Kasai hepatoportoenterostomy in South Australia: a case for 'centralized decentralization'.

Science.gov (United States)

Tu, Chen Gang; Khurana, Sanjeev; Couper, Richard; Ford, Andrew W D

2015-11-01

Recent follow-up studies have demonstrated significant improvement in overall survival as well as survival with native liver following geographic centralization of services to three centres in the UK. However, this model has not been replicated in countries with relatively low population density such as Australia and Canada. Retrospective evaluation of all patients born with biliary atresia (BA) in South Australia from 1989 to 2010 was performed. Thirty-one patients with BA were discovered. Two patients were excluded because the initial Kasai procedure (KP) was performed interstate. Outcome parameters measured were (i) clearance of jaundice (bilirubin of less than 20 μmol/L, by 6 months); (ii) survival with native liver; and (iii) overall survival. Kaplan-Meier survival curves were plotted for both survival with native liver and overall survival. The incidence of BA in South Australia between 1989 and 2010 was 7.48 per 100,000 live births. Following KP, clearance of jaundice was achieved in 42.9% of patients. Five-year actuarial survival with native liver was 55.2%, and overall 5-year actuarial survival was 89.3%. The results of KP performed at Women's and Children's Hospital from 1989 to 2010 can be considered comparable with international benchmarks. Based on these results, we propose the creation of a 'centralized' pool of surgeons in Australia to help continue providing 'decentralized' care of BA. © 2014 Royal Australasian College of Surgeons.

(Coleoptera: Carabidae: Pterostichinae) from south-central Turkey

African Journals Online (AJOL)

PRECIOUS

2009-11-02

Nov 2, 2009 ... Key words: Amara, Pterostichinae, Carabidae, Turkey. INTRODUCTION. This publication is the second part of a taxonomic and geographical treatment of the Pterostichinae of south- central Turkey, with a focus on sites in the province of. Kahramanmaraş and some of the geographically adjacent provinces.

Oil supply in Central and South America

International Nuclear Information System (INIS)

Aguilera, Roberto F.

2009-01-01

This paper estimates a cumulative supply curve for conventional oil in the Central and South American (CSA) region. The curve includes volumes from provinces not previously assessed by other organizations, as well as reserve growth. Volumes for the previously unassessed provinces are estimated using a variable shape distribution (VSD) model. Then the volumes are allocated to CSA countries based on each country's share of proved reserves. Figures provided by the cumulative supply curve are stock variables for all time, unlike the traditional supply curve where they are flow variables that can continue from one period to the next. In this study, the fixed stock approach is used since it provides practical information with respect to the concerns that some have expressed about oil scarcity in the near future. Results indicate that Central and South American oil is more abundant than often assumed, and can be produced at costs below current market oil prices, and substantially below mid-2008 prices.

Detection and Characterisation of Anaplasma marginale and A. centrale in South Africa

Directory of Open Access Journals (Sweden)

Paidashe Hove

2018-03-01

Full Text Available Bovine anaplasmosis is endemic in South Africa and it has a negative economic impact on cattle farming. An improved understanding of Anaplasma marginale and Anaplasma marginale variety centrale (A. centrale transmission, together with improved tools for pathogen detection and characterisation, are required to inform best management practices. Direct detection methods currently in use for A. marginale and A. centrale in South Africa are light microscopic examination of tissue and organ smears, conventional, nested, and quantitative real-time polymerase chain reaction (qPCR assays, and a reverse line blot hybridisation assay. Of these, qPCR is the most sensitive for detection of A. marginale and A. centrale in South Africa. Serological assays also feature in routine diagnostics, but cross-reactions prevent accurate species identification. Recently, genetic characterisation has confirmed that A. marginale and A. centrale are separate species. Diversity studies targeting Msp1a repeats for A. marginale and Msp1aS repeats for A. centrale have revealed high genetic variation and point to correspondingly high levels of variation in A. marginale outer membrane proteins (OMPs, which have been shown to be potential vaccine candidates in North American studies. Information on these OMPs is lacking for South African A. marginale strains and should be considered in future recombinant vaccine development studies, ultimately informing the development of regional or global vaccines.

Neurocysticercosos in South-Central America and the Indian Subcontinent: a comparative evaluation

Directory of Open Access Journals (Sweden)

Gagandeep Singh

1997-09-01

Full Text Available Neurocysticercosis is an important public health problem in South-Central America and South Asia. A review of the differences in epidemiological and clinical attributes of cysticercosis and taeniasis in South Central America and India, respectively, is undertaken in the present communication. Intestinal taeniasis is hyperendemic in several American countries. In comparison, the prevalence of Taenia solium infestation is lower in India. The clinical manifestations in several American neurocysticercosis series comprise epilepsy, intracranial hypertension and meningeal - racemose cysticercosis, in roughly equal proportions. An overwhelming majority of the Indian subjects present with seizures. The commonest pathological substrate of the disorder in Indian patients is the solitary parenchymal degenerating cyst. The reasons for the predominance of solitary forms in India, and of multilesional forms in South Central America are discussed. The magnitude of Taenia solium infestation and the frequency of pork consumption in a given population appear to influence the quantum of cyst load in affected individuals.

Pattern of sudden death at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South West Nigeria

Directory of Open Access Journals (Sweden)

Akinwusi PO

2013-06-01

Full Text Available Patience Olayinka Akinwusi,1,2 Akinwumi Oluwole Komolafe,3 Olanrewaju Olayinka Olayemi,2 Adeleye Abiodun Adeomi41Department of Medicine, College of Health Sciences, Osun State University, 2Department of Medicine, LAUTECH Teaching Hospital, Osogbo, 3Department of Morbid Anatomy, Obafemi Awolowo University Teaching, Hospitals Complex, Ile-Ife, Osun State, 4Department of Community Medicine, LAUTECH Teaching Hospital, Ogbomoso, Oyo State, NigeriaBackground: The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH Teaching Hospital, South West Nigeria.Methods: This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases.Results: Sudden death accounted for 29 (4.0% of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25–74 years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%, followed by respiratory disease (20.7%, pulmonary thromboembolism (10.4%, central nervous system disease (13.8%, gastrointestinal disorders (13.8%, severe chemical/drug poisoning (13.8%, and combined cardiovascular and central nervous system disease (13.8%. Hypertension-related causes were responsible for 14/29 (48.3% of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe

Management of incomplete abortion in South African public hospitals.

Science.gov (United States)

Brown, H C; Jewkes, R; Levin, J; Dickson-Tetteh, K; Rees, H

2003-04-01

To describe the current management of incomplete abortion in South African public hospitals and to discuss the extent to which management is clinically appropriate. A multicentre, prospective descriptive study. South African public hospitals that manage gynaecological emergencies. Hospitals were selected using a stratified random sampling method. All women who presented to the above sampled hospitals with incomplete abortion during the three week data collection period in 2000 were included. A data collection sheet was completed at the time of discharge for each woman admitted with a diagnosis of incomplete, complete, missed or inevitable abortion during the study period. Information gathered included demographic data, clinical signs and symptoms at admission, medical management, surgical management, anaestetic management, use of blood products and antibiotics and complications. Three clinical severity categories were used for the purpose of data analysis and interpretation. Detail of medical management, detail of surgical management, use of blood products and antibiotics, methods of analgesia and anaesthesia used, and use of abortifacients. There is a trend towards low cost technology such as the use of manual vacuum aspiration and sedation anaesthesia; however, this is mainly limited to the better resourced tertiary hospitals linked to academic units. The use of antibiotics and blood products has decreased but much of the use is inappropriate. The use of abortifacients does include some use of misoprostol but merely as an adjunct to surgical evacuation. The management of incomplete abortion remains a problem in South Africa, a low income country that is still managing a common clinical problem with costly interventions. The evidence of a trend towards low cost technology is promising, albeit limited to tertiary centres. This study has given us information as how to best address this problem. More training in low cost methods is needed, targeting in particular the

Impact of nationwide centralization of pancreaticoduodenectomy on hospital mortality

NARCIS (Netherlands)

de Wilde, R. F.; Besselink, M. G. H.; van der Tweel, I.; de Hingh, I. H. J. T.; van Eijck, C. H. J.; Dejong, C. H. C.; Porte, R. J.; Gouma, D. J.; Busch, O. R. C.; Molenaar, I. Q.

Background: The impact of nationwide centralization of pancreaticoduodenectomy (PD) on mortality is largely unknown. The aim of this study was to analyse changes in hospital volumes and in-hospital mortality after PD in the Netherlands between 2004 and 2009. Methods: Nationwide data on International

Impact of nationwide centralization of pancreaticoduodenectomy on hospital mortality

NARCIS (Netherlands)

de Wilde, R. F.; Besselink, M. G. H.; van der Tweel, I.; de Hingh, I. H. J. T.; van Eijck, C. H. J.; Dejong, C. H. C.; Porte, R. J.; Gouma, D. J.; Busch, O. R. C.; Molenaar, I. Q.

2012-01-01

Background: The impact of nationwide centralization of pancreaticoduodenectomy (PD) on mortality is largely unknown. The aim of this study was to analyse changes in hospital volumes and in-hospital mortality after PD in the Netherlands between 2004 and 2009. Methods: Nationwide data on International

Primary prevention in psychiatry in general hospitals in South Asia

Science.gov (United States)

Sood, Mamta; Chadda, Rakesh Kumar; Kallivayalil, Roy Abraham

2017-01-01

The focus of primary prevention is on reducing the disease incidence. Primary prevention in mental health has been given minimal priority in low-resource settings with no significant investments. General hospitals are one of the main providers of mental health services in South Asia. This paper focuses on primary prevention activities, which can be undertaken in a general hospital in South Asia with abysmally low-mental health resources. For implementing primary prevention in psychiatry, a general hospital may be conceptualized as a population unit, located in a well-populated area with easy accessibility where different kinds of communities, for example, students and resident doctors, consultants, patients and their caregivers, and paramedical, nursing, administrative and other supportive staff, coexist and have varied functions. All the functional components of the general hospital psychiatric units (GHPUs) offer scope for introducing primary preventive psychiatry services. Psychiatrists in GHPUs can lead efforts for primary prevention in mental health in the hospital by employing strategies in the framework of universal, selective, and indicated prevention. The preventive strategies could be targeted at the patients visiting the hospital for various health services and their caregivers, employees, and the trainees. Similar principles can be employed in teaching and training. PMID:29497199

Transit traverse in Missouri, 1900-1937. Part 2, South-central Missouri, 1908-37

Science.gov (United States)

Staack, John George

1940-01-01

This bulletin, which for convenience is to be published in eight parts, contains the results of all transit traverse* done In Missouri through 1937 by the Geological Survey, United States Department of the Interior, including those heretofore published. (See page X.) Each of the parts deals with one of eight sections into which the State has been divided for this purpose and which have been designated northeastern, northwestern, southeastern, southwestern, central, east-central, south-central, and west-central Missouri. In each part descriptions of the points for which geodetic positions have been determined are listed according to the quadrangles in which the points occur. Results of transit traverse other than that done by the Geological Survey have not been included.South-central Missouri, as the term is used in this bulletin and as the subject of part 2 of the bulletin, is that section of the State lying south of latittude, 38°00' and between longitudes 91°15' and 93°00'.

Influences on hospital admission for asthma in south Asian and white adults: qualitative interview study.

Science.gov (United States)

Griffiths, C; Kaur, G; Gantley, M; Feder, G; Hillier, S; Goddard, J; Packe, G

2001-10-27

To explore reasons for increased risk of hospital admission among south Asian patients with asthma. Qualitative interview study using modified critical incident technique and framework analysis. Newham, east London, a deprived area with a large mixed south Asian population. 58 south Asian and white adults with asthma (49 admitted to hospital with asthma, 9 not admitted); 17 general practitioners; 5 accident and emergency doctors; 2 out of hours general practitioners; 1 asthma specialist nurse. Patients' and health professionals' views on influences on admission, events leading to admission, general practices' organisation and asthma strategies, doctor-patient relationship, and cultural attitudes to asthma. South Asian and white patients admitted to hospital coped differently with asthma. South Asians described less confidence in controlling their asthma, were unfamiliar with the concept of preventive medication, and often expressed less confidence in their general practitioner. South Asians managed asthma exacerbations with family advocacy, without systematic changes in prophylaxis, and without systemic corticosteroids. Patients describing difficulty accessing primary care during asthma exacerbations were registered with practices with weak strategies for asthma care and were often south Asian. Patients with easy access described care suggesting partnerships with their general practitioner, had better confidence to control asthma, and were registered with practices with well developed asthma strategies that included policies for avoiding hospital admission. The different ways of coping with asthma exacerbations and accessing care may partly explain the increased risk of hospital admission in south Asian patients. Interventions that increase confidence to control asthma, confidence in the general practitioner, understanding of preventive treatment, and use of systemic corticosteroids in exacerbations may reduce hospital admissions. Development of more sophisticated

Severe Enterovirus Infections in Hospitalized Children in the South of England

Science.gov (United States)

de Graaf, Hans; Pelosi, Emanuela; Cooper, Andrea; Pappachan, John; Sykes, Kim; MacIntosh, Iain; Gbesemete, Diane; Clark, Tristan W.; Patel, Sanjay V.; Faust, Saul N.

2016-01-01

Background: Most enterovirus surveillance studies lack detailed clinical data, which limits their clinical usefulness. This study aimed to describe the clinical spectrum and outcome of severe enterovirus infections in children, and to determine whether there are associations between causative enterovirus genotypes and clinical phenotypes. Methods: Retrospective analysis of microbiological and clinical data from a tertiary children’s hospital in the South of England over a 17-month period (2012–2013). Results: In total, 30 patients were identified, comprising sepsis (n = 9), myocarditis (n = 8), meningitis (n = 8) and encephalitis (n = 5). Cases with sepsis or myocarditis were significantly younger than those with central nervous system disease (median age 21 and 15 days vs. 79 days; P = 0.0244 and P = 0.0310, respectively). There was considerable diversity in the causative genotypes in each of the clinical phenotypes, with some predominance of echoviruses in the meningitis group, and coxsackie B viruses in the myocarditis group. Thirteen cases required mechanical ventilation, 11 cases inotropic support, 3 cases dialysis and 3 cases extracorporal membrane oxygenation. The overall mortality was 10% (sepsis group, n = 1; myocarditis group, n = 2). Of the survivors, 5 (19%) had long-term sequelae (myocardial dysfunction, n = 2; neurological sequelae, n = 3). Patients with encephalitis had the longest hospital stay (median: 16 days), compared with 9, 6 and 3 days in patients with myocarditis, sepsis and meningitis, respectively (P = 0.005). Conclusions: Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality. The results show that there are currently no strong associations between clinical phenotypes and particular causative enterovirus genotypes in the South of England. PMID:26882165

International stock market integration: Central and South Eastern Europe compared

Czech Academy of Sciences Publication Activity Database

Horváth, Roman; Petrovski, D.

2013-01-01

Roč. 37, č. 1 (2013), s. 81-91 ISSN 0939-3625 R&D Projects: GA ČR GA402/09/0965 Institutional support: RVO:67985556 Keywords : stock markets * South Eastern Europe Subject RIV: AH - Economics Impact factor: 0.611, year: 2013 http://library.utia.cas.cz/separaty/2013/E/horvath-international stock market integration central and south eastern europe compared.pdf

Tribal engagement strategy of the South Central Climate Science Center, 2014

Science.gov (United States)

Andrews, William J.; Taylor, April; Winton, Kimberly T.

2014-01-01

The South Central Climate Science Center was established by the U.S. Department of the Interior in 2012 to increase understanding of climate change and coordinate an effective response to climate-change effects on Native American tribes and natural and cultural resources that the Department manages. The eight regional Climate Science Centers of the U.S. Department of the Interior work closely with natural-resource management agencies, university researchers, and others such as tribes and private landowners on climate-change issues. The relatively large number of Native Americans in the south central United States and their special knowledge of changing ecosystems make working with tribes and tribal members on climate-change issues particularly important in this part of the Nation. This circular describes priorities of the South Central Climate Science Center and provides information about resources available from Climate Science Centers and partner agencies regarding climate change. The circular also describes how this Climate Science Center, tribes and tribal members, and others can collaborate to minimize potential harmful effects of climate change on human society and our surrounding ecosystems.

The relationship between bed size and profitability in South Carolina hospitals.

Science.gov (United States)

Kim, Yang K; Glover, Saundra H; Stoskopf, Carleen H; Boyd, Suzan D

2002-01-01

The purpose of the study is to identify factors affecting hospital profitability and to find the optimal hospital bed size that assures maximum profit. This is a cross-sectional study using survey data obtained from acute care hospitals in South Carolina in 1997. The relationship of hospital profitability and hospital bed size revealed that when bed size increases, hospital profitability increases, decreases, and then increases again. For the patient profit proportion, the turning points in bed size are 238.22 and 560.08. For the total profit proportion, the turning points in bed size are 223.31 and 503.86. The results on the relationship between bed size and hospital profitability indicate that medium-size hospitals have less profitability.

Challenges Facing Managers in Managing Conflict in Schools in the South and South Central Regions of Botswana

Science.gov (United States)

Morake, Nnior Machomi; Monobe, Ratau John; Dingwe, Stephonia

2011-01-01

The purpose of this study was to examine the challenges facing managers in managing conflict in schools of South and South Central Regions of Botswana. In this study, the schedule of interview was used to collect empirical data. A random sample of 50 school managers and deputy school managers was selected for interviews. Major findings of the…

Uranium metallogenic geological conditions in the south central section of da hinggan mountains

International Nuclear Information System (INIS)

Wang Qing; Liu Qing

2014-01-01

The south central section of Da Hinggan Mountains, where the Zha Lantun prospecting zones of volcanic type uranium ore, is a high density concentrated distribution area of uranium and polymetallic mineral. This article elaborated uranium metallogenic geological conditions in the south central section of Da Hinggan Mountain, from the tectonic conditions, the source of uranium, the heat source, the space for ore-forming, hydrothermal alteration, the mineralization, and ect. This area has a good prospecting foreground and potentiality. (authors)

Prevalence and causes of vision loss in Central and South Asia: 1990-2010.

