WorldWideScience

Sample records for sources including hospital

  1. Organisation of the disposal of radioactive sources from Scottish hospitals

    International Nuclear Information System (INIS)

    Corrigall, R S; Martin, C J; Watson, I

    2004-01-01

    An amnesty for disposal of sealed radioactive sources from Scottish hospitals has been funded by the Scottish Executive to address problems arising from accumulation of sources. The contract was awarded to a company involved in radioactive source recycling. Coordination of uplifts from several hospitals allowed considerable financial savings to be made, so source amnesties could offer monetary advantages to Health and Education Departments elsewhere in the UK, as well as alleviating the problem from security and storage of sources that are no longer required. The sources originated in 14 hospitals, but were uplifted from five pick-up points. There were a total of 246 sources with 167 of these being caesium-137. The total activity was 16.2 TBq with one large 16.1 TBq blood irradiator source and the activities of all the other sources adding up to 167 GBq. This paper describes organisation of the collection. Options for achieving compliance with the Radioactive Substances Act 1993 are discussed, although in the event, special authorisations were obtained for each hospital. Arrangements for transport of the sources and source security were drawn up including emergency procedures for dealing with foreseeable incidents. The police provided secure overnight storage for the loaded truck and assistance in directing and monitoring progress of the load

  2. Traceable calibration of hospital 192Ir HDR sources

    International Nuclear Information System (INIS)

    Govinda Rajan, K.N.; Bhatt, B.C.; Pendse, A.M.; Kannan, V.

    2002-01-01

    Presently, no primary standard exists for the standardization of remote afterloading 192 Ir HDR sources. These sources are, therefore, being standardized by a few Secondary Standard Dosimetry Laboratories (SSDLs), in terms of Air Kerma Strength (AKS) or Reference Air Kerma Rate (RAKR) using a 0.6 cc Farmer type chamber, set up as an Interim Standard. These SSDLs offer calibration to well type of ionization chambers that are normally used by the hospitals for calibrating the 192 lr HDR source. Presently, in many countries, including India, well chambers are not commercially available. Nor do these countries offer any calibration service for 192 lr HDR source. With the result users make use of well chambers imported from different countries with their calibration traceable to the country of origin. Since no intercomparisons between these countries have been reported, the measurement consistency between hospitals becomes questionable. The problem is compounded by the fact that these chambers are used for several years without re-calibration since no calibration service is locally available. For instance, in India, the chambers have been in use in hospitals, since 1994, without a second calibration. Not all hospitals use the well chamber for the calibration of the 192 lr HDR source. Many hospitals make use of 0.6 cc chambers, in air, at short source to chamber distances, for measuring the AKS of the source. The latter method is prone to much larger inaccuracy due to the use of very short source to chamber distances without proper calibration jigs, use of 60 Co calibration factor for 192 Ir HDR source calibrations, neglecting correction factors for room scatter, fluence non-uniformity, use of arbitrary buildup factors for the buildup cap of the chamber etc. A comparison of the procedures used at hospitals revealed that various arbitrary methods are in use at hospitals. An indigenously developed well chamber was calibrated against a Reference Standard traceable to the

  3. Do the enigmatic ``Infrared-Faint Radio Sources'' include pulsars?

    Science.gov (United States)

    Hobbs, George; Middelberg, Enno; Norris, Ray; Keith, Michael; Mao, Minnie; Champion, David

    2009-04-01

    The Australia Telescope Large Area Survey (ATLAS) team have surveyed seven square degrees of sky at 1.4GHz. During processing some unexpected infrared-faint radio sources (IFRS sources) were discovered. The nature of these sources is not understood, but it is possible that some of these sources may be pulsars within our own galaxy. We propose to observe the IFRS sources with steep spectral indices using standard search techniques to determine whether or not they are pulsars. A pulsar detection would 1) remove a subset of the IFRS sources from the ATLAS sample so they would not need to be observed with large optical/IR telescopes to find their hosts and 2) be intrinsically interesting as the pulsar would be a millisecond pulsar and/or have an extreme spatial velocity.

  4. Source term reduction at DAEC (including stellite ball recycling)

    International Nuclear Information System (INIS)

    Smith, R.; Schebler, D.

    1995-01-01

    The Duane Arnold Energy Center was seeking methods to reduce dose rates from the drywell due to Co-60. Duane Arnold is known in the industry to have one of the highest drywell dose rates from the industry standardized 'BRAC' point survey. A prime method to reduce dose rates due to Co-60 is the accelerated replacement of stellite pins and rollers in control rod blades due to their high stellite (cobalt) content. Usually the cobalt content in alloys of stellite is greater than 60% cobalt by weight. During the RFO-12 refueling outage at Duane Arnold, all of the remaining cobalt bearing control rod blades were replaced and new stellite free control rod blades were installed in the core. This left Duane Arnold with the disposal of highly radioactive stellite pins and rollers. The processing of control rod blades for disposal is a very difficult evolution. First, the velocity limiter (a bottom portion of the component) and the highly radioactive upper stellite control rod blade ins and rollers are separated from the control rod blade. Next, the remainder of the control rod blade is processed (chopped and/or crushed) to aid packaging the waste for disposal. The stellite bearings are then often carefully placed in with the rest of the waste in a burial liner to provide shielding for disposal or more often are left as 'orphans' in the spent fuel pool because their high specific activity create shipping and packaging problems. Further investigation by the utility showed that the stellite balls and pins could be recycled to a source manufacturer rather than disposed of in a low-level burial site. The cost savings to the utility was on the order of $200,000 with a gross savings of $400,000 in savings in burial site charges. A second advantage of the recycling of the stellite pins and rollers was a reduction in control in radioactive waste shipments

  5. 77 FR 6463 - Revisions to Labeling Requirements for Blood and Blood Components, Including Source Plasma...

    Science.gov (United States)

    2012-02-08

    ... Blood Components, Including Source Plasma; Correction AGENCY: Food and Drug Administration, HHS. ACTION..., Including Source Plasma,'' which provided incorrect publication information regarding a 60-day notice that...

  6. A Cyber Security Risk Assessment of Hospital Infrastructure including TLS/SSL and other Threats

    OpenAIRE

    Millar, Stuart

    2016-01-01

    Cyber threats traditionally target governments, financial institutions and businesses. However, of growing concern is the threat to healthcare organizations. This study conducts a cyber security risk assessment of a theoretical hospital environment, to include TLS/SSL, which is an encryption protocol for network communications, plus other physical, logical and human threats. Despite significant budgets in the UK for the NHS, the spend on cyber security appears worryingly low and many hospital...

  7. The relative importance of information sources in consumers' choice of hospitals.

    Science.gov (United States)

    Gooding, S K

    1995-01-01

    The research presented focuses on an examination of the relative importance of word-of-mouth, expert opinion, external communication, and past experience in the context of hospital choice. Past research has examined the effect of each individually and various combinations of the four sources, but not all four simultaneously. Results of the present study suggest that past experience plays a greater role in hospital choice than other information sources, including expert opinion. The strength of word-of-mouth as a source of information is also verified. The implications of this research include the following: (1) health care researchers need to incorporate word-of-mouth when investigating informations sources, and (2) local hospitals need to be aware of "negative perceptions" and strive for consumer satisfaction. Health care delivery systems incorporating consumer-based choice render these findings especially valuable as researchers and practitioners address the challenges that these evolving systems will bring.

  8. The physician as a source of hospital capital.

    Science.gov (United States)

    Fried, J M

    1984-06-01

    As hospitals search for means of financing renovation during the next decade, physicians will represent a source of capital through tax-shelter financing. Limited partnerships, condominiums , and joint ventures in acquiring medical equipment or syndicating existing facilities are among the most promising investment vehicles for taking advantage of tax benefits that normally do not apply to nonprofit institutions. In a hospital-physician limited partnership, tax deductions are passed through to the partners, of which there are two kinds: general partners and limited partners. Income (or loss) and tax credits from the entire venture can be divided among the partners and reflected on an individual limited partner's tax return. Rather than shouldering the whole cost of renovating a medical office building, thereby losing the potential tax credit, a hospital could carry out the renovation through a limited partnership with physicians. This would reduce the hospital's capital costs and debt requirements, maintain its credit, and enable it to take advantage of the depreciation deduction. In a condominium venture, the individual physician actually owns the office within which he or she works. As with the limited partnership, the hospital will want to restrict physicians' ability to dispose of their ownership interests.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Large Variability in the Diversity of Physiologically Complex Surgical Procedures Exists Nationwide Among All Hospitals Including Among Large Teaching Hospitals.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H; Thenuwara, Kokila; Lubarsky, David A

    2017-11-22

    Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province). The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl). A total of 53.9% of all hospitals commonly performed 3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P 30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures). The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that "large teaching hospital" alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the

  10. Contamination at a hospital from a leaking radiotherapy source

    International Nuclear Information System (INIS)

    Ward, R.S.

    1979-01-01

    Routine monitoring of waste arising from the use of small sealed radiotherapy sources led to the discovery of extensive cesium-137 contamination of the floor, walls and equipment in the source preparation room. The origin of the contamination was a damaged cesium chloride bead which was part of a 'train' of beads reassembled in the room about a month beforehand. The sterilising fluid used to clean the sources was still in use, and was responsible for the spread of radioactive contamination. Whole body monitoring revealed two members of staff recording 1100 Bq and 5500 Bq respectively as a result of cesium-137 intake, but the committed dose equivalent did not exceed 500 μSv in the worst case. The incident was expensive, but could have been far worse without the good working procedures by the hospital staff which minimized the radiation doses to staff and patients. (UK)

  11. Elevator buttons as unrecognized sources of bacterial colonization in hospitals.

    Science.gov (United States)

    Kandel, Christopher E; Simor, Andrew E; Redelmeier, Donald A

    2014-01-01

    Elevators are ubiquitous and active inside hospitals, potentially facilitating bacterial transmission. The objective of this study was to estimate the prevalence of bacterial colonization on elevator buttons in large urban teaching hospitals. A total of 120 elevator buttons and 96 toilet surfaces were swabbed over separate intervals at 3 tertiary care hospitals on weekdays and weekends in Toronto, Ontario. For the elevators, swabs were taken from 2 interior buttons (buttons for the ground floor and one randomly selected upper-level floor) and 2 exterior buttons (the "up" button from the ground floor and the "down" button from the upper-level floor). For the toilet surfaces, swabs were taken from the exterior and interior handles of the entry door, the privacy latch, and the toilet flusher. Samples were obtained using standard bacterial collection techniques, followed by plating, culture, and species identification by a technician blind to sample source. The prevalence of colonization of elevator buttons was 61% (95% confidence interval 52%-70%). No significant differences in colonization prevalence were apparent in relation to location of the buttons, day of the week, or panel position within the elevator. Coagulase-negative staphylococci were the most common organisms cultured, whereas Enterococcus and Pseudomonas species were infrequent. Elevator buttons had a higher prevalence of colonization than toilet surfaces (61% v. 43%, p = 0.008). Hospital elevator buttons were commonly colonized by bacteria, although most pathogens were not clinically relevant. The risk of pathogen transmission might be reduced by simple countermeasures.

  12. Traceable calibration of hospital 192Ir HDR sources

    International Nuclear Information System (INIS)

    Govinda Rajan, K.N.; Sharma, S.D.; Palaniselvam, T.; Vandana, S.; Bhatt, B.C.; Vinatha, S.; Patki, V.S.; Pendse, A.M.; Kannan, V.

    2004-01-01

    A HDR 1000 PLUS well type ionization chamber, procured from Standard Imaging, USA, and maintained by medical Physics and Safety Section (MPSS), Bhabha Atomic Research Centre (BARC), India, as a reference well chamber 1 (RWCH1), was traceably calibrated against the primary standard established by Radiological Standards Laboratory (RSL), BARC for 192 Ir HDR source, in terms of air kerma strength (AKS). An indigenously developed well-type ionization chamber, reference well chamber 2 (RWCH2) and electrometer system, fabricated by CD High Tech (CDHT) Instruments Private Ltd., Bangalore, India, was in turn calibrated against RWCH1. The CDHT system (i.e. RWCH2 and CDHT electrometer system) was taken to several hospitals, in different regions of the country, to check the calibration status of 192 Ir HDR sources. The result of this calibration audit work is reported here. (author)

  13. Including Internet insurance as part of a hospital computer network security plan.

    Science.gov (United States)

    Riccardi, Ken

    2002-01-01

    Cyber attacks on a hospital's computer network is a new crime to be reckoned with. Should your hospital consider internet insurance? The author explains this new phenomenon and presents a risk assessment for determining network vulnerabilities.

  14. Auralization of airborne sound insulation including the influence of source room

    DEFF Research Database (Denmark)

    Rindel, Jens Holger

    2006-01-01

    The paper describes a simple and acoustically accurate method for the auralization of airborne sound insulation between two rooms by means of a room acoustic simulation software (ODEON). The method makes use of a frequency independent transparency of the transmitting surface combined...... with a frequency dependent power setting of the source in the source room. The acoustic properties in terms of volume and reverberation time as well as the area of the transmitting surface are all included in the simulation. The user only has to select the position of the source in the source room and the receiver...... of the transmitting surface is used for the simulation of sound transmission. Also the reduced clarity of the auralization due to the reverberance of the source room is inherent in the method. Currently the method is restricted to transmission loss data in octave bands....

  15. Hospital cost of Clostridium difficile infection including the contribution of recurrences in French acute-care hospitals.

    Science.gov (United States)

    Le Monnier, A; Duburcq, A; Zahar, J-R; Corvec, S; Guillard, T; Cattoir, V; Woerther, P-L; Fihman, V; Lalande, V; Jacquier, H; Mizrahi, A; Farfour, E; Morand, P; Marcadé, G; Coulomb, S; Torreton, E; Fagnani, F; Barbut, F

    2015-10-01

    The impact of Clostridium difficile infection (CDI) on healthcare costs is significant due to the extra costs of associated inpatient care. However, the specific contribution of recurrences has rarely been studied. The aim of this study was to estimate the hospital costs of CDI and the fraction attributable to recurrences in French acute-care hospitals. A retrospective study was performed for 2011 on a sample of 12 large acute-care hospitals. CDI costs were estimated from both hospital and public insurance perspectives. For each stay, CDI additional costs were estimated by comparison to controls without CDI extracted from the national DRG (diagnosis-related group) database and matched on DRG, age and sex. When CDI was the primary diagnosis, the full cost of stay was used. A total of 1067 bacteriological cases of CDI were identified corresponding to 979 stays involving 906 different patients. Recurrence(s) were identified in 118 (12%) of these stays with 51.7% of them having occurred within the same stay as the index episode. Their mean length of stay was 63.8 days compared to 25.1 days for stays with an index case only. The mean extra cost per stay with CDI was estimated at €9,575 (median: €7,514). The extra cost of CDI in public acute-care hospitals was extrapolated to €163.1 million at the national level, of which 12.5% was attributable to recurrences. The economic burden of CDI is substantial and directly impacts healthcare systems in France. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  16. 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...

  17. Urinary tract infections in hospital pediatrics: many previous antibiotherapy and antibiotics resistance, including fluoroquinolones.

    Science.gov (United States)

    Garraffo, A; Marguet, C; Checoury, A; Boyer, S; Gardrat, A; Houivet, E; Caron, F

    2014-02-01

    We studied antibiotic resistance in pediatric UTIs and we evaluated the impact of antibiotic exposure in the previous 12 months, very little French data being available for this population. We conducted a multicenter prospective study including children consulting for, or admitted in 2 hospitals. Prior antibiotic exposure was documented from their health record. One hundred and ten patients (73 girls), 11 days to 12 years of age, were included in 10 months. Ninety-six percent presented with pyelonephritis, associated to uropathy for 25%. Escherichia coli was predominant (78%), followed by Proteus spp. and Enterococcus spp. The antibiotic resistance rate of E. coli was high and close to that reported for adults with complicated UTIs: amoxicillin 60%, amoxicillin-clavulanate 35%, cefotaxim 5%, trimethoprim-sulfametoxazole 26%, nalidixic acid 9%, ciprofloxacin 7%, gentamycin 1%, nitrofurantoin and fosfomycin 0%. The antibiotic exposure in the previous 12 months involved 62 children (56%) most frequently with β-lactams (89%) for a respiratory tract infection (56%). A clear relationship between exposure and resistance was observed for amoxicillin (71% vs. 46%), first generation (65% vs. 46%) and third generation (9% vs. 3%) cephalosporins, or trimethoprim-sulfamethoxazole (36% vs. 15%). However, antibiotic exposure could not account alone for the results, as suggested by the 7% of ciprofloxacin resistance, observed without any identified previous treatment. Bacterial species and antibiotic resistance level in children are similar to those reported for adults. Antibiotic exposure in the previous 12 months increases the risk of resistance but other factors are involved (previous antibiotic therapies and fecal-oral or mother-to-child transmission). Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  18. Should clinical case definitions of influenza in hospitalized older adults include fever?

    Science.gov (United States)

    Falsey, Ann R; Baran, Andrea; Walsh, Edward E

    2015-08-01

    Influenza is a major cause of morbidity and mortality in elderly persons. Fever is included in all standard definitions of influenza-like illness (ILI), yet older patients may have diminished febrile response to infection. Therefore, we examined the utility of various thresholds to define fever for case definitions of influenza in persons ≥ 65 years of age. Data from two prospective surveillance studies for respiratory viral infection in adults hospitalized with acute cardiopulmonary illnesses with or without fever were examined. The highest temperature reported prior to admission or measured during the first 24 h after admission was recorded. The diagnosis of influenza was made by a combination of viral culture, reverse-transcription polymerase chain reaction, antigen testing, and serology. A total of 2410 subjects (66% ≥ 65 years of age) were enrolled; 281 had influenza (261 influenza A, 19 influenza B, and one mixed influenza A and B). The commonly used definition of ILI (fever ≥ 37·8°C and cough) resulted in 57% sensitivity and 71% specificity in older adults. Receiver operating characteristic curves examining the various temperature thresholds combined with cough and/or sore throat showed the optimal balance between sensitivity and specificity to be 37·9°C (AUC 0·71) and 37·3°C (AUC 0·66), in younger and older persons, respectively. Clinical decision rules using the presence of cough and fever may be helpful when screening for influenza or empiric antiviral treatment when rapid influenza testing is not available; however, lower fever thresholds may be considered for elderly subjects. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  19. Pseudodynamic Source Characterization for Strike-Slip Faulting Including Stress Heterogeneity and Super-Shear Ruptures

    KAUST Repository

    Mena, B.

    2012-08-08

    Reliable ground‐motion prediction for future earthquakes depends on the ability to simulate realistic earthquake source models. Though dynamic rupture calculations have recently become more popular, they are still computationally demanding. An alternative is to invoke the framework of pseudodynamic (PD) source characterizations that use simple relationships between kinematic and dynamic source parameters to build physically self‐consistent kinematic models. Based on the PD approach of Guatteri et al. (2004), we propose new relationships for PD models for moderate‐to‐large strike‐slip earthquakes that include local supershear rupture speed due to stress heterogeneities. We conduct dynamic rupture simulations using stochastic initial stress distributions to generate a suite of source models in the magnitude Mw 6–8. This set of models shows that local supershear rupture speed prevails for all earthquake sizes, and that the local rise‐time distribution is not controlled by the overall fault geometry, but rather by local stress changes on the faults. Based on these findings, we derive a new set of relations for the proposed PD source characterization that accounts for earthquake size, buried and surface ruptures, and includes local rise‐time variations and supershear rupture speed. By applying the proposed PD source characterization to several well‐recorded past earthquakes, we verify that significant improvements in fitting synthetic ground motion to observed ones is achieved when comparing our new approach with the model of Guatteri et al. (2004). The proposed PD methodology can be implemented into ground‐motion simulation tools for more physically reliable prediction of shaking in future earthquakes.

  20. Behavioral analysis of preterm neonates included in a tactile and kinesthetic stimulation program during hospitalization.

    Science.gov (United States)

    Ferreira, Andréia M; Bergamasco, Niélsy H P

    2010-01-01

    To evaluate the effect of tactile and kinesthetic stimulation on behavioral and clinical development in preterm neonates while still in the hospital. Thirty-two clinically stable preterm infants weighing kinesthetic stimulation (n=16). Data on the infants' clinical progress were collected from medical charts and behavioral evaluations by means of a series of weekly, eight-minute films recorded from the time of inclusion into the study until hospital discharge. There was a trend towards a shorter duration of hospital stay, increased daily weight gain and a predominance of self-regulated behavior (regular breathing, state of alertness, balanced tonus, a range of postures, coordinated movements, hand-to-face movement control, suction, grip, support) in infants in the SG. With respect to motor control, comparative analysis of postconceptional ages according to age-bracket (I - 31-33 weeks 6/7; II - 34-36 weeks 6/7; and III - 37-39 weeks 6/7) revealed balanced tonus and coordinated voluntary movements in all three periods, a longer time spent in a range of postures (age bracket I) or in flexion (age bracket II) and more regular breathing in age bracket I in the SG. In the hospital, tactile and kinesthetic stimulation was shown to have a positive effect, contributing towards adjustment and self-regulation of behavior in the preterm newborn infant. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under the number ACTRN12610000133033.

  1. A practical algorithm for distribution state estimation including renewable energy sources

    Energy Technology Data Exchange (ETDEWEB)

    Niknam, Taher [Electronic and Electrical Department, Shiraz University of Technology, Modares Blvd., P.O. 71555-313, Shiraz (Iran); Firouzi, Bahman Bahmani [Islamic Azad University Marvdasht Branch, Marvdasht (Iran)

    2009-11-15

    Renewable energy is energy that is in continuous supply over time. These kinds of energy sources are divided into five principal renewable sources of energy: the sun, the wind, flowing water, biomass and heat from within the earth. According to some studies carried out by the research institutes, about 25% of the new generation will be generated by Renewable Energy Sources (RESs) in the near future. Therefore, it is necessary to study the impact of RESs on the power systems, especially on the distribution networks. This paper presents a practical Distribution State Estimation (DSE) including RESs and some practical consideration. The proposed algorithm is based on the combination of Nelder-Mead simplex search and Particle Swarm Optimization (PSO) algorithms, called PSO-NM. The proposed algorithm can estimate load and RES output values by Weighted Least-Square (WLS) approach. Some practical considerations are var compensators, Voltage Regulators (VRs), Under Load Tap Changer (ULTC) transformer modeling, which usually have nonlinear and discrete characteristics, and unbalanced three-phase power flow equations. The comparison results with other evolutionary optimization algorithms such as original PSO, Honey Bee Mating Optimization (HBMO), Neural Networks (NNs), Ant Colony Optimization (ACO), and Genetic Algorithm (GA) for a test system demonstrate that PSO-NM is extremely effective and efficient for the DSE problems. (author)

  2. Risk Factor Analysis for AKI Including Laboratory Indicators: a Nationwide Multicenter Study of Hospitalized Patients

    Directory of Open Access Journals (Sweden)

    Sasa Nie

    2017-10-01

    Full Text Available Background/Aims: Risk factor studies for acute kidney injury (AKI in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. Methods: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes’ definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality. Results: The morbidity of AKI was 0.97%. Independent risk factors for AKI were advancing age, male gender, hypertension, and chronic kidney disease. All-cause mortality was 16.5%. The predictors of mortality in AKI patients were advancing age, tumor, higher uric acid level and increases in Acute Physiologic Assessment and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. The hazard ratio (HR for mortality with uric acid levels > 9.1 mg/dl compared with ≤ 5.2 mg/dl was 1.78 (95% CI: 1.23 to 2.58 for the AKI patients as a group, and was 1.73 (95% CI: 1.24 to 2.42 for a propensity score-matched set. Conclusion: In addition to traditional risk factors, uric acid level is an independent predictor of all-cause mortality after AKI.

  3. Open source challenges for hospital information system (HIS in developing countries: a pilot project in Mali

    Directory of Open Access Journals (Sweden)

    Chaacho Saad

    2010-04-01

    Full Text Available Abstract Background We are currently witnessing a significant increase in use of Open Source tools in the field of health. Our study aims to research the potential of these software packages for developing countries. Our experiment was conducted at the Centre Hospitalier Mere Enfant in Mali. Methods After reviewing several Open Source tools in the field of hospital information systems, Mediboard software was chosen for our study. To ensure the completeness of Mediboard in relation to the functionality required for a hospital information system, its features were compared to those of a well-defined comprehensive record management tool set up at the University Hospital "La Timone" of Marseilles in France. It was then installed on two Linux servers: a first server for testing and validation of different modules, and a second one for the deployed full implementation. After several months of use, we have evaluated the usability aspects of the system including feedback from end-users through a questionnaire. Results Initial results showed the potential of Open Source in the field of health IT for developing countries like Mali. Five main modules have been fully implemented: patient administrative and medical records management of hospital activities, tracking of practitioners' activities, infrastructure management and the billing system. This last component of the system has been fully developed by the local Mali team. The evaluation showed that the system is broadly accepted by all the users who participated in the study. 77% of the participants found the system useful; 85% found it easy; 100% of them believe the system increases the reliability of data. The same proportion encourages the continuation of the experiment and its expansion throughout the hospital. Conclusions In light of the results, we can conclude that the objective of our study was reached. However, it is important to take into account the recommendations and the challenges discussed

  4. Subjective Response to Foot-Fall Noise, Including Localization of the Source Position

    DEFF Research Database (Denmark)

    Brunskog, Jonas; Hwang, Ha Dong; Jeong, Cheol-Ho

    2011-01-01

    annoyance, using simulated binaural room impulse responses, with sources being a moving point source or a nonmoving surface source, and rooms being a room with a reverberation time of 0.5 s or an anechoic room. The paper concludes that no strong effect of the source localization on the annoyance can...

  5. The European source-term evaluation code ASTEC: status and applications, including CANDU plant applications

    International Nuclear Information System (INIS)

    Van Dorsselaere, J.P.; Giordano, P.; Kissane, M.P.; Montanelli, T.; Schwinges, B.; Ganju, S.; Dickson, L.

    2004-01-01

    Research on light-water reactor severe accidents (SA) is still required in a limited number of areas in order to confirm accident-management plans. Thus, 49 European organizations have linked their SA research in a durable way through SARNET (Severe Accident Research and management NETwork), part of the European 6th Framework Programme. One goal of SARNET is to consolidate the integral code ASTEC (Accident Source Term Evaluation Code, developed by IRSN and GRS) as the European reference tool for safety studies; SARNET efforts include extending the application scope to reactor types other than PWR (including VVER) such as BWR and CANDU. ASTEC is used in IRSN's Probabilistic Safety Analysis level 2 of 900 MWe French PWRs. An earlier version of ASTEC's SOPHAEROS module, including improvements by AECL, is being validated as the Canadian Industry Standard Toolset code for FP-transport analysis in the CANDU Heat Transport System. Work with ASTEC has also been performed by Bhabha Atomic Research Centre, Mumbai, on IPHWR containment thermal hydraulics. (author)

  6. 76 FR 62452 - Avon Products, Inc. Including On-Site Leased Workers From Spherion/Source Right, Springdale, OH...

    Science.gov (United States)

    2011-10-07

    .... Including On-Site Leased Workers From Spherion/Source Right, Springdale, OH; Amended Certification Regarding... workers of the subject firm. The company reports that workers leased from Spherion/Source Right were...., including on-site leased workers from Spherion/Source Right, Springdale, Ohio, who became totally or...

  7. 76 FR 62451 - Avon Products, Inc., Including On-Site Leased Workers From Spherion/Source Right, Springdale...

    Science.gov (United States)

    2011-10-07

    ...., Including On-Site Leased Workers From Spherion/Source Right, Springdale, Ohio; Amended Certification... workers of the subject firm. The company reports that workers leased from Spherion/Source Right were...., including on-site leased workers from Spherion/Source Right, Springdale, Ohio, who became totally or...

  8. Preliminary data summary for the hospitals point-source category

    International Nuclear Information System (INIS)

    Strassler, E.; Hund, F.H.

    1989-09-01

    The summaries were prepared in order to allow EPA to respond to the mandate of Section 304(m) of the Clean Water Act. Summaries for categories already subject to rulemaking were developed for comparison purposes, and contain only the minimum amount of data needed to provide some perspective on the relative magnitude of the pollution problems created across the categories. The document summarizes the most current information available regarding the discharge of wastewater and solid wastes containing priority and hazardous non-priority pollutants by hospitals. The document provides a technical basis for determining whether additional national regulations should be developed pursuant to the Clean Water Act (CWA), and makes available preliminary information regarding the discharge of priority and hazardous non-priority pollutants by the hospital industry

  9. Hybrid Design of Electric Power Generation Systems Including Renewable Sources of Energy

    Science.gov (United States)

    Wang, Lingfeng; Singh, Chanan

    2008-01-01

    With the stricter environmental regulations and diminishing fossil-fuel reserves, there is now higher emphasis on exploiting various renewable sources of energy. These alternative sources of energy are usually environmentally friendly and emit no pollutants. However, the capital investments for those renewable sources of energy are normally high,…

  10. Energy-Water Nexus Relevant to Baseload Electricity Source Including Mini/Micro Hydropower Generation

    Science.gov (United States)

    Fujii, M.; Tanabe, S.; Yamada, M.

    2014-12-01

    Water, food and energy is three sacred treasures that are necessary for human beings. However, recent factors such as population growth and rapid increase in energy consumption have generated conflicting cases between water and energy. For example, there exist conflicts caused by enhanced energy use, such as between hydropower generation and riverine ecosystems and service water, between shale gas and ground water, between geothermal and hot spring water. This study aims to provide quantitative guidelines necessary for capacity building among various stakeholders to minimize water-energy conflicts in enhancing energy use. Among various kinds of renewable energy sources, we target baseload sources, especially focusing on renewable energy of which installation is required socially not only to reduce CO2 and other greenhouse gas emissions but to stimulate local economy. Such renewable energy sources include micro/mini hydropower and geothermal. Three municipalities in Japan, Beppu City, Obama City and Otsuchi Town are selected as primary sites of this study. Based on the calculated potential supply and demand of micro/mini hydropower generation in Beppu City, for example, we estimate the electricity of tens through hundreds of households is covered by installing new micro/mini hydropower generation plants along each river. However, the result is based on the existing infrastructures such as roads and electric lines. This means that more potentials are expected if the local society chooses options that enhance the infrastructures to increase micro/mini hydropower generation plants. In addition, further capacity building in the local society is necessary. In Japan, for example, regulations by the river law and irrigation right restrict new entry by actors to the river. Possible influences to riverine ecosystems in installing new micro/mini hydropower generation plants should also be well taken into account. Deregulation of the existing laws relevant to rivers and

  11. Assessment on security system of radioactive sources used in hospitals of Thailand

    Science.gov (United States)

    Jitbanjong, Petchara; Wongsawaeng, Doonyapong

    2016-01-01

    Unsecured radioactive sources have caused deaths and serious injuries in many parts of the world. In Thailand, there are 17 hospitals that use teletherapy with cobalt-60 radioactive sources. They need to be secured in order to prevent unauthorized removal, sabotage and terrorists from using such materials in a radiological weapon. The security system of radioactive sources in Thailand is regulated by the Office of Atoms for Peace in compliance with Global Threat Reduction Initiative (GTRI), U.S. DOE, which has started to be implemented since 2010. This study aims to perform an assessment on the security system of radioactive sources used in hospitals in Thailand and the results can be used as a recommended baseline data for development or improvement of hospitals on the security system of a radioactive source at a national regulatory level and policy level. Results from questionnaires reveal that in 11 out of 17 hospitals (64.70%), there were a few differences in conditions of hospitals using radioactive sources with installation of the security system and those without installation of the security system. Also, personals working with radioactive sources did not clearly understand the nuclear security law. Thus, government organizations should be encouraged to arrange trainings on nuclear security to increase the level of understanding. In the future, it is recommended that the responsible government organization issues a minimum requirement of nuclear security for every medical facility using radioactive sources.

  12. Assessment on security system of radioactive sources used in hospitals of Thailand

    Energy Technology Data Exchange (ETDEWEB)

    Jitbanjong, Petchara, E-mail: petcharajit@gmail.com; Wongsawaeng, Doonyapong [Nuclear Engineering Department, Faculty of Engineering, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330 (Thailand)

    2016-01-22

    Unsecured radioactive sources have caused deaths and serious injuries in many parts of the world. In Thailand, there are 17 hospitals that use teletherapy with cobalt-60 radioactive sources. They need to be secured in order to prevent unauthorized removal, sabotage and terrorists from using such materials in a radiological weapon. The security system of radioactive sources in Thailand is regulated by the Office of Atoms for Peace in compliance with Global Threat Reduction Initiative (GTRI), U.S. DOE, which has started to be implemented since 2010. This study aims to perform an assessment on the security system of radioactive sources used in hospitals in Thailand and the results can be used as a recommended baseline data for development or improvement of hospitals on the security system of a radioactive source at a national regulatory level and policy level. Results from questionnaires reveal that in 11 out of 17 hospitals (64.70%), there were a few differences in conditions of hospitals using radioactive sources with installation of the security system and those without installation of the security system. Also, personals working with radioactive sources did not clearly understand the nuclear security law. Thus, government organizations should be encouraged to arrange trainings on nuclear security to increase the level of understanding. In the future, it is recommended that the responsible government organization issues a minimum requirement of nuclear security for every medical facility using radioactive sources.

  13. Assessment on security system of radioactive sources used in hospitals of Thailand

    International Nuclear Information System (INIS)

    Jitbanjong, Petchara; Wongsawaeng, Doonyapong

    2016-01-01

    Unsecured radioactive sources have caused deaths and serious injuries in many parts of the world. In Thailand, there are 17 hospitals that use teletherapy with cobalt-60 radioactive sources. They need to be secured in order to prevent unauthorized removal, sabotage and terrorists from using such materials in a radiological weapon. The security system of radioactive sources in Thailand is regulated by the Office of Atoms for Peace in compliance with Global Threat Reduction Initiative (GTRI), U.S. DOE, which has started to be implemented since 2010. This study aims to perform an assessment on the security system of radioactive sources used in hospitals in Thailand and the results can be used as a recommended baseline data for development or improvement of hospitals on the security system of a radioactive source at a national regulatory level and policy level. Results from questionnaires reveal that in 11 out of 17 hospitals (64.70%), there were a few differences in conditions of hospitals using radioactive sources with installation of the security system and those without installation of the security system. Also, personals working with radioactive sources did not clearly understand the nuclear security law. Thus, government organizations should be encouraged to arrange trainings on nuclear security to increase the level of understanding. In the future, it is recommended that the responsible government organization issues a minimum requirement of nuclear security for every medical facility using radioactive sources

  14. Comparison of 201Tl solution sources in UK hospitals, 2001

    International Nuclear Information System (INIS)

    Baker, M.; Woods, M.

    2001-01-01

    During recent years, concerns have been raised within the nuclear medicine field about the accuracy of activity measurements for 201 Tl. And indeed, NPL calibrations repeatedly indicated that the level of impurities present in such samples and the significant amount of activity adsorbed onto the glass wall of the container could produce erroneous results. In addition, the standard P6 vials, in which 201 Tl solution had been previously supplied, were recently replaced with the new ''10R Type 1 plus'' Schott vials. To assess the magnitude of these effects on the accuracy of clinical measurements of the activity of 201 Tl, an intercomparison exercise was conducted between the National Physical Laboratory (NPL), Nycomed-Amersham (NA) and the UK hospital physics community. The majority of the 273 reported results were within the ± 10 % limit of accuracy that hospitals aim to achieve for diagnosis, biased high. The tendency to overestimate the activity was more evident for syringe measurements. The exercise also revealed that the adsorption losses experienced with P6 vials had been solved by the introduction of the 10R vials, but individual calibrators need to be recalibrated for this new container. (author)

  15. A Study on Conjugate Heat Transfer Analysis of Reactor Vessel including Irradiated Structural Heat Source

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Kunwoo; Cho, Hyuksu; Im, Inyoung; Kim, Eunkee [KEPCO EnC, Daejeon (Korea, Republic of)

    2015-10-15

    Though Material reliability programs (MRPs) have a purpose to provide the evaluation or management methodologies for the operating RVI, the similar evaluation methodologies can be applied to the APR1400 fleet in the design stage for the evaluation of neutron irradiation effects. The purposes of this study are: to predict the thermal behavior whether or not irradiated structure heat source; to evaluate effective thermal conductivity (ETC) in relation to isotropic and anisotropic conductivity of porous media for APR1400 Reactor Vessel. The CFD simulations are performed so as to evaluate thermal behavior whether or not irradiated structure heat source and effective thermal conductivity for APR1400 Reactor Vessel. In respective of using irradiated structure heat source, the maximum temperature of fluid and core shroud for isotropic ETC are 325.8 .deg. C, 341.5 .deg. C. The total amount of irradiated structure heat source is about 5.41 MWth and not effect to fluid temperature.

  16. 77 FR 41873 - In the Matter of Alternative Energy Sources, Inc., Arlington Hospitality, Inc., Consolidated Oil...

    Science.gov (United States)

    2012-07-16

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] In the Matter of Alternative Energy Sources, Inc., Arlington Hospitality, Inc., Consolidated Oil & Gas, Inc., CSMG Technologies, Inc., Dakotah... Alternative Energy Sources, Inc. because it has not filed any periodic reports since the period ended...

  17. Private patients in NHS hospitals: comparison of two sources of information.

    Science.gov (United States)

    Williams, B T; Pearson, J

    1999-03-01

    The use of National Health Service (NHS) hospitals to treat private patients is debatable on the grounds of equity of access. Hospital Episodes Statistics (HES) annual reports are the only routine source of information on the scale of this activity. The accuracy of the information is doubted. This enquiry tested the completeness of HES data against information obtained directly from private patient unit managers. Managers of the 71 pay bed units in NHS hospitals in England were asked to supply from local registers and accounts the numbers of in-patients and day cases admitted in 1995-1996. Their reports were matched with the numbers of first consultant episodes for private in-patients and day cases shown for those hospitals in the HES data file for that year. Of the 71 units 62 responded; 53 of these gave usable data. The 53 included, and 18 excluded from the comparison, matched on median and range of bed numbers. Managers identified 16 per cent more total admissions than did HES, 62,572 against 54,131; 13 per cent more in-patient admissions, 39,776 against 35,319; and 21 per cent more day cases, 22,796 against 18,812. More total admissions were reported by managers of 38 pay bed units than were recorded in HES, fewer by 12, and equal numbers by three. Similar sized discrepancies were noted for in-patient admissions and day cases. Reasons for the under-reporting of private patients in HES included the use of separate patient administration systems for private patients with a failure to feed data to HES, and the omission of some provider units altogether by a minority of trusts from the returns made to the Department of Health. Overall, HES underestimates the amount of private patient activity reported directly by NHS hospitals. No method of validating private patient data is currently available. An amendment to an existing statistical return would provide a check on numbers. Central guidance on the inclusion of private patient activity in data transmitted by

  18. 13 CFR 120.102 - Funds not available from alternative sources, including personal resources of principals.

    Science.gov (United States)

    2010-01-01

    ... source) when that owner's liquid assets exceed the amounts specified in paragraphs (a) (1) through (3) of... applicant must inject any personal liquid assets which are in excess of two times the total financing... the applicant must inject any personal liquid assets which are in excess of one and one-half times the...

  19. Sensitivity of a search for cosmic ray sources including magnetic field effects

    Energy Technology Data Exchange (ETDEWEB)

    Urban, Martin; Erdmann, Martin; Mueller, Gero [III. Physikalisches Institut A, RWTH Aachen University (Germany)

    2016-07-01

    We analyze the sensitivity of a new method investigating correlations between ultra-high energy cosmic rays and extragalactic sources taking into account deflections in the galactic magnetic field. In comparisons of expected and simulated arrival directions of cosmic rays we evaluate the directional characteristics and magnitude of the field. We show that our method is capable of detecting anisotropy in data sets with a low signal fraction.

  20. Controlled Carbon Source Addition to an Alternating Nitrification-Denitrification Wastewater Treatment Process Including Biological P Removal

    DEFF Research Database (Denmark)

    Isaacs, Steven Howard; Henze, Mogens

    1995-01-01

    The paper investigates the effect of adding an external carbon source on the rate of denitrification in an alternating activated sludge process including biological P removal. Two carbon sources were examined, acetate and hydrolysate derived from biologically hydrolyzed sludge. Preliminary batch ...

  1. Projects of SR sources including research and development for insertion devices in the USSR

    International Nuclear Information System (INIS)

    Kulipanov, G.

    1990-01-01

    Some technical information on the electron and positron storage rings - SR sources that are being constructed, used or developed at the Novosibirsk Institute of Nuclear Physics (INP), is given. The parameters and construction of wigglers and undulators (electromagnetic, superconducting, and based on permanent magnets) that are intended to be used at such storage rings are described. Various schemes of installation of wigglers, undulators and FEL at storage rings is considered. The ways of minimizing the influence of their magnetic fields on particle motion in storage rings are treated. (author)

  2. The Sources of Work Stress among Nurses in Private Hospitals in Shiraz, 2016

    Directory of Open Access Journals (Sweden)

    Heshmatollah Asadi

    2017-07-01

    Full Text Available Introduction: Since there are few studies on stress experienced by nursing staff in private hospitals, this study aimed to determine the sources of job stress among nurses in private hospitals in southwest of Iran. Method: In a cross-sectional design, nurses in private hospitals in Shiraz were investigated; about 160 nurses were selected by single-stage cluster sampling as the study samples in three selected hospitals. A standard questionnaire on the sources of job stress was used for data collection. The data were analyzed through SPSS, version 21, using Mann-Whitney and Kruskal-Wallis tests. The level of significance was considered as 0.05. Results: Five important causes of stress among nurses were low income, lack of job security, work-home interface, lack of enough time for work, and exposure with unsuitable physical situation. There were significant associations between the source of stress and having persons with chronic disease in family and concurrent education and work (P = 0.021, X2= 426.5 and P = 0.022, X2 = 717.5, respectively. Conclusion: The sources of job stress should be considered for effective working of the hospital. Attention to nurses’ salary and job security reduces job stress.

  3. Pseudodynamic Source Characterization for Strike-Slip Faulting Including Stress Heterogeneity and Super-Shear Ruptures

    KAUST Repository

    Mena, B.; Dalguer, L. A.; Mai, Paul Martin

    2012-01-01

    . (2004), we propose new relationships for PD models for moderate‐to‐large strike‐slip earthquakes that include local supershear rupture speed due to stress heterogeneities. We conduct dynamic rupture simulations using stochastic initial stress

  4. A hierarchical Bayesian model for improving short-term forecasting of hospital demand by including meteorological information

    OpenAIRE

    Sahu, Sujit K.; Baffour, Bernard; Minty, John; Harper, Paul; Sarran, Christophe

    2013-01-01

    The effect of weather on health has been widely researched, and the ability to forecast meteorological events is able to offer valuable insights into the impact on public health services. In addition, better predictions of hospital demand that are more sensitive to fluctuations in weather can allow hospital administrators to optimise resource allocation and service delivery. Using historical hospital admission data and several seasonal and meteorological variables for a site near the hospital...

  5. Occurance of Staphylococcus nepalensis strains in different sources including human clinical material.

    Science.gov (United States)

    Nováková, Dana; Pantůcek, Roman; Petrás, Petr; Koukalová, Dagmar; Sedlácek, Ivo

    2006-10-01

    Five isolates of coagulase-negative staphylococci were obtained from human urine, the gastrointestinal tract of squirrel monkeys, pig skin and from the environment. All key biochemical characteristics of the tested strains corresponded with the description of Staphylococcus xylosus species. However, partial 16S rRNA gene sequences obtained from analysed strains corresponded with those of Staphylococcus nepalensis reference strains, except for two strains which differed in one residue. Ribotyping with EcoRI and HindIII restriction enzymes, whole cell protein profile analysis performed by SDS-PAGE and SmaI macrorestriction analysis were used for more precise characterization and identification of the analysed strains. Obtained results showed that EcoRI and HindIII ribotyping and whole cell protein fingerprinting are suitable and reliable methods for the differentiation of S. nepalensis strains from the other novobiocin resistant staphylococci, whereas macrorestriction analysis was found to be a good tool for strain typing. The isolation of S. nepalensis is sporadic, and according to our best knowledge this study is the first report of the occurrence of this species in human clinical material as well as in other sources.

  6. Resort loan securities as a source of investing the hospitality industry

    Directory of Open Access Journals (Sweden)

    Alla Yu. Baranova

    2016-03-01

    Full Text Available Objective to prove the possibility of attracting funds of population and corporate organizations to invest into hospitality industry. Methods the basis of the study was the methods of logical and structural analysis the dialectical method which determined the main regularities of financial relations development in hospitality industry. Results basing on the study of formation and use of financial resources of organizations we have revealed the following at the present stage attention is paid to the functioning and investment of the hospitality industry in accordance with federal and regional target programs measures are proposed for the effective financing from the budget and resources of various funds the creation of tourist and recreational clusters is proposed but the savings of the population and corporate entities are not attracted as sources of investment in hospitality industry. Scientific novelty the measures are proposed aimed at involving the financial resources of the population and organizations through corporate bonds by the creation of a resort consortium to promote investment in hospitality industry. Practical significance the proposed recommendations will contribute to enhance the financing of hospitality industry due to the source which is currently not being used. nbsp

  7. The Evaluation of Conventional X-ray Exposure Parameters Including Tube Voltage and Exposure Time in Private and Governmental Hospitals of Lorestan Province, Iran

    Directory of Open Access Journals (Sweden)

    Mehrdad Gholami

    2015-07-01

    Full Text Available Introduction In radiography, dose and image quality are dependent on radiographic parameters. The problem is caused from incorrect use of radiography equipment and from the radiation exposure to patients much more than required. Therefore, the aim of this study was to implement a quality-control program to detect changes in exposure parameters, which may affect diagnosis or patient radiation dose. Materials and Methods This cross-sectional study was performed on seven stationary X-ray units in sixhospitals of Lorestan province. The measurements were performed, using a factory-calibrated Barracuda dosimeter (model: SE-43137. Results According to the results, the highest output was obtained in A Hospital (M1 device, ranging from 107×10-3 to 147×10-3 mGy/mAs. The evaluation of tube voltage accuracy showed a deviation from the standard value, which ranged between 0.81% (M1 device and 17.94% (M2 device at A Hospital. The deviation ranges at other hospitals were as follows: 0.30-27.52% in B Hospital (the highest in this study, 8.11-20.34% in C Hospital, 1.68-2.58% in D Hospital, 0.90-2.42% in E Hospital and 0.10-1.63% in F Hospital. The evaluation of exposure time accuracy showed that E, C, D and A (M2 device hospitals complied with the requirements (allowing a deviation of ±5%, whereas A (M1 device, F and B hospitals exceeded the permitted limit. Conclusion The results of this study showed that old X-ray equipments with poor or no maintenance are probably the main sources of reducing radiographic image quality and increasing patient radiation dose.

  8. Free software, Open source software, licenses. A short presentation including a procedure for research software and data dissemination

    OpenAIRE

    Gomez-Diaz , Teresa

    2014-01-01

    4 pages. Spanish version: Software libre, software de código abierto, licencias. Donde se propone un procedimiento de distribución de software y datos de investigación; The main goal of this document is to help the research community to understand the basic concepts of software distribution: Free software, Open source software, licenses. This document also includes a procedure for research software and data dissemination.

  9. Renewable Energy Sources in the Function of Sustainable Business in Tourism and Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Ljerka Cerović

    2014-07-01

    Full Text Available Trends on the international tourist market are recording numerous changes almost on a daily basis, regarding the development of ecological tourist offer. Modern tourists are becoming more and more aware of the necessity of applying the principles of sustainable development in everyday life, so the same preferences are being expressed during their stay in their chosen tourist destination. The management of ecologically oriented tourist destination must pay special attention to the use of renewable energy sources, and in its micro-environment encourage an approach to business according to modern ecological standards. The implementation of renewable energy sources in tourism and hospitality industry aims at ensuring the improvement of business, profiling of an ecologically responsible tourist destination, repositioning of the current tourist offer on the international tourist market and achieving competitive advantages and conquest of a specific tourist segment of ecologically-oriented consumers. The aim of the research is to point out the advantages which sustainable development and application of renewable energy sources has on business development in tourism and hospitality industry, with a goal of improving competitive advantages and positive effect on the environment

  10. Ambient particle source apportionment and daily hospital admissions among children and elderly in Copenhagen

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Wahlin, P.; Raaschou-Nielsen, Ole

    2007-01-01

    period (01 January 1999 to 31 December 2004), we examined associations between urban background PM(10) in the presence of gaseous pollutants (CO, NO(2)) and hospital admissions due to cardiovascular and respiratory disease in the elderly (age>/=65), and asthma in children (age 5-18) in Copenhagen......An association between particulate air pollution and morbidity and mortality is well established. However, little is known about which sources of particulate matter contribute most to the adverse health effects. Identification of responsible sources would merit more efficient control. For a 6-year......, influenza epidemics, grass pollen, school holidays, and meteorology, with up to 5 days lagged air pollution exposure. We found positive associations between PM(10) and the three health outcomes, with strongest associations for asthma. The PM(10) effect remained robust in the presence of CO and NO(2). We...

