in middle income countries with differing priorities and needs, little attention has been paid to this issue. In this paper we explore the policies and processes for the selection and use of medicines in a group of hospitals in Chile, a middle income country which has recently joined the OECD. Methods A combination of qualitative and quantitative methods was used. A national survey questionnaire was distributed to investigate the role and operation of PTCs (Pharmacy and Therapeutics Committees. Interviews were conducted with key actors in the selection of medicines in large urban public hospitals. Results The national survey had an overall response rate of 42% (83 out of 196, whilst 7 out of 14 hospitals participated in the qualitative study. High complexity hospitals are large urban hospitals; all of which claim to have a working PTC. The pharmacy offices are mainly involved in dispensing medicines with little involvement in clinical duties. The interviews conducted suggest that the formulary of all the hospitals visited is no more than a stock list. PTCs are unable to influence the prescribing practices of doctors. Members do not feel prepared to challenge the opinions of specialists requesting a certain drug, and decisions are based primarily on costs. The inclusion of medicines in the clinical practice of hospitals is as a result of doctors bypassing the PTC and requesting the purchase of exceptional items, some of which are included in the formulary if they are widely used. Conclusions There is an urgent need to develop medicine policies in hospitals in Chile. The procedures used to purchase medicines need to be revised. Central guidance for PTCs could help ensure a more rational use of medicines. PTCs need to be empowered to design formularies which cover all the clinical

  17. Selection of medicines in Chilean public hospitals: an exploratory study.

    Science.gov (United States)

    Collao, Juan F; Smith, Felicity; Barber, Nick

    2013-01-07

    There is a growing interest in high income countries to control expenditure on medicines by improving the rationale for their selection. However, in middle income countries with differing priorities and needs, little attention has been paid to this issue. In this paper we explore the policies and processes for the selection and use of medicines in a group of hospitals in Chile, a middle income country which has recently joined the OECD. A combination of qualitative and quantitative methods was used. A national survey questionnaire was distributed to investigate the role and operation of PTCs (Pharmacy and Therapeutics Committees). Interviews were conducted with key actors in the selection of medicines in large urban public hospitals. The national survey had an overall response rate of 42% (83 out of 196), whilst 7 out of 14 hospitals participated in the qualitative study. High complexity hospitals are large urban hospitals; all of which claim to have a working PTC. The pharmacy offices are mainly involved in dispensing medicines with little involvement in clinical duties.The interviews conducted suggest that the formulary of all the hospitals visited is no more than a stock list. PTCs are unable to influence the prescribing practices of doctors. Members do not feel prepared to challenge the opinions of specialists requesting a certain drug, and decisions are based primarily on costs. The inclusion of medicines in the clinical practice of hospitals is as a result of doctors bypassing the PTC and requesting the purchase of exceptional items, some of which are included in the formulary if they are widely used. There is an urgent need to develop medicine policies in hospitals in Chile. The procedures used to purchase medicines need to be revised. Central guidance for PTCs could help ensure a more rational use of medicines. PTCs need to be empowered to design formularies which cover all the clinical needs of doctors, training members in the analysis of scientific

  18. Influenza vaccine effectiveness among healthcare workers in comparison to hospitalized patients: A 2004-2009 case-test, negative-control, prospective study

    Science.gov (United States)

    Vanhems, P; Baghdadi, Y; Roche, S; Bénet, T; Regis, C; Lina, B; Robert, O; Voirin, N; Ecochard, R; Amour, S

    2016-01-01

    The objective of this study was to calculate Vaccine Effectiveness (VE) in healthcare workers (HCW) and to compare VE between patients and HCW. A case-control investigation based on the prospective study was conducted between 2004 and 2009 in a teaching hospital. All HCW with influenza-like illness (ILI) from participating units (n = 24) were included, and vaccination status was characterized by interview. A total of 150 HCW presented ILI; 130 (87%) were female, 27 (18%) were positive for influenza, and 42 (28%) were vaccinated. Adjusted VE was 89% (95% CI 39 to 98). Among patients, adjusted VE was 42% (95% CI −39 to 76). The difference of VE (VEhcw - VEpat) was 46.15% (95% CI 2.41 to 144). The VE ratio (VEhcw / VEpat) was 2.09 (95% CI −1.60 to 134.17). Influenza VE differed between HCW and patients when the flu season was taken into account. This finding confirms the major impact of host determinants on influenza VE. PMID:26327520

  19. Handgrip strength predicts functional decline at discharge in hospitalized male elderly: a hospital cohort study.

    Directory of Open Access Journals (Sweden)

    Carmen García-Peña

    Full Text Available Functional decline after hospitalization is a common adverse outcome in elderly. An easy to use, reproducible and accurate tool to identify those at risk would aid focusing interventions in those at higher risk. Handgrip strength has been shown to predict adverse outcomes in other settings. The aim of this study was to determine if handgrip strength measured upon admission to an acute care facility would predict functional decline (either incident or worsening of preexisting at discharge among older Mexican, stratified by gender. In addition, cutoff points as a function of specificity would be determined. A cohort study was conducted in two hospitals in Mexico City. The primary endpoint was functional decline on discharge, defined as a 30-point reduction in the Barthel Index score from that of the baseline score. Handgrip strength along with other variables was measured at initial assessment, including: instrumental activities of daily living, cognition, depressive symptoms, delirium, hospitalization length and quality of life. All analyses were stratified by gender. Logistic regression to test independent association between handgrip strength and functional decline was performed, along with estimation of handgrip strength test values (specificity, sensitivity, area under the curve, etc.. A total of 223 patients admitted to an acute care facility between 2007 and 2009 were recruited. A total of 55 patients (24.7% had functional decline, 23.46% in male and 25.6% in women. Multivariate analysis showed that only males with low handgrip strength had an increased risk of functional decline at discharge (OR 0.88, 95% CI 0.79-0.98, p = 0.01, with a specificity of 91.3% and a cutoff point of 20.65 kg for handgrip strength. Females had not a significant association between handgrip strength and functional decline. Measurement of handgrip strength on admission to acute care facilities may identify male elderly patients at risk of having functional decline

  20. Handgrip Strength Predicts Functional Decline at Discharge in Hospitalized Male Elderly: A Hospital Cohort Study

    Science.gov (United States)

    García-Peña, Carmen; García-Fabela, Luis C.; Gutiérrez-Robledo, Luis M.; García-González, Jose J.; Arango-Lopera, Victoria E.; Pérez-Zepeda, Mario U.

    2013-01-01

    Functional decline after hospitalization is a common adverse outcome in elderly. An easy to use, reproducible and accurate tool to identify those at risk would aid focusing interventions in those at higher risk. Handgrip strength has been shown to predict adverse outcomes in other settings. The aim of this study was to determine if handgrip strength measured upon admission to an acute care facility would predict functional decline (either incident or worsening of preexisting) at discharge among older Mexican, stratified by gender. In addition, cutoff points as a function of specificity would be determined. A cohort study was conducted in two hospitals in Mexico City. The primary endpoint was functional decline on discharge, defined as a 30-point reduction in the Barthel Index score from that of the baseline score. Handgrip strength along with other variables was measured at initial assessment, including: instrumental activities of daily living, cognition, depressive symptoms, delirium, hospitalization length and quality of life. All analyses were stratified by gender. Logistic regression to test independent association between handgrip strength and functional decline was performed, along with estimation of handgrip strength test values (specificity, sensitivity, area under the curve, etc.). A total of 223 patients admitted to an acute care facility between 2007 and 2009 were recruited. A total of 55 patients (24.7%) had functional decline, 23.46% in male and 25.6% in women. Multivariate analysis showed that only males with low handgrip strength had an increased risk of functional decline at discharge (OR 0.88, 95% CI 0.79–0.98, p = 0.01), with a specificity of 91.3% and a cutoff point of 20.65 kg for handgrip strength. Females had not a significant association between handgrip strength and functional decline. Measurement of handgrip strength on admission to acute care facilities may identify male elderly patients at risk of having functional decline, and

  1. Low-birth-weight babies among hospital deliveries in Nepal: a hospital-based study

    Directory of Open Access Journals (Sweden)

    Koirala AK

    2015-06-01

    Full Text Available Arun K Koirala,1 Dharma N Bhatta2,3 1Administrative Department, Helping Hands Community Hospital, Chabahil, Kathmandu, 2Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 3Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Background: Birth weight is an important indicator of a population’s health and is associated with numerous interrelated factors in the infant, mother, and physical environment. The objective of this study was to assess the proportion of low birth weight and identify the associated factors for low birth weight in a liveborn infant among the women in Morang, Nepal.Methods: A cross-sectional survey was carried out from December 2010 to March 2011 among 255 mothers who gave birth during the study period at the Koshi Zonal Hospital, Nepal. Data were collected using a structured questionnaire with face-to-face interviews. Data were analyzed through logistic regression and presented with crude and adjusted odds ratios (AORs with 95% confidence intervals (CIs.Results: The study showed that the prevalence of low-birth-weight babies was 23.1% (95% CI: 17.9–28.1. The mean (standard deviation age of mothers was 23.23 (4.18 years. The proportion of low birth weight of previous baby was 3.9% (95% CI: 0.1–7.9, and 15.7% (95% CI: 11.5–20.5 of the respondents had preterm delivery. Nearly one-third (36.1%; 95% CI: 26.4–45.6 of the respondents had >2 years’ gap after the previous delivery. Nonformal employment (AOR: 2.14; 95% CI: 0.523–8.74, vegetarian diet (AOR: 1.47; 95% CI: 0.23–9.36, and no rest during pregnancy (AOR: 1.38; 95% CI: 0.41–4.39 were factors more likely to determine low birth weight. However, none of the variables showed a significant association between low birth weight and other dependent variables.Conclusion: Low birth weight is an important factor for perinatal morbidity and mortality and is a common problem in the developing world. The

  2. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  4. Nursing Care Systematization: A Study At A Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Louise Passos Vigolvino Macêdo

    2017-03-01

    Full Text Available Objective: Investigate the understanding of nurses who work at a teaching hospital, in relation to NCS and the nursing process; ascertain facilities/difficulties related to the applicability of the nursing process in that service; and verify the opinions of those professionals for the improvement and/or effectiveness of the nursing process at the hospitalization units of the hospital. Method: Exploratory, descriptive study, with a qualitative approach. The sample consisted of 42 nurses who answered a questionnaire. The empirical material was analyzed and categorized based on the content analysis technique and discussed in the light of the literature. Results: From the participants' discourses, two categories of analysis emerged: 1 understanding of NCS as a tool to organize the Nursing work process and improve the quality of care; and 2 applicability of the nursing process at the various hospitalization units of the institution. Conclusion: The implementation and applicability of that method depend on not only the knowledge and motivation of the nursing professionals, but also on a strategic planning involving management and staff, from the recognition of their importance in order to obtain adherence and effective operationalization in practice. Descriptors: Nursing; Nursing Process; Professional Practice.

  5. The impact of stakeholder involvement in hospital policy decision-making: a study of the hospital's business processes.

    Science.gov (United States)

    Malfait, Simon; Van Hecke, Ann; Hellings, Johan; De Bodt, Griet; Eeckloo, Kristof

    2017-02-01

    In many health care systems, strategies are currently deployed to engage patients and other stakeholders in decisions affecting hospital services. In this paper, a model for stakeholder involvement is presented and evaluated in three Flemish hospitals. In the model, a stakeholder committee advises the hospital's board of directors on themes of strategic importance. To study the internal hospital's decision processes in order to identify the impact of a stakeholder involvement committee on strategic themes in the hospital decision processes. A retrospective analysis of the decision processes was conducted in three hospitals that implemented a stakeholder committee. The analysis consisted of process and outcome evaluation. Fifteen themes were discussed in the stakeholder committees, whereof 11 resulted in a considerable change. None of these were on a strategic level. The theoretical model was not applied as initially developed, but was altered by each hospital. Consequentially, the decision processes differed between the hospitals. Despite alternation of the model, the stakeholder committee showed a meaningful impact in all hospitals on the operational level. As a result of the differences in decision processes, three factors could be identified as facilitators for success: (1) a close interaction with the board of executives, (2) the inclusion of themes with a more practical and patient-oriented nature, and (3) the elaboration of decisions on lower echelons of the organization. To effectively influence the organization's public accountability, hospitals should involve stakeholders in the decision-making process of the organization. The model of a stakeholder committee was not applied as initially developed and did not affect the strategic decision-making processes in the involved hospitals. Results show only impact at the operational level in the participating hospitals. More research is needed connecting stakeholder involvement with hospital governance.

  6. A comparative study of ICU patient diaries vs. hospital charts

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Christensen, Doris

    2010-01-01

    Intensive care survivors often suffer from memory disorders, and some go on to develop anxiety, depression, and posttraumatic stress. Since the 1980s nurses have written diaries for intensive care patients to help them understand their illness and come to terms with their experiences after...... discharge. The central question we posed in this study was: Why do nurses write diaries in addition to conventional charting in the medical record? To answer this question, we compared intensive care diaries and hospital charts using textual analysis and narrative theory. The aims of our study were...... to compare patient diaries and hospital charts to explore (a) what each documentation instrument has to offer patients in their quest to make sense of their illness, and (b) why it is worthwhile for nurses to sustain the practice of writing diaries. The study findings show that the diary is coherent...

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  8. Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization.

    Science.gov (United States)

    Barreto, Maynara Fernanda Carvalho; Dellaroza, Mara Solange Gomes; Kerbauy, Gilselena; Grion, Cintia Magalhães Carvalho

    2016-04-01

    To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients. Estimar o custo da internação de pacientes com sepse grave ou choque séptico admitidos ou diagnosticados no setor de Urgências e Emergências de um hospital universitário e seguidos até o desfecho clínico. Estudo epidemiológico, prospectivo e observacional, realizado em um hospital público do sul do Brasil, no período de 1 ano (agosto de 2013 a agosto de 2014). A coleta dos dados clínico-epidemiológicos utilizou fichas de notificação de sepse, prontuários e dados do setor de custos. Foi realizada análise de tendência central, dispersão e quartis dos custos das internações. Amostra composta por 95 pacientes que totalizaram elevado custo da internação (R$ 3.692.421,00), com média de R$ 38.867,60 por paciente. Mais da metade do valor total do tratamento da sepse (R$ 2.215.773,50) destinou-se a pacientes que evoluíram a

  9. A perspective study on green cleaning for Malaysian public hospital

    Science.gov (United States)

    Ramli, N. A.; Zawawi, E. M.; Arif, N. R. M.; Mahbob, N. S.; Sulaiman, Z.; Zainol, N. N.

    2018-02-01

    Cleaning being a major contributor to the operations and maintenance expenditure and also Indoor Environmental Quality (IEQ) issues. Improper and ineffective cleaning can harm the environment and poses greatest risk to health. The use of traditional cleaning products presents a variety of human health and ecological concerns; and may contribute to poor IEQ. As an effort to reduce the issue of operations and maintenance costs and IEQ issues in a building, it is important to establish a green cleaning programme to ensure that the buildings are cleaned in a green way. Numbers of scholars has pointed out the factors which had prevented the green cleaning implementation in hospital buildings. Nonetheless, the significance of these factors has yet to be practically explored in the Malaysian context. Hence, the aim of the paper is to identify the most critical factor that prevents the implementation of green cleaning in Malaysian hospital building. A questionnaire survey and personal communication (i.e. interview) was conducted which involved two groups of respondents. They are the hospital maintenance staff (Cleansing Service Department) and cleaning contractors. Frequency and criticality index calculations have been used to rank these factors according to the level of importance. The result showed that an “unclear components and requirements of green cleaning” indicated as the most critical factor that prevent the implementation of green cleaning in Malaysian hospital building. In the concern for a successful implementation of green cleaning, it is hope that the findings of these studies can be enlightenment to the cleaning contractors as well as the hospital maintenance management team in Malaysia.

  10. CLINICAL STUDY OF APPENDICULAR PERFORATION IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Venkata Anantha Lakshmi Manabala

    2016-06-01

    Full Text Available INTRODUCTION Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. In early 1900s, Ochsner in Chicago and Sherren at the London Hospital were both advocates of conservative treatment in late cases. Appendicular perforation is a serious complication in view of the ensuing peritonitis with the consequent sequelae and morbidity. AIM To study the incidence, morbidity and sequelae of appendicular perforation. MATERIALS & METHODS This is a prospective study done in our hospital where 110 cases of peritonitis due to appendicular perforation were selected for our study. All the cases where peritonitis was due to appendicular perforation at laparotomy were included. The study period was from January 2014 to December 2015. The cases of peritonitis due to other causes like duodenal, gastric, enteric perforation were excluded. Patients with acute abdominal emergency with clinical diagnosis of peritonitis were examined carefully with detailed history and clinical examination. Necessary investigations were done and patients taken up for emergency surgery. CONCLUSIONS Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. Age incidence of appendicular perforation is maximum in the age group of 21–30 years. Next common age group is 31–40 yrs. Incidence is more in males. Male to female ratio is 2.4:1. Pain abdomen, vomiting, fever and anorexia were common symptoms in all the patients. Majority of the patients came late to the hospital accounting for the cause of perforation and subsequent mortality and morbidity.

  11. Hospital nurses' lived experiences of intelligent resilience: a phenomenological study.

    Science.gov (United States)

    Imani, Behzad; Kermanshahi, Sima Mohamad Khan; Vanaki, Zohreh; Kazemnejad Lili, Anoshiravan

    2018-02-15

    The aim of this study was to explore Iranian hospital nurses' lived experiences of intelligent resilience. Nurses do high levels of emotional work when fulfilling patients' and their family members' complex needs. Intelligent resilience can alleviate nurses' stress and enhance their endurance. This study was based on the Husserlian descriptive phenomenology. A purposive sample of ten hospital nurses was drawn from hospitals affiliated with Hamadan University of Medical Sciences, Hamadan, Iran. In-depth semi-structured interviews were held to collect data. The seven-step data analysis approach proposed by Colaizzi was used for the data analysis. In this study, the adherence to consolidated criteria for reporting qualitative guidelines has been followed. The participating hospital nurses' lived experiences of intelligent resilience came into four main themes of patience and wisdom, reverence, situational self-control, and appealing to religiosity. Each of the four main themes included two subthemes which were having peace and wise quietness, reverence for the patients, physicians and nurses, distancing themselves from stressful situations and displacing staff who cause stress, and the nurse's trust in God as well as the patient and his family's trust in God, respectively. Nurses with intelligent resilience are able to bring peace, reverence for others, and situational self-control to stressors thereby providing higher quality of care to their patients. Nurses work in unstable and stressful conditions. The findings of this study provide better understanding about the concept of nurses' intelligent resilience and its indicators and attributes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. CLINICAL STUDY OF APPENDICULAR PERFORATION IN A TERTIARY CARE HOSPITAL

    OpenAIRE

    Venkata Anantha Lakshmi Manabala; Krishna Mohan Narayanrao

    2016-01-01

    INTRODUCTION Acute Appendicitis is the commonest abdominal surgical emergency in young adults all over the world. In early 1900s, Ochsner in Chicago and Sherren at the London Hospital were both advocates of conservative treatment in late cases. Appendicular perforation is a serious complication in view of the ensuing peritonitis with the consequent sequelae and morbidity. AIM To study the incidence, morbidity and sequelae of appendicular perforation. MATERIALS & METHODS ...

  13. Process management in healthcare. Sant Camil Hospital case study

    OpenAIRE

    Sánchez Ruiz, Lidia; Blanco Rojo, Beatriz; Simón, Rosa María

    2013-01-01

    Nowadays due to the crisis, some government measures are aimed at reducing healthcare spending, affecting in some level or another the quality offered. Process management is said to be a useful tool for reducing healthcare costs by improving management without any additional economic investment. That is doing more with the same resources and without reducing the quality offered. In this study an empirical case of a Catalan hospital is presented. Overall, the usefulness of process management i...

  14. Tuberculosis patients hospitalized in the Albert Schweitzer Hospital, Lambaréné, Gabon-a retrospective observational study

    NARCIS (Netherlands)

    Stolp, S. M.; Huson, M. A. M.; Janssen, S.; Beyeme, J. O.; Grobusch, M. P.

    2013-01-01

    Epidemiological data on tuberculosis in Central Africa are limited. We performed a retrospective observational study on clinical characteristics of 719 hospitalized tuberculosis patients in Lambaréné, Gabon. Human immunodeficiency virus (HIV) co-infection rate was high (34%) and in-hospital

  15. Hospital visitors as controls in case-control studies

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    Gulnar Azevedo S Mendonça

    2001-10-01

    Full Text Available OBJECTIVE: Selecting controls is one of the most difficult tasks in the design of case-control studies. Hospital controls may be inadequate and random controls drawn from the base population may be unavailable. The aim was to assess the use of hospital visitors as controls in a case-control study on the association of organochlorinated compounds and other risk factors for breast cancer conducted in the main hospital of the "Instituto Nacional de Câncer" -- INCA (National Cancer Institute in Rio de Janeiro (Brazil. METHODS: The study included 177 incident cases and 377 controls recruited among female visitors. Three different models of control group composition were compared: Model 1, with all selected visitors; Model 2, excluding women visiting relatives with breast cancer; and Model 3, excluding all women visiting relatives with any type of cancer. Odds ratios (OR and 95% confidence intervals were calculated to test the associations. RESULTS: Age-adjusted OR for breast cancer associated with risk factors other than family history of cancer, except smoking and breast size, were similar in the three models. Regarding family history of all cancers, except for breast cancer, there was a decreased risk in Models 1 and 2, while in Model 3 there was an increased risk, but not statistically significant. Family history of breast cancer was a risk factor in Models 2 and 3, but no association was found in Model 1. In multivariate analysis a significant risk of breast cancer was found when there was a family history of breast cancer in Models 2 and 3 but not in Model 1. CONCLUSIONS: These results indicate that while investigating risk factors unrelated to family history of cancer, the use of hospital visitors as controls may be a valid and feasible alternative.

  16. Galvanizing medical students in the administration of influenza vaccines: the Stanford Flu Crew.

    Science.gov (United States)

    Rizal, Rachel E; Mediratta, Rishi P; Xie, James; Kambhampati, Swetha; Hills-Evans, Kelsey; Montacute, Tamara; Zhang, Michael; Zaw, Catherine; He, Jimmy; Sanchez, Magali; Pischel, Lauren

    2015-01-01

    Many national organizations call for medical students to receive more public health education in medical school. Nonetheless, limited evidence exists about successful servicelearning programs that administer preventive health services in nonclinical settings. The Flu Crew program, started in 2001 at the Stanford University School of Medicine, provides preclinical medical students with opportunities to administer influenza immunizations in the local community. Medical students consider Flu Crew to be an important part of their medical education that cannot be learned in the classroom. Through delivering vaccines to where people live, eat, work, and pray, Flu Crew teaches medical students about patient care, preventive medicine, and population health needs. Additionally, Flu Crew allows students to work with several partners in the community in order to understand how various stakeholders improve the delivery of population health services. Flu Crew teaches students how to address common vaccination myths and provides insights into implementing public health interventions. This article describes the Stanford Flu Crew curriculum, outlines the planning needed to organize immunization events, shares findings from medical students' attitudes about population health, highlights the program's outcomes, and summarizes the lessons learned. This article suggests that Flu Crew is an example of one viable service-learning modality that supports influenza vaccinations in nonclinical settings while simultaneously benefiting future clinicians.

  17. Application of the FluEgg model to predict transport of Asian carp eggs in the Saint Joseph River (Great Lakes tributary)

    Science.gov (United States)

    Garcia, Tatiana; Murphy, Elizabeth A.; Jackson, P. Ryan; Garcia, Marcelo H.

    2015-01-01

    The Fluvial Egg Drift Simulator (FluEgg) is a three-dimensional Lagrangian model that simulates the movement and development of Asian carp eggs until hatching based on the physical characteristics of the flow field and the physical and biological characteristics of the eggs. This tool provides information concerning egg development and spawning habitat suitability including: egg plume location, egg vertical and travel time distribution, and egg-hatching risk. A case study of the simulation of Asian carp eggs in the Lower Saint Joseph River, a tributary of Lake Michigan, is presented. The river hydrodynamic input for FluEgg was generated in two ways — using hydroacoustic data and using HEC-RAS model data. The HEC-RAS model hydrodynamic input data were used to simulate 52 scenarios covering a broad range of flows and water temperatures with the eggs at risk of hatching ranging from 0 to 93% depending on river conditions. FluEgg simulations depict the highest percentage of eggs at risk of hatching occurs at the lowest discharge and at peak water temperatures. Analysis of these scenarios illustrates how the interactive relation among river length, hydrodynamics, and water temperature influence egg transport and hatching risk. An improved version of FluEgg, which more realistically simulates dispersion and egg development, is presented. Also presented is a graphical user interface that facilitates the use of FluEgg and provides a set of post-processing analysis tools to support management decision-making regarding the prevention and control of Asian carp reproduction in rivers with or without Asian carp populations.

  18. Prediction (early recognition) of emerging flu strain clusters

    Science.gov (United States)

    Li, X.; Phillips, J. C.

    2017-08-01

    Early detection of incipient dominant influenza strains is one of the key steps in the design and manufacture of an effective annual influenza vaccine. Here we report the most current results for pandemic H3N2 flu vaccine design. A 2006 model of dimensional reduction (compaction) of viral mutational complexity derives two-dimensional Cartesian mutational maps (2DMM) that exhibit an emergent dominant strain as a small and distinct cluster of as few as 10 strains. We show that recent extensions of this model can detect incipient strains one year or more in advance of their dominance in the human population. Our structural interpretation of our unexpectedly rich 2DMM involves sialic acid, and is based on nearly 6000 strains in a series of recent 3-year time windows. Vaccine effectiveness is predicted best by analyzing dominant mutational epitopes.

  19. Health promoting hospitals: a study on educational hospitals of Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Atefeh Afshari

    2016-03-01

    Conclusion: It seems that some of the health promoting hospitals (HPS duties carried out by hospitals. So, to improve the quality of health services, it seems useful to encourage policymakers and health service managers to create coherent policies and guidelines in HPS.

  20. Swine Flu: Knowledge, Attitude, and Practices Survey of Medical and Dental Students of Karachi.

    Science.gov (United States)

    Hasan, Fariha; Khan, Mohammad O; Ali, Mukarram

    2018-01-09

    Introduction Pakistan is extremely susceptible to an influenza outbreak, as it shares borders with the most affected countries, namely China and India. The medical and dental students come into direct contact with the affected population and should be aware of the risk factors and signs and symptoms pertaining to swine influenza virus (SIV). Hence, this survey was conducted to assess the knowledge, perceptions and self-care practices of the medical and dental students with regards to this pandemic. Methods A descriptive, cross-sectional study was conducted to evaluate the swine flu-related knowledge, attitudes and practices of the medical and dental students at various institutions in Karachi, Pakistan. We approached 613 students that were available on the dates of this survey, keeping a medical to dental student ratio of 75:25. All students from first to final year comprised of the study population, and no internists or medical personnel were included. The questionnaire was divided into three sections, namely knowledge, attitudes and, practices. All questions were based on a multiple choice format. The data were entered and interpreted using the IBM Statistical Package for the Social Sciences 23.0 (IBM Corp., Armonk, New York). Results The majority of the students were aware that the swine flu is a transmittable disease (n=485, 80.8%). Most students identified the signs and symptoms correctly; however, diarrhea (15.5%) and vomiting (32.2%) were the least correct answers (n=93, n=193 respectively). Most of the preventative measures were reported accurately by the participants. Despite this, only 15.5% students (n=93) reported the use of a facemask when suffering from fever, cough and a runny nose. Conclusion There is a dire need for the routine integration of the awareness and management programs in the medical and dental schools. There exists a gap between the policy and practice, and it is high time we bridge the divide. The students should also be vaccinated

  1. Workarounds to hospital electronic prescribing systems: a qualitative study in English hospitals.

    Science.gov (United States)

    Cresswell, Kathrin M; Mozaffar, Hajar; Lee, Lisa; Williams, Robin; Sheikh, Aziz

    2017-07-01

    Concerns with the usability of electronic prescribing (ePrescribing) systems can lead to the development of workarounds by users. To investigate the types of workarounds users employed, the underlying reasons offered and implications for care provision and patient safety. We collected a large qualitative data set, comprising interviews, observations and project documents, as part of an evaluation of ePrescribing systems in five English hospitals, which we conceptualised as case studies. Data were collected at up to three different time points throughout implementation and adoption. Thematic analysis involving deductive and inductive approaches was facilitated by NVivo 10. Our data set consisted of 173 interviews, 24 rounds of observation and 17 documents. Participating hospitals were at various stages of implementing a range of systems with differing functionalities. We identified two types of workarounds: informal and formal. The former were informal practices employed by users not approved by management, which were introduced because of perceived changes to professional roles, issues with system usability and performance and challenges relating to the inaccessibility of hardware. The latter were formalised practices that were promoted by management and occurred when systems posed threats to patient safety and organisational functioning. Both types of workarounds involved using paper and other software systems as intermediaries, which often created new risks relating to a lack of efficient transfer of real-time information between different users. Assessing formal and informal workarounds employed by users should be part of routine organisational implementation strategies of major health information technology initiatives. Workarounds can create new risks and present new opportunities for improvement in system design and integration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  2. Hospital waste management status in Iran: a case study in the teaching hospitals of Iran University of Medical Sciences.

    Science.gov (United States)

    Farzadkia, Mahdi; Moradi, Arash; Mohammadi, Mojtaba Shah; Jorfi, Sahand

    2009-06-01

    Hospital waste materials pose a wide variety of health and safety hazards for patients and healthcare workers. Many of hospitals in Iran have neither a satisfactory waste disposal system nor a waste management and disposal policy. The main objective of this research was to investigate the solid waste management in the eight teaching hospitals of Iran University of Medical Sciences. In this cross-sectional study, the main stages of hospital waste management including generation, separation, collection, storage, and disposal of waste materials were assessed in these hospitals, located in Tehran city. The measurement was conducted through a questionnaire and direct observation by researchers. The data obtained was converted to a quantitative measure to evaluate the different management components. The results showed that the waste generation rate was 2.5 to 3.01 kg bed(-1) day(-1), which included 85 to 90% of domestic waste and 10 to 15% of infectious waste. The lack of separation between hazardous and non-hazardous waste, an absence of the necessary rules and regulations applying to the collection of waste from hospital wards and on-site transport to a temporary storage location, a lack of proper waste treatment, and disposal of hospital waste along with municipal garbage, were the main findings. In order to improve the existing conditions, some extensive research to assess the present situation in the hospitals of Iran, the compilation of rules and establishment of standards and effective training for the personnel are actions that are recommended.