Science.gov (United States)

Jonas, Jost B; George, Ronnie; Asokan, Rashima; Flaxman, Seth R; Keeffe, Jill; Leasher, Janet; Naidoo, Kovin; Pesudovs, Konrad; Price, Holly; Vijaya, Lingam; White, Richard A; Wong, Tien Y; Resnikoff, Serge; Taylor, Hugh R; Bourne, Rupert R A

2014-05-01

To examine the prevalence, patterns and trends of vision impairment and its causes from 1990 to 2010 in Central and South Asia. Based on the Global Burden of Diseases Study 2010 and ongoing literature searches, we examined prevalence and causes of moderate and severe vision impairment (MSVI; presenting visual acuity Central Asia, the estimated age-standardised prevalence of blindness decreased from 0.4% (95% CI 0.3% to 0.6%) to 0.2% (95% CI 0.2% to 0.3%) and of MSVI from 3.0% (95% CI 1.9% to 4.7%) to 1.9% (95% CI 1.2% to 3.2%), and in South Asia blindness decreased from 1.7% (95% CI 1.4% to 2.1%) to 1.1% (95% CI 0.9% to 1.3%) and MSVI from 8.9% (95% CI 6.9% to 10.9%) to 6.4% (95% CI 5.2% to 8.2%). In 2010, 135 000 (95% CI 99,000 to 194,000) people were blind in Central Asia and 10,600,000 (95% CI 8,397,000 to 12,500,000) people in South Asia. MSVI was present in 1,178,000 (95% CI 772,000 to 2,243,000) people in the Central Asia, and in 71,600,000 (95% CI 57,600,000 to 92,600,000) people in South Asia. Women were generally more often affected than men. The leading causes of blindness (cataract) and MSVI (undercorrected refractive error) did not change from 1990 to 2010. The prevalence of blindness and MSVI in South Asia is still three times higher than in Central Asia and globally, with women generally more often affected than women. In both regions, cataract and undercorrected refractive error were major causes of blindness and MSVI.

The profile of meningitis in a tertiary paediatric hospital in South Africa

African Journals Online (AJOL)

Background. Meningitis in children is a major health problem worldwide, leading to high rates of mortality and morbidity. Objectives. To describe the profile of patients treated for meningitis at a leading tertiary paediatric hospital (Red Cross War Memorial Children's Hospital) in South Africa. Methods. This study describes all ...

From The Mountain To The Sea: Exchange Between The South-Central Highlands And The South Coast During The Early Horizon Period

OpenAIRE

Young, Michele

2017-01-01

This article reviews the evidence of the exchange of obsidian and cinnabar, highly coveted resources that traveled in prehistoric Peru from the south-central highlands to the Paracas culture area. The evidence for exchange of these materials is compared with evidence of cultural exchange between the coast and the south-central highlands, focusing on ceramic materials uncovered from excavations at the archaeological site Atalla, located in the region of Huancavelica, Peru. The article argues t...

Management of snakebites at a rural South African hospital ...

African Journals Online (AJOL)

... snakebites at this rural hospital where they were treated frequently. It is crucial for primary care physicians to be familiar with the most common venomous snakes in South Africa and the management of their bites in humans. Elevation of the affected limb, administration of intravenous fluids and administration of analgesia, ...

Central and South America GPS geodesy - CASA Uno

Science.gov (United States)

Kellogg, James N.; Dixon, Timothy H.

1990-01-01

In January 1988, scientists from over 25 organizations in 13 countries and territories cooperated in the largest GPS campaign in the world to date. A total of 43 GPS receivers collected approximately 590 station-days of data in American Samoa, Australia, Canada, Colombia, Costa Rica, Ecuador, New Zealand, Norway, Panama, Sweden, United States, West Germany, and Venezuela. The experiment was entitled CASA Uno. Scientific goals of the project include measurements of strain in the northern Andes, subduction rates for the Cocos and Nazca plates beneath Central and South America, and relative motion between the Caribbean plate and South America. A second set of measurements are planned in 1991 and should provide preliminary estimates of crustal deformation and plate motion rates in the region.

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

Science.gov (United States)

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

2017-10-01

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

A review of governance of maternity services at South Tipperary general hospital

LENUS (Irish Health Repository)

Flory, David

2015-09-01

This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

Geographic variations and temporal trends of Salmonella-associated hospitalization in the U.S. elderly, 1991-2004: a time series analysis of the impact of HACCP regulation.

Science.gov (United States)

Chui, Kenneth K H; Webb, Patrick; Russell, Robert M; Naumova, Elena N

2009-12-03

About 1.4 million Salmonella infections, a common food-borne illness, occur in the U.S. annually; the elderly (aged 65 or above) are most susceptible. In 1997, the USDA introduced the Pathogen Reduction and Hazard Analysis and Critical Control Points Systems (PR/HACCP) which demands regular Salmonella testing in various establishments processing meat products, such as broiler chickens. Impact evaluations of PR/HACCP on hospitalizations related to Salmonella are lacking. Hospitalization records of the U.S. elderly in 1991-2004 were obtained from the Centers of Medicare and Medicaid Services. Harmonic regression analyses were performed to evaluate the long-term trends of Salmonella-related hospitalizations in pre- and post-HACCP periods. Seasonal characteristics of the outcome in the nine Census divisions of the contiguous U.S. were also derived and contrasted. Predicted rates decreased in most divisions after 1997, except South Atlantic, East South Central, and West South Central. These three divisions also demonstrated higher overall hospitalization rates, pronounced seasonal patterns, and consistent times to peak at about 32nd to 34th week of the year. The impact of HACCP was geographically different. South Atlantic, East South Central, and West South Central divisions should be targeted in further Salmonella preventive programs. Further research is needed to identify the best program type and timing of implementation.

Prevalence of Legionella spp. in water systems of hospitals and hotels in South Western Greece.

Science.gov (United States)

Fragou, K; Kokkinos, P; Gogos, C; Alamanos, Y; Vantarakis, A

2012-01-01

The aim of the present study was to determine the prevalence of Legionella spp. in water systems of hospitals and hotels located in South Western Greece, to study the molecular epidemiology of the isolated strains and their possible association with bacterial contamination (total count and Pseudomonas aeruginosa), the water pH, and temperature. A prevalence survey for Legionella spp. by culturing techniques in water distribution systems of eight hospitals and nine hotels occurred in South Western Greece. Water sampling and microbiological analysis were carried out following the ISO methods. Legionella pneumophila was detected in 33% and 36% of the distribution systems of hospitals and hotels, respectively. Our survey results suggest a frequent prevalence of elevated concentrations of Legionella spp. in water systems of hospitals and hotels. Our investigation has confirmed the need to regularly monitor the microbiological condition of water systems in hospitals and hotels.

Geologic framework and petroleum systems of Cook Inlet basin, south-central Alaska

Science.gov (United States)

LePain, D.L.; Stanley, R.G.; Helmold, K.P.; Shellenbaum, D.P.; Stone, D.M.; Hite, D.M.

2013-01-01

This report provides a comprehensive overview of the stratigraphy, structure, tectonics, and petroleum systems of the Cook Inlet basin, an important oil- and gas-producing region in south-central Alaska.

Food habits of Northern Goshawks nesting in south central Wyoming

Science.gov (United States)

John R. Squires

2000-01-01

Northern Goshawks (Accipiter gentiles) nesting in south central Wyoming consumed at least 33 species of prey; 14 were mammals and 19 were birds. Based on percent occurrence in regurgitated pellets, dominant (>10% frequency) prey species included: red squirrel (Tamiasciurus hudsonicus; present in 50% of pellets), Northern Flicker (Colaptes auratus; 34...

P02.05 Peripheral Nerve Sheath Tumor Epidemiology in the South Central Hospital of High Specialty from PEMEX in Mexico

Science.gov (United States)

Guerra Mora, J.; Cordoba Mosqueda, M.; Hernandez Resendiz, R.; Loya Aguilar, I.; Vicuña Gonzalez, R.; Garcia Gonzalez, U.

2016-01-01

Abstract Introduction: The peripheral sheath tumors are part of a large group of neoplasms that range from biologically benign with minimal disorders in life quality to highly malign with life quality deterioration and high mortality. There are subtypes with high prevalence like Schwannomas and some much rarer like the intracranial peripheral nerve sheath tumor which happen to have very bad prognosis. The aim of this study is to describe the epidemiologic and clinical characteristics of patients with peripheral nerve sheat tumors in a hospital of high specialty. Method and materials: Observational study with patients from March 1999 to March 2016 with confirmed diagnosis of peripheral nerve sheath tumor in the electronic files of the South Central Hospital of High Specialty PEMEX. A statistical analysis is made through the SPSS Statistics of the disease in this Institution program. Results: There were 84 patients with the diagnosis of peripheral nerve sheath tumor with a median age of 48.04 years, 65.5% were males, the most common histological type found was the Schwannoma with a 72.6%, followed by senescent Schwannoma 13.1%, neurofibroma 8.3%, and malign peripheral nerve sheath tumor 2.4%. The most frequent location was at the site of cranial nerves, followed by cervical level 27.4%, lumbar 16.7% and thoracic 9.5%. The most common initial symptom was pain in 23.8% of the patients, and the time of the onset of symptoms to the diagnosis was 31.6 months. From the total of patients 8.3% had neurofibromatosis type 1, 6.0% neurofibromatosis type 2. Conclusions: We realized in our series of reported cases that the frequency is similar to those reported in worldwide population; nevertheless the time between the onset of symptoms and the diagnosis is much higher in our cases as well as the population of patients with neurofibromatosis. This study justifies the need of attention quality improvement and the knowledge of this information the medical doctor of first

Introduction: seismology and earthquake engineering in Central and South America.

Science.gov (United States)

Espinosa, A.F.

1983-01-01

Reports the state-of-the-art in seismology and earthquake engineering that is being advanced in Central and South America. Provides basic information on seismological station locations in Latin America and some of the programmes in strong-motion seismology, as well as some of the organizations involved in these activities.-from Author

A case study investigation of the indoor environmental noise in four urban South African hospitals

CSIR Research Space (South Africa)

Van Reenen, CA

2015-11-01

Full Text Available This multiple case study was designed to investigate acoustics in multi-bed general wards in four urban South African hospitals. Evidence-based research shows that a quiet indoor environment has positive outcomes for hospital patients and staff...

Endometrial pathology in a teaching hospital in North Central ...

African Journals Online (AJOL)

The study was a 5 year histopathological survey of endometrial biopsies seen at the University of Ilorin Teaching Hospital , Ilorin, North Central Nigeria from January 1st 1997 to December 31st 2001. It aimed at identifying the morphological patterns of endometrial disorders, prevalence of these disorders and the ...

Forest health restoration in south-central Alaska: a problem analysis.

Science.gov (United States)

Darrell W. Ross; Gary E. Daterman; Jerry L. Boughton; Thomas M. Quigley

2001-01-01

A spruce beetle outbreak of unprecedented size and intensity killed most of the spruce trees on millions of acres of forest land in south-central Alaska in the 1990s. The tree mortality is affecting every component of the ecosystem, including the socioeconomic culture dependent on the resources of these vast forests. Based on information obtained through workshops and...

Warm and Dry Spells (WDS in Austral Winter over Central South America

Directory of Open Access Journals (Sweden)

P. Satyamurty

2007-06-01

Full Text Available The horizontal and vertical structure of unusually warm and dry spells (WDS over the central parts of South America during the winter and post-winter months (JJAS are studied. During WDS the mean temperature and humidity anomalies over central Brazil are about +4.1°C and −13.2%, respectively. The mean duration of WDS is 11 days and their mean frequency is less than one per year during the months of JJAS. Apparently, WDS have no preference for the phase of ENSO. Widespread and persistent subsidence in the middle troposphere is observed in tropical Brazil during WDS, which renders the lower tropospheric air warm and dry. The negative anomalies of the specific humidity are observed to be associated with the subsidence regions. A strong, slow moving ridge in the eastern South Pacific and a low-pressure center in northern Argentina are important surface characteristics during the WDS. A more detailed investigation of two specific WDS events, a strong event (August–September 1999 and a moderate one (June 2002, shows a blocking-like situation in the 500-hPa geopotential and surface pressure fields in the Pacific. The South Atlantic subtropical high somewhat approaches the continent. Strong northerlies over the central and eastern parts of Brazil are also observed in the lower troposphere. During WDS the regional circulation acquires summertime characteristics, except for the absence of precipitation, and the circulation in the meridional plane is in the opposite sense from the Hadley circulation. A frontal system, supported by a 500-hPa trough, advances into central Brazil, causing the dissipation of the anomalous situation.

Predictors of loss to follow-up among patients on ART at a rural hospital in KwaZulu-Natal, South Africa.

Science.gov (United States)

Arnesen, Rachel; Moll, Anthony P; Shenoi, Sheela V

2017-01-01

Improved HIV outcomes as a result of expanded antiretroviral therapy (ART) access is threatened by increasing rates of loss to follow up (LTFU) among those on ART, largely reported in urban populations. Some reports suggest that LTFU rates are overestimated due to patient movement to other facilities and inadequate medical records. To define the proportion disengaging from HIV care as well as the characteristics of those LTFU in order to design and implement appropriate interventions to increase retention. We performed a retrospective review of patients who discontinued ART at a central hospital ART clinic in rural South Africa and compared with patients receiving care at the 15 primary health clinics (PHCs) to determine the true proportion of those who were LTFU. We also compared those who discontinued ART with those who did not at the central hospital ART clinic to determine predictors of loss to follow up. Among 3242 patients on ART, 820 were originally marked as LTFU. Among all patients, 272 (8.4%) were found at a clinic on treatment, 56 (1.7%) were found at a clinic from which they had since discontinued treatment, and 10 (0.3%) returned to care between June and July 2016, leaving 475 (14.7%) unaccounted for and thus categorized as 'true' LTFU. Factors found to be associated with discontinuation include being male, age 18-35, having a CD4 count under 200 cells/μL, and being on ART for under six months. Young men with low CD4 counts early after ART initiation are at highest risk of ART disengagement in this rural South African HIV clinic. Novel interventions targeting this group are needed to improve retention in care.

An integrated outsourcing solution at York Central Hospital.

Science.gov (United States)

Marr, Jo-Anne; Tam, Richard; Simms, Stephen; Bacchus, Feria

2011-01-01

Canadian hospitals struggle to balance the need to increase and improve operational services and quality with diminishing resources. Many realize that sustaining their organization depends on how well they focus their resources and talents on their core business, clinical care delivery. Outsourcing of non-core, non-clinical support services is a solution for many organizations. Most often, this is put into action one service provider at a time. In 2007, however, York Central Hospital (YCH) implemented Sodexo's integrated Comprehensive Service Solutions (CSS) for all its support service functions. In doing so, YCH achieved significant improvements in patient and staff satisfaction rates, substantial cost savings through improved operational efficiency from process improvements and leveraging technology investments, and increased retail food revenue.

Severe Enterovirus Infections in Hospitalized Children in the South of England: Clinical Phenotypes and Causative Genotypes.

Science.gov (United States)

de Graaf, Hans; Pelosi, Emanuela; Cooper, Andrea; Pappachan, John; Sykes, Kim; MacIntosh, Iain; Gbesemete, Diane; Clark, Tristan W; Patel, Sanjay V; Faust, Saul N; Tebruegge, Marc

2016-07-01

Most enterovirus surveillance studies lack detailed clinical data, which limits their clinical usefulness. This study aimed to describe the clinical spectrum and outcome of severe enterovirus infections in children, and to determine whether there are associations between causative enterovirus genotypes and clinical phenotypes. Retrospective analysis of microbiological and clinical data from a tertiary children's hospital in the South of England over a 17-month period (2012-2013). In total, 30 patients were identified, comprising sepsis (n = 9), myocarditis (n = 8), meningitis (n = 8) and encephalitis (n = 5). Cases with sepsis or myocarditis were significantly younger than those with central nervous system disease (median age 21 and 15 days vs. 79 days; P = 0.0244 and P = 0.0310, respectively). There was considerable diversity in the causative genotypes in each of the clinical phenotypes, with some predominance of echoviruses in the meningitis group, and coxsackie B viruses in the myocarditis group. Thirteen cases required mechanical ventilation, 11 cases inotropic support, 3 cases dialysis and 3 cases extracorporal membrane oxygenation. The overall mortality was 10% (sepsis group, n = 1; myocarditis group, n = 2). Of the survivors, 5 (19%) had long-term sequelae (myocardial dysfunction, n = 2; neurological sequelae, n = 3). Patients with encephalitis had the longest hospital stay (median: 16 days), compared with 9, 6 and 3 days in patients with myocarditis, sepsis and meningitis, respectively (P = 0.005). Enterovirus infections, particularly enteroviral myocarditis and encephalitis, can cause significant morbidity and mortality. The results show that there are currently no strong associations between clinical phenotypes and particular causative enterovirus genotypes in the South of England.

Prevalence of Neonatal Jaundice on Central Hospital, Warri, Delta ...

African Journals Online (AJOL)

Methods: 272 babies (aged 1 – 30 days) the Neonatal Clinic of the Department of Child Health, Central Hospital, Warri, Delta State between June 2009 and June 2010 were examined daily for evidence of jaundice. Those with serum bilirubin ³15mg/100ml were subjected to additional clinical and laboratory investigations to ...

Differences in Hospital Readmission Risk across All Payer Groups in South Carolina.