  11. EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis.

    Science.gov (United States)

    Delorme, Arnaud; Makeig, Scott

    2004-03-15

    We have developed a toolbox and graphic user interface, EEGLAB, running under the crossplatform MATLAB environment (The Mathworks, Inc.) for processing collections of single-trial and/or averaged EEG data of any number of channels. Available functions include EEG data, channel and event information importing, data visualization (scrolling, scalp map and dipole model plotting, plus multi-trial ERP-image plots), preprocessing (including artifact rejection, filtering, epoch selection, and averaging), independent component analysis (ICA) and time/frequency decompositions including channel and component cross-coherence supported by bootstrap statistical methods based on data resampling. EEGLAB functions are organized into three layers. Top-layer functions allow users to interact with the data through the graphic interface without needing to use MATLAB syntax. Menu options allow users to tune the behavior of EEGLAB to available memory. Middle-layer functions allow users to customize data processing using command history and interactive 'pop' functions. Experienced MATLAB users can use EEGLAB data structures and stand-alone signal processing functions to write custom and/or batch analysis scripts. Extensive function help and tutorial information are included. A 'plug-in' facility allows easy incorporation of new EEG modules into the main menu. EEGLAB is freely available (http://www.sccn.ucsd.edu/eeglab/) under the GNU public license for noncommercial use and open source development, together with sample data, user tutorial and extensive documentation.

  12. Hot water systems as sources of Legionella pneumophila in hospital and nonhospital plumbing fixtures.

    Science.gov (United States)

    Wadowsky, R M; Yee, R B; Mezmar, L; Wing, E J; Dowling, J N

    1982-05-01

    Samples obtained from plumbing systems of hospitals, nonhospital institutions and homes were cultured for Legionella spp. by plating the samples directly on a selective medium. Swab samples were taken from the inner surfaces of faucet assemblies (aerators, spouts, and valve seats), showerheads, and shower pipes. Water and sediment were collected from the bottom of hot-water tanks. Legionella pneumophila serogroups 1, 5, and 6 were recovered from plumbing fixtures of the hospitals and nonhospital institutions and one of five homes. The legionellae (7 to 13,850 colony-forming units per ml) were also present in water and sediment from hot-water tanks maintained at 30 to 54 degrees C, but not in those maintained at 71 and 77 degrees C. Legionella micdadei was isolated from one tank. Thus legionellae are present in hot-water tanks which are maintained at warm temperatures or whose design results in warm temperatures at the bottom of the tanks. We hypothesize that hot-water tanks are a breeding site and a major source of L. pneumophila for the contamination of plumbing systems. The existence of these bacteria in the plumbing systems and tanks was not necessarily associated with disease. The extent of the hazard of this contamination needs to be delineated.

  13. Hot water systems as sources of Legionella pneumophila in hospital and nonhospital plumbing fixtures

    Energy Technology Data Exchange (ETDEWEB)

    Wadowsky, R.M.; Yee, R.B.; Mezmar, L.; Wing, E.J.; Dowling, J.N.

    1982-05-01

    Samples obtained from plumbing systems of hospitals, nonhospital institutions, and homes were cultured for Legionella spp. by plating the samples directly on a selective medium. Swab samples were taken from the inner surfaces of faucet assemblies (aerators, spouts, and valve seats), showerheads, and shower pipes. Water and sediment were collected from the bottom of hot-water tanks. Legionella pnenumophila serogroups 1.5, and 6 were recovered from plubming fixtures of the hospitals and nonhospital institutions and one of five homes. The legionellae (7 to 13,850 colony-forming units per ml) were also present in water and sediment from hot-water tanks maintained at 30 to 54/sup 0/C, but not in those maintained at 71 and 77/sup 0/C. Legionella micdadei was isolated from one tank. Thus legionellae are present in hot-water tanks which are maintained at warm temperatures or whose design results in warm temperatures at the bottom of the tanks. We hypothesize that hot-water tanks are a breeding site and a major source of L. pneumophila for the contamination of plumbing systems. The existence of these bacteria in the plumbing systems and tanks was not necessarily associated with disease. The extent of the hazard of this contamination needs to be delineated.

  14. Exploring data sources for road traffic injury in Cameroon: Collection and completeness of police records, newspaper reports, and a hospital trauma registry.

    Science.gov (United States)

    Juillard, Catherine; Kouo Ngamby, Marquise; Ekeke Monono, Martin; Etoundi Mballa, Georges Alain; Dicker, Rochelle A; Stevens, Kent A; Hyder, Adnan A

    2017-12-01

    Road traffic injury surveillance systems are a cornerstone of organized efforts at injury control. Although high-income countries rely on established trauma registries and police databases, in low- and middle-income countries, the data source that provides the best collection of road traffic injury events in specific low- and middle-income country contexts without mature surveillance systems is unclear. The objective of this study was to compare the information available on road traffic injuries in 3 data sources used for surveillance in the sub-Saharan African country of Cameroon, providing potential insight on data sources for road traffic injury surveillance in low- and middle-income countries. We assessed the number of events captured and the information available in Yaoundé, Cameroon, from 3 separate sources of data on road traffic injuries: trauma registry, police records, and newspapers. Data were collected from a single-hospital trauma registry, police records, and the 6 most widely circulated newspapers in Yaoundé during a 6-month period in 2009. The number of road traffic injury events, mortality, and other variables included commonly in injury surveillance systems were recorded. We compared these sources using descriptive analysis. Hospital, police, and newspaper sources recorded 1,686, 273, and 480 road traffic injuries, respectively. The trauma registry provided the most complete data for the majority of variables explored; however, the newspaper data source captured 2, mass casualty, train crash events unrecorded in the other sources. Police data provided the most complete information on first responders to the scene, missing in only 7%. Investing in the hospital-based trauma registry may yield the best surveillance for road traffic injuries in some low- and middle-income countries, such as Yaoundé, Cameroon; however, police and newspaper reports may serve as alternative data sources when specific information is needed. Copyright © 2017 Elsevier

  15. 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...

  16. Hospital Nurses' and Physicians' Use of Information Sources during their Production of Discharge Summaries: A Cross-Sectional Study

    OpenAIRE

    Hellesø, Ragnhild; Sogstad, Maren Kristine Raknes

    2014-01-01

    Hospital nurses' and physicians' production and exchange of accurate information between levels of care are crucial for ensuring safe and seamless care for patients in transition. We report on a study in which we explored hospital providers' use of information sources when they prepared discharge information for colleges in the community health-care sector. In this cross-sectional study, 510 nurses and 236 physicians responded through a questionnaire. Our findings show that nurses and physici...

  17. Novel Method To Identify Source-Associated Phylogenetic Clustering Shows that Listeria monocytogenes Includes Niche-Adapted Clonal Groups with Distinct Ecological Preferences

    DEFF Research Database (Denmark)

    Nightingale, K. K.; Lyles, K.; Ayodele, M.

    2006-01-01

    population are identified (TreeStats test). Analysis of sequence data for 120 L. monocytogenes isolates revealed evidence of clustering between isolates from the same source, based on the phylogenies inferred from actA and inlA (P = 0.02 and P = 0.07, respectively; SourceCluster test). Overall, the Tree...... are biologically valid. Overall, our data show that (i) the SourceCluster and TreeStats tests can identify biologically meaningful source-associated phylogenetic clusters and (ii) L. monocytogenes includes clonal groups that have adapted to infect specific host species or colonize nonhost environments......., including humans, animals, and food. If the null hypothesis that the genetic distances for isolates within and between source populations are identical can be rejected (SourceCluster test), then particular clades in the phylogenetic tree with significant overrepresentation of sequences from a given source...

  18. Comparison the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Shahriari M

    2015-05-01

    Full Text Available Background and Objective: Proper nutritional support is one of the important caring aspects in patients who were hospitalized in Intensive Care Unit. Although the several studies have been done concerning the selection of proper nutrition method for patients, but there is no agreement on this issue. The aim of current study was the compare the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit.  Materials and Method: The current clinical trial was conducted on patients who were hospitalized in intensive care unit in Alzahra hospital in Isfahan, 2013. Fifty patients were selected through convenient sampling and were randomly assigned into two groups of 25 people of intervention and control. Nutrition was done through infusion pump in intervention group and by bolus in control group. Gastric residual volume and diarrhea was assessed each four hours for four days. Data were gathered through checklist and were analyzed by SPSS18 using descriptive and inferential statistics including independent T-test, Fisher's exact test and repeated measures ANOVA.  Results: The results showed that the mean of gastric residual volume in control group was more than the intervention group on the third day (p=0.04. Also, the mean of gastric residual volume did not show significant difference at different times in intervention group, but the mean of gastric residual volume was significantly increased in control group at different times (p=0.04. Fisher's exact test showed no significant difference between two groups concerning the diarrhea frequency.  Conclusion: In nutritional support with continuous infusion method, gastric residual volume was not increased and gastric emptying rate was not diminished. Therefore, this method can be used as an appropriate nutritional support in intensive care unit.

  19. Assessing the Applicability of Currently Available Methods for Attributing Foodborne Disease to Sources, Including Food and Food Commodities

    DEFF Research Database (Denmark)

    Pires, Sara Monteiro

    2013-01-01

    on the public health question being addressed, on the data requirements, on advantages and limitations of the method, and on the data availability of the country or region in question. Previous articles have described available methods for source attribution, but have focused only on foodborne microbiological...

  20. Electromagnetic Pulse (EMP) from the Magnetic Bubble Source as a Discriminator of Underground Nuclear Explosions, Including Cavity Decoupling

    Science.gov (United States)

    2011-02-01

    planned shock physics experiments (SPE) 4. Design/develop a very low frequency (VLF)/ELF pulsar to serve as an underground calibration source 5...Carry out underground (in tunnels, etc.) pulsar calibration experiments  A-1 APPENDIX A. ABBREVIATIONS AND ACRONYMS CORRTEX Continuous Reflectometry...Site Office P.O. Box 98521 M/S NLV 101 Las Vegas, NV 89193-8521 ATTN: Ping Lee 1 Los Alamos National Laboratory PO Box 1663 Los Alamos, NM 87545

  1. Ranking sources of hospital quality information for orthopedic surgery patients: consequences for the system of managed competition.

    Science.gov (United States)

    Bes, Romy Evelien; van den Berg, Bernard

    2013-01-01

    Healthcare quality information is crucial for the system of managed competition. Within a system of managed competition, health insurers can selectively contract care providers and are allowed to channel patients towards contracted providers. The idea is that insurers have a stronger bargaining position compared to care providers when they are able to channel patients. In the Dutch system of managed competition that was implemented in 2006, channelling patients to preferred providers has not yet been very successful. Empirical knowledge of which sources of hospital quality information they find important may help us to understand how to channel patients to preferred providers. The objective of this survey was to measure how patients rank various sources of information when they compare hospital quality in a system of managed competition. A written survey was conducted among clients of a large Dutch health insurance company. These clients underwent orthopedic surgery on the hip or knee no longer than 12 months ago. Two major players within a system of managed competition-health insurers and the government-were not seen as important sources of hospital quality information. In contrast, own experience and general practitioners (GPs) were seen as the most important sources of hospital quality information within the Dutch system of managed competition. Health insurers should take the main finding-that GPs are the most important source of hospital quality information-into account when they contract care providers and develop strategies for channeling patients towards preferred providers. A well-functioning system of managed competition will benefit patients, as it involves incentives for care providers to increase healthcare quality and to produce at the lowest cost per unit of quality.

  2. Sources

    International Nuclear Information System (INIS)

    Duffy, L.P.

    1991-01-01

    This paper discusses the sources of radiation in the narrow perspective of radioactivity and the even narrow perspective of those sources that concern environmental management and restoration activities at DOE facilities, as well as a few related sources. Sources of irritation, Sources of inflammatory jingoism, and Sources of information. First, the sources of irritation fall into three categories: No reliable scientific ombudsman to speak without bias and prejudice for the public good, Technical jargon with unclear definitions exists within the radioactive nomenclature, and Scientific community keeps a low-profile with regard to public information. The next area of personal concern are the sources of inflammation. This include such things as: Plutonium being described as the most dangerous substance known to man, The amount of plutonium required to make a bomb, Talk of transuranic waste containing plutonium and its health affects, TMI-2 and Chernobyl being described as Siamese twins, Inadequate information on low-level disposal sites and current regulatory requirements under 10 CFR 61, Enhanced engineered waste disposal not being presented to the public accurately. Numerous sources of disinformation regarding low level radiation high-level radiation, Elusive nature of the scientific community, The Federal and State Health Agencies resources to address comparative risk, and Regulatory agencies speaking out without the support of the scientific community

  3. Whole-genome sequencing for identification of the source in hospital-acquired Legionnaires' disease

    DEFF Research Database (Denmark)

    Rosendahl Madsen, A M; Holm, A; Jensen, T G

    2017-01-01

    Acquisition of Legionnaires' disease is a serious complication of hospitalization. Rapid determination of whether or not the infection is caused by strains of Legionella pneumophila in the hospital environment is crucial to avoid further cases. This study investigated the use of whole-genome sequ......Acquisition of Legionnaires' disease is a serious complication of hospitalization. Rapid determination of whether or not the infection is caused by strains of Legionella pneumophila in the hospital environment is crucial to avoid further cases. This study investigated the use of whole...

  4. Hospitals; hospitals13

    Data.gov (United States)

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

  5. Text mining electronic hospital records to automatically classify admissions against disease: Measuring the impact of linking data sources.

    Science.gov (United States)

    Kocbek, Simon; Cavedon, Lawrence; Martinez, David; Bain, Christopher; Manus, Chris Mac; Haffari, Gholamreza; Zukerman, Ingrid; Verspoor, Karin

    2016-12-01

    Text and data mining play an important role in obtaining insights from Health and Hospital Information Systems. This paper presents a text mining system for detecting admissions marked as positive for several diseases: Lung Cancer, Breast Cancer, Colon Cancer, Secondary Malignant Neoplasm of Respiratory and Digestive Organs, Multiple Myeloma and Malignant Plasma Cell Neoplasms, Pneumonia, and Pulmonary Embolism. We specifically examine the effect of linking multiple data sources on text classification performance. Support Vector Machine classifiers are built for eight data source combinations, and evaluated using the metrics of Precision, Recall and F-Score. Sub-sampling techniques are used to address unbalanced datasets of medical records. We use radiology reports as an initial data source and add other sources, such as pathology reports and patient and hospital admission data, in order to assess the research question regarding the impact of the value of multiple data sources. Statistical significance is measured using the Wilcoxon signed-rank test. A second set of experiments explores aspects of the system in greater depth, focusing on Lung Cancer. We explore the impact of feature selection; analyse the learning curve; examine the effect of restricting admissions to only those containing reports from all data sources; and examine the impact of reducing the sub-sampling. These experiments provide better understanding of how to best apply text classification in the context of imbalanced data of variable completeness. Radiology questions plus patient and hospital admission data contribute valuable information for detecting most of the diseases, significantly improving performance when added to radiology reports alone or to the combination of radiology and pathology reports. Overall, linking data sources significantly improved classification performance for all the diseases examined. However, there is no single approach that suits all scenarios; the choice of the

  6. Analysis of the spatial dose according to the type of radiation source used in multi-bed hospital room

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Dong Gun [Dept. of Nuclear Medicine, Dongnam Institute of Radiological and Medical Sciences Cancer center, Busan (Korea, Republic of); Kim, Jung Hoon [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of); Park, Eun Tae [Dept. of Radiation Oncology, Busan Paik Hospital, Inje University, Busan (Korea, Republic of)

    2017-09-15

    Medical radiation offers significant benefits in diagnosing and treating patients, but it also generates unnecessary radiation exposure to those nearby. Accordingly, the objective of the present study was to analyze spatial dose rate according to types of radiation source term in multi-bed hospital rooms occupied by patients and general public. MCNPX was used for geometric simulation of multi-bed hospital rooms and radiation source terms, while the radiation source terms were established as whole body bone scan patients and imaging using a portable X-ray generator. The results of simulation on whole body bone scan patients showed 3.46 μSv/hr to another patient position, while experimental results on imaging using a portable X-ray generator showed 1.47 × 10{sup -8} μSv/irradiation to another patient position in chest imaging and 2.97 × 10{sup -8} μSv/irradiation to another patient position in abdomen imaging. Multi-bed hospital room, unnecessary radiation generated in the surrounding patients, while legal regulations and systematic measures are needed for radiation exposure in multi-bed hospital rooms that are currently lacking in Korea.

  7. Importance of Including the Acoustic Medium in Rooms on the Transmission Path between Source and Receiver Rooms within a Building

    DEFF Research Database (Denmark)

    Andersen, Lars; Kirkegaard, Poul Henning; Dickow, Kristoffer Ahrens

    2011-01-01

    Low-frequency noise is a potential nuisance to inhabitants in lightweight building structures. Hence, development of efficient and accurat methods for prediction of noice in such buildings is important. The aim of this paper is to assess the necessity of including the acoustic medium in rooms along...

  8. Introduction of a breast cancer care programme including ultra short hospital stay in 4 early adopter centres: framework for an implementation study.

    Science.gov (United States)

    de Kok, Mascha; Frotscher, Caroline N A; van der Weijden, Trudy; Kessels, Alfons G H; Dirksen, Carmen D; van de Velde, Cornelis J H; Roukema, Jan A; Bell, Antoine V R J; van der Ent, Fred W; von Meyenfeldt, Maarten F

    2007-07-02

    Whereas ultra-short stay (day care or 24 hour hospitalisation) following breast cancer surgery was introduced in the US and Canada in the 1990s, it is not yet common practice in Europe. This paper describes the design of the MaDO study, which involves the implementation of ultra short stay admission for patients after breast cancer surgery, and evaluates whether the targets of the implementation strategy are reached. The ultra short stay programme and the applied implementation strategy will be evaluated from the economic perspective. The MaDO study is a pre-post-controlled multi-centre study, that is performed in four hospitals in the Netherlands. It includes a pre and post measuring period of six months each with six months of implementation in between in at least 40 patients per hospital per measurement period. Primary outcome measure is the percentage of patients treated in ultra short stay. Secondary endpoints are the percentage of patients treated according to protocol, degree of involvement of home care nursing, quality of care from the patient's perspective, cost-effectiveness of the ultra short stay programme and cost-effectiveness of the implementation strategy. Quality of care will be measured by the QUOTE-breast cancer instrument, cost-effectiveness of the ultra short stay programme will be measured by means of the EuroQol (administered at four time-points) and a cost book for patients. Cost-effectiveness analysis will be performed from a societal perspective. Cost-effectiveness of the implementation strategy will be measured by determination of the costs of implementation activities. This study will reveal barriers and facilitators for implementation of the ultra short stay programme. Moreover, the results of the study will provide information about the cost-effectiveness of the ultra short stay programme and the implementation strategy. Current Controlled Trials ISRCTN77253391.

  9. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, Including Changes Related to the Electronic Health Record Incentive Program; Extensions of the Medicare-Dependent, Small Rural Hospital Program and the Low-Volume Payment Adjustment for Hospitals. Final rule; interim final rule with comment period.

    Science.gov (United States)

    2015-08-17

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2016. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Pathway for Sustainable Growth Reform(SGR) Act of 2013, the Protecting Access to Medicare Act of 2014, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, and other legislation. We also are addressing the update of the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2016.As an interim final rule with comment period, we are implementing the statutory extensions of the Medicare dependent,small rural hospital (MDH)Program and changes to the payment adjustment for low-volume hospitals under the IPPS.We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2016 and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific providers (acute care hospitals,PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare, including related provisions for eligible hospitals and critical access hospitals participating in the Medicare Electronic Health Record (EHR)Incentive Program. We also are updating policies relating to the

  10. The formation and design of the 'Acute Admission Database'- a database including a prospective, observational cohort of 6279 patients triaged in the emergency department in a larger Danish hospital

    Directory of Open Access Journals (Sweden)

    Barfod Charlotte

    2012-04-01

    Full Text Available Abstract Background Management and care of the acutely ill patient has improved over the last years due to introduction of systematic assessment and accelerated treatment protocols. We have, however, sparse knowledge of the association between patient status at admission to hospital and patient outcome. A likely explanation is the difficulty in retrieving all relevant information from one database. The objective of this article was 1 to describe the formation and design of the 'Acute Admission Database', and 2 to characterize the cohort included. Methods All adult patients triaged at the Emergency Department at Hillerød Hospital and admitted either to the observationary unit or to a general ward in-hospital were prospectively included during a period of 22 weeks. The triage system used was a Danish adaptation of the Swedish triage system, ADAPT. Data from 3 different data sources was merged using a unique identifier, the Central Personal Registry number; 1 Data from patient admission; time and date, vital signs, presenting complaint and triage category, 2 Blood sample results taken at admission, including a venous acid-base status, and 3 Outcome measures, e.g. length of stay, admission to Intensive Care Unit, and mortality within 7 and 28 days after admission. Results In primary triage, patients were categorized as red (4.4%, orange (25.2%, yellow (38.7% and green (31.7%. Abnormal vital signs were present at admission in 25% of the patients, most often temperature (10.5%, saturation of peripheral oxygen (9.2%, Glasgow Coma Score (6.6% and respiratory rate (4.8%. A venous acid-base status was obtained in 43% of all patients. The majority (78% had a pH within the normal range (7.35-7.45, 15% had acidosis (pH 7.45. Median length of stay was 2 days (range 1-123. The proportion of patients admitted to Intensive Care Unit was 1.6% (95% CI 1.2-2.0, 1.8% (95% CI 1.5-2.2 died within 7 days, and 4.2% (95% CI 3.7-4.7 died within 28 days after admission

  11. Hospital effluents as a source of emerging pollutants: An overview of micropollutants and sustainable treatment options

    Science.gov (United States)

    Verlicchi, P.; Galletti, A.; Petrovic, M.; Barceló, D.

    2010-08-01

    SummaryHospital wastewaters contain a variety of toxic or persistent substances such as pharmaceuticals, radionuclides, solvents and disinfectants for medical purposes in a wide range of concentrations due to laboratory and research activities or medicine excretion. Most of these compounds belong to the so called emerging contaminants; quite often unregulated pollutants which may be candidates for future regulation depending on research on their potential health effects and monitoring of their occurrence. Their main characteristic is that they do not need to persist in the environment to cause negative effects since their high transformation/removal rates can be compensated for by their continuous introduction into the environment. Some of these compounds, most of them pharmaceuticals and personal care products may also be present in urban wastewaters. Their concentrations in the effluents may vary from ng L -1 to μg L -1. In this paper, hospital effluents and urban wastewaters are compared in terms of quali-quantitative characteristics. On the basis of an in-depth survey: (i) hospital average specific daily water consumptions (L patient -1 day -1) are evaluated and compared to urban ones (L person -1 day -1), (ii) conventional parameters concentrations in hospital effluents are compared to urban ones and (iii) main pharmaceuticals and other emerging compounds contents are compared in the two wastewaters. Finally, an overview of the removal capacity of the different treatments is reported.

  12. Incremental Yield of Including Determine-TB LAM Assay in Diagnostic Algorithms for Hospitalized and Ambulatory HIV-Positive Patients in Kenya.

    Science.gov (United States)

    Huerga, Helena; Ferlazzo, Gabriella; Bevilacqua, Paolo; Kirubi, Beatrice; Ardizzoni, Elisa; Wanjala, Stephen; Sitienei, Joseph; Bonnet, Maryline

    2017-01-01

    Determine-TB LAM assay is a urine point-of-care test useful for TB diagnosis in HIV-positive patients. We assessed the incremental diagnostic yield of adding LAM to algorithms based on clinical signs, sputum smear-microscopy, chest X-ray and Xpert MTB/RIF in HIV-positive patients with symptoms of pulmonary TB (PTB). Prospective observational cohort of ambulatory (either severely ill or CD4<200cells/μl or with Body Mass Index<17Kg/m2) and hospitalized symptomatic HIV-positive adults in Kenya. Incremental diagnostic yield of adding LAM was the difference in the proportion of confirmed TB patients (positive Xpert or MTB culture) diagnosed by the algorithm with LAM compared to the algorithm without LAM. The multivariable mortality model was adjusted for age, sex, clinical severity, BMI, CD4, ART initiation, LAM result and TB confirmation. Among 474 patients included, 44.1% were severely ill, 69.6% had CD4<200cells/μl, 59.9% had initiated ART, 23.2% could not produce sputum. LAM, smear-microscopy, Xpert and culture in sputum were positive in 39.0% (185/474), 21.6% (76/352), 29.1% (102/350) and 39.7% (92/232) of the patients tested, respectively. Of 156 patients with confirmed TB, 65.4% were LAM positive. Of those classified as non-TB, 84.0% were LAM negative. Adding LAM increased the diagnostic yield of the algorithms by 36.6%, from 47.4% (95%CI:39.4-55.6) to 84.0% (95%CI:77.3-89.4%), when using clinical signs and X-ray; by 19.9%, from 62.2% (95%CI:54.1-69.8) to 82.1% (95%CI:75.1-87.7), when using clinical signs and microscopy; and by 13.4%, from 74.4% (95%CI:66.8-81.0) to 87.8% (95%CI:81.6-92.5), when using clinical signs and Xpert. LAM positive patients had an increased risk of 2-months mortality (aOR:2.7; 95%CI:1.5-4.9). LAM should be included in TB diagnostic algorithms in parallel to microscopy or Xpert request for HIV-positive patients either ambulatory (severely ill or CD4<200cells/μl) or hospitalized. LAM allows same day treatment initiation in patients at

  13. Patterns and sources of alcohol consumption preceding alcohol-affected attendances to a New Zealand hospital emergency department.

    Science.gov (United States)

    Das, Manidipa; Stewart, Rebecca; Ardagh, Michael; Deely, Joanne M; Dodd, Stuart; Bartholomew, Nadia V; Pearson, Scott; Spearing, Ruth; Williams, Tracey; Than, Martin

    2014-08-29

    To perform a descriptive study of the drinking behaviour (amounts, types, sources of alcohol consumed) preceding alcohol-affected presentations to Christchurch Hospital Emergency Department (ED). Over 336 hours in the ED, patients with recent alcohol consumption or alcohol-related attendances were identified, classified as alcohol-affected or alcohol- unaffected, and invited to consent to answering questions on types, amounts and sources of alcohol consumed in the drinking session preceding or implicated in their ED attendance. Demographic information and level of intoxication were also recorded. Data were summarised descriptively. Alcohol-affected patients were more frequently young (16-25 years) and male. Median alcohol consumption was 14 (range 1 to 71) standard drinks. Beer was the most popular beverage (34%), but spirits (23%), ready-to-drink mixes (21%) and wine (20%) were also popular. Liquor stores (45%) were the most popular source of alcohol, followed by on-licence premises (25%), and supermarkets (21%). The popularity of different types of beverages and their source varied according to patient age and gender. Consumption of large amounts, as well as allegedly 'safe' amounts, of a range of alcoholic beverages, most commonly from an off-licence source, contributed to alcohol-affected presentations to the ED. Beverage and source popularity varied by age and gender.

  14. A revised dosimetric characterization of the model S700 electronic brachytherapy source containing an anode-centering plastic insert and other components not included in the 2006 model

    International Nuclear Information System (INIS)

    Hiatt, Jessica R.; Davis, Stephen D.; Rivard, Mark J.

    2015-01-01

    Purpose: The model S700 Axxent electronic brachytherapy source by Xoft, Inc., was characterized by Rivard et al. in 2006. Since then, the source design was modified to include a new insert at the source tip. Current study objectives were to establish an accurate source model for simulation purposes, dosimetrically characterize the new source and obtain its TG-43 brachytherapy dosimetry parameters, and determine dose differences between the original simulation model and the current model S700 source design. Methods: Design information from measurements of dissected model S700 sources and from vendor-supplied CAD drawings was used to aid establishment of an updated Monte Carlo source model, which included the complex-shaped plastic source-centering insert intended to promote water flow for cooling the source anode. These data were used to create a model for subsequent radiation transport simulations in a water phantom. Compared to the 2006 simulation geometry, the influence of volume averaging close to the source was substantially reduced. A track-length estimator was used to evaluate collision kerma as a function of radial distance and polar angle for determination of TG-43 dosimetry parameters. Results for the 50 kV source were determined every 0.1 cm from 0.3 to 15 cm and every 1° from 0° to 180°. Photon spectra in water with 0.1 keV resolution were also obtained from 0.5 to 15 cm and polar angles from 0° to 165°. Simulations were run for 10 10 histories, resulting in statistical uncertainties on the transverse plane of 0.04% at r = 1 cm and 0.06% at r = 5 cm. Results: The dose-rate distribution ratio for the model S700 source as compared to the 2006 model exceeded unity by more than 5% for roughly one quarter of the solid angle surrounding the source, i.e., θ ≥ 120°. The radial dose function diminished in a similar manner as for an 125 I seed, with values of 1.434, 0.636, 0.283, and 0.0975 at 0.5, 2, 5, and 10 cm, respectively. The radial dose function

  15. A revised dosimetric characterization of the model S700 electronic brachytherapy source containing an anode-centering plastic insert and other components not included in the 2006 model

    Energy Technology Data Exchange (ETDEWEB)

    Hiatt, Jessica R. [Department of Radiation Oncology, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903 (United States); Davis, Stephen D. [Department of Medical Physics, McGill University Health Centre, Montreal, Quebec H3G 1A4 (Canada); Rivard, Mark J., E-mail: mark.j.rivard@gmail.com [Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts 02111 (United States)

    2015-06-15

    Purpose: The model S700 Axxent electronic brachytherapy source by Xoft, Inc., was characterized by Rivard et al. in 2006. Since then, the source design was modified to include a new insert at the source tip. Current study objectives were to establish an accurate source model for simulation purposes, dosimetrically characterize the new source and obtain its TG-43 brachytherapy dosimetry parameters, and determine dose differences between the original simulation model and the current model S700 source design. Methods: Design information from measurements of dissected model S700 sources and from vendor-supplied CAD drawings was used to aid establishment of an updated Monte Carlo source model, which included the complex-shaped plastic source-centering insert intended to promote water flow for cooling the source anode. These data were used to create a model for subsequent radiation transport simulations in a water phantom. Compared to the 2006 simulation geometry, the influence of volume averaging close to the source was substantially reduced. A track-length estimator was used to evaluate collision kerma as a function of radial distance and polar angle for determination of TG-43 dosimetry parameters. Results for the 50 kV source were determined every 0.1 cm from 0.3 to 15 cm and every 1° from 0° to 180°. Photon spectra in water with 0.1 keV resolution were also obtained from 0.5 to 15 cm and polar angles from 0° to 165°. Simulations were run for 10{sup 10} histories, resulting in statistical uncertainties on the transverse plane of 0.04% at r = 1 cm and 0.06% at r = 5 cm. Results: The dose-rate distribution ratio for the model S700 source as compared to the 2006 model exceeded unity by more than 5% for roughly one quarter of the solid angle surrounding the source, i.e., θ ≥ 120°. The radial dose function diminished in a similar manner as for an {sup 125}I seed, with values of 1.434, 0.636, 0.283, and 0.0975 at 0.5, 2, 5, and 10 cm, respectively. The radial dose

  16. A revised dosimetric characterization of the model S700 electronic brachytherapy source containing an anode-centering plastic insert and other components not included in the 2006 model.

    Science.gov (United States)

    Hiatt, Jessica R; Davis, Stephen D; Rivard, Mark J

    2015-06-01

    The model S700 Axxent electronic brachytherapy source by Xoft, Inc., was characterized by Rivard et al. in 2006. Since then, the source design was modified to include a new insert at the source tip. Current study objectives were to establish an accurate source model for simulation purposes, dosimetrically characterize the new source and obtain its TG-43 brachytherapy dosimetry parameters, and determine dose differences between the original simulation model and the current model S700 source design. Design information from measurements of dissected model S700 sources and from vendor-supplied CAD drawings was used to aid establishment of an updated Monte Carlo source model, which included the complex-shaped plastic source-centering insert intended to promote water flow for cooling the source anode. These data were used to create a model for subsequent radiation transport simulations in a water phantom. Compared to the 2006 simulation geometry, the influence of volume averaging close to the source was substantially reduced. A track-length estimator was used to evaluate collision kerma as a function of radial distance and polar angle for determination of TG-43 dosimetry parameters. Results for the 50 kV source were determined every 0.1 cm from 0.3 to 15 cm and every 1° from 0° to 180°. Photon spectra in water with 0.1 keV resolution were also obtained from 0.5 to 15 cm and polar angles from 0° to 165°. Simulations were run for 10(10) histories, resulting in statistical uncertainties on the transverse plane of 0.04% at r = 1 cm and 0.06% at r = 5 cm. The dose-rate distribution ratio for the model S700 source as compared to the 2006 model exceeded unity by more than 5% for roughly one quarter of the solid angle surrounding the source, i.e., θ ≥ 120°. The radial dose function diminished in a similar manner as for an (125)I seed, with values of 1.434, 0.636, 0.283, and 0.0975 at 0.5, 2, 5, and 10 cm, respectively. The radial dose function ratio between the current

  17. Field Measurements of Trace Gases and Aerosols Emitted by Undersampled Combustion Sources Including Wood and Dung Cooking Fires, Garbage and Crop Residue Burning, and Indonesian Peat Fires

    Science.gov (United States)

    Stockwell, C.; Jayarathne, T. S.; Goetz, D.; Simpson, I. J.; Selimovic, V.; Bhave, P.; Blake, D. R.; Cochrane, M. A.; Ryan, K. C.; Putra, E. I.; Saharjo, B.; Stone, E. A.; DeCarlo, P. F.; Yokelson, R. J.

    2017-12-01

    Field measurements were conducted in Nepal and in the Indonesian province of Central Kalimantan to improve characterization of trace gases and aerosols emitted by undersampled combustion sources. The sources targeted included cooking with a variety of stoves, garbage burning, crop residue burning, and authentic peat fires. Trace gas and aerosol emissions were studied using a land-based Fourier transform infrared spectrometer, whole air sampling, photoacoustic extinctiometers (405 and 870nm), and filter samples that were analyzed off-line. These measurements were used to calculate fuel-based emission factors (EFs) for up to 90 gases, PM2.5, and PM2.5 constituents. The aerosol optical data measured included EFs for the scattering and absorption coefficients, the single scattering albedo (at 870 and 405 nm), as well as the absorption Ångström exponent. The emissions varied significantly by source, although light absorption by both brown and black carbon (BrC and BC, respectively) was important for all non-peat sources. For authentic peat combustion, the emissions of BC were negligible and absorption was dominated by organic aerosol. The field results from peat burning were in reasonable agreement with recent lab measurements of smoldering Kalimantan peat and compare well to the limited data available from other field studies. The EFs can be used with estimates of fuel consumption to improve regional emissions inventories and assessments of the climate and health impacts of these undersampled sources.

  18. Ambient particle source apportionment and daily hospital admissions among children and elderly in Copenhagen

    DEFF Research Database (Denmark)

    Andersen, Zorana Jovanovic; Wahlin, P.; Raaschou-Nielsen, Ole

    2007-01-01

    , Denmark. We further studied associations between fractions of PM(10) assigned to six sources (biomass, secondary, oil, crustal, sea salt, and vehicle) and admissions during a 1(1/2) -year campaign. We used Poisson generalized additive time-series model adjusted for season, day of the week, public holidays...... found different PM(10) sources to be variably associated with different outcomes: crustal and secondary sources showed strongest associations with cardiovascular, biomass with respiratory, and vehicle with asthma admissions. These novel results may merit future research of potential mechanism, whereas...

  19. Diurnal variations in incidence and outcome of out-of-hospital cardiac arrest including prior comorbidity and pharmacotherapy: a nationwide study in Denmark.

    Science.gov (United States)

    Karlsson, Lena I M; Wissenberg, Mads; Fosbøl, Emil L; Hansen, Carolina Malta; Lippert, Freddy K; Bagai, Akshay; McNally, Bryan; Granger, Christopher B; Christensen, Erika Frischknecht; Folke, Fredrik; Rajan, Shahzleen; Weeke, Peter; Nielsen, Søren L; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian

    2014-09-01

    To investigate diurnal variations in incidence and outcomes following out-of-hospital cardiac arrest (OHCA). OHCA of presumed cardiac etiology were identified through the nationwide Danish Cardiac Arrest Registry (2001-2010). Time of day was divided into three time periods: daytime 07.00-14.59; evening 15.00-22.59; and nighttime 23.00-06.59. We identified 18,929 OHCA patients, aged ≥18 years. The median age was 72 years (IQR 62-80) and the majority were male (67.5%). OHCA occurrence varied across time periods, with 43.9%, 35.7% and 20.6% occurring during daytime, evening and nighttime, respectively. Nighttime patients were more likely to have: severe comorbidity (i.e. COPD), arrest in private home (87.2% vs. 69.0% and 73.0% daytime and evening, respectively), non-witnessed arrest (51.2% vs. 48.4% and 43.7%), no bystander CPR (75.9% vs. 68.4% and 66.1%), longer time interval from recognition of OHCA to rhythm analysis (12 min vs. 11 min and 11 min), and non-shockable heart rhythm (80.1% vs. 70.3% and 69.4%), all p<0.0001. Nighttime patients were less likely to achieve return of spontaneous circulation on arrival at the hospital (7.5% vs. 14.8% and 15.1%) and 1-year survival (2.8% vs. 7.2% and 7.1%), p<0.0001. Overall, the lower 1-year survival rate persisted after adjusting for patient-related and cardiac-arrest related characteristics mentioned above (OR 0.47, 95%CI 0.37-0.59; OR 0.51, 95%CI 0.40-0.65, compared to daytime and evening, respectively). We found nighttime patients to have a lower survival compared to daytime and evening that persisted when adjusting for patient-related and cardiac-arrest related characteristics including comorbidities. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. At most hospitals in the state of Iowa, most surgeons' daily lists of elective cases include only 1 or 2 cases: Individual surgeons' percentage operating room utilization is a consistently unreliable metric.

    Science.gov (United States)

    Dexter, Franklin; Jarvie, Craig; Epstein, Richard H

    2017-11-01

    Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals. The important mathematical parameter for the prior observations is the percentage of surgeon lists of elective cases that include 1 or 2 cases; "list" meaning a combination of surgeon, hospital, and date. We measure the incidence among many hospitals. Observational cohort study. 117 hospitals in Iowa from July 2013 through September 2015. Surgeons with same identifier among hospitals. Surgeon lists of cases including at least one outpatient surgical case, so that Relative Value Units (RVU's) could be measured. Averaging among hospitals in Iowa, more than half of the surgeons' lists included 1 or 2 cases (77%; P<0.00001 vs. 50%). Approximately half had 1 case (54%; P=0.0012 vs. 50%). These percentages exceeded 50% even though nearly all the surgeons operated at just 1 hospital on days with at least 1 case (97.74%; P<0.00001 vs. 50%). The cases were not of long durations; among the 82,928 lists with 1 case, the median was 6 intraoperative RVUs (e.g., adult inguinal herniorrhaphy). Accurate confidence intervals for raw or adjusted utilizations are so wide for individual surgeons that decisions based on utilization are equivalent to decisions based on random error. The implication of the current study is generalizability of that finding from the largest teaching hospital in the state to the other hospitals in the state. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Stethoscopes as a source of hospital-acquired methicillin-resistant Staphylococcus aureus.

    Science.gov (United States)

    Russell, Abigail; Secrest, Janet; Schreeder, Carolyn

    2012-04-01

    Stethoscopes are potential vectors of methicillin-resistant Staphylococcus aureus (MRSA). The purpose of this project was to determine the presence of MRSA on the diaphragms of personal and unit stethoscopes within a hospital setting before and after cleaning with alcohol prep pads. The sample consisted of 141 personal and unit stethoscopes in adult medical-surgical and intensive care units of a large university hospital in the Southeast. Each stethoscope was cultured once before cleaning and once after cleaning. Cultures were obtained using sterile swabs and inoculated on a selective medium for MRSA. Bacterial growth was noted in the precleaning group, but no MRSA colonies were detected. The postcleaning group had no bacterial growth. There was not enough data to statistically support that isopropyl alcohol is effective in decreasing bacterial counts; however, these findings suggest that current disinfection guidelines are effective in preventing MRSA colonization on stethoscopes in this setting. Copyright © 2012 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  2. Fate of antibiotics from hospital and domestic sources in a sewage network.

    Science.gov (United States)

    Dinh, QuocTuc; Moreau-Guigon, Elodie; Labadie, Pierre; Alliot, Fabrice; Teil, Marie-Jeanne; Blanchard, Martine; Eurin, Joelle; Chevreuil, Marc

    2017-01-01

    Investigation of domestic and hospital effluents in a sewage system of an elementary watershed showed that antibiotics belonging to eight classes were present with concentrations ranging from antibiotics used in veterinary and human medicine, fourteen were quantified in both the wastewater treatment plant (WWTP) input and output: erythromycin, amoxicillin, tetracycline, trimethoprim, ormethoprim, sulfamethoxazole, vancomycin and seven quinolones (flumequine, enrofloxacin, enoxacin, ofloxacin, lomefloxacin, norfloxacin and ciprofloxacin). Antibiotic concentrations in the hospital effluent (from 0.04 to 17.9μgL -1 ) were ten times higher than those measured in the domestic effluent (from 0.03 to 1.75μgL -1 ), contributing to 90% of the antibiotic inputs to the WWTP. Some molecules such as sulfamethoxazole, erythromycin and trimethoprim displayed higher concentrations after wastewater treatment due to deconjugation of their metabolites, which restores the parent molecules. For other compounds, the antibiotic elimination showed discrepancies depending on their physicochemical properties. For fluoroquinolones, the apparent removal processes were mainly based on adsorption mechanisms, followed by settling, leading to sludge contamination (from 13 to 18,800μgkg -1 dry weight). Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Ozonation for source treatment of pharmaceuticals in hospital wastewater - ozone lifetime and required ozone dose

    DEFF Research Database (Denmark)

    Hansen, Kamilla Marie Speht; Spiliotopoulou, Aikaterini; Chhetri, Ravi Kumar

    2016-01-01

    Ozonation aimed at removing pharmaceuticals was studied in an effluent from an experimental pilot system using staged moving bed biofilm reactor (MBBR) tanks for the optimal biological treatment of wastewater from a medical care unit of Aarhus University Hospital. Dissolved organic carbon (DOC......) and pH in samples varied considerably, and the effect of these two parameters on ozone lifetime and the efficiency of ozone in removing pharmaceuticals were determined. The pH in the effluent varied from 5.0 to 9.0 resulting in approximately a doubling of the required ozone dose at the highest p......H for each pharmaceutical. DOC varied from 6 to 20 mg-DOC/L. The ozone required for removing each pharmaceutical, varied linearly with DOC and thus, ozone doses normalized to DOC (specific ozone dose) agreed between water samples (typically within 15%). At neutral pH the specific ozone dose required...

  4. Order No 485 on the use of unsealed radioactive sources in hospitals, laboratories, etc

    International Nuclear Information System (INIS)

    1985-11-01

    This Order, made in furtherance of an Order of 20 Novembre 1975 concerning safety precautions in the use of radioactive substances, implements in Directive 80/836/Euratom on radiation protection. It lays down a licensing system for the purchase and use of unsealed radioactive sources and also provides for their storage and disposal. The National Board of Health is the licensing authority. The Order also prescribes radiation protection measures for laboratory personnel [fr

  5. Hospital effluents are one of several sources of metal, antibiotic resistance genes and bacterial markers disseminated in Sub-Saharan urban rivers

    Directory of Open Access Journals (Sweden)

    Amandine Laffite

    2016-07-01

    Full Text Available Data concerning the occurrence of emerging biological contaminants such as antibiotic resistance genes (ARGs and fecal indicator bacteria (FIB in aquatic environments in Sub-Saharan African countries is limited. On the other hand, antibiotic resistance remains a worldwide problem which may pose serious potential risks to human and animal health. Consequently, there is a growing number of reports concerning the prevalence and dissemination of these contaminants into various environmental compartments. Sediments provide the opportunity to reconstruct the pollution history and evaluate impacts so this study investigates the abundance and distribution of toxic metals, FIB, and ARGs released from hospital effluent wastewaters and their presence in river sediments receiving systems. ARGs (blaTEM, blaCTX-M, blaSHV, and aadA, total bacterial load, and selected bacterial species FIB (E. coli, Enterococcus (ENT and Pseudomonas species (Psd were quantified by targeting species specific genes using quantitative PCR (qPCR in total DNA extracted from the sediments recovered from 4 hospital outlet pipes (HOP and their river receiving systems in the City of Kinshasa in the Democratic Republic of the Congo. The results highlight the great concentration of toxic metals in HOP, reaching the values (in mg kg-1 of 47.9 (Cr, 213.6 (Cu, 1434.4 (Zn, 2.6 (Cd, 281.5 (Pb, and 13.6 (Hg. The results also highlight the highest (P˂0.05 values of 16S rRNA, FIB, and ARGs copy numbers in all sampling sites including upstream (control site, discharge point, and downstream of receiving rivers, indicating that the hospital effluent water is not an exclusive source of the biological contaminants entering the urban rivers. Significant correlation were observed between (i all analyzed ARGs and total bacterial load (16S rRNA 0.51 to 0.72 (p<0.001, n=65; (ii ARGs (except blaTEM and FIB and Psd 0.57 < r < 0.82 (p<0.001, n=65; and (iii ARGs (except blaTEM and toxic metals (Cd, Cr, Cu

  6. Blood pressure control status and relationship between salt intake and lifestyle including diet in hypertensive outpatients treated at a general hospital.

    Science.gov (United States)

    Ohta, Yuko; Kimura, Yorio; Kitaoka, Chie; Sakata, Tomoko; Abe, Isao; Kawano, Yuhei

    2017-01-01

    The purpose of the present study was to investigate blood pressure (BP) control and salt intake in hypertensive outpatients treated at a general hospital and to examine the relationship between their lifestyles and amount of salt intake. Subjects comprised 429 hypertensive patients (206 males, 223 females, and average age of 71 ± 11 years). We estimated 24-hour salt excretion using spot urine samples and assessed lifestyle using a self-description questionnaire. Average clinic BP and the number of antihypertensive drugs were 132 ± 11/73 ± 8 mmHg and 1.8 ± 0.9, respectively. In all subjects, average estimated salt intake was 9.2 ± 2.8 g/day and the rate of achievement of the estimated salt intake of hospital. It may be important to provide data on actual salt intake and guide salt restriction in the individual management of hypertension.

  7. Geologic sources and concentrations of selenium in the West-Central Denver Basin, including the Toll Gate Creek watershed, Aurora, Colorado, 2003-2007

    Science.gov (United States)

    Paschke, Suzanne S.; Walton-Day, Katherine; Beck, Jennifer A.; Webbers, Ank; Dupree, Jean A.

    2014-01-01

    Toll Gate Creek, in the west-central part of the Denver Basin, is a perennial stream in which concentrations of dissolved selenium have consistently exceeded the Colorado aquatic-life standard of 4.6 micrograms per liter. Recent studies of selenium in Toll Gate Creek identified the Denver lignite zone of the non-marine Cretaceous to Tertiary-aged (Paleocene) Denver Formation underlying the watershed as the geologic source of dissolved selenium to shallow ground-water and surface water. Previous work led to this study by the U.S. Geological Survey, in cooperation with the City of Aurora Utilities Department, which investigated geologic sources of selenium and selenium concentrations in the watershed. This report documents the occurrence of selenium-bearing rocks and groundwater within the Cretaceous- to Tertiary-aged Denver Formation in the west-central part of the Denver Basin, including the Toll Gate Creek watershed. The report presents background information on geochemical processes controlling selenium concentrations in the aquatic environment and possible geologic sources of selenium; the hydrogeologic setting of the watershed; selenium results from groundwater-sampling programs; and chemical analyses of solids samples as evidence that weathering of the Denver Formation is a geologic source of selenium to groundwater and surface water in the west-central part of the Denver Basin, including Toll Gate Creek. Analyses of water samples collected from 61 water-table wells in 2003 and from 19 water-table wells in 2007 indicate dissolved selenium concentrations in groundwater in the west-central Denver Basin frequently exceeded the Colorado aquatic-life standard and in some locations exceeded the primary drinking-water standard of 50 micrograms per liter. The greatest selenium concentrations were associated with oxidized groundwater samples from wells completed in bedrock materials. Selenium analysis of geologic core samples indicates that total selenium

  8. Dairy meals of hospitalized children as a source of energy, calcium and phosphorus in satisfying their daily needs

    Directory of Open Access Journals (Sweden)

    Diana Vukman

    2016-07-01

    Full Text Available A dairy meal is defined as a specific food serving composed from milk and dairy products. Because of its nutritional value and complex chemical composition, milk and dairy products play an important role in the diet of children and represent a rich source of calcium, phosphorus, as well as valuable proteins, B vitamins and minerals. Healthy children should consume at least three servings of dairy products daily, which contributes to the total energy and nutrients that children need. The needs of an unhealthy child are often higher than those who are healthy and depend on the state of the body. The aim of this study was to determine the incidence of consumption of dairy meals in hospitalized children and to find out if their energy needs, as well as their need for calcium and phosphorus through the consumption of the same were met. Significant differences were found between recommended energy intake from dairy products and actual energy intake from consumed milk and dairy products in three Croatian regions (P=0.021 tested. The highest values were recorded in central Croatia (253 Kcal or 34.4 % and the lowest in the northern Croatian coastal region (17.05 Kcal or 20.1 %, which indicates a greater representation of milk and dairy meals in children’s daily menu. Furthermore, hospitalized children meet almost half of their recommended daily intake of calcium and phosphorus from dairy meals for all three regions. The highest rate was found in central Croatia, 48.7 % or 400 mg of calcium, respectively 42.9 % or 322.69 mg phosphorus, while the remaining portion of calcium and phosphorus originates from different rich non-dairy food sources. In all regions the most common forms of dairy foods consumed were milk and dairy desserts.