  3. A hospital based autopsy study of 50 cases at combined military hospital (cmh), sialkot

    International Nuclear Information System (INIS)

    Asif, N.

    2014-01-01

    To analyze the pattern of deaths on autopsy carried out on Armed Forces personnel in CMH Sialkot. Study Design: Retrospective analytical study Place and Duration of Study: Combined Military Hospital Sialkot (CMH), from 2009 to 2012 Materials and Methods: In a total of fifty (50) cases detailed postmortems were carried out and gross features on external examination and different systemic examinations were recorded. Histopathology of various organs was done in all cases. Chemical and toxicological examination of various abdominal viscera was carried out in all sudden and suspicious deaths. Results: Ischemic Heart Disease (IHD) was most common cause of death (38%) followed by road traffic accidents (14%) and electrocution (8%). Sudden adult death syndrome accounted for 4 cases of deaths. Other causes were drowning, cerebral malaria, heat stroke, gunshot wounds, myocarditis, brain hemorrhage, meningitis and diabetic ketoacidosis. Most of these cases were young soldiers (n=30) followed by Non-Commissioned Officers (n=17). Conclusion: A large number of our young soldiers dying of heart problems is an alarming situation. Awareness among the troops of various risk factors is most important. Precautionary measures against preventable causes should be taken. (author)

  4. Are there any differences in clinical and laboratory findings on admission between H1N1 positive and negative patients with flu-like symptoms?

    Directory of Open Access Journals (Sweden)

    Zarogoulidis Kostas

    2011-01-01

    Full Text Available Abstract Background The World Health Organization alert for the H1N1 influenza pandemic led to the implementation of certain measures regarding admission of patients with flu-like symptoms. All these instructions were adopted by the Greek National Health System. The aim of this study was to retrospectively examine the characteristics of all subjects admitted to the Unit of Infectious Diseases with symptoms indicating H1N1 infection, and to identify any differences between H1N1 positive or negative patients. Patients from the ED (emergency department with flu-like symptoms (sore throat, cough, rhinorhea, or nasal congestion and fever >37.5°C were admitted in the Unit of Infectious diseases and gave pharyngeal or nasopharyngeal swabs. Swabs were tested with real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR. Findings Patients were divided into two groups. Group A comprised 33 H1N1 positive patients and Group B (control group comprised of 27 H1N1 negative patients. The two groups did not differ in terms of patient age, co-morbidities, length of hospitalization, temperature elevation, hypoxemia, as well as renal and liver function. There were also no significant differences in severity on admission. C-reactive protein (CRP (mean 12.8 vs. 5.74 and white blood count (WBC (mean 10.528 vs. 7.114 were significantly higher in group B than in group A upon admission. Obesity was noted in 8 patients of Group A (mean 31.67 and 14 patients of Group B (mean 37.78. Body mass index (BMI was lower in H1N1 positive than in H1N1 negative patients (mean 31.67 vs. 37.78, respectively; p = 0.009. Conclusions The majority of patients in both groups were young male adults. CRP, WBC and BMI were higher among H1N1 negative patients. Finally, clinical course of patients in both groups was mild and uneventful.

  5. Cervical pap smear- A prospective study in a tertiary hospital

    Directory of Open Access Journals (Sweden)

    S Pudasaini

    2015-09-01

    Full Text Available Background: Cervical cancer is a leading cause of mortality and morbidity among women worldwide and most common gynaecological cancer in developing countries. Papanicolaou smear is a simple and cost effective screening test for cervical cancer. The aim of this study is to evaluate and interpret the cervical pap smear cytology in a tertiary hospital. The interpretation and reporting of the pap smear is based on 2001Bethesda system.Materials and methods: This is a prospective study conducted in a tertiary hospital, Nepal Medical College over a period of two and a half years (January 2013 to June 2015. All cervical pap smears received in the department of Pathology in the study period were included.Results: A total of 4160 cervical pap smears were reported in the study period. Majority of the cases were Negative for Intraepithelial lesion or malignancy (87.9%. Bacterial vaginosis, atrophy and reactive cellular changes associated with inflammation were seen in 5.3%, 2.4% and 1.5% cases respectively.   Epithelial cell abnormalities (0.5% include Atypical squamous cells of undetermined significance, Low grade squamous intraepithelial lesion and High grade intraepithelial lesion. 88% of Low grade squamous intraepithelial lesion was seen in reproductive age group (20-45 years.Conclusion: Cervical cancer is the most common gynaecological cancer in the developing countries. Pap smear is the simple and cost effective screening tool to detect pre invasive cervical epithelial lesions.

  6. Productivity growth, case mix and optimal size of hospitals. A 16-year study of the Norwegian hospital sector.

    Science.gov (United States)

    Anthun, Kjartan Sarheim; Kittelsen, Sverre Andreas Campbell; Magnussen, Jon

    2017-04-01

    This paper analyses productivity growth in the Norwegian hospital sector over a period of 16 years, 1999-2014. This period was characterized by a large ownership reform with subsequent hospital reorganizations and mergers. We describe how technological change, technical productivity, scale efficiency and the estimated optimal size of hospitals have evolved during this period. Hospital admissions were grouped into diagnosis-related groups using a fixed-grouper logic. Four composite outputs were defined and inputs were measured as operating costs. Productivity and efficiency were estimated with bootstrapped data envelopment analyses. Mean productivity increased by 24.6% points from 1999 to 2014, an average annual change of 1.5%. There was a substantial growth in productivity and hospital size following the ownership reform. After the reform (2003-2014), average annual growth was case mix between hospitals, and thus provides a framework for future studies. The study adds to the discussion on optimal hospital size. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Study of cardiovascular diseases in hospitalized AECOPD patients

    Directory of Open Access Journals (Sweden)

    Mohamed El-Shabrawy

    2017-01-01

    Conclusions: The prevalence of cardiovascular diseases (CVD in patients hospitalized for COPD in Zagazig University Hospital was high. Age, sex and CVD trends, as well as life style changes, should be considered when prevention and control strategies are formulated.

  8. Organizational entrepreneurship and administrators of hospitals: case study of Iran.

    Science.gov (United States)

    Raadabadi, Mehdi; Fayaz-Bakhsh, Ahmad; Nazari, Aslan; Mousavi, Seyed Masood; Fayaz-Bakhsh, Mohammadali

    2014-04-11

    Due to rapid changes of technology and scientific advances in health systems and need for fast planning in health care, entrepreneurial spirit among employers and employees is a crucial element. According to the field of entrepreneurship research has not been solved and where learning and innovation for healthcare organizations due to the nature of the work required. This study aims to examine the entrepreneurial activities within the hospitals affiliated to Tehran University of Medical Sciences, Iran. To achieve the aim of the study, a questionnaire containing 29 items regarding the areas of innovation, creative behavior, flexibility, empowerment, rewarding systems and the management support was distributed among the hospitals' managers. Establishment of a culture of entrepreneurship in healthcare organizations led to the development unit controlled, changing the culture of the hospital. The analysis of the data showed that the majority of the managers agreed with all five areas of entrepreneurship namely the existence of innovation and innovative behavior, flexibility, decision making, rewarding and encouraging system, as well as management supportive system of personnel's new ideas. In fact, the managers generally had positive attitude towards entrepreneurship in their organizations The Pearson correlation test also showed that there is a significant relationship between the areas of entrepreneurship and the managers' age as well as their working experience (P<0.05). Entrepreneurial activities in healthcare can be improved through providing a suitable environment, adjusting reward and encouragement systems, giving more authority to subordinates, promoting awareness and education, and mobilizing managers to attract appropriate opportunities for organization. Further active involvement of employees, more stable in front of changes and increased ability managers to capture opportunities in domestic and foreign situation.

  9. Implementing RFID in a hospital library: a scoping study.

    Science.gov (United States)

    Norwood, Joseph; Skinner, Ben

    2012-06-01

    This article discusses a scoping study on implementing radio frequency identification device (RFID) in a hospital library context, conducted by Joseph Norwood for his MA dissertation at the University of Brighton. The study was carried out during the summer of 2011 to support possible RFID implementation at the Brighton and Sussex University Hospitals (BSUH) Trust, and the library staff were able to use the findings to good effect to create a business plan. This article also acts as the template for the new Dissertations into Practice feature, which was introduced in the March issue (Marshall, A. Health Information and Libraries Journal 2012, 29, 72). The dissertation highlighted here is very practical in nature and had immediate and quantifiable benefits for the Trust library. Future feature articles are likely to reflect the range of health-related dissertation topics which students choose and will include studies on user information behaviour, information services related to mental health and well-being, as well as the impact of technology on health-related library or information services.AM. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  10. Recognition and Ranking Critical Success Factors of Business Intelligence in Hospitals -- Case Study: Hasheminejad Hospital

    OpenAIRE

    Naderinejad, Marjan; Tarokh, Mohammad Jafar; Poorebrahimi, Alireza

    2014-01-01

    Business Intelligence, not as a tool of a product but as a new approach is propounded in organizations to make tough decisions in business as shortly as possible. Hospital managers often need business intelligence in their fiscal, operational, and clinical reports and indices. The main goal of recognition and ranking CSF is implementation of a business intelligent system in hospitals to increase success factor of application of business intelligence in health and treatment sector. This paper ...

  11. Bird Flu Fears: Is There a Better Way to Develop Drugs?

    OpenAIRE

    Dean Baker

    2005-01-01

    Government-granted patent monopolies have limited the ability to produce and stockpile large quantities of the drugs deemed most effective in treating the Avian Flu. This report examines alternative mechanisms for financing the development of pharmaceutical products.

  12. Time To Talk About Natural Products for the Flu and Colds: What Does the Science Say?

    Science.gov (United States)

    ... What Does the Science Say? Share: It’s that time of year again— cold and flu season. Each ... effects of taking probiotics for long periods of time. Most people may be able to use probiotics ...

  13. Health and social care workers: don't risk flu infection

    OpenAIRE

    Public Health Agency

    2015-01-01

    This leaflet explains why health and social care workers should receive the new flu vaccine. It provides a range of information, including how to get vaccinated, how the vaccine works, how effective it is and possible side effects.

  14. Influenza (flu) vaccine (Inactivated or Recombinant): What you need to know

    Science.gov (United States)

    ... taken in its entirety from the CDC Inactivated Influenza Vaccine Information Statement (VIS) www.cdc.gov/vaccines/hcp/vis/vis-statements/flu.html CDC review information for Inactivated Influenza VIS: ...

  15. Descriptive Study: Anesthesia for Awake Craniotomy in Siriraj Hospital

    Directory of Open Access Journals (Sweden)

    Saipin Muangman

    2016-03-01

    Full Text Available Background: The purpose of awake craniotomy is to test neurological functions to ensure accurate lesion surgery and lessen postoperative neurological complications. There are several methods to provide anesthesia during awake craniotomy including local anesthesia infiltration, local anesthesia plus conscious sedation, general anesthesia and wake-up during surgery and sleep again (asleep-awake-asleep or AAA. Each method has its pro and con with different complications. In Siriraj Hospital, there was no prior study of anesthetic techniques and complications of awake craniotomy. Methods: The retrospective descriptive study of awake craniotomy was carried out with 60 patients in Siriraj Hospital 2007-2011. Results: There were 35 males (58.3% with average age 40.7±12.6 years and weight 64.2±12 kilograms undergoing awake craniotomy. Twenty patients (33.3% presented with seizure before surgery. Most diagnosis was oligodendroglioma in 25 patients (41.7%, mostly at the frontal lobe (44 patients or 73.3%. The most common position was supine(46patientsor76.7%. ICU lengthof stay was1.4±0.9(0,6days. Hospital stay was11.1±9 (4,55days. Total intravenous anesthesia (TIVA was mostlyused(52patientsor90% while18patients (30% received scalp block. Most patients (85% did not require nasal airways while 8 patients (13.3% did, and only 1 patient (1.7% required laryngeal mask airway (LMA to help open up air passage. The drugs used during asleep1 and asleep2 were propofol together with dexmedetomidine and fentanyl in 34 patients (56.7% and 23 patients (38.3%, respectively. Whilebeingawake (15patientsor20%,dexmedetomidine and/or fentanyl were administered. Complications during anesthesia were hypertension (33.3%, hypotension (26.7%, upper airway obstruction(23.3%, bradycardia (15%, tachycardia (10%, seizure (1.7% andnausea (1.7%. Conclusion: The most common anesthesia method inSiriraj Hospital for awake craniotomy was TIVA (90%, using propofol together with

  16. Hospital Acquired Thrombosis (HAT) Prevention in an Acute Hospital; A Single Centre Cross-Sectional Study

    LENUS (Irish Health Repository)

    Khan, MI

    2017-04-01

    Evidence based guidelines are effective in reducing incidence of venous thromboembolism (VTE) which is associated with morbidly, mortality and economic burden. This study aimed to identify the proportion of inpatients who had a VTE risk assessment (RA) performed and who received thromboprophylaxis (TP), in Cork University Hospital. There was no structured RA tool at the time; information was obtained from medical and drug charts to ascertain if a RA was performed. Patients were then RA by researchers and stratified as per NICE guidelines and the proportion who received TP was calculated. One thousand and nineteen inpatients were screened. Risk was documented in 24% of cases. TP was prescribed in 43.2% of inpatients. Following application of a RA tool >80% were at high risk of VTE with low risk of bleeding with TP prescription in 46.3% of inpatients. A national collaborative effort should be encouraged to develop a standardized approach for safe RA of inpatients and prescription of TP for prevention of HAT

  17. Taiwanese women's experiences of hospital midwifery care: a phenomenological study.

    Science.gov (United States)

    Kuo, Su-Chen; Wu, Cheng Jing; Mu, Pei-Fan

    2010-08-01

    to explore women's experiences in interaction with their midwives during their antenatal checks and during labour. a qualitative study using a phenomenological approach. Data were collected via tape-recorded interviews. All interviews were transcribed verbatim. Data were analysed using Colaizzi's method for data analysis. the homes of the study participants in the district of a Taipei (Taiwan) teaching hospital. a purposive sample of 11 Taiwanese women, one primipara, and 10 multiparae, who were one to three months post-childbirth at the time of interview. five major themes revealed the essence of women's experiences of their interaction with a midwife during pregnancy and childbirth: (1) being respected, (2) being accompanied, (3) trust, (4) being satisfied, and (5) professional competence. the women recognised the service model of the midwife; they treasured their mutual relationships and the benefits that women derived from midwifery care during childbirth. In Taiwan, the government is mandated to offer midwifery models of care in hospitals, and to allow women to choose different types of care provider. an awareness of women's experiences will help identify the caring behaviours as recognised by the women and may help health-care professionals provide better support and care for women during the pregnancy and childbirth periods. These findings can serve as references for future midwifery practice models and improvements in quality of care. Crown Copyright 2008. Published by Elsevier Ltd. All rights reserved.

  18. OSELTAMIVIR APPLICATION AMONG HIV-INFECTED CHILDREN, SUFFERING FROM THE FLU

    Directory of Open Access Journals (Sweden)

    Yu.A. Fomin

    2007-01-01

    Full Text Available The article provides the Oseltamivir application experience in flu treatment among HIV-infected children. The researchers showed that Oseltamivir is an effective medication for the given category of patients, reducing duration of the catarrhal syndrome and intoxication signs. The undesirable phenomena related to the medication intake proved to be transient and called for no cancellation of its use.Key words: children, hiv infection, flu, Oseltamivir.

  19. Isoniazid-induced flu-like syndrome: A rare side effect

    Directory of Open Access Journals (Sweden)

    Sudipta Pandit

    2013-01-01

    Full Text Available Drug-induced flu-like syndrome is very rare. It is mainly produced by rifampicin. We report a case of pulmonary tuberculosis (PTB that developed isoniazid-induced flu-like syndrome, but could be cured with a modified regimen replacing isoniazid with levofloxacin. A 10-year-old girl with PTB was treated with isoniazid (H, rifampicin (R, ethambutol (E, and pyrazinamide (Z. She developed features of flu from the sixth day. Symptoms recurred everyday within 1 h of drug ingestion and subsided automatically by next 12 h. After admission, HREZ were continued. She developed symptoms of flu after 1 h of drug ingestion. Antitubercular therapy (ATT was stopped and symptoms subsided automatically. Individual drug was started one by one after three days. Severe symptoms of flu developed after taking isoniazid, while other drugs were tolerated well. Levofloxacin was used as an alternative to isoniazid. She was cured after 6 months of chemotherapy. Isoniazid can possibly cause flu-like syndrome and the treating physician should be aware of this possible side effect when using ATT.

  20. Statistical study on cancer patients of cancer research hospital

    International Nuclear Information System (INIS)

    Shim, Yoon Sang; Choi, Soo Yong; Won, Hyuk; Kim, Kee Hwa

    1991-01-01

    The total number of malignant neoplasms included on this study 7,787 cases(10.4%) among 74,928 cases for 2 years. On sex, females with 57.6% were much more than males with 42.4%. The highest proportion of cancer 50-59 age group. The most frequent primary site among males was found to be stomach with 36.2%, followed by liver(12.3%), lung(12.2%), esophagus(15.5%) and larynx(4.9%). In females, the first order was uterine cervix with 47.3%, followed most common type of morphology of malignant neoplasms was adenocarcinoma(39.0%) in males an squamous cell carcinoma(56.2%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 4.6% for patient with carcinoma-in-situ, 76.3% for patients with localized involvement, 11.6% for patients with regional involvement and 7.5% for patients with distant involvement. Among,the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 19.0% for surgery, 27.7 for radiotherapy and 24.2% for chemotherapy. Among the cancer patients confirmed by medical records, 11.2% was traced more than 5 years. (Author)

  1. The effect of performance-related pay of hospital doctors on hospital behaviour: a case study from Shandong, China

    Directory of Open Access Journals (Sweden)

    Mills Anne

    2005-10-01

    Full Text Available Abstract Background With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors – termed the "bonus" system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary. Methods The primary concerns of this study were to assess the effects of the bonus system on hospital revenue, cost recovery and productivity, and to explore whether various forms of bonus pay were associated with the provision of unnecessary care. The study drew on longitudinal data on revenue and productivity from six panel hospitals, and a detailed record review of 2303 tracer disease patients (1161 appendicitis patients and 1142 pneumonia patients was used to identify unnecessary care. Results The study found that bonus system change over time contributed significantly to the increase in hospital service revenue and hospital cost recovery. There was an increase in unnecessary care and in the probability of admission when the bonus system switched from one with a weaker incentive to increase services to one with a stronger incentive, suggesting that improvement in the financial health of public hospitals was achieved at least in part through the provision of more unnecessary care and drugs and through admitting more patients. Conclusion There was little evidence that the performance-related pay system as designed by the sample of Chinese public hospitals was socially desirable. Hospitals should be monitored more closely

  2. Sexual harassment and its consequences: a study within Turkish hospitals.

    Science.gov (United States)

    Kisa, Adnan; Dziegielewski, Sophia F; Ates, Metin

    2002-01-01

    Sexual harassment remains a universal factor that can affect nursing performance and worker productivity in any type of health care facility. There are few studies in this area that have been conducted in developing countries. To measure the occurrence of sexual harassment, a questionnaire was given to 353 nurses in two different hospitals yielding a response rate of 61%. Overall, the majority of the respondents (n = 157 out of 251) reported that they had been subjected to sexual harassment in the workplace, and the harassment experience was strong enough to affect worker productivity. In addition, many nurses reported the belief that sexual harassment remains a disturbing problem in this developing country that should not be ignored. Based on these findings, implications for policy and further study are suggested.

  3. Hospital implementation of resuscitation guidelines and review of CPR training programmes: a nationwide study.

    Science.gov (United States)

    Schmidt, Anders S; Lauridsen, Kasper G; Adelborg, Kasper; Løfgren, Bo

    2016-06-01

    This study aimed to investigate cardiopulmonary resuscitation (CPR) guideline implementation and CPR training in hospitals. This nationwide study included mandatory resuscitation protocols from each Danish hospital. Protocols were systematically reviewed for adherence to the European Resuscitation Council (ERC) 2010 guidelines and CPR training in each hospital. Data were included from 45 of 47 hospitals. Adherence to the ERC basic life support (BLS) algorithm was 49%, whereas 63 and 58% of hospitals adhered to the recommended chest compression depth and rate. Adherence to the ERC advanced life support (ALS) algorithm was 81%. Hospital BLS course duration was [median (interquartile range)] 2.3 (1.5-2.5) h, whereas ALS course duration was 4.0 (2.5-8.0) h. Implementation of ERC 2010 guidelines on BLS is limited in Danish hospitals 2 years after guideline publication, whereas the majority of hospitals adhere to the ALS algorithm. CPR training differs among hospitals.

  4. Determinants of care outcomes for patients who die in hospital in Ireland: a retrospective study.

    LENUS (Irish Health Repository)

    McKeown, Kieran

    2015-04-18

    More people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008\\/9. The study was undertaken as part of the Irish Hospice Foundation\\'s Hospice Friendly Hospitals Programme (2007-2012).

  5. Innovative medical devices and hospital decision making: a study comparing the views of hospital pharmacists and physicians.

    Science.gov (United States)

    Billaux, Mathilde; Borget, Isabelle; Prognon, Patrice; Pineau, Judith; Martelli, Nicolas

    2016-06-01

    Objectives Many university hospitals have developed local health technology assessment processes to guide informed decisions about new medical devices. However, little is known about stakeholders' perceptions and assessment of innovative devices. Herein, we investigated the perceptions regarding innovative medical devices of their chief users (physicians and surgeons), as well as those of hospital pharmacists, because they are responsible for the purchase and management of sterile medical devices. We noted the evaluation criteria used to assess and select new medical devices and suggestions for improving local health technology assessment processes indicated by the interviewees. Methods We randomly selected 18 physicians and surgeons (nine each) and 18 hospital pharmacists from 18 French university hospitals. Semistructured interviews were conducted between October 2012 and August 2013. Responses were coded separately by two researchers. Results Physicians and surgeons frequently described innovative medical devices as 'new', 'safe' and 'effective', whereas hospital pharmacists focused more on economic considerations and considered real innovative devices to be those for which no equivalent could be found on the market. No significant difference in evaluation criteria was found between these groups of professionals. Finally, hospital pharmacists considered the management of conflicts of interests in local health technology assessment processes to be an issue, whereas physicians and surgeons did not. Conclusions The present study highlights differences in perceptions related to professional affiliation. The findings suggest several ways in which current practices for local health technology assessment in French university hospitals could be improved and studied. What is known about the topic? Hospitals are faced with ever-growing demands for innovative and costly medical devices. To help hospital management deal with technology acquisition issues, hospital

  6. [Dementia friendly care services in general hospitals : Representative results of the general hospital study (GHoSt)].

    Science.gov (United States)

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

    2017-11-06

    Mostly model projects report on special care services and procedures for general hospital patients with cognitive impairment. The objective of this study was to determine the frequency of special care services and procedures in general hospitals on the basis of a representative cross-sectional study. From a list of all general hospitals in southern Germany we randomly selected a specified number of hospitals und somatic wards. The hospitals were visited and all older patients on the selected wards on that day were included in the study. Information about care services and their utilization was collected with standardized instruments. A total of 33 general hospitals and 172 wards participated in the study. The patient sample included 1469 persons over 65 (mean age 78.6 years) and 40% of the patients showed cognitive impairments. The staff reported that the most frequent measures for patients with cognitive impairments concerned patients with wandering behavior (63.1%), efforts to involve the patients' relatives to help with their daily care (60.1%), conducting nonintrusive interviews to identify cognitive impairments (59.9%), allocation to other rooms (58%) and visual aids for place orientation of patients (50.6%). In accordance with earlier studies our results show that other dementia friendly services implemented in pilot projects were rare. The existing special services for patients with cognitive impairment were rarely used by the patients or their relatives. The results demonstrate the urgent need to improve special care services and routines for identification of elderly patients with cognitive impairment and risk of delirium in general hospitals.

  7. Oral manifestations of hospitalized cirrhotics at shaikh zayed hospital, lahore: a pilot study

    International Nuclear Information System (INIS)

    Ijaz, S.; Ijaz, T.Q.; Butt, A.K.

    2006-01-01

    In Pakistan cirrhosis has reached alarming proportions due to spread of HCV and HBV viruses. Some of the oral manifestations of cirrhosis have been found to exhibit geographically variability. There is no research available on the oral health of these patients in Pakistan and their specific oral problems are not known. This study examined a cohort of cirrhotic patients admitted at Shaikh Zayed hospital Lahore to assess their oral health status and needs. Materials and methods: Thirty consecutive patients admitted with diagnosis of cirrhosis were examined for oral health status. Extra oral examination included any visible lesions or abnormalities on the face, head or neck region, lymph node enlargement and TMJ dysfunction. Intra oral examination included measurement of caries (DMFT) and periodontal disease level (CPITN), oral mucosal lesions, prosthetic status and prosthetic needs of the patients. All findings were recorded on the standard WHO oral health survey form. The oral health of this cohort was poor compared to the general population. Xerostomia (20%), papillary atrophy (100%), oral Melanosis (90%), petechieal hemorrhages (26%) and glossitis (53%) were found prevalent in the sample. Two females had oral lichen planus and one of the patients had oral ulceration. DMFT score (Mean=5.7) was not different from national average (Mean=8.02). Periodontal disease was more severe than general population. Less than 21% of the sample wore prostheses and over 50% needed one. TMJ dysfunction was common but fewer patient complained of the condition that the number of patients with clinical signs. Conclusions: Oral health of cirrhotic population is worse than general population and they have significant oral health needs. Further research is required to investigate this relationship. Effective oral health education of patients and physicians is required to reduce the burden of oral disease thus improving quality of life for these patients. (author)

  8. Changes in knowledge and attitudes of hospital environmental services staff: The Researching Effective Approaches to Cleaning in Hospitals (REACH) study.

    Science.gov (United States)

    Mitchell, Brett G; White, Nicole; Farrington, Alison; Allen, Michelle; Page, Katie; Gardner, Anne; Halton, Kate; Riley, Thomas V; Gericke, Christian A; Paterson, David L; Graves, Nicholas; Hall, Lisa

    2018-03-14

    The Researching Effective Approaches to Cleaning in Hospitals (REACH) study tested a multimodal cleaning intervention in Australian hospitals. This article reports findings from a pre/post questionnaire, embedded into the REACH study, that was administered prior to the implementation of the intervention and at the conclusion of the study. A cross-sectional questionnaire, nested within a stepped-wedge trial, was administered. The REACH intervention was a cleaning bundle comprising 5 interdependent components. The questionnaire explored the knowledge, reported practice, attitudes, roles, and perceived organizational support of environmental services staff members in the hospitals participating in the REACH study. Environmental services staff members in 11 participating hospitals completed 616 pre- and 307 post-test questionnaires (n = 923). Increases in knowledge and practice were seen between the pre-and post-test questionnaires. Minimal changes were observed in attitudes regarding the role of cleaning and in perceived organizational support. To our knowledge, this is the first study to report changes in knowledge, attitudes, and perceived organizational support in environmental services staff members, in the context of a large multicenter clinical trial. In this underexplored group of hospital workers, findings suggest that environmental services staff members have a high level of knowledge related to cleaning practices and understand the importance of their role. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  9. Implementation of Advanced Warehouses in a Hospital Environment - Case study

    Science.gov (United States)

    Costa, J.; Sameiro Carvalho, M.; Nobre, A.

    2015-05-01

    In Portugal, there is an increase of costs in the healthcare sector due to several factors such as the aging of the population, the increased demand for health care services and the increasing investment in new technologies. Thus, there is a need to reduce costs, by presenting the effective and efficient management of logistics supply systems with enormous potential to achieve savings in health care organizations without compromising the quality of the provided service, which is a critical factor, in this type of sector. In this research project the implementation of Advanced Warehouses has been studied, in the Hospital de Braga patient care units, based in a mix of replenishment systems approaches: the par level system, the two bin system and the consignment model. The logistics supply process is supported by information technology (IT), allowing a proactive replacement of products, based on the hospital services consumption records. The case study was developed in two patient care units, in order to study the impact of the operation of the three replenishment systems. Results showed that an important inventory holding costs reduction can be achieved in the patient care unit warehouses while increasing the service level and increasing control of incoming and stored materials with less human resources. The main conclusion of this work illustrates the possibility of operating multiple replenishment models, according to the types of materials that healthcare organizations deal with, so that they are able to provide quality health care services at a reduced cost and economically sustainable. The adoption of adequate IT has been shown critical for the success of the project.

  10. Reliability, Validity, and Responsiveness of InFLUenza Patient-Reported Outcome (FLU-PRO©) Scores in Influenza-Positive Patients.

    Science.gov (United States)

    Powers, John H; Bacci, Elizabeth D; Guerrero, M Lourdes; Leidy, Nancy Kline; Stringer, Sonja; Kim, Katherine; Memoli, Matthew J; Han, Alison; Fairchok, Mary P; Chen, Wei-Ju; Arnold, John C; Danaher, Patrick J; Lalani, Tahaniyat; Ridoré, Michelande; Burgess, Timothy H; Millar, Eugene V; Hernández, Andrés; Rodríguez-Zulueta, Patricia; Smolskis, Mary C; Ortega-Gallegos, Hilda; Pett, Sarah; Fischer, William; Gillor, Daniel; Macias, Laura Moreno; DuVal, Anna; Rothman, Richard; Dugas, Andrea; Ruiz-Palacios, Guillermo M

    2018-02-01

    To assess the reliability, validity, and responsiveness of InFLUenza Patient-Reported Outcome (FLU-PRO©) scores for quantifying the presence and severity of influenza symptoms. An observational prospective cohort study of adults (≥18 years) with influenza-like illness in the United States, the United Kingdom, Mexico, and South America was conducted. Participants completed the 37-item draft FLU-PRO daily for up to 14 days. Item-level and factor analyses were used to remove items and determine factor structure. Reliability of the final tool was estimated using Cronbach α and intraclass correlation coefficients (2-day reliability). Convergent and known-groups validity and responsiveness were assessed using global assessments of influenza severity and return to usual health. Of the 536 patients enrolled, 221 influenza-positive subjects comprised the analytical sample. The mean age of the patients was 40.7 years, 60.2% were women, and 59.7% were white. The final 32-item measure has six factors/domains (nose, throat, eyes, chest/respiratory, gastrointestinal, and body/systemic), with a higher order factor representing symptom severity overall (comparative fit index = 0.92; root mean square error of approximation = 0.06). Cronbach α was high (total = 0.92; domain range = 0.71-0.87); test-retest reliability (intraclass correlation coefficient, day 1-day 2) was 0.83 for total scores and 0.57 to 0.79 for domains. Day 1 FLU-PRO domain and total scores were moderately to highly correlated (≥0.30) with Patient Global Rating of Flu Severity (except nose and throat). Consistent with known-groups validity, scores differentiated severity groups on the basis of global rating (total: F = 57.2, P FLU-PRO score improvement by day 7 than did those who did not, suggesting score responsiveness. Results suggest that FLU-PRO scores are reliable, valid, and responsive to change in influenza-positive adults. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes

  11. Ten thousand steps: a pedometer study of junior dentists in a major British teaching hospital and a district general hospital.