Science.gov (United States)

Chakraborty, Hrishikesh; Axon, Robert Neal; Brittingham, Jordan; Lyons, Genevieve Ray; Cole, Laura; Turley, Christine B

2017-06-01

To evaluate differences in hospital readmission risk across all payers in South Carolina (SC). South Carolina Revenue and Fiscal Affairs Office (SCRFA) statewide all payer claims database including 2,476,431 hospitalizations in SC acute care hospitals between 2008 and 2014. We compared the odds of unplanned all-cause 30-day readmission for private insurance, Medicare, Medicaid, uninsured, and other payers and examined interaction effects between payer and index admission characteristics using generalized estimating equations. SCRFA receives claims and administrative health care data from all SC health care facilities in accordance with SC state law. Odds of readmission were lower for females compared to males in private, Medicare, and Medicaid payers. African Americans had higher odds of readmission compared to whites across private insurance, Medicare, and Medicaid, but they had lower odds among the uninsured. Longer length of stay had the strongest association with readmission for private and other payers, whereas an increased number of comorbidities related to the highest readmission odds within Medicaid. Associations between index admission characteristics and readmission likelihood varied significantly with payer. Findings should guide the development of payer-specific quality improvement programs. © Health Research and Educational Trust.

Central radiological department of the Jahn Ferenc hospital and medical center

Energy Technology Data Exchange (ETDEWEB)

Erdelyi, M Jr [Jahn Ferenc Korhaz-Rendeloeintezet, Budapest (Hungary). Koezponti Radiologia

1982-01-01

The design, organisation and functioning of the central X-ray diagnostical unit of the new hospital, inaugurated in December 1980 are reviewed. The experiences of the shortcomings of the planning are summerized, too.

Glass injuries seen in the emergency department of a South African district hospital

OpenAIRE

Nzaumvila, Doudou; Govender, Indiran; Kramer, Efraim B.

2015-01-01

BACKGROUND: The emergency department of Embhuleni Hospital frequently manages patients with glass-related injuries. This study assessed these injuries and the glass that caused them in more detail. AIM: The objectives of our study included determining the type of glass causing these injuries and describing the circumstances associated with different types of glass injuries. SETTING: The emergency department of Embhuleni Hospital in Elukwatini, Mpumalanga province, South Africa. METHODS: This ...

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

International Nuclear Information System (INIS)

Nemathaga, Felicia; Maringa, Sally; Chimuka, Luke

2008-01-01

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

Diabetic retinopathy at the Yaoundé Central Hospital in Cameroon ...

African Journals Online (AJOL)

We carried out a cross-sectional analytical survey using data from patients who had done Fluorescein Angiography at the Yaounde Central Hospital Diabetic Retinopathy Prevention and Management Project between October 2007 and January 2010 to identify the risk factors, incidence and severity of different types of ...

Preliminary report on theNeurology workload ina central hospital in ...

African Journals Online (AJOL)

Introduction: Identification of the local pattern of neurological diseases is expected to help setting the priorities for good planning of management and public education. Objectives: To identify the pattern of neurological disorders in a second biggest central hospital in Sudan. Methodology: Review of the diagnosis of 170 ...

Audit of appendicectomies at Frere Hospital | Rogers | South African ...

African Journals Online (AJOL)

Objective. We sought to evaluate the surgical service in the central part of the Eastern Cape Province by reviewing the practice of appendicectomy at Frere Hospital. Specifically, it was our aim to compare the service to those patients who reside in and outside the East London metropolitan area and the outcomes of patients ...

Stream and Aquifer Biology of South-Central Texas - A Literature Review, 1973-97

National Research Council Canada - National Science Library

Ourso, Robert T; Hornig, C. E

2000-01-01

This report summarizes in table format 32 aquatic vertebrate (primarily fish), 54 aquatic invertebrate, and 13 aquatic plant studies available for the area of the South-Central Texas study unit of the U.S...

Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

Science.gov (United States)

Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

2009-04-01

Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

From Central Asia to South Africa: In Search of Inspiration in Rock Art Studies

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Rozwadowski Andrzej

2017-06-01

Full Text Available The paper describes the story of discovering South African rock art as an inspiration for research in completely different part of the globe, namely in Central Asia and Siberia. It refers to those aspect of African research which proved to importantly develop the understanding of rock art in Asia. Several aspects are addressed. First, it points to importance of rethinking of relationship between art, myth and ethnography, which in South Africa additionally resulted in reconsidering the ontology of rock images and the very idea of reading of rock art. From the latter viewpoint particularly inspiring appeared the idea of three-dimensionality of rock art ‘text’. The second issue of South African ‘origin,’ which notably inspired research all over the world, concerns a new theorizing of shamanism. The paper then discusses how and to what extent this new theory add to the research on the rock art in Siberia and Central Asia.

The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals

Directory of Open Access Journals (Sweden)

Laetitia C. Rispel

2015-05-01

Full Text Available Background: Globally, flexible work arrangements – through the use of temporary nursing staff – are an important strategy for dealing with nursing shortages in hospitals. Objective: The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Methods: Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices. Results: In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million. The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467 and at Hospital 2 the value was R300,121 (US$42,874, thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Conclusion

The indirect costs of agency nurses in South Africa: a case study in two public sector hospitals.

Science.gov (United States)

Rispel, Laetitia C; Moorman, Julia

2015-01-01

Globally, flexible work arrangements - through the use of temporary nursing staff - are an important strategy for dealing with nursing shortages in hospitals. The objective of the study was to determine the direct and indirect costs of agency nurses, as well as the advantages and the problems associated with agency nurse utilisation in two public sector hospitals in South Africa. Following ethical approval, two South African public sector hospitals were selected purposively. Direct costs were determined through an analysis of hospital expenditure information for a 5-year period from 2005 until 2010, obtained from the national transversal Basic Accounting System database. At each hospital, semi-structured interviews were conducted with the chief executive officer, executive nursing services manager, the maternity or critical care unit nursing manager, the human resource manager, and the finance manager. Indirect costs measured were the time spent on pre-employment checks, and nurse recruitment, orientation, and supervision. All expenditure is expressed in South African Rands (R: 1 USD=R7, 2010 prices). In the 2009/10 financial year, Hospital 1 spent R38.86 million (US$5.55 million) on nursing agencies, whereas Hospital 2 spent R10.40 million (US$1.49 million). The total estimated time spent per week on indirect cost activities at Hospital 1 was 51.5 hours, and 60 hours at Hospital 2. The estimated monetary value of this time at Hospital 1 was R962,267 (US$137,467) and at Hospital 2 the value was R300,121 (US$42,874), thus exceeding the weekly direct costs of nursing agencies. Agency nurses assisted the selected hospitals in dealing with problems of nurse recruitment, absenteeism, shortages, and skills gaps in specialised clinical areas. The problems experienced with agency nurses included their perceived lack of commitment, unreliability, and providing sub-optimal quality of patient care. Hospital managers and policy-makers need to address the effective

Geological analysis of paleozoic large-scale faulting in the south-central Pyrenees

NARCIS (Netherlands)

Speksnijder, A.

1986-01-01

Detailed structural and sedimentological analysis reveals the existence of an east-west directed fundamental fault zone in the south-central Pyrenees, which has been intermittently active from (at least) the Devonian on. Emphasis is laid on the stUdy of fault-bounded post-Variscan

Planned home and hospital births in South Australia, 1991-2006: differences in outcomes.

Science.gov (United States)

Kennare, Robyn M; Keirse, Marc J N C; Tucker, Graeme R; Chan, Annabelle C

2010-01-18

To examine differences in outcomes between planned home births, occurring at home or in hospital, and planned hospital births. Population-based study using South Australian perinatal data on all births and perinatal deaths during the period 1991-2006. Analysis included logistic regression adjusted for predictor variables and standardised perinatal mortality ratios. Perinatal death, intrapartum death, death attributed to intrapartum asphyxia, Apgar score home births accounted for 0.38% of 300,011 births in South Australia. They had a perinatal mortality rate similar to that for planned hospital births (7.9 v 8.2 per 1000 births), but a sevenfold higher risk of intrapartum death (95% CI, 1.53-35.87) and a 27-fold higher risk of death from intrapartum asphyxia (95% CI, 8.02-88.83). Review of perinatal deaths in the planned home births group identified inappropriate inclusion of women with risk factors for home birth and inadequate fetal surveillance during labour. Low Apgar scores were more frequent among planned home births, and use of specialised neonatal care as well as rates of postpartum haemorrhage and severe perineal tears were lower among planned home births, but these differences were not statistically significant. Planned home births had lower caesarean section and instrumental delivery rates, and a seven times lower episiotomy rate than planned hospital births. Perinatal safety of home births may be improved substantially by better adherence to risk assessment, timely transfer to hospital when needed, and closer fetal surveillance.

The opinion of patients at a local South Africa teaching hospital on ...

African Journals Online (AJOL)

Objectives: This study aimed to determine how South African patients at a regional state hospital perceived the practice of physicians accepting gifts from the pharmaceutical industry. The physician-patient relationship is built on trust, with an understanding that the physician will act ethically and in patients' best interests.

"A dictate of both interest and mercy"? Slave hospitals in the antebellum South.

Science.gov (United States)

Kenny, Stephen C

2010-01-01

As a contribution to debates on slave health and welfare, this article investigates the variety, functions, and overall significance of infirmaries for the enslaved in the antebellum South. Newspapers, case histories, and surviving institutional records of antebellum Southern infirmaries providing medical treatment for slaves offer a unique opportunity to examine the development of modern American medicine within the "peculiar institution," and to explore a complex site of interactions between the enslaved, physicians, and slave owners. The world of the medical college hospital in South Carolina and an experimenting clinic in Alabama are reconstructed using newspapers and medical case histories. The Patient Register of the Hotel Dieu (1859-64) and the Admission Book of Touro Infirmary (1855-60) are used to highlight the types of enslaved patients sent to these two New Orleans commercial hospitals and to explore connections between the practice of medicine and the business of slave trading in the city. In addition to providing physicians with a steady income, slave infirmaries were key players in the domestic slave trade, as well as mechanisms for professionalization and the mobilization of medical ideas in the American South.

A 600-year-long stratigraphic record of tsunamis in south-central Chile

Science.gov (United States)

Hong, Isabel; Dura, Tina; Ely, Lisa L.; Horton, Benajamin P.; Nelson, Alan R.; Cisternas, Marco; Nikitina, Daria; Wesson, Robert L.

2017-01-01

The stratigraphy within coastal river valleys in south-central Chile clarifies and extends the region’s history of large, earthquakes and accompanying tsunamis. Our site at Quidico (38.1°S, 73.3°W) is located in an overlap zone between ruptures of magnitude 8–9 earthquakes in 1960 and 2010, and, therefore, records tsunamis originating from subduction-zone ruptures north and south of the city of Concepción. Hand-dug pits and cores in a 3-m-thick sequence of freshwater peat in an abandoned meander (a little-examined depositional environment for tsunami deposits) and exposures along the Quidico River show five sand beds that extend as much as 1.2 km inland. Evidence for deposition of the beds by tsunamis includes tabular sand beds that are laterally extensive (>100 m), well sorted, fine upward, have sharp lower contacts, and contain diatom assemblages dominated by brackish and marine taxa. Using eyewitness accounts of tsunami inundation, 137Cs analyses, and 14C dating, we matched the upper four sand beds with historical tsunamis in 2010, 1960, 1835, and 1751. The oldest prehistoric bed dates to 1445–1490 CE and correlates with lacustrine and coastal records of similar-aged earthquakes and tsunamis in south-central Chile.

Geological analysis of paleozoic large-scale faulting in the south-central Pyrenees

NARCIS (Netherlands)

Speksnijder, A.

1986-01-01

Detailed structural and sedimentological analysis reveals the existence of an east-west directed fundamental fault zone in the south-central Pyrenees, which has been intermittently active from (at least) the Devonian on. Emphasis is laid on the stUdy of fault-bounded post-Variscan (StephanoPermian)

Tectonic recherche of the central, south and sotheast regions of the peninsula

International Nuclear Information System (INIS)

Capote, R.; Goy, J.L.; Zazo, C.; Carbo, A.; Gonzalez de Vallejo, L.; Hernandez Enrile, J.L.; Urbanell, A.G.; Vegas, R.

1984-01-01

The research works done on neotectonics and its applications in the central region of the Peninsule (Central System, Tajo and Duero Tertiary Basins and Iberian Range), in the South and Southeast Regions (Provinces of Cadiz, Huelva, Almeria and Murcia) and in the Eastern Region (Province of Valencia and northern part of Alicante) are presented. In these regions, the analysis of the postmiocene tectonic is studied in the continental and coastal areas, using several different technics, from tectonic, geophysic and remote sensing methods to geomorphologic methods. (author)

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

Science.gov (United States)

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

2013-11-01

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

Workplace Violence Against Nurses: Vhembe District Hospitals, South Africa.

Science.gov (United States)

Mahani, Tshifularo Olga; Akinsola, Henry Abayomi; Mabunda, Jabu; Oni, Helen Tosin

2017-02-01

Work-related violence is a common problem worldwide. In South Africa, the Medical Research Council conducted a study on workplace violence in the health care industry and reported that most respondents had experienced it in different forms. This study aimed to identify the types and causes of workplace violence toward nurses in Thulamela hospitals, Vhembe district. The study employed a quantitative approach using a cross-sectional design. The target population was all nurses working in one regional and two district hospitals in the municipality. The sample consisted of 100 randomly selected participants from each hospital giving a total sample size of 300. Prior to the data collection, an ethical clearance and written informed consent were obtained from each participant. Data were collected using a self-administered questionnaire. Analysis was done using SPSS Version 20.0. The study revealed that 85% of the respondents (255) had experienced workplace violence in the last 12 months with a range of 95% for threats to 60% for bullying. Regarding the gender of the perpetrators, females (71%) were the main perpetrators. This study concludes that workplace violence is a major occupational health issue in the district, most especially among the psychiatric nurses.

Prevalence of psychological distress and associated factors in urban hospital outpatients in South Africa

Directory of Open Access Journals (Sweden)

Karl Peltzer

2012-02-01

Full Text Available Objective. The aim of this study was to assess the prevalence of psychological distress and associated factors among outpatients in an urban hospital in South Africa. Method. A sample of 1 532 consecutively selected patients (56.4% men and 43.6% women from various hospital outpatient departments were interviewed with a structured questionnaire. Results. Based on assessment with the Kessler Psychological Distress Scale, a measure of psychological distress, 17.1% of the patients (15.5% of men and 19.4% of women had severe psychological distress. Logistic multiple regression identified no income, poor health status, migraine headache and tuberculosis as significant factors associated with severe psychological stress for men. For women the factors identified were lower education, no income, having been diagnosed with a sexually transmitted disease, stomach ulcer and migraine headache. Conclusion. The study found a high prevalence of psychological distress among hospital outpatients in South Africa. Brief psychological therapies for adult patients with anxiety, depression or mixed common mental health problems treated in hospital outpatient departments are indicated. Accurate diagnosis of co-morbid depressive and anxiety disorders in patients with chronic medical illness is essential in understanding the cause and optimising the management of somatic symptom burden.

Nature and pattern of primary teeth extractions in a tertiary care hospital setting in South India

Directory of Open Access Journals (Sweden)

Shini Susan Samuel

2018-01-01

Full Text Available Background: Many studies have been carried out on the prevalence of dental diseases in children although not much information is available regarding its outcome among Indian children. Aim: The aim of the present study was to analyze the type of primary tooth extracted and the reasons for the extraction among children attending a tertiary care hospital in the Southern part of India. Materials and Methods: The dental records of pediatric patients who had visited the dental clinic of a tertiary care hospital located in Tamil Nadu, South India from December 2013 to November 2016 were reviewed. Patients who underwent extraction of at least one primary tooth under local or general anesthesia were included in the study. Results: A total of 943 primary teeth were extracted from 447 patients over 3 years. The most commonly extracted tooth type was the first primary molar followed by the primary central incisor. Grouping by age, the most frequently extracted tooth type between 2 and 5 years was the primary central incisor, the first primary molar among the 6–9-year-old and the second primary molar among 10–15-year-old. The majority of primary teeth extractions were performed in the age group of 6–9 years. No significant gender differences were noted. The most common reason for extraction of primary teeth in children was dental caries. Conclusions: This study demonstrates a high prevalence of untimely primary teeth extractions in young children and dental caries continues to be the leading cause. It clearly reflects on the lack of infant oral health care, the inadequacy of awareness and underutilization of oral health services among children in India.

Mio-Pliocene aridity in the south-central Andes associated with Southern Hemisphere cold periods.

Science.gov (United States)

Amidon, William H; Fisher, G Burch; Burbank, Douglas W; Ciccioli, Patricia L; Alonso, Ricardo N; Gorin, Andrew L; Silverhart, Perri H; Kylander-Clark, Andrew R C; Christoffersen, Michael S

2017-06-20

Although Earth's climate history is best known through marine records, the corresponding continental climatic conditions drive the evolution of terrestrial life. Continental conditions during the latest Miocene are of particular interest because global faunal turnover is roughly synchronous with a period of global glaciation from ∼6.2-5.5 Ma and with the Messinian Salinity Crisis from ∼6.0-5.3 Ma. Despite the climatic and ecological significance of this period, the continental climatic conditions associated with it remain unclear. We address this question using erosion rates of ancient watersheds to constrain Mio-Pliocene climatic conditions in the south-central Andes near 30° S. Our results show two slowdowns in erosion rate, one from ∼6.1-5.2 Ma and another from 3.6 to 3.3 Ma, which we attribute to periods of continental aridity. This view is supported by synchrony with other regional proxies for aridity and with the timing of glacial ‟cold" periods as recorded by marine proxies, such as the M2 isotope excursion. We thus conclude that aridity in the south-central Andes is associated with cold periods at high southern latitudes, perhaps due to a northward migration of the Southern Hemisphere westerlies, which disrupted the South American Low Level Jet that delivers moisture to southeastern South America. Colder glacial periods, and possibly associated reductions in atmospheric CO 2 , thus seem to be an important driver of Mio-Pliocene ecological transitions in the central Andes. Finally, this study demonstrates that paleo-erosion rates can be a powerful proxy for ancient continental climates that lie beyond the reach of most lacustrine and glacial archives.

Early urban and colonized regions of central and south Italy : A case study in comparative landscape archaeology

NARCIS (Netherlands)

Attema, P; Darvill, T; Gojda, M

2001-01-01

Systematic field surveys and topographical research undertaken to date in various Italian regions south of Rome shou, that responses to early urbanization in central and south Italy, and the interplay of early urbanization with Greek and Roman colonization, differed widely between regions. In this

Online Bibliographic Databases in South Central Pennsylvania: Current Status and Training Needs.