  9. Calibration of photon and beta ray sources used in brachytherapy. Guidelines on standardized procedures at Secondary Standards Dosimetry Laboratories (SSDLs) and hospitals

    International Nuclear Information System (INIS)

    2002-03-01

    It has generally been recognized that international harmonization in radiotherapy dosimetry is essential. Consequently, the IAEA has given much effort to this, for example by publishing a number of reports in the Technical Reports Series (TRS) for external beam dosimetry, most notably TRS-277 and more recently TRS-398. Both of these reports describe in detail the steps to be taken for absorbed dose determination in water and they are often referred to as 'dosimetry protocols'. Similar to TRS-277, it is expected that TRS-398 will be adopted or used as a model by a large number of countries as their national protocol. In 1996, the IAEA established a calibration service for low dose rate (LDR) 137 Cs brachytherapy sources, which is the most widely used source for treatment of gynecological cancer. To further enhance harmonization in brachytherapy dosimetry, the IAEA published in 1999 IAEA-TECDOC-1079 entitled 'Calibration of Brachytherapy Sources. Guidelines on Standardized Procedures for the Calibration of Brachytherapy Sources at Secondary Standard Dosimetry Laboratories (SSDLs) and Hospitals'. The report was well received and was distributed in a large number of copies to the members of the IAEA/WHO network of SSDLs and to medical physicists working with brachytherapy. The present report is an update of the aforementioned TECDOC. Whereas TECDOC-1079 described methods for calibrating brachytherapy sources with photon energies at or above those of 192 Ir, the current report has a wider scope in that it deals with standardization of calibration of all the most commonly used brachytherapy sources, including both photon and beta emitting sources. The latter sources have been in use for a few decades already, but their calibration methods have been unclear. Methods are also described for calibrating sources used in the rapidly growing field of cardiovascular angioplasty. In this application, irradiation of the vessel wall is done in an attempt to prevent restenosis after

  10. Genotypic and phenotypic diversity of Ralstonia pickettii and Ralstonia insidiosa isolates from clinical and environmental sources including High-purity Water.

    LENUS (Irish Health Repository)

    Ryan, Michael P

    2011-08-30

    Abstract Background Ralstonia pickettii is a nosocomial infectious agent and a significant industrial contaminant. It has been found in many different environments including clinical situations, soil and industrial High Purity Water. This study compares the phenotypic and genotypic diversity of a selection of strains of Ralstonia collected from a variety of sources. Results Ralstonia isolates (fifty-nine) from clinical, industrial and environmental origins were compared genotypically using i) Species-specific-PCR, ii) PCR and sequencing of the 16S-23S rRNA Interspatial region (ISR) iii) the fliC gene genes, iv) RAPD and BOX-PCR and v) phenotypically using biochemical testing. The species specific-PCR identified fifteen out of fifty-nine designated R. pickettii isolates as actually being the closely related species R. insidiosa. PCR-ribotyping of the 16S-23S rRNA ISR indicated few major differences between the isolates. Analysis of all isolates demonstrated different banding patterns for both the RAPD and BOX primers however these were found not to vary significantly. Conclusions R. pickettii species isolated from wide geographic and environmental sources appear to be reasonably homogenous based on genotypic and phenotypic characteristics. R. insidiosa can at present only be distinguished from R. pickettii using species specific PCR. R. pickettii and R. insidiosa isolates do not differ significantly phenotypically or genotypically based on environmental or geographical origin.

  11. Guideline-recommended therapy, including beta-blocker utilization, in patients with chronic heart failure: results from a Canadian community hospital heart function clinic

    Directory of Open Access Journals (Sweden)

    Heffernan M

    2016-06-01

    Full Text Available Michael Heffernan Division of Cardiology, Oakville Trafalgar Memorial Hospital, Oakville, ON, Canada Abstract: A comprehensive analysis of beta-blocker utilization and other guideline-recommended therapies for the treatment of chronic heart failure in a Canadian community hospital heart function clinic has not been undertaken and was, therefore, the focus of this study. The proportion of patients who would be potential candidates for ivabridine and sacubitril–valsartan therapy as a result of fulfilling the criteria for enrollment in either the Systolic Heart failure treatment with the If inhibitor ivabradine Trial (SHIFT study (left-ventricular ejection fraction [LVEF] >35%, sinus rhythm, New York Heart Association II–IV or the Prospective Comparison of angiotensin receptor-neprilysin inhibitor (ARNI with angiotensin-converting enzyme inhibitor (ACEI to determine impact on global Mortality and Morbidity in Heart Failure (PARADIGM-HF study (LVEF <40%, New York Heart Association II–IV, glomerular filtration rate >30 mL/min, was also assessed. A retrospective cross-sectional analysis was carried out in all 371 patients treated in this community heart function clinic for at least a 12-month period. The patients were elderly (mean age 74±13.3 years and predominately male (61.5% with symptomatic (82.5% moderate left-ventricular dysfunction (LVEF 45.4%±15.6%. A substantial proportion of the patients also had a diagnosis of atrial fibrillation (52.8%. The total use of beta blockers exceeded 87%, while 100% of patients without a documented contraindication or intolerance to a beta blocker received therapy. Adherence to other guideline-recommended pharmacotherapies specifically for heart failure with reduced left ventricular ejection was high: 86.1% of the eligible patients were treated with an ACEI/angiotensin receptor blocker and 61.9% received a mineralcorticoid receptor antagonist. We determined that 13.7% of the complement of this heart

  12. High-performance control of a three-phase voltage-source converter including feedforward compensation of the estimated load current

    International Nuclear Information System (INIS)

    Leon, Andres E.; Solsona, Jorge A.; Busada, Claudio; Chiacchiarini, Hector; Valla, Maria Ines

    2009-01-01

    In this paper a new control strategy for voltage-source converters (VSC) is introduced. The proposed strategy consists of a nonlinear feedback controller based on feedback linearization plus a feedforward compensation of the estimated load current. In our proposal an energy function and the direct-axis current are considered as outputs, in order to avoid the internal dynamics. In this way, a full linearization is obtained via nonlinear transformation and feedback. An estimate of the load current is feedforwarded to improve the performance of the whole system and to diminish the capacitor size. This estimation allows to obtain a more rugged and cheaper implementation. The estimate is calculated by using a nonlinear reduced-order observer. The proposal is validated through different tests. These tests include performance in presence of switching frequency, measurement filters delays, parameters uncertainties and disturbances in the input voltage.

  13. Molecular characterization of Aspergillus infections in an Iranian educational hospital using RAPD-PCR method

    Directory of Open Access Journals (Sweden)

    Kambiz Diba

    2014-09-01

    Conclusion: The hospital sources for the Aspergillus clinical isolates included air condition and walls. RAPD-PCR analysis can play a trivial role to find the hospital sources of Aspergillus clinical isolates.

  14. Multidrug-resistant Enterobacteriaceae including metallo-β-lactamase producers are predominant pathogens of healthcare-associated infections in an Indian teaching hospital

    Directory of Open Access Journals (Sweden)

    J B Sarma

    2011-01-01

    Full Text Available Purpose: A study was carried out in an Indian teaching hospital in 2009 to detect the rate of surgical site infections (SSI and peripheral vascular access site infections. Materials and Methods: The study was a point-prevalence study involving over 300 patients. The presence of infection was determined according to the CDC criteria. Swabs were taken from the infected sites and identification and sensitivity were carried out using VITEK® 2 automated system. Characterisation of β-lactamase was carried out at ARRML, Colindale, London. Results: The rate of SSI was 15% for the clean and clean-contaminated categories while that for the dirty contaminated category was 85% (NNIS risk index 0. Cultures yielded definite or probable pathogens from 64% (9/14 of the patients with SSI. In 1/3 rd of the cultures, Staphylococcus aureus was grown and the rest had Enterobacteriaceae, either extended-spectrum β-lactamase (ESBL producers or Amp-C hyperproducers and, alarmingly, three isolates were positive for newly recognised New Delhi metallo-β-lactamase-1 (NDM-1. In medicine, 87% (n = 99 of the patients had a peripheral IV access device, 55% developed associated phlebitis/infection and, in seven, probable pathogens were isolated (Candida species and Escherichia coli producing ESBL and NDM-1, respectively, Staphylococcus aureus and Enterococcus faecium. All ESBL and metallo-β-lactamase producers were resistant to multiple classes of antimicrobials, the latter being sensitive only to colistin and tigecycline. The study also found that all post-operative patients were on antibiotics, 92% on IV [213 defined daily doses (DDD/100 post-op patients] limited mainly to the third-generation cephalosporins (26% and aminoglycosides (24% and imidazole derivatives (30%. In medicine, 83% (n = 82 were on IV antibiotics (123 DDD/100 bed-days, limited mainly to the third-generation cephalosporins (74%. Conclusion: Indiscriminate use of antibiotics is a major problem

  15. sources

    Directory of Open Access Journals (Sweden)

    Shu-Yin Chiang

    2002-01-01

    Full Text Available In this paper, we study the simplified models of the ATM (Asynchronous Transfer Mode multiplexer network with Bernoulli random traffic sources. Based on the model, the performance measures are analyzed by the different output service schemes.

  16. The hospital information system as a source for the planning and feed-back of specialized health care.

    Science.gov (United States)

    Liebelt, P; Sleyster, E; Leeferink-Smit, J

    1995-01-01

    1. INTRODUCTION. In university hospitals, choices are made to which extend specialized health care will be supported. It is characteristic, for this type of care, that it takes place in a process of the continual advance of medical technology and the growing awareness by consumers and payors. Specialized healthcare contributes to the hospital qualifiers having a political and strategic impact. The hospital board needs information for planning and budgeting these new tasks. Much of the information will be based on data stored in the Hospital Information System (HIS). Due to load limitations, instant retrieval is not preferred. A separate executive information system, uploaded with HIS data, features statistics, on a corporate level, with the power to drill-down to detailed levels. However, the ability to supply information on new types of healthcare is limited since most of these topics require a flexible system for new dedicated cross-sections, like medical treatment from several specialisms and functional levels. 2. DATA RETRIEVAL AND DISTRIBUTION. During the information analysis, details were gathered on the necessary working procedures and the administrative organization, including the data registration in the HIS. In the next phase, all relevant data was organized in a relational datamodel. For each topic of care, dedicated views were developed at both low and high aggregation levels. It revealed that a matching change of the administrative organization was required, with an emphasis on financial registration aspects. For the selection of relevant data, a bottom-up approach was applied, which was based on the registrations starting from the patient administrative subsystem, through several transactional systems, ending at the general ledger in the HIS. Data on all levels was gathered, resulting in medical details presented in quantities, up to financial figures expressed in amounts of money. This procedure distinguishes from the predefined top-down techniques

  17. The Minister Council decree about conditions for to bring into the Polish customs area, to take away from the Polish customs area, and to transit through this area nuclear materials, radioactive sources and device including such sources

    International Nuclear Information System (INIS)

    Miller, L.

    2002-01-01

    The decree refers to conditions for to bring into the Polish customs area, to take away from the Polish customs area, and to transit through this area nuclear materials, radioactive sources and devices containing such sources

  18. The ACCESS study a Zelen randomised controlled trial of a treatment package including problem solving therapy compared to treatment as usual in people who present to hospital after self-harm: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Parag Varsha

    2011-05-01

    Full Text Available Abstract Background People who present to hospital after intentionally harming themselves pose a common and important problem. Previous reviews of interventions have been inconclusive as existing trials have been under powered and done on unrepresentative populations. These reviews have however indicated that problem solving therapy and regular written communications after the self-harm attempt may be an effective treatment. This protocol describes a large pragmatic trial of a package of measures which include problem solving therapy, regular written communication, patient support, cultural assessment, improved access to primary care and a risk management strategy in people who present to hospital after self-harm using a novel design. Methods We propose to use a double consent Zelen design where participants are randomised prior to giving consent to enrol a large representative cohort of patients. The main outcome will be hospital attendance following repetition of self-harm, in the 12 months after recruitment with secondary outcomes of self reported self-harm, hopelessness, anxiety, depression, quality of life, social function and hospital use at three months and one year. Discussion A strength of the study is that it is a pragmatic trial which aims to recruit large numbers and does not exclude people if English is not their first language. A potential limitation is the analysis of the results which is complex and may underestimate any effect if a large number of people refuse their consent in the group randomised to problem solving therapy as they will effectively cross over to the treatment as usual group. However the primary analysis is a true intention to treat analysis of everyone randomised which includes both those who consent and do not consent to participate in the study. This provides information about how the intervention will work in practice in a representative population which is a major advance in this study compared to what has

  19. The occurrence and removal of algae (including cyanobacteria) and their related organic compounds from source water in Vaalkop Dam with conventional and advanced drinking water treatment processes

    OpenAIRE

    Swanepoel, A; Du Preez, HH; Cloete, N

    2017-01-01

    Cyanobacterial bloom formation in freshwaters, such as rivers, lakes and dams, is known to occur throughout the world. The Vaalkop Dam, which serves as source to the Vaalkop drinking water treatment works (DWTW), is no exception. Blooms of cyanobacteria occur annually in Vaalkop Dam as well as in dams from which Vaalkop is replenished during low-rainfall periods. These blooms during the summer months are associated with the production of cyanotoxins and taste and odour compounds such as geosm...

  20. Improvement of gamma-ray Sn transport calculations including coherent and incoherent scatterings and secondary sources of bremsstrahlung and fluorescence: Determination of gamma-ray buildup factors

    International Nuclear Information System (INIS)

    Kitsos, S.; Diop, C.M.; Assad, A.; Nimal, J.C.; Ridoux, P.

    1996-01-01

    Improvements of gamma-ray transport calculations in S n codes aim at taking into account the bound-electron effect of Compton scattering (incoherent), coherent scattering (Rayleigh), and secondary sources of bremsstrahlung and fluorescence. A computation scheme was developed to take into account these phenomena by modifying the angular and energy transfer matrices, and no modification in the transport code has been made. The incoherent and coherent scatterings as well as the fluorescence sources can be strictly treated by the transfer matrix change. For bremsstrahlung sources, this is possible if one can neglect the charged particles path as they pass through the matter (electrons and positrons) and is applicable for the energy range of interest for us (below 10 MeV). These improvements have been reported on the kernel attenuation codes by the calculation of new buildup factors. The gamma-ray buildup factors have been carried out for 25 natural elements up to 30 mean free paths in the energy range between 15 keV and 10 MeV

  1. [Problems with Using Hospital Quality Reports as a Secondary Data Source for Health Services Research in Germany].

    Science.gov (United States)

    Kraska, R A; de Cruppe, W; Geraedts, M

    2017-07-01

    Background Since 2005, German hospitals are required by law to publish structured quality reports (QRs). Because of the detailed data basis, the QRs are being increasingly used for secondary data analyses in health services research. Up until now, methodological difficulties that can cause distorted results of the analyses have essentially been overlooked. The aim of this study is to systematically list the methodological problems associated with using QR and to suggest solution strategies. Methods The QRs from 2006-2012 form the basis of the analyses and were aggregated in a database using an individualized data linkage procedure. Thereafter, a correlation analysis between a quality indicator and the staffing of hospitals was conducted, serving as an example for both cross-sectional as well as longitudinal studies. The resulting methodological problems are described qualitatively and quantitatively, and potential solutions are derived from the statistical literature. Results In each reporting year, 2-15% of the hospitals delivered no QR. In 2-16% of the QRs, it is not recognizable whether a report belongs to a hospital network or a single location. In addition, 6-66% of the location reports falsely contain data from the hospital network. 10% of the hospitals changed their institution code (IC), in 5% of the cases, the same "IC-location-number-combination" was used for different hospitals over the years. Therefore, 10-20% of the QRs cannot be linked with the IC as key variable. As a remedy for the linking of QR, the combination of the IC, the address and the number of beds represents a suitable solution. Using this solution, hospital network reports, location reports and missing reports can be identified and considered in an analysis. Conclusions Secondary data analyses with quality reports provide a high potential for error due to the inconsistent data base and the problems of the data linkage procedure. These can distort calculated parameters and limit the

  2. Wavelet-Transform-Based Power Management of Hybrid Vehicles with Multiple On-board Energy Sources Including Fuel Cell, Battery and Ultracapacitor

    Science.gov (United States)

    2008-09-12

    considered to be promising for application as distributed generation sources due to high efficiency and compactness [1-2], [21-24]. The PEMFC is...also a primary candidate for environment-friendly vehicles. The nomenclatures of the PEMFC are as follows: B , C : Constants to calculate the...0 O H H-O H-O 1 2 N I q q r r FU = (10) The block diagram of the PEMFC model based on the above equations is shown in Fig

  3. Te Ira Tangata: A Zelen randomised controlled trial of a treatment package including problem solving therapy compared to treatment as usual in Maori who present to hospital after self harm

    Directory of Open Access Journals (Sweden)

    Wikiriwhi Karen

    2011-05-01

    Full Text Available Abstract Background Maori, the indigenous people of New Zealand, who present to hospital after intentionally harming themselves, do so at a higher rate than non-Maori. There have been no previous treatment trials in Maori who self harm and previous reviews of interventions in other populations have been inconclusive as existing trials have been under powered and done on unrepresentative populations. These reviews have however indicated that problem solving therapy and sending regular postcards after the self harm attempt may be an effective treatment. There is also a small literature on sense of belonging in self harm and the importance of culture. This protocol describes a pragmatic trial of a package of measures which include problem solving therapy, postcards, patient support, cultural assessment, improved access to primary care and a risk management strategy in Maori who present to hospital after self harm using a novel design. Methods We propose to use a double consent Zelen design where participants are randomised prior to giving consent to enrol a representative cohort of patients. The main outcome will be the number of Maori scoring below nine on the Beck Hopelessness Scale. Secondary outcomes will be hospital repetition at one year; self reported self harm; anxiety; depression; quality of life; social function; and hospital use at three months and one year. Discussion A strength of the study is that it is a pragmatic trial which aims to recruit Maori using a Maori clinical team and protocol. It does not exclude people if English is not their first language. A potential limitation is the analysis of the results which is complex and may underestimate any effect if a large number of people refuse their consent in the group randomised to problem solving therapy as they will effectively cross over to the treatment as usual group. This study is the first randomised control trial to explicitly use cultural assessment and management. Trial

  4. Cellular Phone Towers, Cell tower locations as derived from various sources including the Department of Licenses and Inspections and the Department of Planning and Zoning., Published in 2010, 1:2400 (1in=200ft) scale, Howard County Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Cellular Phone Towers dataset current as of 2010. Cell tower locations as derived from various sources including the Department of Licenses and Inspections and the...

  5. Modular design of processing and storage facilities for small volumes of low and intermediate level radioactive waste including disused sealed sources

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-06-15

    A number of IAEA Member States generate relatively small quantities of radioactive waste and/or disused sealed sources in research or in the application of nuclear techniques in medicine and industry. This publication presents a modular approach to the design of waste processing and storage facilities to address the needs of such Member States with a cost effective and flexible solution that allows easy adjustment to changing needs in terms of capacity and variety of waste streams. The key feature of the publication is the provision of practical guidance to enable the users to determine their waste processing and storage requirements, specify those requirements to allow the procurement of the appropriate processing and storage modules and to install and eventually operate those modules.

  6. An Online Q-learning Based Multi-Agent LFC for a Multi-Area Multi-Source Power System Including Distributed Energy Resources

    Directory of Open Access Journals (Sweden)

    H. Shayeghi

    2017-12-01

    Full Text Available This paper presents an online two-stage Q-learning based multi-agent (MA controller for load frequency control (LFC in an interconnected multi-area multi-source power system integrated with distributed energy resources (DERs. The proposed control strategy consists of two stages. The first stage is employed a PID controller which its parameters are designed using sine cosine optimization (SCO algorithm and are fixed. The second one is a reinforcement learning (RL based supplementary controller that has a flexible structure and improves the output of the first stage adaptively based on the system dynamical behavior. Due to the use of RL paradigm integrated with PID controller in this strategy, it is called RL-PID controller. The primary motivation for the integration of RL technique with PID controller is to make the existing local controllers in the industry compatible to reduce the control efforts and system costs. This novel control strategy combines the advantages of the PID controller with adaptive behavior of MA to achieve the desired level of robust performance under different kind of uncertainties caused by stochastically power generation of DERs, plant operational condition changes, and physical nonlinearities of the system. The suggested decentralized controller is composed of the autonomous intelligent agents, who learn the optimal control policy from interaction with the system. These agents update their knowledge about the system dynamics continuously to achieve a good frequency oscillation damping under various severe disturbances without any knowledge of them. It leads to an adaptive control structure to solve LFC problem in the multi-source power system with stochastic DERs. The results of RL-PID controller in comparison to the traditional PID and fuzzy-PID controllers is verified in a multi-area power system integrated with DERs through some performance indices.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-05-15

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

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  9. The choice of primary energy source including PV installation for providing electric energy to a public utility building - a case study

    Science.gov (United States)

    Radomski, Bartosz; Ćwiek, Barbara; Mróz, Tomasz M.

    2017-11-01

    The paper presents multicriteria decision aid analysis of the choice of PV installation providing electric energy to a public utility building. From the energy management point of view electricity obtained by solar radiation has become crucial renewable energy source. Application of PV installations may occur a profitable solution from energy, economic and ecologic point of view for both existing and newly erected buildings. Featured variants of PV installations have been assessed by multicriteria analysis based on ANP (Analytic Network Process) method. Technical, economical, energy and environmental criteria have been identified as main decision criteria. Defined set of decision criteria has an open character and can be modified in the dialog process between the decision-maker and the expert - in the present case, an expert in planning of development of energy supply systems. The proposed approach has been used to evaluate three variants of PV installation acceptable for existing educational building located in Poznań, Poland - the building of Faculty of Chemical Technology, Poznań University of Technology. Multi-criteria analysis based on ANP method and the calculation software Super Decisions has proven to be an effective tool for energy planning, leading to the indication of the recommended variant of PV installation in existing and newly erected public buildings. Achieved results show prospects and possibilities of rational renewable energy usage as complex solution to public utility buildings.

  10. Health effects of an increased protein intake on kidney function and colorectal cancer risk factors, including the role of animal and plant protein sources – the PREVIEW project

    DEFF Research Database (Denmark)

    Møller, Grith

    intake, including the role of animal and plant protein in pre-diabetic, overweight or obese individuals on health outcomes: markers of kidney function and putative risk factors for colorectal cancer as well as insulin sensitivity and kidney function in healthy individuals. The thesis is based on PREVIEW......, especially plant protein, on insulin sensitivity and kidney function. In paper II, the aim of the study was to assess the effect after one year of a higher protein intake on kidney function, measured by in creatinine clearance. This was investigated in pre-diabetic older adults based on a sub-group of 310...... pre-diabetic individuals included in the PREVIEW RCT. We found that a higher protein intake was associated with a significant increase in urea to creatinine ratio and serum urea after one year. There were no associations between increased protein intake and creatinine clearance, estimated glomerular...

  11. Low dose rate 137Cs Brachytherapy source calibration with farmer type ionisation chamber and specialised fabricated jig in Korle-Bu Teaching Hospital

    International Nuclear Information System (INIS)

    Opare-Asare, K.

    2013-06-01

    An important part of a general quality assurance (QA) program for brachytherapy dosimetry is the source calibration because wide ranges of uncertainties are quoted by manufactures. This research is aimed at calibrating LDR 137 Cs brachytherapy source in the Korle-Bu Teaching Hospital by multiple-distance air kerma measurement technique using a specialized designed jig and a calibrated therapy ionization chamber. Specialized jig was fabricated with source holder positions and ionization chamber positions on the jig. Farmer type ionization chamber of volume 0.6cm 3 was used with and without build up cap. The results were validated using well type ionization chamber on channels on 1 and 5 taking into account decay correction. Air Kerma rates were determined at multiple distances between 8cm to 12cm from measured charges recorded by Max 4000 electrometer. The scatter dose relationship described by Ezzell [1992] was used to determine scattered radiation. The analytical method of determining air kerma calibration factor of 137 Cs described by Sharma et.al [2011] was used to determine beam quality correction factor for the 137 Cs. Beam attenuation was determined. Experimental data were compared with manufacturer's quoted source strength for verification. Well type ionization chamber results and experimental results on channel V1 and V5 deviated by 2.39% and 1.58% respectively. Experimental data deviated by 4.73% and 1.24% from theoretical data on channels V1 and V5 respectively. The mean of the experimental data deviated from the theoretical data by ±3.1% and from the well type measurements data by ±1.98%. The well type chamber results compared well with the experimental data. This is an indication that the method used for source calibration is a reliable alternative method of source calibration. The method used in this work has proven to be an efficient way of determining the actual source strength of the LDR brachytherapy 137 Cs source in Korle-Bu Radiotherapy Centre

  12. A qualitative study of patient involvement in medicines management after hospital discharge: an under-recognised source of systems resilience.

    Science.gov (United States)

    Fylan, Beth; Armitage, Gerry; Naylor, Deirdre; Blenkinsopp, Alison

    2017-11-16

    There are risks to the safety of medicines management when patient care is transferred between healthcare organisations, for example, when a patient is discharged from hospital. Using the theoretical concept of resilience in healthcare, this study aimed to better understand the proactive role that patients can play in creating safer, resilient medicines management at a common transition of care. Qualitative interviews with 60 cardiology patients 6 weeks after their discharge from 2 UK hospitals explored patients' experiences with their discharge medicines. Data were initially subjected to an inductive thematic analysis and a subsequent theory-guided deductive analysis. During interviews 23 patients described medicines management resilience strategies in two main themes: identifying system vulnerabilities; and establishing self-management strategies. Patients could anticipate problems in the system that supplied them with medicines and took specific actions to prevent them. They also identified when errors had occurred both before and after medicines had been supplied and took corrective action to avoid harm. Some reported how they had not foreseen problems or experienced patient safety incidents. Patients recounted how they ensured information about medicines changes was correctly communicated and acted upon, and described their strategies to enhance their own reliability in adherence and resource management. Patients experience the impact of vulnerabilities in the medicines management system across the secondary-primary care transition but many are able to enhance system resilience through developing strategies to reduce the risk of medicines errors occurring. Consequently, there are opportunities-with caveats-to elicit, develop and formalise patients' capabilities which would contribute to safer patient care and more effective medicines management. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

  13. Assessment of ultrasound equipment as a possible source of nosocomial infection in Lagos state hospitals and radio-diagnostic centres

    International Nuclear Information System (INIS)

    Akpochafor, M.O.; Eze, C.U.; Adeneye, S.O.; Ajekigbe, A.T.

    2015-01-01

    Aim: To assess the role of ultrasound equipment as a possible source of nosocomial infection in Lagos metropolis, Nigeria. Methods: Microbiological cultures were carried out on samples obtained from ultrasound probes, gel and couch before and after scanning period. Cultures were incubated in a culture plate (Chocolate and MacConkey agar) for 48 h at a temperature of 37 ° in order to grow microorganism, after which the culture plate was examined microscopically against a bright light in order to identify the isolated organisms based on their colonial characteristics. Results: Transabdominal ultrasound probes, transvaginal probe, ultrasound couch and ultrasound gel all were contaminated with microorganisms. Staphylococcus aureus was the most frequent and most common organisms found (33.8%). Other organisms such as Staphylococcus epidermidis (15.4%), Candida albicans (6.2%), aerobic spore formers (26.2%), Klebsiella pneumonia (6.2%), Pseudomonas aeruginosa (3.1%), among others were also identified. Conclusion: The ultrasound equipment posed a significant risk for infection transmission. Patients who underwent ultrasonography within the period of the study had significant chances of being infected with Staphylococcus aureus, S. epidermidis and Aerobic spore formers. - Highlights: • Ultrasound equipment has been shown to be a possible source of nosocomial infection for patient undergoing ultrasonography. • The study showed that Staphylococcus aureus was the most commonly isolated organism. • Transabdominal probe was the most commonly contaminated ultrasound equipment in the finding. • The ultrasound gel was also contaminated with organisms like S. aureus, etc. • There was a statistical significant difference between site of collection of sample and growth density of microorganisms (p = 0.03)

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

    Science.gov (United States)

    Chang, Xiaotian; Meyer, M.T.; Liu, Xiuying; Zhao, Q.; Hao, Chen; Chen, J.-a.; Qiu, Z.; Yang, L.; Cao, J.; Shu, W.

    2010-01-01

    Sewage samples from 4 hospitals, 1 nursery, 1 slaughter house, 1 wastewater treatment plant and 5 source water samples of Chongqing region of Three Gorge Reservoir were analyzed for macrolide, lincosamide, trimethoprim, fluorouinolone, sulfonamide and tetracycline antibiotics by online solid-phase extraction and liquid chromatography-tandem mass spectrometry. Results showed that the concentration of ofloxacin (OFX) in hospital was the highest among all water environments ranged from 1.660????g/L to 4.240????g/L and norfloxacin (NOR, 0.136-1.620????g/L), ciproflaxacin (CIP, ranged from 0.011????g/L to 0.136????g/L), trimethoprim (TMP, 0.061-0.174????g/L) were commonly detected. Removal range of antibiotics in the wastewater treatment plant was 18-100% and the removal ratio of tylosin, oxytetracycline and tetracycline were 100%. Relatively higher removal efficiencies were observed for tylosin (TYL), oxytetracycline (OXY) and tetracycline (TET)(100%), while lower removal efficiencies were observed for Trimethoprim (TMP, 1%), Epi-iso-chlorotetracycline (EICIC, 18%) and Erythromycin-H2O (ERY-H2O, 24%). Antibiotics were removed more efficiently in primary treatment compared with those in secondary treatment. ?? 2009 Elsevier Ltd. All rights reserved.

  15. Efficacy and safety of ceftazidime-avibactam versus imipenem-cilastatin in the treatment of complicated urinary tract infections, including acute pyelonephritis, in hospitalized adults: results of a prospective, investigator-blinded, randomized study.

    Science.gov (United States)

    Vazquez, José A; González Patzán, Luis Demetrio; Stricklin, David; Duttaroy, Dipesh D; Kreidly, Zouheir; Lipka, Joy; Sable, Carole

    2012-12-01

    The aim of this prospective phase II, randomized, investigator-blinded study (NCT00690378) was to compare the efficacy and safety of ceftazidime-avibactam and imipenem-cilastatin in hospitalized adults with serious complicated urinary tract infection (cUTI) due to Gram-negative pathogens. Patients aged between 18 and 90 years with cUTI were enrolled and stratified by infection type (acute pyelonephritis or other cUTI) and randomized 1:1 to receive intravenous ceftazidime 500 mg plus avibactam 125 mg every 8 hours or imipenem-cilastatin 500 mg every 6 hours. Patients meeting pre-specified improvement criteria after 4 days could be switched to oral ciprofloxacin. Patients were treated for a total of 7-14 days. The primary efficacy objective was a favorable microbiological response at the test-of-cure (TOC) visit 5-9 days post-therapy in microbiologically evaluable (ME) patients. Overall, 135 patients received study therapy (safety population); 62 were included in the ME population (ceftazidime-avibactam, n = 27; imipenem-cilastatin, n = 35). The predominant uropathogen was Escherichia coli. Favorable microbiological response was achieved in 70.4% of ME patients receiving ceftazidime-avibactam and 71.4% receiving imipenem-cilastatin at the TOC visit (observed difference -1.1% [95% CI: -27.2%, 25.0%]). Among ME patients with ceftazidime-resistant uropathogens, response was observed in 6/7 (85.7%) receiving ceftazidime-avibactam. Adverse events were observed in 67.6% and 76.1% of patients receiving ceftazidime-avibactam and imipenem-cilastatin, respectively. Limitations of the study include the small number of patients in the ME population. The results suggest that the efficacy and safety of ceftazidime-avibactam may be similar to that of imipenem-cilastatin.

  16. Quality assessment of out sourced after-hours computed tomography teleradiology reports in a Central London University Hospital

    International Nuclear Information System (INIS)

    Hohmann, Joachim; Villiers, Petrie de; Urigo, Carlo; Sarpi, Dino; Newerla, Caroline; Brookes, Jocelyn

    2012-01-01

    The study was designed to assess the quality of out sourced after-hours computed tomography teleradiology service reports. We evaluated 1028 patients over a time period of five month in 2009/2010 (437 female, 591 male, mean age: 51 years, range: 0–97 years) who were referred either by the A and E or other in house departments from 7 pm to 8 am for different reasons. Reporting was done by a teleradiology service provider located in the UK and Australia. Reports were assessed during the routinely performed morning meeting by a panel of in house radiologists. Assessment was done by a five point agreement scale (5 = “No disagreement”, 1 = “…unequivocal potential for serious morbidity or threat to life”). In 811 (79%) patients no disagreement was found, 164 (16%) were rated as category 4, 40 (4%) as category 3 (“…likelihood of harm is low”). In 13 (1.3%) patients a decision of category 2 was made (“…strong likelihood of moderate morbidity but not threat to life”). No category 1 decision was made. As this was just a discrepancy decision, a follow up of the category 2 patients was done over a period of a maximum of 6 months. In 8 (0.8%) patients the in house reports were correct, in 2 (0.2%) patients the teleradiology service provider was right and in 3 (0.3%) patients the final diagnoses remained unclear. In conclusion there was a small rate (0.8%) of proven serious misinterpretations by the teleradiology service provider, but these were less than in comparable studies with preliminary in house staff reports (1.6–24.6%).

  17. Cities, Towns and Villages, We have the county boundaries including Hephzibah, and Blyth, with roads, parcels, schools, hospitals, fire stations, historic areas.points of interest, etc., Published in 2007, 1:1200 (1in=100ft) scale, Augusta-Richmond County Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Cities, Towns and Villages dataset current as of 2007. We have the county boundaries including Hephzibah, and Blyth, with roads, parcels, schools, hospitals, fire...

  18. Radiation protection in hospitals

    International Nuclear Information System (INIS)

    MOuld, R.F.

    1985-01-01

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

  19. Hospital infections waste and its proper disposal

    International Nuclear Information System (INIS)

    Bhatti, A.Q.; Memon, A.A.; Mahar, R.B.

    2002-01-01

    Hazardous hospital waste is a unique in several ways. There are a large variety of wastes but volume is a small relative to industrial wastes. Hospital infections solid waste is getting to be serious problem day by day. This waste contribute to the overall pollution in the city; much of it is also hazardous, thus putting at risk the health of those who come into contact with it. This paper addresses the various aspects of incineration, recycling and landfill process with detailed illustration. Hospital waste management in rural hospitals of Pakistan with particular reference to Gambat Hospital is discussed in this paper, including study of existing waste management system, estimation of waste production per day from different sources of Hospital and suitable waste management system is recommended. (author)

  20. The impact of nurse working hours on patient safety culture: a cross-national survey including Japan, the United States and Chinese Taiwan using the Hospital Survey on Patient Safety Culture

    OpenAIRE

    Wu, Yinghui; Fujita, Shigeru; Seto, Kanako; Ito, Shinya; Matsumoto, Kunichika; Huang, Chiu-Chin; Hasegawa, Tomonori

    2013-01-01

    Background A positive patient safety culture (PSC) is one of the most critical components to improve healthcare quality and safety. The Hospital Survey on Patient Safety Culture (HSOPS), developed by the US Agency for Healthcare Research and Quality, has been used to assess PSC in 31 countries. However, little is known about the impact of nurse working hours on PSC. We hypothesized that long nurse working hours would deteriorate PSC, and that the deterioration patterns would vary between coun...

  1. (including travel dates) Proposed itinerary

    Indian Academy of Sciences (India)

    Ashok

    31 July to 22 August 2012 (including travel dates). Proposed itinerary: Arrival in Bangalore on 1 August. 1-5 August: Bangalore, Karnataka. Suggested institutions: Indian Institute of Science, Bangalore. St Johns Medical College & Hospital, Bangalore. Jawaharlal Nehru Centre, Bangalore. 6-8 August: Chennai, TN.

  2. Can hospitals compete on quality? Hospital competition.

    Science.gov (United States)

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

    2015-09-01

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

  3. Unplanned Hospital Visits - National

    Data.gov (United States)

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

  4. The impact of nurse working hours on patient safety culture: a cross-national survey including Japan, the United States and Chinese Taiwan using the Hospital Survey on Patient Safety Culture.

    Science.gov (United States)

    Wu, Yinghui; Fujita, Shigeru; Seto, Kanako; Ito, Shinya; Matsumoto, Kunichika; Huang, Chiu-Chin; Hasegawa, Tomonori

    2013-10-07

    A positive patient safety culture (PSC) is one of the most critical components to improve healthcare quality and safety. The Hospital Survey on Patient Safety Culture (HSOPS), developed by the US Agency for Healthcare Research and Quality, has been used to assess PSC in 31 countries. However, little is known about the impact of nurse working hours on PSC. We hypothesized that long nurse working hours would deteriorate PSC, and that the deterioration patterns would vary between countries. Moreover, the common trends observed in Japan, the US and Chinese Taiwan may be useful to improve PSC in other countries. The purpose of this study was to clarify the impact of long nurse working hours on PSC in Japan, the US, and Chinese Taiwan using HSOPS. The HSOPS questionnaire measures 12 sub-dimensions of PSC, with higher scores indicating a more positive PSC. Odds ratios (ORs) were calculated using a generalized linear mixed model to evaluate the impact of working hours on PSC outcome measures (patient safety grade and number of events reported). Tukey's test and Cohen's d values were used to verify the relationships between nurse working hours and the 12 sub-dimensions of PSC. Nurses working ≥60 h/week in Japan and the US had a significantly lower OR for patient safety grade than those working working ≥40 h/week had a significantly higher OR for the number of events reported. The mean score on 'staffing' was significantly lower in the ≥60-h group than in the Japan and Chinese Taiwan. Patient safety grade deteriorated and the number of events reported increased with long working hours. Among the 12 sub-dimensions of PSC, long working hours had an impact on 'staffing' and 'teamwork within units' in Japan, the US and Chinese Taiwan.

  5. The effect of chain membership on hospital costs.

    Science.gov (United States)

    Menke, T J

    1997-06-01

    To compare the cost structures of hospitals in multihospital systems and independently owned hospitals. The American Hospital Association's Annual Survey from 1990 for data on hospital costs and attributes. Area characteristics came from the Area Resource File, and the Medicare case-mix index came from the Health Care Financing Administration. Data on wages are from the Bureau of the Census' State and Metropolitan Area Data Book. The Guide to Hospital Performance from HCIA, Inc. provided data on quality of care. Separate cost functions were estimated for chain and independent hospitals. Hybrid translog cost functions included measures of outputs, input prices, and hospital and area characteristics. The estimation method accounted for the simultaneous determination of costs and chain membership, and for any nonrandom selection of hospitals into chains. Several economic cost measures were calculated to compare the cost structures of the two types of hospitals. Data from all sources were merged at the hospital level to form the study sample. Hospitals in multihospital systems were less costly than independently owned hospitals. Among independent hospitals, for-profits had the highest costs. There were no statistically significant differences in costs by ownership among chain members. Economies of scale were enjoyed in both types of hospitals only at high volumes of output, while economies of scope occurred at all volumes for chain hospitals, but only at low and medium volumes for independent hospitals. This study provides support for the idea that growth of the multihospital system sector can provide a market solution to the problem of constraining costs. It does not, however, support the property rights theory that proprietary hospitals are more efficient than nonprofit hospitals.

  6. Source Reference File

    Data.gov (United States)

    Social Security Administration — This file contains a national set of names and contact information for doctors, hospitals, clinics, and other facilities (known collectively as sources) from which...

  7. Hospital Compare

    Data.gov (United States)

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

  8. HCAHPS - Hospital

    Data.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Manish Kumar Manar

    2014-01-01

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

  10. Hospital and urban effluent waters as a source of accumulation of toxic metals in the sediment receiving system of the Cauvery River, Tiruchirappalli, Tamil Nadu, India.

    Science.gov (United States)

    Devarajan, Naresh; Laffite, Amandine; Ngelikoto, Patience; Elongo, Vicky; Prabakar, Kandasamy; Mubedi, Josué I; Piana, Pius T M; Wildi, Walter; Poté, John

    2015-09-01

    Hospital and urban effluents contain a variety of toxic and/or persistent substances in a wide range of concentrations, and most of these compounds belong to the group of emerging contaminants. The release of these substances into the aquatic ecosystem can lead to the pollution of water resources and may place aquatic organisms and human health at risk. Sediments receiving untreated and urban effluent waters from the city of Tiruchirappalli in the state of Tamil Nadu, India, are analyzed for potential environmental and human health risks. The sediment samples were collected from five hospital outlet pipes (HOP) and from the Cauvery River Basin (CRB) both of which receive untreated municipal effluent waters (Tiruchirappalli, Tamil Nadu, India). The samples were characterized for grain size, organic matter, toxic metals, and ecotoxicity. The results highlight the high concentration of toxic metals in HOP, reaching values (mg kg(-1)) of 1851 (Cr), 210 (Cu), 986 (Zn), 82 (Pb), and 17 (Hg). In contrast, the metal concentrations in sediments from CRB were lower than the values found in the HOP (except for Cu, Pb), with maximum values (mg kg(-1)) of 75 (Cr), 906 (Cu), 649 (Zn), 111 (Pb), and 0.99 (Hg). The metal concentrations in all sampling sites largely exceed the Sediment Quality Guidelines (SQGs) and the Probable Effect Concentration (PEC) for the Protection of Aquatic Life recommendation. The ecotoxicity test with ostracods exposed to the sediment samples presents a mortality rate ranging from 22 to 100 % (in sediments from HOP) and 18-87 % (in sediments from CRB). The results of this study show the variation of toxic metal levels as well as toxicity in sediment composition related to both the type of hospital and the sampling period. The method of elimination of hospital and urban effluents leads to the pollution of water resources and may place aquatic organisms and human health at risk.

  11. A comparative study of financial data sources for critical access hospitals: audited financial statements, the Medicare cost report, and the Internal Revenue Service form 990.

    Science.gov (United States)

    Ozmeral, Alisha Bhadelia; Reiter, Kristin L; Holmes, George M; Pink, George H

    2012-01-01

    Medicare cost reports (MCR), Internal Revenue Service form 990s (IRS 990), and audited financial statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across the MCR, IRS 990, and AFS for a sample of nonprofit critical access hospitals (CAHs). Line items from AFS of 47 CAHs were compared to data reported in the hospitals' MCR and IRS 990s. Line items were based on 9 financial indicators commonly used to assess hospital financial performance. Of the indicators examined, the equity financing ratio most frequently matched between the 3 reports, while salaries and benefits to total expenses and debt service coverage were often different. Variances were driven by differences in individual account balances used to construct the ratios. Relative to AFS, cash was frequently lower on the IRS 990 while marketable securities and unrestricted investments were often higher. Other revenue and net income were consistently lower on the MCR and IRS 990, and depreciation was often higher on the MCR. The majority of total assets and fund balance (equity) values matched across the 3 reports, suggesting differences in classification among detailed accounts were more common than variances between the component totals (total assets, total liabilities, and fund balance). Health policy researchers should consider the impact of these variances on study results and consider ways to improve the availability and quality of financial accounting information. © 2012 National Rural Health Association.

  12. Pseudomonas aeruginosa from hospital environment

    Directory of Open Access Journals (Sweden)

    Milind Davane

    2014-03-01

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

  13. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

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

  14. Hospital burden of road traffic injury: major concern in primary and secondary level hospitals in Bangladesh.

    Science.gov (United States)

    Mashreky, S R; Rahman, A; Khan, T F; Faruque, M; Svanström, L; Rahman, F

    2010-04-01

    To assess the burden of road traffic injury (RTI) in primary and secondary level hospitals in Bangladesh, and its economic impact on affected families. Cross-sectional study. The study was carried out in February and March 2001. To estimate the burden of RTI patients and the length of stay in hospital, the discharge records of primary and secondary level hospitals were used as data sources. Records from 16 district hospitals and 45 Upazila health complexes (subdistrict level hospitals), selected at random, were included in this study. A direct interview method was adopted to estimate the patient costs of RTI; this involved interviewing patients or their attendants. In this study, patient costs included money spent by the patient for medicine, transport, food and lodging (including attendants). Approximately 33% of the beds in primary and secondary level hospitals in Bangladesh were occupied by injury-related patients, and more than 19% of the injury patients had been injured in a road traffic accident. People aged 18-45 years were the major victims of RTI, and constituted 70% of the total RTI-related admissions in primary and secondary level hospitals. More than two-thirds of RTI patients were male. The average duration of hospital stay was 5.7 days, and the average patient cost for each RTI patient was US$86 (5834 BDT). RTI is a major cause of hospital admission in Bangladesh, and represents an economic and social burden for the family and the nation. A national strategy and road safety programme need to be developed to reduce the hospital burden and minimize the economic and social impact. 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Perceived sources of work stress and satisfaction among hospital and community mental health staff, and their relation to mental health, burnout and job satisfaction.

    Science.gov (United States)

    Prosser, D; Johnson, S; Kuipers, E; Szmukler, G; Bebbington, P; Thornicroft, G

    1997-07-01

    This questionnaire study examined perceived sources of stress and satisfaction at work among 121 mental health staff members. Five factors were derived from principal component analysis of sources of work stress items (stress from: role, poor support, clients, future, and overload), and accounted for 70% of the total variance. Four factors were derived from the items related to sources of job satisfaction (satisfaction from: career, working with people, management, and money), accounting for 68% of the variance. The associations of these factors with sociodemographic and job characteristics were examined, and they were entered as explanatory variables into regression models predicting mental health, burnout, and job satisfaction. Stress from "overload" was associated with being based outside an in-patient ward, and with emotional exhaustion and worse mental health. Stress related to the "future" was associated with not being white. Stress from "clients" was associated with the "depersonalization" component of burnout. Higher job satisfaction was associated with "management" and "working with people" as sources of satisfaction, whereas emotional exhaustion and poorer mental health were associated with less "career" satisfaction.

  16. The marketing of partial hospitalization.

    Science.gov (United States)

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

    1987-09-01

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

  17. Hospitality Services Reference Book.

    Science.gov (United States)

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

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

  18. Quantification classification and management of hospital waste in Lahore city

    International Nuclear Information System (INIS)

    Khan, M.R.; Riaz, M

    2010-01-01

    Systematic disposal of hospital waste is a major problem encountered by different countries including Pakistan. Efforts are on the way to achieve this objective techno-economically. To quantify infectious and total waste produced by the hospitals of Lahore, classify it to know the nature of their components and to collect information about its management. The background information and secondary data were collected by consultation of literature in the libraries and visiting different websites on Internet. The primary data were collected by gathering the responses of the Chief Executives, Medical Superintendents and Medical and Environmental Staff of all hospitals scheduled as reference models through interview. The total quantity of infectious waste produced by the hospitals and other health care units is approximately 785 million tons per annum while the total waste including municipal component is approximately 3,925 million tons per annum. The current status of awareness about proper health care waste disposal is improving but at a slow pace. It may be concluded that the management of hospital waste in five hospitals of Lahore city is systematic. However, the staff handling the waste was not fully trained for proper segregation of the hospital wastes. Incinerators being used for waste disposal are a major source of secondary air pollution therefore, this method should be discouraged. Instead, the feasibility of thermoelectric power generation may be looked into. Proper disposal of hospital wastes should be in placed in every hospital and trained staff should be employed for the job. (author)

  19. Hospital diversification strategy.

    Science.gov (United States)

    Eastaugh, Steven R

    2014-01-01

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

  20. Guides to pollution prevention: Selected hospital waste streams

    International Nuclear Information System (INIS)

    1990-06-01

    The hazardous wastes generated by general medical and surgical hospitals are small in volume relative to those of industrial facilities; however, the wastes are of a wide variety. Some of the hazardous materials used by hospitals that become part of their waste streams include chemotherapy and antineoplastic chemicals, solvents, formaldehyde, photographic chemicals, radionuclides, mercury, waste anesthetic gases; and other toxic, corrosive and miscellaneous chemicals. Additional wastes such as infectious waste, incinerator exhaust, laundry-related waste, utility wastes, and trash were not addressed in the guide. Reducing the generation of these materials at the source, or recycling the wastes on- or off-site, will benefit hospitals by reducing disposal costs and lowering the liabilities associated with hazardous waste disposal. The guide provides an overview of hospital waste generating processes and presents options for minimizing waste generation through source reduction and recycling

  1. New seismograph includes filters

    Energy Technology Data Exchange (ETDEWEB)

    1979-11-02

    The new Nimbus ES-1210 multichannel signal enhancement seismograph from EG and G geometrics has recently been redesigned to include multimode signal fillers on each amplifier. The ES-1210F is a shallow exploration seismograph for near subsurface exploration such as in depth-to-bedrock, geological hazard location, mineral exploration, and landslide investigations.