    Science.gov (United States)

    Keat, R M; Thomas, M; McKechnie, A

    2017-05-01

    Sedentary behaviour is widely associated with deleterious health outcomes that in modern medicine have similar connotations to smoking tobacco and alcohol misuse. The integration of e-portfolio, e-logbook, British National Formulary (BNF) and encrypted emails has made smartphones a necessity for trainees. Smartphones also have the ability to record the amount of exercise taken, which allows activity at work to be monitored. The aim of this study to compare the activity of the same group of dental core trainees when they worked within a large multisite teaching hospital and a smaller district general hospital, to find out if supplementary activity was needed outside work. Data were collected from smartphones. To ensure continuity, data were collected only from those who had calibrated iPhones (n=10). At the teaching hospital six of the trainees walked over 10 000 steps a day while working (mean (SD) 10 004 (639)). At the district hospital none of the trainees walked 10 000 steps. The mean (SD) number of steps completed by all trainees was 6265 (119). Walking at work provides the full quota of recommended daily exercise most of the time for those working in the teaching hospital, but additional exercise is occasionally required. While working at the district hospital they walk less, meaning that they should try to increase their activity outside work. Trainees working in the teaching hospital walk significantly more steps than in the district hospital. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Renato Humberto Fabri

    2002-04-01

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

  13. Using a verbal prompt to increase protein consumption in a hospital setting: a field study

    NARCIS (Netherlands)

    Zanden, van der L.D.T.; Essen, van H.; Kleef, van E.; Wijk, de R.A.; Trijp, van J.C.M.

    2015-01-01

    Background: Sufficient protein intake among hospitalized patients may contribute to faster recovery and a decrease in healthcare costs. Nevertheless, hospitalized patients are often found to consume too little protein. This field study explored the success of a small, inexpensive intervention

  14. The burden of hospital malnutrition in Spain: methods and development of the PREDyCES® study.

    Science.gov (United States)

    Planas Vila, M; Álvarez Hernández, J; García de Lorenzo, A; Celaya Pérez, S; León Sanz, M; García-Lorda, P; Brosa, M

    2010-01-01

    It is well known that hospital malnutrition is a highly prevalent condition associated to increase morbidity and mortality as well as related healthcare costs. Although previous studies have already measured the prevalence and/or costs of hospital nutrition in our country, their local focus (at regional or even hospital level) make that the true prevalence and economic impact of hospital malnutrition for the National Health System remain unknown in Spain. The PREDyCES® (Prevalence of hospital malnutrition and associated costs in Spain) study was aimed to assess the prevalence of hospital malnutrition in Spain and to estimate related costs. Some aspects made this study unique: a) It was the first study in a representative sample of hospitals of Spain; b) different measures to assess hospital malnutrition (NRS2002, MNA as well as anthropometric and biochemical markers) where used both at admission and discharge and, c) the economic consequences of malnutrition where estimated using the perspective of the Spanish National Health System.

  15. Status of infection control policies and organisation in European hospitals, 2001: the ARPAC study.

    NARCIS (Netherlands)

    Struelens, M.J.; Wagner, D.; Bruce, J.; MacKenzie, F.M.; Cookson, B.; Voss, A.; Broek, P.J.J.A. van den; Gould, I.

    2006-01-01

    Patient safety in hospital care depends on effective infection control (IC) programmes. The Antimicrobial Resistance Prevention and Control (ARPAC) study assessed the organisation, components and human resources of IC programmes in European hospitals. A questionnaire survey of policies and

  16. Prisons' preparedness for pandemic flu and the ethical issues.

    Science.gov (United States)

    van't Hoff, G; Fedosejeva, R; Mihailescu, L

    2009-06-01

    In Europe at any given time there are about 1,8 million people imprisoned in penal institutions. About 1 million personnel are working in prisons. With prisons, from the start there are fundamental problems in many parts of Europe. Poor housing conditions in prisons and a high proportion of prisoners who already suffer from severe health problems mean the chance of an outbreak in prison during a pandemic must be quite high. We expect it can be up to 90%. In this article we explain what the characteristics are of the prison population from a health point of view. A high rate of detainees suffers from mental health disorders and/or addiction. A high prevalence of communicable and infectious diseases is the rule, not an exception. According to the European Prison Rules and many other international rules, statements and documents prison health care should be an integral part of the public health system of any country. However, it has to be accepted that the prison population is the least popular in society and in politics. In reality in many countries in Europe the situation in prison cannot meet the level strived for by the European Prison Rules. We compare preparedness on pandemic flu in The Netherlands, Latvia and Romania. We explore the problems and ethical issues that may arise if a pandemic breaks out. There are three ethical dilemmas that require consideration: equivalence of care and prisoners' right to health care; prisoners' interests verses society's interests; countries in need and calls for bilateral help.

  17. Evaluation of the Hospital Wastewater Activated Sludge Extended Aeration System in the Removal of Estrogenic Compounds (Case Study: Khuzestan Hospitals

    Directory of Open Access Journals (Sweden)

    A. Takdastan

    2016-02-01

    Full Text Available Background and Objective: Estrogen is a steroid hormone that is in the water and cause risks for aquatic organisms, especially fish is. Estrogenic hormones naturally (caused by endocrine or artificial (due to hormonal contraceptives such as birth control pills to sewage and hospital to find. This study aimed to determine the amount of estrogen in the sewage and Golestan and Abuzar hospital in Ahvaz were studied. Material and Methods: Sampling was done by tracking estrogen in the aquatic environment. 56 samples 4 months in different parts of the Golestan and Abuzar hospital wastewater treatment plant in Ahvaz were taken. Sample a little electro luminescence (ECL were analyzed by laboratory Iranian city of Ahvaz. In this study, different forms of estrogen (estrone, 17-beta-estradiol, estriol, 17-alpha-ethinyl estradiol has been studied as estrogen. Results: Mean hormone found in raw wastewater to the Golestan hospital wastewater treatment plant effluent from the treatment plant hormone 69.08 ng/l and 7.28 ng/l mean. Mean testosterone in Ahvaz Abuzar hospital treatment input 70.61 ng/l and 18.94 ng/l is refinery output. According to the results of high impact biological treatment is the removal of estrogenic compounds. Conclusion: Secondary treatment of sewage is effective in reducing hormones that can do this at this stage of the biological treatment effect.

  18. Information security risk management for computerized health information systems in hospitals: a case study of Iran.

    Science.gov (United States)

    Zarei, Javad; Sadoughi, Farahnaz

    2016-01-01

    In recent years, hospitals in Iran - similar to those in other countries - have experienced growing use of computerized health information systems (CHISs), which play a significant role in the operations of hospitals. But, the major challenge of CHIS use is information security. This study attempts to evaluate CHIS information security risk management at hospitals of Iran. This applied study is a descriptive and cross-sectional research that has been conducted in 2015. The data were collected from 551 hospitals of Iran. Based on literature review, experts' opinion, and observations at five hospitals, our intensive questionnaire was designed to assess security risk management for CHISs at the concerned hospitals, which was then sent to all hospitals in Iran by the Ministry of Health. Sixty-nine percent of the studied hospitals pursue information security policies and procedures in conformity with Iran Hospitals Accreditation Standards. At some hospitals, risk identification, risk evaluation, and risk estimation, as well as risk treatment, are unstructured without any specified approach or methodology. There is no significant structured approach to risk management at the studied hospitals. Information security risk management is not followed by Iran's hospitals and their information security policies. This problem can cause a large number of challenges for their CHIS security in future. Therefore, Iran's Ministry of Health should develop practical policies to improve information security risk management in the hospitals of Iran.

  19. Information security risk management for computerized health information systems in hospitals: a case study of Iran

    Science.gov (United States)

    Zarei, Javad; Sadoughi, Farahnaz

    2016-01-01

    Background In recent years, hospitals in Iran – similar to those in other countries – have experienced growing use of computerized health information systems (CHISs), which play a significant role in the operations of hospitals. But, the major challenge of CHIS use is information security. This study attempts to evaluate CHIS information security risk management at hospitals of Iran. Materials and methods This applied study is a descriptive and cross-sectional research that has been conducted in 2015. The data were collected from 551 hospitals of Iran. Based on literature review, experts’ opinion, and observations at five hospitals, our intensive questionnaire was designed to assess security risk management for CHISs at the concerned hospitals, which was then sent to all hospitals in Iran by the Ministry of Health. Results Sixty-nine percent of the studied hospitals pursue information security policies and procedures in conformity with Iran Hospitals Accreditation Standards. At some hospitals, risk identification, risk evaluation, and risk estimation, as well as risk treatment, are unstructured without any specified approach or methodology. There is no significant structured approach to risk management at the studied hospitals. Conclusion Information security risk management is not followed by Iran’s hospitals and their information security policies. This problem can cause a large number of challenges for their CHIS security in future. Therefore, Iran’s Ministry of Health should develop practical policies to improve information security risk management in the hospitals of Iran. PMID:27313481

  20. Hospital work and pregnancy outcomes: a study in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Suárez-Varela, María M Morales; Kaerlev, Linda; Zhu, Jin Liang

    2009-01-01

    In hospitals, women of reproductive age do a range of work tasks, some of which are known to carry potential risks. Tasks such as working with radiation, chemicals, and infectious agents, as well as performing heavy lifting or tasks requiring erratic sleep patterns have been reported to increase...... the risk of reproductive failures. Our aim was to study pregnancy outcomes in female hospital workers in Denmark. We performed a cohort study of 5976 female hospital workers and used as a reference group 60,890 women employed outside of hospitals. The reproductive health of hospital workers working during...... pregnancy is comparable to those of non-hospital workers for the majority of reproductive failures studied. However, an increased prevalence of congenital abnormalities was noted in some subgroups of hospital workers, which may indicate that some hospital work still entails fetotoxic hazards....

  1. Organizational culture change in U.S. hospitals: a mixed methods longitudinal intervention study.

    Science.gov (United States)

    Curry, Leslie A; Linnander, Erika L; Brewster, Amanda L; Ting, Henry; Krumholz, Harlan M; Bradley, Elizabeth H

    2015-03-07

    Improving outcomes for patients with acute myocardial infarction (AMI) is a priority for hospital leadership, clinicians, and policymakers. Evidence suggests links between hospital organizational culture and hospital performance; however, few studies have attempted to shift organizational culture in order to improve performance, fewer have focused on patient outcomes, and none have addressed mortality for patients with AMI. We sought to address this gap through a novel longitudinal intervention study, Leadership Saves Lives (LSL). This manuscript describes the methodology of LSL, a 2-year intervention study using a concurrent mixed methods design, guided by open systems theory and the Assess, Innovate, Develop, Engage, Devolve (AIDED) model of diffusion, implemented in 10 U.S. hospitals and their peer hospital networks. The intervention has three primary components: 1) annual convenings of the ten intervention hospitals; 2) semiannual workshops with guiding coalitions at each hospital; and 3) continuous remote support across all intervention hospitals through a web-based platform. Primary outcomes include 1) shifts in key dimensions of hospital organizational culture associated with lower mortality rates for patients with AMI; 2) use of targeted evidence-based practices associated with lower mortality rates for patients with AMI; and 3) in-hospital AMI mortality. Quantitative data include annual surveys of guiding coalition members in the intervention hospitals and peer network hospitals. Qualitative data include in-person, in-depth interviews with all guiding coalition members and selective observations of key interactions in care for patients with AMI, collected at three time points. Data integration will identify patterns and major themes in change processes across all intervention hospitals over time. LSL is novel in its use of a longitudinal mixed methods approach in a diverse sample of hospitals, its focus on objective outcome measures of mortality, and its

  2. Statistical study on cancer patients of Korea cancer centre hospital

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Yong; Kim, Kee Hwa; Mok, Kang Sung [Korea Cancer Center Hospital of Korea Atomic Energy Research Institute, Seoul (Korea, Republic of)

    1994-12-01

    The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author).

  3. Statistical study on cancer patients of cancer research hospital

    International Nuclear Information System (INIS)

    Shim, Yun Sang; Choi, Soo Yong; Kim, Ki Wha; Kang, Sung Mok

    1993-01-01

    The total number of malignant neoplasms included in this study 15,737 cases(11.8%) among 133,251 cases for 3 years. On sex, females with 52.9% were much more than males with 47.1%. The highest proportion of cancer patients by age was 33.7% in males and 28.5% in females, respectivelty for 50-59 age group. The most frequent primary site among males was found to be stomach with 35.5%, followed by liver(14.7%), lung(13.0%), esophagus(5.4%) and colon (3.2%). In females, the first order was uterine cervix with 40.6%, followed by stomach(17.2%), breast(14.4), rectum(3.7%) and lung(3.4%). The most common type of morphology of malignant neoplasms was adenocarcinoma(47.4%) in males an squamous cell carcinoma(58.0%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the exent of disease was 2.5% for patient with carcinoma-in-situ, 54.1% for patients with localized involvement, 13.3% for patients with regional involvement and 8.5% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 23.6% for surgery, 25.3% for radiotherapy and 30.3% for chemotherapy. Among the cancer patients confirmed by medical records, 7.7% was traced more than 5 years. (Author)

  4. Statistical study on cancer patients of Korea cancer centre hospital

    International Nuclear Information System (INIS)

    Choi, Soo Yong; Kim, Kee Hwa; Kang Sung Mok

    1994-12-01

    The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author)

  5. Winter excess in hospital admissions, in-patient mortality and length of acute hospital stay in stroke: a hospital database study over six seasonal years in Norfolk, UK.

    Science.gov (United States)

    Myint, Phyo K; Vowler, Sarah L; Woodhouse, Peter R; Redmayne, Oliver; Fulcher, Robert A

    2007-01-01

    Several studies have examined the incidence and mortality of stroke in relation to season. However, the evidence is conflicting partly due to variation in the populations (community vs. hospital-based), and in climatic conditions between studies. Moreover, they may not have been able to take into account the age, sex and stroke type of the study population. We hypothesized that the age, sex and type of stroke are major determinants of the presence or absence of winter excess in morbidity and mortality associated with stroke. We analyzed a hospital-based stroke register from Norfolk, UK to examine our prior hypothesis. Using Curwen's method, we performed stratified sex-specific analyses by (1) seasonal year and (2) quartiles of patients' age and stroke subtype and calculated the winter excess for the number of admissions, in-patient deaths and length of acute hospital stay. There were 5,481 patients (men=45%). Their ages ranged from 17 to 105 years (median=78 years). There appeared to be winter excess in hospital admissions, deaths and length of acute hospital stay overall accounting for 3/100,000 extra admissions (winter excess index of 3.4% in men and 7.6% in women) and 1/100,000 deaths (winter excess index of 4.7 and 8.6% in women) due to stroke in winter compared to non-winter periods. Older patients with non-haemorrhagic stroke mainly contribute to this excess. If our findings are replicated throughout England and Wales, it is estimated that there are 1,700 excess admissions, 600 excess in-patient deaths and 24,500 extra acute hospital bed days each winter, related to stroke within the current population of approximately 60 million. Further research should be focused on the determinants of winter excess in morbidity and mortality associated with stroke. This may subsequently reduce the morbidity and mortality by providing effective preventive strategies in future. (c) 2007 S. Karger AG, Basel.

  6. Galvanizing medical students in the administration of influenza vaccines: the Stanford Flu Crew

    Directory of Open Access Journals (Sweden)

    Rizal RE

    2015-07-01

    Full Text Available Rachel E Rizal,1,* Rishi P Mediratta,1,* James Xie,1 Swetha Kambhampati,1 Kelsey Hills-Evans,1 Tamara Montacute,1 Michael Zhang,1 Catherine Zaw,2 Jimmy He,2 Magali Sanchez,2 Lauren Pischel1 1Stanford University School of Medicine, Stanford, CA, USA; 2Stanford University, Stanford, CA, USA *These authors contributed equally to this work Abstract: Many national organizations call for medical students to receive more public health education in medical school. Nonetheless, limited evidence exists about successful service-learning programs that administer preventive health services in nonclinical settings. The Flu Crew program, started in 2001 at the Stanford University School of Medicine, provides preclinical medical students with opportunities to administer influenza immunizations in the local community. Medical students consider Flu Crew to be an important part of their medical education that cannot be learned in the classroom. Through delivering vaccines to where people live, eat, work, and pray, Flu Crew teaches medical students about patient care, preventive medicine, and population health needs. Additionally, Flu Crew allows students to work with several partners in the community in order to understand how various stakeholders improve the delivery of population health services. Flu Crew teaches students how to address common vaccination myths and provides insights into implementing public health interventions. This article describes the Stanford Flu Crew curriculum, outlines the planning needed to organize immunization events, shares findings from medical students' attitudes about population health, highlights the program’s outcomes, and summarizes the lessons learned. This article suggests that Flu Crew is an example of one viable service-learning modality that supports influenza vaccinations in nonclinical settings while simultaneously benefiting future clinicians. Keywords: immunizations, vaccine delivery, vaccinations 

  7. The prevalence of undernutrition upon hospitalization in children in a developing country: A single hospital study from Malaysia.

    Science.gov (United States)

    Lee, Way-Seah; Ahmad, Zulfadly

    2017-10-01

    Undernourished children who require hospital care have a longer duration of hospitalization and respond poorly to modern medical therapy. The objective of the present study was to ascertain the nutritional status of children admitted to a pediatric tertiary center in Malaysia and the risk factors leading to undernutrition upon admission. In this cross-sectional, hospital-based study, anthropometric measurements [weight, length/height, mid-upper arm circumference (MUAC), triceps skinfold thickness were performed in 285 children aged from 3 months to 15 years who were admitted to University Malaya Medical Centre, Kuala Lumpur in November 2013. Acute (wasting) and chronic (stunting) undernutrition were defined as weight-for-height (WFH) and height-for-age (HFA) standard deviation (S.D.), respectively. Underweight was defined as weight-for-age definition for acute undernutrition (HFA definition of acute undernutrition, an additional eight patients were noted to have acute undernutrition (n = 40, 14%). No significant risk factors associated with undernutrition were identified. The prevalence of undernutrition among children admitted to a tertiary hospital in Malaysia was 14%. Strategies for systematic screening and provision of nutritional support in children at risk of undernutrition as well as treatment of undernutrition in children requiring hospitalization are needed. Copyright © 2017. Published by Elsevier B.V.

  8. A study on job satisfaction among clinical and non-clinical hospital staff in a teaching hospital in Lagos, Nigeria.

    Science.gov (United States)

    Coker, O O; Coker, A O; Onuoha, B

    2011-12-01

    Previous studies had demonstrated that continuous and effective productivity of hospital staff are linked to job satisfaction and only those who are satisfied with their job can be maximally effective and productive. This cross-sectional descriptive survey was designed to determine the levels of job satisfaction among various groups of health care professionals working in a teaching hospital in Lagos, Nigeria. Two hundred clinical and non-clinical hospital staff were invited to take part in the study. They completed a sociodemographic questionnaire and the Job Descriptive Index (JDI). The results indicated that majority clinical and non-clinical staff were satisfied with their jobs as regards the parameters of the JDI compared with those not satisfied with their jobs. The government and health policy makers should continue to pay attention to boost job morale and satisfaction of medical health workers to continue to make them to be satisfied with their job.

  9. Improving hospital death certification in Viet Nam: results of a pilot study implementing an adapted WHO hospital death report form in two national hospitals.

    Science.gov (United States)

    Walton, Merrilyn; Harrison, Reema; Chevalier, Anna; Esguerra, Esmond; Van Duong, Dang; Chinh, Nguyen Duc; Giang, Huong

    2016-01-01

    Viet Nam does not have a system for the national collection of death data that meets international requirements for mortality reporting. It is identified as a 'no-report' country by the WHO. Verbal autopsy reports are used in the community but exclude deaths in hospitals. This project was undertaken in Bach Mai National General Hospital and Viet Duc Surgical and Trauma Hospital in Viet Nam from 1 March 2013 to 31 March 2015. In phase 1, a modified hospital death report form, consistent with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, was developed. Small group training in use of the report form was delivered to 427 doctors. In phase two, death data were collected, collated and analysed. In phase three, a random sample (7%) of all report forms was checked for accuracy and completeness against medical records. During the 23 months of the study, 3956 deaths were recorded. Across both hospitals, 222 distinct causes of deaths were recorded. Traumatic cerebral oedema was the immediate cause of death (15% of cases, 575/3956 patients), followed by septic shock (13%, 528/3956), brain compression (11%, 416/3956), intracerebral haemorrhage (8%, 336/3956) and pneumonia (5%, 186/3956); 67% (2639/3956) of patients were discharged home to die and 33% (1314/3956) of deaths were due to a road traffic accident, or injury at home or at work. This study confirms the viability of implementing a death report form system compliant with international standards in hospitals in Viet Nam and provides the foundation for introducing a national death report form scheme. These data are critical to comprehensive knowledge of causes of death in Viet Nam. Death data about patients discharged home to die is presented for the first time, with implications for countries where this is a cultural preference.

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  11. Dying in Hospital with Dementia and Pneumonia: A Nationwide Study Using Death Certificate Data

    NARCIS (Netherlands)

    Houttekier, D.; Reyniers, T.; Deliens, L.; Den Noortgate, N.; Cohen, J.

    2014-01-01

    Background: For people with dementia dying from pneumonia, hospitalization at the end of life may be of little benefit and result in unfavourable outcomes such as hospital death. Objective: The aim of this study is to estimate the incidence of and factors associated with hospital death in people

  12. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital

    OpenAIRE

    Chen, Qiwei; Yang, Lan; Feng, Qiming; Tighe, Scott S.

    2017-01-01

    Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction o...

  13. Study of radiation safety education practices in acute care Texas hospitals

    International Nuclear Information System (INIS)

    Lemley, A.A.; Hedl, J.J. Jr.; Griffin, E.E.

    1987-01-01

    A survey study was performed to assess the extent of radiation safety education and training in acute care Texas hospitals for radiologic technologists and other hospital personnel. The findings revealed a self-perceived need by hospital administrative personnel and were interpreted to suggest a quantitative need for increased radiation safety education for several classes of hospital personnel. The findings are discussed relative to potential certification requirements for technologists and implications for the training of other personnel

  14. Study of surface an atmospheric pollution in radioiodine from Hospitals

    International Nuclear Information System (INIS)

    Gomez Palacios, M.; Cuetos Menendez, A.

    1999-01-01

    In hospitals environment, the radioactive iodine surface contamination is one of the most important incident from the point of view of radiation protection. Among this kind of incidents we can consider vomit or urine spillage from ''131 I therapy or spillage of liquids contaminated with ''125 I from RIA laboratories. We have studied the dynamic of the contamination flow from the contaminated surface to the indoor air, using total activity in the spill, indoor air renewal rate, and resuspension rate as parameters. We describe a method to estimate the resuspension rate, assuming that this parameter is usually unknown, and its results for the following cases: urine or water, on paper-covered or uncovered plastic surface. By using the experimental results, we have studied the indoor air contamination evolution with time, as a function of both initial activity, and indoor air renewal rate. The maximum value of indoor air contamination is not dependent on the initial activity value. The resuspension process is slower in the case of urine spillage that in watery leakage. The use of porous paper may establish the difference between keeping and indoor air contamination below derived air concentration limit (CDAC), or clearly above DAC for may days. The indoor air contamination dependence from the air renewal rate, shows the convenience of high air renewal rate in places where contamination from ''131 I therapy were possible, and how although this factor is not so critical, it should be taken into account in RIA laboratories. (Author) 6 refs

  15. Prehospital tidal volume influences hospital tidal volume: A cohort study.

    Science.gov (United States)

    Stoltze, Andrew J; Wong, Terrence S; Harland, Karisa K; Ahmed, Azeemuddin; Fuller, Brian M; Mohr, Nicholas M

    2015-06-01

    The purposes of the study are to describe current practice of ventilation in a modern air medical system and to measure the association of ventilation strategy with subsequent ventilator care and acute respiratory distress syndrome (ARDS). Retrospective observational cohort study of intubated adult patients (n = 235) transported by a university-affiliated air medical transport service to a 711-bed tertiary academic center between July 2011 and May 2013. Low tidal volume ventilation was defined as tidal volumes less than or equal to 8 mL/kg predicted body weight. Multivariable regression was used to measure the association between prehospital tidal volume, hospital ventilation strategy, and ARDS. Most patients (57%) were ventilated solely with bag valve ventilation during transport. Mean tidal volume of mechanically ventilated patients was 8.6 mL/kg predicted body weight (SD, 0.2 mL/kg). Low tidal volume ventilation was used in 13% of patients. Patients receiving low tidal volume ventilation during air medical transport were more likely to receive low tidal volume ventilation in the emergency department (P tidal volume (P = .840). Low tidal volume ventilation was rare during air medical transport. Air transport ventilation strategy influenced subsequent ventilation but was not associated with ARDS. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. [Study on empowerment factors for career continuity of hospital nurses].

    Science.gov (United States)

    Kato, Hirosato; Ito, Yukie; Yoshida, Aki; Mizuno, Shizue; Ogoshi, Kumiko; Imamura, Tomoaki

    2015-01-01

    The resignation rate of nurses working in hospitals is extremely high. This study aims to identify both the factors related to the resignation of nurses and the empowerment factors supporting their job retention. In 2011 we conducted a Web-based questionnaire survey of nurses with less than 10 years of working experience. There were 25 survey items including the following reasons for choosing the current employment position, intention of continuing work, sense of fulfillment and the presence or absence of problems in the current workplace. In addition, nurses who previously had resigned were asked why they left their last workplace. The reasons why they chose the current workplace were markedly different between the not-resigned (A group) and previously resigned (B group) nurses. As a result of cluster analysis, the reasons for resignation were classified into six clusters; "overwork", "burnout", "bad atmosphere", "work life balance factors", "working conditions" and "marriage". In this study, it is shown that there is a positive correlation between the sense of fulfillment at work and the intention to do research work. It is suggested that encouragement of nurses to undertake research work is one of the empowerment factors supporting their job retention.

  17. Risky Zoographies: The Limits of Place in Avian Flu Management

    Directory of Open Access Journals (Sweden)

    Natalie Porter

    2012-11-01

    Full Text Available Global anxieties about avian influenza stem from a growing recognition that highly-virulent, highly-mobile disease vectors infiltrate human spaces in ways that are difficult to perceive, and even more difficult to manage. This article analyses a participatory health intervention in Việt Nam to explore how avian influenza threats challenge long-held understandings of animals’ place in the environment and society. In this intervention, poultry farmers collaborated with health workers to illustrate maps of avian flu risks in their communities. Participant-observation of the risk-mapping exercises shows that health workers treated poultry as commodities, and located these animals in environments that could be transformed and dominated by humans. However, these maps did not sufficiently represent the physical and social landscapes where humans and poultry coexist in Việt Nam. As such, farmers located poultry in environments dominated by risky nonhuman forces such as winds, waterways, and other organisms. I argue that these divergent risk maps demonstrate how ecological factors, interpersonal networks, and global market dynamics combine to engender a variety of interspecies relationships, which in turn shape the location of disease risks in space. I develop the term risky zoographies to signal the emergence of competing descriptions of animals and their habitats in zoonotic disease contexts. This concept suggests that as wild animals, livestock products, and microbial pathogens continue to globalise, place-based health interventions that limit animals to particular locales are proving inadequate. Risky zoographies signal the inextricability of nonhuman animals from human spaces, and reveal interspecies interactions that transect and transcend environments.

  18. Human resource crises in German hospitals?an explorative study

    OpenAIRE

    Schermuly, Carsten C; Draheim, Michael; Glasberg, Ronald; Stantchev, Vladimir; Tamm, Gerrit; Hartmann, Michael; Hessel, Franz

    2015-01-01

    Background The complexity of providing medical care in a high-tech environment with a highly specialized, limited labour force makes hospitals more crisis-prone than other industries. An effective defence against crises is only possible if the organizational resilience and the capacity to handle crises become part of the hospitals? organizational culture. To become more resilient to crises, a raised awareness?especially in the area of human resource (HR)?is necessary. The aim of this paper is...

  19. Use of social media by Western European hospitals: longitudinal study.

    OpenAIRE

    Belt, T.H. van de; Berben, S.A.A.; Samsom, M.; Engelen, L.J.; Schoonhoven, L.

    2012-01-01

    BACKGROUND: Patients increasingly use social media to communicate. Their stories could support quality improvements in participatory health care and could support patient-centered care. Active use of social media by health care institutions could also speed up communication and information provision to patients and their families, thus increasing quality even more. Hospitals seem to be becoming aware of the benefits social media could offer. Data from the United States show that hospitals inc...

  20. STUDY OF GASTROINTESTINAL CANCERS IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Rema Nair Sarkar

    2017-11-01

    Full Text Available BACKGROUND Cancer is one of the leading cause of death both in developed and developing countries. In India, it accounts for 0.3 million deaths per year. Cancers of lung, GIT and oral cancers dominated among men while breast, cervix, ovary and oral cavity were commonest cancer seen in women. Among the gastrointestinal cancers, cancers of the oesophagus, stomach, colon, rectum and liver cancers were commonest. The aim of the study is to evaluate the incidence of the various GIT cancers in a tertiary hospital of Coastal Andhra when compared to other studies. MATERIALS AND METHODS In this retrospective study, a total of 509 health records of patients affected by cancers were studied and relevant details noted. RESULTS A total of 509 cancer cases were reported in this period of 18 months (January 2016 - June 2017 of which 85 cases (16.3% were of Gastrointestinal (GIT cancers. The age group between 40 and 60 recorded the maximum incidence of 47 cancers (55.1%. The incidence of gastrointestinal cancers were significantly higher in the men (56 cases (65.8% than the women (29 cases (34.11%. The commonest site of GIT cancers was the colorectal region (30 cases (35.7%. The most common type of cancer seen was adenocarcinoma seen in 73 cases (85.8%. CONCLUSION Public education and awareness for the warning symptoms should be increased to prevent reduction of the life span and health caused by the gastrointestinal cancers with intense awareness drive using various means including social media undertaken to educate the public regarding the warning symptoms and screening of such group for GIT cancers.