Science.gov (United States)

Townley, Charles

A survey of libraries in south central Pennsylvania was designed to identify those that are using or planning to use databases and assess their perceived training needs. This report describes the methodology and analyzes the responses received form the 57 libraries that completed the questionnaire. Data presented in eight tables are concerned with…

IAEA/WHO postal dose audits for radiotherapy hospitals in Eastern and South-Eastern Europe

International Nuclear Information System (INIS)

Izewska, J.; Vatnitsky, S.; Shortt, K.R.

2004-01-01

The IAEA/WHO TLD programme has been in operation for 34 years. In this period the calibration of approximately 5200 high-energy photon beams in over 1300 radiotherapy hospitals in 115 countries worldwide was checked. Of these, 18% of the audits were performed in Eastern and South-Eastern Europe. There are large contrasts in the region; while the results are very good for most countries, a few countries struggle with basic problems in dosimetry. The hospitals operating radiotherapy services without qualified medical physicists or dosimetry equipment have poorer results than those properly equipped and staffed. Only about 2/3 of TLD audit participants in Eastern Europe have the appropriate dosimetry equipment. To achieve consistency of the audit results within Eastern and South-Eastern Europe, strengthening of radiotherapy infrastructure in a few countries would be necessary. (authors)

Healthcare Costs for Acute Hospitalized and Chronic Heart Failure in South Korea: A Multi-Center Retrospective Cohort Study.

Science.gov (United States)

Ku, Hyemin; Chung, Wook Jin; Lee, Hae Young; Yoo, Byung Soo; Choi, Jin Oh; Han, Seoung Woo; Jang, Jieun; Lee, Eui Kyung; Kang, Seok Min

2017-09-01

Although heart failure (HF) is recognized as a leading contributor to healthcare costs and a significant economic burden worldwide, studies of HF-related costs in South Korea are limited. This study aimed to estimate HF-related costs per Korean patient per year and per visit. This retrospective cohort study analyzed data obtained from six hospitals in South Korea. Patients with HF who experienced ≥one hospitalization or ≥two outpatient visits between January 1, 2013 and December 31, 2013 were included. Patients were followed up for 1 year [in Korean won (KRW)]. Among a total of 500 patients (mean age, 66.1 years; male sex, 54.4%), the mean 1-year HF-related cost per patient was KRW 2,607,173, which included both, outpatient care (KRW 952,863) and inpatient care (KRW 1,654,309). During the post-index period, 22.2% of patients had at least one hospitalization, and their 1-year costs per patient (KRW 8,530,290) were higher than those of patients who had only visited a hospital over a 12-month period (77.8%; KRW 917,029). Among 111 hospitalized patients, the 1-year costs were 1.7-fold greater in patients (n=52) who were admitted to the hospital via the emergency department (ED) than in those (n=59) who were not (KRW 11,040,453 vs. KRW 6,317,942; pSouth Korea was related to hospitalization, especially admissions via the ED. Appropriate treatment strategies including modification of risk factors to prevent or decrease hospitalization are needed to reduce the economic burden on HF patients. © Copyright: Yonsei University College of Medicine 2017

A 54 year analysis of articles from Mpilo Central Hospital, Bulawayo ...

African Journals Online (AJOL)

PubMed and Google Scholar were searched to obtain articles originating from Mpilo Central Hospital, Bulawayo, Zimbabwe - 1958 to August 2011 (54 years). 168 articles cited 999 times were retrieved giving about 6 citations per article. Analysis of publication trends over time as well as publication avenues is made.

Nuclear Power in South-Central Brazil

International Nuclear Information System (INIS)

Cintra do Prado, L.

1966-01-01

The region of South-Central Brazil includes the states of Sao Paulo, Rio de Janeiro, Guanabara and Minas Gerais. The most recent power study was made by Canambra Engineering Consultants Limited. This group reported that the public-grid electricity output for the area in 1962 was 2.16 GW (average generation), with an installed capacity of 3.41 GW and annual mean load factor of 63.4; an increase in power requirements for 1970 was forecast, corresponding to an average output of 5.37 GW and an installed capacity of 8.3 GW. This forecast was based on an annual growth rate of 11.9% in generation. ''The energy requirements have grown at an average annual rate of 10.9% since 1955; however, the present forecast is based on the assumption of power being available as required, and hence includes the suppressed demand resulting from existing restrictions in generating and distribution capacity''

'This place is making me more depressed': The organisation of care for suicide attempters in a South African hospital.

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Bantjes, Jason; Nel, Annemi; Louw, Kerry-Ann; Frenkel, Louise; Benjamin, Ereshia; Lewis, Ian

2017-09-01

People who attend hospital following a suicide attempt represent a well-delineated high-risk group of patients who may be amenable to targeted interventions to reduce the risk of suicidal behaviour. Little is, however, known about how hospitals in South Africa respond to suicide attempters, what quality of care these patients receive or what possibilities exist for hospital-based suicide prevention interventions. We describe an ethnographic study conducted at a large hospital in South Africa to investigate the impact of current procedures and practices on the care received by those who attempt suicide. Findings suggest that the organisation of care within the hospital is a significant barrier to patients receiving optimal care and represents a lost opportunity for suicide prevention. Findings highlight the mismatch between the needs of suicide attempters and current services and call attention to the need for greater psychological input as well as hospital-based suicide prevention interventions that can be offered to patients without necessitating admissions.

U.S. Department of the Interior South Central Climate Science Center strategic science plan, 2013--18

Science.gov (United States)

Winton, Kim T.; Dalton, Melinda S.; Shipp, Allison A.

2013-01-01

The Department of the Interior (DOI) recognizes and embraces the unprecedented challenges of maintaining our Nation’s rich natural and cultural resources in the 21st century. The magnitude of these challenges demands that the conservation community work together to develop integrated adaptation and mitigation strategies that collectively address the impacts of climate change and other landscape-scale stressors. On September 14, 2009, DOI Secretary Ken Salazar signed Secretarial Order 3289 (amended February 22, 2010) entitled, “Addressing the Impacts of Climate Change on America’s Water, Land, and Other Natural and Cultural Resources.” The Order establishes the foundation for two partner-based conservation science entities to address these unprecedented challenges: Climate Science Centers (CSCs and Landscape Conservation Cooperatives (LCCs). CSCs and LCCs are the Department-wide approach for applying scientific tools to increase understanding of climate change and to coordinate an effective response to its impacts on tribes and the land, water, ocean, fish and wildlife, and cultural-heritage resources that DOI manages. Eight CSCs have been established and are managed through the U.S. Geological Survey (USGS) National Climate Change and Wildlife Science Center (NCCWSC); each CSC works in close collaboration with their neighboring CSCs, as well as those across the Nation, to ensure the best and most efficient science is produced. The South Central CSC was established in 2012 through a cooperative agreement with the University of Oklahoma, Texas Tech University, Louisiana State University, the Chickasaw Nation, the Choctaw Nation of Oklahoma, Oklahoma State University, and NOAA’s Geophysical Fluid Dynamics Lab; hereafter termed the ”Consortium” of the South Central CSC. The Consortium has a broad expertise in the physical, biological, natural, and social sciences to address impacts of climate change on land, water, fish and wildlife, ocean, coastal, and

PROCSEE: Policy Challenges for Professional Higher Education in Central and South-Eastern Europe

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Policnik, Jasmina; Sauli Miklavcic, Alicia Leonor; Alupei-Durach, Flavia; Nožica, Žarko; Chrást, Ondrej; Voldánová, Iva; Karpíšek, Michal; Dinya, László; Medve, Anna; Wéber, György; Racsko, Réka; Perényi, Petra; Camilleri, Anthony F.

2016-01-01

PROCSEE is a policy-oriented project, aimed at strengthening the provision of professional higher education, by strengthening the policy-work conducted by umbrella organizations representing professional higher education institutions in Central and South-Eastern in Europe. Working together over three years, the project intends to: (1) identify the…

Head and neck cancer burden and preventive measures in Central and South America.

Science.gov (United States)

Perdomo, Sandra; Martin Roa, Guillermo; Brennan, Paul; Forman, David; Sierra, Mónica S

2016-09-01

Central and South America comprise one of the areas characterized by high incidence rates for head and neck cancer. We describe the geographical and temporal trends in incidence and mortality of head and neck cancers in the Central and South American region in order to identify opportunities for intervention on the major identified risk factors: tobacco control, alcohol use and viral infections. We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries and cancer deaths from the WHO mortality database for 18 countries. Age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 person-years were estimated. Brazil had the highest incidence rates for oral and pharyngeal cancer in the region for both sexes, followed by Cuba, Uruguay and Argentina. Cuba had the highest incidence and mortality rates of laryngeal cancer in the region for males and females. Overall, males had rates about four times higher than those in females. Most countries in the region have implemented WHO recommendations for both tobacco and alcohol public policy control. Head and neck squamous-cell cancer (HNSCC) incidence and mortality rates in the Central and South America region vary considerably across countries, with Brazil, Cuba, French Guyana, Uruguay and Argentina experiencing the highest rates in the region. Males carry most of the HNSCC burden. Improvement and implementation of comprehensive tobacco and alcohol control policies as well as the monitoring of these factors are fundamental to prevention of head and neck cancers in the region. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

HIV-Related Medical Admissions to a South African District Hospital Remain Frequent Despite Effective Antiretroviral Therapy Scale-Up

NARCIS (Netherlands)

Meintjes, Graeme; Kerkhoff, Andrew D.; Burton, Rosie; Schutz, Charlotte; Boulle, Andrew; van Wyk, Gavin; Blumenthal, Liz; Nicol, Mark P.; Lawn, Stephen D.

2015-01-01

The public sector scale-up of antiretroviral therapy (ART) in South Africa commenced in 2004. We aimed to describe the hospital-level disease burden and factors contributing to morbidity and mortality among hospitalized HIV-positive patients in the era of widespread ART availability. Between June

P17.05 Epidemiology and clinical in patients with primary and secondary lymphomas with a nervous system condition in the South Central Hospital of High Specialty from PEMEX in Mexico

Science.gov (United States)

Cordoba Mosqueda, M.; Guerra Mora, J.; Hernandez Resendiz, R.; Loya Aguilar, I.; Vicuña Gonzalez, R.; Ibarra de la Torre, A.; Garcia Gonzalez, U.

2016-01-01

Abstract Introduction: Primary lymphomas of the central nervous system are a type of Non Hodgkin Lymphoma with high morbidity and mortality. They are frequently associated with HIV infection, nevertheless the prevalence in non HIV patients has been tripled recently without any justified cause. In occasions it is difficult to identify the difference between primary and secondary origin in the central nervous system, this is crucial since the prognosis also changes. Method and Materials: Observational study with a range of patients from March 1999- March 2016 with reported diagnosis of Non Hodgkin Lymphoma with Central Nervous System involvement inside the electronic files of the South Central Hospital of High Specialty PEMEX. A statistical analysis is made through the SPSS Statistics of the Disease in this Institution program. Results: There were a total of 20 patients found with the diagnosis of Non Hodgkin Lymphoma with Central Nervous System involvement with a media of 57.7 ± 16 years of age, 60% males. 45% were classified as primary; multiple variables were analyzed such as the histological subtype from which the most common was Giant B cell types in a 40%. Within the symptoms the most common was headheach and pyramidal syndrome with 25%. At the time of diagnosis we found that with most prevalence ECOG of the population was of 1 reported case of 55 % of patients, nevertheless the survival rate after diagnosis had a global media of 40.3 ± 21 months, being of 56 months in secondary lymphoma and of 16 months in primary lymphoma, there were no significant statistical differences in both groups. Conclusions: The clinical and epidemiological characteristics in both groups were similar to the ones reported in the literature, nonetheless compared with the time of diagnosis based on the ECOG the overall rate of survival in both groups is low, which brings a great challenge for medical and surgical management. It is important to denote that the clinical

Medical costs, Cesarean delivery rates, and length of stay in specialty hospitals vs. non-specialty hospitals in South Korea.

Directory of Open Access Journals (Sweden)

Seung Ju Kim

Full Text Available Since 2011, specialty hospitals in South Korea have been known for providing high- quality care in specific clinical areas. Much research related to specialty hospitals and their performance in many such areas has been performed, but investigations about their performance in obstetrics and gynecology are lacking. Thus, we aimed to compare specialty vs. non-specialty hospitals with respect to mode of obstetric delivery, especially the costs and length of stay related to Cesarean section (CS procedures, and to provide evidence to policy-makers for evaluating the success of hospitals that specialize in obstetric and gynecological (OBGYN care.We obtained National Health Insurance claim data from 2012 to 2014, which included information from 418,141 OBGYN cases at 214 hospitals. We used a generalized estimating equation model to identify a potential association between the likelihood of CS at specialty hospitals compared with other hospitals. We also evaluated medical costs and length of stay in specialty hospitals according to type of delivery.We found that 150,256 (35.9% total deliveries were performed by CS. The odds ratio of CS was significantly lower in specialty hospitals (OR: 0.95, 95% CI: 0.93-0.96compared to other hospitals Medical costs (0.74% and length of stay (1% in CS cases increased in specialty hospitals, although length of stay following vaginal delivery was lower (0.57% in specialty hospitals compared with other hospitals.We determined that specialty hospitals are significantly associated with a lower likelihood of CS delivery and shorter length of stay after vaginal delivery. Although they are also associated with higher costs for delivery, the increased cost could be due to the high level of intensive care provided, which leads to improve quality of care. Policy-makers should consider incentive programs to maintain performance of specialty hospitals and promote efficiency that could reduce medical costs accrued by patients.

Let him not be alone: perspectives of older British South Asian minority ethnic patients on dying in acute hospitals.

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Venkatasalu, Munikumar Ramasamy

2017-09-02

To investigate older British South Asians' views on dying at acute hospitals. Older people, including those from ethnic minorities prefer 'home as a haven' for their last days of life; however, they are more likely to die in hospital. Constructive grounded theory was used as a methodological approach that informed data collection to data analysis. Open meetings with 11 local South Asian community organisations enabled the researchers to recruit a total of 55 older South Asians in this study. Data were collected using gender-based focus groups (n=5) and in-depth, semi-structured interviews (n=29). Transcripts were analysed using Nvivo 9. Three key themes were identified: 'mistrust', 'let him not be alone' and 'family as a protective shield'. The theme 'mistrust' is explored through examination of beliefs, attitudes and expectations about 'hospital' as a place in the care of the dying. The theme of 'let him not be alone' draws the family's preferences and concerns in relation to leaving their older dying relative alone in the hospital. The final theme of 'family as a protective shield' describes the element of family care as a protective shield for their older one to have peaceful end-of-life care moments in the hospital. Allowing older relatives to die in hospital seems to evoke feelings of missed filial responsibilities and guilt among family carers among older ethnic minorities. The presence of cultural paranoia and mistrust often led minorities to experience sub-standard end-of-life care in acute hospitals.

Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals.

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Liliwe L Shuping

Full Text Available Hospital-associated methicillin-resistant S. aureus (HA-MRSA remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa.We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA.Of the 9971 patients with positive blood cultures, 7.7% (772 had S. aureus bacteraemia (SAB. The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%- 34.3%. HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%- 31.7%. Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7-34.4, age ≤1 month (aOR 8.7; 95% CI 3.0-24.6, residency at a long-term care facility (aOR 5.2; 95% CI, 1.5-17.4, antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8-9.1, hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3-5.6 and mechanical ventilation (aOR 2.2; 95% CI 1.07-4.6, were independent risk factors for HA-MRSA infection.The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients.

Deglaciation events in part of the Manchester South 7.5' quadrangle south-central New Hampshire

Science.gov (United States)

Stone, Byron D.

1971-01-01

The study-area lies in south-central New Hampshire, and is bordered on the west by the Merrimack River, the principal north-south drainage route of central New Hampshire. The classical two tills of New England outcrop in the area. In a unique exposure of the sandy upper till, a loose ablation unit overlies a compact basal unit. Both upper till facies overlie a sheared section of dense, olive-gray lower till. Outwash sequences mapped in the study-area are progressively younger to the north, indicating backwastage of the Wisconsinan ice sheet. Primary structures in proglacial Lake Merrimack sediments include contorted bedding, buckled laminae, and folds. A large slumped section in lake sediments exhibits three distinct deformation zones, characterized by brittle, ductile, and unconsolidated deformation. Cross-cutting relationships establish four fold generations and a deformation sequence in the slumped section. Slip in each fold generation was along nearly parallel slip-lines, as deduced from analyses of fold rotation senses. The primary and slump deformation features contrast sharply with the intense style of deformation of lake beds below till at an apparent ice readvance cut. The deduced drag fold slip-line agrees with till fabric point maxima and dip-slip on one group of thrust faults. A southerly movement of readvancing ice is inferred.The study-area was deglaciated about 13,000 years ago, according to a proposed deglaciation model for New Hampshire. The model is based on Nye's theoretical glacier surface gradient, and evidence for active retreat of the Wisconsinan ice sheet.

Cretaceous alkaline volcanism in south Marzanabad, northern central Alborz, Iran: Geochemistry and petrogenesis

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Roghieh Doroozi

2016-11-01

Full Text Available The alkali-basalt and basaltic trachy-andesites volcanic rocks of south Marzanabad were erupted during Cretaceous in central Alborz, which is regarded as the northern part of the Alpine-Himalayan orogenic belt. Based on petrography and geochemistry, en route fractional crystallization of ascending magma was an important process in the evolution of the volcanic rocks. Geochemical characteristics imply that the south Marzanabad alkaline basaltic magma was originated from the asthenospheric mantle source, whereas the high ratios of (La/YbN and (Dy/YbN are related to the low degree of partial melting from the garnet bearing mantle source. Enrichment pattern of Nb and depletion of Rb, K and Y, are similar to the OIB pattern and intraplate alkaline magmatic rocks. The K/Nb and Zr/Nb ratios of volcanic rocks range from 62 to 588 and from 4.27 to 9 respectively, that are some higher in more evolved samples which may reflect minor crustal contamination. The isotopic ratios of Sr and Nd respectively vary from 0.70370 to 0.704387 and from 0.51266 to 0.51281 that suggest the depleted mantle as a magma source. The development of south Marzanabad volcanic rocks could be related to the presence of extensional phase, upwelling and decompressional melting of asthenospheric mantle in the rift basin which made the alkaline magmatism in Cretaceous, in northern central Alborz of Iran.