  2. Sources of funding for adult and paediatric CT procedures at a metropolitan tertiary hospital: How much do Medicare statistics really cover?

    Science.gov (United States)

    Hayton, Anna; Wallace, Anthony; Johnston, Peter

    2015-12-01

    The radiation dose to the Australian paediatric population as a result of medical imaging is of growing concern, in particular the dose from CT. Estimates of the Australian population dose have largely relied on Medicare Australia statistics, which capture only a fraction of those imaging procedures actually performed. The fraction not captured has been estimated using a value obtained for a survey of the adult population in the mid-1990s. To better quantify the fraction of procedures that are not captured by Medicare Australia, procedure frequency and funding data for adult and paediatric patients were obtained from a metropolitan tertiary teaching and research hospital. Five calendar years of data were obtained with a financial class specified for each individual procedure. The financial classes were grouped to give the percentage of Medicare Australia billable procedures for both adult and paediatric patients. The data were also grouped to align with the Medicare Australia age cohorts. The percentage of CT procedures billable to Medicare Australia increased from 16% to 28% between 2008 and 2012. In 2012, the percentage billable for adult and paediatric patients was 28% and 33%, respectively; however, many adult CT procedures are performed at stand-alone clinics, which bulk bill. Using Medicare Australia statistics alone, the frequency of paediatric CT procedures performed on the Australian paediatric population will be grossly under estimated. A correction factor of 4.5 is suggested for paediatric procedures and 1.5 for adult procedures. The fraction of actual procedures performed that are captured by Medicare Australia will vary with time. © 2015 The Royal Australian and New Zealand College of Radiologists.

  3. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  4. Hospital operations management: improving organizational efficiency.

    Science.gov (United States)

    2013-08-01

    Reducing operational inefficiencies represents one of the most promising sources of potential savings in hospitals today. Health Forum convened a panel of hospital executives and industry experts to discuss the daunting challenges and big opportunities that lie ahead.

  5. Financially fragile rural hospitals: mergers and closures.

    Science.gov (United States)

    Holmes, Mark

    2015-01-01

    Rural hospitals serve as major sources of health care and employment for their communities, but recently they have been under increased financial stress. What are the causes of this stress, and how have hospitals and their communities responded?

  6. Analytic device including nanostructures

    KAUST Repository

    Di Fabrizio, Enzo M.; Fratalocchi, Andrea; Totero Gongora, Juan Sebastian; Coluccio, Maria Laura; Candeloro, Patrizio; Cuda, Gianni

    2015-01-01

    A device for detecting an analyte in a sample comprising: an array including a plurality of pixels, each pixel including a nanochain comprising: a first nanostructure, a second nanostructure, and a third nanostructure, wherein size of the first nanostructure is larger than that of the second nanostructure, and size of the second nanostructure is larger than that of the third nanostructure, and wherein the first nanostructure, the second nanostructure, and the third nanostructure are positioned on a substrate such that when the nanochain is excited by an energy, an optical field between the second nanostructure and the third nanostructure is stronger than an optical field between the first nanostructure and the second nanostructure, wherein the array is configured to receive a sample; and a detector arranged to collect spectral data from a plurality of pixels of the array.

  7. Saskatchewan resources. [including uranium

    Energy Technology Data Exchange (ETDEWEB)

    1979-09-01

    The production of chemicals and minerals for the chemical industry in Saskatchewan are featured, with some discussion of resource taxation. The commodities mentioned include potash, fatty amines, uranium, heavy oil, sodium sulfate, chlorine, sodium hydroxide, sodium chlorate and bentonite. Following the successful outcome of the Cluff Lake inquiry, the uranium industry is booming. Some developments and production figures for Gulf Minerals, Amok, Cenex and Eldorado are mentioned.

  8. Allegheny County Hospitals

    Data.gov (United States)

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

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

    Directory of Open Access Journals (Sweden)

    Glenn A. Melnick PhD

    2016-06-01

    Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

  10. Being Included and Excluded

    DEFF Research Database (Denmark)

    Korzenevica, Marina

    2016-01-01

    Following the civil war of 1996–2006, there was a dramatic increase in the labor mobility of young men and the inclusion of young women in formal education, which led to the transformation of the political landscape of rural Nepal. Mobility and schooling represent a level of prestige that rural...... politics. It analyzes how formal education and mobility either challenge or reinforce traditional gendered norms which dictate a lowly position for young married women in the household and their absence from community politics. The article concludes that women are simultaneously excluded and included from...... community politics. On the one hand, their mobility and decision-making powers decrease with the increase in the labor mobility of men and their newly gained education is politically devalued when compared to the informal education that men gain through mobility, but on the other hand, schooling strengthens...

  11. Radiation hazard control in hospitals

    International Nuclear Information System (INIS)

    Denley, H.V.

    1981-02-01

    This manual is designed to aid in the training of hospital personnel engaged in work with the more common sources of ionizing radiation. It emphasizes the essentials of safety procedures for users of radioisotopes and x-rays

  12. Funds for Treatment of Hospitalized Patients: Evidence from Bangladesh

    Science.gov (United States)

    Begum, Farhana; Hossain, Akmal

    2014-01-01

    ABSTRACT This study was designed to explore sources of funds for health expenditure of patients if they are hospitalized. We have included 379 patients of 3 private and 7 public hospitals to estimate total expenditure. Of them, 229 (60.4%) were from public and 150 (39.6%) from private hospitals. Mean expenditure was Tk 60,613.3 and 8,262.7, and duration of hospital stay was 10.7 and 11.8 days in private and public hospitals respectively. More than half (55%) of the patients from middle class were treated in private hospitals. Of them, 278 (74.0%) were funded by themselves, 48 (12.8%) by loan with interest rate of 100% to 180%, 23 (6.1%) by loan without interest, 17 (4.5%) by losing their fixed asset, and 4 (1.1%) by begging in the street. Most of the patients did bear expenditure by themselves, followed by loan with high interest rate. ‘Distress’ selling of property was also a source. Middle-class patients could be comfortable with expenditure if they were in public hospitals. PMID:25395909

  13. Funds for treatment of hospitalized patients: evidence from Bangladesh.

    Science.gov (United States)

    Begum, Farhana; Alam, Shahinul; Hossain, Akmal

    2014-09-01

    This study was designed to explore sources of funds for health expenditure of patients if they are hospitalized. We have included 379 patients of 3 private and 7 public hospitals to estimate total expenditure. Of them, 229 (60.4%) were from public and 150 (39.6%) from private hospitals. Mean expenditure was Tk 60,613.3 and 8,262.7, and duration of hospital stay was 10.7 and 11.8 days in private and public hospitals respectively. More than half (55%) of the patients from middle class were treated in private hospitals. Of them, 278 (74.0%) were funded by themselves, 48 (12.8%) by loan with interest rate of 100% to 180%, 23 (6.1%) by loan without interest, 17 (4.5%) by losing their fixed asset, and 4 (1.1%) by begging in the street. Most of the patients did bear expenditure by themselves, followed by loan with high interest rate. 'Distress' selling of property was also a source. Middle-class patients could be comfortable with expenditure if they were in public hospitals.

  14. Human milk use in Australian hospitals, 1949-1985.

    Science.gov (United States)

    Thorley, Virginia

    2012-07-01

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

  15. CMS penalizes 758 hospitals for safety incidents

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-12-01

    Full Text Available No abstract available. Article truncated after 150 words. The Centers for Medicare and Medicaid Services (CMS is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those were also fined last year, as reported by Kaiser Health News (1. Among the hospitals being financially punished are some well-known institutions, including Yale New Haven Hospital, Medstar Washington Hospital Center in DC, Grady Memorial Hospital, Northwestern Memorial Hospital in Chicago, Indiana University Health, Brigham and Womens Hospital, Tufts Medical Center, University of North Carolina Hospital, the Cleveland Clinic, Hospital of the University of Pennsylvania, Parkland Health and Hospital, and the University of Virginia Medical Center (Complete List of Hospitals Penalized 2016. In the Southwest the list includes Banner University Medical Center in Tucson, Ronald Reagan UCLA Medical Center, Stanford Health Care, Denver Health Medical Center and the University of New Mexico Medical Center (for list of Southwest hospitals see Appendix 1. In total, CMS ...

  16. Drug shortage management in Alabama hospital pharmacies

    Directory of Open Access Journals (Sweden)

    Oliver W. Holmes, III

    2013-01-01

    Full Text Available Purpose: The purpose of this study is to identify effective strategies used by Alabama hospitals to manage drug shortages. Moreover, this study aims to determine if there are any relationships among hospital size, utilization of a standard policy for drug shortage management and perceived usefulness of standard procedures for drug shortages. Methods: A paper survey was mailed to 129 hospital pharmacies in Alabama (per the Alabama Hospital Association directory. The survey consisted of 5 demographic questions, questions involving perception of current medication shortages, sources of information about shorted drugs, and frequency of discussion at P&T committee meetings. Most importantly, the survey contained questions about the use of a standard policy for handling drug shortages, the effectiveness of the policy if one is used, and an open-ended question asking the recipient to describe the policy being used. Results: A response rate of 55% was achieved as 71 surveys were completed and returned. Approximately 70% of the survey respondents described the current drug shortage issue as a top priority in their pharmacy department. The pharmacy distributor served as the primary source of information regarding drug shortages for 45% of the facilities. There is a direct relationship between size of hospital and likelihood of utilization of a standard policy or procedure for drug shortage management among the sample. The smaller facilities of the sample perceived their management strategies as effective more frequently than the larger hospitals. Conclusion: Common components of effective management strategies included extensive communication of shortage details and the ability to locate alternative products. The use of portable technology (e.g., Smart phones and tablets along with mobile applications may emerge as popular means for communicating drug product shortage news and updates within a facility or healthcare system.   Type: Original Research

  17. Drug shortage management in Alabama hospital pharmacies

    Directory of Open Access Journals (Sweden)

    Oliver W. Holmes III, Pharm.D. Candidate 2013

    2013-01-01

    Full Text Available Purpose: The purpose of this study is to identify effective strategies used by Alabama hospitals to manage drug shortages. Moreover, this study aims to determine if there are any relationships among hospital size, utilization of a standard policy for drug shortage management and perceived usefulness of standard procedures for drug shortages.Methods: A paper survey was mailed to 129 hospital pharmacies in Alabama (per the Alabama Hospital Association directory. The survey consisted of 5 demographic questions, questions involving perception of current medication shortages, sources of information about shorted drugs, and frequency of discussion at P&T committee meetings. Most importantly, the survey contained questions about the use of a standard policy for handling drug shortages, the effectiveness of the policy if one is used, and an open-ended question asking the recipient to describe the policy being used.Results: A response rate of 55% was achieved as 71 surveys were completed and returned. Approximately 70% of the survey respondents described the current drug shortage issue as a top priority in their pharmacy department. The pharmacy distributor served as the primary source of information regarding drug shortages for 45% of the facilities. There is a direct relationship between size of hospital and likelihood of utilization of a standard policy or procedure for drug shortage management among the sample. The smaller facilities of the sample perceived their management strategies as effective more frequently than the larger hospitals.Conclusion: Common components of effective management strategies included extensive communication of shortage details and the ability to locate alternative products. The use of portable technology (e.g., Smart phones and tablets along with mobile applications may emerge as popular means for communicating drug product shortage news and updates within a facility or healthcare system.

  18. Motorcycle crash-related emergency department visits and hospitalizations for traumatic brain injury in North Carolina.

    Science.gov (United States)

    Harmon, Katherine J; Marshall, Stephen W; Proescholdbell, Scott K; Naumann, Rebecca B; Waller, Anna E

    2015-01-01

    To examine statewide emergency department (ED) visit data for motorcycle crash morbidity and healthcare utilization due to traumatic brain injuries (TBIs) and non-TBIs. North Carolina ED data (2010-2012) and hospital discharge data (2009-2011). Statewide ED visits and hospitalizations due to injuries from traffic-related motorcycle crashes stratified by TBI status. Descriptive study. Descriptive statistics include age, sex, mode of transport, disposition, expected source of payment, hospital length of stay, and hospital charges. Over the study period, there were 18 780 ED visits and 3737 hospitalizations due to motorcycle crashes. Twelve percent of ED visits for motorcycle crashes and 26% of hospitalizations for motorcycle crashes had a diagnosis of TBI. Motorcycle crash-related hospitalizations with a TBI diagnosis had median hospital charges that were nearly $9000 greater than hospitalizations without a TBI diagnosis. Emergency department visits and hospitalizations due to motorcycle crashes with a TBI diagnosis consumed more healthcare resources than motorcycle crash-related ED visits and hospitalizations without a TBI diagnosis. Increased awareness of motorcyclists by other road users and increased use of motorcycle helmets are 2 strategies to mitigate the incidence and severity of motorcycle crash injuries, including TBIs.

  19. Removal of micropollutants during physicochemical pretreatment of Hospital Wastewater

    International Nuclear Information System (INIS)

    Suarez, S.; Omil, F.; Lema, J. M.

    2009-01-01

    The fate and occurrence of micro-pollutants, such as pharmaceuticals, hormones or cosmetic ingredients, has attracted an increasing attention in environmental research. The main sources for such compounds in the environment include domestic sewage. hospital effluents and discharges from the pharmaceutical manufacturing industry. The aim of the presented work was to analyse the efficiency of coagulation-flocculation and flotation processes for the pre-treatment of hospital wastewaters, focusing on the removal of 12 Pharmaceutical and Personal Care Products (PPCPs), including musk fragrances, anti-epileptics, tranquillisers, anti-inflammatory drugs, antibiotics and one iodinated contras media. (Author)

  20. Removal of micropollutants during physicochemical pretreatment of Hospital Wastewater

    Energy Technology Data Exchange (ETDEWEB)

    Suarez, S.; Omil, F.; Lema, J. M.

    2009-07-01

    The fate and occurrence of micro-pollutants, such as pharmaceuticals, hormones or cosmetic ingredients, has attracted an increasing attention in environmental research. The main sources for such compounds in the environment include domestic sewage. hospital effluents and discharges from the pharmaceutical manufacturing industry. The aim of the presented work was to analyse the efficiency of coagulation-flocculation and flotation processes for the pre-treatment of hospital wastewaters, focusing on the removal of 12 Pharmaceutical and Personal Care Products (PPCPs), including musk fragrances, anti-epileptics, tranquillisers, anti-inflammatory drugs, antibiotics and one iodinated contras media. (Author)

  1. Hospital Inspections

    Data.gov (United States)

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

  2. [Health, hospitality sector and tobacco industry].

    Science.gov (United States)

    Abella Pons, Francesc; Córdoba Garcia, Rodrigo; Suárez Bonel, Maria Pilar

    2012-11-01

    To present the strategies used by the tobacco industry to meet government regulatory measures of its products. To demonstrate the relationship between tobacco industry and the hospitality sector. Note that the arguments and strategies used routinely by the hospitality industry have been previously provided by the tobacco industry. Location of key documents by meta-search, links to declassified documents, specific websites of the tobacco and hospitality industry, news sources and published articles in health journals. This review reveals the close relationship between tobacco industry and hospitality sector. It highlights the strategies carried out by the tobacco industry, including strategic hoarding of information, public relations, lobbying, consultation program, smoker defence groups, building partnerships, intimidation and patronage. The arguments and strategies used by the hospitality industry to match point by point that used by the tobacco industry. These arguments are refutable from the point of view of public health as it is scientifically proven that totally smoke-free environments are the only way to protect non-smokers from tobacco smoke exposure and its harmful effects on health. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  3. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

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

  4. Exploring hospitality within hospital meals by means of visual methodologies

    DEFF Research Database (Denmark)

    Justesen, Lise

    2016-01-01

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

  5. Performance of interventional procedures in a day-hospital system

    International Nuclear Information System (INIS)

    Bae, Jae Ik; Park, Auh Whan; Cho, Hye Seon; Park, Eun Hee; Choi, Gap Suk; Lee, Seon Ju; Kim, Yong Woo; Juhn, Je Ryang

    2007-01-01

    We wanted to describe the practice and results of applying the day-hospital system in an interventional radiology clinic. From Oct. 2004 to Dec. 2005, the day-hospital system was applied to various interventional procedures with using a part of the recovery room of an angiography suite as a facility for hospital admission. The study included 91 cases in 73 patients. The source of the patient referral, the procedures, hospital courses and complications were analyzed and questionnaire surveys were conducted for the available 55 patients. Among the patients, 70% (n=64) were referred form other departments, 5% (n=5) from other hospitals, 5% (n=4) were new patients and 20% (n=18) were re-admissions. The procedures included gastrointestinal, biliary, urinary, hemodialysis related-and implantable port related interventions. 96% (n=87) of the patients were successfully discharged in a day and admission to the general ward was only 4% (n=4). Minor complications occurred after discharges in 3% (n=3). The questionnaire survey revealed that 96% (n=53) of the patients were satisfied with the service and they were not anxious after discharge. Most of common interventional procedures were safely done under the day-hospital system with the patients being highly satisfied. The day-hospital system can be a good tool for establishing admitting privileges for an interventional radiology clinic

  6. The health of hospitals and lessons from history: public health and sanitary reform in the Dublin hospitals, 1858-1898.

    Science.gov (United States)

    Fealy, Gerard M; McNamara, Martin S; Geraghty, Ruth

    2010-12-01

    The aim was to examine, critically, 19th century hospital sanitary reform with reference to theories about infection and contagion. In the nineteenth century, measures to control epidemic diseases focused on providing clean water, removing waste and isolating infected cases. These measures were informed by the ideas of sanitary reformers like Chadwick and Nightingale, and hospitals were an important element of sanitary reform. Informed by the paradigmatic tradition of social history, the study design was a historical analysis of public health policy. Using the methods of historical research, documentary primary sources, including official reports and selected hospital archives and related secondary sources, were consulted. Emerging theories about infection were informing official bodies like the Board of Superintendence of Dublin Hospitals in their efforts to improve hospital sanitation. The Board secured important reforms in hospital sanitation, including the provision of technically efficient sanitary infrastructure. Public health measures to control epidemic infections are only as effective as the state of knowledge of infection and contagion and the infrastructure to support sanitary measures. Today, public mistrust about the safety of hospitals is reminiscent of that of 150 years ago, although the reasons are different and relate to a fear of contracting antimicrobial-resistant infections. A powerful historical lesson from this study is that resistance to new ideas can delay progress and improved sanitary standards can allay public mistrust. In reforming hospital sanitation, policies and regulations were established--including an inspection body to monitor and enforce standards--the benefits of which provide lessons that resonate today. Such practices, especially effective independent inspection, could be adapted for present-day contexts and re-instigated where they do not exist. History has much to offer contemporary policy development and practice reform and

  7. Sistema hospitalar como fonte de informações para estimar a mortalidade neonatal e a natimortalidade The Brazilian hospital system as a source of information to estimate stillbirth and neonatal mortality rates

    Directory of Open Access Journals (Sweden)

    Joyce MA Schramm

    2000-06-01

    Full Text Available OBJETIVO: Apesar da reconhecida importância em acompanhar a evolução temporal da mortalidade infantil precoce, a deficiência das estatísticas vitais no Brasil ainda permanece na agenda atual dos problemas que impedem o seu acompanhamento espaço-temporal. Realizou-se estudo com o objetivo de investigar o Sistema de Informações Hospitalares (SIH/SUS como fonte de informações, para estimar a natimortalidade e a mortalidade neonatal. MÉTODOS: Propõe-se um método para estimar a natimortalidade e a mortalidade neonatal, o qual foi aplicado para todos os Estados das regiões Nordeste, Sul e Sudeste e para o Pará, no ano de 1995. Para fins comparativos, o Sistema de Informações sobre Mortalidade (SIM/MS foi utilizado para estimar as taxas sob estudo, após a correção do número de nascidos vivos por um método demográfico. RESULTADOS: O SIH/SUS forneceu mais óbitos fetais e neonatais precoces do que o SIM/MS em grande parte das unidades federadas da região Nordeste. Adicionalmente para os Estados localizados nas regiões Sul e Sudeste, que apresentam, em geral, boa cobertura do registro de óbitos, as taxas calculadas pelos dois sistemas de informação tiveram valores semelhantes. CONCLUSÕES: Considerando a cobertura incompleta das estatísticas vitais no Brasil e a agilidade do SIH/SUS em disponibilizar as informações em meio magnético, conclui-se que o uso do SIH/SUS poderá trazer inúmeras contribuições para análise do comportamento espaço-temporal do componente neonatal da mortalidade infantil no território brasileiro, em anos recentes.OBJECTIVE: Studies on the evolution of infant mortality rate are very relevant. Nevertheless, lack of vital statistics in Brazil limits the temporal and spatial analysis of this indicator. This study aims to investigate the possible use of the Brazilian Hospital Information System as an alternative information source for stillbirth and neonatal mortality rates by age group. METHODS: A

  8. Sources of polarized neutrons

    International Nuclear Information System (INIS)

    Walter, L.

    1983-01-01

    Various sources of polarized neutrons are reviewed. Monoenergetic source produced with unpolarized or polarized beams, white sources of polarized neutrons, production by transmissions through polarized hydrogen targets and polarized thermal neutronsare discussed, with appropriate applications included. (U.K.)

  9. Pacemakers lower sources

    International Nuclear Information System (INIS)

    Greatbatch, W.

    1984-01-01

    Energy sources for cardiac facing are considered including radioisotope sources, in a broad conceptual and historical framework.The main guidelines for future development of energy sources are assessed

  10. Hospital Acquisitions Before Healthcare Reform.

    Science.gov (United States)

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

    2015-01-01

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

  11. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

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

  12. Healthcare-associated infection in Burkina Faso: an assessment in a district hospital

    Directory of Open Access Journals (Sweden)

    Hervé Hien

    2012-12-01

    Full Text Available In developing countries, few data are available on healthcare-associated infections. In Burkina Faso, there has been a failure to take into account risk management and patient safety in the quality assurance program. The main objective of our study was to carry out an assessment of healthcare-associated infection in a first level hospital. We conducted a crosssectional study in June 2011 in the care units of Ziniaré District Hospital (Ziniaré, Burkina Faso. The hospital has been divided in three components: i hospital population (care providers, in-patients and patients’ guardians; ii healthcare and services organization; iii hospital environment. We included: care providers of the clinical services, hospital inpatients and patients’ guardians, hospitalization infrastructure and nursing units, and all the documents relating to standards and protocols. Data collection has been done by direct observation, interviews and biological samples taken at different settings. In hospital population, care providers and patients’ guardians represented a high source of infection: adherence to hygiene practice on the part of care providers was low (12/19, and no patients’ guardian experienced good conditions of staying in the hospital. In healthcare and services organization, healthcare waste management represented a high-risk source of infection. In hospital environment, hygiene level of the infrastructure in the hospital rooms was low (6.67%. Prevalence of isolated bacteria was 71.8%. Urinary-tract catheters infections were the most significant in our sample, followed by surgical-site infections. In total, 56.26% (9/19 of germs were -Lactamase producers (ESBL. They were represented by Escherichia coli and Klebsiella pneumoniae. Our analysis identified clearly healthcare-associated infection as a problem in Ziniaré district hospital. Hence, a national program of quality assurance in the hospitals should now integrate the risk infectious management

  13. Hospitals, The featured data collection is the USGS-LAGIC Coastal Parishes Structures Project. This ongoing project was started in 2009 with the intent to map critical infrastructure in the Coastal Zone. The initial four parishes included Lafourche, Plaquemine, St. , Published in 2011, 1:12000 (1in=1000ft) scale, LSU Louisiana Geographic Information Center (LAGIC).

    Data.gov (United States)

    NSGIC Education | GIS Inventory — Hospitals dataset current as of 2011. The featured data collection is the USGS-LAGIC Coastal Parishes Structures Project. This ongoing project was started in 2009...

  14. Hospitals, The featured data collection is the USGS-LAGIC Coastal Parishes Structures Project. This ongoing project was started in 2009 with the intent to map critical infrastructure in the Coastal Zone. The initial four parishes included Lafourche, Plaquemine, St., Published in 2011, 1:12000 (1in=1000ft) scale, LSU Louisiana Geographic Information Center (LAGIC).

    Data.gov (United States)

    NSGIC Education | GIS Inventory — Hospitals dataset current as of 2011. The featured data collection is the USGS-LAGIC Coastal Parishes Structures Project. This ongoing project was started in 2009...

  15. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

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

  16. Do Staphylococcus epidermidis Genetic Clusters Predict Isolation Sources?

    Science.gov (United States)

    Tolo, Isaiah; Thomas, Jonathan C.; Fischer, Rebecca S. B.; Brown, Eric L.; Gray, Barry M.

    2016-01-01

    Staphylococcus epidermidis is a ubiquitous colonizer of human skin and a common cause of medical device-associated infections. The extent to which the population genetic structure of S. epidermidis distinguishes commensal from pathogenic isolates is unclear. Previously, Bayesian clustering of 437 multilocus sequence types (STs) in the international database revealed a population structure of six genetic clusters (GCs) that may reflect the species' ecology. Here, we first verified the presence of six GCs, including two (GC3 and GC5) with significant admixture, in an updated database of 578 STs. Next, a single nucleotide polymorphism (SNP) assay was developed that accurately assigned 545 (94%) of 578 STs to GCs. Finally, the hypothesis that GCs could distinguish isolation sources was tested by SNP typing and GC assignment of 154 isolates from hospital patients with bacteremia and those with blood culture contaminants and from nonhospital carriage. GC5 was isolated almost exclusively from hospital sources. GC1 and GC6 were isolated from all sources but were overrepresented in isolates from nonhospital and infection sources, respectively. GC2, GC3, and GC4 were relatively rare in this collection. No association was detected between fdh-positive isolates (GC2 and GC4) and nonhospital sources. Using a machine learning algorithm, GCs predicted hospital and nonhospital sources with 80% accuracy and predicted infection and contaminant sources with 45% accuracy, which was comparable to the results seen with a combination of five genetic markers (icaA, IS256, sesD [bhp], mecA, and arginine catabolic mobile element [ACME]). Thus, analysis of population structure with subgenomic data shows the distinction of hospital and nonhospital sources and the near-inseparability of sources within a hospital. PMID:27076664

  17. Taxation as metaphor. The hospital and public responsibility.

    Science.gov (United States)

    Friedman, E

    1992-01-01

    In the debate over the tax status of voluntary hospitals, most hospital executives and trustees do not seem to comprehend--or want to comprehend--the underlying issues. First, the terror of being associated with a tax hike has led many politicians to seek other "revenue enhancements" that are more ingenious than they are honest. On the other hand, many of these governments have legitimate financial problems and are seeking new sources of revenue. A second, related issue is uncertainty over what should be done about the uninsured and Medicaid populations. In the absence of an acceptable solution, we will continue to provide direct public support to public hospitals and indirect public support to private providers--including charitable tax exemptions. The third underlying issue is hospitals' curiously narrow view of their private-sector status. Most of the functions hospitals provide are not only publicly funded; they are, in fact, public functions. Finally, hospitals believe they are inherently moral organizations because they provide an inherently moral service. But hospitals grew to their present role in society almost by accident; their services are neither unique nor ethically superior. It is in how hospitals provide care that their morality can be measured, not in the fact that they provide some kind of care to somebody. An honest appraisal of these issues will help each hospital answer the basic question: As an ethical and moral matter, should this organization be paying taxes? But is this fight really about taxes? I believe society and government are using taxation as a metaphor for trust in hospitals.

  18. Parent-provider communication during hospitalization.

    Science.gov (United States)

    Fisher, Mark J; Broome, Marion E

    2011-02-01

    Parents and health care providers interact and communicate with each other during a child's hospitalization. The purpose of this study was to compare communication experiences of parents, nurses, and physicians. A unique aspect of this study involved combining three individual data sources into a collective unit of study (triad). Triads involved in the care of three children in the inpatient setting of an urban children's hospital served as the sample for this study (n = 10). Participants were asked semistructured questions during face-to-face interviews. Findings included (a) the importance of providing information by health care providers using a caring and inclusive approach, (b) the benefits of establishing interpersonal connections and nurturing relationships, and (c) the identification of specific behaviors in all members of the triad that contribute to and sustain positively perceived communication. Future research directions examining triadic interactions, communication, and relationships among parents, nurses, and physicians are recommended. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Introduction: Special Issue on Hospitality

    OpenAIRE

    Ruth Rios-Morales; Ian Jenkins

    2012-01-01

    In the era of globalization, the economic contribution of the tourism, hospitality and leisure industry to the world’s GDP is significant. Tourism represents one of the main sources of income for many countries; tourism creates jobs, enhances exports and contributes to the economic welfare of a host country. Although the contribution of tourism, hospitality and the leisure industry in the era of globalization has been broadly recognized, there are also numerous challenges that this industry f...

  20. Introduction: Special issue in hospitality

    OpenAIRE

    Ríos-Morales, Ruth; Jenkins, Ian

    2012-01-01

    In the era of globalization, the economic contribution of the tourism, hospitality and leisure industry to the world’s GDP is significant. Tourism represents one of the main sources of income for many countries; tourism creates jobs, enhances exports and contributes to the economic welfare of a host country. Although the contribution of tourism, hospitality and the leisure industry in the era of globalization has been broadly recognized, there are also numerous challenges that this industry f...

  1. The Impact of Hospital Size on CMS Hospital Profiling.

    Science.gov (United States)

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

    2016-04-01

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

  2. Biological risk among hospital housekeepers.

    Science.gov (United States)

    Ream, Priscilla Santos Ferreira; Tipple, Anaclara Ferreira Veiga; Barros, Dayane Xavier; Souza, Adenícia Custódia Silva; Pereira, Milca Severino

    2016-01-01

    Although not directly responsible for patient care, hospital housekeepers are still susceptible to accidents with biological material. The objectives of this study were to establish profile and frequency of accidents among hospital housekeepers, describe behaviors pre- and postaccident, and risk factors. This was a cross-sectional study with hospital housekeepers in Goiania, Brazil. Data were obtained from interviews and vaccination records. The observations were as follows: (1) participating workers: 94.3%; (2) incomplete hepatitis B vaccination: 1 in 3; and (3) accident rate: 26.5%, mostly percutaneous with hypodermic needles, and involved blood from an unknown source; roughly half occurred during waste management. Upon review, length of service less than 5 years, completed hepatitis B vaccination, and had been tested for anti-HBs (hepatitis B surface antigen) influenced frequency of accidents. These findings suggest that improper disposal of waste appears to enhance the risk to hospital housekeepers. All hospital workers should receive continued training with regard to waste management.

  3. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

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

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

    Science.gov (United States)

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

    2008-10-01

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

  5. Neutron source

    International Nuclear Information System (INIS)

    Cason, J.L. Jr.; Shaw, C.B.

    1975-01-01

    A neutron source which is particularly useful for neutron radiography consists of a vessel containing a moderating media of relatively low moderating ratio, a flux trap including a moderating media of relatively high moderating ratio at the center of the vessel, a shell of depleted uranium dioxide surrounding the moderating media of relatively high moderating ratio, a plurality of guide tubes each containing a movable source of neutrons surrounding the flux trap, a neutron shield surrounding one part of each guide tube, and at least one collimator extending from the flux trap to the exterior of the neutron source. The shell of depleted uranium dioxide has a window provided with depleted uranium dioxide shutters for each collimator. Reflectors are provided above and below the flux trap and on the guide tubes away from the flux trap

  6. Crowd Sourcing.

    Science.gov (United States)

    Baum, Neil

    2016-01-01

    The Internet has contributed new words and slang to our daily vernacular. A few terms, such as tweeting, texting, sexting, blogging, and googling, have become common in most vocabularies and in many languages, and are now included in the dictionary. A new buzzword making the rounds in industry is crowd sourcing, which involves outsourcing an activity, task, or problem by sending it to people or groups outside a business or a practice. Crowd sourcing allows doctors and practices to tap the wisdom of many instead of relying only on the few members of their close-knit group. This article defines "crowd sourcing," offers examples, and explains how to get started with this approach that can increase your ability to finish a task or solve problems that you don't have the time or expertise to accomplish.

  7. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

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

  8. Antifungal therapy in European hospitals

    DEFF Research Database (Denmark)

    Zarb, P; Amadeo, B; Muller, A

    2012-01-01

    The study aimed to identify targets for quality improvement in antifungal use in European hospitals and determine the variability of such prescribing. Hospitals that participated in the European Surveillance of Antimicrobial Consumption Point Prevalence Surveys (ESAC-PPS) were included. The WHO...

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

    Science.gov (United States)

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

    2012-01-01

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

  10. Value-based purchasing and hospital acquired conditions: are we seeing improvement?

    Science.gov (United States)

    Spaulding, Aaron; Zhao, Mei; Haley, D Rob

    2014-12-01

    To determine if the Value-Based Purchasing Performance Scoring system correlates with hospital acquired condition quality indicators. This study utilizes the following secondary data sources: the American Hospital Association (AHA) annual survey and the Centers for Medicare and Medicaid (CMS) Value-Based Purchasing and Hospital Acquired Conditions databases. Zero-inflated negative binomial regression was used to examine the effect of CMS total performance score on counts of hospital acquired conditions. Hospital structure variables including size, ownership, teaching status, payer mix, case mix, and location were utilized as control variables. The secondary data sources were merged into a single database using Stata 10. Total performance scores, which are used to determine if hospitals should receive incentive money, do not correlate well with quality outcome in the form of hospital acquired conditions. Value-based purchasing does not appear to correlate with improved quality and patient safety as indicated by Hospital Acquired Condition (HAC) scores. This leads us to believe that either the total performance score does not measure what it should, or the quality outcome measurements do not reflect the quality of the total performance scores measure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Association between value-based purchasing score and hospital characteristics

    Directory of Open Access Journals (Sweden)

    Borah Bijan J

    2012-12-01

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

  12. Hospital diversification: how to involve the pharmacy.

    Science.gov (United States)

    Smith, J E; Black, B L

    1987-05-01

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

  13. Patient experience and hospital profitability: Is there a link?

    Science.gov (United States)

    Richter, Jason P; Muhlestein, David B

    Patient experience has had a direct financial impact on hospitals since value-based purchasing was instituted by the Centers for Medicare & Medicaid Services in 2013 as a method to reward or punish hospitals based on performance on various measures, including patient experience. Although other industries have shown an indirect impact of customer experience on overall profitability, that link has not been well established in the health care industry. Return-to-provider rate and perceptions of health quality have been associated with profitability in the health care industry. Our aims were to assess whether, independent of a direct financial impact, a more positive patient experience is associated with increased profitability and whether a more negative patient experience is associated with decreased profitability. We used a sample of 19,792 observations from 3767 hospitals over the 6-year period 2007-2012. The data were sourced from Centers for Medicare & Medicaid Services and Hospital Consumer Assessment of Healthcare Providers and Systems. Using generalized estimating equations to account for repeated measures, we fit four separate models for three dependent variables: net patient revenue, net income, and operating margin. Each model included one of the following independent variables of interest: percentage of patients who definitely recommend the hospital, percentage of patients who definitely would not recommend the hospital, percentage of patients who rated the hospital 9 or 10, and percentage of patients who rated the hospital 6 or lower. We identified that a positive patient experience is associated with increased profitability and a negative patient experience is even more strongly associated with decreased profitability. Management should have greater justification for incurring costs associated with bolstering patient experience programs. Improvements in training, technology, and staffing can be justified as a way to improve not only quality but now

  14. Hospital charitable lotteries: taking a gamble on systems thinking.

    Science.gov (United States)

    Reynolds, Jennifer

    2013-12-01

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

  15. How a new 'public plan' could affect hospitals' finances and private insurance premiums.

    Science.gov (United States)

    Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory

    2009-01-01

    Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.

  16. Leakage of caesium braquitherapy sources

    International Nuclear Information System (INIS)

    Lozada, J.A.

    1998-01-01

    In several Venezuelan public hospitals where cervix uteri tumours are treated by intracavitary radiotherapy, that use manual after loading Fletcher method, with Caesium 137 sources, the use of improper source holders, locally manufactured from pieces of drainage plastic tubing, which deteriorated and created a corrosive environment all around the sources, omission of manufacturer's recommendations regarding corrosion information, source storage, inspection and testing, violation of International Atomic Energy Agency Radiation Protection Procedures, and lack of proper regulatory control, resulted integrity damage to about sixty special form sources (ISO2919 C 63322), leakage of Cs-137 from a supposed insoluble refractory active content (caesium silicoaluminate), and contamination of applicators, floors and bedding. When the situation was detected by means removal contamination tests, after routine inspections, the sources were removed from the hospitals, decontaminated by means of immersion in 3% EDTA solution in ultrasonic bath, subjected to leaking assessment tests, and the ones that passed were placed in low cost stainless steel source holders, designed and built by the instituto Venezolano de Investigaciones Cientificas (IVIC) returned to the hospitals. The leaking sources were removed from use and considered radioactive waste. In order to avoid the occurrence of similar situations, all the importers of such sources are now required to send them to IVIC for testing and placement in proper source holders, before they are shipped to the hospitals. (author)

  17. THE CHANDRA SOURCE CATALOG

    International Nuclear Information System (INIS)

    Evans, Ian N.; Primini, Francis A.; Glotfelty, Kenny J.; Anderson, Craig S.; Bonaventura, Nina R.; Chen, Judy C.; Doe, Stephen M.; Evans, Janet D.; Fabbiano, Giuseppina; Galle, Elizabeth C.; Gibbs, Danny G.; Grier, John D.; Hain, Roger M.; Harbo, Peter N.; He Xiangqun; Karovska, Margarita; Kashyap, Vinay L.; Davis, John E.; Houck, John C.; Hall, Diane M.

    2010-01-01

    The Chandra Source Catalog (CSC) is a general purpose virtual X-ray astrophysics facility that provides access to a carefully selected set of generally useful quantities for individual X-ray sources, and is designed to satisfy the needs of a broad-based group of scientists, including those who may be less familiar with astronomical data analysis in the X-ray regime. The first release of the CSC includes information about 94,676 distinct X-ray sources detected in a subset of public Advanced CCD Imaging Spectrometer imaging observations from roughly the first eight years of the Chandra mission. This release of the catalog includes point and compact sources with observed spatial extents ∼<30''. The catalog (1) provides access to the best estimates of the X-ray source properties for detected sources, with good scientific fidelity, and directly supports scientific analysis using the individual source data; (2) facilitates analysis of a wide range of statistical properties for classes of X-ray sources; and (3) provides efficient access to calibrated observational data and ancillary data products for individual X-ray sources, so that users can perform detailed further analysis using existing tools. The catalog includes real X-ray sources detected with flux estimates that are at least 3 times their estimated 1σ uncertainties in at least one energy band, while maintaining the number of spurious sources at a level of ∼<1 false source per field for a 100 ks observation. For each detected source, the CSC provides commonly tabulated quantities, including source position, extent, multi-band fluxes, hardness ratios, and variability statistics, derived from the observations in which the source is detected. In addition to these traditional catalog elements, for each X-ray source the CSC includes an extensive set of file-based data products that can be manipulated interactively, including source images, event lists, light curves, and spectra from each observation in which a

  18. The Chandra Source Catalog

    Science.gov (United States)

    Evans, Ian N.; Primini, Francis A.; Glotfelty, Kenny J.; Anderson, Craig S.; Bonaventura, Nina R.; Chen, Judy C.; Davis, John E.; Doe, Stephen M.; Evans, Janet D.; Fabbiano, Giuseppina; Galle, Elizabeth C.; Gibbs, Danny G., II; Grier, John D.; Hain, Roger M.; Hall, Diane M.; Harbo, Peter N.; He, Xiangqun Helen; Houck, John C.; Karovska, Margarita; Kashyap, Vinay L.; Lauer, Jennifer; McCollough, Michael L.; McDowell, Jonathan C.; Miller, Joseph B.; Mitschang, Arik W.; Morgan, Douglas L.; Mossman, Amy E.; Nichols, Joy S.; Nowak, Michael A.; Plummer, David A.; Refsdal, Brian L.; Rots, Arnold H.; Siemiginowska, Aneta; Sundheim, Beth A.; Tibbetts, Michael S.; Van Stone, David W.; Winkelman, Sherry L.; Zografou, Panagoula

    2010-07-01

    The Chandra Source Catalog (CSC) is a general purpose virtual X-ray astrophysics facility that provides access to a carefully selected set of generally useful quantities for individual X-ray sources, and is designed to satisfy the needs of a broad-based group of scientists, including those who may be less familiar with astronomical data analysis in the X-ray regime. The first release of the CSC includes information about 94,676 distinct X-ray sources detected in a subset of public Advanced CCD Imaging Spectrometer imaging observations from roughly the first eight years of the Chandra mission. This release of the catalog includes point and compact sources with observed spatial extents lsim30''. The catalog (1) provides access to the best estimates of the X-ray source properties for detected sources, with good scientific fidelity, and directly supports scientific analysis using the individual source data; (2) facilitates analysis of a wide range of statistical properties for classes of X-ray sources; and (3) provides efficient access to calibrated observational data and ancillary data products for individual X-ray sources, so that users can perform detailed further analysis using existing tools. The catalog includes real X-ray sources detected with flux estimates that are at least 3 times their estimated 1σ uncertainties in at least one energy band, while maintaining the number of spurious sources at a level of lsim1 false source per field for a 100 ks observation. For each detected source, the CSC provides commonly tabulated quantities, including source position, extent, multi-band fluxes, hardness ratios, and variability statistics, derived from the observations in which the source is detected. In addition to these traditional catalog elements, for each X-ray source the CSC includes an extensive set of file-based data products that can be manipulated interactively, including source images, event lists, light curves, and spectra from each observation in which a

  19. Hospital waste management in Lebanon

    International Nuclear Information System (INIS)

    Chaker, Alissar

    1999-01-01

    Hospital wastes comprises approximately 80% domestic waste components, also known as non-risk waste and 20% hazardous or risk waste. The 20% of the hospital waste stream or the risk waste (also known as infectious, medical, clinical wastes) comprises components which could be potentially contaminated with infections, chemical or radioactive agents. Therefore, it should be handled and disposed of in such a manner as to minimize potential human exposure and cross-contamination. Hospital risk waste and be subdivided into seven general categories as follows: infections, anatomical/pathological, chemical, pharmaceutical, radioactive waste, sharps and pressurised containers. These waste categories are generated by many types of health care establishments, including hospitals, clinics, infirmaries.... The document presents also tables of number of hospitals and estimated bed number in different regions in Lebanon; estimated hospital risk and non-risk waste generation per tonnes per day for the years 1998 until 2010 and finally sensitivity analysis of estimated generation of hospital risk waste in Lebanon per tonnes per day for the years 1998 until 2010. The management, treatment and disposal of hospital risk waste constitute important environmental and public safety issues. It is recognised that there is alack of infrastructure for the safe and environmentally acceptable disposal of hospital waste in Lebanon

  20. Maternal Clinical Diagnoses and Hospital Variation in the Risk of Cesarean Delivery: Analyses of a National US Hospital Discharge Database

    Science.gov (United States)

    Kozhimannil, Katy B.; Arcaya, Mariana C.; Subramanian, S. V.

    2014-01-01

    Background Cesarean delivery is the most common inpatient surgery in the United States, where 1.3 million cesarean sections occur annually, and rates vary widely by hospital. Identifying sources of variation in cesarean use is crucial to improving the consistency and quality of obstetric care. We used hospital discharge records to examine the extent to which variability in the likelihood of cesarean section across US hospitals was attributable to individual women's clinical diagnoses. Methods and Findings Using data from the 2009 and 2010 Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project—a 20% sample of US hospitals—we analyzed data for 1,475,457 births in 1,373 hospitals. We fitted multilevel logistic regression models (patients nested in hospitals). The outcome was cesarean (versus vaginal) delivery. Covariates included diagnosis of diabetes in pregnancy, hypertension in pregnancy, hemorrhage during pregnancy or placental complications, fetal distress, and fetal disproportion or obstructed labor; maternal age, race/ethnicity, and insurance status; and hospital size and location/teaching status. The cesarean section prevalence was 22.0% (95% confidence interval 22.0% to 22.1%) among women with no prior cesareans. In unadjusted models, the between-hospital variation in the individual risk of primary cesarean section was 0.14 (95% credible interval 0.12 to 0.15). The difference in the probability of having a cesarean delivery between hospitals was 25 percentage points. Hospital variability did not decrease after adjusting for patient diagnoses, socio-demographics, and hospital characteristics (0.16 [95% credible interval 0.14 to 0.18]). A limitation is that these data, while nationally representative, did not contain information on parity or gestational age. Conclusions Variability across hospitals in the individual risk of cesarean section is not decreased by accounting for differences in maternal diagnoses. These findings highlight

  1. Pain prevalence in hospitalized children

    DEFF Research Database (Denmark)

    Walther-Larsen, S; Pedersen, M T; Friis, S M

    2017-01-01

    admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation. CONCLUSION: This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority......BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric...... patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. RESULTS: Two hundred and thirteen children (37%) responded that they had experienced...

  2. 76 FR 18407 - Standards of Performance for New Stationary Sources and Emissions Guidelines for Existing Sources...

    Science.gov (United States)

    2011-04-04

    ... Standards of Performance for New Stationary Sources and Emissions Guidelines for Existing Sources: Hospital... performance standards and emissions guidelines for hospital/medical/infectious waste incinerators by the U.S... amendments to the new source performance standards and emissions guidelines, correcting inadvertent drafting...

  3. 2011 NATA - Emissions Sources

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset includes all emissions sources that were modeled in the 2011 National Air Toxics Assessment (NATA), inlcluding point, nonpoint, and mobile sources, and...

  4. Does electronic health record use improve hospital financial performance? Evidence from panel data.

    Science.gov (United States)

    Collum, Taleah H; Menachemi, Nir; Sen, Bisakha

    2016-01-01

    The aim of this study was to examine the impact of electronic health record (EHR) adoption on hospital financial performance. We constructed a longitudinal panel using data from the three secondary sources: (a) the 2007-2010 American Hospital Association (AHA) Annual Survey, (b) the 2007-2010 AHA Annual Survey Information Technology Supplement, and (c) the 2007-2011 Medicare Cost Reports from Centers for Medicare and Medicaid Services. Because potential financial benefits attributable to EHR adoption may take some time to accrue, we ran regressions with lags of 1 and 2 years that included hospital and year fixed effects to examine the relationship between the level of EHR adoption and three hospital financial performance measures. A change in the level of EHR adoption was not associated with changes in operating margin or return on assets within hospitals. However, total margin was significantly improved, after 2 years, in hospitals that moved from no EHR to having a comprehensive EHR in all areas of their hospital (β = 0.030, p financial performance measures examined. The improvements in total margin, as opposed to operating margin, are likely due to hospital incentive payments under the Health Information Technology for Economic and Clinical Health Act that are reflected in nonpatient revenues and therefore show up in total margin calculations. Thus, after 2 years of EHR adoption, hospital financial performance is observed to improve based only on meaningful use incentive payments. More research will be needed to determine whether EHR adoption impacts financial performance on a longer time horizon.

  5. Hospital waste management and other small producers

    International Nuclear Information System (INIS)

    Herbst, H.; Roy, J.C.

    1992-01-01

    This paper describes waste management in hospitals and other waste producers. Low-level radioactive wastes are collected by ANDRA (French Agency for radioactive waste management) and informations on waste processing or regulations on radiation sources are given

  6. AHP Expert Programme As A Tool For Unsealed Sources Contamination Control Of The Environment

    International Nuclear Information System (INIS)

    Amin, E.T.; Ibrahim, M.S.; Hussein, A.Z.