  1. Design of multiligand inhibitors for the swine flu H1N1 neuraminidase binding site

    Directory of Open Access Journals (Sweden)

    Narayanan MM

    2013-08-01

    Full Text Available Manoj M Narayanan,1,2 Chandrasekhar B Nair,2 Shilpa K Sanjeeva,2 PV Subba Rao,2 Phani K Pullela,1,2 Colin J Barrow11Centre for Chemistry and Biotechnology, Deakin University, Geelong, VIC, Australia; 2Bigtec Pvt Ltd, Rajajinagar, Bangalore, IndiaAbstract: Viral neuraminidase inhibitors such as oseltamivir and zanamivir prevent early virus multiplication by blocking sialic acid cleavage on host cells. These drugs are effective for the treatment of a variety of influenza subtypes, including swine flu (H1N1. The binding site for these drugs is well established and they were designed based on computational docking studies. We show here that some common natural products have moderate inhibitory activity for H1N1 neuraminidase under docking studies. Significantly, docking studies using AutoDock for biligand and triligand forms of these compounds (camphor, menthol, and methyl salicylate linked via methylene bridges indicate that they may bind in combination with high affinity to the H1N1 neuraminidase active site. These results also indicate that chemically linked biligands and triligands of these natural products could provide a new class of drug leads for the prevention and treatment of influenza. This study also highlights the need for a multiligand docking algorithm to understand better the mode of action of natural products, wherein multiple active ingredients are present.Keywords: neuraminidase, influenza, H1N1, multiligand, binding energy, molecular docking, virus

  2. Physical activity among hospitalized older adults - an observational study.

    Science.gov (United States)

    Evensen, Sigurd; Sletvold, Olav; Lydersen, Stian; Taraldsen, Kristin

    2017-05-16

    Low level of physical activity is common among hospitalized older adults and is associated with worse prognosis. The aim of this paper is to describe the pattern and level of physical activity in a group of hospitalized older adults and to identify factors associated with physical activity. We measured physical activity on day three after admission using accelerometer based activity monitors and time in upright position as outcome measure. We collected data of physical function (Short Physical Performance Battery, SPPB. 0-12), cognitive function (Mini Mental Status Examination, MMSE, 0-30 and diagnosis of cognitive impairment at discharge, yes/no), personal Activities of Daily Living (p-ADL, Barthel Index, BI, 0-20) and burden of disease (Cumulative Illness Rating Scale, CIRS, 0-56). We analyzed data using univariable and multivariable linear regression models, with time in upright position as dependent variable. We recorded physical activity in a consecutive sample of thirty-eight geriatric patients. Their (mean age 82.9 years, SD 6.3) mean time in upright position one day early after admission was 117.1 min (SD 90.1, n = 38). Mean SPPB score was 4.3 (SD 3.3, n = 34). Mean MMSE score was 19.3 (SD 5.3, n = 30), 73% had a diagnosis of cognitive impairment (n = 38). Mean BI score was 16.4 (SD 4.4, n = 36). Mean CIRS score was 17.0 (SD 4.2, n = 38). There was a significant association between SPPB score and time in upright position (p = 0.048): For each one unit increase in SPPB, the expected increase in upright time was 11.7 min. There was no significant association between age (p = 0.608), diagnosis of cognitive impairment (p = 0.794), p-ADL status (p = 0.127), CIRS score (p = 0.218) and time in upright position. The overall model fit was R 2 0.431. Participants' mean time in upright position one day early after admission was almost two hours, indicating a high level of physical activity compared to results from similar studies. Physical

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

    OpenAIRE

    Shojaee, Jalil; Moosazadeh, Mahmood

    2014-01-01

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

  4. HOSPITAL INFORMATION SYSTEMS: A STUDY OF ELECTRONIC PATIENT RECORDS

    Directory of Open Access Journals (Sweden)

    Pedro Luiz Cortês

    2011-05-01

    Full Text Available The importance of patient records, also known as medical records, is related to different needs and objectives, as they constitute permanent documents on the health of patients. With the advancement of information technologies and systems, patient records can be stored in databases, resulting in a positive impact on patient care. Based on these considerations, a research question that arises is “what are the benefits and problems that can be seen with the use of electronic versions of medical records?” This question leads to the formulation of the following hypothesis: although problems can be identified during the process of using electronic record systems, the benefits outweigh the difficulties, thereby justifying their use. To respond to the question and test the presented hypothesis, a research study was developed with users of the same electronic record system, consisting of doctors, nurses, and administrative personnel in three hospitals located in the city of São Paulo, Brazil. The results show that, despite some problems in their usage, the benefits of electronic patient records outweigh possible disadvantages.

  5. Is There a Relationship Between Value-Based Purchasing and Hospital Profitability? An Exploratory Study of Missouri Hospitals.

    Science.gov (United States)

    Turner, Jason S; Broom, Kevin D; Counte, Michael A

    2015-01-01

    Recent US legislation is attempting to transition inpatient Medicare payments to a value-based purchasing (VBP) program. The VBP program is a pay-for-performance (P4P) system that incentivizes hospitals to improve patient satisfaction, health outcomes, and adherence to clinical protocols while simultaneously holding down costs. Our study evaluates (1) the impact of financial performance on the VBP adjustments and (2) whether there is a correlation between the VBP adjustment and the financial performance of Missouri hospitals that opted into the program. While upward and downward adjustments to the inpatient base rate may be related to hospital financial performance, prior financial performance may also be related to the adjustments. Financial health may allow facilities to invest and position the hospital for favorable future P4P adjustments. The results of our analysis indicate the VBP adjustment to the inpatient base rate is very small (±0.18%), clustered around zero, and is not correlated with financial performance. We also find that financial performance and improvement in the years prior to the adjustment are not related to the VBP adjustment or its respective components. This suggests that CMS is avoiding penalizing less profitable facilities, but the adjustment is also so small and tightly clustered around zero that it is failing to provide an adequate incentive to hospitals. The costs of improving patient satisfaction, clinical process adherence, health care outcomes, and efficiency above that of peers coupled with the growing number of metrics being used to calculate the VBP adjustments call into question the financial incentives of the hospital VBP program.

  6. Nurse scheduling in a hospital emergency department: A case study at a Thai university hospital

    Directory of Open Access Journals (Sweden)

    Aussadavut Dumrongsiri

    2018-02-01

    Full Text Available Common problems of Thai nurses are low quality of life, working long hours, and a high turnover rate. The workload imbalance among nurses also worsens the turnover rate. With careful schedule planning, nurses do not have to work in consecutive shifts and can rest more. We interviewed and collected data from an emergency department at a hospital administered by a Thai university, related to objectives and constraints of monthly nurse scheduling, and actual monthly schedules. A multi-objective mathematical model was developed using the open source “OpenSolver” software in MS-Excel for nurse schedulers to freely use. We tested the model using actual data collected from the department and found that the schedules created by the model tended to provide more balanced workloads and more days off compared to the schedules created manually by a real scheduler. The model also suggested an easy policy to increase the number of nurses for future expansion.

  7. Global response to pandemic flu: more research needed on a critical front

    Directory of Open Access Journals (Sweden)

    Lim Meng-Kin

    2006-10-01

    Full Text Available Abstract If and when sustained human-to-human transmission of H5N1 becomes a reality, the world will no longer be dealing with sporadic avian flu borne along migratory flight paths of birds, but aviation flu – winged at subsonic speed along commercial air conduits to every corner of planet Earth. Given that air transportation is the one feature that most differentiates present day transmission scenarios from those in 1918, our present inability to prevent spread of influenza by international air travel, as reckoned by the World Health Organization, constitutes a major weakness in the current global preparedness plan against pandemic flu. Despite the lessons of SARS, it is surprising that aviation-related health policy options have not been more rigorously evaluated, or scientific research aimed at strengthening public health measures on the air transportation front, more energetically pursued.

  8. Finding a new drug and vaccine for emerging swine flu: What is the concept?

    Directory of Open Access Journals (Sweden)

    Viroj Wiwanitkit

    2009-08-01

    Full Text Available Viroj WiwanitkitWiwanitkit House, Bangkhae, Bangkok 10160Abstract: Influenza is a well known infection of the respiratory system. The main clinical manifestations of influenza include fever, sore throat, headache, cough, coryza, and malaise. Apart from the well known classical influenza, there are also groups of influenza virus infections that are called “atypical infection”. These infections are usually due to a novel influenza virus infection. In early 2009, an emerging novel influenza originating from Mexico called swine flu was reported. The World Health Organization noted a level VI precaution, the highest level precaution possible, for this newest influenza virus infection. As of June 2009, it is not known if this disease will be successfully controlled. Finding new drugs and vaccine for the emerging swine flu is still required to cope with this emerging worldwide problem.Keywords: swine flu, drug, vaccine, concept

  9. Information Systems Evaluation: A Study in Hospital Organizations

    Directory of Open Access Journals (Sweden)

    Laís Coelho Ayala

    2012-06-01

    Full Text Available Given increasing demand for timely and accurate information to support decision making, hospitals, a particularly complex type of service organization, have increasingly resorted to a wide range of tools such as the Clinical Information Systems (CIS. However, research has shown that such systems do not always meet hospital managers’ needs, and assessment processes are necessary both before and after CIS implementation. Aiming to identify whether the CIS do meet hospital managers’ information needs and do fit in the specificities of such organizations, this paper reports on the assessment of four CIS based on the perspective of their users in four hospitals in the Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil. The data was collected by means of semi-structured interviews and non-obtrusive observation. On the one hand, the result shows that the four organizations have difficulties in using their systems, such as accessibility problems, inadequate training and system underutilization. On the other hand, they also benefit from such systems, as they make processes faster and enable information control. One can say that the results from this research contribute to a better understanding of evaluating information systems in hospitals. Managers of such organizations can benefit from these results when seeking to evaluate and improve their information systens.

  10. Being hospitalized with a newly diagnosed chronic illness--a phenomenological study of children's lifeworld in the hospital.

    Science.gov (United States)

    Ekra, Else Mari Ruberg; Gjengedal, Eva

    2012-08-17

    The impact of a hospital environment on children has rarely been investigated. Recently, however, the perspective of hospitalized children has been taken into account. Being hospitalized and facing an illness represent a dramatic change in a child's daily life, and the quality of the environment may influence the child's experiences. The aim of this study was to investigate the experiences of children being hospitalized with newly diagnosed type 1 diabetes and to obtain an increased understanding of the environmental influences on the children's lifeworld. The study used a hermeneutic phenomenological approach. The design is a combination of observation of the participant, interviews, and photographs. Nine children, aged between 7 and 12 years, participated in the study. The data were collected between October 2008 and February 2010 and analysed in accordance with thematic analysis as described by van Manen. The children experienced change through recognition and adaptation. They perceived the environment as strange but still comfortable because of the "child-friendly" atmosphere, close contact with their relatives, and access to private space. The children were gradually able to adapt to their new life; they perceived their illness through bodily changes and developed practical skills and understanding. The findings underscored the necessity for an emphasis on the mutual relationship between the body and its environment. Bodily changes that occur during illness may lead to changes in one's perception of the environment. Children seem to be particularly affected when the body appears alien and the hospital environment is unfamiliar. A well-adapted environment, active involvement, and the incorporation of new habits are significant elements of gradually returning to a more familiar life. However, the child's new life requires alertness to the body's signals and acclimation to a demanding diabetes treatment regime. All these factors remind children of their body

  11. Being hospitalized with a newly diagnosed chronic illness—A phenomenological study of children's lifeworld in the hospital

    Directory of Open Access Journals (Sweden)

    Else Mari Ruberg Ekra

    2012-08-01

    Full Text Available The impact of a hospital environment on children has rarely been investigated. Recently, however, the perspective of hospitalized children has been taken into account. Being hospitalized and facing an illness represent a dramatic change in a child's daily life, and the quality of the environment may influence the child's experiences. The aim of this study was to investigate the experiences of children being hospitalized with newly diagnosed type 1 diabetes and to obtain an increased understanding of the environmental influences on the children's lifeworld. The study used a hermeneutic phenomenological approach. The design is a combination of observation of the participant, interviews, and photographs. Nine children, aged between 7 and 12 years, participated in the study. The data were collected between October 2008 and February 2010 and analysed in accordance with thematic analysis as described by van Manen. The children experienced change through recognition and adaptation. They perceived the environment as strange but still comfortable because of the “child-friendly” atmosphere, close contact with their relatives, and access to private space. The children were gradually able to adapt to their new life; they perceived their illness through bodily changes and developed practical skills and understanding. The findings underscored the necessity for an emphasis on the mutual relationship between the body and its environment. Bodily changes that occur during illness may lead to changes in one's perception of the environment. Children seem to be particularly affected when the body appears alien and the hospital environment is unfamiliar. A well-adapted environment, active involvement, and the incorporation of new habits are significant elements of gradually returning to a more familiar life. However, the child's new life requires alertness to the body's signals and acclimation to a demanding diabetes treatment regime. All these factors remind

  12. Being hospitalized with a newly diagnosed chronic illness—A phenomenological study of children's lifeworld in the hospital

    Science.gov (United States)

    Gjengedal, Eva

    2012-01-01

    The impact of a hospital environment on children has rarely been investigated. Recently, however, the perspective of hospitalized children has been taken into account. Being hospitalized and facing an illness represent a dramatic change in a child's daily life, and the quality of the environment may influence the child's experiences. The aim of this study was to investigate the experiences of children being hospitalized with newly diagnosed type 1 diabetes and to obtain an increased understanding of the environmental influences on the children's lifeworld. The study used a hermeneutic phenomenological approach. The design is a combination of observation of the participant, interviews, and photographs. Nine children, aged between 7 and 12 years, participated in the study. The data were collected between October 2008 and February 2010 and analysed in accordance with thematic analysis as described by van Manen. The children experienced change through recognition and adaptation. They perceived the environment as strange but still comfortable because of the “child-friendly” atmosphere, close contact with their relatives, and access to private space. The children were gradually able to adapt to their new life; they perceived their illness through bodily changes and developed practical skills and understanding. The findings underscored the necessity for an emphasis on the mutual relationship between the body and its environment. Bodily changes that occur during illness may lead to changes in one's perception of the environment. Children seem to be particularly affected when the body appears alien and the hospital environment is unfamiliar. A well-adapted environment, active involvement, and the incorporation of new habits are significant elements of gradually returning to a more familiar life. However, the child's new life requires alertness to the body's signals and acclimation to a demanding diabetes treatment regime. All these factors remind children of their body

  13. Pre-hospital National Early Warning Score (NEWS is associated with in-hospital mortality and critical care unit admission: A cohort study

    Directory of Open Access Journals (Sweden)

    Tom E.F. Abbott

    2018-03-01

    Conclusion: Pre-hospital NEWS was associated with death or critical care unit escalation within 48 h of hospital admission. NEWS could be used by ambulance crews to assist in the early triage of patients requiring hospital treatment or rapid transport. Further cohort studies or trials in large samples are required before implementation.

  14. Health Care Delivery Meets Hospitality: A Pilot Study in Radiology.

    Science.gov (United States)

    Steele, Joseph Rodgers; Jones, A Kyle; Clarke, Ryan K; Shoemaker, Stowe

    2015-06-01

    The patient experience has moved to the forefront of health care-delivery research. The University of Texas MD Anderson Cancer Center Department of Diagnostic Radiology began collaborating in 2011 with the University of Houston Conrad N. Hilton College of Hotel and Restaurant Management, and in 2013 with the University of Nevada, Las Vegas, William F. Harrah College of Hotel Administration, to explore the application of service science to improving the patient experience. A collaborative pilot study was undertaken by these 3 institutions to identify and rank the specific needs and expectations of patients undergoing imaging procedures in the MD Anderson Department of Diagnostic Radiology. We first conducted interviews with patients, providers, and staff to identify factors perceived to affect the patient experience. Next, to confirm these factors and determine their relative importance, we surveyed more than 6,000 patients by e-mail. All factors considered important in the interviews were confirmed as important in the surveys. The surveys showed that the most important factors were acknowledgment of the patient's concerns, being treated with respect, and being treated like a person, not a "number"; these factors were more important than privacy, short waiting times, being able to meet with a radiologist, and being approached by a staff member versus having one's name called out in the waiting room. Our work shows that it is possible to identify and rank factors affecting patient satisfaction using techniques employed by the hospitality industry. Such factors can be used to measure and improve the patient experience. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  15. An epidemiological study of septic arthritis in Kuala Lumpur Hospital.

    Science.gov (United States)

    Razak, M; Nasiruddin, J

    1998-09-01

    Forty-one patients with 42 joint infections were admitted to the hospital between June 1989 and June 1994. An overview on the behaviour of septic arthritis in both children and adults, at presentation and after various types of treatment was done. There were 32 knees, 7 hips, 2 elbows and 1 shoulder. Duration of symptoms, type of organism, type of joint drainage, presence of preexisting joint problems and presence of osteomyelitis are among the important factors with prognostic significance. Seventy three percent of patients with less than 7 days duration of symptoms had satisfactory results. Whereas when the duration of symptoms exceeded 7 days, 75% of the patients had unsatisfactory outcome. All cases with poor outcome had positive cultures. Staphylococcus aureus was responsible for 77% of the culture-positive cases. All Staphylococcus aureus in this study were penicillin-resistant but sensitive to cloxacillin. There were 3 instances where Staphylococcus became resistant to cloxacillin following recurrence of septic arthritis. However, they were still sensitive to third generation cephalosporin. Staphylococcus aureus was capable of producing poor results even when the case was treated early. Other organisms were gram-negative bacilli which infect patients with suppressed immune system, that is, intravenous drug abuser, systemic steroid therapy and diabetes mellitus. Open arthrotomy was the method of drainage used in all hip sepsis. This method was also the most reliable method of joint drainage in other joints compared to aspiration method when frank pus was already present. Most immuno-compromised patients recovered badly from septic arthritis. Associated adjacent osteomyelitis, preexisting chronic arthritis and recent intra-articular fractures were also noted to adversely affect the functional outcome.

  16. Acute necrotizing encephalopathy of childhood: a fatal complication of swine flu

    International Nuclear Information System (INIS)

    Khan, M.R.; Maheshwari, P.K.; Haque, A.

    2010-01-01

    Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition characterized by the presence of multifocal symmetrical brain lesions involving mainly thalami, brainstem, cerebellum and white matter. ANEC is a serious and life threatening complication of simple viral infections. We present a case of a young child who developed this condition with classical clinical and radiological findings consistent with ANEC, secondary to swine flu (H1N1). He needed ventilatory support and had profound motor and intellectual deficit on discharge. We report this case with aim of raising awareness about this fatal complication of swine flu which has become a global health care issue these days. (author)

  17. Major Differences in Advanced Life Support Training Strategies Among Danish Hospitals - A Nationwide Study

    DEFF Research Database (Denmark)

    Glerup Lauridsen, Kasper; Mygind-Klausen, Troels; Stærk, Mathilde

    2017-01-01

    Introduction: Advanced life support (ALS) training may increase survival from in-hospital cardiac arrest. Efficient ALS training includes practice of both technical and non-technical skills in a realistic setting with frequent retraining to avoid decay in ALS skills. ALS training strategies among...... hospitals are currently unknown. This study aimed to investigate ALS training strategies in Danish hospitals.Methods: We included all public, somatic hospitals in Denmark with a cardiac arrest team (n=46). Online questionnaires were distributed to resuscitation officers in each hospital. Questionnaires...... inquired information on: A) Course duration and retraining interval, B) Training methods and setting, C) Scenario training and practicing non-technical skills.Results: In total, 44 hospitals replied (response rate: 96%). ALS training was conducted in 43 hospitals (98%). Median (range) ALS course duration...

  18. 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.

  19. Lactobacillus paracasei feeding improves the control of secondary experimental meningococcal infection in flu-infected mice.

    Science.gov (United States)

    Belkacem, Nouria; Bourdet-Sicard, Raphaëlle; Taha, Muhamed-Kkeir

    2018-04-10

    The use of probiotics to improve anti-microbial defence, such as for influenza infections, is increasingly recommended. However, no data are available on the effect of probiotics on flu-associated secondary bacterial infections. There is strong evidence of a spatiotemporal association between influenza virus infection and invasive Neisseria meningitidis. We thus investigated the effect of feeding mice Lactobacillus paracasei CNCM I-1518 in a mouse model of sequential influenza-meningococcal infection. We intranasally infected BALB/c mice with a strain of influenza A virus (IAV) H3N2 that was first adapted to mice. Seven days later, a secondary bacterial infection was induced by intranasal administration of bioluminescent N. meningitidis. During the experiment, mice orally received either L. paracasei CNCM I-1518 or PBS as a control. The effect of L. paracasei administration on secondary bacterial infection by N. meningitidis was evaluated. Oral consumption of L. paracasei CNCM I-1518 reduced the weight loss of infected mice and lowered the bioluminescent signal of infecting meningococci. This improvement was associated with higher recruitment of inflammatory myeloid cells, such as interstitial monocytes and dendritic cells, to the lungs. Our data highlight the role of the gut-lung axis. L. paracasei CNCM I-1518 may boost the defence against IAV infection and secondary bacterial infection, which should be further studied and validated in clinical trials.

  20. A Prospective Study of Adolescent Suicidal Behavior Following Hospitalization.

    Science.gov (United States)

    King, Cheryl A.; And Others

    1995-01-01

    Identifies specific predictors of suicidal behavior in 100 adolescents during a 6-month follow-up period after psychiatric hospitalization. Eighteen percent reported suicidal behavior during the follow-up period, and this behavior was associated with suicidal thoughts, family dysfunction, and dysthymia. It was not associated with initial…

  1. Building and growing a hospital intranet: a case study.

    Science.gov (United States)

    Ong, K R; Polkowski, M; McLemore, G; Greaker, M; Murray, M

    2001-01-01

    The Intranet is a rapidly evolving technology in large hospitals. In this paper, we describe the first phase of an Intranet project in a multi-hospital system in New York City. (1) To encourage the use of the Intranet among physicians, nurses, managers, and other associates in a multi-hospital system; and (2) to build the Intranet in a cost-effective manner using existing resources. A WebTrends Log Analyzer assessed the Intranet use in terms of the number of accesses from each department. A broad range of features, including medical knowledge resources, clinical practice guidelines, directions, patient education, online forms, phone directory, and discussion forums were developed. Analysis of more than 890,000 hits revealed the departments with hits greater than 1,000 were the Library (6,130), Physicians Gateway (2,539), Marketing (1,321), Information Systems (1,241), and Nutrition (1,221). Of 819 unique visitors, 74 per cent visited more than once. It is possible to create and diffuse an Intranet in a multi-hospital system in a cost-effective manner. However, the key challenges were selling the potential of this new technology to opinion leaders and other stakeholders, and converting pre-existing printed content by obtaining word processed and image files from other departments or contracted print publishers.

  2. The efficiency and budgeting of public hospitals: case study of iran.

    Science.gov (United States)

    Yusefzadeh, Hasan; Ghaderi, Hossein; Bagherzade, Rafat; Barouni, Mohsen

    2013-05-01

    Hospitals are the most costly and important components of any health care system, so it is important to know their economic values, pay attention to their efficiency and consider factors affecting them. The aim of this study was to assess the technical scale and economic efficiency of hospitals in the West Azerbaijan province of Iran, for which Data Envelopment Analysis (DEA) was used to propose a model for operational budgeting. This study was a descriptive-analysis that was conducted in 2009 and had three inputs and two outputs. Deap2, 1 software was used for data analysis. Slack and radial movements and surplus of inputs were calculated for selected hospitals. Finally, a model was proposed for performance-based budgeting of hospitals and health sectors using the DEA technique. The average scores of technical efficiency, pure technical efficiency (managerial efficiency) and scale efficiency of hospitals were 0.584, 0.782 and 0.771, respectively. In other words the capacity of efficiency promotion in hospitals without any increase in costs and with the same amount of inputs was about 41.5%. Only four hospitals among all hospitals had the maximum level of technical efficiency. Moreover, surplus production factors were evident in these hospitals. Reduction of surplus production factors through comprehensive planning based on the results of the Data Envelopment Analysis can play a major role in cost reduction of hospitals and health sectors. In hospitals with a technical efficiency score of less than one, the original and projected values of inputs were different; resulting in a surplus. Hence, these hospitals should reduce their values of inputs to achieve maximum efficiency and optimal performance. The results of this method was applied to hospitals a benchmark for making decisions about resource allocation; linking budgets to performance results; and controlling and improving hospitals performance.

  3. Use of acute care hospital services by immigrant seniors in Ontario: A linkage study.

    Science.gov (United States)

    Ng, Edward; Sanmartin, Claudia; Tu, Jack; Manuel, Doug

    2014-10-01

    Seniors constitute the largest group of hospital users. The increasing share of immigrants in Canada's senior population can affect the demand for hospital care. This study used the linked 2006 Census-Hospital Discharge Abstract Database to examine hospitalization during the 2004-to-2006 period, by immigrant status, of Ontario seniors living in the community. Hospitalization was assessed with logistic regressions; cumulative length of stay, with zero-truncated negative binomial regressions. All-cause hospitalization and hospitalizations specific to circulatory and digestive diseases were examined. Immigrant seniors had significantly low age-/sex-adjusted odds of hospitalization, compared with Canadian-born seniors (OR = 0.81). The odds varied from 0.4 among East Asians to 0.89 among Europeans, and rose with length of time since arrival from 0.54 for recent (1994 to 2003) to 0.86 for long-term (before 1984) immigrants. Adjustment for demographic and socio-economic characteristics did not change the overall patterns. Immigrants' cumulated length of hospital stay tended to be shorter than or similar to that of Canadian-born seniors. Immigrant seniors, especially recent arrivals, had lower odds of hospitalization and similar time in hospital, compared with Canadian-born seniors. These patterns likely reflect differences in health status. Variations by world region and disease reflect the diverse health care needs of immigrant seniors.

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

    OpenAIRE

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

    2013-01-01

    Background 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. Methods 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 cos...

  5. Using the Competitive Dimensions to Achieve Competitive Advantage A Study on Jordanian Private Hospitals

    OpenAIRE

    Salah M. Diab

    2014-01-01

    This study aims to know, if the Jordanian private hospitals using the competitive dimensions to achieve competitive advantage, the Study populations consists of all managers at the Jordanian private hospital, were as the sample consisting of (200) managers. The simple statistical methods were used like repetitions, percentages, means, standard deviations, and multiple liner regression .The results showed that the Jordanian private hospitals used all the competition dimensions to achieve compe...

  6. Corporate social responsibility in health sector: a case study in the government hospitals in Medan, Indonesia

    Directory of Open Access Journals (Sweden)

    Arlina Nurbaity Lubis

    2018-03-01

    Full Text Available Contemporary society demands that every organization operate with a sense of social responsibility. Many organizations now include corporate social responsibility (CSR activities in their work programs. In the health sector, however, the role of CSR has not been studied as intensively as in private corporations because the services provided by the health sector are already valued as directly serving humanity. This research aims to evaluate the impact of CSR on the health sector, specifically on government hospitals. This model was developed by analyzing the influence of CSR on hospital reputation, customer loyalty, and hospital values. By answering questionnaires, a total of 200 hospital patients from four government hospitals participated in the study. The proposed model was evaluated using path analysis with AMOS tools. The results of this study provide empirical evidence that overall, CSR positively affects the reputation of the hospital, patient loyalty, and hospital value. Although there is a direct negative effect of CSR on hospital value, the larger influence of indirect effect that occurs through the mediating role of reputation and patient loyalty variables shows that CSR is able to increase the hospital value. Practically, these results imply that CSR should be applied as a strategic tool in improving the value of the hospital.

  7. Structure for prevention of health care-associated infections in Brazilian hospitals: A countrywide study.

    Science.gov (United States)

    Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco; Kiffer, Carlos; Barth, Afonso Luís; Carneiro, Irna Carla do Rosário Souza; Giamberardino, Heloisa Ilhe Garcia; Rodrigues, Jorge Luiz Nobre; Santos Filho, Lauro; de Mello, Maria Júlia Gonçalves; Pereira, Milca Severino; Gontijo Filho, Paulo; Rocha, Mirza; de Medeiros, Eduardo Alexandrino Servolo; Pignatari, Antonio Carlos Campos

    2016-01-01

    Minimal structure is required for effective prevention of health care-associated infection (HAI). The objective of this study was to evaluate the structure for prevention of HAI in a sample of Brazilian hospitals. This was a cross-sectional study from hospitals in 5 Brazilian regions (n = 153; total beds: 13,983) classified according to the number of beds; 11 university hospitals were used as reference for comparison. Trained nurses carried out the evaluation by using structured forms previously validated. The evaluation of conformity index (CI) included elements of structure of the Health Care-Associated Prevention and Control Committee (HAIPCC), hand hygiene, sterilization, and laboratory of microbiology. The median CI for the HAIPCC varied from 0.55-0.94 among hospital categories. Hospitals with >200 beds had the worst ratio of beds to sinks (3.9; P hospitals with hospitals (3.3; P hospitals were more likely to have their own laboratory of microbiology than other hospitals. This study highlights the need for public health strategies aiming to improve the structure for HAI prevention in Brazilian hospitals. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  8. Predictors of Hospitalization among Children on ART in Ethiopia: a Cohort study.

    Science.gov (United States)

    Haileamlak, Abraham; Hagos, Tesfalem; Abebe, Workeabeba; Abraham, Loko; Asefa, Henok; Teklu, Alula M

    2017-02-01

    Substantial progress has been made in the management of pediatric HIV infection in Ethiopia with the implementation of mother-to-child-prevention programs. Since the introduction of HAART in 2005, mortality among HIV-infected children has reduced while the rate of hospitalization was expected to rise. The purpose of this study, therefore, was to assess predictors of hospitalization in children on ART in seven university referral hospitals in Ethiopia. A prospective cohort study design was employed on children age 0-18 years as part of a multisite observational study. ART-experienced eligible and ART-naïve children with HIV/AIDS were enrolled into the Advanced Clinical Monitoring (ACM) till December 31, 2012 were included. From the database, information on hospitalization and other independent variables were extracted. Analysis was done using both SPSS for Windows version 16.0 and STATA. Descriptive analyses and modeling was done using logistic regression. Of the 405 children on ART (174 experienced, 231 naive), 86 (20.7%) were hospitalized for various reasons; two children were excluded since they were hospitalized for unrelated conditions (appendicitis and burn). Fifty one (60.7%) of the eighty four admitted children were hospitalized in the first six months of ART initiation. Of the independent variables, only the presence of opportunistic infections and duration on ART were significantly associated with hospitalization both on bi-variable and multivariable analyses (P-value ART increased by one month, the risk of hospitalization decreased by 5.4%, which is statistically significant (P hospitalized increased by 35.2% (P = 0.002). Of the individual opportunistic infections, pneumonia was found to be the only predictor of hospitalization (P-value = 0.002). This study showed that nearly two-third of the hospitalization was within 6 months of initiation of ART; and presence of OI and duration on ART were the only predictors of hospitalization.