An Examination of Social Media Policy Usage of South Central United States' Universities

Science.gov (United States)

Eaton, Virginia J.; Luse, Donna W.; Hodge, Thomas G.

2012-01-01

Since the use of social media tools by universities has expanded exponentially, a university can easily find itself in a precarious situation in a moment's notice because social media tools have been used inadvertently. This study investigated the social media policies of AACSB-International accredited schools in the SREB South Central Region of…

Helicopter electromagnetic and magnetic geophysical survey data, Hunton anticline, south-central Oklahoma

Science.gov (United States)

Smith, Bruce D.; Smith, David V.; Deszcz-Pan, Maryla; Blome, Charles D.; Hill, Patricia

2011-01-01

This report is a digital data release for multiple geophysical surveys conducted in the Hunton anticline area of south-central Oklahoma. The helicopter electromagnetic and magnetic surveys were flown on March 16–17, 2007, in four areas of the Hunton anticline in south-central Oklahoma. The objective of this project is to improve the understanding of the geohydrologic framework of the Arbuckle-Simpson aquifer. The electromagnetic sensor for the helicopter electromagnetic survey consisted of six different transmitter-receiver orientations that measured the earth's electrical response at six distinct frequencies from approximately 500 Hertz to approximately 115,000 Hertz. The electromagnetic measurements were converted to electrical resistivity values, which were gridded and plotted on georeferenced maps. The map from each frequency represents a different depth of investigation for each area. The range of subsurface investigation is comparable to the depth of shallow groundwater. The four areas selected for the helicopter electromagnetic study, blocks A–D, have different geologic and hydrologic settings. Geophysical and hydrologic information from U.S. Geological Survey studies are being used by modelers and resource managers to develop groundwater resource plans for the Arbuckle-Simpson aquifer.

Field Evaluations of Topical Arthropod Repellents in North, Central, and South America

Science.gov (United States)

2014-09-01

De La Rocque et al. 2011) and their spread into higher elevations of Africa, Latin America , and Asia (Epstein 2001). Dengue fever and...denguehemorrhagic fever have resurgeddramatically in Latin America (Zell 2004). In North America ,West Nile virus has impacted signiÞcantly the health and welfare of...VECTOR CONTROL, PEST MANAGEMENT, RESISTANCE, REPELLENTS Field Evaluations of Topical Arthropod Repellents in North, Central , and South America KENDRA

IAU South West and Central Asian Regional Office of Astronomy for Development

Science.gov (United States)

Mickaelian, A. M.; Hakopian, S. A.; Farmanyan, S. V.; Mikayelyan, G. A.

2017-12-01

The International Astronomical Union (IAU) announced its Strategic Plan on Astronomy for Development in 2009, during the International Year of Astronomy (IYA). One of its main components was the creation of the Office of Astronomy for Development (OAD) and corresponding Regional Offices (ROADs) for implementation and coordination of its aims. The OAD was created in Cape Town, South Africa and later on ROADs were created in 8 regions. Since 2015, Armenia hosts one of them, IAU South West Asian (SWA), later renamed to South West and Central Asian (SWCA) ROAD. At present, already 6 countries have officially joined (Armenia, Georgia, Iran, Kazakhstan, Tajikistan, and Turkey), but the Office serves for a rather broad region, from Eastern Europe to Central Asia. Armenia's geographical location and its historical role in astronomy (both for well-known archaeoastronomical heritage and the presence of the famous Byurakan Astrophysical Observatory (BAO) founded by Viktor Ambartsumian in 1946) serve as a link between Europe and Eastern Partnership countries, Middle East and Asia in general. We run activities in 3 directions, Task Forces (TF): TF1 Universities and Research, TF2 Children and Schools and TF3 Public Outreach. We present our projects and all other accomplishments and discuss the role of our ROAD in maintaining contacts and development of astronomy in the region, as well as contacts between Europe and the Eastern Partnership countries. Most up-to-date information about the IAU SWCA ROAD is available on its webpage at http://iau-swa-road.aras.am/eng/index.php.

P12.01 Epidemiology in spinal tumors treated surgically at the South Central Hospital of High Specialty from PEMEX in Mexico

Science.gov (United States)

Hernandez Resendiz, R.; Cordoba Mosqueda, M.; Guerra Mora, J.; Loya Aguilar, I.; Garcia Gonzalez, U.

2016-01-01

Abstract Introduction: The spinal tumors are rare neoplasms, they can be primary or metastatic; in the literature they are divided in extradural and intradural, extramedullary and intramedullary, from which extradural tumors are the most frequent and are usually metastatic, the intramedullary are generally gliomas. From the primary tumors up to 78% are benign and 22% malign, the histological stripe and the involvement to the spinal compartments are of great importance for the results and the treatment which is mainly surgical, individualized and meticulously planned with the support of technological resources such as the electrophysiological monitoring during the surgery. Methods and Materials: Observational study with a range of patients from March 1999- March 2016 to whom surgical resection of the spinal tumor was performed and reported on the Electronic Files of the South Central Hospital of High Specialty PEMEX. A Statistical analysis is made with the SPSS Statistic of disease of the Institution program. Results: 23 patients with spinal tumor surgical resection were found. The median age was 53 ± 10 years. The most common clinical manifestation was radiculopathy (65%). The Karnofsky scale was used for initial evaluation where a 43% of patients had a 90 score at the moment of the diagnosis, while 65% had an ECOG 1. The most frequent tumor was the Spinal Shwannoma (39%), followed in prevalence by the Condroid Cordoma (17%), where the intradural extramedullary location was the most prevalent (78%). The medium rate of survival after the surgical procedure was from 11 months. Conclusions: Our cases and the international statistics coincide. Radiculopathy as high prevalence initial manifestation conceals us to dismiss in the sixth decade of life any possibility for spinal tumor presentation. Most of spinal tumor patients do not have any clinical deterioration in their basal state, which indicates that performing a successful surgical procedure and the right

The relationship of centralization, organizational culture and performance indexes in teaching hospitals affiliated to Tehran University of Medical Sciences.

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Nasirpour, Amir Ashkan; Gohari, Mahmoud Reza; Moradi, Saied

2010-01-01

One of the main problems in the efficiency and efficacy of an organization is its structural issue. Organizational culture is also considered as an effective factor in the performance of many organizations. The main goal of the present study was to determine the relationship of Centralization and organizational culture and performance indexes in Teaching Hospitals affiliated to Tehran University of Medical Sciences. This correlation study was performed in the year 2007. The population studied consisted of 4408 personnel from 13 hospitals among whom 441 subjects were selected and studied via a class sampling method. Data was compiled using a check list concerning the evaluation status of Centralization and another form concerning performance indexes as well as Robbin's organizational culture questionnaire. Data were obtained from the subjects by self answering and analyzed by using descriptive statistical indexes, T- test and Fisher's exact tests. Among the organizational culture indexes of the hospitals studied, control and organizational identity was better as compared to others (mean=3.32 and 3.30). Concerning the extent of Centralization in the hospitals studied, 53.85 % and 46.15 % were reported to have upper and lower organizational Centralization, respectively. Mean ratio of surgical operations to inpatients was 40%, the mean rate of admissions per active bed was 60.83, mean bed occupancy coefficient was 70.79%, average length of stay was 6.96 days, and mean net death rate was 1.41%. No significant correlation was seen between Centralization degree, organizational culture and performance indexes in teaching hospitals Tehran university of medical sciences. (with 95% confidence interval). Due to the fact that first grade Teaching hospitals use board certified members, expert personnel, and advanced equipments and because of the limitation of patients choice and, the extent of Centralization and many organizational culture components have no significant

Abundance of Armillaria within old-growth eastern hemlock stands in South-Central Pennsylvania

Science.gov (United States)

Matthew S. Fromm; Donald D. Davis

2007-01-01

Abstract—In early summer 2002, 329 soil-sampling pits were dug within an old-growth, eastern hemlock (Tsuga canadensis [L.] Carrière) stand in south-central Pennsylvania recently infested with the hemlock woolly adelgid (Adelges tsugae Annand). For comparison, 199 similar pits were dug in an adjacent hardwood stand. Rhizomorphs of...

Natural phenomena hazards, Hanford Site, south central Washington

International Nuclear Information System (INIS)

Tallman, A.M.

1996-01-01

This document presents the natural phenomena hazard (NPH) loads for use in implementing DOE Order 5480.28, Natural Phenomena Hazards Mitigation, at the Hanford Site in south-central Washington State. The purpose of this document is twofold: (1) summarize the NPH that are important to the design and evaluation of structures, systems, and components at the Hanford Site; (2) develop the appropriate natural phenomena loads for use in the implementation of DOE Order 5480.28. The supporting standards, DOE-STD-1020-94, Natural Phenomena Hazards Design and Evaluation Criteria for Department of Energy Facilities (DOE 1994a); DOE-STD-1022-94, Natural Phenomena Hazards Site Characteristics Criteria (DOE 1994b); and DOE-STD-1023-95, Natural Phenomena Hazards Assessment Criteria (DOE 1995) are the basis for developing the NPH loads

Sandy lower Gotherivian reservoirs in the south central Turkmeniya. [Siberia

Energy Technology Data Exchange (ETDEWEB)

Mavyyev, N.Ch.; Nedirov, B.R.

1982-01-01

Composition and capacitance-filtering properties of sandy rocks of the early Gotherivian age developed on the fields of Karadzhaulak and Cirili within the northeast slope of the Predkopetdag marginal trough and on areas of Dengli Bakharadok of the Bakharadok monocline are studied. These rocks are viewed as analogs of the gas-bearing Shatlyk level of the Murgabskiy Basin. They can be considered the main potential source of hydrocarbons on the studied territory. In the upper part of the lower Gotherivian, a level of sandy rocks is traced. Rocks represented by small-and average-grained red and light grey differences in sandstones of polymictic composition. The porosity of the sandstones is 20-22%, permeability is 200-500 mdarcy. Not only a similar stratigraphic position of the described sandstones in the lower Gotherivian was found, but also lithological common nature of the rocks. In the south central Turkmeniya one can isolate age analogs of the Shatlyk level, the main productive level of southeast Turkmeniya. The thickness of the sandy beds is from 17 to 45 m. The sandstones of the Karadzhaulak area have the best capacitance-filtering properties. Post sedimentation changes depend on the quantity and composition of the cement, influence of formation waters, and possibly thermobaric conditions of rock formation. The presence of sandy rocks with high collector properties in the cross section of the lower Gotherivian deposits in south central Turkmeniya should be considered in determining the objects for further prospecting and exploration. The areas of Kumbet and Karadzhaulak are primary.

Occurrence of Coccolithophorids in the Northeastern and Central South China Sea

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Tien-Nan Yang

2003-03-01

Full Text Available Coccolithophorids in the northeastern and central South China Sea (SCS were surveyed in March and October 1996. The cell density of coccolithophorids ranged from 25 x 103 cells L-1 to 31 x 103 cells L-1 in sea-surface water (0–25 m in depth, and from 12 x 103 cells L-1 to 62 x 103 cells L-1 in subsurface water (150 m in depth. The lowest cell number was recorded in the subsurface (150 m in depth in the central gyral area, while the highest one was at the same depth in the northeastern realm. A total of thirty-one species were identified. The species richness in the northeastern SCS is higher than in the central area. Emiliania huxleyi (Lohmann Hay et Mohler, Gephyrocapsa oceanica Kamptner, Umbellosphaera Paasche spp. And Syracosphaera Lohmann spp. Dominated the surface assemblages, whereas Florisphaera profunda Okada et Honjo, Gladiolithus flabellatus (Halldal et Markali Jordan et Chamberlain predominated in the subsurface layer. In contrast, Palusphaera vandeli Lecal emend. R. E. Norris presented in both surface and subsurface assemblages.

Managerial competencies of hospital managers in South Africa: a survey of managers in the public and private sectors

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Pillay Rubin

2008-02-01

Full Text Available Abstract Background South Africa has large public and private sectors and there is a common perception that public sector hospitals are inefficient and ineffective while the privately owned and managed hospitals provide superior care and are more sustainable. The underlying assumption is that there is a potential gap in management capacity between the two sectors. This study aims to ascertain the skills and competency levels of hospital managers in South Africa and to determine whether there are any significant differences in competency levels between managers in the different sectors. Methods A survey using a self administered questionnaire was conducted among hospital managers in South Africa. Respondents were asked to rate their proficiency with seven key functions that they perform. These included delivery of health care, planning, organizing, leading, controlling, legal and ethical, and self-management. Ratings were based on a five point Likert scale ranging from very low skill level to very high skill level. Results The results show that managers in the private sector perceived themselves to be significantly more competent than their public sector colleagues in most of the management facets. Public sector managers were also more likely than their private sector colleagues to report that they required further development and training. Conclusion The findings confirm our supposition that there is a lack of management capacity within the public sector in South Africa and that there is a significant gap between private and public sectors. It provides evidence that there is a great need for further development of managers, especially those in the public sector. The onus is therefore on administrators and those responsible for management education and training to identify managers in need of development and to make available training that is contextually relevant in terms of design and delivery.

Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals

Science.gov (United States)

Kuonza, Lazarus; Musekiwa, Alfred; Iyaloo, Samantha; Perovic, Olga

2017-01-01

Introduction Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. Methods We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA. Results Of the 9971 patients with positive blood cultures, 7.7% (772) had S. aureus bacteraemia (SAB). The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%– 34.3%). HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%– 31.7%). Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7–34.4), age ≤1 month (aOR 8.7; 95% CI 3.0–24.6), residency at a long-term care facility (aOR 5.2; 95% CI, 1.5–17.4), antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8–9.1), hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3–5.6) and mechanical ventilation (aOR 2.2; 95% CI 1.07–4.6), were independent risk factors for HA-MRSA infection. Conclusion The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients. PMID:29145465

Development of personnel radiation monitoring program for occupationally exposed workers in Malawian Hospitals : A case study of Kamuzu Central, Bwaila and Mtengo Wa Nthenga Hospitals

International Nuclear Information System (INIS)

Chinangwa, Getrude

2016-07-01

Malawi became an IAEA member state in 2006 and developed the Atomic Energy Act and Regulations in 2011 and 2012 respectively. However, regulatory authority and personnel monitoring services have not yet been established. As such, hospitals operating radiological services in Malawi do not have personnel monitoring programme. This study aimed at developing the personnel radiation monitoring program for three hospitals in Malawi namely; Kamuzu Central Hospital, Bwaila Hospital, and Mtengo wa Nthenga Hospital. A radiation protection questionnaire was administered to the X-ray Departments involved in the study to investigate radiation protection practices in the hospitals. Dose rate measurements in the facilities were taken using survey meters and doses to individuals were recorded using personal dosimeters. The results showed that the hospitals lack radiation protection program which covers the critical issues of quality assurance and control as well as the personnel dose monitoring. Average ambient dose rate values were 0.39 μSv/hr for Mtengo wa Nthenga Hospital, 5.03 μSv/hr for Bwaila Hospital and 4μSv/hr for Kamuzu Central Hospital. Average monthly dose for workers was 0.247 mSv. The study recommends the establishment of a regulatory authority, consistent dose assessment, quality control tests and structural shielding assessment in these and probably all the diagnostic facilities in Malawi. The personnel monitoring programme developed from this study is intended to guide diagnostic facilities and personnel monitoring service providers in Malawi in tracking and reporting exposure record for their occupationally exposed workers. (au)

Unretrieved shooting loss of mourning doves in north-central South Carolina

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Haas, G.H.

1977-01-01

Unretrieved loss for mourning doves (Zenaida macroura) in north-central South Carolina was between 27 and 41 percent of the retrieved kill for the 1973 through 1975 hunting seasons based on 1,396 doves shot by 281 hunters. Dove hunters hunted in groups, fired 8.6 shots per retrieved dove, and engaged in a substantial number of illegal activities. Increased dove populations and hunter bag resulted in increased unretrieved loss, numbers of shots per bagged bird, and illegal activities. Retriever dogs increased the efficiency of dove hunters.

Lichen communities and species indicate climate thresholds in southeast and south-central Alaska, USA

Science.gov (United States)

Heather T. Root; Bruce. McCune; Sarah. Jovan

2014-01-01

Because of their unique physiology, lichen communities are highly sensitive to climatic conditions,making them ideal bioindicators for climate change. Southeast and south-central Alaska host diverse and abundant lichen communities and are faced with a more rapidly changing climate than many more southerly latitudes. We develop sensitive lichen-based indicators for...

The development of hospitalbased palliative care services in public hospitals in the Western Cape South Africa

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L Gwyther

2018-02-01

Full Text Available With the recent approval of a South African (SA National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western Cape, SA. Palliative care services in SA started in the non-governmental sector in the 1980s. The first SA hospital-based palliative care team was established in Charlotte Maxeke Johannesburg Academic Hospital in 2001. The awareness of the benefit of palliative care in the hospital setting led to the development of isolated pockets of excellence providing palliative care in the public health sector in SA. This article describes models for palliative care at tertiary, provincial and district hospital level, which could inform development of hospital-based palliative care as the national policy for palliative care is implemented in SA.

Environmental factors in infancy and ulcerative colitis in the Central South of Chile: a case-control study.