    2007-01-01

    Unsealed sources of radionuclides are widely used in hot laboratories of medical centers and hospitals which can be easily dispersed and may be taken undue into the body. The presence of radioactive substances inside the human body generates risk of internal intakes of radionuclides and organ's tissue retention. In order to make control for any contamination occurring from unsealed sources, an AHP programme (PC programme) has been developed so that it includes all data of most unsealed sources used in the hot laboratories of nuclear medicine units at hospitals/medical centers. Sequence of questions are retrieved by the programme in relevance to the place address, uses, activity and half life of the unsealed radioisotopes that may cause contamination. The programme will also give information output about the hospital that use the unsealed source and its location which facilitate emergency planning and contamination control to the environment

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

    Science.gov (United States)

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

    2014-01-01

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

  8. [Leadership in the hospital].

    Science.gov (United States)

    Schrappe, Matthias

    2009-01-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  10. Electric Power Monthly, August 1990. [Glossary included

    Energy Technology Data Exchange (ETDEWEB)

    1990-11-29

    The Electric Power Monthly (EPM) presents monthly summaries of electric utility statistics at the national, Census division, and State level. The purpose of this publication is to provide energy decisionmakers with accurate and timely information that may be used in forming various perspectives on electric issues that lie ahead. Data includes generation by energy source (coal, oil, gas, hydroelectric, and nuclear); generation by region; consumption of fossil fuels for power generation; sales of electric power, cost data; and unusual occurrences. A glossary is included.

  11. Source rock

    Directory of Open Access Journals (Sweden)

    Abubakr F. Makky

    2014-03-01

    Full Text Available West Beni Suef Concession is located at the western part of Beni Suef Basin which is a relatively under-explored basin and lies about 150 km south of Cairo. The major goal of this study is to evaluate the source rock by using different techniques as Rock-Eval pyrolysis, Vitrinite reflectance (%Ro, and well log data of some Cretaceous sequences including Abu Roash (E, F and G members, Kharita and Betty formations. The BasinMod 1D program is used in this study to construct the burial history and calculate the levels of thermal maturity of the Fayoum-1X well based on calibration of measured %Ro and Tmax against calculated %Ro model. The calculated Total Organic Carbon (TOC content from well log data compared with the measured TOC from the Rock-Eval pyrolysis in Fayoum-1X well is shown to match against the shale source rock but gives high values against the limestone source rock. For that, a new model is derived from well log data to calculate accurately the TOC content against the limestone source rock in the study area. The organic matter existing in Abu Roash (F member is fair to excellent and capable of generating a significant amount of hydrocarbons (oil prone produced from (mixed type I/II kerogen. The generation potential of kerogen in Abu Roash (E and G members and Betty formations is ranging from poor to fair, and generating hydrocarbons of oil and gas prone (mixed type II/III kerogen. Eventually, kerogen (type III of Kharita Formation has poor to very good generation potential and mainly produces gas. Thermal maturation of the measured %Ro, calculated %Ro model, Tmax and Production index (PI indicates that Abu Roash (F member exciting in the onset of oil generation, whereas Abu Roash (E and G members, Kharita and Betty formations entered the peak of oil generation.

  12. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

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

  13. An outbreak of Legionnaires disease associated with a decorative water wall fountain in a hospital.

    Science.gov (United States)

    Haupt, Thomas E; Heffernan, Richard T; Kazmierczak, James J; Nehls-Lowe, Henry; Rheineck, Bruce; Powell, Christine; Leonhardt, Kathryn K; Chitnis, Amit S; Davis, Jeffrey P

    2012-02-01

    To detect an outbreak-related source of Legionella, control the outbreak, and prevent additional Legionella infections from occurring. Epidemiologic investigation of an acute outbreak of hospital-associated Legionnaires disease among outpatients and visitors to a Wisconsin hospital. Patients with laboratory-confirmed Legionnaires disease who resided in southeastern Wisconsin and had illness onsets during February and March 2010. Patients with Legionnaires disease were interviewed using a hypothesis-generating questionnaire. On-site investigation included sampling of water and other potential environmental sources for Legionella testing. Case-finding measures included extensive notification of individuals potentially exposed at the hospital and alerts to area healthcare and laboratory personnel. Laboratory-confirmed Legionnaires disease was diagnosed in 8 patients, all of whom were present at the same hospital during the 10 days prior to their illness onsets. Six patients had known exposure to a water wall-type decorative fountain near the main hospital entrance. Although the decorative fountain underwent routine cleaning and maintenance, high counts of Legionella pneumophila serogroup 1 were isolated from cultures of a foam material found above the fountain trough. This outbreak of Legionnaires disease was associated with exposure to a decorative fountain located in a hospital public area. Routine cleaning and maintenance of fountains does not eliminate the risk of bacterial contamination. Our findings highlight the need to evaluate the safety of water fountains installed in any area of a healthcare facility.

  14. A financial planning model for estimating hospital debt capacity.

    Science.gov (United States)

    Hopkins, D S; Heath, D; Levin, P J

    1982-01-01

    A computer-based financial planning model was formulated to measure the impact of a major capital improvement project on the fiscal health of Stanford University Hospital. The model had to be responsive to many variables and easy to use, so as to allow for the testing of numerous alternatives. Special efforts were made to identify the key variables that needed to be presented in the model and to include all known links between capital investment, debt, and hospital operating expenses. Growth in the number of patient days of care was singled out as a major source of uncertainty that would have profound effects on the hospital's finances. Therefore this variable was subjected to special scrutiny in terms of efforts to gauge expected demographic trends and market forces. In addition, alternative base runs of the model were made under three distinct patient-demand assumptions. Use of the model enabled planners at the Stanford University Hospital (a) to determine that a proposed modernization plan was financially feasible under a reasonable (that is, not unduly optimistic) set of assumptions and (b) to examine the major sources of risk. Other than patient demand, these sources were found to be gross revenues per patient, operating costs, and future limitations on government reimbursement programs. When the likely financial consequences of these risks were estimated, both separately and in combination, it was determined that even if two or more assumptions took a somewhat more negative turn than was expected, the hospital would be able to offset adverse consequences by a relatively minor reduction in operating costs. PMID:7111658

  15. Gun Violence Following Inpatient Psychiatric Treatment: Offense Characteristics, Sources of Guns, and Number of Victims.

    Science.gov (United States)

    Kivisto, Aaron J

    2017-10-01

    This study presents data on the relative contribution to gun violence by people with a history of inpatient psychiatric treatment and on federal efforts to deter presumptively dangerous persons from obtaining firearms, information useful for analyzing the potential public health benefits of gun policies targeting people with serious mental illness. The study also estimates the reduction in gun violence victims that would be expected if individuals with a previous psychiatric hospitalization were prohibited from purchasing firearms. Data from 838 violent gun offenders from a nationally representative sample of state prison inmates were analyzed. Those with and without a history of psychiatric hospitalization were compared on a range of offense characteristics, including relationship to the victim, number of victims, location of the offense, and source of firearms. Inmates with a history of hospitalization constituted 12% of all violent gun offenders and accounted for 13% of the sample's victims. They were less likely than those without a previous hospitalization to victimize strangers (odds ratio=.52) and were no more likely to commit gun violence in public or to have multiple victims. Among those with previous hospitalizations, 78% obtained guns from sources not subject to federal background checks. Of the total 1,041 victims of gun violence, only 3% were victimized by participants with a history of hospitalization who obtained guns from currently regulated sources. Prohibiting all individuals with a history of psychiatric hospitalization from purchasing firearms, absent expanded background checks, was estimated to reduce the number of gun violence victims by only 3%.

  16. Help prevent hospital errors

    Science.gov (United States)

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

  17. Food production and service in UK hospitals.

    Science.gov (United States)

    Ahmed, Mohamed; Jones, Eleri; Redmond, Elizabeth; Hewedi, Mahmoud; Wingert, Andreas; Gad El Rab, Mohamed

    2015-01-01

    The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food. Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK. The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations. Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals. The paper identifies opportunities for enhancing hospital food production systems. The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.

  18. A traceability establishment for the 125I IsoSeed I25.S06 source from Bebig at the hospital level; Propuesta de obtencion de trazabilidad a nivel hospitalario para la fuente de 125I IsoSeed I25.S06 de Bebig

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Calatayud, J.; Bejar, M.J.; Lliso, F.; Colmenares, R.; Fernandez, J.; Andrassy, M.; Carmona, V.; Ferrer, N.; Vivanco, J.

    2010-07-01

    The purpose of this work has been on one side to solve the traceability problem in hospitals for the I25.S06 seed users, already solved for other seeds, and on the other to design a holder in order to allow the measurement of the reference air-kerma rate for the strand by means of a well-type ionization chamber, widely used in brachytherapy in hospitals. At a joint calibration-measurement session of the involved institutions the following steps were performed: calibration of the HDR 1000 and SourceCheck detectors with a standard source from the Physikalisch-Technische Bundesanstalt (PTB); reference air-kerma rate measurements for the 5 seeds strand provided by Bebig with the SourceCheck detector and with the HDR 1000 detector and the new insert holder by SIHO (Spain); separation of the stranded seeds by the specialist from Bebig who dissolved the plastic; reference air-kerma rate measurement of each of the seeds of the strand with one of the of HDR 1000 detectors previously calibrated. We present the calibration factors obtained and the analysis of the uncertainties associated with the process. (Author).

  19. Costs of terminal patients who receive palliative care or usual care in different hospital wards.

    Science.gov (United States)

    Simoens, Steven; Kutten, Betty; Keirse, Emmanuel; Berghe, Paul Vanden; Beguin, Claire; Desmedt, Marianne; Deveugele, Myriam; Léonard, Christian; Paulus, Dominique; Menten, Johan

    2010-11-01

    In addition to the effectiveness of hospital care models for terminal patients, policy makers and health care payers are concerned about their costs. This study aims to measure the hospital costs of treating terminal patients in Belgium from the health care payer perspective. Also, this study compares the costs of palliative and usual care in different types of hospital wards. A multicenter, retrospective cohort study compared costs of palliative care with usual care in acute hospital wards and with care in palliative care units. The study enrolled terminal patients from a representative sample of hospitals. Health care costs included fixed hospital costs and charges relating to medical fees, pharmacy and other charges. Data sources consisted of hospital accountancy data and invoice data. Six hospitals participated in the study, generating a total of 146 patients. The findings showed that palliative care in a palliative care unit was more expensive than palliative care in an acute ward due to higher staffing levels in palliative care units. Palliative care in an acute ward is cheaper than usual care in an acute ward. This study suggests that palliative care models in acute wards need to be supported because such care models appear to be less expensive than usual care and because such care models are likely to better reflect the needs of terminal patients. This finding emphasizes the importance of the timely recognition of the need for palliative care in terminal patients treated in acute wards.

  20. AMS at the ANU including biomedical applications

    Energy Technology Data Exchange (ETDEWEB)

    Fifield, L K; Allan, G L; Cresswell, R G; Ophel, T R [Australian National Univ., Canberra, ACT (Australia); King, S J; Day, J P [Manchester Univ. (United Kingdom). Dept. of Chemistry

    1994-12-31

    An extensive accelerator mass spectrometry program has been conducted on the 14UD accelerator at the Australian National University since 1986. In the two years since the previous conference, the research program has expanded significantly to include biomedical applications of {sup 26}Al and studies of landform evolution using isotopes produced in situ in surface rocks by cosmic ray bombardment. The system is now used for the measurement of {sup 10}Be, {sup 14}C, {sup 26}Al, {sup 36}Cl, {sup 59}Ni and {sup 129}I, and research is being undertaken in hydrology, environmental geochemistry, archaeology and biomedicine. On the technical side, a new test system has permitted the successful off-line development of a high-intensity ion source. A new injection line to the 14UD has been established and the new source is now in position and providing beams to the accelerator. 4 refs.

  1. AMS at the ANU including biomedical applications

    Energy Technology Data Exchange (ETDEWEB)

    Fifield, L.K.; Allan, G.L.; Cresswell, R.G.; Ophel, T.R. [Australian National Univ., Canberra, ACT (Australia); King, S.J.; Day, J.P. [Manchester Univ. (United Kingdom). Dept. of Chemistry

    1993-12-31

    An extensive accelerator mass spectrometry program has been conducted on the 14UD accelerator at the Australian National University since 1986. In the two years since the previous conference, the research program has expanded significantly to include biomedical applications of {sup 26}Al and studies of landform evolution using isotopes produced in situ in surface rocks by cosmic ray bombardment. The system is now used for the measurement of {sup 10}Be, {sup 14}C, {sup 26}Al, {sup 36}Cl, {sup 59}Ni and {sup 129}I, and research is being undertaken in hydrology, environmental geochemistry, archaeology and biomedicine. On the technical side, a new test system has permitted the successful off-line development of a high-intensity ion source. A new injection line to the 14UD has been established and the new source is now in position and providing beams to the accelerator. 4 refs.

  2. Digital intelligence sources transporter

    International Nuclear Information System (INIS)

    Zhang Zhen; Wang Renbo

    2011-01-01

    It presents from the collection of particle-ray counting, infrared data communication, real-time monitoring and alarming, GPRS and other issues start to realize the digital management of radioactive sources, complete the real-time monitoring of all aspects, include the storing of radioactive sources, transporting and using, framing intelligent radioactive sources transporter, as a result, achieving reliable security supervision of radioactive sources. (authors)

  3. Theory including future not excluded

    DEFF Research Database (Denmark)

    Nagao, K.; Nielsen, H.B.

    2013-01-01

    We study a complex action theory (CAT) whose path runs over not only past but also future. We show that, if we regard a matrix element defined in terms of the future state at time T and the past state at time TA as an expectation value in the CAT, then we are allowed to have the Heisenberg equation......, Ehrenfest's theorem, and the conserved probability current density. In addition,we showthat the expectation value at the present time t of a future-included theory for large T - t and large t - T corresponds to that of a future-not-included theory with a proper inner product for large t - T. Hence, the CAT...

  4. Characterization of Hospital Residuals

    International Nuclear Information System (INIS)

    Blanco Meza, A.; Bonilla Jimenez, S.

    1997-01-01

    The main objective of this investigation is the characterization of the solid residuals. A description of the handling of the liquid and gassy waste generated in hospitals is also given, identifying the source where they originate. To achieve the proposed objective the work was divided in three stages: The first one was the planning and the coordination with each hospital center, in this way, to determine the schedule of gathering of the waste can be possible. In the second stage a fieldwork was made; it consisted in gathering the quantitative and qualitative information of the general state of the handling of residuals. In the third and last stage, the information previously obtained was organized to express the results as the production rate per day by bed, generation of solid residuals for sampled services, type of solid residuals and density of the same ones. With the obtained results, approaches are settled down to either determine design parameters for final disposition whether for incineration, trituration, sanitary filler or recycling of some materials, and storage politics of the solid residuals that allow to determine the gathering frequency. The study concludes that it is necessary to improve the conditions of the residuals handling in some aspects, to provide the cleaning personnel of the equipment for gathering disposition and of security, minimum to carry out this work efficiently, and to maintain a control of all the dangerous waste, like sharp or polluted materials. In this way, an appreciable reduction is guaranteed in the impact on the atmosphere. (Author) [es

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

    Science.gov (United States)

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

    2015-06-01

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

  6. Using HL7 in hospital staff assignments.

    Science.gov (United States)

    Unluturk, Mehmet S

    2014-02-01

    Hospital staff assignments are the instructions that allocate the hospital staff members to the hospital beds. Currently, hospital administrators make the assignments without accessing the information regarding the occupancy of the hospital beds and the acuity of the patient. As a result, administrators cannot distinguish between occupied and unoccupied beds, and may therefore assign staff to unoccupied beds. This gives rise to uneven and inefficient staff assignments. In this paper, the hospital admission-discharge-transfer (ADT) system is employed both as a data source and an assignment device to create staff assignments. When the patient data is newly added or modified, the ADT system updates the assignment software client with the relevant data. Based on the relevant data, the assignment software client is able to construct staff assignments in a more efficient way. © 2013 Elsevier Ltd. All rights reserved.

  7. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

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

  8. Waterborne microorganisms and biofilms related to hospital infections: strategies for prevention and control in healthcare facilities.

    Science.gov (United States)

    Capelletti, Raquel Vannucci; Moraes, Ângela Maria

    2016-02-01

    Water is the main stimulus for the development of microorganisms, and its flow has an important role in the spreading of contaminants. In hospitals, the water distribution system requires special attention since it can be a source of pathogens, including those in the form of biofilms often correlated with resistance of microorganisms to various treatments. In this paper, information relevant to cases of nosocomial infections involving water circuits as a source of contaminants is compiled, with emphasis on the importance of microbiological control strategies to prevent the installation, spreading and growth of microorganisms in hospitals. An overview of the worldwide situation is provided, with emphasis on Brazilian hospitals. Different approaches normally used to control the occurrence of nosocomial infections due to waterborne contaminants are analyzed, and the use of the polysaccharide chitosan for this specific application is briefly discussed.

  9. Early discharge hospital at home.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

    2017-06-26

    Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit. We searched clinical trials registries. Randomised trials comparing early discharge hospital at home with acute hospital inpatient care for adults. We excluded obstetric, paediatric and mental health hospital at home schemes.   DATA COLLECTION AND ANALYSIS: We followed the standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 32 trials (N = 4746), six of them new for this update, mainly conducted in high-income countries. We judged most of the studies to have a low or unclear risk of bias. The intervention was delivered by hospital outreach services (17 trials), community-based services (11 trials), and was co-ordinated by a hospital-based stroke team or physician in conjunction with community-based services in four trials.Studies recruiting people recovering from strokeEarly discharge hospital at home probably makes little or no difference to mortality at three to six months (risk ratio (RR) 0.92, 95% confidence interval (CI) 0.57 to 1.48, N = 1114, 11 trials, moderate-certainty evidence) and may make little or no difference to the risk of hospital readmission (RR 1.09, 95% CI 0.71 to 1.66, N = 345, 5 trials, low-certainty evidence). Hospital at home may lower the risk of living in institutional setting at six months (RR 0.63, 96% CI

  10. Análise comportamental de recém-nascidos pré-termos incluídos em um programa de estimulação tátil-cinestésica durante a internação hospitalar Behavioral analysis of preterm neonates included in a tactile and kinesthetic stimulation program during hospitalization

    Directory of Open Access Journals (Sweden)

    Andréia M. Ferreira

    2010-04-01

    Full Text Available OBJETIVO: Avaliar o efeito da estimulação tátil-cinestésica na evolução do padrão comportamental e clínico de recém-nascidos pré-termos (RNPT durante o período de internação hospitalar. MÉTODOS: Trinta e dois RNPT, com peso ao nascimento inferior a 2.500 gramas, clinicamente estáveis e destituídos de asfixia perinatal importante foram divididos em 16 bebês do grupo controle (GC e 16 do experimental (GE. Foram coletados dados da evolução clínica a partir dos registros hospitalares e da avaliação comportamental por meio de filmagens semanais de oito minutos, desde a inclusão do RNPT na amostra até a alta hospitalar. RESULTADOS: Tendência a redução do tempo de internação hospitalar, aumento do ganho de peso diário e predominância de comportamentos auto-organizados (respiração regular, estado de alerta, tônus equilibrado, posturas mistas, movimentação coordenada, movimentos de mão na face, sucção, preensão, apoio para os RNPT do GE. A análise comparativa das idades pós-conceptuais divididas em intervalos (I - 31 a 33 semanas 6/7; II - 34 a 36 semanas 6/7; e III - 37 a 39 semanas 6/7 ressaltou, no aspecto motor, um tônus equilibrado e movimentação voluntária coordenada para os três períodos, maior permanência em posturas mistas (intervalo I ou em flexão (intervalo II e a obtenção de respiração mais regular na faixa etária I do GE. CONCLUSÃO: Destaque da estimulação tátil-cinestésica como método de intervenção durante o período de internação hospitalar, contribuindo para a auto-organização e regulação comportamental de RNPT. Artigo registrado no Australian New Zealand Clinical Trials Registry (ANZCTR sob o número ACTRN12610000133033.OBJECTIVE: To evaluate the effect of tactile and kinesthetic stimulation on behavioral and clinical development in preterm neonates while still in the hospital. METHODS: Thirty-two clinically stable preterm infants weighing <2.500 grams, with no

  11. [On comparison of hospital performance].

    Science.gov (United States)

    Kjekshus, L E

    2000-10-20

    The motivation to identify the causes of rising health care cost and variations across providers has intensified in all industrialized countries. These countries have an ongoing debate on efficiency and effectiveness in hospital production. In this debate, national and international comparative studies are important. There are very few international comparative studies that include Norwegian hospitals. Actually we know very little about how Norwegian hospitals are performing compared to others. This paper gives an introduction to comparative studies and to the DEA model which is often used in such studies and also a multilevel model which is not so common. A short review is given of a comparative study of Norwegian and North American hospitals. I also discuss the feasibility of comparative studies of hospitals from the Nordic countries, with references to several comparative studies performed in these countries. Comparative studies are often closely linked to national health politics, policy making and reforms; thus the outcome of such studies is important for the hospitals included. This makes such studies a sensitive field of research. It is important to be aware of the strength and weaknesses of comparative studies and acknowledge their importance beyond the development of new knowledge.

  12. Device including a contact detector

    DEFF Research Database (Denmark)

    2011-01-01

    arms (12) may extend from the supporting body in co-planar relationship with the first surface. The plurality of cantilever arms (12) may extend substantially parallel to each other and each of the plurality of cantilever arms (12) may include an electrical conductive tip for contacting the area......The present invention relates to a probe for determining an electrical property of an area of a surface of a test sample, the probe is intended to be in a specific orientation relative to the test sample. The probe may comprise a supporting body defining a first surface. A plurality of cantilever...... of the test sample by movement of the probe relative to the surface of the test sample into the specific orientation.; The probe may further comprise a contact detector (14) extending from the supporting body arranged so as to contact the surface of the test sample prior to any one of the plurality...

  13. Neoclassical transport including collisional nonlinearity.

    Science.gov (United States)

    Candy, J; Belli, E A

    2011-06-10

    In the standard δf theory of neoclassical transport, the zeroth-order (Maxwellian) solution is obtained analytically via the solution of a nonlinear equation. The first-order correction δf is subsequently computed as the solution of a linear, inhomogeneous equation that includes the linearized Fokker-Planck collision operator. This equation admits analytic solutions only in extreme asymptotic limits (banana, plateau, Pfirsch-Schlüter), and so must be solved numerically for realistic plasma parameters. Recently, numerical codes have appeared which attempt to compute the total distribution f more accurately than in the standard ordering by retaining some nonlinear terms related to finite-orbit width, while simultaneously reusing some form of the linearized collision operator. In this work we show that higher-order corrections to the distribution function may be unphysical if collisional nonlinearities are ignored.

  14. OCCUPATIONAL ROLE AFTER PSYCHIATRIC HOSPITALIZATION

    Directory of Open Access Journals (Sweden)

    GH.R GHASSEMI

    2003-03-01

    Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

  15. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

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

  16. Hospital Library Administration.

    Science.gov (United States)

    Cramer, Anne

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

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

    Science.gov (United States)

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

    2017-10-01

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

  18. Maximizing profitability in a hospital outpatient pharmacy.

    Science.gov (United States)

    Jorgenson, J A; Kilarski, J W; Malatestinic, W N; Rudy, T A

    1989-07-01

    This paper describes the strategies employed to increase the profitability of an existing ambulatory pharmacy operated by the hospital. Methods to generate new revenue including implementation of a home parenteral therapy program, a home enteral therapy program, a durable medical equipment service, and home care disposable sales are described. Programs to maximize existing revenue sources such as increasing the capture rate on discharge prescriptions, increasing "walk-in" prescription traffic and increasing HMO prescription volumes are discussed. A method utilized to reduce drug expenditures is also presented. By minimizing expenses and increasing the revenues for the ambulatory pharmacy operation, net profit increased from +26,000 to over +140,000 in one year.

  19. UK surplus source disposal programme - 16097

    International Nuclear Information System (INIS)

    John, Gordon H.; Reeves, Nigel; Nisbet, Amy C.; Garnett, Andrew; Williams, Clive R.

    2009-01-01

    The UK Surplus Source Disposal Programme (SSDP), managed by the Environment Agency, was designed to remove redundant radioactive sources from the public domain. The UK Government Department for Environment, Food and Rural Affairs (Defra) was concerned that disused sources were being retained by hospitals, universities and businesses, posing a risk to public health and the environment. AMEC provided a range of technical and administrative services to support the SSDP. A questionnaire was issued to registered source holders and the submitted returns compiled to assess the scale of the project. A member of AMEC staff was seconded to the Environment Agency to provide technical support and liaise directly with source holders during funding applications, which would cover disposal costs. Funding for disposal of different sources was partially based on a sliding scale of risk as determined by the IAEA hazard categorisation system. This funding was also sector dependent. The SSDP was subsequently expanded to include the disposal of luminised aircraft instruments from aviation museums across the UK. These museums often hold significant radiological inventories, with many items being unused and in a poor state of repair. These instruments were fully characterised on site by assessing surface dose rate, dimensions, source integrity and potential contamination issues. Calculations using the Microshield computer code allowed gamma radiation measurements to be converted into total activity estimates for each source. More than 11,000 sources were disposed of under the programme from across the medical, industrial, museum and academic sectors. The total activity disposed of was more than 8.5 E+14 Bq, and the project was delivered under budget. (authors)

  20. ELEMENTAL FORMS OF HOSPITALITY

    OpenAIRE

    Maximiliano Emanuel Korstanje

    2010-01-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Magdalena Iorga

    2017-12-01

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

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

    Science.gov (United States)

    Pan, Zhi Xiong; Pokharel, Shaligram

    2007-01-01

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

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

    Science.gov (United States)

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

    2017-12-11

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

  5. Hip fracture in hospitalized medical patients

    Directory of Open Access Journals (Sweden)

    Zapatero Antonio

    2013-01-01

    Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p  Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.

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

    Science.gov (United States)

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

    2012-12-01

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

  7. [Flexibility and safety in hospitals].

    Science.gov (United States)

    Fara, G M; Barni, M

    2011-01-01

    The paper explains the reasons according to which the newly-planned hospitals must adopt the concept of advanced flexibility (structural, technological, organizational, diagnostic and therapeutic), in order to avoid the risk of being already obsolete at the moment of their opening, and this due to the fact that too much time elapses in this Country between the moment of planning a new hospital and the moment of the start of its activity. Flexibility is needed at different levels: at low or medium levels for what concerns administrative spaces and also patient rooms (except, in this latter case, when differential intensity of care is adopted); at advanced levelfor what concerns diagnostic and therapeutic areas, which must be rapidly adaptable to new solutions offered by advances in technology and organization. From a different standpoint, flexibility applies also to the fact that hospital must increasingly become a node of a large net including territorial health services: the latter devoted to take care of chronicity, while hospitals should concentrate on acute pathology. Of course the territory surrounding the hospital, through its outpatient service and consultories, is in charge also for first level diagnosy and therapy, leaving the hospital to more sophisticated activities.

  8. The Impact of Medicaid Disproportionate Share Hospital Payment on Provision of Hospital Uncompensated Care

    Science.gov (United States)

    Hsieh, Hui-Min; Bazzoli, Gloria J.

    2012-01-01

    This study examines the association between hospital uncompensated care (UC) and reductions in Medicaid Disproportionate Share Hospital (DSH) payments resulting from the 1997 Balanced Budget Act. Data on California hospitals from 1996 to 2003 were examined using two-stage least squares with a first-differencing model to control for potential feedback effects. Our findings suggest that not-for-profit hospitals did reduce UC provision in response to reductions in Medicaid DSH, but the response was inelastic in value. Policy makers need to continue to monitor how UC changes as sources of support for indigent care change with the Patient Protection and Affordable Care Act (PPACA). PMID:23230705

  9. [Moral responsibility of hospital management].

    Science.gov (United States)

    Schmidt-Wilcke, Heinrich Alyosius

    2009-03-15

    The self-concept of hospitals today includes the role of service providers, and so they act accordingly. This attitude is chiefly held by hospital administrators. It means that at management level there is a shift of values toward business ethics. However, hospital management is responsible not only for the business aspects of the hospital but also for the provision of adequate medical care to patients. Therefore, hospitals as service providers must be governed by the principles of medical as well as of business ethics. These principles, although from different areas, can be made to largely coincide, but can also lead to divergent positions within a hospital. The result is what within the scope of medical ethics, too, is experienced as a conflict of principles, e.g., the principle of beneficence versus the principle of autonomy. A reconciliation of such divergent moral positions can often be effected by analyzing the actual conflict situation and thus reaching consensus. The conflict between the principles of medical ethics and business ethics takes place chiefly within the sphere of activity of those providing medical and nursing care. As a consequence, a necessary business decision taken by the management to improve the productivity of medical and nursing activities can lead to serious deficits on the staff side. In terms of business ethics, this is a lack of beneficence toward individual staff members that are perhaps overtaxed, and at the same time, in terms of medical ethics, a potential lack of beneficence toward hospital patients is implicitly accepted. In general, management has the responsibility for bringing about, in the day-to-day operation of a hospital, a plausible reconciliation of the ethical principles of two spheres of activity that are only apparently independent of each other.

  10. Hungry in hospital, well-fed in prison? A comparative analysis of food service systems.

    Science.gov (United States)

    Johns, Nick; Edwards, John S A; Hartwell, Heather J

    2013-09-01

    Meals served in prisons and hospitals are produced in similar ways and have similar characteristics, yet hospital patients are often at risk of being undernourished, while prisoners typically are not. This article examines field notes collected during nutritional studies of prison and hospital food service, which confirmed the difference in nutrient intake claimed by other authors. A comparison of food service processes and systems showed that the production of meals and the quality leaving the kitchen was similar in both types of institution. However, the delivery and service system was found to be much less coherent in hospital than in prison. Transport and service of hospital food were subject to delays and disruptions from a number of sources, including poor communication and the demands of medical professionals. These meant that meals reached hospital patients in a poorer, less appetising condition than those received by prisoners. The findings are discussed in the light of previous work and in terms of hospital food service practice. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  11. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    Science.gov (United States)

    Anderson, David W.

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Courtney Suess Raeisinafchi

    2017-06-01

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

  13. Source Water Protection Contaminant Sources

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Simplified aggregation of potential contaminant sources used for Source Water Assessment and Protection. The data is derived from IDNR, IDALS, and US EPA program...

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

    Directory of Open Access Journals (Sweden)

    Motomura Noboru

    2008-11-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  16. Organization of infection control in European hospitals.

    Science.gov (United States)

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

    2015-12-01

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

  17. [The hospital as space and as territory].

    Science.gov (United States)

    Stiefel, Friedrich; Marion-Veyron, Régis; Englebert, Jérôme

    2018-02-07

    Space is lived individually and collectively and can become a source of existential affectation, especially when the lived experience is modified by disease. The fact that the hospital is also a place of territorialisation can potentiate this affectation, with at times surprising consequences. We aim - based on a reflection about the relationship patients and clinicians establish with the territory of the hospital- to identify some psychological and existential issues at stake with regard to space as a social construction.

  18. Ethics issues in security hospitals.

    Science.gov (United States)

    Weinstein, Henry C

    2002-01-01

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

  19. Lifestyle practices and the health promoting environment of hospital nurses.

    Science.gov (United States)

    Hope, A; Kelleher, C C; O'Connor, M

    1998-08-01

    Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern/worry in caring for AIDS patients than qualified nurses.

  20. Lifestyle practices and the health promoting environment of hospital nurses.

    LENUS (Irish Health Repository)

    Hope, A

    1998-08-01

    Lifestyle practices and the health promoting environment of hospital nurses This paper examined the lifestyle practices of hospital nurses and the impact of specific interventions in the hospital environment. The perception of nurse as health promoter and as carer of AIDS patients was also examined. A self-administered questionnaire was used to collect data at two different time periods. The sample represented 729 nurses (at pre- and post-time periods), both qualified and student nurses. Qualified nurses reported the highest stress levels while student nurses reported more negative lifestyle practices such as smoking, alcohol consumption and drug use. A greater number of current smokers (29%) consumed alcohol and used drugs than non-smokers. The impact of intervention strategies around compliance with smoking policy and work-site walk routes reduced exposure to passive smoking at work for qualified nurses and increased exercise participation for both groups of nurses. Workplace was identified as the main source of stress which included relationships at work and demands of the job. Hospital nurses experiencing high work stress were more likely to use professional support and personal coping (discuss problems with friends\\/family, have a good cry and eat more) than others. Nurses believed in the importance of health promotion as part of their work; however, qualified nurses felt more confident and gave more health related information than student nurses. Student nurses perceived a lower risk of contacting AIDS through work and a higher concern\\/worry in caring for AIDS patients than qualified nurses.

  1. Sealed radioactive source management

    International Nuclear Information System (INIS)

    2005-01-01

    Sealed radioactive sources have been used in a wide range of application in medicine, agriculture, geology, industry and other fields. Since its utilization many sources have become out of use and became waste but no proper management. This has lead to many accidents causing deaths and serious radiation injuries worldwide. Spent sources application is expanding but their management has seen little improvements. Sealed radioactive sources have become a security risk calling for prompt action. Source management helps to maintain sources in a good physical status and provide means of source tracking and control. It also provides a well documented process of the sources making any future management options safe, secure and cost effective. Last but not least good source management substantially reduces the risk of accidents and eliminates the risk of malicious use. The International Atomic Energy Agency assists Member States to build the infrastructure to properly manage sealed radioactive sources. The assistance includes training of national experts to handle, condition and properly store the sources. For Member States that do not have proper facilities, we provide the technical assistance to design a proper facility to properly manage the radioactive sources and provide for their proper storage. For Member States that need to condition their sources properly but don't have the required infrastructure we provide direct assistance to physically help them with source recovery and provide an international expert team to properly condition their sources and render them safe and secure. We offer software (Radioactive Waste Management Registry) to properly keep a complete record on the sources and provide for efficient tracking. This also helps with proper planning and decision making for long term management

  2. Racial Disparity in Duration of Patient Visits to the Emergency Department: Teaching Versus Non-teaching Hospitals

    Directory of Open Access Journals (Sweden)

    Zynal Karaca

    2013-09-01

    Full Text Available Introduction: The sources of racial disparity in duration of patients’ visits to emergency departments (EDs have not been documented well enough for policymakers to distinguish patient-related factors from hospital- or area-related factors. This study explores the racial disparity in duration of routine visits to EDs at teaching and non-teaching hospitals.Methods: We performed retrospective data analyses and multivariate regression analyses to investigate the racial disparity in duration of routine ED visits at teaching and non-teaching hospitals. The Healthcare Cost and Utilization Project (HCUP State Emergency Department Databases (SEDD were used in the analyses. The data include 4.3 million routine ED visits encountered in Arizona, Massachusetts, and Utah during 2008. We computed duration for each visit by taking the difference between admission and discharge times.Results: The mean duration for a routine ED visit was 238 minutes at teaching hospitals and 175 minutes at non-teaching hospitals. There were significant variations in duration of routine ED visits across race groups at teaching and non-teaching hospitals. The risk-adjusted results show that the mean duration of routine ED visits for Black/African American and Asian patients when compared to visits for white patients was shorter by 10.0 and 3.4%, respectively, at teaching hospitals; and longer by 3.6 and 13.8%, respectively, at non-teaching hospitals. Hispanic patients, on average, experienced 8.7% longer ED stays when compared to white patients at non-teaching hospitals.Conclusion: There is significant racial disparity in the duration of routine ED visits, especially in non-teaching hospitals where non-White patients experience longer ED stays compared to white patients. The variation in duration of routine ED visits at teaching hospitals when compared to non-teaching hospitals was smaller across race groups. [West J Emerg Med. 2013;14(5:529–541.

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

    Science.gov (United States)

    So, Cynthia; Pierluissi, Edgar

    2012-04-01

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

  4. Experience with an end-of-life practice at a university hospital.

    Science.gov (United States)

    Campbell, M L; Frank, R R

    1997-01-01

    To describe a 10-yr experience with an end-of-life practice in a hospital. A nonexperimental, prospective, descriptive design was used to record variables from a convenience sample of patients transferred to the Comprehensive Supportive Care Team. Detroit Receiving Hospital is an urban, university-affiliated, Level I trauma/emergency hospital. Patients who are not expected to survive hospitalization, and for whom a decision has been made to focus care on palliative interventions, are candidates for care by this practice. None. Patient demographics, including the following information: age, gender; diagnoses; illness severity; mortality rate; and disposition. Measures of resource utilization included: referral sources; Therapeutic intervention Scoring System values; bed costs; and length of hospital stay. Satisfactory patient/family care with a measurable reeducation in the use of resources can be achieved in the hospital setting. A hands-on approach to the care of dying patients by this specialty, palliative care service has provided patients, families, and clinicians with the type of support needed for satisfactory end-of-life care. A summary of our experience may be useful to others.

  5. Development of a technical scheme for the management of chemical dangerous substances in hospitable environments

    International Nuclear Information System (INIS)

    Calleja Amador, C.E.

    2002-01-01

    The chemical substances that are used in the hospitals, and their remainders, represent risks for the environment, the health and security of those who work in these establishments, and of the civil population. The deficiency of a norm that establishes the directives for the handling responsible for such products in the hospitals that our country has motivated the elaboration of a technical scheme that serves as it guides for the correct manipulation, storage and safe disposition of chemical substances in the twenty-nine hospitals of the Caja Costarricense del Seguro Social, establishing Procedures of Standard Operation for its management. To development of the guideline proposal it took a sample of hospitals that includes three levels of comple complexity: national, regional and peripheral. Applying a methodology of evaluation of risks two factors of risk of hospitable were determined, the zones and the population but affected by the existence of chemical substances, which allowed to identify some operative deficiencies in the product handling diverse. The qualitative analysis of the results lead to the elaboration of a technical scheme that includes an instrument for the identification of risks, guideline for the management responsible for hospitable chemical substances, a friendly tool computations like complementary source of intelligence and the proposal of a governing group in charge of the monitoring of the fulfillment of these lineament. (Author) [es

  6. Methicillin-resistant staphylococcal contamination of cellular phones of personnel in a veterinary teaching hospital

    Directory of Open Access Journals (Sweden)

    Julian Timothy

    2012-07-01

    Full Text Available Abstract Background Hospital-associated infections are an increasing cause of morbidity and mortality in veterinary patients. With the emergence of multi-drug resistant bacteria, these infections can be particularly difficult to eradicate. Sources of hospital-associated infections can include the patients own flora, medical staff and inanimate hospital objects. Cellular phones are becoming an invaluable feature of communication within hospitals, and since they are frequently handled by healthcare personnel, there may be a potential for contamination with various pathogens. The objective of this study was to determine the prevalence of contamination of cellular phones (hospital issued and personal carried by personnel at the Ontario Veterinary College Health Sciences Centre with methicillin-resistant Staphylococcus pseudintermedius (MRSP and methicillin-resistant Staphylococcus aureus (MRSA. Results MRSP was isolated from 1.6% (2/123 and MRSA was isolated from 0.8% (1/123 of cellular phones. Only 21.9% (27/123 of participants in the study indicated that they routinely cleaned their cellular phone. Conclusions Cellular phones in a veterinary teaching hospital can harbour MRSP and MRSA, two opportunistic pathogens of significant concern. While the contamination rate was low, cellular phones could represent a potential source for infection of patients as well as infection of veterinary personnel and other people that might have contact with them. Regardless of the low incidence of contamination of cellular phones found in this study, a disinfection protocol for hospital-issued and personal cellular phones used in veterinary teaching hospitals should be in place to reduce the potential of cross-contamination.

  7. Positron sources

    International Nuclear Information System (INIS)

    Chehab, R.

    1994-01-01

    A tentative survey of positron sources is given. Physical processes on which positron generation is based are indicated and analyzed. Explanation of the general features of electromagnetic interactions and nuclear β + decay makes it possible to predict the yield and emittance for a given optical matching system between the positron source and the accelerator. Some kinds of matching systems commonly used - mainly working with solenoidal field - are studied and the acceptance volume calculated. Such knowledge is helpful in comparing different matching systems. Since for large machines, a significant distance exists between the positron source and the experimental facility, positron emittance has to be preserved during beam transfer over large distances and methods used for that purpose are indicated. Comparison of existing positron sources leads to extrapolation to sources for future linear colliders. Some new ideas associated with these sources are also presented. (orig.)

  8. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

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

  9. The interstices of hospitality

    African Journals Online (AJOL)

    jane.b

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

  10. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

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

  11. The Hospitable Meal Model

    DEFF Research Database (Denmark)

    Justesen, Lise; Overgaard, Svend Skafte

    2017-01-01

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

  12. Structural Measures - Hospital

    Data.gov (United States)

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

  13. Hospital Compare - Archived Data

    Data.gov (United States)

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

  14. Research in Hospitality Management

    African Journals Online (AJOL)

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

  15. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

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

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

    Science.gov (United States)

    Cangelosi, J D

    1997-01-01

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

  17. Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema

    Science.gov (United States)

    ... Submit Button NCHS Home Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema Recommend on Facebook ... Percent of visits to office-based physicians with COPD indicated on the medical record: 3.2% Source: ...

  18. Sources management

    International Nuclear Information System (INIS)

    Mansoux, H.; Gourmelon; Scanff, P.; Fournet, F.; Murith, Ch.; Saint-Paul, N.; Colson, P.; Jouve, A.; Feron, F.; Haranger, D.; Mathieu, P.; Paycha, F.; Israel, S.; Auboiroux, B.; Chartier, P.

    2005-01-01

    Organized by the section of technical protection of the French society of radiation protection ( S.F.R.P.), these two days had for objective to review the evolution of the rule relative to the sources of ionising radiations 'sealed and unsealed radioactive sources, electric generators'. They addressed all the actors concerned by the implementation of the new regulatory system in the different sectors of activities ( research, medicine and industry): Authorities, manufacturers, and suppliers of sources, holders and users, bodies involved in the approval of sources, carriers. (N.C.)

  19. Radioisotopic heat source

    Science.gov (United States)

    Jones, G.J.; Selle, J.E.; Teaney, P.E.

    1975-09-30

    Disclosed is a radioisotopic heat source and method for a long life electrical generator. The source includes plutonium dioxide shards and yttrium or hafnium in a container of tantalum-tungsten-hafnium alloy, all being in a nickel alloy outer container, and subjected to heat treatment of from about 1570$sup 0$F to about 1720$sup 0$F for about one h. (auth)

  20. Using Primary Source Documents.

    Science.gov (United States)

    Mintz, Steven

    2003-01-01

    Explores the use of primary sources when teaching about U.S. slavery. Includes primary sources from the Gilder Lehrman Documents Collection (New York Historical Society) to teach about the role of slaves in the Revolutionary War, such as a proclamation from Lord Dunmore offering freedom to slaves who joined his army. (CMK)

  1. 42 CFR 409.10 - Included services.

    Science.gov (United States)

    2010-10-01

    ... an inpatient of a participating hospital or of a participating CAH or, in the case of emergency... practitioner and clinical nurse specialist services, as defined in section 1861(s)(2)(K)(ii) of the Act. (6...

  2. Command in a field hospital.

    Science.gov (United States)

    Bricknell, M C M

    2003-03-01

    This paper examines the challenges involved in commanding a field hospital. There are frequent, dynamic tensions between the military culture that is based on a task-focussed, hierarchical structure and the clinical culture that is based on flat, process-focussed, multidisciplinary teams. The paper outlines the cultural environment of the field hospital and then examines the deployment sequence whereby a functioning clinical facility may be created from a group of disparate individuals. There are a number of tools that may assist with this including the personality of the Commanding Officer, individual skills, the creation of an organizational identity and the choice of command structure.

  3. External collection of Hospital Wastes: Danish example. Recogida externa de residuos hospitalarios: el ejemplo danes

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, P

    1994-01-01

    Hospital Waste not only comes from hospital, in recent years, the potential hazard and nuisance caused by similar waste categories from other sources have been focused on more and more. Typical examples of such sources are: doctor's practice, dentist's clinics, veterinary hospitals, medical and biochemical laboratories, pharmacies, nursing homes, visting nurses, private homes, public conveniences, public places in troubled areas.

  4. Implementing Patient Safety Initiatives in Rural Hospitals

    Science.gov (United States)

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  5. Introduction to Hospitality and Tourism. Teacher Edition.

    Science.gov (United States)

    Walker, Susan S.

    This teacher's guide is the core publication of a series of instructional materials developed for the hospitality and tourism industry. It includes the entry-level competencies students will need to enter any of the occupational areas identified in the four cluster areas of the hospitality and tourism industry: lodging, food service, travel and…

  6. Hospitality Management: Perspectives from Industry Advisor

    Directory of Open Access Journals (Sweden)

    Rachel Roginsky

    2013-07-01

    Full Text Available In prior quarterly reports, Pinnacle Advisory Group presented timely updates about the New England lodging industry, which included focused profiles on particular cities. In this issue, the firm offers more general insight about the hospitality industry. Several Pinnacle executives recently participated in a panel discussion about investment, management, and careers in the hospitality industry.

  7. The European View of Hospital Undernutrition

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.

    2003-01-01

    of clearly defined responsibilities, 2) lack of sufficient education, 3) lack of influence and knowledge of the patients, 4) lack of cooperation between different staff groups, and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined timely and concerted effort...... is required from national authorities and hospital staff, including managers, to ensure appropriate nutritional care and support.......Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial...

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

    Science.gov (United States)

    Carter, Mary W

    2003-08-01

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

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

    Science.gov (United States)

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

    2014-06-01

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

  10. Elements of a thermic method of preparing beta-sources with fused carriers, including strontium-90; Elements d'une methode thermique de preparation de sources beta avec des entraineurs fondus, y compris le strontium-90; Osnovy termicheskogo metoda prigotovleniya beta-istochnikov s plavlennymi nositelyami, vklyuchayushchimi strontsij-90; Bases de un metodo termico de preparacion de fuentes beta con portadores fundidos, incluido el estroncio-90

    Energy Technology Data Exchange (ETDEWEB)

    Bogdanov, N I; Zakharova, K P; Zimakov, P V; Kulichenko, V V

    1962-01-15

    Sources of ionizing radiation based on the radioisotope Sr{sup 90} are widely used in apparatus and systems of automatic control and regulation of industrial processes. The technology of the preparation of sources is based on dehydration of a mixture of a radioactive solution of strontium nitrate with components such as boric anhydride, silica, and alumina. Thermic treatment of the dehydrated mixture at a high temperature produces a very mobile melt. This cools to a vitreous mass containing the required quantity of the radioisotope Sr{sup 90}. The paper gives data and discusses the results of dehydration of the system SrO - B{sub 2}O{sub 3} - SiO{sub 2} within a temperature range of 100 - 1000{sup o}C and justifies the choice of the main parameters of the technological process. It summarizes a method of mounting a vitreous preparation containing the required quantity of the radioisotope Sr{sup 90} on bases of various shapes and sizes made of steel, ceramic and other materials. The authors discuss the main parameters, ensuring that various types of sources shall be reliable and safe in operation, and give data of Sr{sup 90} sources prepared by the thermic method. (author) [French] Les sources de rayonnements ionisants a base de strontium-90 trouvent une large application dans les appareils et les systemes de controle et de reglage automatique des procedes de production. Le procede de preparation des sources se fonde sur la deshydratation d'un melange compose d'une solution radioactive de nitrate de strontium et d'elements comme l'anhydride borique, la silice, l'alumine, etc. Le traitement thermique du melange deshydrate a haute temperature donne lieu a la formation d'une masse fondue tres mobile, dont le refroidissement fournit une masse vitreuse contenant la quantite requise du radioisotope {sup 59}Sr. Les auteurs citent les donnees et examinent Jes resultats d'une etude sur la deshydratation du systeme SrO - B{sub 2}O{sub 3} - SiO{sub 2} a des temperatures

  11. Environmental Data Sources

    Data.gov (United States)

    Kansas Data Access and Support Center — This database includes gauging stations, climatic data centers, and storet sites. The accuracy of the locations is dependent on the source data for each of the...

  12. [Continuity of hospital identifiers in hospital discharge data - Analysis of the nationwide German DRG Statistics from 2005 to 2013].