  9. The HOSPITAL score and LACE index as predictors of 30 day readmission in a retrospective study at a university-affiliated community hospital

    Directory of Open Access Journals (Sweden)

    Robert Robinson

    2017-03-01

    Full Text Available Introduction Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP program. Validated risk assessment tools such as the HOSPITAL score and LACE index have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. This study aims to evaluate the utility of HOSPITAL score and LACE index for predicting hospital readmission within 30 days in a moderate-sized university affiliated hospital in the midwestern United States. Materials and Methods All adult medical patients who underwent one or more ICD-10 defined procedures discharged from the SIU-SOM Hospitalist service from Memorial Medical Center (MMC from October 15, 2015 to March 16, 2016, were studied retrospectively to determine if the HOSPITAL score and LACE index were a significant predictors of hospital readmission within 30 days. Results During the study period, 463 discharges were recorded for the hospitalist service. The analysis includes data for the 432 discharges. Patients who died during the hospital stay, were transferred to another hospital, or left against medical advice were excluded. Of these patients, 35 (8% were readmitted to the same hospital within 30 days. A receiver operating characteristic evaluation of the HOSPITAL score for this patient population shows a C statistic of 0.75 (95% CI [0.67–0.83], indicating good discrimination for hospital readmission. The Brier score for the HOSPITAL score in this setting was 0.069, indicating good overall performance. The Hosmer–Lemeshow goodness of fit test shows a χ2 value of 3.71 with a p value of 0.59. A receiver operating characteristic evaluation of the LACE index for this patient population shows a C statistic of 0.58 (95% CI [0.48–0.68], indicating poor discrimination for hospital readmission. The Brier score for the LACE index in this setting was 0.082, indicating good

  10. Potential of Complementary and Alternative Medicine in Preventive Management of Novel H1N1 Flu (Swine Flu Pandemic: Thwarting Potential Disasters in the Bud

    Directory of Open Access Journals (Sweden)

    Rajesh Arora

    2011-01-01

    Full Text Available The emergence of novel H1N1 has posed a situation that warrants urgent global attention. Though antiviral drugs are available in mainstream medicine for treating symptoms of swine flu, currently there is no preventive medicine available. Even when available, they would be in short supply and ineffective in a pandemic situation, for treating the masses worldwide. Besides the development of drug resistance, emergence of mutant strains of the virus, emergence of a more virulent strain, prohibitive costs of available drugs, time lag between vaccine developments, and mass casualties would pose difficult problems. In view of this, complementary and alternative medicine (CAM offers a plethora of interesting preventive possibilities in patients. Herbs exhibit a diverse array of biological activities and can be effectively harnessed for managing pandemic flu. Potentially active herbs can serve as effective anti influenza agents. The role of CAM for managing novel H1N1 flu and the mode of action of these botanicals is presented here in an evidence-based approach that can be followed to establish their potential use in the management of influenza pandemics. The complementary and alternative medicine approach deliberated in the paper should also be useful in treating the patients with serious influenza in non pandemic situations.

  11. Pathway for inpatients with depressive episode in Flemish psychiatric hospitals: a qualitative study

    Directory of Open Access Journals (Sweden)

    Simoens Steven R

    2009-10-01

    Full Text Available Abstract Background Within the context of a biopsychosocial model of the treatment of depressive episodes, a multidisciplinary approach is needed. Clinical pathways have been developed and implemented in hospitals to support multidisciplinary teamwork. The aim of this study is to explore current practice for the treatment of depressive episodes in Flemish psychiatric hospitals. Current practice in different hospitals is studied to get an idea of the similarities (outlined as a pathway and the differences in the treatment of depressive episodes. Methods A convenience sample of 11 Flemish psychiatric hospitals participated in this qualitative study. Semi-structured interviews were conducted with different types of health care professionals (n = 43. The websites of the hospitals were searched for information on their approach to treating depressive episodes. Results A flow chart was made including the identified stages of the pathway: pre-admission, admission (observation and treatment, discharge and follow-up care. The characteristics of each stage are described. Although the stages are identified in all hospitals, differences between hospitals on various levels of the pathway exist. Hospitals emphasized the individual approach of each patient. The results point to a biopsychosocial approach to treating depressive episodes. Conclusion This study outlined current practice as a pathway for Flemish inpatients with depressive episodes. Within the context of surveillance of quality and quantity of care, this study may encourage hospitals to consider developing clinical pathways.

  12. Application of life cycle assessment for hospital solid waste management: A case study.

    Science.gov (United States)

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

    2016-10-01

    This study was meant to determine environmental aspects of hospital waste management scenarios using a life cycle analysis approach. The survey for this study was conducted at the largest hospital in a major city of Pakistan. The hospital was thoroughly analyzed from November 2014 to January 2015 to quantify its wastes by category. The functional unit of the study was selected as 1 tonne of disposable solid hospital waste. System boundaries included transportation of hospital solid waste and its treatment and disposal by landfilling, incineration, composting, and material recycling methods. These methods were evaluated based on their greenhouse gas emissions. Landfilling and incineration turned out to be the worst final disposal alternatives, whereas composting and material recovery displayed savings in emissions. An integrated system (composting, incineration, and material recycling) was found as the best solution among the evaluated scenarios. This study can be used by policymakers for the formulation of an integrated hospital waste management plan. This study deals with environmental aspects of hospital waste management scenarios. It is an increasing area of concern in many developing and resource-constrained countries of the world. The life cycle analysis (LCA) approach is a useful tool for estimation of greenhouse gas emissions from different waste management activities. There is a shortage of information in existing literature regarding LCA of hospital wastes. To the best knowledge of the authors this work is the first attempt at quantifying the environmental footprint of hospital waste in Pakistan.

  13. Assessment of hospitalization and mortality of scleroderma in-patients: a thirteen-year study

    Directory of Open Access Journals (Sweden)

    Saeedeh Shenavandeh

    2017-08-01

    Full Text Available Objective: Systemic sclerosis (SSc is an uncommon non-hereditary sporadic disease that increases the risk of premature death, especially in diffuse type. We determined the prevalence of SSc in the last 13 years in our rheumatologic hospitals as a referral center for southern Iranian patients, the causes of hospitalization, the average length of stay (LOS, the mortality rate, and the reason for their mortality. Material and methods : A cross-sectional study was performed in Shiraz University of Medical Sciences, Iran. The studied population included all patients diagnosed with systemic sclerosis. We calculated the hospitalization rates, in-hospital mortality rates, and mean LOS. Results: There were 446 admissions by 181 patients with SSc. The female to male ratio was about 10.7 : 1. The overall mean LOS was 5.95 days. Digital ulcer and interstitial lung disease (ILD were the most common causes of hospitalizations among the SSc-related events. For those with a non-SSc-related condition, infection was the most prevalent event. Most of the deaths were due to ILD and pulmonary artery hypertension(PAH, and the overall in-hospital mortality rate was 16.5%. Conclusions : Women with SSc had higher rates of hospitalization but lower in-hospital mortality than men.There were some differences between our study and other similar studies in the causes of hospitalization and in-hospital death among SSc patients, especially the lower age of death. The patients with digital ulcers and those with intestinal lung disease or pulmonary hipertension were most commonly admitted to the hospital in our study group. Probably, increasing the skin care of these patients and asking other specialty groups to cooperate will decrease the high rate of hospitalizations in our population.

  14. Association between air pollution and hospital admission: Case study at three monitoring stations in Malaysia

    Science.gov (United States)

    Zahari, Marina; Zin@Ibrahim, Wan Zawiah Wan; Ismail, Noriszura; Ni, Tan Hui

    2014-06-01

    The relationships between the exposure of pollutants towards hospitalized admission and mortality have been identified in several studies on Asian cities such as Taipei, Bangkok and Tokyo. In Malaysia, evidence on the health risks associated with exposure to pollutants is limited. In this study, daily time-series data were analysed to estimate risks of cardiovascular and respiratory hospitalized admissions associated with particulate matter ≤ 10 μm (PM10), carbon monoxide (CO), nitrogen dioxide, sulphur dioxide, and ozone concentrations in Klang Valley during 2004-2009. Daily counts of hospital admissions for cardiovascular and respiratory outcomes were obtained from eleven hospitals while pollutants data were taken from several air quality monitoring stations located nearest to the hospitals. These data were fitted with Generalised Additive Poisson regression models. Additionally, temperature, humidity, and time data were also included to allow for potential effect of weather and time-varying influences on hospital admissions. CO showed the most significant (P Malaysia.

  15. A study on sustainability practices in the Malaysian Hospitality Industry

    OpenAIRE

    Kaur, Jasvinder

    2014-01-01

    The hospitality industry encompasses an extensive variety of services that include food service, tourism and hotels. It can be considered a major service sector in the world economy today and described as an industry that has a great impact on the environment, discharging a huge amount of raw and solid waste, constituting a threat to the environment. While much as been done to promote tourism in Malaysia through activities such as Visit Malaysia Year (VMY), very little is done to ensure a sus...

  16. Tuberculosis patients hospitalized in the Albert Schweitzer Hospital, Lambaréné, Gabon-a retrospective observational study.

    Science.gov (United States)

    Stolp, S M; Huson, M A M; Janssen, S; Beyeme, J O; Grobusch, M P

    2013-11-01

    Epidemiological data on tuberculosis in Central Africa are limited. We performed a retrospective observational study on clinical characteristics of 719 hospitalized tuberculosis patients in Lambaréné, Gabon. Human immunodeficiency virus (HIV) co-infection rate was high (34%) and in-hospital mortality was significantly higher in HIV-positive patients (10% versus 2%). Long-term information on patient outcome was limited; however, from 2008 to 2011, loss to follow up was noted in 28% of cases. Our data illustrate the high burden of TB in Gabon, where loss to follow up and emerging drug resistance are important problems for which comprehensive data are still lacking. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  17. Are Hospital Workers Healthy?: A Study of Cardiometabolic, Behavioral, and Psychosocial Factors Associated With Obesity Among Hospital Workers.

    Science.gov (United States)

    Sharma, Shreela V; Upadhyaya, Mudita; Karhade, Mandar; Baun, William B; Perkison, William B; Pompeii, Lisa A; Brown, Henry S; Hoelscher, Deanna M

    2016-12-01

    This study evaluated the cardiometabolic, behavioral, and psychosocial factors associated with weight status among hospital employees. A total of n = 924 employees across the six hospitals in Texas participated in this cross-sectional study, 2012 to 2013. Association between weight status and waist circumference, blood pressure, biomarkers, diet, physical activity, sedentary behaviors, and psychosocial factors was assessed. About 78.1% of employees were overweight/obese. Obese participants (body mass index [BMI] ≥30.0 kg/m) had higher consumption of potatoes, fats, sugary beverages, and spent more time watching television, playing computer games, and sitting than those having normal weight. Being obese was positively associated with blood pressure, blood glucose, low-density lipoprotein, and negatively associated with high-density lipoprotein. Finally, 78.8% of workers were dissatisfied with their worksite wellness with dissatisfaction being higher among obese employees. Being overweight (BMI 25.0 to 29.9 kg/m) was positively associated with blood pressure, but not other variables. Understanding the risk profile of hospital workers is critical to developing effective interventions.

  18. Factor selection for service quality evaluation: a hospital case study.

    Science.gov (United States)

    Ameryoun, Ahmad; Najafi, Seyedvahid; Nejati-Zarnaqi, Bayram; Khalilifar, Seyed Omid; Ajam, Mahdi; Ansarimoghadam, Ahmad

    2017-02-13

    Purpose The purpose of this paper is to develop a systematic approach to predict service quality dimension's influence on service quality using a novel analysis based on data envelopment and SERVQUAL. Design/methodology/approach To assess hospital service quality in Tehran, expectation and perception of those who received the services were evaluated using SERVQUAL. The hospital service quality dimensions were found by exploratory factor analysis (EFA). To compare customer expectation and perception, perceived service quality index (PSQI) was measured using a new method based on common weights. A novel sensitivity approach was used to test the service quality factor's impact on the PSQI. Findings A new service quality dimension named "trust in services" was found using EFA, which is not an original SERVQUAL factor. The approach was applied to assess the hospital's service quality. Since the PSQI value was 0.76 it showed that improvements are needed to meet customer expectations. The results showed the factor order that affect PSQI. "Trust in services" has the strongest influence on PSQI followed by "tangibles," "assurance," "empathy," and "responsiveness," respectively. Practical implications This work gives managers insight into service quality by following a systematic method; i.e., measuring perceived service quality from the customer viewpoint and service factors' impact on customer perception. Originality/value The procedure helps managers to select the required service quality dimensions which need improvement and predict their effects on customer perception.

  19. Hospital restructuring and physician job satisfaction: an empirical study.

    Science.gov (United States)

    Mascia, Daniele; Morandi, Federica; Cicchetti, Americo

    2014-02-01

    The adoption of clinical directorates through the internal reconfiguration of hospital organizations has been one of the most widespread restructuring interventions in many Western European countries. Despite its extensive adoption, a lack of knowledge remains on the analysis of how this reorganization affects professionals' job satisfaction. This paper contributes to the debate on clinical directorates by exploring how the structural characteristics of newly adopted organizational models influence physician's job satisfaction. More than 300 physicians in 18 clinical directorates in the Italian National Health Service were surveyed regarding their overall job satisfaction following the introduction of departmental arrangements. Survey results were then linked to another survey that classified newly adopted models according to the criteria used to merge hospital wards into directorates, by recognizing "Process-integration", "Specialty-integration" and "Mixed-integration" types of directorates. Our findings show that structural aspects of change significantly influenced overall job satisfaction, and that a physician's openness to experience moderated the adoption and implementation of new clinical directorates. Specifically, results demonstrate that physicians with high openness to experience scores were more receptive to the positive impacts of change on overall job satisfaction. Implications for how these findings may facilitate organizational shifts within hospital settings are discussed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. An Observational study of prehospital and hospital delay in reperfusion for acute myocardial infarction at a University Hospital in India

    Directory of Open Access Journals (Sweden)

    Rahul Choudhary

    2016-01-01

    Full Text Available Objective: Cardiovascular disease is the leading cause of death among Indian adults, and approximately 50% of deaths usually occur during the 1st hour after symptom onset before arriving at the hospital. A study was planned to evaluate the prehospital and hospital delay in patients with acute myocardial infarction (AMI. Methods: This was a prospective observational study of 390 patients with AMI admitted to the Department of Cardiology between March 2014 and August 2015. Detailed patient demographics, socioeconomic status, and prehospital and hospital delay were reviewed. Results: The mean age of presentation for male and female was 57 ± 12.91 and 61.5 ± 12.83 years, respectively. The mean prehospital delay, time to act after chest pain, and travel time were 9.08 ± 6.3, 7.16 ± 6.1, and 1.84 ± 0.8 h, respectively, and only three (9.7% patients reached the hospital within 2 h after symptom onset. Out of 300 patients who received reperfusion therapy, thrombolysis was done in 276 (92% patients while primary percutaneous coronary intervention was performed in only 24 (8% patients. Mean door-to-needle (D-N time and door-to-device time for those who received reperfusion therapy were 27.8 ± 4.3 and 78.95 ± 9.5 min, respectively. A multivariate logistic regression analysis revealed that the prehospital delay was significantly associated with older age, female sex, rural background, diabetes, having atypical pain, and lack of knowledge regarding the seriousness of chest pain. Conclusion: Approximately 79% of total prehospital delay was due to patient-related factors; old age, female sex, rural background, diabetes, atypical angina, and lack of knowledge being the significant attributes. D-N time and door-to-device time were within the limits of those recommended by current guidelines.

  1. 77 FR 30016 - Clinical Study Design and Performance of Hospital Glucose Sensors

    Science.gov (United States)

    2012-05-21

    ...] Clinical Study Design and Performance of Hospital Glucose Sensors AGENCY: Food and Drug Administration, HHS... Sensors.'' The purpose of this public meeting is to discuss clinical study design considerations and performance metrics for innovative glucose sensors intended to be used in hospital point of care settings...

  2. Case-controlled Study on Risk Factors for the Development of Constipation in Hospitalized Patients

    OpenAIRE

    Ueki, Tetsuya; Nagai, Keiko; Ooe, Nobuharu; Nakashima, Mihoko N.; Nishida, Koyo; Nakamura, Junzo; Nakashima, Mikiro

    2011-01-01

    Constipation is a common problem in hospitalized patients; however, the relative risks of its development with various factors have not been clarified. To clarify the risk factors associated with constipation, we performed a case-controlled study of 165 hospitalized patients who were not laxative users on admission. They were divided into case (n=35) and control (n=130) groups according to laxative administration during hospitalization. Comparison of the patient backgrounds in the two groups ...

  3. Nurses' perceptions of leadership style in hospitals: a grounded theory study.

    Science.gov (United States)

    Su, Shu-Fen; Jenkins, Mary; Liu, Po-Erh

    2012-01-01

    This paper explores the leadership style of hospital managers. Leadership has been widely studied in nursing from the perspective of nurses' psychological strain caused by nursing leadership. There is, however, little contained in the Western and Eastern literatures on the leadership style of hospital managers and certainly no study has explored managers' leadership style in Taiwanese hospitals from the nurses' stance. Grounded theory. A sample of 28 nurses from seven teaching hospitals in Taiwan, Republic of China was selected through theoretical sampling. A multi-step analytic procedure based on the grounded theory approach was used to analyse the qualitative data. The Chinese culture was found to affect the leadership style of Taiwanese hospital managers. They had extreme power and led nurses in a hierarchical manner. Nurse managers followed the autocratic leadership style of their hospital managers. The main category found in this study was thus hierarchical leadership. The Confucian principles of authoritarianism and obedience were found to be part of the Taiwanese hospitals' organisational cultures and strongly impacted on the managers' leadership style. Hospital managers' treatment of doctors and nurses was dependent on their social rankings. Nurses' lowly ranking fed into these enculturated managerial tendencies of using power and obedience thus increasing psychological strain on nurses. Managers of the hospitals demonstrate power and misuse obedience through their leadership style, resulting in deterioration of nurses' work environment. Nurses' managers are not given enough power by the hospitals in Taiwan. Subsequently, nurses feel themselves the lowest and most powerless subordinates. This study reveals that the Chinese cultural burdens are embedded in the leadership of Taiwanese hospitals. These findings enhance the knowledge of leadership and add to the understanding of managerial attitudes in Chinese hospitals located worldwide. © 2011 Blackwell

  4. General Considerations on Leadership in the Hospitality Industry. Conceptual Analysis and Practical Studies

    OpenAIRE

    Andreia ISPAS

    2010-01-01

    Leadership in the hospitality industry is still an open research field especially in describing the effects of leadership style on hotel employees. The purpose of the paper is to present and analyze the following concepts: leadership and leadership style, hospitality industry; the practical aspects of leadership in the hospitality industry and to identify relevant studies regarding the importance of leadership styles applied in this industry. The research methodology consists of analyzing the...

  5. Case study: improving efficiency in a large hospital laboratory.

    Science.gov (United States)

    Bartel, Marilynn

    2004-01-01

    Saint Francis Health System (SFHS) consists of three hospitals and one clinic: Saint Francis Hospital (SFH); Broken Arrow Medical Center; Laureate Psychiatric Hospital; and Warren Clinic. SFHS has 670 physicians on staff and serves medical (oncology, orthopedic, neurology, and renal), surgical, cardiac, women and infant, pediatric, transplant, and trauma patients in Tulsa County, Oklahoma, which has a population of 660,000. SFH incorporates 706 staffed beds, including 126 pediatric beds and 119 critical care beds. Each year, the health system averages 38,000 admissions, 70,000 emergency department visits, 25,000 surgeries, and 3,500 births. Saint Francis Laboratory is located within the main hospital facility (SFH) and functions as a core lab for the health system. The lab also coordinates lab services with Saint Francis Heart Hospital, a physician-system joint venture. The Optimal Equipment Configuration (OEC) Project was designed by the Clinical Laboratory Services division of Premier, a group purchasing organization, with the goal of determining whether laboratories could improve efficiency and decrease unit cost by using a single-source vendor. Participants included seven business partners (Abbott, Bayer, Beckman/Coulter, Dade/Behring, J&J/ Ortho, Olympus, and Roche) and 21 laboratory sites (a small, mid-sized, and large site for each vendor). SFH laboratory staff embraced Premier's concept and viewed the OEC project as an opportunity to "energize" laboratory operations. SFH partnered with Abbott, their primary equipment vendor, for the project. Using resources and tools made available through the project, the laboratory was re-engineered to simplify workflow, increase productivity, and decrease costs by adding automation and changing to centralized specimen processing. Abbott and SFH shared a common vision for the project and enhanced their partnership through increased communication and problem solving. Abbott's area representatives provided for third

  6. Information technology governance domains in hospitals: a case study in Iran.

    Science.gov (United States)

    Shahi, Mehraban; Sadoughi, Farahnaz; Ahmadi, Maryam

    2014-11-30

    IT governance is a set of organizational structures ensuring decision-making rights and responsibilities with regard to the organization's IT assets. This qualitative study was carried out to identify the IT governance domains in teaching hospitals affiliated to Iran University of Medical Sciences. There were 10 heads of IT departments and 10 hospital directors. Semi structured interviews used for data collection. To analyze the data content analysis was applied. All the interviewees (100%) believed that decisions upon hospital software needs could be made in a decentralized fashion by the IT department of the university. Most of the interviewees (90%) believed that there were policies for logistics and maintenance of networks, purchase and maintenance, standards and general policies in the direction of the policies of the ministry of health and medical education. About 80% of the interviewees believed that the current emphasis of the hospital's IT unit and the hospital management for outsourcing of services were in the format of specialized contracts and under supervision of the university Statistic and IT department. A hospital strategic committee is an official organizational group consisting of hospital executives, heads of IT and multiple functional areas and business units in a hospital. In this committee, "the head of hospital" acts as the director of IT activities and ensures that IT strategies are alignment with the hospital business strategies.

  7. Developing a master plan for hospital solid waste management: A case study

    International Nuclear Information System (INIS)

    Karamouz, Mohammad; Zahraie, Banafsheh; Kerachian, Reza; Jaafarzadeh, Nemat; Mahjouri, Najmeh

    2007-01-01

    Disposal of about 1750 tons of solid wastes per day is the result of a rapid population growth in the province of Khuzestan in the south west of Iran. Most of these wastes, especially hospital solid wastes which have contributed to the pollution of the environment in the study area, are not properly managed considering environmental standards and regulations. In this paper, the framework of a master plan for managing hospital solid wastes is proposed considering different criteria which are usually used for evaluating the pollution of hospital solid waste loads. The effectiveness of the management schemes is also evaluated. In order to rank the hospitals and determine the share of each hospital in the total hospital solid waste pollution load, a multiple criteria decision making technique, namely analytical hierarchy process (AHP), is used. A set of projects are proposed for solid waste pollution control and reduction in the proposed framework. It is partially applied for hospital solid waste management in the province of Khuzestan, Iran. The results have shown that the hospitals located near the capital city of the province, Ahvaz, produce more than 43% of the total hospital solid waste pollution load of the province. The results have also shown the importance of improving management techniques rather than building new facilities. The proposed methodology is used to formulate a master plan for hospital solid waste management

  8. Organizational and market factors associated with leadership development programs in hospitals: a national study.

    Science.gov (United States)

    Kim, Tae Hyun; Thompson, Jon M

    2012-01-01

    Effective leadership in hospitals is widely recognized as the key to organizational performance. Clinical, financial, and operational performance is increasingly being linked to the leadership practices of hospital managers. Moreover, effective leadership has been described as a means to achieve competitive advantage. Recent environmental forces, including reimbursement changes and increased competition, have prompted many hospitals to focus on building leadership competencies to successfully address these challenges. Using the resource dependence theory as our conceptual framework, we present results from a national study of hospitals examining the association of organizational and market factors with the provision of leadership development program activities, including the presence of a leadership development program, a diversity plan, a program for succession planning, and career development resources. The data are taken from the American Hospital Association's (AHA) 2008 Survey of Hospitals, the Area Resource File, and the Centers for Medicare & Medicaid Services. The results of multilevel logistic regressions of each leadership development program activity on organizational and market factors indicate that hospital size, system and network affiliation, and accreditation are significantly and positively associated with all leadership development program activities. The market factors significantly associated with all leadership development activities include a positive odds ratio for metropolitan statistical area location and a negative odds ratio for the percentage of the hospital's service area population that is female and minority. For-profit hospitals are less likely to provide leadership development program activities. Additional findings are presented, and the implications for hospital management are discussed.

  9. Preparing for the Flu During the 2009-10 School Year: Questions and Answers for Schools

    Science.gov (United States)

    US Department of Education, 2009

    2009-01-01

    This brochure provides answers to the following questions: (1) Why do school districts, schools, teachers, parents, and communities need to plan for the continuation of learning for students during flu season this year? (2) How should districts and schools go about planning to continue students' education when they are at home because of H1N1?…

  10. CAN FLU-LIKE ILLNESS BE AN INDICATION OF RECENT ORGANOPHOSPHATE PESTICIDE EXPOSURE IN PRESCHOOL CHILDREN?

    Science.gov (United States)

    Can flu-like illness be an indication of recent organophosphate pesticide exposure in preschool children? P Mendola*, D Barr, D Walsh, S Hern, S Rhoney, L Needham, E Hilborn, M Gonzales, C Carty, G Robertson, J Creason (US EPA, ORD, NHEERL, Research Triangle Park, NC 27711)<...

  11. Mathematical formulation and numerical simulation of bird flu infection process within a poultry farm

    Science.gov (United States)

    Putri, Arrival Rince; Nova, Tertia Delia; Watanabe, M.

    2016-02-01

    Bird flu infection processes within a poultry farm are formulated mathematically. A spatial effect is taken into account for the virus concentration with a diffusive term. An infection process is represented in terms of a traveling wave solutions. For a small removal rate, a singular perturbation analysis lead to existence of traveling wave solutions, that correspond to progressive infection in one direction.

  12. The neuropsychiatric aspects of influenza/swine flu: A selective review

    Directory of Open Access Journals (Sweden)

    Narayana Manjunatha

    2011-01-01

    Full Text Available The world witnessed the influenza virus during the seasonal epidemics and pandemics. The current strain of H1N1 (swine flu pandemic is believed to be the legacy of the influenza pandemic (1918-19. The influenza virus has been implicated in many neuropsychiatric disorders. In view of the recent pandemic, it would be interesting to review the neuropsychiatric aspects of influenza, specifically swine flu. Author used popular search engine ′PUBMED′ to search for published articles with different MeSH terms using Boolean operator (AND. Among these, a selective review of the published literature was done. Acute manifestations of swine flu varied from behavioral changes, fear of misdiagnosis during outbreak, neurological features like seizures, encephalopathy, encephalitis, transverse myelitis, aseptic meningitis, multiple sclerosis, and Guillian-Barre Syndrome. Among the chronic manifestations, schizophrenia, Parkinson′s disease, mood disorder, dementia, and mental retardation have been hypothesized. Further research is required to understand the etiological hypothesis of the chronic manifestations of influenza. The author urges neuroscientists around the world to make use of the current swine flu pandemic as an opportunity for further research.

  13. Hand Hygiene Adherence Among Health Care Workers at Japanese Hospitals: A Multicenter Observational Study in Japan.

    Science.gov (United States)

    Sakihama, Tomoko; Honda, Hitoshi; Saint, Sanjay; Fowler, Karen E; Shimizu, Taro; Kamiya, Toru; Sato, Yumiko; Arakawa, Soichi; Lee, Jong Ja; Iwata, Kentaro; Mihashi, Mutsuko; Tokuda, Yasuharu

    2016-03-01

    Although proper hand hygiene among health care workers is an important component of efforts to prevent health care-associated infection, there are few data available on adherence to hand hygiene practices in Japan. The aim of this study was to examine hand hygiene adherence at teaching hospitals in Japan. An observational study was conducted from July to November 2011 in 4 units (internal medicine, surgery, intensive care, and/or emergency department) in 4 geographically diverse hospitals (1 university hospital and 3 community teaching hospitals) in Japan. Hand hygiene practice before patient contact was assessed by an external observer. In a total of 3545 health care worker-patient observations, appropriate hand hygiene practice was performed in 677 (overall adherence, 19%; 95% confidence interval, 18%-20%). Subgroup rates of hand hygiene adherence were 15% among physicians and 23% among nurses. The ranges of adherence were 11% to 25% between hospitals and 11% to 31% between units. Adherence of the nurses and the physicians to hand hygiene was correlated within each hospital. There was a trend toward higher hand hygiene adherence in hospitals with infection control nurses, compared with hospitals without them (29% versus 16%). The hand hygiene adherence in Japanese teaching hospitals in our sample was low, even lower than reported mean values from other international studies. Greater adherence to hand hygiene should be encouraged in Japan.

  14. Hospital managers' need for information in decision-making--An interview study in nine European countries.

    Science.gov (United States)

    Kidholm, Kristian; Ølholm, Anne Mette; Birk-Olsen, Mette; Cicchetti, Americo; Fure, Brynjar; Halmesmäki, Esa; Kahveci, Rabia; Kiivet, Raul-Allan; Wasserfallen, Jean-Blaise; Wild, Claudia; Sampietro-Colom, Laura

    2015-11-01

    Assessments of new health technologies in Europe are often made at the hospital level. However, the guidelines for health technology assessment (HTA), e.g. the EUnetHTA Core Model, are produced by national HTA organizations and focus on decision-making at the national level. This paper describes the results of an interview study with European hospital managers about their need for information when deciding about investments in new treatments. The study is part of the AdHopHTA project. Face-to-face, structured interviews were conducted with 53 hospital managers from nine European countries. The hospital managers identified the clinical, economic, safety and organizational aspects of new treatments as being the most relevant for decision-making. With regard to economic aspects, the hospital managers typically had a narrower focus on budget impact and reimbursement. In addition to the information included in traditional HTAs, hospital managers sometimes needed information on the political and strategic aspects of new treatments, in particular the relationship between the treatment and the strategic goals of the hospital. If further studies are able to verify our results, guidelines for hospital-based HTA should be altered to reflect the information needs of hospital managers when deciding about investments in new treatments. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. Senior Friendly Hospitals: Development and Application of Criteria: A Descriptive Study.