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Boneberger, Anja; Weiss, Eduardo Hebel; Calvo, Mario; Torres, Lilibeth; Wagner, Johanna; Kabesch, Michael; Radon, Katja

2011-10-01

Evidence for the role of the hygiene hypothesis and the development of Ulcerative Colitis (UC) is unclear. We aimed to explore the association between environmental factors in infancy and UC. A hospital-based case-control study (52 UC cases, response: 77%, 174 age- , sex and place of living matched controls, response: 62%) was carried out in the Central South of Chile in 2009/2010. Patients or parents underwent a personal interview about early life experiences. High paternal education (adjusted Odds Ratio (aOR): 2.1; 95% CI: 1.0-4.5) as proxy for socioeconomic status was positively associated with case status in the final multivariate logistic regression model. Likewise, having older siblings was a risk factor for UC (aOR: 2.2; 95%CI: 1.1.-4.4). The importance for some early life environmental factors in the development of UC was established. However, the role of the hygiene hypothesis could not be confirmed for all environmental factors. Copyright © 2011 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

OpenAIRE

Muzigaba, Moise; van Wyk, Brian; Puoane, Thandi

2018-01-01

Background Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. Objective To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa. Methods An explora...

Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals

OpenAIRE

Moise Muzigaba; Brian van Wyk; Thandi Puoane

2018-01-01

Background: Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas.Objective: To explore health care workers’ perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa.Methods: An explor...

The burden of oesophageal cancer in Central and South America.

Science.gov (United States)

Barrios, Enrique; Sierra, Monica S; Musetti, Carina; Forman, David

2016-09-01

Oesophageal cancer shows marked geographic variations and is one of the leading causes of cancer death worldwide. We described the burden of this malignancy in Central and South America. Regional and national level incidence data were obtained from 48 population-based cancer registries in 13 countries. Mortality data were obtained from the WHO mortality database. Incidence of oesophageal cancer by histological subtype were available from high-quality population-based cancer registries. Males had higher incidence and mortality rates than females (male-to-female ratios: 2-6:1 and 2-5:1). In 2003-2007, the highest rates were in Brazil, Uruguay, Argentina and Chile. Mortality rates followed the incidence patterns. Incidence of oesophageal squamous cell carcinoma (SCC) was higher than adenocarcinoma (AC), except in females from Cuenca (Ecuador). SCC and AC incidence were higher in males than females, except in the Region of Antofagasta and Valdivia (Chile), Manizales (Colombia) and Cuenca (Ecuador). Incidence and mortality rates tended to decline in Argentina, Chile, Brazil (incidence) and Costa Rica from 1997 to 2008. The geographic variation and sex disparity in oesophageal cancer across Central and South America may reflect differences in the prevalence of tobacco smoking and alcohol consumption which highlights the need to implement and/or strengthen tobacco and alcohol control policies. Maté consumption, obesity, diet and Helicobacter pylori infection may also explain the variation in oesophageal cancer rates but these relationships should be evaluated. Continuous monitoring of oesophageal cancer rates is necessary to provide the basis for cancer prevention and control in the region. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

Presence of rapidly degrading permafrost plateaus in south-central Alaska

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Jones, Benjamin M.; Baughman, Carson; Romanovsky, Vladimir E.; Parsekian, Andrew D.; Babcock, Esther; Stephani, Eva; Jones, Miriam C.; Grosse, Guido; Berg, Edward E

2016-01-01

Permafrost presence is determined by a complex interaction of climatic, topographic, and ecological conditions operating over long time scales. In particular, vegetation and organic layer characteristics may act to protect permafrost in regions with a mean annual air temperature (MAAT) above 0 °C. In this study, we document the presence of residual permafrost plateaus in the western Kenai Peninsula lowlands of south-central Alaska, a region with a MAAT of 1.5 ± 1 °C (1981–2010). Continuous ground temperature measurements between 16 September 2012 and 15 September 2015, using calibrated thermistor strings, documented the presence of warm permafrost (−0.04 to −0.08 °C). Field measurements (probing) on several plateau features during the fall of 2015 showed that the depth to the permafrost table averaged 1.48 m but at some locations was as shallow as 0.53 m. Late winter surveys (augering, coring, and GPR) in 2016 showed that the average seasonally frozen ground thickness was 0.45 m, overlying a talik above the permafrost table. Measured permafrost thickness ranged from 0.33 to  >  6.90 m. Manual interpretation of historic aerial photography acquired in 1950 indicates that residual permafrost plateaus covered 920 ha as mapped across portions of four wetland complexes encompassing 4810 ha. However, between 1950 and ca. 2010, permafrost plateau extent decreased by 60.0 %, with lateral feature degradation accounting for 85.0 % of the reduction in area. Permafrost loss on the Kenai Peninsula is likely associated with a warming climate, wildfires that remove the protective forest and organic layer cover, groundwater flow at depth, and lateral heat transfer from wetland surface waters in the summer. Better understanding the resilience and vulnerability of ecosystem-protected permafrost is critical for mapping and predicting future permafrost extent and degradation across all permafrost regions that are currently warming

A new Starlight Reserve for the central South Island of New Zealand

Science.gov (United States)

Hearnshaw, John

2015-03-01

The Aoraki Mackenzie International Dark Sky Reserve is a new reserve created in 2012 by the International Dark-Sky Association in the central South Island of New Zealand, and covers over 4300 square kilometres around Mt John University Observatory. It is the first such reserve to be recognized at gold tier level and is the largest dark sky reserve in the world. Astro-tourism in the new reserve will be a prominent activity in the coming years.

Enculturating environments: rock art and the archaeology of interior south-central California

OpenAIRE

Sturt, Fraser C.; Robinson, David; Bernard, Julienne

2010-01-01

The disarticulation of rock art from the archaeological record and its changing environment remains a primary obstacle facing many rock art researchers across the globe, but particularly in the American Far West, and California specifically (Robinson & Sturt 2009). A schism, so to speak, exists between the archaeological record and rock art as well as 'dirt' archaeologists and rock art specialists. This is because, in California, and particularly in the rock art rich area of south-central...

Geological analysis of paleozoic large-scale faulting in the south-central Pyrenees

OpenAIRE

Speksnijder, A.

1986-01-01

Detailed structural and sedimentological analysis reveals the existence of an east-west directed fundamental fault zone in the south-central Pyrenees, which has been intermittently active from (at least) the Devonian on. Emphasis is laid on the stUdy of fault-bounded post-Variscan (StephanoPermian) sedimentary basins, and the influence of Late Paleozoic faulting on the underlying Variscan basement. The present structure of the basement is rather complex as it results from multiple Variscan an...

Determining habitat potential and surveying for nine rare plant species in south-central Utah

Science.gov (United States)

Deborah J. Clark; Christine M. Groebner

2001-01-01

In south-central Utah, lands within and adjacent to Capitol Reef National Park contain populations of nine rare plant species. In an effort to enhance the combined knowledge about these species, the Bureau of Land Management, the USDA Forest Service, and the National Park Service signed an Interagency Agreement and hired an interagency biologist and field crew to...

CORRELATION BETWEEN SERVICE QUALITY AND PATIENT LOYALTY AT OUTPATIENT DEPARTMENT IN SPECIALITY EYE HOSPITAL OF SOUTH SUMATERA PROVINCE

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Adelina Fitri

2016-03-01

Full Text Available Background: The increasing number of hospitals in Indonesia, which is managed by the government and private demand to provide giving the level of care, professionalism and the maximum of competence to reflect the best quality of service. Quality gives special encouragement for company to understand customer expectations which in turn can increase customer satisfaction and create customer loyalty. The objective of the study is analyse correlation between service quality and patient loyalty Method: This study used a survey of analytical methods, with the cross-sectional approach. The samples in this study were patients who were treated in outpatient installation specialty eye hospital South Sumatera Province with total 102 people based on inclusion criteria. The Sampling was taken by proportions random sampling. The data analysis was performed in univariate and bivariate statistical fisher-exact test. The data were presented in p-value, prevalence ratio(PR and 95% confidence intervals (CI. Results: Generally 46.2% respondent who are loyal aged 41-64 years, 32.3% graduate from primary school and 80.6% have distance >5 KM from hospital. From the bivariate analyzes relating to patients loyalty in specialty eye hospital South Sumatera Province are access to services (95% CI 4.3 PR (1.293-14.300 and officer interaction with patients (95% CI 6.786 PR (2.140-21.515, whereas safety (95% CI PR 1.248(0.281-5.540, convenience (95% CI PR 4.136 (1.201-14.246 and waiting times (95% CI PR 1.951 (0.259-14.717 does not have a correlation with patient loyalty. Conclusion: The loyalty of patients in Specialty Eyes Hospital South Sumatera Province have been affected by access to services and officer interaction with the patient.

Three-dimensional geologic model of the Arbuckle-Simpson aquifer, south-central Oklahoma

Science.gov (United States)

Faith, Jason R.; Blome, Charles D.; Pantea, Michael P.; Puckette, James O.; Halihan, Todd; Osborn, Noel; Christenson, Scott; Pack, Skip

2010-01-01

The Arbuckle-Simpson aquifer of south-central Oklahoma encompasses more than 850 square kilometers and is the principal water resource for south-central Oklahoma. Rock units comprising the aquifer are characterized by limestone, dolomite, and sandstones assigned to two lower Paleozoic units: the Arbuckle and Simpson Groups. Also considered to be part of the aquifer is the underlying Cambrian-age Timbered Hills Group that contains limestone and sandstone. The highly faulted and fractured nature of the Arbuckle-Simpson units and the variable thickness (600 to 2,750 meters) increases the complexity in determining the subsurface geologic framework of this aquifer. A three-dimensional EarthVision (Trademark) geologic framework model was constructed to quantify the geometric relationships of the rock units of the Arbuckle-Simpson aquifer in the Hunton anticline area. This 3-D EarthVision (Trademark) geologic framework model incorporates 54 faults and four modeled units: basement, Arbuckle-Timbered Hills Group, Simpson Group, and post-Simpson. Primary data used to define the model's 54 faults and four modeled surfaces were obtained from geophysical logs, cores, and cuttings from 126 water and petroleum wells. The 3-D framework model both depicts the volumetric extent of the aquifer and provides the stratigraphic layer thickness and elevation data used to construct a MODFLOW version 2000 regional groundwater-flow model.

Palynological and iridium anomalies at Cretaceous-Tertiary boundary, south-central Saskatchewan

Science.gov (United States)

Nichols, D.J.; Jarzen, D.M.; Orth, C.J.; Oliver, P.Q.

1986-01-01

The Cretaceous-Tertiary boundary in south-central Saskatchewan is marked by coincident anomalies in abundance of iridium and fern spores at the extinction level of a suite of Cretaceous pollen taxa. Evidence of disruption of the terrestrial flora includes the fern-spore abundance anomaly and local extinction of as much as 30 percent of angiosperm species. The reorganized earliest Tertiary flora is made up largely of surviving species that assumed new roles of dominance. Persistence of climatically sensitive taxa across the boundary indicates that if paleoclimate was altered by the terminal Cretaceous event, it returned quickly to the pre-event condition.

Wind energy resource atlas. Volume 7. The south central region

Energy Technology Data Exchange (ETDEWEB)

Edwards, R.L.; Graves, L.F.; Sprankle, A.C.; Elliott, D.L.; Barchet, W.R.; George, R.L.

1981-03-01

This atlas of the south central region combines seven collections of wind resource data: one for the region, and one for each of the six states (Arkansas, Kansas, Louisiana, Missouri, Oklahoma, and Texas). At the state level, features of the climate, topography, and wind resource are discussed in greater detail than that provided in the regional discussion, and the data locations on which the assessment is based are mapped. Variations, over several time scales, in the wind resource at selected stations in each state are shown on graphs of monthly average and interannual wind speed and power, and hourly average wind speed for each season. Other graphs present speed, direction, and duration frequencies of the wind at these locations.

Hospital Nurses' Competencies in Disaster Situations: A Qualitative Study in the South of Brazil.

Science.gov (United States)

Marin, Sandra M; Witt, Regina R

2015-12-01

Introduction Hospital nurses play a key role in the aftermath of the occurrence of disasters and need specific competencies to work in these situations. From a global perspective, few models exist that focus on disaster nursing. This study aimed to identify hospital nurses' competencies in disaster situations. A qualitative, descriptive, exploratory study was developed using focus groups as a method of data collection. Three meetings were held from June through September 2012 with nurses who worked at a hospital used as reference for disaster situations in the South of Brazil. Thematic analysis of collected data generated the competencies. For statement standardization, a format consistent with a verb, a noun, and a complement was adopted. The group validated 17 competencies, which were organized according to the phases of emergency management described by the World Health Organization (WHO) and classified in domain areas of management, health care, communication, and education. The competencies identified in this study can contribute to the education and practice of nurses in the hospital ambience, strengthening its capacity to face disaster situations.

Safety climate and attitude toward medication error reporting after hospital accreditation in South Korea.

Science.gov (United States)

Lee, Eunjoo

2016-09-01

This study compared registered nurses' perceptions of safety climate and attitude toward medication error reporting before and after completing a hospital accreditation program. Medication errors are the most prevalent adverse events threatening patient safety; reducing underreporting of medication errors significantly improves patient safety. Safety climate in hospitals may affect medication error reporting. This study employed a longitudinal, descriptive design. Data were collected using questionnaires. A tertiary acute hospital in South Korea undergoing a hospital accreditation program. Nurses, pre- and post-accreditation (217 and 373); response rate: 58% and 87%, respectively. Hospital accreditation program. Perceived safety climate and attitude toward medication error reporting. The level of safety climate and attitude toward medication error reporting increased significantly following accreditation; however, measures of institutional leadership and management did not improve significantly. Participants' perception of safety climate was positively correlated with their attitude toward medication error reporting; this correlation strengthened following completion of the program. Improving hospitals' safety climate increased nurses' medication error reporting; interventions that help hospital administration and managers to provide more supportive leadership may facilitate safety climate improvement. Hospitals and their units should develop more friendly and intimate working environments that remove nurses' fear of penalties. Administration and managers should support nurses who report their own errors. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Animals′ Role in Proper Behaviour: Cheŵa Women′s Instructions in South-Central Africa

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Leslie F Zubieta

2016-01-01

Full Text Available The most common role of animals in the Cheŵa culture of south-central Africa is twofold: they are regarded as an important source of food, and they also provide raw materials for the creation of traditional medicines. Animals, however, also have a nuanced symbolic role that impacts the way people behave with each other by embodying cultural protocols of proper — and not so proper — behaviour. They appear repeatedly in storytelling and proverbs to reference qualities that people need to avoid or pursue and learn from the moral of the story in which animals interplay with each other, just as humans do. For example, someone who wants to prevent the consequences of greed is often advised to heed hyena stories and proverbs. My contribution elaborates on Brian Morris's instrumental work in south-central Africa, which has permitted us to elucidate the symbolism of certain animals and the perception of landscape for Indigenous populations in this region. I discuss some of the ways in which animals have been employed to teach and learn proper behaviour in a particular sacred ceremony of the Cheŵa people which takes place in celebration of womanhood: Chinamwali.

Lead in drinking water: sampling in primary schools and preschools in south central Kansas.

Science.gov (United States)

Massey, Anne R; Steele, Janet E

2012-03-01

Studies in Philadelphia, New York City, Houston, Washington, DC, and Greenville, North Carolina, have revealed high lead levels in drinking water. Unlike urban areas, lead levels in drinking water in suburban and rural areas have not been adequately studied. In the study described in this article, drinking water in primary schools and preschools in five suburban and rural south central Kansas towns was sampled to determine if any exceeded the U.S. Environmental Protection Agency (U.S. EPA) guidance level for schools and child care facilities of 20 parts per billion (ppb). The results showed a total of 32.1% of the samples had detectable lead levels and 3.6% exceeded the U.S. EPA guidance level for schools and child care providers of 20 ppb. These results indicate that about one-third of the drinking water consumed by children age six and under in the five suburban and rural south central Kansas towns studied has some lead contamination, exposing these children to both short-term and long-term health risks. The authors suggest a need for increased surveillance of children's drinking water in these facilities.

Clinical risk management in hospitals: strategy, central coordination and dialogue as key enablers.

Science.gov (United States)

Briner, Matthias; Manser, Tanja; Kessler, Oliver

2013-04-01

The study aims to identify key enablers fostering clinical risk management (CRM) in hospitals to guide health care in this vital area of patient safety. A cross-sectional survey was conducted at the national level in 324 Swiss hospitals in 2007-2008 to assess the relationship between key elements and systematic CRM. Therefore, a comprehensive monitoring instrument for CRM was used for the first time. Organizational factors (e.g. strategy, coordination, resources) and structural conditions (e.g. hospital size) were tested as key elements. CRM was assessed by evaluating its maturity (i.e. the level of CRM development) by 12 theoretically derived indices joining together essential aspects of CRM at the hospital level and the service level. Chi-square measures were used to analyse the relationships between organizational factors or structural conditions and maturity of CRM. Participation in this voluntary survey was good, with CRM experts of 138 out of 324 hospitals responding (response rate 43%). Three key enablers for CRM were identified: implementing a function for central CRM coordination, assuring dialogue with and between the different hospital services, and developing strategic CRM objectives. This study offers, for the first time, an assessment of the maturity of hospitals' CRM and identifies key enablers related to CRM. This is a feasible first step in guiding hospitals to shape their CRM and presents a basis for future studies, for example, linking CRM to outcome data. © 2012 Blackwell Publishing Ltd.

An examination of blood center structure and hospital customer satisfaction: what can centralized and decentralized blood centers learn from each other?

Science.gov (United States)

Carden, Robert; DelliFraine, Jami L

2005-01-01

The cost of blood and blood products has increased rapidly over the last several years while the supply of available blood donors has simultaneously decreased. Higher blood costs and donor shortages have put a strain on the relationship between blood suppliers and their hospital customers. This study examines the association between blood center centralization or decentralization and several aspects of hospital satisfaction. Centralized and decentralized blood centers have significant differences in various aspects of hospital customer satisfaction. Advantages and disadvantages of the two structures are discussed, as well as areas for future research.

Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. II. - August of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX II.- Agosto de 2001

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

2001-10-15

The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)0.

Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Julio de 2001

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A.; Vizuet G, J.; Benitez S, J. A

2001-09-15

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

Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. III. - September of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX III.- Septiembre de 2001

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A; Vizuet G, J; Benitez S, J A; Rodriguez A, F; Garcia A, J

2001-12-15

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

Two-tier charging in Maputo Central Hospital: costs, revenues and effects on equity of access to hospital services.

Science.gov (United States)

McPake, Barbara; Hongoro, Charles; Russo, Giuliano

2011-06-02

Special services within public hospitals are becoming increasingly common in low and middle income countries with the stated objective of providing higher comfort services to affluent customers and generating resources for under funded hospitals. In the present study expenditures, outputs and costs are analysed for the Maputo Central Hospital and its Special Clinic with the objective of identifying net resource flows between a system operating two-tier charging, and, ultimately, understanding whether public hospitals can somehow benefit from running Special Clinic operations. A combination of step-down and bottom-up costing strategies were used to calculate recurrent as well as capital expenses, apportion them to identified cost centres and link costs to selected output measures. The results show that cost differences between main hospital and clinic are marked and significant, with the Special Clinic's cost per patient and cost per outpatient visit respectively over four times and over thirteen times their equivalent in the main hospital. While the main hospital cost structure appeared in line with those from similar studies, salary expenditures were found to drive costs in the Special Clinic (73% of total), where capital and drug costs were surprisingly low (2 and 4% respectively). We attributed low capital and drug costs to underestimation by our study owing to difficulties in attributing the use of shared resources and to the Special Clinic's outsourcing policy. The large staff expenditure would be explained by higher physician time commitment, economic rents and subsidies to hospital staff. On the whole it was observed that: (a) the flow of capital and human resources was not fully captured by the financial systems in place and stayed largely unaccounted for; (b) because of the little consideration given to capital costs, the main hospital is more likely to be subsidising its Special Clinic operations, rather than the other way around. We conclude that the

Two-tier charging in Maputo Central Hospital: Costs, revenues and effects on equity of access to hospital services

Directory of Open Access Journals (Sweden)

Russo Giuliano

2011-06-01

Full Text Available Abstract Background Special services within public hospitals are becoming increasingly common in low and middle income countries with the stated objective of providing higher comfort services to affluent customers and generating resources for under funded hospitals. In the present study expenditures, outputs and costs are analysed for the Maputo Central Hospital and its Special Clinic with the objective of identifying net resource flows between a system operating two-tier charging, and, ultimately, understanding whether public hospitals can somehow benefit from running Special Clinic operations. Methods A combination of step-down and bottom-up costing strategies were used to calculate recurrent as well as capital expenses, apportion them to identified cost centres and link costs to selected output measures. Results The results show that cost differences between main hospital and clinic are marked and significant, with the Special Clinic's cost per patient and cost per outpatient visit respectively over four times and over thirteen times their equivalent in the main hospital. Discussion While the main hospital cost structure appeared in line with those from similar studies, salary expenditures were found to drive costs in the Special Clinic (73% of total, where capital and drug costs were surprisingly low (2 and 4% respectively. We attributed low capital and drug costs to underestimation by our study owing to difficulties in attributing the use of shared resources and to the Special Clinic's outsourcing policy. The large staff expenditure would be explained by higher physician time commitment, economic rents and subsidies to hospital staff. On the whole it was observed that: (a the flow of capital and human resources was not fully captured by the financial systems in place and stayed largely unaccounted for; (b because of the little consideration given to capital costs, the main hospital is more likely to be subsidising its Special Clinic

Radiated Seismic Energy of Earthquakes in the South-Central Region of the Gulf of California, Mexico

Science.gov (United States)

Castro, Raúl R.; Mendoza-Camberos, Antonio; Pérez-Vertti, Arturo

2018-05-01

We estimated the radiated seismic energy (ES) of 65 earthquakes located in the south-central region of the Gulf of California. Most of these events occurred along active transform faults that define the Pacific-North America plate boundary and have magnitudes between M3.3 and M5.9. We corrected the spectral records for attenuation using nonparametric S-wave attenuation functions determined with the whole data set. The path effects were isolated from the seismic source using a spectral inversion. We computed radiated seismic energy of the earthquakes by integrating the square velocity source spectrum and estimated their apparent stresses. We found that most events have apparent stress between 3 × 10-4 and 3 MPa. Model independent estimates of the ratio between seismic energy and moment (ES/M0) indicates that this ratio is independent of earthquake size. We conclude that in general the apparent stress is low (σa < 3 MPa) in the south-central and southern Gulf of California.

Cefazolin high-inoculum effect in methicillin-susceptible Staphylococcus aureus from South American hospitals.

Science.gov (United States)

Rincón, Sandra; Reyes, Jinnethe; Carvajal, Lina Paola; Rojas, Natalia; Cortés, Fabián; Panesso, Diana; Guzmán, Manuel; Zurita, Jeannete; Adachi, Javier A; Murray, Barbara E; Nannini, Esteban C; Arias, Cesar A

2013-12-01

Clinical failures with cefazolin have been described in high-inoculum infections caused by methicillin-susceptible Staphylococcus aureus (MSSA) producing type A β-lactamase. We investigated the prevalence of the cefazolin inoculum effect (InE) in MSSA from South American hospitals, since cefazolin is used routinely against MSSA due to concerns about the in vivo efficacy of isoxazolyl penicillins. MSSA isolates were recovered from bloodstream (n = 296) and osteomyelitis (n = 68) infections in two different multicentre surveillance studies performed in 2001-02 and 2006-08 in South American hospitals. We determined standard-inoculum (10(5)cfu/mL) and high-inoculum (10(7) cfu/mL) cefazolin MICs. PFGE was performed on all isolates that exhibited a cefazolin InE. Multilocus sequence typing (MLST) and sequencing of part of blaZ were performed on representative isolates. The overall prevalence of the cefazolin InE was 36% (131 isolates). A high proportion (50%) of MSSA isolates recovered from osteomyelitis infections exhibited the InE, whereas it was observed in 33% of MSSA recovered from bloodstream infections. Interestingly, Ecuador had the highest prevalence of the InE (45%). Strikingly, 63% of MSSA isolates recovered from osteomyelitis infections in Colombia exhibited the InE. MLST revealed that MSSA isolates exhibiting the InE belonged to diverse genetic backgrounds, including ST5, ST8, ST30 and ST45, which correlated with the prevalent methicillin-resistant S. aureus clones circulating in South America. Types A (66%) and C (31%) were the most prevalent β-lactamases. Our results show a high prevalence of the cefazolin InE associated with type A β-lactamase in MSSA isolates from Colombia and Ecuador, suggesting that treatment of deep-seated infections with cefazolin in those countries may be compromised.

Prevalencia de displasia y cáncer cervicouterino y factores asociados en el Hospital Central de Chihuahua, México

OpenAIRE

Ivonne Salas-Urrutia; Eyra Alejandra Villalobos; Brenda Lizeth Ramírez-Vega

2006-01-01

Objetivos: Los objetivos del presente estudio fueron determinar la prevalencia y los factores de riesgo asociados a cáncer cervicouterino en; las mujeres que acuden al Hospital Central de Chihuahua en el 2004 ya que no se cuenta registros de esta entidad en la ciudad de Chihuahua.; Material y Métodos: Se realizó un estudio observacional, transversal, donde se incluyó a mujeres que demandaron realizarse la citología; cervical en el Hospital Central del Estado de Chihuahua, en el año 2...

A RETROSPECTIVE ANALYSIS OF ACUTE APPENDICITIS, RUPTURED APPENDICITIS AND THE LEVEL OF LEUKOCYTOSIS IN PAEDIATRIC SURGICAL PATIENTS OF NELSON MANDELA CENTRAL HOSPITAL.

Science.gov (United States)

Mtimba, L; Dhaffala, A; Molaoa, S Z

2017-06-01

Appendicectomy is the most commonly performed operation worldwide. The diagnosis is predominantly based on clinical findings. Some patients will clinically be unclear if ruptured or acute inflamed appendicitis; the level of white cell count has been used as the predictor for ruptured appendicitis. This was a retrospective chart review of paediatric surgical patients admitted at Nelson Mandela Central Hospital, Mthatha South Africa. A total of 214 patients with a diagnosis of acute appendicitis. Overall, the ruptured appendicitis was 62% and 38% were inflamed appendicitis. Nature of the acute appendicitis: White cell count, Inflamed, Ruptured, Total p-value 30 0 4 4. This study has demonstrated that in patients who are diagnosed with acute appendicitis clinically, the normal white cell count does not necessarily rule out ruptured acute appendicitis. But the risks of ruptured acute appendicitis increase with the increase level of white cell count.

Beyond the bundle: a survey of central line-associated bloodstream infection prevention practices used in US and Canadian pediatric hospitals.

Science.gov (United States)

Klieger, Sarah B; Potter-Bynoe, Gail; Quach, Caroline; Sandora, Thomas J; Coffin, Susan E

2013-11-01

We surveyed US and Canadian pediatric hospitals about their use of central line-associated bloodstream infection (CLABSI) prevention strategies beyond typical insertion and maintenance bundles. We found wide variation in supplemental strategies across hospitals and in their penetration within hospitals. Future studies should assess specific adjunctive prevention strategies and CLABSI rates.

Spectra of the earthquake sequence February-March, 1981, in south-central Sweden

OpenAIRE

O. Kulhánek; T. van Eck; N. John; K. Meyer; Rutger Wahlström

1983-01-01

On February 13, 1981, a relatively strong earthquake occurred in the Lake Vanern region in south-central Sweden. The shock had a magnitude of M"SUB L" = 3.3 and was followed within three weeks by three aftershocks, with magnitudes 0.5 = or < M"SUB L" = or < 1.0. The focal mechanism solution of the main shock indicates reverse faulting with a strike in the N-S or NE-SW direction and a nearly horizontal compressional stress. The aftershocks were too small to yield data for a full mechanism solu...

An essential hospital package for South Africa--selection criteria, costs and affordability.

Science.gov (United States)

Söderlund, N

1999-07-01

In 1995 the Committee of Enquiry into National Health Insurance (NHI) recommended that formally employed individuals and their employers be required to fund at least a minimum package of hospital cover for workers and their dependents. This has recently been echoed in a Department of Health policy paper on social health insurance. This research aims to define and cost a minimum package of essential hospital care for competing (public and private) health insurers in South Africa. CRITERIA FOR PACKAGE DEFINITION: Based on the objectives implict in the NHI Committee report, the following criteria were used to define the essential package: (i) the extent to which there was another appropriate responsible party who should pay for treatment; (ii) the degree of discretion in deciding whether or not to provide treatment (roughly equivalent to 'urgency'); and (iii) the cost and effectiveness of treatment. On the basis of the above criteria, 396 out of 598 possible interventions were included in the package. Using local mine hospital and private sector utilisation rates and mine hospital cost data, it was estimated that the essential inpatient package would cost around R502 per enrollee per year, using 1998 prices, for a working age population and their dependents. Age-sex standardised outpatient care costs in the mine hospital population studied were estimated at R183 per person per year. It was therefore estimated that the total inpatient and outpatient hospital package would cost around R685 per person per year. The results presented in this paper are intended to inform the process of defining a national essential hospital benefit package. Assuming that contributions were proportionally related to income, and that costs should not exceed 6% of wages, the package should be affordable to all of those earning above R20,000 per year. Significant additional work is required, firstly at a technical level to assess the appropriateness of the prioritization approach used here

Post-traumatic stress disorder among paramedic and hospital emergency personnel in south-east Iran

Institute of Scientific and Technical Information of China (English)

Sedigheh Iranmanesh; Batool Tirgari; Hojat Sheikh Bardsiri

2013-01-01

BACKGROUND:Paramedic and emergency personnel may encounter directly many events that threat their own wellbeing during their daily work.This study was conducted to examine the prevalence rate of post-traumatic stress disorder(PTSD) among two groups of paramedic and emergency personnel in south-east Iran.METHODS:The study employed a descriptive design and was conducted in four hospital emergency wards and a pre-hospital emergency base supervised by Kerman Medical University.Using Mississippi PTSD,we assessed the prevalence rate in paramedics(n=150) and emergency personnel(n=250).RESULTS:The two groups had different levels of education,marital status,experience of traumatic events,work hours per month,and gender.Most(94%) of paramedic and hospital emergency personnel reported moderate PTSD.The two groups had significant different levels of PTSD in all subscale.CONCLUSION:The study suggests that health care managers should organize systematic and dynamic policies and procedures in dealing with PTSD to assist both groups of personnel.

The spectrum of central nervous system infections in an adult referral hospital in hanoi, Vietnam

NARCIS (Netherlands)

Taylor, Walter R.; Nguyen, Kinh; Nguyen, Duc; Nguyen, Huyen; Horby, Peter; Nguyen, Ha L.; Lien, Trinh; Tran, Giang; Tran, Ninh; Nguyen, Ha M.; Nguyen, Thai; Nguyen, Ha H.; Nguyen, Thanh; Tran, Giap; Farrar, Jeremy; de Jong, Menno; Schultsz, Constance; Tran, Huong; Nguyen, Diep; Vu, Bich; Le, Hoa; Dao, Trinh; Nguyen, Trung; Wertheim, Heiman

2012-01-01

To determine prospectively the causative pathogens of central nervous system (CNS) infections in patients admitted to a tertiary referral hospital in Hanoi, Vietnam. From May 2007 to December 2008, cerebrospinal fluid (CSF) samples from 352 adults with suspected meningitis or encephalitis underwent

To relieve the sufferings of humanity, irrespective of party, politics or creed?: conflict, consensus and voluntary hospital provision in Edwardian South Wales.

Science.gov (United States)

Thompson, Steven

2003-08-01

This article examines the provision of voluntary hospital facilities for injured workers in the mining valleys of Edwardian South Wales. It considers the co-operation and conflict that characterized efforts to establish hospitals, and examines the attitudes and activities of workers, employers, and other interested groups. Despite certain instances of disagreement and conflict, this article demonstrates the significant levels of co-operation and consensus that characterized the efforts of employers and workers to provide communities with hospital facilities. This co-operation was perhaps surprising considering the bitter industrial conflict and social unrest of that period. The article uses this material to question assertions that hospitals reflect the social and political milieus of the communities in which they were situated and argues that the social relations produced by hospital provision sometimes coincided with wider social and industrial relations, but at other times differed from them or transcended them. Furthermore, the article demonstrates that the co-operation between employers and workers in the provision of hospitals in Edwardian South Wales did not stabilize social and industrial relations in the way that historians of associational voluntarism in other contexts have found.

Book review: Vetter, H. 2005. Terralog. Turtles of the World. Vol. 3. Central and South America

Directory of Open Access Journals (Sweden)

2006-12-01

Full Text Available Book review: Vetter, H. 2005. Terralog. Turtles of the World. Vol. 3. Central and South America/Schildkröten der Welt Band 3. Mittel- und Südamerika: 1-128, color pictures 606 + 9. Edition Chimaira, Frankfurt, Germany.ISBN 3-930612-82-8; 29.7 x 20.8 cm

River profile response to normal fault growth and linkage: an example from the Hellenic forearc of south-central Crete, Greece

Science.gov (United States)

Gallen, Sean F.; Wegmann, Karl W.

2017-02-01

Topography is a reflection of the tectonic and geodynamic processes that act to uplift the Earth's surface and the erosional processes that work to return it to base level. Numerous studies have shown that topography is a sensitive recorder of tectonic signals. A quasi-physical understanding of the relationship between river incision and rock uplift has made the analysis of fluvial topography a popular technique for deciphering relative, and some argue absolute, histories of rock uplift. Here we present results from a study of the fluvial topography from south-central Crete, demonstrating that river longitudinal profiles indeed record the relative history of uplift, but several other processes make it difficult to recover quantitative uplift histories. Prior research demonstrates that the south-central coastline of Crete is bound by a large ( ˜ 100 km long) E-W striking composite normal fault system. Marine terraces reveal that it is uplifting between 0.1 and 1.0 mm yr-1. These studies suggest that two normal fault systems, the offshore Ptolemy and onshore South-Central Crete faults, linked together in the recent geologic past (ca. 0.4-1 My BP). Fault mechanics predict that when adjacent faults link into a single fault the uplift rate in footwalls of the linkage zone will increase rapidly. We use this natural experiment to assess the response of river profiles to a temporal jump in uplift rate and to assess the applicability of the stream power incision model to this setting. Using river profile analysis we show that rivers in south-central Crete record the relative uplift history of fault growth and linkage as theory predicts that they should. Calibration of the commonly used stream power incision model shows that the slope exponent, n, is ˜ 0.5, contrary to most studies that find n ≥ 1. Analysis of fluvial knickpoints shows that migration distances are not proportional to upstream contributing drainage area, as predicted by the stream power incision model

Chart review of acute myocardial infarction at a district hospital in KwaZulu-Natal, South Africa

Directory of Open Access Journals (Sweden)

Roland Chetty

2016-03-01

Full Text Available Background: Incidence and prevalence of non-communicable diseases, including ischaemic heart disease (IHD and associated acute myocardial infarction (AMI, are increasing in South Africa. Local studies are needed as contextual factors, such as healthcare systems, gender and ethnicity, may affect presentation and management. In AMI, reviews on time between onset of chest pain and initiation of urgent treatment are useful, as delays in initiation of thrombolytic treatment significantly increase morbidity and mortality. Aim: The aim of the study was to determine the profile and management of patients admitted with ischaemic chest pain.Setting: The study was carried out in a busy urban-based district hospital in KwaZulu-Natal, South Africa. The population served is poor, and patients are mainly Indian with associated high risk of IHD. Methods: A chart review of all patients seen at the hospital with acute ischaemic chest pain between 01 March and 31 August 2014 was undertaken. Results: More male than female patients were admitted, with a wide variation in age. Most eligible patients received required thrombolytic intervention within an acceptable time period after arrival at hospital. Conclusion: Chest pain and AMI were a relatively common presentation at the study site, and urgent diagnosis and initiation of fibrinolytic therapy are essential. The encouraging door-toneedle time may have been influenced by the availability of specialist family physicians, trained as ‘expert generalists’ to provide appropriate care in a variety of settings and consultant support to junior staff. The role of the family physician and primary healthcare doctor in primary prevention are re-emphasised through the study findings. Keywords: Acute myocardial infarction; KwaZulu-Natal; district hospital; Asian population; hospital chart review; door-to-needle-time

E-health readiness assessment for e-health framework for Africa: a case study of hospitals in South Africa

CSIR Research Space (South Africa)

Coleman, A

2011-11-01

Full Text Available This study assessed e-healthcare readiness of rural and urban hospitals in North West Province of South Africa. Outcome of assessment led to creation of e-health architectural framework for e-health solutions. Assessment was conducted in usage...