    Science.gov (United States)

    Nimptsch, Ulrike; Wengler, Annelene; Mansky, Thomas

    2016-11-01

    In Germany, nationwide hospital discharge data (DRG statistics provided by the research data centers of the Federal Statistical Office and the Statistical Offices of the 'Länder') are increasingly used as data source for health services research. Within this data hospitals can be separated via their hospital identifier ([Institutionskennzeichen] IK). However, this hospital identifier primarily designates the invoicing unit and is not necessarily equivalent to one hospital location. Aiming to investigate direction and extent of possible bias in hospital-level analyses this study examines the continuity of the hospital identifier within a cross-sectional and longitudinal approach and compares the results to official hospital census statistics. Within the DRG statistics from 2005 to 2013 the annual number of hospitals as classified by hospital identifiers was counted for each year of observation. The annual number of hospitals derived from DRG statistics was compared to the number of hospitals in the official census statistics 'Grunddaten der Krankenhäuser'. Subsequently, the temporal continuity of hospital identifiers in the DRG statistics was analyzed within cohorts of hospitals. Until 2013, the annual number of hospital identifiers in the DRG statistics fell by 175 (from 1,725 to 1,550). This decline affected only providers with small or medium case volume. The number of hospitals identified in the DRG statistics was lower than the number given in the census statistics (e.g., in 2013 1,550 IK vs. 1,668 hospitals in the census statistics). The longitudinal analyses revealed that the majority of hospital identifiers persisted in the years of observation, while one fifth of hospital identifiers changed. In cross-sectional studies of German hospital discharge data the separation of hospitals via the hospital identifier might lead to underestimating the number of hospitals and consequential overestimation of caseload per hospital. Discontinuities of hospital

  13. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

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

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

    African Journals Online (AJOL)

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

  15. Sourcing Excellence

    DEFF Research Database (Denmark)

    Adeyemi, Oluseyi

    2011-01-01

    Sourcing Excellence is one of the key performance indicators (KPIs) in this world of ever changing sourcing strategies. Manufacturing companies need to access and diagnose the reliability and competencies of existing suppliers in order to coordinate and develop them. This would help in managing...

  16. Children's psychological responses to hospitalization.

    Science.gov (United States)

    Vessey, Judith A

    2003-01-01

    The data-based literature addressing children's psychological responses to hospitalization was reviewed using methods outlined by Cooper (1989). Using a developmental science perspective, early research was reviewed and a model of variables that contribute to children's responses was constructed. This model consists of three major foci, including maturational and cognitive variables (developmental level, experience, coping style), ecological variables (family and hospital milieu), and biological variables (inborn factors and pathophysiology). Coping serves as the overarching framework for examining these variables and their contributions to children's responses to hospitalization. A variety of theoretical perspectives from the social sciences have been used, with psychoanalytic and stress and adaptation theories predominating. The majority of the research used simple case study, descriptive, or pre- and post-test designs. Methodologic issues were common. Little qualitative work has been done. Future research directions call for studies to adopt new theoretical and empirical models that are methodologically rigorous and clinically relevant and that embrace the precepts of developmental science.

  17. Are hospitals also for relatives?

    DEFF Research Database (Denmark)

    Nissen, Nina Konstantin; Madsen, Mette; Kjøller, Mette

    2008-01-01

    at relatives of patients with cardiac diseases is sparse. This study aimed to survey the prevalence of health services for relatives of cardiac patients in Denmark. METHODS: We surveyed activities offered by Danish hospitals to the relatives of cardiac patients. Data were obtained from an Internet-based survey...... and 50 of 55 invited hospital departments participated. RESULTS: Almost all departments offer activities to relatives of cardiac patients, but only one-quarter have activities specifically aimed at supporting relatives. Large departments offer activities for relatives more often than smaller departments....... Participation rates for relatives are generally low, and the departments experience numerous barriers in providing activities for relatives of heart patients. CONCLUSIONS: Danish hospitals focus very little on relatives of cardiac patients, and this seems to be due to several factors, including lack...

  18. Emission sources and quantities

    International Nuclear Information System (INIS)

    Heinen, B.

    1991-01-01

    The paper examines emission sources and quantities for SO 2 and NO x . Natural SO 2 is released from volcanic sources and to a much lower extent from marsh gases. In nature NO x is mainly produced in the course of the chemical and bacterial denitrification processes going on in the soil. Manmade pollutants are produced in combustion processes. The paper concentrates on manmade pollution. Aspects discussed include: mechanism of pollution development; manmade emission sources (e.g. industry, traffic, power plants and domestic sources); and emission quantities and forecasts. 11 refs., 2 figs., 5 tabs

  19. Positron sources

    International Nuclear Information System (INIS)

    Chehab, R.

    1989-01-01

    A tentative survey of positron sources is given. Physical processes on which positron generation is based are indicated and analyzed. Explanation of the general features of electromagnetic interactions and nuclear β + decay makes it possible to predict the yield and emittance for a given optical matching system between the positron source and the accelerator. Some kinds of matching systems commonly used - mainly working with solenoidal fields - are studied and the acceptance volume calculated. Such knowledge is helpful in comparing different matching systems. Since for large machines, a significant distance exists between the positron source and the experimental facility, positron emittance has to be preserved during beam transfer over large distances and methods used for that purpose are indicated. Comparison of existing positron sources leads to extrapolation to sources for future linear colliders

  20. Success under duress: policies and practices managers view as keys to profitability in five California hospitals with challenging payer mix.

    Science.gov (United States)

    Rundall, Thomas; Oberlin, Shelley; Thygesen, Brian; Janus, Katharina

    2012-01-01

    Hospitals with a challenging payer mix (CPM)-high proportions of uninsured and Medicaid patients and a low proportion of commercially insured patients-are an important source of care for low-income, uninsured people. Achieving profitability is difficult for CPM hospitals. From 2005 through 2008, only one-third of 67 CPM hospitals in California reported positive total margins. In-depth group interviews were completed with the management leadership teams of a diverse group of five profitable CPM hospitals to identify the management strategies and practices that the hospitals' leadership teams credited for their financial success. Twelve management policy and practice topics were identified. Four of the policies and practices that managers identified involve organizational actions to increase hospital revenue or operational efficiency. These factors are consistent with those identified in previous research. However, managers also identified eight factors not previously revealed in research on hospital profitability, including management policies and practices that establish the organizational culture, workforce, relationships, monitoring systems, and governance necessary to ensure that hospital employees and affiliated physicians support and successfully implement organizational actions necessary to achieve profitability.

  1. 'Hospitality' Is an Inviting Field at Many Colleges.

    Science.gov (United States)

    Collison, Michele N-K

    1988-01-01

    Hospitality programs, which include courses in hotel, restaurant, and institutional management, are more popular than ever, due to a boom in the hotel and restaurant industries. Interest has also been spurred by increased demands from hospitals and retirement homes. (MLW)

  2. Recommendations for Using Barcode in Hospital Process.

    Science.gov (United States)

    Hachesu, Peyman Rezaei; Zyaei, Leila; Hassankhani, Hadi

    2016-06-01

    Lack of attention to the proper barcode using leads to lack of use or misuse in the hospitals. The present research aimed to investigate the requirements and barrier for using barcode technology and presenting suggestions to use it. The research is observational-descriptive. The data was collected using the designed checklist which its validity was assessed. This check list consists of two parts: "Requirements" and "barrier" of using the barcodes. Research community included 10 teaching hospitals and a class of 65 participants included people in the hospitals. The collected data was analyzed using descriptive statistics. Required changes of workflow processes in the hospital and compliance them with the hospital policy are such requirements that had been infringed in the 90 % of hospitals. Prioritization of some hospital processes for barcoding, system integration with Hospital Information system (HIS), training of staff and budgeting are requirements for the successful implementation which had been infringed in the 80% of hospitals. Dissatisfaction with the quality of barcode labels and lacks of adequate scanners both whit the rate of 100 %, and the lack of understanding of the necessary requirements for implementation of barcodes as 80% were the most important barrier. Integrate bar code system with clinical workflow should be considered. Lack of knowledge and understanding toward the infrastructure, inadequate staff training and technologic problems are considered as the greatest barriers.

  3. Specialty and full-service hospitals: a comparative cost analysis.

    Science.gov (United States)

    Carey, Kathleen; Burgess, James F; Young, Gary J

    2008-10-01

    To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

  4. Hospital distribution in a metropolitan city: assessment by a geographical information system grid modelling approach

    Directory of Open Access Journals (Sweden)

    Kwang-Soo Lee

    2014-05-01

    Full Text Available Grid models were used to assess urban hospital distribution in Seoul, the capital of South Korea. A geographical information system (GIS based analytical model was developed and applied to assess the situation in a metropolitan area with a population exceeding 10 million. Secondary data for this analysis were obtained from multiple sources: the Korean Statistical Information Service, the Korean Hospital Association and the Statistical Geographical Information System. A grid of cells measuring 1 × 1 km was superimposed on the city map and a set of variables related to population, economy, mobility and housing were identified and measured for each cell. Socio-demographic variables were included to reflect the characteristics of each area. Analytical models were then developed using GIS software with the number of hospitals as the dependent variable. Applying multiple linear regression and geographically weighted regression models, three factors (highway and major arterial road areas; number of subway entrances; and row house areas were statistically significant in explaining the variance of hospital distribution for each cell. The overall results show that GIS is a useful tool for analysing and understanding location strategies. This approach appears a useful source of information for decision-makers concerned with the distribution of hospitals and other health care centres in a city.

  5. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

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

  6. Hospitality and Institutional Meals

    DEFF Research Database (Denmark)

    Justesen, Lise; Strøjer, Anna-Lise

    2017-01-01

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

  7. Hospital turnaround strategies.

    Science.gov (United States)

    Langabeer, James

    2008-01-01

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

  8. ELEMENTAL FORMS OF HOSPITALITY

    Directory of Open Access Journals (Sweden)

    Maximiliano Emanuel Korstanje

    2010-11-01

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

  9. З ІСТОРІЇ ФОРМУВАННЯ ІНСТИТУТУ ГОСТИННОСТІ / Ethnocultural sources of formation of the institute of hospitality

    Directory of Open Access Journals (Sweden)

    Курочкін Олександр

    2015-06-01

    Full Text Available Курочкин О. Из истории формирования института гостеприимства. В сообщении прослеживаются истоки и основные этапы становления общеевропейского института гостеприимства. Анализируется роль в формировании этого феномена таких факторов как религия, бытовая культура, этнический этикет, международная торговля и международный туризм. Ключевые слова: гость, гостеприимство, проксения, этикет, ритуал, благодетельные учреждения, коммерческая сфера услуг, туризм. Kurochkin O. ETHNOCULTURAL SOURCES OF FORMATION OF THE INSTITUTE OF HOSPITALITY. The report traces back sorces and basic periods of development of the europen institute of hospitality. The role of such factors as religion, everyday culture, ethnical ethiquet, international trade and tourism. On the basis of multidisciplinary approach the historical establishment of the institute of hospitality is concisely traced as an important factor of intercultural communication. It is worth while remembering that for a long time humanity existed according to the "law of the jungle": those who for various reasons, found themselves on foreign territory, were considered as mortal enemies that had to be destroyed or chased away. However, already in the distant past there are many examples of tolerant, friendly attitude to strangers. Very indicative in this respect is ancient Greece, where there was a ritual contract of proxeny – mutual hospitality between representatives of different policies. A good example for mankind was also ekehiriyi – a tradition of the sacred peace, which forbade the Greek state to wage war during the

  10. The adoption of provider-based rural health clinics by rural hospitals: a study of market and institutional forces.

    Science.gov (United States)

    Krein, S L

    1999-04-01

    To examine the response of rural hospitals to various market and organizational signals by determining the factors that influence whether or not they establish a provider-based rural health clinic (RHC) (a joint Medicare/Medicaid program). Several secondary sources for 1989-1995: the AHA Annual Survey, the PPS Minimum Data Set and a list of RHCs from HCFA, the Area Resource File, and professional associations. The analysis includes all general medical/surgical rural hospitals operating in the United States during the study period. A longitudinal design and pooled cross-sectional data were used, with the rural hospital as the unit of analysis. Key variables were examined as sets and include measures of competitive pressures (e.g., hospital market share), physician resources, nurse practitioner/physician assistant (NP/PA) practice regulation, hospital performance pressures (e.g., operating margin), innovativeness, and institutional pressure (i.e., the cumulative force of adoption). Adoption of provider-based RHCs by rural hospitals appears to be motivated less as an adaptive response to observable economic or internal organizational signals than as a reaction to bandwagon pressures. Rural hospitals with limited resources may resort to imitating others because of uncertainty or a limited ability to fully evaluate strategic activities. This can result in actions or behaviors that are not consistent with policy objectives and the perceived need for policy changes. Such activity in turn could have a negative effect on some providers and some rural residents.

  11. Orphan sources in Slovenia

    International Nuclear Information System (INIS)

    Janzekovic, H.; Cesarek, J.

    2005-01-01

    For decades the international standards and requirements postulate severe control over all lifecycle phases of radioactive sources in order to prevent risks associated with exposure of people and the environment. Despite this fact the orphan sources became a serious problem as a consequence of enlargement of economic transactions in many countries in Europe as well as in the world. The countries as well as international organisations, aware of this emerging problem, are trying to gain control over orphan sources using different approaches. These approaches include control over sources before they could become orphan sources. In addition, countries are also developing action plans in case that an orphan source could be found. The problems related to orphan sources in Slovenia is discussed based on the case studies from the last years. While in the nineties of the last century just a few cases of orphan sources were identified their number has increased substantially since 2003. The paper discusses the general reasons for the phenomena of orphan sources as well as the experience related to regaining control over orphan sources. (author)

  12. Environmental protection law of the European Community (EU). Source index and content index including the jurisdiction of the European Court of Justice with actual jurisdiction service and special literature according to the individual legal regulations. 34. ed.; Umweltschutzrecht der Europaeischen Union (EU). Fundstellen- und Inhaltsnachweis, einschliesslich der Rechtsprechung des Europaeischen Gerichtshofes - EuGH; mit aktuellem Rechtsprechungsdienst und Spezialliteratur zu den einzelnen Rechtsvorschriften

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Bernd

    2009-07-01

    The 34th edition of the source index of the environment law of the European Union contains the documentary evidence of the total jurisdiction of the European Court of Justice (Luxemburg) with respect to the following topics: (a) General infrastructure / integral environment law; (b) Nature protection, landscape protection as well as protection of species; (c) Dangerous materials and preparations; (d) Waste management law; (e) Water legislation; (f) environmental traffic law; (g) law of air pollution control of climate protection; (h) noise control; (i) environmental commercial law; (j) environmental law of energy.

  13. The cost of hospitalization in Crohn's disease.

    Science.gov (United States)

    Cohen, R D; Larson, L R; Roth, J M; Becker, R V; Mummert, L L

    2000-02-01

    The aim of this study was to evaluate the demographics, resource use, and costs associated with hospitalization of Crohn's disease patients. All patients hospitalized at our institution from 7/1/96 to 6/30/97 with a primary diagnosis of "Crohn's Disease" were analyzed using a computerized database. Data are presented "per hospitalization." A total of 175 hospitalizations (147 patients) were identified. Mean patient age was 36.5 yr; 61% were female; 82% Caucasian. Payer mix was most commonly contracted (57%), commercial (21%), or Medicare (13%). 57% of hospitalizations had a primary surgical procedure; the remainder were medical. Average length of stay was 8.7 days (surgical, 9.6 days; medical, 7.5 days). The average cost of hospitalization, excluding physician fees, was $12,528 (surgical, $14,409; medical, $10,020), whereas average charges were $35,378 (surgical, $46,354; medical, $20,744), including physician fees, which averaged $7,249 (surgical, $11,217; medical, $1,959). Mean reimbursements were $21,968 (surgical, $28,946; medical, $12,666) with average weighted reimbursement rates of 60.17% of hospital charges, 69.57% of physician fees. The distribution of costs across subcategories was: Surgery (39.6%), Pharmacy (18.6%), Laboratory (3.8%), Radiology (2.1%), Pathology (0.8%), Endoscopy (0.3%), and Other Hospital Costs (34.9%). Of the hospitalizations, 87% included treatment with steroids, 23% with immunomodulators, and 14% with aminosalicylates; 27% included the administration of total parenteral nutrition, which accounted for 63% of the total pharmacy costs. Surgery accounts for the majority of hospitalizations, nearly 40% of their total costs, and 75% of overall charges and reimbursements. Therapy that decreases the number of surgical hospitalizations should substantially reduce inpatient Crohn's disease costs, as well as overall costs.

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

    Science.gov (United States)

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

    2018-01-29

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

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

    Science.gov (United States)

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

    2012-01-01

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

  16. Enhancing board oversight on quality of hospital care: an agency theory perspective.

    Science.gov (United States)

    Jiang, H Joanna; Lockee, Carlin; Fraser, Irene

    2012-01-01

    Community hospitals in the United States are almost all governed by a governing board that is legally accountable for the quality of care provided. Increasing pressures for better quality and safety are prompting boards to strengthen their oversight function on quality. In this study, we aimed to provide an update to prior research by exploring the role and practices of governing boards in quality oversight through the lens of agency theory and comparing hospital quality performance in relation to the adoption of those practices. Data on board practices from a survey conducted by The Governance Institute in 2007 were merged with data on hospital quality drawn from two federal sources that measured processes of care and mortality. The study sample includes 445 public and private not-for-profit hospitals. We used factor analysis to explore the underlying dimensions of board practices. We further compared hospital quality performance by the adoption of each individual board practice. Consistent with the agency theory, the 13 board practices included in the survey appear to center around enhancing accountability of the board, management, and the medical staff. Reviewing the hospital's quality performance on a regular basis was the most common practice. A number of board practices, not examined in prior research, showed significant association with better performance on process of care and/or risk-adjusted mortality: requiring major new clinical programs to meet quality-related criteria, setting some quality goals at the "theoretical ideal" level, requiring both the board and the medical staff to be as involved as management in setting the agenda for discussion on quality, and requiring the hospital to report its quality/safety performance to the general public. Hospital governing boards should examine their current practices and consider adopting those that would enhance the accountability of the board itself, management, and the medical staff.

  17. Photon sources for absorptiometric measurements

    International Nuclear Information System (INIS)

    Witt, R.M.; Sandrik, J.M.; Cameron, J.R.

    1976-01-01

    Photon absorptiometry is defined and the requirements of photon sources for these measurements are described. Both x-ray tubes and radionuclide sources are discussed, including the advantages of each in absorptiometric systems

  18. The hospital of tomorrow in 10 points.

    Science.gov (United States)

    Vincent, Jean-Louis; Creteur, Jacques

    2017-04-11

    Technology has advanced rapidly in recent years and is continuing to do so, with associated changes in multiple areas, including hospital structure and function. Here we describe in 10 points our vision of some of the ways in which we see our hospitals, particularly those in developed countries, evolving in the future, including increased specialization, greater use of telemedicine and robots, the changing place of the intensive care unit, improved pre-hospital and post-hospital management, and improved end-of-life care. New technology is going to increasingly impact how we practice medicine. We must learn how best to adapt to and encompass these changes if we are to achieve maximum benefit from them for ourselves and our patients. Importantly, while the future hospital will be more advanced technologically, it will also be more advanced on a personal, humane patient care level.

  19. Cigarette makers pioneered many of our black arts of disinformation, including the funding of research to distract from the hazards of smoking. Ten Nobel prizes were the result. By funding distraction research, the cigarette industry became an important source of academic corruption, helping also to forge other forms of denialism on a global scale.

    Science.gov (United States)

    Proctor, R. N.

    2014-12-01

    Cigarette Disinformation: Origins and Global Impact Robert N. Proctor The cigarette is the deadliest artifact in the history of human civilization. And whereas "only" a hundred million people died in the 20th century from smoking, we are presently on a pace to have several times that toll in the present century. Much of that catastrophe would not be possible without a massive campaign of disinformation. The cigarette industry pioneered many of the black arts of disinformation, cleverly exploiting the inherent skepticism of science to claim that "more research" was needed to resolve a purported "cigarette controversy." Cigarette makers funded hundreds of millions of dollars worth of "distraction research," most of which was solid empirical science but off topic, focusing on basic biology and biochemistry, viral and genetic causes of disease, and other "cigarette friendly" topics. At least ten Nobel prizes were the result. Cigarette skepticism was thus more complex than we normally imagine: the tobacco industry corrupted science by funding "alternative causation," meaning anything that could be used to draw attention away from cigarettes as a source of disease. The cigarette industry by this means became the most important source of academic corruption since the Nazi era. That corruption has also helped forge other forms of denialism and corruption on a global scale.

  20. Consumption-based approach for assessing the contribution of hospitals towards the load of pharmaceutical residues in municipal wastewater.

    Science.gov (United States)

    Le Corre, Kristell S; Ort, Christoph; Kateley, Diana; Allen, Belinda; Escher, Beate I; Keller, Jurg

    2012-09-15

    Hospitals are considered as major sources of pharmaceutical residues discharged to municipal wastewater, but recent experimental studies showed that the contribution of hospitals to the loads of selected, quantifiable pharmaceuticals in sewage treatment plant (STP) influents was limited. However such conclusions are made based on the experimental analysis of pharmaceuticals in hospital wastewater which is hindered by a number of factors such as access to suitable sampling sites, difficulties in obtaining representative samples and availability of analytical methods. Therefore, this study explores a refined and extended consumption-based approach to predict the contribution of six selected Australian hospitals to the loads of 589 pharmaceuticals in municipal wastewater. In addition, the possibility that hospital-specific substances are present at levels that may pose a risk for human health was evaluated. For 63 to 84% of the pharmaceuticals investigated, the selected hospitals are not a major point source with individual contributions likely to be less than 15% which is in line with previous experimental studies. In contrast, between 10 and 20% of the pharmaceuticals consumed in the selected hospitals are exclusively used in these hospitals. For these hospital-specific substances, 57 distinct pharmaceuticals may cause concerns for human health as concentrations predicted in hospital effluents are less than 100-fold lower than effect thresholds. However, when concentrations were predicted in the influent of the corresponding STP, only 12 compounds (including the antineoplastic vincristine, the antibiotics tazobactam and piperacillin) remain in concentration close to effect thresholds, but further decrease is expected after removal in STP, dilution in the receiving stream and drinking water treatment. The results of this study suggest that risks of human exposure to the pharmaceuticals exclusively administered in the investigated hospitals are limited and

  1. Sensitivity of the Dengue Surveillance System in Brazil for Detecting Hospitalized Cases

    Science.gov (United States)

    2016-01-01

    We evaluated the sensitivity of the dengue surveillance system in detecting hospitalized cases in ten capital cities in Brazil from 2008 to 2013 using a probabilistic record linkage of two independent information systems hospitalization (SIH-SUS) adopted as the gold standard and surveillance (SINAN). Sensitivity was defined as the proportion of cases reported to the surveillance system amid the suspected hospitalized cases registered in SIH-SUS. Of the 48,174 hospitalizations registered in SIH-SUS, 24,469 (50.7%) were reported and registered in SINAN, indicating an overall sensitivity of 50.8% (95%CI 50.3–51.2). The observed sensitivity for each of the municipalities included in the study ranged from 22.0% to 99.1%. The combination of the two data sources identified 71,161 hospitalizations, an increase of 97.0% over SINAN itself. Our results allowed establishing the proportion of underreported dengue hospitalizations in the public health system in Brazil, highlighting the use of probabilistic record linkage as a valuable tool for evaluating surveillance systems. PMID:27192405

  2. The Medicare Cost Report and the limits of hospital accountability: improving financial accounting data.

    Science.gov (United States)

    Kane, N M; Magnus, S A

    2001-02-01

    Health policy makers, legislators, providers, payers, and a broad range of other players in the health care market routinely seek information on hospital financial performance. Yet the data at their disposal are limited, especially since hospitals' audited financial statements--the "gold standard" in hospital financial reporting--are not publicly available in many states. As a result, the Medicare Cost Report (MCR), filed annually by most U.S. hospitals in order to receive payment for treating Medicare patients, has become the primary public source of hospital financial information. However, financial accounting elements in the MCR are unreliable, poorly defined, and lacking in critical detail. Comparative analyses of MCRs and matched, audited financial statements reveal long-standing problems with the MCR's data, including major differences in reported profits; variations in the reporting of both revenues and expenses; an absence of relevant details, such as charity care, bad debt, operating versus nonoperating income, and affiliate transactions; an inconsistent classification of changes in net assets; and a failure to provide cash flow statements. Because of these problems, MCR financial data give only a limited and often inaccurate picture of the financial position of hospitals. Audited financial statements provide a more complete perspective, enabling analysts to address important questions left unanswered by the MCR data. Regulatory action is needed to create a national database of financial information based upon audited statements.

  3. Job satisfaction and turnover intent among hospital social workers in the United States.

    Science.gov (United States)

    Pugh, Greg L

    2016-08-01

    Feelings of job satisfaction and turnover intentions among social workers affect work quality for both social workers and the people for whom they provide services. Existing literature on job satisfaction among hospital social workers is limited, and is overly focused on issues of compensation. There is job satisfaction research with hospital nurses available for comparison. Other informative social work research on job satisfaction and turnover exists in mental health and generally, across settings. Research on turnover intent in social work is primarily from child welfare settings and may not generalize. The literature notes gaps and contradictions about predictors of job satisfaction and turnover intent. Using a large national dataset of hospital social workers, this research clarifies and fills gaps regarding hospital social workers, and explores how Herzberg's theory of work can clarify the difference between sources of job dissatisfaction and job satisfaction. Findings include hospital social workers reporting high job satisfaction and that demographics do not contribute to the predictive models. The findings do support centralized social work departments and variety in the job functions of hospital social workers, and are consistent with the theoretical framework.

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

    Directory of Open Access Journals (Sweden)

    kamran Mirzaie

    2008-02-01

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

  5. Management Development in Hospitality and Tourism.

    Science.gov (United States)

    Teare, Richard, Ed.; And Others

    1990-01-01

    A theme issue devoted to management development in hospitality and tourism includes nine articles on assessing human resource needs and priorities, management development and training, preparing managers, curriculum design, supervised work experience, manager role, and the current business environment. (JOW)

  6. Schools K-12, School locations within Sedgwick County. This layer is maintained interactively by GIS staff. Primary attributes include school name, class, funding source, address, and parachial status. Published to scschoop.shp., Published in 2008, 1:1200 (1in=100ft) scale, Sedgwick County Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Schools K-12 dataset current as of 2008. School locations within Sedgwick County. This layer is maintained interactively by GIS staff. Primary attributes include...

  7. Access to and value of information to support good practice for staff in Kenyan hospitals

    Directory of Open Access Journals (Sweden)

    Naomi Muinga

    2015-05-01

    Full Text Available Background: Studies have sought to define information needs of health workers within very specific settings or projects. Lacking in the literature is how hospitals in low-income settings are able to meet the information needs of their staff and the use of information communication technologies (ICT in day-to-day information searching. Objective: The study aimed to explore where professionals in Kenyan hospitals turn to for work-related information in their day-to-day work. Additionally, it examined what existing solutions are provided by hospitals with regard to provision of best practice care. Lastly, the study explored the use of ICT in information searching. Design: Data for this study were collected in July 2012. Self-administered questionnaires (SAQs were distributed across 22 study hospitals with an aim to get a response from 34 health workers per hospital. Results: SAQs were collected from 657 health workers. The most popular sources of information to guide work were fellow health workers and printed guidelines while the least popular were scientific journals. Of value to health workers were: national treatment policies, new research findings, regular reports from surveillance data, information on costs of services and information on their performance of routine clinical tasks; however, hospitals only partially met these needs. Barriers to accessing information sources included: ‘not available/difficult to get’ and ‘difficult to understand’. ICT use for information seeking was reported and with demographic specific differences noted from the multivariate logistic regression model; nurses compared to medical doctors and older workers were less likely to use ICT for health information searching. Barriers to accessing Internet were identified as: high costs and the lack of the service at home or at work. Conclusions: Hospitals need to provide appropriate information by improving information dissemination efforts and providing an

  8. Workplace breastfeeding support for hospital employees.

    Science.gov (United States)

    Dodgson, Joan E; Chee, Yuet-Oi; Yap, Tian Sew

    2004-07-01

    Breastfeeding initiation rates have been steadily rising in Hong Kong, but most employed women wean prior to returning to work. While health care providers promote breastfeeding, women receive little support from employers. A few health care facilities offer some workplace breastfeeding support, but little is known about the specific types and amount of support that are offered. This paper reports a study whose aim was to describe workplace supports available to breastfeeding women employed by hospitals that provide maternity services in Hong Kong, and to determine if differences in workplace supports exist based on the hospitals' numbers of employees or funding source. In late 2001, a cross-sectional survey was completed by nurse managers or lactation consultants most knowledgeable about supports to breastfeeding employees in 19 hospitals. The number of workplace breastfeeding supports or Breastfeeding Support Score (M = 7.47; sd = 3.37) varied considerably. Mean Breastfeeding Support Score for government-funded hospitals was significantly higher (t = 2.31; P = 0.03) than for private hospitals. Of the 14 hospitals that had a designated space for using a breast pump, only five (26.3%) had a private room with a door that locked. Only two hospitals (11.1%) allowed employees to take breaks as needed to use a pump; employees in 10 (55.6%) had to use their meal and regular break times. Hospitals having a hospital-wide committee that addressed workplace breastfeeding issues had a more supportive environment for breastfeeding employees. Although all surveyed hospitals returned the questionnaire, the sample size was small. It was difficult to ensure accuracy and to differentiate subtle variations in the services provided using a self-report survey. Facilitating continued breastfeeding after employees' return to work requires that employers understand the needs of breastfeeding employees. Policy at the level of the employer and government is an essential component of

  9. eServices for Hospital Equipment

    NARCIS (Netherlands)

    De Jonge, M.; Van der Linden, W.P.M.; Willems, H.X.

    2007-01-01

    In this paper we explore the idea that by combining different sources of information in a hospital environment, valuable e-services canbe developed that may help in reducing cost and improving quality of service. Companies, like Philips Medical Systems, may have a compe-titive advantage, because

  10. Survey alerts hospital to needs of consumers.

    Science.gov (United States)

    Schoenfeldt, R C; Seale, W B; Hale, A W

    1987-09-01

    Because of rapidly changing developments in the healthcare field, more emphasis is being placed on marketing of hospital services. A hospital's success will depend more and more on strategic planning based on timely and accurate information. In light of this, Lourdes Hospital, Paducah, KY, undertook a survey to evaluate its current performance and to determine a path for the future. The survey found, among other discoveries, that patients want more voice in determining their own treatment; they prefer outpatient treatment when possible, even if it is not covered by insurance; and stress management and health assessment clinics are the most popular extra services a hospital could offer. Physicians surveyed said they wanted more input into the evaluation of new services and equipment at the hospital. The survey also found that most patients either select a hospital in conjunction with their physician or have their physician choose the hospital. The findings led to some major changes at the hospital, including a restructuring of the planning process to get physicians more involved, a new marketing strategy to enhance communication with consumers, and increased outpatient services. The results have given direction to the hospital administration, helped shape advertising, and provided support for certificate-of-need requests.

  11. A Tale of Two Baby-Friendly Hospitals: Comparison of a Military and a Civilian Experience.

    Science.gov (United States)

    Terry, Melissa V; Barnes, Courtney; Beal, Katie; Enciso, Angel Jaime; Love-Zaranka, Angela

    2016-10-01

    To compare and contrast military hospital and civilian hospital experiences of achieving Baby-Friendly designation, and to examine administration and staff responses as well as institutional and patient postimplementation outcomes. Staff, administration, and chairs of Baby-Friendly committees at both hospitals were interviewed. Motivating factors and perceived administrative support were similar at both institutions. Both sites saw an increase in exclusive breastfeeding rates upon discharge to a rate of 80-90%, and both noted an overall increase in delivery rates, which may also be attributed to achieving Baby-Friendly designation. Significant differences included the amount of time it took to achieve Baby-Friendly status, the number of specialties represented on the Baby-friendly committee, the percentage of employees who received training, pediatrics involvement and support, and funding sources for staff training.

  12. [Anesthesia practice in Catalan hospitals and other health care facilities].

    Science.gov (United States)

    Villalonga, Antonio; Sabaté, Sergi; Campos, Juan Manuel; Fornaguera, Joan; Hernández, Carmen; Sistac, José María

    2006-05-24

    The aim of this arm of the ANESCAT study was to characterize anesthesia practice in the various types of health care facilities of Catalonia, Spain, in 2003. We analyzed data from the survey according to a) source of a facility's funding: public hospitals financed by the Catalan Public Health Authority (ICS), the network of subsidized hospitals for public use (XHUP), or private hospitals; b) size: facilities without hospital beds, hospitals with fewer than 250 beds, those with 251 to 500, and those with over 500; and c) training accreditation status: whether or not a facility gave medical resident training. A total of 131 facilities participated (11 under the ICS, 47 from the XHUP, and 73 private hospitals). Twenty-six clinics had no hospital beds, 78 facilities had fewer than 250, 21 had 251 to 500, and 6 had more than 500. Seventeen hospitals trained medical residents. XHUP hospitals performed 44.3% of all anesthetic procedures, private hospitals 36.7%, and ICS facilities 18.5%. Five percent of procedures were performed in clinics without beds, 42.9% in facilities with fewer than 250 beds, 35% in hospitals with 251 to 500, and 17.1% in hospitals with over 500. Anesthetists in teaching hospitals performed 35.5% of all procedures. The mean age of patients was lower in private hospitals, facilities with fewer than 250 beds, and hospitals that did not train medical residents. The physical status of patients was worse in ICS hospitals, in facilities with over 500 beds, and in teaching hospitals. It was noteworthy that 25% of anesthetic procedures were performed on an emergency basis in XHUP and ICS hospitals, in facilities with more than 250 beds, and in teaching hospitals. Anesthesia for outpatient procedures accounted for 40% of the total in private hospitals and 31% of the practice in ICS and XHUP hospitals. The duration of anesthesia and postanesthetic recovery was longer in ICS hospitals, in facilities with over 500 beds, and in those with medical resident

  13. Alternative indicators for measuring hospital productivity.

    Science.gov (United States)

    Serway, G D; Strum, D W; Haug, W F

    1987-08-01

    This article explores the premise that the appropriateness and usefulness of typical hospital productivity measures have been affected by three changes in delivery: Organizational restructuring and other definition and data source changes that make full-time equivalent employee (FTE) measurements ambiguous. Transition to prospective payment (diagnosis-related groups). Increase in capitation (prepaid, at risk) programs. The effects of these changes on productivity management indicate the need for alternative productivity indicators. Several productivity measures that complement these changes in internal operations and the external hospital business environment are presented. These are based on an analysis of four hospitals within a multihospital system, and an illustration and interpretation of an array of measures, based on ten months of actual data, is provided. In conclusion, the recommendation is made for hospital management to collect an expanded set of productivity measures and review them in light of changing expense and revenue management schemes inherent in new payment modes.

  14. Mining of hospital laboratory information systems

    DEFF Research Database (Denmark)

    Søeby, Karen; Jensen, Peter Bjødstrup; Werge, Thomas

    2015-01-01

    of hospital laboratory data as a source of information, we analyzed enzymatic plasma creatinine as a model analyte in two large pediatric hospital samples. Methods: Plasma creatinine measurements from 9700 children aged 0-18 years were obtained from hospital laboratory databases and partitioned into high...... in creatinine levels at different time points after birth and around the early teens, which challenges the establishment and usefulness of reference intervals in those age groups. Conclusions: The study documents that hospital laboratory data may inform on the developmental aspects of creatinine, on periods...... with pronounced heterogeneity and valid reference intervals. Furthermore, part of the heterogeneity in creatinine distribution is likely due to differences in biological and chronological age of children and should be considered when using age-specific reference intervals....

  15. Overview of physician-hospital ventures.

    Science.gov (United States)

    Cohn, Kenneth H; Allyn, Thomas R; Rosenfield, Robert H; Schwartz, Richard

    2005-01-01

    An ongoing environment of reimbursement lagging behind escalating expenses has led physicians to explore new sources of revenue. The goal of physician-hospital ventures is to create a valuable entity that benefits patients, physicians, and the hospital. Physicians may choose to invest in healthcare facilities to improve patient care and obtain increased control over daily operations. If so, they should seek counsel to avoid violating Stark laws and anti-kickback laws. Modalities for investing in physician-hospital ventures are joint equity (stock) ventures, participating bond transactions (PBTs), and contractual integration, a new method to align the goals of specialists and hospital management without using joint equity ventures. Physicians and management should invest time in developing a shared vision of the future before beginning contract negotiations. Successful partnering requires transparency and stepwise building of trust. The greatest gain in joint ventures arises when both sides become active owners, rather than passive investors.

  16. Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals : A systematic review of literature

    NARCIS (Netherlands)

    Stalpers, Dewi; de Brouwer, Brigitte J M; Kaljouw, Marian J.; Schuurmans, Marieke J.

    2015-01-01

    Objective: To systematically review the literature on relationships between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals. Data sources: The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. Review methods: Included were

  17. Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: a systematic review of literature

    NARCIS (Netherlands)

    Stalpers, D.; Brouwer, B.J.M. de; Kaljouw, M.J.; Schuurmans, M.J.

    2015-01-01

    OBJECTIVE: To systematically review the literature on relationships between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals. DATA SOURCES: The search was performed in Medline (PubMed), Cochrane, Embase, and CINAHL. REVIEW METHODS: Included were

  18. Hospital Dermatology, Introduction.

    Science.gov (United States)

    Fox, Lindy P

    2017-03-01

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

  19. Hospital-acquired listeriosis.

    Science.gov (United States)

    Graham, J C; Lanser, S; Bignardi, G; Pedler, S; Hollyoak, V

    2002-06-01

    We report four cases of listeriosis that occurred over a two-month period in north east England. Due to the apparent nosocomial acquisition of infection and the clustering of cases in time and place, extended epidemiological investigation was performed and the outbreak was traced to a caterer who was providing sandwiches for hospital shops. We discuss the difficulties in preventing food-borne listeriosis in the hospital setting. Copyright 2002 The Hospital Infection Society.

  20. Hospital Management Software Development

    OpenAIRE

    sobogunGod, olawale

    2012-01-01

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

  1. Job satisfaction of nurses and identifying factors of job satisfaction in Slovenian Hospitals

    OpenAIRE

    Lorber, Mateja; Skela Savič, Brigita

    2012-01-01

    Aim To determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing. Methods The study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the lea...

  2. Hospital Medicine Resident Training Tracks: Developing the Hospital Medicine Pipeline.

    Science.gov (United States)

    Sweigart, Joseph R; Tad-Y, Darlene; Kneeland, Patrick; Williams, Mark V; Glasheen, Jeffrey J

    2017-03-01

    Hospital medicine (HM) is rapidly evolving into new clinical and nonclinical roles. Traditional internal medicine (IM) residency training likely does not optimally prepare residents for success in HM. Hospital medicine residency training tracks may offer a preferred method for specialized HM education. Internet searches and professional networks were used to identify HM training tracks. Information was gathered from program websites and discussions with track directors. The 11 HM tracks at academic medical centers across the United States focus mostly on senior residents. Track structure and curricular content are determined largely by the structure and curricula of the IM residency programs in which they exist. Almost all tracks feature experiential quality improvement projects. Content on healthcare economics and value is common, and numerous track leaders report this content is expanding from HM tracks into entire residency programs. Tracks also provide opportunities for scholarship and professional development, such as workshops on abstract creation and job procurement skills. Almost all tracks include HM preceptorships as well as rotations within various disciplines of HM. HM residency training tracks focus largely on quality improvement, health care economics, and professional development. The structures and curricula of these tracks are tightly linked to opportunities within IM residency programs. As HM continues to evolve, these tracks likely will expand to bridge clinical and extra-clinical gaps between traditional IM training and contemporary HM practice. Journal of Hospital Medicine 2017;12:173-176. © 2017 Society of Hospital Medicine

  3. Fraud in Hospitals

    OpenAIRE

    Musau, Steve; Vian, Taryn

    2008-01-01

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

  4. Hospital waste management status in Lebanon

    International Nuclear Information System (INIS)

    Karam, R.; Oueida, F.; Tissot-Guerraz, F.; Trepo, D.; Collombel, C.

    2000-01-01

    author.The existing management of hospital waste in Lebanon currently poses both an environmental hazard as well as a public health risk. This is due mainly to lack of legislation, information and modern treatment and disposal facilities designed for this purpose. A nation-wide questionnaire survey was conducted to asses the status of hospital waste management. The study started from October 1997 till August 1998. We found that 75% of the surveyed hospitals completely ignore their total waste quantity: 73% of hospitals surveyed practice segregation at source of infectious, pathological, sharps and pharmaceuticals; more than 40% dispose of their hospital risk wastes through the municipality waste disposal, 24% by burning in open fires, 14% by on-site hospital incinerators, 11% in on-site dumping, 8% handled by a private contractor and 1% in uncontrolled landfill. We conclude that with some exceptions, the hospital waste management situation in Lebanon is very far from being satisfactory and therefore needs to be reconsidered. 1 Fig., 6 tabs., 18 refs

  5. Hospital en Neuwitteisbach, Alemania Federal

    Directory of Open Access Journals (Sweden)

    Haindl, Friedrich F.

    1975-04-01

    Full Text Available It consists of: the actual hospital, one house for the staff, one service yard and underground garage. The hospital comprises four storeys and two basements, whilst the other building only has three floors. On the ground floor of the hospital are we located: the entrance; the nucleus of vertical communication; work rooms for the doctors and nurses; the administration section; X-ray and cobalt installations; and a small chapel. The three remaining upper floors contain 160 beds distributed over 6 wards and in single, double or triple rooms. Each floor is equipped with a service section. The first basement includes the ambulance entrance, the medical wards of the hospital, the staff dining-room, a kitchen and the heating installation. The second basement is reserved for kitchen storage rooms and the remaining installations of the building. Structure of reinforced concrete and outer walls of brick covered with panels of washed concrete.Está formado por: el hospital propiamente dicho, un edificio destinado a viviendas para el personal, patio de servicio y garaje subterráneo. El hospital consta de cuatro plantas y dos sótanos, mientras que el otro edificio sólo tiene tres plantas. En la planta baja del hospital se encuentran: la entrada; el núcleo de comunicación vertical; las salas de trabajo de médicos y enfermeras; la zona de administración; las instalaciones de rayos X y bomba de cobalto; y una pequeña capilla. En las tres plantas superiores se distribuyen 160 camas repartidas en seis unidades de hospitalización, con habitaciones de 1, 2 ó 3 camas. Cada planta cuenta, además, con una zona de servicio. En el primer sótano se hallan, además de la entrada de ambulancias, los servicios médicos del hospital, los comedores del personal, una cocina, y la instalación de calefacción. El segundo sótano se dedica, en su totalidad, a almacenes de la cocina y del resto de las instalaciones del edificio. Estructura de

  6. Photonic crystal light source

    Science.gov (United States)

    Fleming, James G [Albuquerque, NM; Lin, Shawn-Yu [Albuquerque, NM; Bur, James A [Corrales, NM

    2004-07-27

    A light source is provided by a photonic crystal having an enhanced photonic density-of-states over a band of frequencies and wherein at least one of the dielectric materials of the photonic crystal has a complex dielectric constant, thereby producing enhanced light emission at the band of frequencies when the photonic crystal is heated. The dielectric material can be a metal, such as tungsten. The spectral properties of the light source can be easily tuned by modification of the photonic crystal structure and materials. The photonic crystal light source can be heated electrically or other heating means. The light source can further include additional photonic crystals that exhibit enhanced light emission at a different band of frequencies to provide for color mixing. The photonic crystal light source may have applications in optical telecommunications, information displays, energy conversion, sensors, and other optical applications.

  7. Neutron sources and applications

    Energy Technology Data Exchange (ETDEWEB)

    Price, D.L. [ed.] [Argonne National Lab., IL (United States); Rush, J.J. [ed.] [National Inst. of Standards and Technology, Gaithersburg, MD (United States)

    1994-01-01

    Review of Neutron Sources and Applications was held at Oak Brook, Illinois, during September 8--10, 1992. This review involved some 70 national and international experts in different areas of neutron research, sources, and applications. Separate working groups were asked to (1) review the current status of advanced research reactors and spallation sources; and (2) provide an update on scientific, technological, and medical applications, including neutron scattering research in a number of disciplines, isotope production, materials irradiation, and other important uses of neutron sources such as materials analysis and fundamental neutron physics. This report summarizes the findings and conclusions of the different working groups involved in the review, and contains some of the best current expertise on neutron sources and applications.

  8. Neutron sources and applications

    International Nuclear Information System (INIS)

    Price, D.L.; Rush, J.J.

    1994-01-01

    Review of Neutron Sources and Applications was held at Oak Brook, Illinois, during September 8--10, 1992. This review involved some 70 national and international experts in different areas of neutron research, sources, and applications. Separate working groups were asked to (1) review the current status of advanced research reactors and spallation sources; and (2) provide an update on scientific, technological, and medical applications, including neutron scattering research in a number of disciplines, isotope production, materials irradiation, and other important uses of neutron sources such as materials analysis and fundamental neutron physics. This report summarizes the findings and conclusions of the different working groups involved in the review, and contains some of the best current expertise on neutron sources and applications

  9. Loyalty of hospital patients: a vital marketing objective.

    Science.gov (United States)

    MacStravic, R S

    1987-01-01

    Hospitals must strive for patient loyalty as a top priority objective in their marketing strategies. Loyal patients are sources of repeat business, potential users of new services, and positive spokespersons in word-of-mouth advertising.

  10. Energy sources

    International Nuclear Information System (INIS)

    Vajda, Gy.

    1998-01-01

    A comprehensive review is presented of the available sources of energy in the world is presented. About 80 percent of primary energy utilization is based on fossile fuels, and their dominant role is not expected to change in the foreseeable future. Data are given on petroleum, natural gas and coal based power production. The role and economic aspects of nuclear power are analyzed. A brief summary of renewable energy sources is presented. The future prospects of the world's energy resources are discussed, and the special position of Hungary regarding fossil, nuclear and renewable energy and the country's energy potential is evaluated. (R.P.)

  11. 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.

  12. [Hospital pharmaceutical practice in prison].

    Science.gov (United States)

    Harcouët, L

    2010-09-01

    Since 1994, hospital pharmaceutical teams have been in charge of pharmaceutical tasks in "unités de consultation et de soins ambulatoires" (UCSA), which are hospital consulting care units in French prisons. In 2008, pharmaceutical team in Parisian prisons received 6500 prescriptions and prepared 85,000 nominative bags containing drugs. Prisoners were 1.3% to receive treatments against HIV, 8.2% cardiovascular drugs, 7.2% opioid substitution treatments, and 52.9% psychoactive drugs, including 39.3% hypnotics, 40.5% anxiolytics, 11.3% antidepressants and 12.2% neuroleptics. In prison, the dichotomy between somatic and mental care is marked, attitudes of prisoners about their medicines are complex (important claims, embezzlement, etc.) and it is difficult for law defendants to maintain treatment confidentiality and to prepare prison outing in terms of health. To attenuate the heterogeneity of drug distribution systems in French prisons, we propose pharmaceutical analysis of prescriptions and nominative dispensation, computerization in UCSA in coordination with hospitals, a better contribution of prison medical and pharmaceutical staff in hospital "drug committees" and the redaction of pharmaceutical guidelines. Acting in concert with multidisciplinary medical staff in UCSA, pharmaceutical teams have to develop epidemiological studies to improve knowledge in prisoner's health and also prevention and health care in prison. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  13. Hospital autopsy: Endangered or extinct?

    Science.gov (United States)

    Turnbull, Angus; Osborn, Michael; Nicholas, Nick

    2015-08-01

    To determine the hospital autopsy rate for the UK in 2013. A study of data from a 'Freedom of Information' request to all (n=186) acute NHS Trusts within England (n=160), NHS Boards in Scotland (n=14) and Wales (n=7) and Social Care Trusts in Northern Ireland (n=5). Hospital autopsy rates were calculated from the number of hospital autopsies performed in 2013 as a percentage of total inpatient deaths in the Trust that year. The UK response rate was 99% (n=184), yielding a mean autopsy rate of 0.69%. The mean rates were 0.51% (England), 2.13% (Scotland), 0.65% (Wales) and 0.46% (Northern Ireland). 23% (n=38) of all included respondents had a rate of 0% and 86% (n=143) a rate less than 1%. The decline in hospital autopsy has continued relentlessly and, for better or for worse, the practice is on the verge of extinction in the UK. The study highlights to health professionals and policy makers the magnitude of this decline. Further research should investigate the impact of this on patient safety, clinical audit, public health and medical education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Radiation sources working group summary

    International Nuclear Information System (INIS)

    Fazio, M.V.