    Science.gov (United States)

    Rashmi, M R; Kasthuri, Arvind; Rodrigues, Rashmi J

    2016-01-01

    The world's population is rapidly aging. Between 2000 and 2050, the proportion of the world's population over the age of 60 will double from about 11% to 22%; more so in the developing countries. The prevalence of frailty and morbidity among the elderly is high. There is a need to assess the "preparedness" of the health care system including hospitals to respond to the needs of the elderly. 1. To develop criteria for a senior friendly hospital and 2. To assess the feasibility of application of these criteria. A descriptive study was done at Bangalore, India, involving 100 subjects sampled by purposive sampling. Study population consisted of senior citizens, their caretakers, physicians, hospital support staff, nurses, geriatricians, hospital administrators, and architects. They were interviewed using a validated translated interview schedule. The study consisted of two phases; Phase 1: Developing a checklist to assess senior friendliness of a hospital by using modified Delphi technique. Phase 2: Application of the checklist thus developed to selected hospitals in order to assess the feasibility of administration. The data was then analyzed using Statistical Package for the Social Sciences (SPSS) for frequencies, proportions, central tendency and dispersion, interclass reliability, intraclass reliability, and Cronbach's alpha. A checklist containing 44 items to assess the senior friendliness of a hospital was developed. The checklist was found feasible and easy to administer. The checklist thus developed to assess senior friendliness of a hospital has wider application as it has a potential to be considered for framing senior friendly hospital guidelines/policies.

  16. A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage Scheme

    Directory of Open Access Journals (Sweden)

    Winch Peter J

    2011-04-01

    Full Text Available Abstract Background In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Methods Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large, location (urban/rural, and type (public/private. Results Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1 Discharge Summarization, 2 Completeness Checking, 3 Diagnosis and Procedure Coding, 4 Code Checking, 5 Relative Weight Challenging, 6 Coding Report, and 7 Internal Audit. The hospital coding practice can be affected by at least five main factors: 1 Internal Dynamics, 2 Management Context, 3 Financial Dependency, 4 Resource and Capacity, and 5 External Factors. Conclusions Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors.

  17. "Hospital at home" for neuromuscular disease patients with respiratory tract infection: a pilot study.

    Science.gov (United States)

    Vianello, Andrea; Savoia, Francesca; Pipitone, Emanuela; Nordio, Beatrice; Gallina, Giulia; Paladini, Luciana; Concas, Alessandra; Arcaro, Giovanna; Gallan, Federico; Pegoraro, Elena

    2013-12-01

    The "hospital-at-home" model may provide adequate care without an adverse effect on clinical outcome, and is generally well received by users. Our objective was to compare hospital-at-home and in-patient hospital care for neuromuscular disease (NMD) patients with respiratory tract infections. We conducted a prospective randomized controlled trial in a university teaching hospital offering secondary care service to a population of approximately 500,000. We recruited selected NMD patients with respiratory tract infection for whom hospital admission had been recommended after medical assessment. Hospital-at-home was provided as an alternative to in-patient admission. The main outcome measures were need for hospitalization, treatment failure, time to recovery, death during the first 3 months following exacerbation, and cost of patient care. Among 59 consecutive NMD patients eligible for the study, 53 met the criteria for hospital-at-home. Twenty-six subjects were randomized to home care and 27 to hospital care. No significant differences were found in treatment failure (8/26 vs 13/27, P = .19), time to recovery (8.9 ± 4.6 vs 9 ± 8.9 d, P = .21), or mortality at 3 months (3/26 vs 4/27 deaths, P = .42) between the groups. Hospital-at-home failure was independently correlated with type of NMD (P = .004) with an odds ratio of failure of 17.3 (95% CI 2.1 to infinity) for subjects with amyotrophic lateral sclerosis. The total and daily direct cost of patient healthcare was significantly lower for the subjects who were successfully treated at home, compared to the hospitalized individuals. Hospital-at-home is an effective alternative to hospital admission for selected NMD patients with respiratory tract infections.

  18. A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage scheme.

    Science.gov (United States)

    Pongpirul, Krit; Walker, Damian G; Winch, Peter J; Robinson, Courtland

    2011-04-08

    In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large), location (urban/rural), and type (public/private). Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1) Discharge Summarization, 2) Completeness Checking, 3) Diagnosis and Procedure Coding, 4) Code Checking, 5) Relative Weight Challenging, 6) Coding Report, and 7) Internal Audit. The hospital coding practice can be affected by at least five main factors: 1) Internal Dynamics, 2) Management Context, 3) Financial Dependency, 4) Resource and Capacity, and 5) External Factors. Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors.

  19. Clinical audit of COPD patients requiring hospital admissions in Spain: AUDIPOC study.

    Directory of Open Access Journals (Sweden)

    Francisco Pozo-Rodríguez

    Full Text Available BACKGROUNDS: AUDIPOC is a nationwide clinical audit that describes the characteristics, interventions and outcomes of patients admitted to Spanish hospitals because of an exacerbation of chronic obstructive pulmonary disease (ECOPD, assessing the compliance of these parameters with current international guidelines. The present study describes hospital resources, hospital factors related to case recruitment variability, patients' characteristics, and adherence to guidelines. METHODOLOGY/PRINCIPAL FINDINGS: An organisational database was completed by all participant hospitals recording resources and organisation. Over an 8-week period 11,564 consecutive ECOPD admissions to 129 Spanish hospitals covering 70% of the Spanish population were prospectively identified. At hospital discharge, 5,178 patients (45% of eligible were finally included, and thus constituted the audited population. Audited patients were reassessed 90 days after admission for survival and readmission rates. A wide variability was observed in relation to most variables, hospital adherence to guidelines, and readmissions and death. Median inpatient mortality was 5% (across-hospital range 0-35%. Among discharged patients, 37% required readmission (0-62% and 6.5% died (0-35%. The overall mortality rate was 11.6% (0-50%. Hospital size and complexity and aspects related to hospital COPD awareness were significantly associated with case recruitment. Clinical management most often complied with diagnosis and treatment recommendations but rarely (<50% addressed guidance on healthy life-styles. CONCLUSIONS/SIGNIFICANCE: The AUDIPOC study highlights the large across-hospital variability in resources and organization of hospitals, patient characteristics, process of care, and outcomes. The study also identifies resources and organizational characteristics associated with the admission of COPD cases, as well as aspects of daily clinical care amenable to improvement.

  20. Development of personnel radiation monitoring program for occupationally exposed workers in Malawian Hospitals : A case study of Kamuzu Central, Bwaila and Mtengo Wa Nthenga Hospitals

    International Nuclear Information System (INIS)

    Chinangwa, Getrude

    2016-07-01

    Malawi became an IAEA member state in 2006 and developed the Atomic Energy Act and Regulations in 2011 and 2012 respectively. However, regulatory authority and personnel monitoring services have not yet been established. As such, hospitals operating radiological services in Malawi do not have personnel monitoring programme. This study aimed at developing the personnel radiation monitoring program for three hospitals in Malawi namely; Kamuzu Central Hospital, Bwaila Hospital, and Mtengo wa Nthenga Hospital. A radiation protection questionnaire was administered to the X-ray Departments involved in the study to investigate radiation protection practices in the hospitals. Dose rate measurements in the facilities were taken using survey meters and doses to individuals were recorded using personal dosimeters. The results showed that the hospitals lack radiation protection program which covers the critical issues of quality assurance and control as well as the personnel dose monitoring. Average ambient dose rate values were 0.39 μSv/hr for Mtengo wa Nthenga Hospital, 5.03 μSv/hr for Bwaila Hospital and 4μSv/hr for Kamuzu Central Hospital. Average monthly dose for workers was 0.247 mSv. The study recommends the establishment of a regulatory authority, consistent dose assessment, quality control tests and structural shielding assessment in these and probably all the diagnostic facilities in Malawi. The personnel monitoring programme developed from this study is intended to guide diagnostic facilities and personnel monitoring service providers in Malawi in tracking and reporting exposure record for their occupationally exposed workers. (au)

  1. Patient safety challenges in a case study hospital--of relevance for transfusion processes?

    Science.gov (United States)

    Aase, Karina; Høyland, Sindre; Olsen, Espen; Wiig, Siri; Nilsen, Stein Tore

    2008-10-01

    The paper reports results from a research project with the objective of studying patient safety, and relates the finding to safety issues within transfusion medicine. The background is an increased focus on undesired events related to diagnosis, medication, and patient treatment in general in the healthcare sector. The study is designed as a case study within a regional Norwegian hospital conducting specialised health care services. The study includes multiple methods such as interviews, document analysis, analysis of error reports, and a questionnaire survey. Results show that the challenges for improved patient safety, based on employees' perceptions, are hospital management support, reporting of accidents/incidents, and collaboration across hospital units. Several of these generic safety challenges are also found to be of relevance for a hospital's transfusion service. Positive patient safety factors are identified as teamwork within hospital units, a non-punitive response to errors, and unit manager's actions promoting safety.

  2. A study of the information seeking behaviour of hospital pharmacists: empirical evidence from Greece.

    Science.gov (United States)

    Kostagiolas, Petros A; Aggelopoulou, Vasiliki A; Niakas, Dimitris

    2011-12-01

    Hospital pharmacists need access to high-quality information in order to constantly update their knowledge and improve their skills. In their modern role, they are expected to address three types of challenges: scientific, organizational and administrative, thus having an increased need for adequate information and library services. This study investigates the information-seeking behaviour of public hospital pharmacists providing evidence from Greece that could be used to encourage the development of effective information hospital services and study the links between the information seeking behaviour of hospital pharmacists and their modern scientific and professional role. An empirical research was conducted between January and February 2010 with the development and distribution of a structured questionnaire. The questionnaire was filled in and returned by 88 public hospital pharmacists from a total of 286 working in all Greek public hospitals, providing a response rate of 31%. The hospital pharmacists in Greece are in search of scientific information and, more particularly, pharmaceutical information (e.g., drug indications, storage, dosage and prices). The Internet and the National Organization of Medicines are their main information sources, while the lack of time and organized information are the main obstacles they have to face when seeking information. The modern professional role of hospital pharmacists as invaluable contributors to efficient and safer healthcare services may be further supported through the development of specialized libraries and information services within Greek public hospitals. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  3. High-level managers' considerations for RFID adoption in hospitals: an empirical study in Taiwan.

    Science.gov (United States)

    Lai, Hui-Min; Lin, I-Chun; Tseng, Ling-Tzu

    2014-02-01

    Prior researches have indicated that an appropriate adoption of information technology (IT) can help hospitals significantly improve services and operations. Radio Frequency Identification (RFID) is believed to be the next generation innovation technology for automatic data collection and asset/people tracking. Based on the Technology-Organization-Environment (TOE) framework, this study investigated high-level managers' considerations for RFID adoption in hospitals. This research reviewed literature related IT adoption in business and followed the results of a preliminary survey with 37 practical experts in hospitals to theorize a model for the RFID adoption in hospitals. Through a field survey of 102 hospitals and hypotheses testing, this research identified key factors influencing RFID adoption. Follow-up in-depth interviews with three high-level managers of IS department from three case hospitals respectively also presented an insight into the decision of RFID's adoption. Based on the research findings, cost, ubiquity, compatibility, security and privacy risk, top management support, hospital scale, financial readiness and government policy were concluded to be the key factors influencing RFID adoption in hospitals. For practitioners, this study provided a comprehensive overview of government policies able to promote the technology, while helping the RFID solution providers understand how to reduce the IT barriers in order to enhance hospitals' willingness to adopt RFID.

  4. Ethical issues in purchasing: a field study of Midwest hospitals.

    Science.gov (United States)

    Tomaszewski, K; Motwani, J

    1995-01-01

    A large sum of money is spent annually by salespeople on gifts and favors for purchasing executives. The provision of gifts and favors to buyers remains a common practice despite the fact that it often leads to ethical conflicts for purchasing executives, sales managers, and salespeople. This paper investigates the perceptions of 51 purchasing executives of midwest hospitals regarding their behavior towards certain buying practices, the favors offered by vendors, favors actually accepted, as well as purchasers' discomfort and repayment levels regarding indebtedness. Based on the data analysis, this paper provides conclusions and directions for future research.

  5. Standard regulation of obligatory immunoprevention of flu in a control system of incidence of health workers

    Directory of Open Access Journals (Sweden)

    A. E. Zobov

    2016-01-01

    Full Text Available In article the interconnected provisions of the federal legislation and regulations of federal executive authorities regulating a question of obligatory immunization of health workers against flu in aspect of legal consequences of refusal of her are considered. The analysis of the existing regulations and materials of jurisprudence concerning carrying out obligatory vaccination of health workers against flu is carried out. By results of the analysis it is shown that today a problematic issue is absence of the accurate standardly consolidated criteria of reference of these or those categories of medical personnel to group of the subjects of obligatory immunization performing works with sick infectious diseases and, respectively, against flu. It doesn’t allow the management of the medical organizations to differentiate specifically mentioned professions and positions owing to what the requirement about obligatory carrying out preventive inoculations against flu of those health workers whose obligatory vaccination isn’t provided actually is compulsion to vaccination. Therefore, the subsequent discharge from work in case of refusal it работни from carrying out an inoculation strikes at his rights (as in this case, for example, time of discharge isn’t subject to payment and inclusion in the length of service granting the right for the annual paid vacation and is illegal.It is offered to accept as such criterion the labor function fixed by the statutory act of authorized federal executive authority for concrete positions of employees of the medical organizations providing performance of work with sick infectious diseases. The recommendations to heads of the medical organizations concerning the publication of local acts on the organization of vaccinal prevention of flu and adoption of administrative decisions after written refusals of vaccination are provided.

  6. Characteristics of small areas with high rates of hospital-treated self-harm: deprived, fragmented and urban or just close to hospital? A national registry study.

    LENUS (Irish Health Repository)

    O'Farrell, I B

    2014-10-15

    Previous research has shown an inconsistent relationship between the spatial distribution of hospital treated self-harm and area-level factors such as deprivation and social fragmentation. However, many of these studies have been confined to urban centres, with few focusing on rural settings and even fewer studies carried out at a national level. Furthermore, no previous research has investigated if travel time to hospital services can explain the area-level variation in the incidence of hospital treated self-harm.

  7. Hospital readmission performance and patterns of readmission: retrospective cohort study of Medicare admissions

    Science.gov (United States)

    Hsieh, Angela F; Lin, Zhenqiu; Bueno, Héctor; Ross, Joseph S; Horwitz, Leora I; Barreto-Filho, José Augusto; Kim, Nancy; Suter, Lisa G; Bernheim, Susannah M; Drye, Elizabeth E; Krumholz, Harlan M

    2013-01-01

    Objectives To determine whether high performing hospitals with low 30 day risk standardized readmission rates have a lower proportion of readmissions from specific diagnoses and time periods after admission or instead have a similar distribution of readmission diagnoses and timing to lower performing institutions. Design Retrospective cohort study. Setting Medicare beneficiaries in the United States. Participants Patients aged 65 and older who were readmitted within 30 days after hospital admission for heart failure, acute myocardial infarction, or pneumonia in 2007-09. Main outcome measures Readmission diagnoses were classified with a modified version of the Centers for Medicare and Medicaid Services’ condition categories, and readmission timing was classified by day (0-30) after hospital discharge. Hospital 30 day risk standardized readmission rates over the three years of study were calculated with public reporting methods of the US federal government, and hospitals were categorized with bootstrap analysis as having high, average, or low readmission performance for each index condition. High and low performing hospitals had ≥95% probability of having an interval estimate respectively less than or greater than the national 30 day readmission rate over the three year period of study. All remaining hospitals were considered average performers. Results For readmissions in the 30 days after the index admission, there were 320 003 after 1 291 211 admissions for heart failure (4041 hospitals), 102 536 after 517 827 admissions for acute myocardial infarction (2378 hospitals), and 208 438 after 1 135 932 admissions for pneumonia (4283 hospitals). The distribution of readmissions by diagnosis was similar across categories of hospital performance for all three conditions. High performing hospitals had fewer readmissions for all common diagnoses. Median time to readmission was similar by hospital performance for heart failure and acute myocardial

  8. Factors of U.S. Hospitals Associated with Improved Profit Margins: An Observational Study.

    Science.gov (United States)

    Ly, Dan P; Cutler, David M

    2018-02-14

    Hospitals face financial pressure from decreased margins from Medicare and Medicaid and lower reimbursement from consolidating insurers. The objectives of this study are to determine whether hospitals that became more profitable increased revenues or decreased costs more and to examine characteristics associated with improved financial performance over time. The design of this study is retrospective analyses of U.S. non-federal acute care hospitals between 2003 and 2013. There are 2824 hospitals as subjects of this study. The main measures of this study are the change in clinical operating margin, change in revenues per bed, and change in expenses per bed between 2003 and 2013. Hospitals that became more profitable had a larger magnitude of increases in revenue per bed (about $113,000 per year [95% confidence interval: $93,132 to $133,401]) than of decreases in costs per bed (about - $10,000 per year [95% confidence interval: - $28,956 to $9617]), largely driven by higher non-Medicare reimbursement. Hospitals that improved their margins were larger or joined a hospital system. Not-for-profit status was associated with increases in operating margin, while rural status and having a larger share of Medicare patients were associated with decreases in operating margin. There was no association between improved hospital profitability and changes in diagnosis related group weight, in number of profitable services, or in payer mix. Hospitals that became more profitable were more likely to increase their admissions per bed per year. Differential price increases have led to improved margins for some hospitals over time. Where significant price increases are not possible, hospitals will have to become more efficient to maintain profitability.

  9. A Study on Out Patient Satisfaction at a Super Specialty Hospital in ...

    African Journals Online (AJOL)

    Patients and staff satisfaction is an important component of the health care industry in this competitive modern era. In the hospital, the Outpatient Department is often called “Shop Window”. Patients' satisfaction leads to drift in both new and old patients, which hinders the sustainability of any hospital in long run. This study ...

  10. Care complexity in the general hospital - Results from a European study

    NARCIS (Netherlands)

    de Jonge, P; Huyse, FJ; Slaets, JPJ; Herzog, T; Lobo, A; Lyons, JS; Opmeer, BC; Stein, B; Arolt, [No Value; Balogh, N; Cardoso, G; Fink, P; Rigatelli, M; van Dijck, R; Mellenbergh, GJ

    2001-01-01

    There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between

  11. A case study investigation of the indoor environmental noise in four urban South African hospitals

    CSIR Research Space (South Africa)

    Van Reenen, CA

    2015-11-01

    Full Text Available This multiple case study was designed to investigate acoustics in multi-bed general wards in four urban South African hospitals. Evidence-based research shows that a quiet indoor environment has positive outcomes for hospital patients and staff...

  12. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study

    NARCIS (Netherlands)

    Aiken, L.H.; Sloane, D.M.; Bruyneel, L.; Heede, K. Van den; Griffiths, P.; Busse, R.; Diomidous, M.; Kinnunen, J.; Kozka, M.; Lesaffre, E.; McHugh, M.D.; Moreno-Casbas, M.T.; Rafferty, A.M.; Schwendimann, R.; Scott, P.A.; Tishelman, C.; Achterberg, T. van; Sermeus, W.; et al.,

    2014-01-01

    BACKGROUND: Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. The RN4CAST study was designed to inform decision making about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether

  13. Prevalence, Nature, Severity and Risk Factors for Prescribing Errors in Hospital Inpatients: Prospective Study in 20 UK Hospitals.

    Science.gov (United States)

    Ashcroft, Darren M; Lewis, Penny J; Tully, Mary P; Farragher, Tracey M; Taylor, David; Wass, Valerie; Williams, Steven D; Dornan, Tim

    2015-09-01

    It has been suggested that doctors in their first year of post-graduate training make a disproportionate number of prescribing errors. This study aimed to compare the prevalence of prescribing errors made by first-year post-graduate doctors with that of errors by senior doctors and non-medical prescribers and to investigate the predictors of potentially serious prescribing errors. Pharmacists in 20 hospitals over 7 prospectively selected days collected data on the number of medication orders checked, the grade of prescriber and details of any prescribing errors. Logistic regression models (adjusted for clustering by hospital) identified factors predicting the likelihood of prescribing erroneously and the severity of prescribing errors. Pharmacists reviewed 26,019 patients and 124,260 medication orders; 11,235 prescribing errors were detected in 10,986 orders. The mean error rate was 8.8 % (95 % confidence interval [CI] 8.6-9.1) errors per 100 medication orders. Rates of errors for all doctors in training were significantly higher than rates for medical consultants. Doctors who were 1 year (odds ratio [OR] 2.13; 95 % CI 1.80-2.52) or 2 years in training (OR 2.23; 95 % CI 1.89-2.65) were more than twice as likely to prescribe erroneously. Prescribing errors were 70 % (OR 1.70; 95 % CI 1.61-1.80) more likely to occur at the time of hospital admission than when medication orders were issued during the hospital stay. No significant differences in severity of error were observed between grades of prescriber. Potentially serious errors were more likely to be associated with prescriptions for parenteral administration, especially for cardiovascular or endocrine disorders. The problem of prescribing errors in hospitals is substantial and not solely a problem of the most junior medical prescribers, particularly for those errors most likely to cause significant patient harm. Interventions are needed to target these high-risk errors by all grades of staff and hence

  14. Older people's perspectives on an elderly-friendly hospital environment: an exploratory study

    Directory of Open Access Journals (Sweden)

    Karki S

    2015-05-01

    Full Text Available Sushmita Karki,1 Dharma Nand Bhatta,1,2 Umesh Raj Aryal3 1Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 2Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand; 3Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal Background: Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people's perspectives on an "elderly-friendly" hospital. Methods: Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results: Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people's health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion: Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that

  15. Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil.

    Science.gov (United States)

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thumé, Elaine; Thomaz, Erika Bárbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-08-22

    Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access

  16. The availability of abortion at state hospitals in Turkey: A national study.

    Science.gov (United States)

    O'Neil, Mary Lou

    2017-02-01

    Abortion in Turkey has been legal since 1983 and remains so today. Despite this, in 2012 the Prime Minister declared that, in his opinion, abortion was murder. Since then, there has been growing evidence that abortion access particularly in state hospitals is being restricted, although no new legislation has been offered. The study aimed to determine the number of state hospitals in Turkey that provide abortions. The study employed a telephone survey in 2015-2016 where 431 state hospitals were contacted and asked a set of questions by a mystery patient. If possible, information was obtained directly from the obstetrics/gynecology department. I removed specialist hospitals from the data set and the remaining data were analyzed for frequency and cross-tabulations were performed. Only 7.8% of state hospitals provide abortion services without regard to reason which is provided for by the current law, while 78% provide abortions when there is a medical necessity. Of the 58 teaching and research hospitals in Turkey, 9 (15.5%) provide abortion care without restriction to reason, 38 (65.5%) will do the procedure if there is a medical necessity and 11 (11.4%) of these hospitals refuse to provide abortion services under any circumstances. There are two regions, encompassing 1.5 million women of childbearing age, where no state hospital provides for abortion without restriction as to reason. The vast majority of state hospitals only provide abortions in the narrow context of a medical necessity, and thus are not implementing the law to its full extent. It is clear that although no new legislation restricting abortion has been enacted, state hospitals are reducing the provision of abortion services without restriction as to reason. This is the only nationwide study to focus on abortion provision at state hospitals. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Noise pollution in the hospital environment of a developing country: A case study of Lahore (Pakistan).

    Science.gov (United States)

    Baqar, Mujtaba; Arslan, Muhammad; Abbasi, Saddam A; Ashraf, Uzma; Khalid, Anam; Zahid, Hina

    2017-08-24

    The present study investigates the noise pollution levels in public- and private-sector hospitals of Lahore. The noise pollution parameters were investigated from 20 public and 10 private hospitals. We observed that the equivalent continuous sound level (Leq) values varied significantly in different departments of the hospitals as well as at different times of the day. The public-sector hospitals had significantly higher noise pollution compared to the private-sector hospitals. The Wilcoxon Mann-Whitney two-sample rank-sum test revealed significant difference between noise levels in intensive care unit (ICU) during morning and in emergency, waiting area, intensive care unit (ICU), and reception during daytimes. However, no significant differences were found for any department during the evening. The Leq values were found to be higher than the international norms (WHO standards) for all hospitals, higher than USEPA for 29 hospitals and higher than local standards for 27 hospitals. Overall, significantly lower sound levels were always observed in private hospitals.

  18. The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?

    Science.gov (United States)

    Linnen, Daniel T; Kornak, John; Stephens, Caroline

    2018-03-28

    Evidence suggests an association between rurality and decreased life expectancy. To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive pulmonary disease, heart attack, heart failure, and pneumonia across 277 California hospitals between July 2011 and June 2014. We used generalized estimating equations to evaluate the association of urban-rural county classifications on mortality ratings. Unfavorable Medicare hospital mortality rating "worse than the national rate" compared with "better" or "same." Compared with large central "metro" (metropolitan) counties, hospitals in medium-sized metro counties had 6.4 times the odds of rating "worse than the national rate" for hospital mortality (95% confidence interval = 2.8-14.8, p centers may contribute to these results, a potential factor that future research should examine.

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

    Directory of Open Access Journals (Sweden)

    Massimo Cannas

    2014-11-01

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

  20. Study on factors inducing workplace violence in Chinese hospitals based on the broken window theory: a cross-sectional study.

    Science.gov (United States)

    Zhou, Chenyu; Mou, Huitong; Xu, Wen; Li, Zhe; Liu, Xin; Shi, Lei; Peng, Boshi; Zhao, Yan; Gao, Lei; Fan, Lihua

    2017-07-28

    To explore the potential components of hospital workplace violence (HWPV) from the perspectives of hospital administrators and patients, and put forward corresponding strategies for its prevention and control. Using convenience sampling methods, 116 hospitals in 14 provinces of China were surveyed using a self-designed questionnaire. A cross-sectional study was used. Hospital administrators and patients from 116 hospitals in 14 provinces of China. First, hospital administrators point of workplace factors included six factors, with the following weighting coefficients: hospital administrator factors (29.40%), patient-related factors (20.08%), hospital environmental factors (19.45%), policy and institutional factors (11.92%), social psychological factors (10.26%), objective events factors (8.89%). Second, patients from the hospital workplace predisposing factors included three common factors. The weight coefficients of these were hospital-related factors (60.27%), social and governmental factors (23.64%) and patient-related factors (16.09%). A wide range of factors according to hospital administrators, patients and in the hospital environment play important roles in HWPV. From the perspectives of hospital administrators, communication skills and attitude to the service are important factors for inducing HWPV. From the perspective of patients, the characteristics of staff personalities and medical cognition are more important inducing factors. As far as social factors are concerned, economic compensation of medical malpractice is an important inducing factor for HWPV. In terms of environmental factors, management of Chinese medical hospitals, medical procedures and the layout of departments are all potential factors for the occurrence of violence. Corresponding defects were exposed in the health legal system and the supervision system for influencing public opinion. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017

  1. No consistent effects of prenatal or neonatal exposure to Spanish flu on late-life mortality in 24 developed countries

    Directory of Open Access Journals (Sweden)

    Alan Cohen

    2010-04-01

    Full Text Available We test the effects of early life exposure to disease on later health by looking for differences in late-life mortality in cohorts born around the 1918-1919 flu pandemic using data from the Human Mortality Database for 24 countries. After controlling for age, period, and sex effects, residual mortality rates did not differ systematically for flu cohorts relative to surrounding cohorts. We calculate at most a 20-day reduction in life expectancy for flu cohorts; likely values are much smaller. Estimates of influenza incidence during the pandemic suggest that exposure was high enough for this to be a robust negative result.

  2. Distinguishing in-hospital and out-of-hospital status epilepticus: clinical implications from a 10-year cohort study.

    Science.gov (United States)

    Sutter, R; Semmlack, S; Spiegel, R; Tisljar, K; Rüegg, S; Marsch, S

    2017-09-01

    The aim was to determine differences of clinical, treatment and outcome characteristics between patients with in-hospital and out-of-hospital status epilepticus (SE). From 2005 to 2014, clinical data were assessed in adults with SE treated in an academic medical care centre. Clinical characteristics, treatment and outcomes were compared between patients with in-hospital and out-of-hospital SE. Amongst 352 patients, 213 were admitted with SE and 139 developed in-hospital SE. Patients with in-hospital SE had more acute/fatal aetiologies (60% vs. 35%, P Status Epilepticus Severity Score (STESS) was an independent predictor for death in both groups, increased Charlson Comorbidity Index and treatment refractory SE were associated with death only in patients with in-hospital SE. Continuous anaesthesia for refractory SE was associated with increased mortality only in patients with out-of-hospital SE. The area under the receiver operating curve was 0.717 for prediction of death by STESS in patients with in-hospital SE and 0.811 in patients with out-of-hospital SE. Patients with in-hospital SE had more fatal aetiologies and comorbidities, refractory SE, less return to functional baseline, and increased mortality compared to patients with out-of-hospital SE. Whilst the STESS was a robust predictor for death in both groups, the association between continuous anaesthesia and death was limited to out-of-hospital SE. © 2017 EAN.

  3. A HOSPITAL-BASED STUDY ON THE PREVALENCE OF DRY EYES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Prashant V. Solanke

    2017-06-01

    Full Text Available BACKGROUND Dry eye syndrome is a common eye disease. Dry Eye Syndrome (DES, also known as Keratoconjunctivitis Sicca (KCS, is the condition of having dry eyes. Other associated symptoms include irritation, redness, discharge and easily fatigued eyes. Blurred vision may also occur. The symptoms can range from mild and occasional to severe and continuous. Scarring of the cornea may occur in some cases without treatment. Dry eye occurs when either the eye does not produce enough tears or when the tears evaporate too quickly. Tobacco smoke exposure or infection may also lead to the condition. Diagnosis is mostly based on the symptoms, though a number of other tests may be used. Prevalence of dry eyes are commoner in females than males. There is a positive relationship between glaucoma and ocular dryness as well as diabetic retinopathy and ocular dryness. Dry eye is a multifactorial disease of the tears and ocular surface. Ocular symptoms such as pain, irritation and poor vision can result from dry eye. The aim of the study is to study the prevalence, symptomatology and distribution of dry eyes. MATERIALS AND METHODS A cross-sectional study was conducted during July 2016 to March 2017. Study place was Outpatient Department of Ophthalmology at Sree Mookambika Institute of Medical Sciences, Kulasekharam. Sample size was calculated by 4PQ/d², which was 132. Systemic random sampling was used for the study. RESULTS Prevalence of dry eyes - 17.8%. Dry eyes in males - 16.8% and in females - 24.6%. Dry eyes in age 40 yrs. - 21.8%. Prevalence of dry eyes in contact lens wearers - 36.5%. Prevalence of dry eyes in glaucoma cases - 38.2%. Prevalence of dry eyes in farmers - 27.3%, in smokers - 36.7%. Dry eyes in emmetropes - 12.8% in myopes - 17.2% in hypermetropes - 28.6%. CONCLUSION Dry eyes prevalence obtained was 17.8%. Dry eyes were seen more in females. As age increases, prevalence of dry eyes increases. Ocular surface dryness was observed more in contact

  4. Mutual Expectations of Mothers of Hospitalized Children and Pediatric Nurses Who Provided Care: Qualitative Study.

    Science.gov (United States)

    Konuk Şener, Dilek; Karaca, Aysel

    This study attempted to identify the mutual expectations of mothers whose children were hospitalized in the pediatric department of a university hospital and nurses who provided care. A descriptive phenomenological design has been used in this study. Data were obtained through tape-recorded semi-structured interviews. This study was conducted at a pediatric clinic, at a university hospital in a small city in Turkey. Participants comprised five nurses working in the children's clinic and 24 mothers who accompanied their children to the hospital. The six major themes that emerged were mothers' feelings and thoughts about the hospital experience, mothers' expectations for attention and support during hospitalization, mothers' expectations for invasive procedures, issues regarding physical comfort and hospital infrastructure, nurses' feelings and thoughts about working in the pediatric clinic, and nurses' expectations of the mothers. Mothers expected nurses to provide physical support including medication administration, and installing/applying IV and nebulizer treatments; and emotional support in terms of having a friendly, rather than critical attitude, and being approachable and receptive of mothers' questions and anxieties. Nurses stated that they were aware of these expectations but needed mothers to be understanding and tolerant, considering their difficult working conditions. Children's hospitalization is a stressful experience for parents. Open and therapeutic communication and relationships between parents and nurses contribute to improving the quality of care provided to children and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Modeling of the influence of humidity on H1N1 flu in China

    Science.gov (United States)

    PEI, Y.; Tian, H.; Xu, B.

    2015-12-01

    In 2009, a heavy Flu hit the whole world. It was caused by the virus H1N1. The influenza first broke out in Mexico in March and the United States in April, 2009. The World Health Organization (WHO) announced that the H1N1 influenza became pandemic, alert to a warning phase of six. By the end of 2011, 181302 H1N1 cases were reported in mainland China. To improve our understanding on the impact of environmental factors on the disease transmission, we constructed an SIR (Susceptible - Infectious - Recovered) model incorporating environmental factors. It was found that the absolute humidity was a dominant environmental factor. The study interpolated the humidity data monitored with 340 weather stations from 1951 to 2011 in mainland China. First, the break point of the trend for the absolutely humidity was detected by the BFAST (Break For Additive Season and Trend) method. Then, the SIR model with and without the absolutely humidity incorporated in the model was built and tested. Finally, the results with the two scenarios were compared. Results indicate that lower absolutely humidity may promote the transmission of the H1N1 cases. The calculated basic reproductive number ranges from 1.65 to 3.66 with a changing absolute humidity. This is consistent with the former study result with basic reproductive number ranging from 2.03 to 4.18. The average recovery duration was estimated to be 5.7 days. The average duration to get immunity from the influenza is 399.02 days. A risk map is also produced to illustrate the model results.

  6. How efficient are Greek hospitals? A case study using a double bootstrap DEA approach.

    Science.gov (United States)

    Kounetas, Kostas; Papathanassopoulos, Fotis

    2013-12-01

    The purpose of this study was to measure Greek hospital performance using different input-output combinations, and to identify the factors that influence their efficiency thus providing policy makers with valuable input for the decision-making process. Using a unique dataset, we estimated the productive efficiency of each hospital through a bootstrapped data envelopment analysis (DEA) approach. In a second stage, we explored, using a bootstrapped truncated regression, the impact of environmental factors on hospitals' technical and scale efficiency. Our results reveal that over 80% of the examined hospitals appear to have a technical efficiency lower than 0.8, while the majority appear to be scale efficient. Moreover, efficiency performance differed with inclusion of medical examinations as an additional variable. On the other hand, bed occupancy ratio appeared to affect both technical and scale efficiency in a rather interesting way, while the adoption of advanced medical equipment and the type of hospital improves scale and technical efficiency, correspondingly. The findings of this study on Greek hospitals' performance are not encouraging. Furthermore, our results raise questions regarding the number of hospitals that should operate, and which type of hospital is more efficient. Finally, the results indicate the role of medical equipment in performance, confirming its misallocation in healthcare expenditure.

  7. Organizational capacities for health promotion implementation: results from an international hospital study.

    Science.gov (United States)

    Röthlin, Florian; Schmied, Hermann; Dietscher, Christina

    2015-06-01

    In this article, organizational structures in hospitals are discussed as possible capacities for hospital health promotion (HP) implementation, based on data from the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals & Health Services (HPH-Network) and was conducted in 2008-2012. Data from 159 acute care hospitals were used in the analysis. Twelve organizational structures, which were denoted as possible organizational health promotion capacities in previous literature, were tested for their association with certain strategic HP implementation approaches. Four organizational structures were significantly (p = 0.05) associated with one or more elaborate and comprehensive strategic HP implementation approaches: (1) a health promotion specific quality assessment routine; (2) an official hospital health promotion team; (3) a fulltime hospital health promotion coordinator; and (4) officially documented health promotion policies, strategies or standards. The results add further evidence to the importance of organizational capacity structures for hospital health promotion and identify four tangible structures as likely candidates for organizational HP capacities in hospitals. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. [Hospitalizations for ambulatory care-sensitive conditions: validation study at a Hospital Information System (SIH) in the Federal District, Brazil, in 2012].

    Science.gov (United States)

    Cavalcante, Danyelle Monteiro; de Oliveira, Maria Regina Fernandes; Rehem, Tânia Cristina Morais Santa Bárbara

    2016-03-01

    This study analyzes hospitalizations due to ambulatory care-sensitive conditions with a focus on infectious and parasitic diseases (IPDs) and validates the Hospital Information System, Brazilian Unified National Health System (SIH/SUS) for recording hospitalizations due to ambulatory care-sensitive conditions in a hospital in the Federal District, Brazil, in 2012. The study estimates the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the SIH for recording hospitalizations due to ambulatory care-sensitive conditions, with the patient's medical file as the gold standard. There were 1,604 hospitalizations for hospitalizations due to ambulatory care-sensitive conditions (19.6%, 95%CI: 18.7-20.5), and the leading IPDs were renal and urinary tract infection, infection of the skin and subcutaneous tissue, and infectious gastroenteritis. IPDs were the leading cause of hospitalization in the 20 to 29-year age bracket and caused 28 deaths. Sensitivity was 70.1% (95%CI: 60.5-79.7), specificity 88.4% (95%CI: 85.6-91.2), PPV = 51.7% (95%CI: 42.7-60.7), and NPV = 94.3% (95%CI: 92.2-96.4). The findings for admissions due to ACSCs in this hospital were similar to those of other studies, featuring admissions for IPDs. The SIH/SUS database was more specific than sensitive.

  9. Quality of Public Hospitals Websites: A Cross-Sectional Analytical Study in Iran.

    Science.gov (United States)

    Salarvand, Shahin; Samadbeik, Mahnaz; Tarrahi, Mohammad Javad; Salarvand, Hamed

    2016-04-01

    Nowadays, hospitals have turned increasingly towards the Internet and develop their own web presence. Hospital Websites could be operating as effective web resources of information and interactive communication mediums to enhance hospital services to the public. Therefore, the aim of this study was to assess the quality of websites in Tehran's public hospitals. This cross-sectional analysis involved all public hospitals in Iran's capital city, Tehran, with a working website or subsites between April and June, 2014 (N=59). The websites were evaluated using three validated instruments: a localized checklist, Google page rank, and the Alexa traffic ranking. The mentioned checklist consisted of 112 items divided into five sections: technical characteristics, hospital information and facilities, medical services, interactive on-line services and external activities. Data were analyzed using descriptive and analytical statistics. The mean website evaluation score was 45.7 out of 224 for selected public hospitals. All the studied websites were in the weak category based on the earned quality scores. There was no statistically significant association between the website evaluation score with Google page rank (P=0.092), Alexa global traffic rank and Alexa traffic rank in Iran (P>0.05). The hospital websites had a lower quality score in the interactive online services and external activities criteria in comparing to other criteria. Due to the low quality level of the studied websites and the importance of hospital portals in providing information and services on the Internet, the authorities should do precise planning for the appreciable improvement in the quality of hospital websites.

  10. Workplace Discrimination and Depressive Symptoms: A Study of Multi-Ethnic Hospital Employees

    OpenAIRE

    Hammond, Wizdom Powell; Gillen, Marion; Yen, Irene H.

    2010-01-01

    Workplace discrimination reports have recently increased in the U.S. Few studies have examined racial/ethnic differences and the mental health consequences of this exposure. We examined the association between self-reported workplace discrimination and depressive symptoms among a multi-ethnic sample of hospital employees. Data came from the prospective case–control Gradients of Occupational Health in Hospital Workers (GROW) study (N = 664). We used the Center for Epidemiological Studies Depre...

  11. The Effect of Service Quality on Patient loyalty: a Study of Private Hospitals in Tehran, Iran

    OpenAIRE

    Arab, M; Tabatabaei, SM Ghazi; Rashidian, A; Forushani, A Rahimi; Zarei, E

    2012-01-01

    Background: Service quality is perceived as an important factor for developing patient’s loyalty. The aim of this study was to determine the hospital service quality from the patients’ viewpoints and the relative importance of quality dimensions in predicting the patient’s loyalty. Methods: A cross-sectional study was conducted in 2010. The study sample was composed of 943 patients selected from eight private general hospitals in Tehran. The survey instrument was a questionnaire included 24 i...

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

    Science.gov (United States)

    Shojaee, Jalil; Moosazadeh, Mahmood

    2014-02-01

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

  13. Generalist palliative care in hospital - Cultural and organisational interactions. Results of a mixed-methods study.

    Science.gov (United States)

    Bergenholtz, Heidi; Jarlbaek, Lene; Hølge-Hazelton, Bibi

    2016-06-01

    It can be challenging to provide generalist palliative care in hospitals, owing to difficulties in integrating disease-oriented treatment with palliative care and the influences of cultural and organisational conditions. However, knowledge on the interactions that occur is sparse. To investigate the interactions between organisation and culture as conditions for integrated palliative care in hospital and, if possible, to suggest workable solutions for the provision of generalist palliative care. A convergent parallel mixed-methods design was chosen using two independent studies: a quantitative study, in which three independent datasets were triangulated to study the organisation and evaluation of generalist palliative care, and a qualitative, ethnographic study exploring the culture of generalist palliative nursing care in medical departments. A Danish regional hospital with 29 department managements and one hospital management. Two overall themes emerged: (1) 'generalist palliative care as a priority at the hospital', suggesting contrasting issues regarding prioritisation of palliative care at different organisational levels, and (2) 'knowledge and use of generalist palliative care clinical guideline', suggesting that the guideline had not reached all levels of the organisation. Contrasting issues in the hospital's provision of generalist palliative care at different organisational levels seem to hamper the interactions between organisation and culture - interactions that appear to be necessary for the provision of integrated palliative care in the hospital. The implementation of palliative care is also hindered by the main focus being on disease-oriented treatment, which is reflected at all the organisational levels. © The Author(s) 2015.

  14. Quantifying the demand for hospital care services: a time and motion study.

    Science.gov (United States)

    van Oostveen, Catharina J; Gouma, Dirk J; Bakker, Piet J; Ubbink, Dirk T

    2015-01-22

    The actual amount of care hospitalised patients need is unclear. A model to quantify the demand for hospital care services among various clinical specialties would avail healthcare professionals and managers to anticipate the demand and costs for clinical care. Three medical specialties in a Dutch university hospital participated in this prospective time and motion study. To include a representative sample of patients admitted to clinical wards, the most common admission diagnoses were selected from the most recent update of the national medical registry (LMR) of ICD-10 admission diagnoses. The investigators recorded the time spent by physicians and nurses on patient care. Also the costs involved in medical and nursing care, (surgical) interventions, and diagnostic procedures as an estimate of the demand for hospital care services per hospitalised patient were calculated and cumulated. Linear regression analysis was applied to determine significant factors including patient and healthcare outcome characteristics. Fifty patients on the Surgery (19), Pediatrics (17), and Obstetrics & Gynecology (14) wards were monitored during their hospitalization. Characteristics significantly associated with the demand for healthcare were: polypharmacy during hospitalization, complication severity level, and whether a surgical intervention was performed. A set of predictors of the demand for hospital care services was found applicable to different clinical specialties. These factors can all be identified during hospitalization and be used as a managerial tool to monitor the patients' demand for hospital care services and to detect trends in time.

  15. Case Study: Evidence-Based Interventions Enhancing Diabetic Foot Care Behaviors among Hospitalized DM Patients

    Directory of Open Access Journals (Sweden)

    Titis Kurniawan

    2011-01-01

    Full Text Available Background: Improving diabetic patients’ foot care behaviors is one of the most effective strategies in minimizing diabetic foot ulceration and its further negative impacts, either in diabetic hospitalized patients or outpatients.Purpose: To describe foot care knowledge and behaviors among hospitalized diabetic patients, to apply selected foot care knowledge and behaviors improvement evidence, and to evaluate its effectiveness.Method: Four diabetic patients who were under our care for at least three days and could communicate in Thai language were selected from a surgical ward in a university hospital. The authors applied educational program based on patients’ learning needs, provided diabetic foot care leaflet, and assisted patients to set their goal and action plans. In the third day of treatment, we evaluated patients’ foot care knowledge and their goal and action plan statements in improving foot care behaviors.Result: Based on the data collected among four hospitalized diabetic patients, it was shown that all patients needed foot care behaviors improvement and the educational program improved hospitalized patients’ foot care knowledge and their perceived foot care behaviors. The educational program that combined with goal setting and action plans method was easy, safe, and seemed feasibly applicable for diabetic hospitalized patients.Conclusion: The results of this study provide valuable information for improvement of hospitalized diabetic patients’ foot care knowledge and behaviors. The authors recommend nurses to use this evidence-based practice to contribute in improving the quality of diabetic care.Keywords: Intervention, diabetic foot care, hospitalized diabetic patients

  16. Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study.

    Science.gov (United States)

    Challener, Douglas; Marcelin, Jasmine; Visscher, Sue; Baddour, Larry

    2017-12-01

    Hospital admissions for non-purulent lower extremity cellulitis (NLEC) are common and can be prolonged and costly. Newer treatment options and preventive strategies are expected to result in cost savings before implementation, but few studies have quantified the cost of conventional treatment. Using the Rochester Epidemiology Project, the incidence of NLEC in Olmsted County, MN in 2013 was 176.6 per 100,000 persons. The subset of patients who required hospitalization for NLEC in 2013 was determined. Hospital admissions were analyzed retrospectively using standardized cost analysis within several relevant categories. Thirty-four patients had an average hospital length of stay of 4.7 days. The median total inpatient cost was $7,341. The median cost per day was $2,087, with 49% due to room and board. Antibiotics administered for treatment of NLEC contributed a median cost of $75 per day of hospitalization, and laboratory and imaging test costs were $73 and $44, respectively, per day of hospitalization. Hospitalizations for NLEC can be costly and prolonged with room and board accounting for much of the cost. Therefore, newer management strategies should seek to reduce hospital length of stay and/or avoid inpatient admission to reduce cost.

  17. Outsourcing: two case studies from the Victorian public hospital sector.

    Science.gov (United States)

    Young, Suzanne

    2007-02-01

    Outsourcing was one process of privatisation used in the Victorian public health sector in the 1990s. However it was used to varying degrees and across a variety of different services. This paper attempts to answer the questions: Why have managers outsourced? What have managers considered when they have decided to outsource? The research was carried out in a rural hospital and a metropolitan network in Victoria. The key findings highlight the factors that decision makers considered to be important and those that led to negative outcomes. Economic factors, such as frequency of exchange, length of relationships between the parties, and information availability, were often ignored. However, other factors such as outcome measurability, technology, risk, labour market characteristics and goal conflict, and political factors such as relative power of management over labour were often perceived as important in the decision-making process. Negative outcomes from outsourcing were due to the short length of relationships and accompanying difficulties with trust, commitment and loyalty; poor quality; and excessive monitoring and the measurement of outcomes.

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

    Science.gov (United States)

    Mullings, Lauren; Sankaranarayanan, Jayashri

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

  19. Inpatient Obstetric Care at Irwin Army Community Hospital: A Study to Determine the Most Efficient Organization

    National Research Council Canada - National Science Library

    Bergeron, Timothy

    2001-01-01

    This study attempts to compare, analyze, and recommend the most efficient model with which to deliver inpatient obstetrics and gynecological services to the served population of Irwin Army Community Hospital...

  20. Hospital reform and staff morale in South Africa: a case study of Dr ...

    African Journals Online (AJOL)

    2012-02-16

    Feb 16, 2012 ... Settings and subjects: This study included all medical and nursing staff working at ... Keywords: hospital reform, staff morale, quality of care, healthcare resources ..... of healthcare workers' goals to cure patients.3 This differs.

  1. An empirical study of patients' expectations and satisfactions in Egyptian hospitals.

    Science.gov (United States)

    Mostafa, Mohamed M

    2005-01-01

    This paper seeks to investigate how patients perceive service quality in Egypt's public and private hospitals. The paper also tests the SERVQUAL dimensions in hospitals within an Arab, non-Western context. The authors used a cross-sectional questionnaire survey, performed in 2005. A sample of 332 patients from eight hospitals in Egypt participated in the study. The results highlighted a three-factor solution for the SERVQUAL instrument with 67 per cent of variance explained. This result does not support the five-components original SERVQUAL. A discriminant function was estimated for patients who selected public hospitals and those who selected private hospitals. The model was found to be significant in explaining patients' choice of the type of hospital. The use of quantitative methods alone is valuable in establishing relationships between variables, but is considered weak when attempting to identify the reasons for those relationships. Patients may have a complex set of important beliefs that cannot be captured in the questionnaire. Therefore, using qualitative research along quantitative methods in future studies may enhance the findings of this study. This article will be of interest to both public and private hospitals wishing to determine what patients expect from the quality of service provided to them.

  2. Gestational flu exposure induces changes in neurochemicals, affiliative hormones and brainstem inflammation, in addition to autism-like behaviors in mice.

    Science.gov (United States)

    Miller, V M; Zhu, Y; Bucher, C; McGinnis, W; Ryan, L K; Siegel, A; Zalcman, S

    2013-10-01

    The prevalence of neurodevelopmental disorders such as autism is increasing, however the etiology of these disorders is unclear and thought to involve a combination of genetic, environmental and immune factors. A recent epidemiological study found that gestational viral exposure during the first trimester increases risk of autism in offspring by twofold. In mice gestational viral exposures alter behavior of offspring, but the biological mechanisms which underpin these behavioral changes are unclear. We hypothesized that gestational viral exposure induces changes in affiliative hormones, brainstem autonomic nuclei and neurotransmitters which are associated with behavioral alterations in offspring. To address this hypothesis, we exposed pregnant mice to influenza A virus (H3N2) on gestational day 9 and determined behavioral, hormonal and brainstem changes in male and female offspring. We found that gestational flu exposure induced dose-dependent alterations in social and aggressive behaviors (p≤0.05) in male and female offspring and increases in locomotor behaviors particularly in male offspring (p≤0.05). We found that flu exposure was also associated with reductions in oxytocin and serotonin (p≤0.05) levels in male and female offspring and sex-specific changes in dopamine metabolism. In addition we found changes in catecholaminergic and microglia density in brainstem tissues of male flu exposed offspring only (p≤0.05). This study demonstrates that gestational viral exposure induces behavioral changes in mice, which are associated with alterations in affiliative hormones. In addition we found sex-specific changes in locomotor behavior, which may be associated with sex-specific alterations in dopamine metabolism and brainstem inflammation. Further investigations into maternal immune responses are necessary to unravel the molecular mechanisms which underpin abnormal hormonal, immune and behavioral responses in offspring after gestational viral exposure

  3. The Swine Flu Triage (SwiFT) study: development and ongoing refinement of a triage tool to provide regular information to guide immediate policy and practice for the use of critical care services during the H1N1 swine influenza pandemic.

    Science.gov (United States)

    Rowan, K M; Harrison, D A; Walsh, T S; McAuley, D F; Perkins, G D; Taylor, B L; Menon, D K

    2010-12-01

    To use, existing critical care and early pandemic, data to inform care during the pandemic influenza A 2009 (H1N1) pandemic (with a possible use for triage - if the demand for critical care seriously exceeded supply). To monitor the impact of the H1N1 pandemic on critical care services, in real time, with regular feedback to critical care clinicians and other relevant jurisdictions to inform ongoing policy and practice. Modelling of data and cohort study. Modelling - 148 adult, general critical care units in England, Wales and Northern Ireland in the Intensive Care National Audit & Research Centre Case Mix Programme. Cohort study - 192 acute hospitals in England, Wales, Northern Ireland, Scotland and the Republic of Ireland. Modelling - 105,397 admissions to adult, general critical care units. Cohort study - 1728 H1N1 pandemic-related admissions referred and assessed as requiring critical care. Modelling - requirement for organ support and acute hospital mortality. Cohort study - survival to the end of critical care. Modelling - cancelled or postponed, elective or scheduled surgery resulted in savings in calendar days of critical, Level 3 and advanced respiratory care of 17, 11 and 10%, respectively. These savings varied across units. Using routine, physiological variables, the best triage models, for all and for acute respiratory admissions, achieved only satisfactory concordance of 0.79 and 0.75, respectively. Application of the best model on all admissions indicated that approximately 12.5% of calendar days of critical care could be saved. Cohort study - research governance approvals were achieved for 192 acute hospitals, for 91 within 1 day of central research and development approval across the five countries. A total of 1725 cases (562 confirmed) were reported. Confirmed cases were young (mean age of 40 years), had low severity of acute illness on presentation [61% CURB-65 (confusion, urea, respiratory rate, blood pressure, age over 65 years) 0-1], but had

  4. Lifestyle Risk Factors Increase the Risk of Hospitalization for Sciatica: Findings of Four Prospective Cohort Studies.

    Science.gov (United States)

    Shiri, Rahman; Euro, Ulla; Heliövaara, Markku; Hirvensalo, Mirja; Husgafvel-Pursiainen, Kirsti; Karppinen, Jaro; Lahti, Jouni; Rahkonen, Ossi; Raitakari, Olli T; Solovieva, Svetlana; Yang, Xiaolin; Viikari-Juntura, Eira; Lallukka, Tea

    2017-12-01

    The purpose of this study is to assess the effects of lifestyle risk factors on the risk of hospitalization for sciatica and to determine whether overweight or obesity modifies the effect of leisure-time physical activity on hospitalization for sciatica. We included 4 Finnish prospective cohort studies (Health 2000 Survey, Mobile Clinic Survey, Helsinki Health Study, and Young Finns Study) consisting of 34,589 participants and 1259 hospitalizations for sciatica during 12 to 30 years of follow-up. Sciatica was based on hospital discharge register data. We conducted a random-effects individual participant data meta-analysis. After adjustment for confounding factors, current smoking at baseline increased the risk of subsequent hospitalization for sciatica by 33% (95% confidence interval [CI], 13%-56%), whereas past smokers were no longer at increased risk. Obesity defined by body mass index increased the risk of hospitalization for sciatica by 36% (95% CI 7%-74%), and abdominal obesity defined by waist circumference increased the risk by 41% (95% CI 3%-93%). Walking or cycling to work reduced the risk of hospitalization for sciatica by 33% (95% CI 4%-53%), and the effect was independent of body weight and other leisure activities, while other types of leisure activities did not have a statistically significant effect. Smoking and obesity increase the risk of hospitalization for sciatica, whereas walking or cycling to work protects against hospitalization for sciatica. Walking and cycling can be recommended for the prevention of sciatica in the general population. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Evaluation models and criteria of the quality of hospital websites: a systematic review study

    OpenAIRE

    Jeddi, Fatemeh Rangraz; Gilasi, Hamidreza; Khademi, Sahar

    2017-01-01

    Introduction Hospital websites are important tools in establishing communication and exchanging information between patients and staff, and thus should enjoy an acceptable level of quality. The aim of this study was to identify proper models and criteria to evaluate the quality of hospital websites. Methods This research was a systematic review study. The international databases such as Science Direct, Google Scholar, PubMed, Proquest, Ovid, Elsevier, Springer, and EBSCO together with regiona...

  6. STUDIES OF ADVERSE DRUG REACTION PROFILE OF ANTISNAKE VENOM AT DISTRICT GENERAL HOSPITAL

    OpenAIRE

    Mulchand Shende *, Sneha Gawali , Kanchan Bhongade , Vivek Bhuskade , Abhijit Nandgaonkar

    2017-01-01

    Snake bite is a common predominant problem of the rural and periurban areas, neglected and frequently devastating environmental and occupational disease, especially in rural areas of tropical developing countries. This study aimed to investigate of the adverse drug reaction profile of anti-snake venom (ASV) in a district general hospital. An observational study was conducted in hospital for six months. A total number of 142 indoor case papers of snake bite from October 2016 to April 2017 were...

  7. Job Satisfaction and Employee Turnover Intention: A Case Study of Private Hospital in Erbil

    OpenAIRE

    Govand Anwar; Inji Shukur

    2015-01-01

    Today it became a huge challenge for Human Resource Managers to retain the employees for longer time of period and decrease the rate of employee turnover. The main research objective is to find out the correlation between job satisfaction and employee turnover intention in private hospital in Erbil. A quantitative method was used to analyze the current study. 144 participants were involved in this study from private hospital in Erbil. The correlation between job satisfaction factor as indepen...

  8. Hospitalizations for varicella in children and adolescents in a referral hospital in Hong Kong, 2004 to 2008: A time series study

    Directory of Open Access Journals (Sweden)

    Chan WM

    2011-05-01

    Full Text Available Abstract Background Varicella accounts for significant morbidities and remains a public health issue worldwide. Climatic factors have been shown to associate with the incidence and transmission of various infectious diseases. We describe the epidemiology of varicella in paediatric patients hospitalized at a tertiary referral hospital in Hong Kong from 2004 to 2008, and to explore the possible association between the occurrence of varicella infection and various climatic factors. Methods The hospital discharge database of Princess Margaret Hospital was retrospectively analyzed for admissions associated with varicella from 2004 to 2008. Meteorological data were obtained from the monthly meteorological reports from the Hong Kong Observatory website. Time series analysis was performed with Poisson regression using a Generalized Estimating Equation (GEE approach. Results During the study period, 598 children were hospitalized for varicella. The mean age on admission was 57.6 months, and the mean duration of hospitalization was 3.7 days. The overall complication rate was 47%. The mean monthly relative humidity, especially in cool seasons, was inversely correlated with the monthly varicella cases of the same month. Conclusions Varicella can lead to serious complications and prolonged hospitalization, even in previously healthy children. Lower relative humidity in cool seasons is associated with higher number of paediatric varicella hospital admissions. These findings are useful for a better understanding of the pattern of paediatric varicella hospitalization in Hong Kong.

  9. Organizational culture in cardiovascular care in Chinese hospitals: a descriptive cross-sectional study.

    Science.gov (United States)

    Yin, Emily S; Downing, Nicholas S; Li, Xi; Singer, Sara J; Curry, Leslie A; Li, Jing; Krumholz, Harlan M; Jiang, Lixin

    2015-12-21

    Organizational learning, the process by which a group changes its behavior in response to newly acquired knowledge, is critical to outstanding organizational performance. In hospitals, strong organizational learning culture is linked with improved health outcomes for patients. This study characterizes the organizational learning culture of hospitals in China from the perspective of a cardiology service. Using a modified Abbreviated Learning Organization Survey (27 questions), we characterized organizational learning culture in a nationally representative sample of 162 Chinese hospitals, selecting 2 individuals involved with cardiovascular care at each hospital. Responses were analyzed at the hospital level by calculating the average of the two responses to each question. Responses were categorized as positive if they were 5+ on a 7-point scale or 4+ on a 5-point scale. Univariate and multiple regression analyses were used to assess the relationship between selected hospital characteristics and perceptions of organizational learning culture. Of the 324 participants invited to take the survey, 316 responded (98 % response rate). Perceptions of organizational learning culture varied among items, among domains, and both among and within hospitals. Overall, the median proportion of positive responses was 82 % (interquartile range = 59 % to 93 %). "Training," "Performance Monitoring," and "Leadership that Reinforces Learning" were characterized as the most favorable domains, while "Time for Reflection" was the least favorable. Multiple regression analyses showed that region was the only factor significantly correlated with overall positive response rate. This nationally representative survey demonstrated variation in hospital organizational learning culture among hospitals in China. The variation was not substantially explained by hospital characteristics. Organizational learning culture domains with lower positive response rates reveal important areas for

  10. The study on the outsourcing of Taiwan's hospitals: a questionnaire survey research.

    Science.gov (United States)

    Hsiao, Chih-Tung; Pai, Jar-Yuan; Chiu, Hero

    2009-05-13

    The aim of this study was to assess the outsourcing situation in Taiwanese hospitals and compares the differences in hospital ownership and in accreditation levels. This research combined two kinds of methods: a questionnaire survey and the in-depth interview to two CEOs of the sample hospitals. One hospital is not-for-profit, while the other is a public hospital and the research samples are from the hospital data from Taiwan's 2005 to 2007 Department of Health qualifying lists of hospital accreditation. The returned questionnaires were analyzed with STATISTICA 7.1 version software. The results for non-medical items showed medical waste and common trash both have the highest rate (94.6 percent) of being outsourced. The gift store (75 percent) and linen (73 percent) follow close behind, while the lowest rate of outsourcing is in utility maintenance (13.5 percent). For medical items, the highest rate of outsourcing is in the ambulance units (51.4 percent), while the hemodialysis center follows close behind with a rate of 50 percent. For departments of nutrition, pharmacy, and nursing however, the outsourcing rate is lower than 3 percent. This shows that Taiwan's hospitals are still conservative in their willingness to outsource for medical items. The results of the satisfaction paired t-test show that the non-medical items have a higher score than the medical items. The factor analysis showed the three significant factors in of non medical items' outsourcing are "performance", "finance", and "human resource". For medical items, the two factors are "operation" and satisfaction". To further exam the factor validity and reliability of the satisfaction model, a confirmative factor analysis (CFA) was conducted using structure equation modeling (SEM) method and found the model fitting well. Hospitals, especially for public hospitals, can get benefits from outsourcing to revive the full-time-equivalent and human resource limitation.