    1998-01-01

    The Radiation Sources Working Group addressed advanced concepts for the generation of RF energy to power advanced accelerators. The focus of the working group included advanced sources and technologies above 17 GHz. The topics discussed included RF sources above 17 GHz, pulse compression techniques to achieve extreme peak power levels, components technology, technology limitations and physical limits, and other advanced concepts. RF sources included gyroklystrons, magnicons, free-electron masers, two beam accelerators, and gyroharmonic and traveling wave devices. Technology components discussed included advanced cathodes and electron guns, high temperature superconductors for producing magnetic fields, RF breakdown physics and mitigation, and phenomena that impact source design such as fatigue in resonant structures due to RF heating. New approaches for RF source diagnostics located internal to the source were discussed for detecting plasma and beam phenomena existing in high energy density electrodynamic systems in order to help elucidate the reasons for performance limitations

  15. The Journey of a Hospital Gown: Performing Needlework

    Directory of Open Access Journals (Sweden)

    Jennifer Talia Frances Richardson

    2016-08-01

    Full Text Available This essay explores issues surrounding psychiatric hospitalization through the intersection of creative writing and artmaking. The writing reflects on four artworks by the author created from appropriated hospital gowns that reflect on issues of representation and historical and contemporary experiences of hospitalization for mental disabilities including questions surrounding dignity, wellness, family, asylum tourism, psychiatric photography, and objectification.

  16. Errors in drug administration by anaesthetists in public hospitals in ...

    African Journals Online (AJOL)

    Objective. To investigate errors in administering drugs by anaesthetists working in public hospitals in the Free State province. Methods. Anonymous questionnaires were distributed to doctors performing anaesthesia in public hospitals in the Free State, i.e. 188 doctors at 22 public sector hospitals. Outcomes included ...

  17. "Hospes": The Wabash Center as a Site of Transformative Hospitality

    Science.gov (United States)

    Jones, Carolyn M.

    2007-01-01

    The Wabash Center for Teaching and Learning in Theology and Religion is a place of hospitality and its staff the epitome of the "good host." This essay explores the meaning of hospitality, including its problematic dimensions, drawing on a number of voices and texts: Jacques Derrida's "Of Hospitality"; Henri M. Nouwen's "Reaching Out: The Three…

  18. 42 CFR 495.104 - Incentive payments to eligible hospitals.

    Science.gov (United States)

    2010-10-01

    ... denominator of the Medicare share fraction using the charity care charges reported on the hospital's Medicare... eligible hospital's charges, not including any charges that are attributable to charity care, divided by... 42 Public Health 5 2010-10-01 2010-10-01 false Incentive payments to eligible hospitals. 495.104...

  19. The microbiological effects of hospital wastes on the environment ...

    African Journals Online (AJOL)

    The effect of twenty four (24) hospital wastes samples taken from different hospitals waste dumpsites on its surrounding soil was examined. The counts of microorganisms in hospital dumpsite soil include the following; aerobic heterotrophic counts from 4.2 x 105 to 1.6 x 1010, anaerobic heterotrophic counts from 1.0 x 105 to ...

  20. Asthma exacerbations: risk factors for hospital readmissions.

    Science.gov (United States)

    Gonzalez-Barcala, F-J; Calvo-Alvarez, U; Garcia-Sanz, M-T; Garcia-Couceiro, N; Martin-Lancharro, P; Pose, A; Carreira, J-M; Moure-Gonzalez, J-D; Valdes-Cuadrado, L; Muñoz, X

    2018-02-01

    The aim of our study is to analyse hospital readmissions due to asthma, as well as the factors associated with their increase. We carried out a retrospective study including all admissions of patients over 18 years old due to exacerbation of asthma occurring in our hospital between the years 2000 and 2010. The data were gathered by two members of the research team, by reviewing the clinical records. The first hospital admission of each patient was included for this study. An early readmission (ER) was defined as that which occurred in the following 15 days after hospital discharge and late readmission (LR) to that occurring from 16 days after discharge. This study included 2166 hospital admissions and 1316 patients, with a mean age of 62.6 years. Of the 1316 patients analysed, 36 (2.7%) had one ER and 313 (23.8%) one LR. The only factor independently associated with a higher probability of an ER was poor lung function. A higher probability of LR was associated with a greater severity of the asthma (OR: 17.8, for severe asthma versus intermittent asthma), to have had any hospital admission in the previous year (OR: 3.5) and the use of a combination of ICS-LABA as maintenance treatment. About 25% of the patients in our area admitted to hospital due to asthma exacerbation had repeat episodes of hospitalisation.

  1. Going to the Hospital

    Science.gov (United States)

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

  2. GENERAL PRACTITIONERS AND HOSPITALS

    African Journals Online (AJOL)

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

  3. Hospital 360°.

    Science.gov (United States)

    Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia

    2015-01-01

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

  4. Hospitality services generate revenue.

    Science.gov (United States)

    Bizouati, S

    1993-01-01

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

  5. Virtual Pediatric Hospital

    Science.gov (United States)

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

  6. Hospitality Services. Curriculum Guide.

    Science.gov (United States)

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

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

  7. Hospitality Occupations. Curriculum Guide.

    Science.gov (United States)

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

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

  8. Can use of an administrative database improve accuracy of hospital-reported readmission rates?

    Science.gov (United States)

    Edgerton, James R; Herbert, Morley A; Hamman, Baron L; Ring, W Steves

    2018-05-01

    Readmission rates after cardiac surgery are being used as a quality indicator; they are also being collected by Medicare and are tied to reimbursement. Accurate knowledge of readmission rates may be difficult to achieve because patients may be readmitted to different hospitals. In our area, 81 hospitals share administrative claims data; 28 of these hospitals (from 5 different hospital systems) do cardiac surgery and share Society of Thoracic Surgeons (STS) clinical data. We used these 2 sources to compare the readmissions data for accuracy. A total of 45,539 STS records from January 2008 to December 2016 were matched with the hospital billing data records. Using the index visit as the start date, the billing records were queried for any subsequent in-patient visits for that patient. The billing records included date of readmission and hospital of readmission data and were compared with the data captured in the STS record. We found 1153 (2.5%) patients who had STS records that were marked "No" or "missing," but there were billing records that showed a readmission. The reported STS readmission rate of 4796 (10.5%) underreported the readmission rate by 2.5 actual percentage points. The true rate should have been 13.0%. Actual readmission rate was 23.8% higher than reported by the clinical database. Approximately 36% of readmissions were to a hospital that was a part of a different hospital system. It is important to know accurate readmission rates for quality improvement processes and institutional financial planning. Matching patient records to an administrative database showed that the clinical database may fail to capture many readmissions. Combining data with an administrative database can enhance accuracy of reporting. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  9. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

    Science.gov (United States)

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2016-01-01

    Background: Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. Objective: This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran. Methods: This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS. Results: The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. Conclusion: By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department. PMID:26234974

  10. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital.

    Science.gov (United States)

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2015-05-17

    Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran.‎ This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS.‎ The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department.

  11. Ion source

    International Nuclear Information System (INIS)

    1977-01-01

    The specifications of a set of point-shape electrodes of non-corrodable material that can hold a film of liquid material of equal thickness is described. Contained in a jacket, this set forms an ion source. The electrode is made of tungsten with a glassy carbon layer for insulation and an outer layer of aluminium-oxide ceramic material

  12. Vacuum Arc Ion Sources

    CERN Document Server

    Brown, I.

    2013-12-16

    The vacuum arc ion source has evolved into a more or less standard laboratory tool for the production of high-current beams of metal ions, and is now used in a number of different embodiments at many laboratories around the world. Applications include primarily ion implantation for material surface modification research, and good performance has been obtained for the injection of high-current beams of heavy-metal ions, in particular uranium, into particle accelerators. As the use of the source has grown, so also have the operational characteristics been improved in a variety of different ways. Here we review the principles, design, and performance of vacuum arc ion sources.

  13. Measuring hospital medical staff organizational structure.

    Science.gov (United States)

    Shortell, S M; Getzen, T E

    1979-01-01

    Based on organization theory and the work of Roemer and Friedman, seven dimensions of hospital medical staff organization structure are proposed and examined. The data are based on a 1973 nationwide survey of hospital medical staffs conducted by the American Hospital Association. Factor analysis yielded six relatively independent dimensions supporting a multidimensional view of medical staff organization structure. The six dimensions include 1) Resource Capability, 2) Generalist Physician Contractual Orientation, 3) Communication/Control, 4) Local Staff Orientation, 5) Participation in Decision Making, and 6) Hospital-Based Physician Contractual Orientation. It is suggested that these dimensions can be used to develop an empirical typology of hospital medical staff organization structure and to investigate the relationship between medical staff organization and public policy issues related to cost containment and quality assurance. PMID:511580

  14. Impact of a DRG-based hospital financing system on quality and outcomes of care in Italy.

    Science.gov (United States)

    Louis, D Z; Yuen, E J; Braga, M; Cicchetti, A; Rabinowitz, C; Laine, C; Gonnella, J S

    1999-01-01

    OBJECTIVE: To examine potential changes in quality of care associated with a recent financing system implementation in Italy: in 1995, hospital financing reform implemented in Italy included the introduction of a DRG-based hospital financing system with the goals of controlling the growth of hospital costs and making hospitals more accountable for their productivity. DATA SOURCES: Hospital discharge abstract data from 1993 through 1996 for all hospitals (N=32) in the Friuli-Venezia-Giulia region of Italy. Regional population data were used to calculate rates. STUDY DESIGN: Changes between 1993 and 1996 in hospital admissions, length of stay, mortality rates, severity of illness, and readmission rates were studied for nine common medical and surgical conditions: appendicitis, diabetes mellitus, colorectal cancer, cholecystitis, bronchitis/chronic obstructive pulmonary disease (COPD), bacterial pneumonia, coronary artery disease, cerebrovascular disease, and hip fracture. PRINCIPAL FINDINGS: The total number of ordinary hospital admissions decreased from 244,581 to 204,054 between 1993 and 1996, a population-based decrease of 17.3 percent (p<.001). The mean length of stay decreased from 9.1 days to 8.8 days, resulting in a 21.1 percent decrease in hospital bed days (p<.001). Day hospital use increased sevenfold from 16,871 encounters in 1993 to 108,517 encounters in 1996. The largest decrease in hospital admissions among study conditions was a 41 percent decrease for diabetes (from 2.25 per 1,000 in 1993 to 1.31 in 1996, p<.001). For eight of the nine conditions, severity of illness increased. Differences between severity-adjusted expected and observed in-hospital mortality rates were small. CONCLUSIONS: Observed trends showed a decrease in ordinary hospital admissions, an increase in day hospital admissions, and a greater severity of illness among hospitalized patients. There was little or no change in mortality and readmission rates. Administrative data can be used

  15. Chandra Source Catalog: User Interface

    Science.gov (United States)

    Bonaventura, Nina; Evans, Ian N.; Rots, Arnold H.; Tibbetts, Michael S.; van Stone, David W.; Zografou, Panagoula; Primini, Francis A.; Glotfelty, Kenny J.; Anderson, Craig S.; Chen, Judy C.; Davis, John E.; Doe, Stephen M.; Evans, Janet D.; Fabbiano, Giuseppina; Galle, Elizabeth C.; Gibbs, Danny G., II; Grier, John D.; Hain, Roger; Hall, Diane M.; Harbo, Peter N.; He, Helen; Houck, John C.; Karovska, Margarita; Kashyap, Vinay L.; Lauer, Jennifer; McCollough, Michael L.; McDowell, Jonathan C.; Miller, Joseph B.; Mitschang, Arik W.; Morgan, Douglas L.; Mossman, Amy E.; Nichols, Joy S.; Nowak, Michael A.; Plummer, David A.; Refsdal, Brian L.; Siemiginowska, Aneta L.; Sundheim, Beth A.; Winkelman, Sherry L.

    2009-09-01

    The Chandra Source Catalog (CSC) is intended to be the definitive catalog of all X-ray sources detected by Chandra. For each source, the CSC provides positions and multi-band fluxes, as well as derived spatial, spectral, and temporal source properties. Full-field and source region data products are also available, including images, photon event lists, light curves, and spectra. The Chandra X-ray Center CSC website (http://cxc.harvard.edu/csc/) is the place to visit for high-level descriptions of each source property and data product included in the catalog, along with other useful information, such as step-by-step catalog tutorials, answers to FAQs, and a thorough summary of the catalog statistical characterization. Eight categories of detailed catalog documents may be accessed from the navigation bar on most of the 50+ CSC pages; these categories are: About the Catalog, Creating the Catalog, Using the Catalog, Catalog Columns, Column Descriptions, Documents, Conferences, and Useful Links. There are also prominent links to CSCview, the CSC data access GUI, and related help documentation, as well as a tutorial for using the new CSC/Google Earth interface. Catalog source properties are presented in seven scientific categories, within two table views: the Master Source and Source Observations tables. Each X-ray source has one ``master source'' entry and one or more ``source observation'' entries, the details of which are documented on the CSC ``Catalog Columns'' pages. The master source properties represent the best estimates of the properties of a source; these are extensively described on the following pages of the website: Position and Position Errors, Source Flags, Source Extent and Errors, Source Fluxes, Source Significance, Spectral Properties, and Source Variability. The eight tutorials (``threads'') available on the website serve as a collective guide for accessing, understanding, and manipulating the source properties and data products provided by the catalog.

  16. British Columbia Hospitals: examination and assessment of payment reform (B-CHeaPR

    Directory of Open Access Journals (Sweden)

    Barer Morris L

    2011-06-01

    Full Text Available Abstract Background Accounting for 36% of public spending on health care in Canada, hospitals are a major target for cost reductions through various efficiency initiatives. Some provinces are considering payment reform as a vehicle to achieve this goal. With few exceptions, Canadian provinces have generally relied on global and line-item budgets to contain hospital costs. There is growing interest amongst policy-makers for using activity based funding (ABF as means of creating financial incentives for hospitals to increase the 'volume' of care, reduce cost, discourage unnecessary activity, and encourage competition. British Columbia (B.C. is the first province in Canada to implement ABF for partial reimbursement of acute hospitalization. To date, there have been no formal examinations of the effects of ABF policies in Canada. This study proposal addresses two research questions designed to determine whether ABF policies affect health system costs, access and hospital quality. The first question examines the impact of the hospital funding policy change on internal hospital activity based on expenditures and quality. The second question examines the impact of the change on non-hospital care, including readmission rates, amount of home care provided, and physician expenditures. Methods/Design A longitudinal study design will be used, incorporating comprehensive population-based datasets of all B.C. residents; hospital, continuing care and physician services datasets will also be used. Data will be linked across sources using anonymized linking variables. Analytic datasets will be created for the period between 2005/2006 and 2012/2013. Discussion With Canadian hospitals unaccustomed to detailed scrutiny of what services are provided, to whom, and with what results, the move toward ABF is significant. This proposed study will provide evidence on the impacts of ABF, including changes in the type, volume, cost, and quality of services provided. Policy

  17. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper

    2015-01-01

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

  18. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

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

  19. Hjertestop uden for hospital

    DEFF Research Database (Denmark)

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

    1989-01-01

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

  20. Disease and Economic Burden of Hospitalizations Attributable to Diabetes Mellitus and Its Complications: A Nationwide Study in Brazil

    Directory of Open Access Journals (Sweden)

    Michelle Quarti Machado Rosa

    2018-02-01

    Full Text Available Diabetes is associated with a significant burden globally. The costs of diabetes-related hospitalizations are unknown in most developing countries. The aim of this study was to estimate the total number and economic burden of hospitalizations attributable to diabetes mellitus (DM and its complications in adults from the perspective of the Brazilian Public Health System in 2014. Data sources included the National Health Survey (NHS and National database of Hospitalizations (SIH. We considered diabetes, its microvascular (retinopathy, nephropathy, and neuropathy and macrovascular complications (coronary heart disease, cerebrovascular disease, and peripheral arterial disease, respiratory and urinary tract infections, as well as selected cancers. Assuming that DM patients are hospitalized for these conditions more frequently that non-DM individuals, we estimated the etiological fraction of each condition related to DM, using the attributable risk methodology. We present number, average cost per case, and overall costs of hospitalizations attributable to DM in Brazil in 2014, stratified by condition, state of the country, gender and age group. In 2014, a total of 313,273 hospitalizations due to diabetes in adults were reported in Brazil (4.6% of total adult hospitalization, totaling (international dollar Int$264.9 million. The average cost of an adult hospitalization due to diabetes was Int$845, 19% higher than hospitalization without DM. Hospitalizations due to cardiovascular diseases related to diabetes accounted for the higher proportion of costs (47.9%, followed by microvascular complications (25.4% and DM per se (18.1%. Understanding the costs of diabetes and its major complications is crucial to raise awareness and to support the decision-making process on policy implementation, also allowing the assessment of prevention and control strategies.

  1. Training Hospital Managers as to Fire Management

    Directory of Open Access Journals (Sweden)

    Roya Khalili

    2015-01-01

    Full Text Available Fire is one of the most dangerous phenomena in the world which yields main damages, healthy and economical, and is thus a major threat to hospitals. Since, most of the residents in hospitals are the individuals who cannot rescue themselves in such situations, fire in hospitals is more hazardous than any other public place; hence, it can endanger several sophisticated medical equipment. Therefore, security against fire plays a very vital role in hospitals and has to be taken into account by authorities. Among the personnel, hospital manager and the security guard supervisor are much more responsible. One of their responsibilities includes planning fire security scheme in hospitals to reduce the death rate caused by fire so that there is less threat to the building of hospital admits content. Due to the significance of this issue in hospitals, it seems necessary for the personnel to be aware of security measures against fire. Therefore, a study was carried out in Isfahan University of Medical Sciences teaching hospitals on all managers, their awareness about this issue was measured through a questionnaire. The results indicated that of a total of 60, the obtained average was (37.63+7.36 in the medium level. Also, most of the managers believed that proper and updated training by skillful trainers regarding hospital security measures and its application can be truly effective on their productivity. Thus, it is concluded that practical training the mentioned target group (hospital personnel especially clerks and the managers about the security plans can be effective in the control of fire and security measures, resulting in reduction of accidents and human and economic loss in the future.

  2. Hospital clinical pharmacy services in Vietnam.

    Science.gov (United States)

    Trinh, Hieu T; Nguyen, Huong T L; Pham, Van T T; Ba, Hai L; Dong, Phuong T X; Cao, Thao T B; Nguyen, Hanh T H; Brien, Jo-Anne

    2018-04-07

    Background Clinical pharmacy is key to the quality use of medicines. While there are different approaches in different countries, international perspectives may inform health service development. The Vietnamese Ministry of Health introduced a legal regulation of clinical pharmacy services in December 2012. Objective To describe the services, and to explore reported barriers and facilitators in implementing clinical pharmacy activities in Vietnamese hospitals after the introduction of Vietnamese Ministry of Health legal regulation. Setting Thirty-nine hospitals in Hanoi, Vietnam, including 22 provincial and 17 district hospitals. Method A mixed methods study was utilized. An online questionnaire was sent to the hospitals. In-depth interviews were conducted with pairs of nominated pharmacists at ten of these hospitals. The questionnaire focused on four areas: facilities, workforce, policies and clinical pharmacy activities. Main outcome measure Proportion of clinical pharmacy activities in hospitals. Themes in clinical pharmacy practice. Results 34/39 (87%) hospitals had established clinical pharmacy teams. Most activities were non-patient-specific (87%) while the preliminary patient-specific clinical pharmacy services were available in only 8/39 hospitals (21%). The most common non-patient-specific activities were providing medicines information (97%), reporting adverse drug reactions (97%), monitoring medication usage (97%). The patient specific activities varied widely between hospitals and were ad hoc. The main challenges reported were: lack of workforce and qualified clinical pharmacists. Conclusion While most hospitals had hospital-based pharmacy activities, the direct patient care was limited. Training, education and an expanded work forces are needed to improve clinical pharmacy services.

  3. Radioactive Sources in Medicine: Impact of Additional Security Measures

    International Nuclear Information System (INIS)

    Classic, K. L.; Vetter, R. J.; Nelson, K. L.

    2004-01-01

    For many years, medical centers and hospitals have utilized appropriate security measures to prevent theft or unauthorized use of radioactive materials. Recent anxiety about orphan sources and terrorism has heightened concern about diversion of radioactive sources for purposes of constructing a radiological dispersion device. Some medical centers and hospitals may have responded by conducting threat assessments and incorporating additional measures into their security plans, but uniform recommendations or regulations have not been promulgated by regulatory agencies. The International Atomic Energy Agency drafted interim guidance for the purpose of assisting member states in deciding what security measures should be taken for various radioactive sources. The recommendations are aimed at regulators, but suppliers and users also may find the recommendations to be helpful. The purpose of this paper is to describe threat assessments and additional security actions that were taken by one large and one medium-sized medical center and the impact these measures had on operations. Both medical centers possess blood bank irradiators, low-dose-rate therapy sources, and Mo-99/Tc-99m generators that are common to many health care organizations. Other medical devices that were evaluated include high-dose-rate after loaders, intravascular brachytherapy sources, a Co-60 stereotactic surgery unit, and self-shielded irradiators used in biomedical research. This paper will discuss the impact additional security has had on practices that utilize these sources, cost of various security alternatives, and the importance of a security culture in assuring the integrity of security measures without negatively impacting beneficial use of these sources. (Author) 10 refs

  4. Hospital librarianship in the United States: at the crossroads.

    Science.gov (United States)

    Wolf, Diane G; Chastain-Warheit, Christine C; Easterby-Gannett, Sharon; Chayes, Marion C; Long, Bradley A

    2002-01-01

    This paper examines recent developments in hospital librarianship in the United States, including the current status of hospital-based clinical library services. Several examples of hospital library services are presented that demonstrate some characteristics of struggling and thriving services. The implications of the informationist concept are considered. The continuation of the hospital librarian's primary role in support of patient care is explored, as core competencies are reexamined for relevancy in the new millennium.

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

    Science.gov (United States)

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

    2015-11-01

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

  6. Exploring positive hospital ward soundscape interventions.

    Science.gov (United States)

    Mackrill, J; Jennings, P; Cain, R

    2014-11-01

    Sound is often considered as a negative aspect of an environment that needs mitigating, particularly in hospitals. It is worthwhile however, to consider how subjective responses to hospital sounds can be made more positive. The authors identified natural sound, steady state sound and written sound source information as having the potential to do this. Listening evaluations were conducted with 24 participants who rated their emotional (Relaxation) and cognitive (Interest and Understanding) response to a variety of hospital ward soundscape clips across these three interventions. A repeated measures ANOVA revealed that the 'Relaxation' response was significantly affected (n(2) = 0.05, p = 0.001) by the interventions with natural sound producing a 10.1% more positive response. Most interestingly, written sound source information produced a 4.7% positive change in response. The authors conclude that exploring different ways to improve the sounds of a hospital offers subjective benefits that move beyond sound level reduction. This is an area for future work to focus upon in an effort to achieve more positively experienced hospital soundscapes and environments. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  7. Methods for the evaluation of hospital cooperation activities (Systematic review protocol

    Directory of Open Access Journals (Sweden)

    Rotter Thomas

    2012-02-01

    Full Text Available Abstract Background Hospital partnerships, mergers and cooperatives are arrangements frequently seen as a means of improving health service delivery. Many of the assumptions used in planning hospital cooperatives are not stated clearly and are often based on limited or poor scientific evidence. Methods This is a protocol for a systematic review, following the Cochrane EPOC methodology. The review aims to document, catalogue and synthesize the existing literature on the reported methods for the evaluation of hospital cooperation activities as well as methods of hospital cooperation. We will search the Database of Abstracts of Reviews of Effectiveness, the Effective Practice and Organisation of Care Register, the Cochrane Central Register of Controlled Trials and bibliographic databases including PubMed (via NLM, Web of Science, NHS EED, Business Source Premier (via EBSCO and Global Health for publications that report on methods for evaluating hospital cooperatives, strategic partnerships, mergers, alliances, networks and related activities and methods used for such partnerships. The method proposed by the Cochrane EPOC group regarding randomized study designs, controlled clinical trials, controlled before and after studies, and interrupted time series will be followed. In addition, we will also include cohort, case-control studies, and relevant non-comparative publications such as case reports. We will categorize and analyze the review findings according to the study design employed, the study quality (low versus high quality studies and the method reported in the primary studies. We will present the results of studies in tabular form. Discussion Overall, the systematic review aims to identify, assess and synthesize the evidence to underpin hospital cooperation activities as defined in this protocol. As a result, the review will provide an evidence base for partnerships, alliances or other fields of cooperation in a hospital setting. PROSPERO

  8. 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.

  9. Stage implementation of RFID in hospitals.

    Science.gov (United States)

    Kumar, Sameer; Livermont, Gregory; McKewan, Gregory

    2010-01-01

    The use of radio frequency identification device (RFID) technology within the healthcare industry was researched and specific instances of implementation of this technology in the hospital environment were examined. The study primarily makes use of ideas from operations and supply chain management, such as work flow diagrams, value stream mapping, and poka-yokes (mistake proofing measures) for investigations of processes, failures, and solutions. This study presents a step-by-step approach of how to implement the use of RFID tracking systems within the entire hospital. A number of poka-yokes were also devised for improving the safety of the patient and cost effectiveness of the hospital to insure the success of the hospital health care delivery system. Many players in the hospital environment may be impacted. This includes patients, doctors, nurses, technicians, administrators, and other hospital personnel. Insurance and government agencies may be impacted as well. Different levels of training of hospital personnel will be required based on the degree of interaction with the RFID system. References to costs, Return On Investment, change management, ethical and legal considerations are also made to help the reader understand the benefits and implications of the technology in the hospital environment.

  10. Leveraging Diverse Data Sources to Identify and Describe U.S. Health Care Delivery Systems.

    Science.gov (United States)

    Cohen, Genna R; Jones, David J; Heeringa, Jessica; Barrett, Kirsten; Furukawa, Michael F; Miller, Dan; Mutti, Anne; Reschovsky, James D; Machta, Rachel; Shortell, Stephen M; Fraze, Taressa; Rich, Eugene

    2017-12-15

    Health care delivery systems are a growing presence in the U.S., yet research is hindered by the lack of universally agreed-upon criteria to denote formal systems. A clearer understanding of how to leverage real-world data sources to empirically identify systems is a necessary first step to such policy-relevant research. We draw from our experience in the Agency for Healthcare Research and Quality's Comparative Health System Performance (CHSP) initiative to assess available data sources to identify and describe systems, including system members (for example, hospitals and physicians) and relationships among the members (for example, hospital ownership of physician groups). We highlight five national data sources that either explicitly track system membership or detail system relationships: (1) American Hospital Association annual survey of hospitals; (2) Healthcare Relational Services Databases; (3) SK&A Healthcare Databases; (4) Provider Enrollment, Chain, and Ownership System; and (5) Internal Revenue Service 990 forms. Each data source has strengths and limitations for identifying and describing systems due to their varied content, linkages across data sources, and data collection methods. In addition, although no single national data source provides a complete picture of U.S. systems and their members, the CHSP initiative will create an early model of how such data can be combined to compensate for their individual limitations. Identifying systems in a way that can be repeated over time and linked to a host of other data sources will support analysis of how different types of organizations deliver health care and, ultimately, comparison of their performance.

  11. Orphan sources

    International Nuclear Information System (INIS)

    Pust, R.; Urbancik, L.

    2008-01-01

    The presentation describes how the stable detection systems (hereinafter referred to as S DS ) have contributed to reveal the uncontrolled sources of ionizing radiation on the territory of the State Office for Nuclear Safety (SONS) Brno Regional Centre (RC Brno). It also describes the emergencies which were solved by or in which the workers from the Brno. Regional Centre participated in. The contribution is divided into the following chapters: A. SDS systems installed on the territory of SONS RC Brno; B. Selected unusual emergencies; C. Comments to individual emergencies; D. Aspects of SDS operation in term of their users; E. Aspects of SDS operation and related activities in term of radiation protection; F. Current state of orphan sources. (authors)

  12. The effect of coverings, including plastic bags and wraps, on mortality and morbidity in preterm and full-term neonates.

    Science.gov (United States)

    Oatley, H K; Blencowe, H; Lawn, J E

    2016-05-01

    Neonatal hypothermia is an important risk factor for mortality and morbidity, and is common even in temperate climates. We conducted a systematic review to determine whether plastic coverings, used immediately following delivery, were effective in reducing the incidence of mortality, hypothermia and morbidity. A total of 26 studies (2271 preterm and 1003 term neonates) were included. Meta-analyses were conducted as appropriate. Plastic wraps were associated with a reduction in hypothermia in preterm (⩽29 weeks; risk ratio (RR)=0.57; 95% confidence interval (CI) 0.46 to 0.71) and term neonates (RR=0.76; 95% CI 0.60 to 0.96). No significant reduction in neonatal mortality or morbidity was found; however, the studies were underpowered for these outcomes. For neonates, especially preterm, plastic wraps combined with other environmental heat sources are effective in reducing hypothermia during stabilization and transfer within hospital. Further research is needed to quantify the effects on mortality or morbidity, and investigate the use of plastic coverings outside hospital settings or without additional heat sources.

  13. Tritium sources

    International Nuclear Information System (INIS)

    Glodic, S.; Boreli, F.

    1993-01-01

    Tritium is the only radioactive isotope of hydrogen. It directly follows the metabolism of water and it can be bound into genetic material, so it is very important to control levels of contamination. In order to define the state of contamination it is necessary to establish 'zero level', i.e. actual global inventory. The importance of tritium contamination monitoring increases with the development of fusion power installations. Different sources of tritium are analyzed and summarized in this paper. (author)

  14. Radioactive source

    International Nuclear Information System (INIS)

    Drabkina, L.E.; Mazurek, V.; Myascedov, D.N.; Prokhorov, P.; Kachalov, V.A.; Ziv, D.M.

    1976-01-01

    A radioactive layer in a radioactive source is sealed by the application of a sealing layer on the radioactive layer. The sealing layer can consist of a film of oxide of titanium, tin, zirconium, aluminum, or chromium. Preferably, the sealing layer is pure titanium dioxide. The radioactive layer is embedded in a finish enamel which, in turn, is on a priming enamel which surrounds a substrate

  15. Muon sources

    International Nuclear Information System (INIS)

    Parsa, Z.

    2001-01-01

    A full high energy muon collider may take considerable time to realize. However, intermediate steps in its direction are possible and could help facilitate the process. Employing an intense muon source to carry out forefront low energy research, such as the search for muon-number non-conservation, represents one interesting possibility. For example, the MECO proposal at BNL aims for 2 x 10 -17 sensitivity in their search for coherent muon-electron conversion in the field of a nucleus. To reach that goal requires the production, capture and stopping of muons at an unprecedented 10 11 μ/sec. If successful, such an effort would significantly advance the state of muon technology. More ambitious ideas for utilizing high intensity muon sources are also being explored. Building a muon storage ring for the purpose of providing intense high energy neutrino beams is particularly exciting.We present an overview of muon sources and example of a muon storage ring based Neutrino Factory at BNL with various detector location possibilities

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

    Data.gov (United States)

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

  17. Informal caregivers in hospitals: Opportunities and threats.

    Science.gov (United States)

    Amiresmaili, Mohammadreza; Emrani, Zahra

    2018-05-20

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

  18. Tailoring hospital marketing efforts to physicians' needs.

    Science.gov (United States)

    Mackay, J M; Lamb, C W

    1988-12-01

    Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.

  19. Temporal data mining for hospital management

    Science.gov (United States)

    Tsumoto, Shusaku; Hirano, Shoji

    2009-04-01

    It has passed about twenty years since clinical information are stored electronically as a hospital information system since 1980's. Stored data include from accounting information to laboratory data and even patient records are now started to be accumulated: in other words, a hospital cannot function without the information system, where almost all the pieces of medical information are stored as multimedia databases. In this paper, we applied temporal data mining and exploratory data analysis techniques to hospital management data. The results show several interesting results, which suggests that the reuse of stored data will give a powerful tool for hospial management.

  20. Corporate Social Responsibility in a Hospitality Organisation

    DEFF Research Database (Denmark)

    Justenlund, Anders; Rebelo, Sofia

    the researchers with structures to set up an interview guide for future qualitative interviews. This research recognises the individual's motives for understanding and excercising CSR in the hospitality industry. The authors aim to construct an analytical framework taking as a starting point the understanding...... of implemented CSR-principles within an international hotel chain, recognised for its best practice. In the long term the intention is to learn how future hospitality professionals (present hospitality students) perceive CSR. The paper also includes refelctions on how different welfare state structures affect...

  1. The effect of menstruation on psychiatric hospitalization.

    Science.gov (United States)

    Weston, Jaclyn; Speroni, Karen Gabel; Ellis, Terri; Daniel, Marlon G

    2012-07-01

    This study evaluated the effect of menstruation on psychiatric hospitalization. We conducted a retrospective chart review of the medical records of 177 women who met the eligibility criteria. Data collected included demographic details, primary and secondary diagnoses, date of last menstrual period (LMP), medication adherence, psychiatric hospitalization length of stay, previous psychiatric admissions (including those related to menstruation), discharge referrals, and readmissions. The majority of women were admitted for major depression, were single, Caucasian, and had a mean age of 34. A disproportionate percentage (37%) of women had their LMP within 5 days of psychiatric hospitalization (p = 0.0006). The overall average length of stay was 4.37 days, and 48.3% had a previous psychiatric admission. Medication adherence was routinely not documented (77.4%). Psychiatric hospitalizations for women are significantly greater within 5 days of their LMP. Nursing education and improved documentation are warranted to decrease the potential for readmission. Copyright 2012, SLACK Incorporated.

  2. Potential sources of transmission of hospital acquired infections in ...

    African Journals Online (AJOL)

    The swabs were cultured on Blood, Chocolate and Mac-Conkey agars and incubated for 24hrs at 35±2ºC afterwhich isolates were identified morphologically and biochemically. Results: A total of 187 (88.8%) bacterial isolates were obtained from the swabs (P<0.0017) made up of 55.5% non-pathogenic isolates, 33.3% ...

  3. Developing standard transmission system for radiology reporting including key images

    International Nuclear Information System (INIS)

    Kim, Seon Chil

    2007-01-01

    Development of hospital information system and Picture Archiving Communication System is not new in the medical field, and the development of internet and information technology are also universal. In the course of such development, however, it is hard to share medical information without a refined standard format. Especially in the department of radiology, the role of PACS has become very important in interchanging information with other disparate hospital information systems. A specific system needs to be developed that radiological reports are archived into a database efficiently. This includes sharing of medical images. A model is suggested in this study in which an internal system is developed where radiologists store necessary images and transmit them is the standard international clinical format, Clinical Document Architecture, and share the information with hospitals. CDA document generator was made to generate a new file format and separate the existing storage system from the new system. This was to ensure the access to required data in XML documents. The model presented in this study added a process where crucial images in reading are inserted in the CDA radiological report generator. Therefore, this study suggests a storage and transmission model for CDA documents, which is different from the existing DICOM SR. Radiological reports could be better shared, when the application function for inserting images and the analysis of standard clinical terms are completed

  4. The security of medical and industrial radioactive sources

    International Nuclear Information System (INIS)

    Bielefeld, Tom; Fischer, Helmut W.

    2008-01-01

    Recent foiled and successful terrorist plots in Europe and the US (including two cases in the UK and Germany which included plans to design radiological dispersal devices in 2004 and 2005), clearly demonstrate that domestic or locally acting terrorist cells have become an important part of the terrorist threat picture. The uncovered 'dirty bomb'-plots involved radioactive material of type or quantity that would not have caused much damage. Still, these observations underscore the necessity to revisit the issue of radioactive sources security in countries which may become the target of a radiological attack. This includes in particular countries in Europe, many of which in the past relied on sophisticated - but safety centred - regulations and functioning oversight institutions. In a pilot study, we have developed plausible attack scenarios involving medical and industrial sources used in Germany. Special emphasis was put on how such sources could be obtained by a locally acting terrorist group using criminal tactics and non-specialized equipment only. To this end, sources storage and handling as well as daily work procedures in hospitals and companies have been analysed to find weak points which could be discovered and exploited by terrorist groups. Publicly available technical information has been used to assess under which circumstances terrorists could obtain various types of sources or whole instruments. Calculations have been performed to estimate the radiation burden to a person handling these sources with improvised equipment. Our study shows that, even in a country with already high regulatory standards, hospitals and industrial facilities still need to introduce improvements to sources security. We therefore discuss and propose a number of affordable security upgrades. Many of our findings in Germany apply to other western countries as well. Hence, we call for a change of mentality of users and manufacturers to take into account not only the safety but

  5. The new wave of hospital consolidation.

    Science.gov (United States)

    Goldstein, Lisa

    2012-04-01

    Reimbursement challenges, spiraling healthcare costs, and a slow economic recovery are driving the latest wave of hospital consolidation. Health insurance companies and provider systems are forming partnerships in the consolidation field with the goal of reducing healthcare costs and improving quality. The "cost" of the acquisition may include debt and other obligations of the acquired hospital, such as pension liabilities, along with a multiyear capital commitment.

  6. Readmissions to Different Hospitals After Common Surgical Procedures and Consequences for Implementation of Perioperative Surgical Home Programs.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H; Sun, Eric C; Lubarsky, David A; Dexter, Elisabeth U

    2017-09-01

    We consider whether there should be greater priority of information sharing about postacute surgical resources used: (1) at skilled nursing facilities or inpatient rehabilitation hospitals to which patients are transferred upon discharge (when applicable) versus (2) at different hospitals where readmissions occur. Obtaining and storing data electronically from these 2 sources for Perioperative Surgical Home initiatives are dissimilar; both can be challenging depending on the country and health system. Using the 2013 US Nationwide Readmissions Database, we studied discharges of surgical diagnosis-related group (DRG) with US national median length of stay (LOS) ≥ 3 days and ≥ 10 hospitals each with ≥ 100 discharges for the Medicare Severity DRG. Nationwide, 16.15% (95% confidence interval [CI], 15.14%-17.22%) of discharges were with a disposition of "not to home" (ie, transfer to a skilled nursing facility or an inpatient rehabilitation hospital). Within 30 days, 0.88% of discharges (0.82%-0.95%) were followed by readmission and to a different hospital than the original hospital where the surgery was performed. Among all discharges, disposition "not to home" versus "to home" was associated with greater odds that the patient would have readmission within 30 days and to a different hospital than where the surgery was performed (2.11, 95% CI, 1.96-2.27; P < .0001). In part, this was because disposition "not to home" was associated with greater odds of readmission to any hospital (1.90, 95% CI, 1.82-1.98; P < .0001). In addition, among the subset of discharges with readmission within 30 days, disposition "not to home" versus "to home" was associated with greater odds that the readmission was to a different hospital than where the surgery was performed (1.20, 95% CI, 1.11-1.31; P < .0001). There was no association between the hospitals' median LOS for the DRG and the odds that readmission was to a different hospital (P = .82). The odds ratio per each 1 day decrease

  7. Treatment planning source assessment

    International Nuclear Information System (INIS)

    Calzetta Larrieu, O.; Blaumann, H.; Longhino, J.

    2000-01-01

    The reactor RA-6 NCT system was improved during the last year mainly in two aspects: the facility itself getting lower contamination factors and using better measurements techniques to obtain lower uncertainties in its characterization. In this job we show the different steps to get the source to be used in the treatment planning code representing the NCT facility. The first one was to compare the dosimetry in a water phantom between the calculation using the entire facility including core, filter and shields and a surface source at the end of the beam. The second one was to transform this particle by particle source in a distribution one regarding the minimum spatial, energy and angular resolution to get similar results. Finally we compare calculation and experimental values with and without the water phantom to adjust the distribution source. The results are discussed. (author)

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

    Science.gov (United States)

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

    2014-10-01

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

  9. Premier Hospital Historical Data

    Data.gov (United States)

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

  10. [Ryazan hospital--80 years].

    Science.gov (United States)

    Klimov, A S; Gromov, M F

    2012-02-01

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

  11. Hospital Compare Data

    Data.gov (United States)

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

  12. Hospital Outpatient PPS

    Data.gov (United States)

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

  13. VT Hospital Site Locations

    Data.gov (United States)

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

  14. Critical Access Hospitals (CAH)

    Science.gov (United States)

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

  15. Physician-Owned Hospitals

    Data.gov (United States)

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

  16. Hospitals as health educators

    Science.gov (United States)

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

  17. Hospital Readmission Reduction

    Data.gov (United States)

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

  18. Hospital Readmissions Reduction Program

    Data.gov (United States)

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

  19. Research in Hospitality Management

    African Journals Online (AJOL)

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

  20. Practice Hospital Bed Safety

    Science.gov (United States)

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

  1. Knowledge and perception of stroke amongst hospital workers in an African community.

    Science.gov (United States)

    Akinyemi, R O; Ogah, O S; Ogundipe, R F; Oyesola, O A; Oyadoke, A A; Ogunlana, M O; Otubogun, F M; Odeyinka, T F; Alabi, B S; Akinyemi, J O; Osinfade, J K; Kalaria, R N

    2009-09-01

    Stroke is a growing public health problem worldwide. Hospital workers are sources of knowledge on health issues including stroke. The present study aimed at assessing the knowledge and perception of a sample of Nigerian hospital workers about stroke. Hospital-based, cross-sectional survey. Respondents selected by systematic random sampling were interviewed using a 29-item pre-tested, structured, semi-closed questionnaire. There were 370 respondents (63% female, mean age: 34.4 +/- 7.5 years; 61% non-clinical workers). Twenty-nine per cent of respondents did not recognize the brain as the organ affected. Hypertension (88.6%) was the commonest risk factor identified; 13.8% identified evil spirit/witchcraft as a cause of stroke, whilst one-sided body weakness (61.9%) was most commonly identified as warning symptom. Hospital treatment was most preferred by 61.1% of respondents whilst spiritual healing was most preferred by 13.0%. In the bivariate analysis, higher level of education and being a clinical worker correlated with better stroke knowledge (P < 0.001). This study demonstrates gaps in the knowledge of these hospital workers about stroke, and treatment choice influenced by cultural and religious beliefs. Health education is still important, even, amongst health workers and stroke awareness campaigns may need to involve faith-based organizations.

  2. Opening Doors to Recovery: Recidivism and Recovery Among Persons With Serious Mental Illnesses and Repeated Hospitalizations.

    Science.gov (United States)

    Compton, Michael T; Kelley, Mary E; Pope, Alicia; Smith, Kelly; Broussard, Beth; Reed, Thomas A; DiPolito, June A; Druss, Benjamin G; Li, Charles; Lott Haynes, Nora

    2016-02-01

    Repeated hospitalizations and arrests or incarcerations diminish the ability of individuals with serious mental illnesses to pursue recovery. Community mental health systems need new models to address recidivism as well as service fragmentation, lack of engagement by local stakeholders, and poor communication between mental health providers and the police. This study examined the initial effects on institutional recidivism and measures of recovery among persons enrolled in Opening Doors to Recovery, an intensive, team-based community support program for persons with mental illness and a history of inpatient psychiatric recidivism. A randomized controlled trial of the model is underway. The number of hospitalizations, days hospitalized, and arrests (all from state administrative sources) in the year before enrollment and during the first 12 months of enrollment in the program were compared. Longitudinal trajectories of recovery-using three self-report and five clinician-rated measures-were examined. Analyses accounted for baseline symptom severity and intensity of involvement in the program. One hundred participants were enrolled, and 72 were included in the analyses. Hospitalizations decreased, from 1.9±1.6 to .6±.9 (precovery measures, and trajectories of improvement were apparent across the entire follow-up period. Opening Doors to Recovery holds promise as a new service approach for reducing hospital recidivism and promoting recovery in community mental health systems and is deserving of further controlled testing.

  3. Risk-adjusted antibiotic consumption in 34 public acute hospitals in Ireland, 2006 to 2014

    Science.gov (United States)

    Oza, Ajay; Donohue, Fionnuala; Johnson, Howard; Cunney, Robert

    2016-01-01

    As antibiotic consumption rates between hospitals can vary depending on the characteristics of the patients treated, risk-adjustment that compensates for the patient-based variation is required to assess the impact of any stewardship measures. The aim of this study was to investigate the usefulness of patient-based administrative data variables for adjusting aggregate hospital antibiotic consumption rates. Data on total inpatient antibiotics and six broad subclasses were sourced from 34 acute hospitals from 2006 to 2014. Aggregate annual patient administration data were divided into explanatory variables, including major diagnostic categories, for each hospital. Multivariable regression models were used to identify factors affecting antibiotic consumption. Coefficient of variation of the root mean squared errors (CV-RMSE) for the total antibiotic usage model was very good (11%), however, the value for two of the models was poor (> 30%). The overall inpatient antibiotic consumption increased from 82.5 defined daily doses (DDD)/100 bed-days used in 2006 to 89.2 DDD/100 bed-days used in 2014; the increase was not significant after risk-adjustment. During the same period, consumption of carbapenems increased significantly, while usage of fluoroquinolones decreased. In conclusion, patient-based administrative data variables are useful for adjusting hospital antibiotic consumption rates, although additional variables should also be employed. PMID:27541730

  4. Ionizing radiation in hospitals

    International Nuclear Information System (INIS)

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

    1985-10-01

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

  5. Preventing falls in hospital.

    Science.gov (United States)

    Pearce, Lynne

    2017-02-27

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

  6. Nutrition support in hospitals

    DEFF Research Database (Denmark)

    Kondrup, Jens

    2005-01-01

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

  7. [Hospital organizational structure].

    Science.gov (United States)

    Bittar, O J

    1994-01-01

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

  8. [Hospital admissions due to varicella in a tertiary hospital].

    Science.gov (United States)

    Guzmán Laura, K P; Periañez Vasco, A; Falcón Neyra, M D; Croche Santander, B

    2014-06-01

    Varicella (chickenpox) can cause serious complications and admission to hospital. Several countries included the varicella vaccine in their immunization schedules. A descriptive and retrospective study of hospitalizations due to varicella and its complications was conducted in a referral center from 2005 to 2011. A total of 1192 children with varicella were seen in the emergency room, of which 99 (8.5%) required admission. The annual incidence of admissions due to varicella and varicella complications was, 19.4 and 15.3 cases per 100,000 children under 14 years, respectively. Complications were more common in children under 5 years (79.5%), and with no underlying disease (78.2%). Infection of skin and soft tissue was the most common complication (62%). The mean hospital stay was 4.5 days (SD 4). Varicella causes high morbidity, and is more frequent in absolute terms in healthy children under 5 years of age. Therefore, routine vaccination recommended by the Immunization Advisory Committee should be mandatory. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  9. Preparedness of Iranian Hospitals Against Disasters

    Directory of Open Access Journals (Sweden)

    Asefzadeh

    2016-08-01

    Full Text Available Context Over the past decade the number of accidents and disasters has been growing around the world. In addition to damaging communities and infrastructures, unexpected disasters also affect service providers. This study aimed to evaluate the readiness of hospitals when confronted with unexpected disasters. Evidence Acquisition The present study was a simple review article, which was conducted via searching different sites, such as: Web of Science, Scopus, Science Direct and PubMed, using different key words such as: Disasters, Crisis, Hospital and preparedness. The relationship between the articles found in relation to our subject was investigated through the title and abstract of articles. The relationship between the articles, which were found in relation to our subject, was investigated through the title and abstract of the articles. Our search included papers published during the period between 2007 and 2015 and we only considered studies that measured the preparedness of hospitals in critical conditions. Among the 30 articles, which were found, 17 were excluded from the study due to lack of relevant data. Hence, 15 papers, which were of proper design and robust data analysis, were included in the current study. Results Hospital preparedness in disaster was evaluated in three dimensions: structural, non-structural factors and vulnerability management performance. A total of readiness of hospitals in three dimensions was mediocre. Conclusions Overall, the results derived from these studies indicated that hospital safety levels in most of the surveyed hospitals were moderate. Although the situation in hospitals is not critical, there is a need to plan and take appropriate measures to improve the safety level of the hospitals.

  10. Male cerebral palsy hospitalization as a potential indicator of neurological effects of methylmercury exposure in Great Lakes communities

    International Nuclear Information System (INIS)

    Gilbertson, Michael

    2004-01-01

    Perinatal exposure to methylmercury is known to result in severe neurological effects on the developing fetus and infant, including cerebral palsy, mental retardation, and seizures. Males are more susceptible than females to neurological damage from perinatal methylmercury exposures. Preliminary analyses of data and statistics for the hospitalization rates of males for cerebral palsy in the 17 Canadian Areas of Concern in the Great Lakes basin indicate a possible geographic association with locations with elevated mercury from natural or industrial sources

  11. 78 FR 8329 - Federal Housing Administration (FHA): Hospital Mortgage Insurance Program-Refinancing Hospital Loans

    Science.gov (United States)

    2013-02-05

    ... available through other sources, and to eliminate from eligibility hospitals with poor financial performance... terminology, based on experience to date, to facilitate understanding how the Section 242 program works. C... divide other. Additionally, revises certain threshold factors that make an initial determination of a...

  12. Frecuencia de infección del tracto urinario en lactantes con fiebre, sin foco infeccioso evidente, que consultan a la Unidad Vida Infantil de la Universidad de Antioquia del Hospital Francisco Valderrama, Turbo (Antioquia Frequency of urinary tract infections in febrile infants without evidence of an infectious source. from the clinic of the Unidad Vida Infantil of the University of Antioquia, Hospital Francisco Valderrama, Turbo, Colombia.