  11. The study on the outsourcing of Taiwan's hospitals: a questionnaire survey research

    Directory of Open Access Journals (Sweden)

    Pai Jar-Yuan

    2009-05-01

    Full Text Available Abstract Background The aim of this study was to assess the outsourcing situation in Taiwanese hospitals and compares the differences in hospital ownership and in accreditation levels. Methods This research combined two kinds of methods: a questionnaire survey and the in-depth interview to two CEOs of the sample hospitals. One hospital is not-for-profit, while the other is a public hospital and the research samples are from the hospital data from Taiwan's 2005 to 2007 Department of Health qualifying lists of hospital accreditation. The returned questionnaires were analyzed with STATISTICA® 7.1 version software. Results The results for non-medical items showed medical waste and common trash both have the highest rate (94.6 percent of being outsourced. The gift store (75 percent and linen (73 percent follow close behind, while the lowest rate of outsourcing is in utility maintenance (13.5 percent. For medical items, the highest rate of outsourcing is in the ambulance units (51.4 percent, while the hemodialysis center follows close behind with a rate of 50 percent. For departments of nutrition, pharmacy, and nursing however, the outsourcing rate is lower than 3 percent. This shows that Taiwan's hospitals are still conservative in their willingness to outsource for medical items. The results of the satisfaction paired t-test show that the non-medical items have a higher score than the medical items. The factor analysis showed the three significant factors in of non medical items' outsourcing are "performance", "finance", and "human resource". For medical items, the two factors are "operation" and satisfaction". To further exam the factor validity and reliability of the satisfaction model, a confirmative factor analysis (CFA was conducted using structure equation modeling (SEM method and found the model fitting well. Conclusion Hospitals, especially for public hospitals, can get benefits from outsourcing to revive the full-time-equivalent and human

  12. Older people’s perspectives on an elderly-friendly hospital environment: an exploratory study

    Science.gov (United States)

    Karki, Sushmita; Bhatta, Dharma Nand; Aryal, Umesh Raj

    2015-01-01

    Background Many older people are vulnerable with multiple health problems and need of extensive care and support for quality of life. The main objective of this study was to explore the older people’s perspectives on an “elderly-friendly” hospital. Methods Hospital was stratified by four domains including government, semi-government, community, and private. We interviewed 33 hospitalized older patients and four hospital managers between June and December 2014 in Kathmandu, Nepal, using purposive sampling technique. We executed a qualitative content analysis step with extensive review of the interviews. Final name of the theme was given after the agreement between the research team and experts to improve trustworthiness. Elderly-friendly services, expectation from government and hospital, and health policy related to senior citizen were developed as main themes. Results Most of the participants were satisfied with the behavior of health personnel. However, none of the health personnel were trained with geriatric health care. Elderly-friendly hospital guidelines and policy were not developed by any hospitals. Older people health card, advocacy for older people’s health and benefit, and hospital environment were the common expectations of older patients. Government policy and budget constraint were the main obstacles to promote elderly-friendly health care services. Conclusion Elderly-related health policies, physical environments of hospital, elderly-friendly health manpower, advocacy, and other facilities and benefits should be improved and developed. There are urgent needs to develop elderly-friendly hospital policies and guidelines that focus on older people’s health benefits and friendly services. PMID:26028980

  13. Identifying Patterns in Implementation of Hospital Pressure Ulcer Prevention Programs: A Multisite Qualitative Study.

    Science.gov (United States)

    Soban, Lynn M; Finley, Erin P; Miltner, Rebecca S

    2016-01-01

    To describe the presence or absence of key components of hospital pressure ulcer (PU) prevention programs in 6 acute care hospitals. Multisite comparative case study. Using purposeful selection based on PU rates (high vs low) and hospital size, 6 hospitals within the Veterans Health Administration health care system were invited to participate. Key informant interviews (n = 48) were conducted in each of the 6 participating hospitals among individuals playing key roles in PU prevention: senior nursing leadership (n = 9), nurse manager (n = 7), wound care specialist (n = 6), frontline RNs (n = 26). Qualitative data were collected during face-to-face, semistructured interviews. Interview protocols were tailored to each interviewee's role with a core set of common questions covering 3 major content areas: (1) practice environment (eg, policies and wound care specialists), (2) current prevention practices (eg, conduct of PU risk assessment and skin inspection), and (3) barriers to PU prevention. We conducted structured coding of 5 key components of PU prevention programs and cross-case analysis to identify patterns in operationalization and implementation of program components across hospitals based on facility size and PU rates (low vs high). All hospitals had implemented all PU prevention program components. Component operationalization varied considerably across hospitals. Wound care specialists were integral to the operationalization of the 4 other program components examined; however, staffing levels and work assignments of wound care specialists varied widely. Patterns emerged among hospitals with low and high PU rates with respect to wound care specialist staffing, data monitoring, and staff education. We found hospital-level variations in PU prevention programs. Wound care specialist staffing may represent a potential point of leverage in achieving other PU program components, particularly performance monitoring and staff education.

  14. 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

  15. Xpert Flu for point-of-care diagnosis of human influenza in industrialized countries.

    Science.gov (United States)

    Salez, Nicolas; Nougairede, Antoine; Ninove, Laetitia; Zandotti, Christine; de Lamballerie, Xavier; Charrel, Rémi N

    2014-05-01

    Respiratory infections, particularly those caused by influenza viruses, represent the third-most important cause of death in the world due to infectious diseases. Nevertheless, despite the enormous publicity attracted by epidemics due to these viruses, laboratory diagnosis, documentation and recording of respiratory diseases is still unsatisfactory. Available diagnostic tests capable of providing results rapidly are either limited and insufficiently sensitive or highly sensitive and specific but insufficiently rapid. Considerable investment and research efforts have been made towards the development of new diagnostics for influenza A and B viruses and the Xpert(®) Flu assay (Cepheid(®), CA, USA) has emerged as one of the most promising. In this article, we review current knowledge of the Xpert Flu test, discuss its potential value as a point-of-care test and outline the potential leads for future development.

  16. Benchmarking healthcare logistics processes: a comparative case study of Danish and US hospitals

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes; Andersen, Bjørn; Jacobsen, Peter

    2017-01-01

    Logistics processes in hospitals are vital in the provision of patient care. Improving healthcare logistics processes provides an opportunity for reduced healthcare costs and better support of clinical processes. Hospitals are faced with increasing healthcare costs around the world and improvement...... initiatives prevalent in manufacturing industries such as lean, business process reengineering and benchmarking have seen an increase in use in healthcare. This study investigates how logistics processes in a hospital can be benchmarked to improve process performance. A comparative case study of the bed...... logistics process and the pharmaceutical distribution process was conducted at a Danish and a US hospital. The case study results identified decision criteria for designing efficient and effective healthcare logistics processes. The most important decision criteria were related to quality, security...

  17. Audit and account billing process in a private general hospital: a case study

    Directory of Open Access Journals (Sweden)

    Raquel Silva Bicalho Zunta

    2017-12-01

    Full Text Available Our study aimed to map, describe and, validate the audit, account billing and billing reports processes in a large, private general hospital.  An exploratory, descriptive, case report study. We conducted non-participatory observation moments in Internal Audit Sectors and  Billing Reports from the hospital, aiming to map the processes which were the study objects. The data obtained was validated by internal and external audit specialists in hospital bills. The described and illustrated processes in three flow-charts favor professionals to rationalize their activities and the time spent in hospital billing, avoiding or minimizing the occurrence of flaws and, generating more effective financial results. The mapping, the description and the audit validation process and billing and, the billing reports propitiated more visibility and legitimacy to actions developed by auditor nurses.

  18. Unravelling the potential mechanisms behind hospitalization-associated disability in older patients : the hospital-associated disability and impact on daily Life (Hospital-ADL) cohort study protocol

    NARCIS (Netherlands)

    Reichardt, Lucienne A.; Aarden, Jesse J.; van Seben, Rosanne; van der Schaaf, Marike; Engelbert, Raoul H.H.; Bosch, Jos A.; Buurman, Bianca M.

    2016-01-01

    BACKGROUND: Over 30 % of older patients experience hospitalization-associated disability (HAD) (i.e., loss of independence in Activities of Daily Living (ADLs)) after an acute hospitalization. Despite its high prevalence, the mechanisms that underlie HAD remain elusive. This paper describes the

  19. Unravelling the potential mechanisms behind hospitalization-associated disability in older patients : The Hospital-Associated Disability and impact on daily Life (Hospital-ADL) cohort study protocol

    NARCIS (Netherlands)

    Reichardt, L.A.; Aarden, J.J.; van Seben, R.; van der Schaaf, M.; Engelbert, R.H.H.; Bosch, J.A.; Buurman, B.M.

    2016-01-01

    BACKGROUND: Over 30 % of older patients experience hospitalization-associated disability (HAD) (i.e., loss of independence in Activities of Daily Living (ADLs)) after an acute hospitalization. Despite its high prevalence, the mechanisms that underlie HAD remain elusive. This paper describes the

  20. H1N1 influenza ('swine 'flu') in the paediatric ICU in South Africa

    African Journals Online (AJOL)

    Schoub B. Swine flu – implications for South Africa. Communicable Diseases Surveillance. Bulletin 2009;7(3):5-7. 5. Ahrens JO, Morrow BM, Argent AC. Influenza A(H1N1)pdm09 in critically ill children admitted to a paediatric intensive care unit, South Africa. S Afr J Crit Care 2015;31(1):4-7. 6. Cox CM, Blanton L, Dhara R, ...

  1. Hospitals as a 'risk environment': an ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs.

    Science.gov (United States)

    McNeil, Ryan; Small, Will; Wood, Evan; Kerr, Thomas

    2014-03-01

    People who inject drugs (PWID) experience high levels of HIV/AIDS and hepatitis C (HCV) infection that, together with injection-related complications such as non-fatal overdose and injection-related infections, lead to frequent hospitalizations. However, injection drug-using populations are among those most likely to be discharged from hospital against medical advice, which significantly increases their likelihood of hospital readmission, longer overall hospital stays, and death. In spite of this, little research has been undertaken examining how social-structural forces operating within hospital settings shape the experiences of PWID in receiving care in hospitals and contribute to discharges against medical advice. This ethno-epidemiological study was undertaken in Vancouver, Canada to explore how the social-structural dynamics within hospitals function to produce discharges against medical advice among PWID. In-depth interviews were conducted with thirty PWID recruited from among participants in ongoing observational cohort studies of people who inject drugs who reported that they had been discharged from hospital against medical advice within the previous two years. Data were analyzed thematically, and by drawing on the 'risk environment' framework and concepts of social violence. Our findings illustrate how intersecting social and structural factors led to inadequate pain and withdrawal management, which led to continued drug use in hospital settings. In turn, diverse forms of social control operating to regulate and prevent drug use in hospital settings amplified drug-related risks and increased the likelihood of discharge against medical advice. Given the significant morbidity and health care costs associated with discharge against medical advice among drug-using populations, there is an urgent need to reshape the social-structural contexts of hospital care for PWID by shifting emphasis toward evidence-based pain and drug treatment augmented by harm

  2. Hospital branding in Italy: A pilot study based on the case method.

    Science.gov (United States)

    Esposito, Annamaria

    2017-01-01

    The article investigates if, and in affirmative case how, Italian hospitals are managing corporate brand communication. Thanks to results of qualitative research, this article offers insights on Italian hospital branding. The pilot study based in the case method is to be considered a starting point for wider investigations on this topic, and it is useful for managers and practitioners who want to understand the role of corporate brand in hospital communication management and to connect health care professionals with the audience in a meaningful way in those countries in which the health care system is a mix of both public and private institutions.

  3. Reinventing the Hospital – A Study of Lost Synergies in Danish Healthcare

    DEFF Research Database (Denmark)

    Bekdik, Baris; Thuesen, Christian

    2016-01-01

    The purpose of this study is to identify the effects of inter organizational relationships in construction projects by investigating how complexities are manifested in variance and repetitions across projects. The case is a set of 27 hospital projects in Denmark including new buildings as well...... project. This lead us to the conclusion that the hospital is reinvented in each project leaving behind unrealized potential for leveraging similarity across the projects. This could have been achieved by a stronger central coordination, thinking of super hospitals as programs and portfolios rather than...

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

    DEFF Research Database (Denmark)

    Mosha, Dominic; Poulsen, Anja; Reyburn, Hugh

    2009-01-01

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

  5. The performance of Luminex ARIES® Flu A/B & RSV and Cepheid Xpert® Flu/RSV XC for the detection of influenza A, influenza B, and respiratory syncytial virus in prospective patient samples.

    Science.gov (United States)

    McMullen, Phillip; Boonlayangoor, Sue; Charnot-Katsikas, Angella; Beavis, Kathleen G; Tesic, Vera

    2017-10-01

    The demand for rapid, accurate viral testing has increased the number of assays available for the detection of viral pathogens. One of the newest FDA cleared platforms is the Luminex ARIES ® Flu A/B & RSV, which is a fully automated, real-time PCR-based assay used for detection of influenza A, influenza B, and respiratory syncytial virus (RSV). We sought to compare the performance of Luminex ARIES ® Flu A/B & RSV assay to the Cepheid Xpert ® Flu/RSV XC assay for rapid Flu and RSV testing. A series of consecutive nasopharyngeal specimens received in the clinical microbiology laboratory during peak influenza season at a major academic center in Chicago, IL, were prospectively tested, using both the ARIES ® Flu A/B & RSV and Xpert ® Flu/RSV XC assays, side by side. Discrepant results were tested on the BioFire FilmArray ® Respiratory Panel for resolution. A total of 143 consecutive nasopharyngeal specimens, obtained from patients ranging from six months to ninety-three years in age were received between January 1st, 2017 and March 21st, 2017. There was 96.6% agreement between the two assays for detection influenza A, 100% agreement for detection influenza B and RSV, and 98.9% agreement for negative results. The Xpert ® Flu/RSV XC performed with an average turn-around time of approximately 60min, compared to the ARIES ® Flu A/B & RSV of approximately 120min. Both assays were equally easy to perform, with a similar amount of hands-on technologist time for each platform. Overall, these results indicate that both tests are comparable in terms of result agreement and technical ease-of-use. The Xpert ® Flu/RSV XC assay did produce results with less turn-around-time, approximately 60min quicker than the ARIES ® Flu A/B & RSV. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. The 2014 French health campaign reminds us that “flu must be taken seriously”

    CERN Multimedia

    Medical Service

    2014-01-01

    The fact is that 5-10% of the global adult population and 20-30% of children worldwide catch the flu every year. The illness can lead to hospitalisation and death, mainly in people who are considered high-risk (infants, the elderly, and those with chronic illnesses). According to the WHO, every year, flu epidemics are responsible for approximately three to five million cases of serious illness and for 250,000 to 500,000 deaths worldwide.   Vaccination is the most effective way of avoiding the illness and any serious consequences and protecting those around you. Safe and effective vaccines are available and have been used for more than 60 years. Remember, anyone working on the CERN site who wishes to be vaccinated against seasonal flu should go to the Infirmary (Building 57, ground floor) with their dose of vaccine. The Medical Service will issue a prescription on the day of the vaccination for the purposes of reimbursement through UNIQA. NB: The Medical Service cannot provide this vaccinat...

  7. A universal long-term flu vaccine may not prevent severe epidemics

    Directory of Open Access Journals (Sweden)

    Blower Sally

    2010-04-01

    Full Text Available Abstract Background Recently, the promise of a new universal long-term flu vaccine has become more tangible than ever before. Such a vaccine would protect against very many seasonal and pandemic flu strains for many years, making annual vaccination unnecessary. However, due to complacency behavior, it remains unclear whether the introduction of such vaccines would maintain high and stable levels of vaccination coverage year after year. Findings To predict the impact of universal long-term flu vaccines on influenza epidemics we developed a mathematical model that linked human cognition and memory with the transmission dynamics of influenza. Our modeling shows that universal vaccines that provide short-term protection are likely to result in small frequent epidemics, whereas universal vaccines that provide long-term protection are likely to result in severe infrequent epidemics. Conclusions Influenza vaccines that provide short-term protection maintain risk awareness regarding influenza in the population and result in stable vaccination coverage. Vaccines that provide long-term protection could lead to substantial drops in vaccination coverage and should therefore include an annual epidemic risk awareness programs in order to minimize the risk of severe epidemics.

  8. Mobility and other predictors of hospitalization for urinary tract infection: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Kaufman Samuel R

    2008-11-01

    Full Text Available Abstract Background Many hospitalizations for residents of skilled nursing facilities are potentially avoidable. Factors that could prevent hospitalization for urinary tract infection (UTI were investigated, with focus on patient mobility. Methods A retrospective cohort study was conducted using 2003–2004 data from the Centers for Medicare and Medicaid Services. The study included 408,192 residents of 4267 skilled nursing facilities in California, Florida, Michigan, New York, and Texas. The patients were followed over time, from admission to the skilled nursing facility to discharge or, for those who were not discharged, for 1 year. Cox proportional hazards regression was conducted with hospitalization for UTI as the outcome. Results The ability to walk was associated with a 69% lower rate of hospitalization for UTI. Maintaining or improving walking ability over time reduced the risk of hospitalization for UTI by 39% to 76% for patients with various conditions. For residents with severe mobility problems, such as being in a wheelchair or having a missing limb, maintaining or improving mobility (in bed or when transferring reduced the risk of hospitalization for UTI by 38% to 80%. Other potentially modifiable predictors included a physician visit at the time of admission to the skilled nursing facility (Hazard Ratio (HR, 0.68, use of an indwelling urinary catheter (HR, 2.78, infection with Clostridium difficile or an antibiotic-resistant microorganism (HR, 1.20, and use of 10 or more medications (HR, 1.31. Patient characteristics associated with hospitalization for UTI were advancing age, being Hispanic or African-American, and having diabetes mellitus, renal failure, Parkinson's disease, dementia, or stroke. Conclusion Maintaining or improving mobility (walking, transferring between positions, or moving in bed was associated with a lower risk of hospitalization for UTI. A physician visit at the time of admission to the skilled nursing facility

  9. Handheld Versus Wearable Interaction Design for Professionals - A Case Study of Hospital Service Work

    DEFF Research Database (Denmark)

    Stisen, Allan; Blunck, Henrik; Kjærgaard, Mikkel Baun

    2014-01-01

    With the blooming of new available wrist worn devices there are potentials for these to support the work done in many professional domains. One such domain is hospital service work. This paper explores two wearable prototypes with regards to challenges and opportunities to support future hospital...... service work. This explorative study was conducted with 4 experienced hospital orderlies who interacted with an application across two wearable concepts, and one handheld smartphone in five scenarios in a hospital environment. The interaction was video recorded with a chest-mounted video afterwards semi...... structured interviews with each participant was conducted. This study shows that wearable computers can effectively support the maintenance work of the orderlies and has domain specific advantages over the handheld smartphone, e.g., the former support glancing at the task information. Furthermore, we outline...

  10. Implementation of nutrition care service development plan at Banning Memorial Hospital: a case study.

    Science.gov (United States)

    Ben Oumlil, A; Rao, C P

    1992-01-01

    Health care service markets in general and hospital care service markets in particular are characterized by many competitive developments. Hence, hospital marketing managers are forced to respond to these emerging competitive pressures. However, in formulating appropriate marketing management strategies, hospital managers need to have detailed knowledge about consumers and their behaviors in the marketplace. This paper focuses on the Nutrition Care division of the Department of Nutrition Service at a hospital and its venture into new service development. This case study is intended to emphasize the significance of acquiring adequate knowledge of customers in the health care services industry. It particularly emphasizes the critical role that this type of information concerning customer behavior plays in the development and implementation of an appropriate business expansion strategy. Furthermore, the aim of this case study is to help the reader to relate the acquired marketing information to the problem at hand, and make the appropriate marketing management decision.

  11. Perinatal outcomes of unplanned out-of-hospital deliveries: a case-control study.

    Science.gov (United States)

    Pasternak, Yael; Wintner, Eliana Muskin; Shechter-Maor, Gil; Pasternak, Yehonatan; Miller, Netanella; Biron-Shental, Tal

    2018-04-01

    To compare the pregnancy and perinatal outcomes of unplanned home or car births vs. in-hospital deliveries. A retrospective, case-control study of women who underwent unplanned out-of-hospital deliveries vs. in-hospital deliveries from 2004 through 2014. Matching was based on gestational age and parity in a ratio of 2:1. There were no significant differences between the groups regarding demographic criteria, prenatal care and delivery complications. Women who delivered out of hospital (n = 90) had significantly fewer cesarean deliveries (1.1 vs. 10.6%; p = 0.05) and operative deliveries (2.2 vs. 13.3%; p = 0.004) in their obstetrical history than did the control group (n = 180). Significantly more newborns delivered out of the hospital had polycythemia (25.6 vs. 1.7%; p unplanned out-of-hospital deliveries tend to have fewer complications in their previous deliveries. Higher rates of polycythemia and hypothermia require attention for neonates born out of the hospital.

  12. Standardised surveillance of Clostridium difficile infection in European acute care hospitals: a pilot study, 2013.

    Science.gov (United States)

    van Dorp, Sofie M; Kinross, Pete; Gastmeier, Petra; Behnke, Michael; Kola, Axel; Delmée, Michel; Pavelkovich, Anastasia; Mentula, Silja; Barbut, Frédéric; Hajdu, Agnes; Ingebretsen, André; Pituch, Hanna; Macovei, Ioana S; Jovanović, Milica; Wiuff, Camilla; Schmid, Daniela; Olsen, Katharina Ep; Wilcox, Mark H; Suetens, Carl; Kuijper, Ed J

    2016-07-21

    Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for CDI cases) and an 'enhanced' option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe. This article is copyright of The Authors, 2016.

  13. Hospital management practices and availability of surgery in sub-Saharan Africa: a pilot study of three hospitals.

    Science.gov (United States)

    Funk, Luke M; Conley, Dante M; Berry, William R; Gawande, Atul A

    2013-11-01

    Sub-Saharan Africa has a high surgical burden of disease but performs a disproportionately low volume of surgery. Closing this surgical gap will require increased surgical productivity of existing systems. We examined specific hospital management practices in three sub-Saharan African hospitals that are associated with surgical productivity and quality. We conducted 54 face-to-face, structured interviews with administrators, clinicians, and technicians at a teaching hospital, district hospital, and religious mission hospital across two countries in sub-Saharan Africa. Questions focused on recommended general management practices within five domains: goal setting, operations management, talent management, quality monitoring, and financial oversight. Records from each interview were analyzed in a qualitative fashion. Each hospital's management practices were scored according to the degree of implementation of the management practices (1 = none; 3 = some; 5 = systematic). The mission hospital had the highest number of employees per 100 beds (226), surgeons per operating room (3), and annual number of operations per operating room (1,800). None of the three hospitals had achieved systematic implementation of management practices in all 14 measures. The mission hospital had the highest total management score (44/70 points; average = 3.1 for each of the 14 measures). The teaching and district hospitals had statistically significantly lower management scores (average 1.3 and 1.1, respectively; p management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.

  14. Pharmacovigilance study of Ayurvedic medicine in Ayurvedic Teaching Hospital: A prospective survey study.

    Science.gov (United States)

    Ajanal, Manjunath N; Nayak, Shradda U; Kadam, Avinash P; Prasad, B S

    2015-01-01

    Though Ayurveda is practiced in the Indian subcontinent since centuries, there is a paucity of systematic documentation related to the occurrence of adverse drug reactions (ADR) and other issues regarding the safety of Ayurveda medicines. To monitor and analyze the pattern and frequency of ADR to Ayurvedic medicines in an Ayurvedic hospital setup. In this prospective study, ADR monitoring was done in KLE Ayurveda Secondary Care Hospital, Belgaum, Karnataka, India by spontaneous and intensive monitoring technique for a span of 1-year (June 2010 to May 2011). Data pertaining to patient demography, drug and reaction characteristics, organ system involved and reaction outcomes were collected and evaluated. The reaction severity and predisposing factors were also assessed. In a span of one year, 84 adverse drug events were reported out of which 52 confirmed as ADR. The overall incidence of ADR in the patient population was 1.14%, out of which 23 (44.23%) were related to Panchakarma (detoxification process), 13 (25.00%) related to the herbal formulations and 06 (11.53%) were of Rasa Aushadhi (mineral or herbo-mineral formulations). The commonly affected organ systems were gastrointestinal system 24 (46.15%) and skin 15 (28.84%). The majority of the reactions were moderate 30 (57.69%) to mild 20 (38.46%) in severity. Most patients recovered from the incidence. The present work has documented the incidence and characteristic of ADR to Ayurvedic medicine in a typical Ayurveda hospital setup. This will help in developing various strategies for boosting pharmacovigilance in Ayurveda, thereby ensuring safer use of Ayurveda medicines.

  15. A bacteriological study of hospital beds before and after disinfection with phenolic disinfectant

    OpenAIRE

    Denise de Andrade; Emília L. S. Angerami; Carlos Roberto Padovani

    2000-01-01

    In hospitals, one of the ways to control microbial contamination is by disinfecting the furniture used by patients. This study's main objective was to evaluate the microbiological condition of hospital mattresses before and after such disinfection, in order to identify bacteria that are epidemiologically important in nosocomial infection, such as Staphylococcus aureus and Pseudomonas aeruginosa. RODAC plates with two different culture media were used to collect specimens. Patient beds were se...

  16. The subjective experience of psychiatric hospitalization : a case study approach / Mark Edward de la Rey

    OpenAIRE

    De la Rey, Mark Edward

    2006-01-01

    The aim of the research was to explore the subjective experience of patients admitted to a psychiatric hospital. Sub-aims were to explore how these experiences relate to self management, stress and psychological well-being. This study was motivated by research literature that documents a wide variety of negative experiences by patients. A recent psychiatric patient survey conducted in England and Wales (Mind, 2004) found that more than 50% of respondents indicated that hospital...

  17. Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

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    Baltazar, J. C.; Tiglao, T. V.; Tempongko, S. B.

    1993-01-01

    The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoe...

  18. Job Satisfaction in the Hospitality Industry Focus: Greece Case Study: Porto Carras Grand Resort

    OpenAIRE

    Salpisti, Elisavet

    2004-01-01

    This dissertation focuses on the notion of Job Satisfaction in the Hospitality Industry. The organisational single-case study has been chosen as a research method, with research taking place in Porto Carras Grand Resort in Northern Greece. The purpose of this research has been to demonstrate the importance of employee job satisfaction in the hospitality industry in particular, since the quality of its services is greatly subject to the 'human chemistry' between employees and customers. Job...

  19. Hospital Audit as a Useful Tool in the Process of Introducing Falsified Medicines Directive (FMD into Hospital Pharmacy Settings—A Pilot Study

    Directory of Open Access Journals (Sweden)

    Urszula Religioni

    2017-11-01

    Full Text Available Background: Recently, the European Union has introduced the Falsified Medicines Directive (FMD. Additionally, in early 2016, a Delegated Act (DA related to the FMD was published. The main objective of this study was to evaluate the usefulness of external audits in the context of implementing new regulations provided by the FMD in the secondary care environment. Methods: The external, in-person workflow audits were performed by an authentication company in three Polish hospital pharmacies. Each audit consisted of a combination of supervision (non-participant observation, secondary data analysis, and expert interviews with the use of an independently designed authorial Diagnostic Questionnaire. The questionnaire included information about hospital drug distribution procedures, data concerning drug usage, IT systems, medication order systems, the processes of medication dispensing, and the preparation and administration of hazardous drugs. Data analysis included a thorough examination of hospital documentation in regard to drug management. All data were subjected to qualitative analysis, with the aim of generating meaningful information through inductive inference. Results: Only one dispensing location in the Polish hospitals studied has the potential to be a primary authentication area. In the audited hospitals, an Automated Drug Dispensing System and unit dose were not identified during the study. Hospital wards contained an enclosed place within the department dedicated to drug storage under the direct supervision of senior nursing staff. An electronic order system was not available. In the largest center, unused medications are re-dispensed to different hospital departments, or may be sold to various institutions. Additionally, in one hospital pharmacy, pharmacists prepared parenteral nutrition and chemotherapeutic drugs for patients admitted to the hospital. Conclusions: External audits might prove beneficial in the course of introducing new

  20. Willingness to pay for municipality hospital services in rural Japan: a contingent valuation study

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    Nakamura Toshihito

    2011-06-01

    Full Text Available Abstract Background The Japanese healthcare system has undergone reforms to address the struggles that municipality hospitals face. Reform guidelines clearly define criteria for administrative improvement. However, criteria to evaluate the demand for healthcare provisions in rural Japan, including the needs of rural residents for municipality hospitals in particular have not been specified. The purpose of this paper is to measure residents' willingness to pay (WTP for municipality hospital services using the contingent valuation method, and to evaluate municipality hospital valuation on the basis of WTP. K town, located in the Hokkaido prefecture of Japan, was selected as the location for this study. Participants were recruited by a town hall healthcare administrator, hospital and clinic staff, and a local dentist. Participants were asked what amount they would be willing to pay as taxes to continue accessing the services of the municipality hospital for one year by using open-ended questions in face-to-face interviews. Findings Forty-eight residents were initially recruited, and 40 participants were selected for the study (response rate 83%. As compared to K town's population, this data slanted toward the elderly, although there was no significant difference in frequency among the characteristics. The median WTP was estimated at 39,484 yen ($438.71, with a 95% confidence interval 27,806-55,437 yen ($308.95-615.96. Logistic regression revealed no significant factors affecting WTP. Conclusions If the total amount of residents' WTP for the municipality hospital were to be estimated by this result, it would calculate with 129,586,000 yen ($1,439,844. This is approximately equal to the amount of money to be transferred from the general account of the government of K town, more than one-half of the town tax of K town, and about two-fold in comparison to Japan as a whole. This showed that K town's residents placed a high valuation on the municipality