    Directory of Open Access Journals (Sweden)

    Harold Durango Galván

    2006-01-01

    ía anorexia, irritabilidad, malestar general y vómito. Los parámetros de laboratorio más específicos fueron tinción de gram positiva (cualquier bacteria y piuria (>10 leucocitos por campo de alto poder. Todas las infecciones urinarias fueron causadas por Escherichia coli. Los antibiogramas mostraron sensibilidad disminuida al trimetroprim sulfa y a la ampicilina. CONCLUSIONES: la infección urinaria es una causa frecuente de síndrome febril agudo sin causa aparente en lactantes, en Turbo, Antioquia. En tales casos, los médicos deben ordenar un UA (leucocitos y bacterias por campo de ato poder y tinción de gram. Si los resultados de estas pruebas son positivas, debe hacerse urocultivo. En este estudio las cepas de Escherichia coli identificadas mostraron resistencia a antibióticos frecuentemente utilizados. BACKGROUND: in infants, it has been documented that urinary tract infections (UTI are a common cause of the acute febrile syndrome without apparent source for the fever. According to the results of some research, the prevalence of UTI varies between 4% and 13%. In infants, especially those under the age of 2 years, UTI are associated with an increased incidence of vesicoureteral reflux and renal parenchymal involvement. Moreover, this group of patients with UTI require special attention in order to prevent renal scarring, hypertension and chronic renal failure. OBJECTIVE: to establish the prevalence rate of UTI in febrile infants under 24 months of age, admitted to the Vida Infantil” Department of the University of Antioquia and the Francisco Valderrama Hospital in Turbo, Antioquia, (Colombia, from February 1st, 2003 through January 31st, 2004. METHODS: a total of 50 children under 24 months of age who had been admitted to the aforementioned Department were enrolled in this prospective study. Patients had fever the cause of which was not definitely known. The following laboratory tests were performed: white blood cell total and differential count (WBC

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

    Science.gov (United States)

    Gravelle, Hugh; Santos, Rita; Siciliani, Luigi

    2014-11-01

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

  14. Rural Hospital Mergers and Acquisitions: Which Hospitals Are Being Acquired and How Are They Performing Afterward?.

    Science.gov (United States)

    Noles, Marissa J; Reiter, Kristin L; Boortz-Marx, Jonathan; Pink, George

    2015-01-01

    The number of stand-alone rural hospitals has been shrinking as larger health systems target these hospitals for mergers and acquisitions (M and As). However, little research has focused specifically on rural hospital M and A transactions. Using data from Irving Levin Associates' Healthcare M and A Report and Medicare Cost Reports from 2005 to 2012, we examined two research questions: (1) What were the characteristics of rural hospitals that merged or were acquired, and (2) were there changes in rural hospital financial performance, staffing, or services after an M and A transaction? We used logistic regression to identify factors predictive of merger, and we used multiple regression to examine various hospital measures after an M or A. Study results showed that hospitals with weaker financial performance but lower staffing levels and staffing costs were more likely to merge or be acquired. Statistically weak evidence suggested that operating margins declined after the merger; stronger evidence suggested reductions in salary expense. There was no statistically significant evidence of changes to the number of full-time equivalent (FTE) employees, the service lines that were included in the study, capital expenditures, or the amount of debt financing among the hospitals that merged or were acquired. M and A may not result in a rapid influx of capital, a relief of debt burden, or an improvement in bottom-line profitability. However, M and A may be a viable option for maintaining the hospital and the access to care it provides.

  15. Land Streamer Surveying Using Multiple Sources

    KAUST Repository

    Mahmoud, Sherif

    2014-12-11

    Various examples are provided for land streamer seismic surveying using multiple sources. In one example, among others, a method includes disposing a land streamer in-line with first and second shot sources. The first shot source is at a first source location adjacent to a proximal end of the land streamer and the second shot source is at a second source location separated by a fixed length corresponding to a length of the land streamer. Shot gathers can be obtained when the shot sources are fired. In another example, a system includes a land streamer including a plurality of receivers, a first shot source located adjacent to the proximal end of the land streamer, and a second shot source located in-line with the land streamer and the first shot source. The second shot source is separated from the first shot source by a fixed overall length corresponding to the land streamer.

  16. Admission of people with dementia to psychiatric hospitals in Japan: factors that can shorten their hospitalizations.

    Science.gov (United States)

    Morikawa, Takako; Maeda, Kiyoshi; Osaki, Tohmi; Kajita, Hiroyuki; Yotsumoto, Kayano; Kawamata, Toshio

    2017-11-01

    People exhibiting serious behavioural and psychological symptoms of dementia are usually voluntarily or involuntarily committed to psychiatric hospitals for treatment. In Japan, the average hospital stay for individuals with dementia is about 2 years. Ideally, individuals should be discharged once their symptoms have subsided. However, we see cases in Japan where individuals remain institutionalized long after behavioural and psychological symptoms of dementia are no longer apparent. This study will attempt to identify factors contributing to shorter stays in psychiatric hospitals for dementia patients. Questionnaires consisting of 17 items were mailed to 121 psychiatric hospitals with dementia treatment wards in western Japan. Out of 121 hospitals that received the questionnaires, 45 hospitals returned them. The total number of new patient admissions at all 45 hospitals during the month of August 2014 was 1428, including 384 dementia patients (26.9%). The average length of stay in the dementia wards in August 2014 was 482.7 days. Our findings revealed that the rate of discharge after 2 months was 35.4% for the dementia wards. In addition, we found that the average stay in hospitals charging or planning to charge the rehabilitation fee to dementia patients was significantly shorter than in hospitals not charging the rehabilitation fee. In Japan, dementia patients account for over 25% of new admissions to psychiatric hospitals with dementia wards. The average length of stay in a psychiatric hospital dementia ward is more than 1 year. A discharge after fewer than 2 months is exceedingly rare for those in a dementia ward compared with dementia patients in other wards. If institutions focus on rehabilitation, it may be possible to shorten the stay of dementia patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

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

    Science.gov (United States)

    Dias, Casimiro; Escoval, Ana

    2013-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  19. Approaching hospital administration about adopting cooling technologies.

    Science.gov (United States)

    Kirkland, Lisa L; Parham, William M; Pastores, Stephen M

    2009-07-01

    The purpose of this article is to provide intensivists with information and examples regarding cooling technology selection, cost assessment, adaptation, barriers, and presentation to hospital administrators. A review of medical and business literature was conducted using the following search terms: technology assessment, organizational innovation, intensive care, critical care, hospital administration, and presentation to administrators. General recommendations for intensivists are made for assessing cooling technology with descriptions of common new technology implementation stages. A study of 16 hospitals implementing a new cardiac surgery technology is described. A description of successful implementation of an induced hypothermia protocol by one of the authors is presented. Although knowledgeable about the applications of new technologies, including cooling technology, intensivists have little guidance or training on tactics to obtain a hospital administration's funding and support. Intensive care unit budgets are usually controlled by nonintensivists whose interests are neutral, at best, to the needs of intensivists. To rise to the top of the large pile of requisition requests, an intensivist's proposal must be well conceived and aligned with hospital administration's strategic goals. Intensivists must understand the hospital acquisition process and administrative structure and participate on high-level hospital committees. Using design thinking and strong leadership skills, the intensivist can marshal support from staff and administrators to successfully implement cooling technology.

  20. Ranking agility factors affecting hospitals in Iran

    Directory of Open Access Journals (Sweden)

    M. Abdi Talarposht

    2017-04-01

    Full Text Available Background: Agility is an effective response to the changing and unpredictable environment and using these changes as opportunities for organizational improvement. Objective: The aim of the present study was to rank the factors affecting agile supply chain of hospitals of Iran. Methods: This applied study was conducted by cross sectional-descriptive method at some point of 2015 for one year. The research population included managers, administrators, faculty members and experts were selected hospitals. A total of 260 people were selected as sample from the health centers. The construct validity of the questionnaire was approved by confirmatory factor analysis test and its reliability was approved by Cronbach's alpha (α=0.97. All data were analyzed by Kolmogorov-Smirnov, Chi-square and Friedman tests. Findings: The development of staff skills, the use of information technology, the integration of processes, appropriate planning, and customer satisfaction and product quality had a significant impact on the agility of public hospitals of Iran (P<0.001. New product introductions had earned the highest ranking and the development of staff skills earned the lowest ranking. Conclusion: The new product introduction, market responsiveness and sensitivity, reduce costs, and the integration of organizational processes, ratings better to have acquired agility hospitals in Iran. Therefore, planners and officials of hospitals have to, through the promotion quality and variety of services customer-oriented, providing a basis for investing in the hospital and etc to apply for agility supply chain public hospitals of Iran.

  1. The impact of varicella vaccination on varicella-related hospitalization rates: global data review

    Directory of Open Access Journals (Sweden)

    Maki Hirose

    Full Text Available Abstract Objective: To describe the impact of varicella vaccination on varicella-related hospitalization rates in countries that implemented universal vaccination against the disease. Data source: We identified countries that implemented universal vaccination against varicella at the http://apps.who.int/immunization_monitoring/globalsummary/schedules site of the World Health Organization and selected articles in Pubmed describing the changes (pre/post-vaccination in the varicella-related hospitalization rates in these countries, using the Keywords "varicella", "vaccination/vaccine" and "children" (or "hospitalization". Publications in English published between January 1995 and May 2015 were included. Data synthesis: 24 countries with universal vaccination against varicella and 28 articles describing the impact of the vaccine on varicella-associated hospitalizations rates in seven countries were identified. The US had 81.4%–99.2% reduction in hospitalization rates in children younger than four years, 6–14 years after the onset of universal vaccination (1995, with vaccination coverage of 90%; Uruguay: 94% decrease (children aged 1–4 years in six years, vaccination coverage of 90%; Canada: 93% decrease (age 1–4 years in 10 years, coverage of 93%; Germany: 62.4% decrease (age 1–4 years in 8 years, coverage of 78.2%; Australia: 76.8% decrease (age 1–4 years in 5 years, coverage of 90%; Spain: 83.5% decrease (age <5 years in four years, coverage of 77.2% and Italy 69.7%–73.8% decrease (general population, coverage of 60%–95%. Conclusions: The publications showed variations in the percentage of decrease in varicella-related hospitalization rates after universal vaccination in the assessed countries; the results probably depend on the time since the implementation of universal vaccination, differences in the studied age group, hospital admission criteria, vaccination coverage and strategy, which does not allow direct comparison between

  2. Routine hospital data - is it good enough for trials? An example using England's Hospital Episode Statistics in the SHIFT trial of Family Therapy vs. Treatment as Usual in adolescents following self-harm.

    Science.gov (United States)

    Wright-Hughes, Alexandra; Graham, Elizabeth; Cottrell, David; Farrin, Amanda

    2018-04-01

    Use of routine data sources within clinical research is increasing and is endorsed by the National Institute for Health Research to increase trial efficiencies; however there is limited evidence for its use in clinical trials, especially in relation to self-harm. One source of routine data, Hospital Episode Statistics, is collated and distributed by NHS Digital and contains details of admissions, outpatient, and Accident and Emergency attendances provided periodically by English National Health Service hospitals. We explored the reliability and accuracy of Hospital Episode Statistics, compared to data collected directly from hospital records, to assess whether it would provide complete, accurate, and reliable means of acquiring hospital attendances for self-harm - the primary outcome for the SHIFT (Self-Harm Intervention: Family Therapy) trial evaluating Family Therapy for adolescents following self-harm. Participant identifiers were linked to Hospital Episode Statistics Accident and Emergency, and Admissions data, and episodes combined to describe participants' complete hospital attendance. Attendance data were initially compared to data previously gathered by trial researchers from pre-identified hospitals. Final comparison was conducted of subsequent attendances collected through Hospital Episode Statistics and researcher follow-up. Consideration was given to linkage rates; number and proportion of attendances retrieved; reliability of Accident and Emergency, and Admissions data; percentage of self-harm episodes recorded and coded appropriately; and percentage of required data items retrieved. Participants were first linked to Hospital Episode Statistics with an acceptable match rate of 95%, identifying a total of 341 complete hospital attendances, compared to 139 reported by the researchers at the time. More than double the proportion of Hospital Episode Statistics Accident and Emergency episodes could not be classified in relation to self-harm (75%) compared

  3. Hospitals look to hospitality service firms to meet TQM goals.

    Science.gov (United States)

    Hard, R

    1992-05-20

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

  4. Reducing hospital noise: a review of medical device alarm management.

    Science.gov (United States)

    Konkani, Avinash; Oakley, Barbara; Bauld, Thomas J

    2012-01-01

    Increasing noise in hospital environments, especially in intensive care units (ICUs) and operating rooms (ORs), has created a formidable challenge for both patients and hospital staff. A major contributing factor for the increasing noise levels in these environments is the number of false alarms generated by medical devices. This study focuses on discovering best practices for reducing the number of false clinical alarms in order to increase patient safety and provide a quiet environment for both work and healing. The researchers reviewed Pub Med, Web of Knowledge and Google Scholar sources to obtain original journal research and review articles published through January 2012. This review includes 27 critically important journal articles that address different aspects of medical device alarms management, including the audibility, identification, urgency mapping, and response time of nursing staff and different solutions to such problems. With current technology, the easiest and most direct method for reducing false alarms is to individualize alarm settings for each patient's condition. Promoting an institutional culture change that emphasizes the importance of individualization of alarms is therefore an important goal. Future research should also focus on the development of smart alarms.

  5. Sources of healthcare financing among surgical patients in a rural Niger Delta practice in Nigeria.

    Science.gov (United States)

    Dienye, P O; Brisibe, S F; Eke, R

    2011-01-01

    The environmental degradation following crude oil exploration in the Niger Delta has resulted in poverty for local rural dwellers. For those who are ill, if herbal treatments and/or self-medication with orthodox drugs are unsuccessful, the only alternative is expensive medical treatment in clinics. Surgical patients in a rural clinic may have to stay beyond than the normal 7 days if they are unable to pay their hospital bill; because this limits bed availability, there is an impacts on the hospital's economic management. This study aimed to determine the pattern of hospital bill payment among rural surgical patients in a rural Nigerian community, including the sources of finance for bill payment, in order to determine ways to resolve this issue. This cross-sectional study was conducted in a rural community in the Niger Delta area (Bethesda Clinic Ngo) over 5 years (2005-2009). In the 5 year study period, 3712 patients were seen, of which 229 were surgical patients who consented to the study. Their ages ranged from 4 to 97 years (mean 45.6 ± 13.5 years) and most were fish farmers (79.91%), secondary-school leavers (56.33%) and of the Christian religion (86.03%). The association of these characteristics with a greater than 7 day hospital stay was statistically significant (p sources of finance for the hospital bill were multiple but mainly personal savings (71.18%). Few (3.06%) had knowledge of the National Health Insurance Scheme, but when informed about it 84.28% were willing to enroll. The sources of finance for payment of hospital bills were multiple but the most common were personal savings and family members.

  6. Variations in the Hospital Standardized Mortality Ratios in Korea

    Directory of Open Access Journals (Sweden)

    Eun-Jung Lee

    2014-07-01

    Full Text Available Objectives: The hospital standardized mortality ratio (HSMR has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care. Methods: All inpatients discharged from hospitals with more than 700 beds (66 hospitals in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx, accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities. Results: For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR. Conclusions: We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.

  7. [Nutritional status and risk in hospitalized children].

    Science.gov (United States)

    Hankard, R; Bloch, J; Martin, P; Randrianasolo, H; Bannier, M F; Machinot, S; Cézard, J P

    2001-11-01

    A few studies report malnutrition in hospitalized patients. This one-day cross-sectional survey performed in January 1999 assessed nutritional status and protein-energy intake in a pediatric population hospitalized in medicine or surgery units. Every child older than six months, hospitalized for more than 48 h and free of nutritional support (parenteral, enteral, or special regimens for metabolic diseases) was included. Fifty-eight children among the 183 present the day of the study met the inclusion criteria and were included in the statistical analysis. They were hospitalized in medicine (48%), psychiatry (31%) and surgery (21%). The body mass index (BMI) was below -2 standard deviations (DS) in 21% of them. Excluding patients with anorexia nervosa, BMI was +2 SD, or in between these limits in respectively 12, 14 and 74%. Energy intake measured at the hospital was below 75% of the recommended dietary allowances in two-thirds of the children whether malnourished or not. Fifty percent of the malnourished children had been referred to a dietician the day of the study. Malnutrition is frequent in a population of hospitalized children. Energy intake and referral to a dietician are insufficient.

  8. Controlling Legal Risk for Effective Hospital Management

    Directory of Open Access Journals (Sweden)

    Hyun Jun Park

    2016-04-01

    Full Text Available Purpose: To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. Materials and Methods: This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. Results: Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%. The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years, and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months. Conclusions: Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.

  9. Trick questions: cosmopolitan hospitality

    Directory of Open Access Journals (Sweden)

    Eleanor Byrne

    2013-08-01

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

  10. [Communication among hospital leaders].

    Science.gov (United States)

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

    2013-12-01

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

  11. [Epilepsy treatment in Serbian medieval monastery hospitals].

    Science.gov (United States)

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

    2009-01-01

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

  12. Service quality for facilities management in hospitals

    CERN Document Server

    Sui Pheng, Low

    2016-01-01

    This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...

  13. [Management characteristics in charity hospitals in Brazil].

    Science.gov (United States)

    Lima, Sheyla Maria Lemos; Barbosa, Pedro Ribeiro; Portela, Margareth C; Ugá, Maria Alicia Dominguez; Vasconcellos, Miguel Murat; Gerschman, Silvia

    2004-01-01

    This paper presents the management characteristics of charity hospitals in Brazil, based on data from a national survey developed in 2001. The sample accounted for the random inclusion of 66 Brazilian Unified Health System (SUS) inpatient care providers with less than 599 beds and all 26 hospitals with at least 599 beds. It also included 10 institutions assumed as non-providers of services to the SUS. The analyses are descriptive, focusing on the classification of the hospitals according to their managerial development level, as well as selected issues regarding the utilization of specific managerial technologies, human resources, technical services, and services contracting. Distinct managerial levels were identified, but it is important to note that 83% of the SUS providers with less than 599 beds were classified as having incipient management. The authors discuss implications of the findings for inpatient care policies, considering the importance of charity hospitals for the Brazilian Health System.

  14. Hospitals and health care establishments

    International Nuclear Information System (INIS)

    1999-01-01

    These guidelines have been drown up to assist all those involved in the management and maintenance of hospitals and health care establishments. Compliance with this guidance should minimise the risk of pollution occurring. The guidelines are jointly produced by the Environment Agency for England and Wales, the Scottish Environment Protection Agency and the Environment and Heritage Service for Northern Ireland, referred to as the Agency or Agencies. It includes guidelines on site drainage, sewage and waste water disposal, treatment of surface water drainage and waste management

  15. Quantitative tools for addressing hospital readmissions

    Directory of Open Access Journals (Sweden)

    Lagoe Ronald J

    2012-11-01

    Full Text Available Abstract Background Increased interest in health care cost containment is focusing attention on reduction of hospital readmissions. Major payors have already developed financial penalties for providers that generate excess readmissions. This subject has benefitted from the development of resources such as the Potentially Preventable Readmissions software. This process has encouraged hospitals to renew efforts to improve these outcomes. The aim of this study was to describe quantitative tools such as definitions, risk estimation, and tracking of patients for reducing hospital readmissions. Findings This study employed the Potentially Preventable Readmissions software to develop quantitative tools for addressing hospital readmissions. These tools included two definitions of readmissions that support identification and management of patients. They also included analytical approaches for estimation of the risk of readmission for individual patients by age, discharge status of the initial admission, and severity of illness. They also included patient specific spreadsheets for tracking of target populations and for evaluation of the impact of interventions. Conclusions The study demonstrated that quantitative tools including the development of definitions of readmissions, estimation of the risk of readmission, and patient specific spreadsheets could contribute to the improvement of patient outcomes in hospitals.

  16. 42 CFR 410.100 - Included services.

    Science.gov (United States)

    2010-10-01

    ... service; however, maintenance therapy itself is not covered as part of these services. (c) Occupational... increase respiratory function, such as graded activity services; these services include physiologic... rehabilitation plan of treatment, including physical therapy services, occupational therapy services, speech...

  17. Radioactive wastes and effluents in hospitals

    International Nuclear Information System (INIS)

    Carlier, V.

    2000-01-01

    Out of sealed sources that have a particular management and regulation, the hospitals and laboratories use radioisotopes in liquid unsealed sources. The radioisotopes receive a particular surveillance, as well for their use as for the wastes they produce. At each step of their use, a follow up of these products and induced wastes is going to be made in a rigorous way, and their noxiousness taken into account. Whatever can be the product, the aim is the same: the matter is to preserve man and his environment from noxious effects of these products. (N.C.)

  18. The Goiania accident: release from hospital criterion

    International Nuclear Information System (INIS)

    Falcao, R.C.; Hunt, J.

    1990-01-01

    On the thirteenth of September 1987, a 1357 Ci Cesium source was removed from the 'Instituto de Radiologia de Goiania' - probably two or three days later the source was opened, causing the internal and external contamination of 247 people, and part of the city of Goiania. This paper describes the release from hospital criterion of the contaminated patients, based on radiation protection principles which were developed for this case. The estimate of the biological half-life for cesium is also described. (author) [pt

  19. 77 FR 7 - Revisions to Labeling Requirements for Blood and Blood Components, Including Source Plasma

    Science.gov (United States)

    2012-01-03

    ... uniform container label for blood and blood components and recommended labels that incorporated barcode... Protein Fraction (part 640, subpart I), and Immune Globulin (part 640, subpart J)). The comment noted that...

  20. Completed Research in Health, Physical Education, Recreation & Dance; Including International Sources. Volume 27. 1985 Edition.

    Science.gov (United States)

    Freedson, Patty S., Ed.

    This compilation lists research completed in the areas of health, physical education, recreation, dance, and allied areas during 1984. The document is arranged in two parts. In the index, references are arranged under the subject headings in alphabetical order. Abstracts of master's and doctor's theses from institutions offering graduate programs…

  1. Nutrition in pregnancy: the argument for including a source of choline

    OpenAIRE

    Zeisel, Steven H

    2013-01-01

    Steven H Zeisel Nutrition Research Institute at Kannapolis, Department of Nutrition, University of North Carolina at Chapel Hill, Kannapolis, NC, USA Abstract: Women, during pregnancy and lactation, should eat foods that contain adequate amounts of choline. A mother delivers large amounts of choline across the placenta to the fetus, and after birth she delivers large amounts of choline in milk to the infant; this greatly increases the demand on the choline stores of the mother. Adequate inta...

  2. Efficiency of hospital cholera treatment in Ecuador

    Directory of Open Access Journals (Sweden)

    Creamer Germán

    1999-01-01

    Full Text Available This study analyzed the efficiency of cholera treatment in three hospitals representative of the Ecuadorian public health system in order to provide hospital directors and administrators and health service policy-makers with information to plan responses to future epidemics and to reduce the costs of cholera treatment in general. For the study, total and excess cholera treatment costs were calculated using hospital files and statistics and an in-hospital surveillance system of the cholera cases. The type and quantity of each input used for each treatment were analyzed, as well as the number of days hospitalized, according to the severity of the illness. With this process, excess costs were determined in relation to a "treatment norm" that would have been appropriate for each patient. The researchers found that 45% of the cholera treatment costs were excessive. The most important contributor was excess recurrent costs (90%, including extended hospital stays, disproportionate use of intravenous rehydration solutions, and unnecessary laboratory tests. Excess capital costs, from land, buildings, and hospital equipment, represented 10% of the total excess treatment costs. No significant relationship was found between treatment costs and the severity of the illness, nor between costs and a patient's age. A patient's sex appeared to be an important variable, with the cost of treating women being notably higher than for men. An inverse relationship was found between treatment costs and the complexity of the hospital. The researchers concluded there was an inefficient use of resources in the treatment of cholera in the three hospitals where the research was performed.

  3. Innovative human resource practices in U.S. hospitals: an empirical study.

    Science.gov (United States)

    Platonova, Elena A; Hernandez, S Robert

    2013-01-01

    Contemporary organizations increasingly recognize human resource (HR) capabilities as a source of sustained competitive advantage; about 80% of an organization's value is attributable to intangible assets, including human assets and capital. Some scholars consider effective human resource management (HRM) the single most important factor affecting organizational performance. This study examined (1) the extent to which HRM strategies were included in organizational strategic planning and (2) the association between the involvement of senior HR professionals in strategic planning and the use of innovative HR practices in U.S. hospitals employing strategic HRM theory. A survey was administered to 168 chief executive officers and HR executives from 85 hospitals during spring 2005. Binary logistic regression was conducted to determine whether HRM involvement was associated with the use of innovative HRM strategies in the hospitals. We found significant associations between HRM strategy inclusion in the strategic planning process and senior HR professionals' involvement in organizational strategic planning and in three innovative HR activities: finding talent in advance for key job openings (odds ratio [OR] = 4.61, 95% confidence interval [CI]: 1.10-7.38), stressing organizational culture and values in the selection process (OR = 3.97, 95% CI: 1.01-3.97), and basing individual or team compensation on goal-oriented results (OR = 6.17, 95% CI: 1.17-3.37). Our data indicate that innovative HR practices were underused in some U.S. hospitals despite their potential to improve overall hospital performance. Hospitals that emphasized effective HRM were more likely to use some of the innovative HR approaches. In this article, we discuss this research and the practical implications of the findings.

  4. National Hospital Discharge Survey: 2001 annual summary with detailed diagnosis and procedure data.

    Science.gov (United States)

    Kozak, Lola Jean; Owings, Maria F; Hall, Margaret J

    2004-06-01

    This report presents 2001 national estimates and selected trend data on the use of non-Federal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Admission source and type, collected for the first time in the 2001 National Hospital Discharge Survey, are shown. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2001, data were collected for approximately 330,000 discharges. Of the 477 eligible non-Federal short-stay hospitals in the sample, 448 (94 percent) responded to the survey. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code numbers. Rates are computed with 2001 population estimates based on the 2000 census. The appendix includes a comparison of rates computed with 1990 and 2000 census-based population estimates. An estimated 32.7 million inpatients were discharged from non-Federal short-stay hospitals in 2001. They used 159.4 million days of care and had an average length of stay of 4.9 days. Common first-listed discharge diagnoses included delivery, psychoses, pneumonia, malignant neoplasm, and coronary atherosclerosis. Males had higher rates for procedures such as cardiac catheterization and coronary artery bypass graft, and females had higher rates for procedures such as cholecystectomy and total knee replacement. The rates of all cesarean deliveries, primary and repeat, rose from 1995 to 2001; the rate of vaginal birth after cesarean delivery dropped 37 percent during this period.

  5. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    ORAU' s Oak Ridge Institute for Science Education (HCTT-CHE)

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster - readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that - help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. This tool has been reviewed by a variety of key subject matter experts from federal, state, and local agencies and organizations. It also has been piloted with various communities that consist of different population sizes, to include large urban to small rural communities.

  6. Static, Lightweight Includes Resolution for PHP

    NARCIS (Netherlands)

    M.A. Hills (Mark); P. Klint (Paul); J.J. Vinju (Jurgen)

    2014-01-01

    htmlabstractDynamic languages include a number of features that are challenging to model properly in static analysis tools. In PHP, one of these features is the include expression, where an arbitrary expression provides the path of the file to include at runtime. In this paper we present two

  7. Article Including Environmental Barrier Coating System

    Science.gov (United States)

    Lee, Kang N. (Inventor)

    2015-01-01

    An enhanced environmental barrier coating for a silicon containing substrate. The enhanced barrier coating may include a bond coat doped with at least one of an alkali metal oxide and an alkali earth metal oxide. The enhanced barrier coating may include a composite mullite bond coat including BSAS and another distinct second phase oxide applied over said surface.

  8. Rare thoracic cancers, including peritoneum mesothelioma

    NARCIS (Netherlands)

    Siesling, Sabine; van der Zwan, Jan Maarten; Izarzugaza, Isabel; Jaal, Jana; Treasure, Tom; Foschi, Roberto; Ricardi, Umberto; Groen, Harry; Tavilla, Andrea; Ardanaz, Eva

    Rare thoracic cancers include those of the trachea, thymus and mesothelioma (including peritoneum mesothelioma). The aim of this study was to describe the incidence, prevalence and survival of rare thoracic tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002,

  9. Rare thoracic cancers, including peritoneum mesothelioma

    NARCIS (Netherlands)

    Siesling, Sabine; Zwan, J.M.V.D.; Izarzugaza, I.; Jaal, J.; Treasure, T.; Foschi, R.; Ricardi, U.; Groen, H.; Tavilla, A.; Ardanaz, E.

    2012-01-01

    Rare thoracic cancers include those of the trachea, thymus and mesothelioma (including peritoneum mesothelioma). The aim of this study was to describe the incidence, prevalence and survival of rare thoracic tumours using a large database, which includes cancer patients diagnosed from 1978 to 2002,

  10. 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

  11. Managerial innovation in the hospital: an analysis of the diffusion of hospital cost-accounting systems.

    Science.gov (United States)

    Counte, M A; Glandon, G L

    1988-01-01

    Currently much interest is focused on the uses of cost-accounting systems within the hospital industry. Proponents frequently contend that such systems will help hospitals successfully adapt to new methods of financial reimbursement because they are essential to a number of major management functions, including competitive bidding, cost management, pricing, and profitability assessment. This article reports the results of a study conducted to examine the extent to which hospitals in a major market are actually beginning to use standard cost-accounting systems and identify factors that either aid or hinder the diffusion of these methods. Chief financial officers from 94 hospitals (83 percent response rate) participated in the study during the summer of 1986 where less than half of the hospitals (43 percent) had recently purchased a cost-accounting system. Detailed information about the interface of cost-accounting systems with other application systems and their specific management uses is reported.

  12. 78 FR 28051 - Federal Plan Requirements for Hospital/Medical/Infectious Waste Incinerators Constructed On or...

    Science.gov (United States)

    2013-05-13

    ... to our description of our standard-setting process; correcting erroneous cross-references in the... Before December 1, 2008, and Standards of Performance for New Stationary Sources: Hospital/Medical... Standards of Performance for New Stationary Sources: Hospital/Medical/Infectious Waste Incinerators AGENCY...

  13. Production of sealed sources

    International Nuclear Information System (INIS)

    Bandi, L.N.

    2016-01-01

    Radioisotope production has been an ongoing activity in India since the sixties. Radioisotopes find wide-ranging applications in various fields, including industry, research, agriculture and medicine. Board of Radiation and Isotope Technology, an industrial unit of Department of Atomic Energy is involved in fabrication and supply of wide variety of sealed sources. The main radioisotopes fabricated and supplied by BRIT are Cobalt-60, Iridium-192. These isotopes are employed in industrial and laboratory irradiators, teletherapy machines, radiography exposure devices, nucleonic gauges. The source fabrication facilities of BRIT are located at Rajasthan Atomic Power Project Cobalt-60 Facility (RAPPCOF), Kota, Radiological Laboratories Group (RLG) and High Intensity Radiation Utilization Project (HIRUP) at Trombay

  14. Variability in the measurement of hospital-wide mortality rates.

    Science.gov (United States)

    Shahian, David M; Wolf, Robert E; Iezzoni, Lisa I; Kirle, Leslie; Normand, Sharon-Lise T

    2010-12-23

    Several countries use hospital-wide mortality rates to evaluate the quality of hospital care, although the usefulness of this metric has been questioned. Massachusetts policymakers recently requested an assessment of methods to calculate this aggregate mortality metric for use as a measure of hospital quality. The Massachusetts Division of Health Care Finance and Policy provided four vendors with identical information on 2,528,624 discharges from Massachusetts acute care hospitals from October 1, 2004, through September 30, 2007. Vendors applied their risk-adjustment algorithms and provided predicted probabilities of in-hospital death for each discharge and for hospital-level observed and expected mortality rates. We compared the numbers and characteristics of discharges and hospitals included by each of the four methods. We also compared hospitals' standardized mortality ratios and classification of hospitals with mortality rates that were higher or lower than expected, according to each method. The proportions of discharges that were included by each method ranged from 28% to 95%, and the severity of patients' diagnoses varied widely. Because of their discharge-selection criteria, two methods calculated in-hospital mortality rates (4.0% and 5.9%) that were twice the state average (2.1%). Pairwise associations (Pearson correlation coefficients) of discharge-level predicted mortality probabilities ranged from 0.46 to 0.70. Hospital-performance categorizations varied substantially and were sometimes completely discordant. In 2006, a total of 12 of 28 hospitals that had higher-than-expected hospital-wide mortality when classified by one method had lower-than-expected mortality when classified by one or more of the other methods. Four common methods for calculating hospital-wide mortality produced substantially different results. This may have resulted from a lack of standardized national eligibility and exclusion criteria, different statistical methods, or

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

    Science.gov (United States)

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

    2018-03-13

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

  16. The Changing Hospital Landscape: An Exploration of International Experiences.

    Science.gov (United States)

    Nolte, Ellen; Pitchforth, Emma; Miani, Celine; Mc Hugh, Sheena

    2014-12-30

    The nature of hospital activity is changing in many countries, with some experiencing a broad trend towards the creation of hospital groups or chains and multi-hospital networks. This study seeks to contribute to the understanding of experiences in other countries about the extent to which different hospital "models" may provide lessons for hospital provision in England by means of a review of four countries: France, Germany, Ireland and the United States, with England included for comparison. We find that there has been a trend towards privatisation and the formation of hospital groups in France, Germany, and the United States although it is important to understand the underlying market structure in these countries explaining the drivers for hospital consolidation. Thus, and in contrast to the NHS, in France, Germany, and the United States, private hospitals contribute to the delivery of publicly funded healthcare services. There is limited evidence suggesting that different forms of hospital cooperation, such as hospital groups, networks or systems, may have different impacts on hospital performance. Available evidence suggests that hospital consolidation may lead to quality improvements as increased size allows for more costly investments and the spreading of investment risk. There is also evidence that a higher volume of certain services such as surgical procedures is associated with better quality of care. However, the association between size and efficiency is not clear-cut and there is a need to balance "quality risk" associated with low volumes and "access risk" associated with the closure of services at the local level.

  17. Hospitals Capability in Response to Disasters Considering Surge Capacity Approach

    Directory of Open Access Journals (Sweden)

    Gholamreza Khademipour

    2016-01-01

    Full Text Available Background: The man-made and natural disasters have adverse effects with sound, apparent, and unknown consequences. Among various components of disaster management in health sector, the most important role is performed by health-treatment systems, especially hospitals. Therefore, the present study aimed to evaluate the surge capacity of hospitals of Kerman Province in disaster in 2015. Materials and Methods: This is a quantitative study, conducted on private, military, and medical sciences hospitals of Kerman Province. The sampling method was total count and data collection for the research was done by questionnaire. The first section of the questionnaire included demographic information of the studied hospitals and second part examined the hospital capacity in response to disasters in 4 fields of equipment, physical space, human resources, and applied programs. The extracted data were analyzed by descriptive statistics. Results: The mean capability of implementing the surge capacity programs by hospitals of Kerman Province in disasters and in 4 fields of equipment, physical space, human resources, and applied programs was evaluated as 7.33% (weak. The surge capacity capability of state hospitals in disasters was computed as 8% and compared to private hospitals (6.07% had a more suitable condition. Conclusion: Based on the results of study and significance of preparedness of hospitals in response to disasters, it is proposed that managers of studied hospitals take measures to promote the hospital response capacity to disasters based on 4 components of increasing hospital capacity.

  18. Rural hospital wages

    Science.gov (United States)

    Hendricks, Ann M.

    1989-01-01

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

  19. Hospital mergers: a panacea?

    Science.gov (United States)

    Weil, Thomas

    2010-10-01

    Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders.

  20. Costs of hospital malnutrition.

    Science.gov (United States)

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

    2017-10-01

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

  1. Optimal Hospital Layout Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine

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

  2. Hospitality, Tourism, and Politics

    Directory of Open Access Journals (Sweden)

    Stephen W. Litvin

    2012-09-01

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

  3. Chandra Source Catalog: User Interfaces

    Science.gov (United States)

    Bonaventura, Nina; Evans, I. N.; Harbo, P. N.; Rots, A. H.; Tibbetts, M. S.; Van Stone, D. W.; Zografou, P.; Anderson, C. S.; Chen, J. C.; Davis, J. E.; Doe, S. M.; Evans, J. D.; Fabbiano, G.; Galle, E.; Gibbs, D. G.; Glotfelty, K. J.; Grier, J. D.; Hain, R.; Hall, D. M.; He, X.; Houck, J. C.; Karovska, M.; Lauer, J.; McCollough, M. L.; McDowell, J. C.; Miller, J. B.; Mitschang, A. W.; Morgan, D. L.; Nichols, J. S.; Nowak, M. A.; Plummer, D. A.; Primini, F. A.; Refsdal, B. L.; Siemiginowska, A. L.; Sundheim, B. A.; Winkelman, S. L.

    2010-03-01

    The CSCview data mining interface is available for browsing the Chandra Source Catalog (CSC) and downloading tables of quality-assured source properties and data products. Once the desired source properties and search criteria are entered into the CSCview query form, the resulting source matches are returned in a table along with the values of the requested source properties for each source. (The catalog can be searched on any source property, not just position.) At this point, the table of search results may be saved to a text file, and the available data products for each source may be downloaded. CSCview save files are output in RDB-like and VOTable format. The available CSC data products include event files, spectra, lightcurves, and images, all of which are processed with the CIAO software. CSC data may also be accessed non-interactively with Unix command-line tools such as cURL and Wget, using ADQL 2.0 query syntax. In fact, CSCview features a separate ADQL query form for those who wish to specify this type of query within the GUI. Several interfaces are available for learning if a source is included in the catalog (in addition to CSCview): 1) the CSC interface to Sky in Google Earth shows the footprint of each Chandra observation on the sky, along with the CSC footprint for comparison (CSC source properties are also accessible when a source within a Chandra field-of-view is clicked); 2) the CSC Limiting Sensitivity online tool indicates if a source at an input celestial location was too faint for detection; 3) an IVOA Simple Cone Search interface locates all CSC sources within a specified radius of an R.A. and Dec.; and 4) the CSC-SDSS cross-match service returns the list of sources common to the CSC and SDSS, either all such sources or a subset based on search criteria.

  4. A Hybrid, Current-Source/Voltage-Source Power Inverter Circuit

    DEFF Research Database (Denmark)

    Trzynadlowski, Andrzej M.; Patriciu, Niculina; Blaabjerg, Frede

    2001-01-01

    A combination of a large current-source inverter and a small voltage-source inverter circuits is analyzed. The resultant hybrid inverter inherits certain operating advantages from both the constituent converters. In comparison with the popular voltage-source inverter, these advantages include...... reduced switching losses, improved quality of output current waveforms, and faster dynamic response to current control commands. Description of operating principles and characteristics of the hybrid inverter is illustrated with results of experimental investigation of a laboratory model....

  5. The impact of managed care penetration and hospital quality on efficiency in hospital staffing.

    Science.gov (United States)

    Mobley, Lee R; Magnussen, Jon

    2002-01-01

    The state of California has recently mandated minimum nurse-staffing ratios, raising concerns about possible affects on hospital efficiency. In this study, we examine how market factors and quality were related to staffing levels in California hospitals in 1995 (prior to implementation of the new law). We are particularly interested in the affect of managed care penetration on this aspect of hospital efficiency because the call to legislative action was predicated on fears that hospitals were reducing staffing below optimal levels in response to managed care pressures. We derive a unique measure of excess staffing in hospitals based on a data envelopment analysis (DEA) production function model, which explicitly includes ancillary care among the inputs and outputs. This careful specification of production is important because ancillary care use has risen relative to daily hospital services, with the spread of managed care and advances in medical technology. We find that market share (adjusted for size) and market concentration are the major determinants of excess staffing while managed care penetration is insignificant. We also find that poor quality (outcomes worse than expected) is associated with less efficient staffing. These findings suggest that the larger, more efficient urban hospitals will be penalized more heavily under binding staffing ratios than smaller, less-urban hospitals.

  6. 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.

  7. Multiple sclerosis and alcohol use disorders: In-hospital mortality, extended hospital stays, and overexpenditures.

    Science.gov (United States)

    Gili-Miner, M; López-Méndez, J; Vilches-Arenas, A; Ramírez-Ramírez, G; Franco-Fernández, D; Sala-Turrens, J; Béjar-Prado, L

    2016-10-22

    The objective of this study was to analyse the impact of alcohol use disorders (AUD) in patients with multiple sclerosis (MS) in terms of in-hospital mortality, extended hospital stays, and overexpenditures. We conducted a retrospective observational study in a sample of MS patients obtained from minimal basic data sets from 87 Spanish hospitals recorded between 2008 and 2010. Mortality, length of hospital stays, and overexpenditures attributable to AUD were calculated. We used a multivariate analysis of covariance to control for such variables as age and sex, type of hospital, type of admission, other addictions, and comorbidities. The 10,249 patients admitted for MS and aged 18-74 years included 215 patients with AUD. Patients with both MS and AUD were predominantly male, with more emergency admissions, a higher prevalence of tobacco or substance use disorders, and higher scores on the Charlson comorbidity index. Patients with MS and AUD had a very high in-hospital mortality rate (94.1%) and unusually lengthy stays (2.4 days), and they generated overexpenditures (1,116.9euros per patient). According to the results of this study, AUD in patients with MS results in significant increases in-hospital mortality and the length of the hospital stay and results in overexpenditures. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Data breach locations, types, and associated characteristics among US hospitals.

    Science.gov (United States)

    Gabriel, Meghan Hufstader; Noblin, Alice; Rutherford, Ashley; Walden, Amanda; Cortelyou-Ward, Kendall

    2018-02-01

    The objectives of this study were to describe the locations in hospitals where data are breached, the types of breaches that occur most often at hospitals, and hospital characteristics, including health information technology (IT) sophistication and biometric security capabilities, that may be predicting factors of large data breaches that affect 500 or more patients. The Office of Civil Rights breach data from healthcare providers regarding breaches that affected 500 or more individuals from 2009 to 2016 were linked with hospital characteristics from the Health Information Management Systems Society and the American Hospital Association Health IT Supplement databases. Descriptive statistics were used to characterize hospitals with and without breaches, data breach type, and location/mode of data breaches in hospitals. Multivariate logistic regression analysis explored hospital characteristics that were predicting factors of a data breach affecting at least 500 patients, including area characteristics, region, health system membership, size, type, biometric security use, health IT sophistication, and ownership. Of all types of healthcare providers, hospitals accounted for approximately one-third of all data breaches and hospital breaches affected the largest number of individuals. Paper and films were the most frequent location of breached data, occurring in 65 hospitals during the study period, whereas network servers were the least common location but their breaches affected the most patients overall. Adjusted multivariate results showed significant associations among data breach occurrences and some hospital characteristics, including type and size, but not others, including health IT sophistication or biometric use for security. Hospitals should conduct routine audits to allow them to see their vulnerabilities before a breach occurs. Additionally, information security systems should be implemented concurrently with health information technologies. Improving

  9. Instructions included? Make safety training part of medical device procurement process.

    Science.gov (United States)

    Keller, James P

    2010-04-01

    Before hospitals embrace new technologies, it's important that medical personnel agree on how best to use them. Likewise, hospitals must provide the support to operate these sophisticated devices safely. With this in mind, it's wise for hospitals to include medical device training in the procurement process. Moreover, purchasing professionals can play a key role in helping to increase the amount of user training for medical devices and systems. What steps should you take to help ensure that new medical devices are implemented safely? Here are some tips.

  10. Community Assessment Tool for Public Health Emergencies Including Pandemic Influenza

    Energy Technology Data Exchange (ETDEWEB)

    HCTT-CHE

    2011-04-14

    The Community Assessment Tool (CAT) for Public Health Emergencies Including Pandemic Influenza (hereafter referred to as the CAT) was developed as a result of feedback received from several communities. These communities participated in workshops focused on influenza pandemic planning and response. The 2008 through 2011 workshops were sponsored by the Centers for Disease Control and Prevention (CDC). Feedback during those workshops indicated the need for a tool that a community can use to assess its readiness for a disaster—readiness from a total healthcare perspective, not just hospitals, but the whole healthcare system. The CAT intends to do just that—help strengthen existing preparedness plans by allowing the healthcare system and other agencies to work together during an influenza pandemic. It helps reveal each core agency partners' (sectors) capabilities and resources, and highlights cases of the same vendors being used for resource supplies (e.g., personal protective equipment [PPE] and oxygen) by the partners (e.g., public health departments, clinics, or hospitals). The CAT also addresses gaps in the community's capabilities or potential shortages in resources. While the purpose of the CAT is to further prepare the community for an influenza pandemic, its framework is an extension of the traditional all-hazards approach to planning and preparedness. As such, the information gathered by the tool is useful in preparation for most widespread public health emergencies. This tool is primarily intended for use by those involved in healthcare emergency preparedness (e.g., community planners, community disaster preparedness coordinators, 9-1-1 directors, hospital emergency preparedness coordinators). It is divided into sections based on the core agency partners, which may be involved in the community's influenza pandemic influenza response.

  11. Radiation sources and technical services

    International Nuclear Information System (INIS)

    Stonek, K.; Satorie, Z.; Vyskocil, I.

    1981-01-01

    Work is briefly described of the department for sealed sources production of the Institute, including leak testing and surface contamination of sealed sources. The department also provides technical services including the inspections of sealed sources used in medicine and geology and repair of damaged sources. It carries out research of the mechanical and thermal strength of sealed sources and of the possibility of reprocessing used 226 Ra sources. The despatch department is responsible for supplying the entire country with home and imported radionuclides. The department of technical services is responsible for testing imported radionuclides, assembling materials testing, industrial and medical irradiation devices, and for the collection and storage of low-level wastes on a national scale. (M.D.)

  12. Patients with worsening chronic heart failure who present to a hospital emergency department require hospital care

    Directory of Open Access Journals (Sweden)

    Shafazand Masoud

    2012-03-01

    Full Text Available Abstract Background Chronic heart failure (CHF is a major public health problem characterised by progressive deterioration with disabling symptoms and frequent hospital admissions. To influence hospitalisation rates it is crucial to identify precipitating factors. To characterise patients with CHF who seek an emergency department (ED because of worsening symptoms and signs and to explore the reasons why they are admitted to hospital. Method Patients (n = 2,648 seeking care for dyspnoea were identified at the ED, Sahlgrenska University Hospital/Östra. Out of 2,648 patients, 1,127 had a previous diagnosis of CHF, and of these, 786 were included in the present study with at least one sign and one symptom of worsening CHF. Results Although several of the patients wanted to go home after acute treatment in the ED, only 2% could be sent home. These patients were enrolled in an interventional study, which evaluated the acute care at home compared to the conventional, in hospital care. The remaining patients were admitted to hospital because of serious condition, including pneumonia/respiratory disease, myocardial infarction, pulmonary oedema, anaemia, the need to monitor cardiac rhythm, pathological blood chemistry and difficulties to communicate. Conclusion The vast majority of patients with worsening CHF seeking the ED required hospital care, predominantly because of co-morbidities. Patients with CHF with symptomatic deterioration may be admitted to hospital without additional emergency room investigations.

  13. Global inventory of NOx sources

    International Nuclear Information System (INIS)

    Delmas, R.; Serca, D.; Jambert, C.

    1997-01-01

    Nitrogen oxides are key compounds for the oxidation capacity of the troposphere. Their concentration depends on the proximity of sources because of their short atmospheric lifetime. An accurate knowledge of the distribution of their sources and sinks is therefore crucial. At the global scale, the dominant sources of nitrogen oxides - combustion of fossil fuel (about 50%) and biomass burning (about 20%) - are basically anthropogenic. Natural sources, including lightning and microbial activity in soils, represent therefore less than 30% of total emissions. Fertilizer use in agriculture constitutes an anthropogenic perturbation to the microbial source. The methods to estimate the magnitude and distribution of these dominant sources of nitrogen oxides are discussed. Some minor sources which may play a specific role in tropospheric chemistry such as NO x emission from aircraft in the upper troposphere or input from production in the stratosphere from N 2 O photodissociation are also considered

  14. Hacking the hospital environment

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  15. Vocabulary of hospitality

    NARCIS (Netherlands)

    Bedir, M.

    2014-01-01

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

  16. Innovations in Hospitality Industry

    Science.gov (United States)

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

    2016-01-01

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

  17. Drawing Hospital Foodscapes

    DEFF Research Database (Denmark)

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

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

  18. Nigerian Hospital Practice

    African Journals Online (AJOL)

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

  19. American Hospital Association

    Science.gov (United States)

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

  20. Responsible Hospitality. Prevention Updates

    Science.gov (United States)

    Colthurst, Tom

    2004-01-01

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