Fire and climate suitability for woody vegetation communities in the south central United States

Science.gov (United States)

Stroh, Esther; Struckhoff, Matthew; Stambaugh, Michael C.; Guyette, Richard P.

2018-01-01

Climate and fire are primary drivers of plant species distributions. Long-term management of south central United States woody vegetation communities can benefit from information on potential changes in climate and fire frequencies, and how these changes might affect plant communities. We used historical (1900 to 1929) and future (2040 to 2069 and 2070 to 2099) projected climate data for the conterminous US to estimate reference and future fire probabilities

Effects of projected climate (2011–50) on karst hydrology and species vulnerability—Edwards aquifer, south-central Texas, and Madison aquifer, western South Dakota

Science.gov (United States)

Mahler, Barbara J.; Stamm, John F.; Poteet, Mary F.; Symstad, Amy J.; Musgrove, MaryLynn; Long, Andrew J.; Norton, Parker A.

2015-12-22

Karst aquifers—formed by the dissolution of soluble rocks such as limestone—are critical groundwater resources in North America, and karst springs, caves, and streams provide habitat for unique flora and fauna. Springflow and groundwater levels in karst terrane can change greatly over short time scales, and therefore are likely to respond rapidly to climate change. How might the biological communities and ecosystems associated with karst respond to climate change and accompanying changes in groundwater levels and springflow? Sites in two central U.S. regions—the Balcones Escarpment of south-central Texas and the Black Hills of western South Dakota (fig. 1)—were selected to study climate change and its potential effects on the local karst hydrology and ecosystem. The ecosystems associated with the Edwards aquifer (Balcones Escarpment region) and Madison aquifer (Black Hills region) support federally listed endangered and threatened species and numerous State-listed species of concern, including amphibians, birds, insects, and plants. Full results are provided in Stamm and others (2014), and are summarized in this fact sheet.

Cave-dwelling bats (Mammalia: Chiroptera) and conservation concerns in South central Mindanao, Philippines

OpenAIRE

Krizler C. Tanalgo; John Aries G. Tabora

2015-01-01

The stable microclimate in caves provides a relatively constant habitat for many bat species in the Philippines, but human encroachment continues to disrupt this habitat and imperil many of the species roosting in the caves.  In South central Mindanao, the diversity and conservation status of cave bats remain undocumented and unexplored.  We employed mist-netting to capture bats from five different caves within the town of Kabacan, northern Cotabato, Philippines.  A total of 14 bat species we...

Tree species composition and structure in an old bottomland hardwood forest in south-central Arkansas

Science.gov (United States)

Brian Roy Lockhart; James M. Guldin; Thomas Foti

2010-01-01

Tree species composition and structure was determined for an old bottomland hardwood forest located in the Moro Creek Bottoms Natural Area in south-central Arkansas. Diversity for this forest was high with species richness ranging from 33 for the overstory and sapling strata to 26 for the seedling stratum and Shannon-Weiner values of 2.54 to 1.02 for the overstory and...

The effect of a local source on the composition of precipitation in south-central Maine

Science.gov (United States)

Scott D. Boyce; Samuel S. Butcher

1976-01-01

Bulk precipitation samples were collected from ten sites in south-central Maine during the period 18 June to 30 September 1974. Data from the chemical analyses of the precipitation were used to determine regional deposition patterns of the ionic constituents. Acidic pH values ranging from 3.8 to 5.0 are characteristic of the region, but relatively alkaline pH values of...

Seizure-related hospital admissions, readmissions and costs: Comparisons with asthma and diabetes in South Australia.

Science.gov (United States)

Bellon, Michelle L; Barton, Christopher; McCaffrey, Nikki; Parker, Denise; Hutchinson, Claire

2017-08-01

Seizures are listed as an Ambulatory Care Sensitive Condition (ACSC), where, in some cases, hospitalisation may be avoided with appropriate preventative and early management in primary care. We examined the frequencies, trends and financial costs of first and subsequent seizure-related hospital admissions in the adult and paediatric populations, with comparisons to bronchitis/asthma and diabetes admissions in South Australia between 2012 and 2014. De-identified hospital separation data from five major public hospitals in metropolitan South Australia were analysed to determine the number of children and adults admitted for the following Australian Refined Diagnosis Related Groups: seizure related conditions; bronchitis/asthma; and diabetes. Additional data included length of hospital stay and type of admission. Demographic data were analysed to identify whether social determinants influence admission, and a macro costing approach was then applied to calculate the financial costs to the Health Care System. The rate of total seizure hospitalizations was 649 per 100,000; lower than bronchitis/asthma (751/100,000), yet higher than diabetes (500/100,000). The highest proportions of subsequent separations were recorded by children with seizures regardless of complexity (47% +CSCC; 17% -CSCC) compared with asthma (11% +CSCC; 14% -CSCC) or diabetes (14% +CSCC; 13% -CSCC), and by adults with seizures with catastrophic or severe complications/comorbidity (25%), compared with diabetes (22%) or asthma (14%). The mean cost per separation in both children and adults was highest for diabetes (AU$4438/$7656), followed by seizures (AU$2408/$5691) and asthma (AU$2084/$3295). Following the lead of well-developed and resourced health promotion initiatives in asthma and diabetes, appropriate primary care, community education and seizure management services (including seizure clinics) should be targeted in an effort to reduce seizure related hospitalisations which may be avoidable

Correlation of proterozoic sediments of Western and Central Africa and South America based upon radiochronological and paleontological data

International Nuclear Information System (INIS)

Bonhomme, M.G.

1982-01-01

Nearly 70 new Rb-Sr isochron ages and many K-Ar conventional ages have been determined between 1975 and 1980 on Proterozoic sedimentary or metasedimentary sequences in western and Central Africa and South America. Some stratigraphic results have been established: (1) five formations have been dated of the Lower Proterozoic; (2) a long sedimentation gap occurs, mainly in western Africa and in some regions of Central Africa and South America between nearly 1600 and 1100 Ma; (3) the upper Riphean assemblages of stromatolites have been dated and compared to those of the Eurasian craton; (4) two main glacial events have been dated, the first one placed at ca. 950 Ma, the second during the Vendian, at ca. 650-620 Ma; (5) it can be stated that, when applied to Precambrian sequences, all stratigraphic methods must be used together. (Auth.)

Spatial Modeling Of Infant Mortality Rate In South Central Timor Regency Using GWLR Method With Adaptive Bisquare Kernel And Gaussian Kernel

Directory of Open Access Journals (Sweden)

Teguh Prawono Sabat

2017-08-01

Full Text Available Geographically Weighted Logistic Regression (GWLR was regression model consider the spatial factor, which could be used to analyze the IMR. The number of Infant Mortality as big as 100 cases in 2015 or 12 per 1000 live birth in South Central Timor Regency. The aim of this study was to determine the best modeling of GWLR with fixed weighting function and Adaptive Gaussian Kernel in the case of infant mortality in South Central Timor District in 2015. The response variable (Y in this study was a case of infant mortality, while variable predictor was the percentage of neonatal first visit (KN1 (X1, the percentage of neonatal visit 3 times (Complete KN (X2, the percentage of pregnant get Fe tablet (X3, percentage of poor families pre prosperous (X4. This was a non-reactive study, which is a measurement which individuals surveyed did not realize that they are part of a study, with analysis unit in 32 sub-districts of South Central Timor Districts. Data analysis used open source program that was Excel, R program, Quantum GIS and GWR4. The best GWLR spatial modeling with Adaptive Gaussian Kernel weighting function, a global model parameters GWLR Adaptive Gaussian Kernel weighting function obtained by g (x = 0.941086 - 0,892506X4, GWLR local models with adaptive Kernel bisquare weighting function in the 13 Districts were obtained g(x = 0 − 0X4, factors that affect the cases of infant mortality in 13 sub-districts of South Central Timor Regency in 2015 was the percentage of poor families pre prosperous.

Diet, dietary selectivity and density of South American grey fox, Lycalopex griseus, in Central Chile.

Science.gov (United States)

Muñoz-Pedreros, Andrés; Yáñez, José; Norambuena, Heraldo V; Zúñiga, Alfredo

2018-01-01

The South American grey fox Lycalopex griseus is a canid widely distributed in southern South America; however, some aspects of its biology are still poorly known. We studied the diet and density of L. griseus in the Lago Peñuelas Biosphere Reserve, in Central Chile. The trophic niche breadth was B = 6.16 (B sta = 0.47) and prey diversity was H' = 2.46 (H max ' = 3.17, J' = 0.78). The highest proportions of prey consumed in the diet were Oryctolagus cuniculus (52.21%) and other mammals (32.78%). We compared these results with a latitudinal gradient of diet results for this species in Chile. L. griseus eats mostly mammals (>90% of total prey), consuming the rodent Phyllotis darwini and reptiles in the northern zone; Oryctolagus cuniculus, Octodon degus and Abrocoma bennetti in the central zone; Abrothrix spp. and lagomorphs in the southern zone; and Lepus capensis and Ovis aries in the austral zone. The estimated density of L. griseus in Lago Peñuelas NR was 1.3 foxes/km 2 . © 2017 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

Anti-N-methyl-d-aspartate receptor encephalitis in children of Central South China: Clinical features, treatment, influencing factors, and outcomes.

Science.gov (United States)

Wang, Ying; Zhang, Weixi; Yin, Jinghua; Lu, Qianjin; Yin, Fei; He, Fang; Peng, Jing

2017-11-15

We analyzed the clinical manifestations of children with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis in Central South China and the factors influencing the effectiveness of treatment. A retrospective study of children (0-14years old) with anti-NMDAR encephalitis in Central South China was carried out from March 2014 to November 2016. Demographics, clinical features, treatment, outcome, and the factors influencing the effectiveness of treatment were reviewed. Fifty-one patients with anti-NMDAR encephalitis were enrolled (age from 4months to 14years old; median age, 8years; 30 females). Forty-five patients (88%) presented with psychiatric symptoms, 40 (78%) with dyskinesia and movement disorders, 39 (77%) with sleep disturbances, 34 (67%) with seizures, 30 (59%) with a decreased level of consciousness (Glasgow scoreanti-NMDAR encephalitis in Central South China. Patients with decreased consciousness, PICU stay and autonomic instability were more likely to have no or limited response to first-line immunotherapy and to require second-line or even more aggressive immunotherapy. Children with anti-NMDAR encephalitis in China have a much lower incidence of tumors, lower mortality rates, and a lower proportion of lethal autonomic instability than adults. Copyright © 2017 Elsevier B.V. All rights reserved.

Pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South East Nigeria

OpenAIRE

Osuji, Charles Ukachukwu; Onwubuya, Emmanuel Ikechukwu; Ahaneku, Gladys Ifesinachi; Omejua, Emeka Godwin

2014-01-01

Introduction Cardiovascular disease (CVD) is one of the top killer diseases in the world sparing neither developed or developing countries. The study was carried out to determine the pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi South East Nigeria. Methods The study was a retrospective study covering the period January 2007 to December 2009. SPSS version 13 software was used to analyze data. Results 537 (15%) patients were admitted into the study ou...

Journal of Genetics | Indian Academy of Sciences

Indian Academy of Sciences (India)

Department of Geriatrics, econd Xiangya Hospital, Central South University, Changsha, Hunan 410011, People's Republic of China; Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, People's Republic of China; Department of Neurology, Second Xiangya Hospital, Central ...

Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - May-June of 2003; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Mayo-Junio de 2003

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A.; Camacho V, B.; Rodriguez A, F

2003-09-15

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

A multi-criteria assessment of scenarios on thermal processing of infectious hospital wastes: A case study for Central Macedonia

International Nuclear Information System (INIS)

Karagiannidis, A.; Papageorgiou, A.; Perkoulidis, G.; Sanida, G.; Samaras, P.

2010-01-01

In Greece more than 14,000 tonnes of infectious hospital waste are produced yearly; a significant part of it is still mismanaged. Only one off-site licensed incineration facility for hospital wastes is in operation, with the remaining of the market covered by various hydroclave and autoclave units, whereas numerous problems are still generally encountered regarding waste segregation, collection, transportation and management, as well as often excessive entailed costs. Everyday practices still include dumping the majority of solid hospital waste into household disposal sites and landfills after sterilization, still largely without any preceding recycling and separation steps. Discussed in the present paper are the implemented and future treatment practices of infectious hospital wastes in Central Macedonia; produced quantities are reviewed, actual treatment costs are addressed critically, whereas the overall situation in Greece is discussed. Moreover, thermal treatment processes that could be applied for the treatment of infectious hospital wastes in the region are assessed via the multi-criteria decision method Analytic Hierarchy Process. Furthermore, a sensitivity analysis was performed and the analysis demonstrated that a centralized autoclave or hydroclave plant near Thessaloniki is the best performing option, depending however on the selection and weighing of criteria of the multi-criteria process. Moreover the study found that a common treatment option for the treatment of all infectious hospital wastes produced in the Region of Central Macedonia, could offer cost and environmental benefits. In general the multi-criteria decision method, as well as the conclusions and remarks of this study can be used as a basis for future planning and anticipation of the needs for investments in the area of medical waste management.

Psychiatric hospital beds and prison populations in South America since 1990: does the Penrose hypothesis apply?

Science.gov (United States)

Mundt, Adrian P; Chow, Winnie S; Arduino, Margarita; Barrionuevo, Hugo; Fritsch, Rosemarie; Girala, Nestor; Minoletti, Alberto; Mitkiewicz, Flávia; Rivera, Guillermo; Tavares, María; Priebe, Stefan

2015-02-01

In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose hypothesized that the numbers of psychiatric hospital beds and the sizes of prison populations were inversely related; 75 years later, the question arises as to whether the hypothesis applies to recent developments in South America. To explore the possible association of changes in the numbers of psychiatric hospital beds with changes in the sizes of prison populations in South America since 1990. We searched primary sources for the numbers of psychiatric hospital beds in South American countries since 1990 (the year that the Latin American countries signed the Caracas Declaration) and compared these changes against the sizes of prison populations. The associations between the numbers of psychiatric beds and the sizes of prison populations were tested using fixed-effects regression of panel data. Economic variables were considered as covariates. Sufficiently reliable and complete data were obtained from 6 countries: Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay. The numbers of psychiatric beds and the sizes of prison populations. Since 1990, the numbers of psychiatric beds decreased in all 6 countries (ranging from -2.0% to -71.9%), while the sizes of prison populations increased substantially (ranging from 16.1% to 273.0%). Panel data regression analysis across the 6 countries showed a significant inverse relationship between numbers of psychiatric beds and sizes of prison populations. On average, the removal of 1 bed was associated with 5.18 more prisoners (95% CI, 3.10-7.26; P = .001), which was reduced to 2.78 prisoners (95% CI, 2.59-2.97; P prison populations remained practically unchanged when income inequality was considered as a covariate (-4.28 [95% CI, -5.21 to -3.36]; P prison populations have increased against a background of strong economic growth. The changes appear to be associated because the numbers of beds decreased more extensively when and

Positions, Dispositions and Practices in Education Policy in Central and South East Europe (Research in Progress)

Science.gov (United States)

Kos Kecojevic, Živa; Gaber, Slavko

2012-01-01

In the article, we present the conceptualisation and selected results of ongoing research dealing with the particular area of top decision making in education in Central and South East Europe. Aiming at a Bourdieuian type of objectification of key agents of decision making in education--ministers--a group of researchers from the region is in the…

Landscape scale attributes of elk centers of activity in the central Black Hills of South Dakota

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Cynthia H. Stubblefield; Kerri T. Vierling; Mark A. Rumble

2006-01-01

We researched the environmental attributes (n = 28) associated with elk (n = 50) summer range (1 May ­30 Sep) in the central Black Hills of South Dakota, USA, during 1998-­2001. We defined high-use areas or centers of activity as landscapes underlying large concentrations of elk locations resulting from the shared fidelity of...

North–south palaeohydrological contrasts in the central Mediterranean during the Holocene: tentative synthesis and working hypotheses

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M. Magny

2013-09-01

Full Text Available On the basis of a multi-proxy approach and a strategy combining lacustrine and marine records along a north–south transect, data collected in the central Mediterranean within the framework of a collaborative project have led to reconstruction of high-resolution and well-dated palaeohydrological records and to assessment of their spatial and temporal coherency. Contrasting patterns of palaeohydrological changes have been evidenced in the central Mediterranean: south (north of around 40° N of latitude, the middle part of the Holocene was characterised by lake-level maxima (minima, during an interval dated to ca. 10 300–4500 cal BP to the south and 9000–4500 cal BP to the north. Available data suggest that these contrasting palaeohydrological patterns operated throughout the Holocene, both on millennial and centennial scales. Regarding precipitation seasonality, maximum humidity in the central Mediterranean during the middle part of the Holocene was characterised by humid winters and dry summers north of ca. 40° N, and humid winters and summers south of ca. 40° N. This may explain an apparent conflict between palaeoclimatic records depending on the proxies used for reconstruction as well as the synchronous expansion of tree species taxa with contrasting climatic requirements. In addition, south of ca. 40° N, the first millennium of the Holocene was characterised by very dry climatic conditions not only in the eastern, but also in the central- and the western Mediterranean zones as reflected by low lake levels and delayed reforestation. These results suggest that, in addition to the influence of the Nile discharge reinforced by the African monsoon, the deposition of Sapropel 1 has been favoured (1 by an increase in winter precipitation in the northern Mediterranean borderlands, and (2 by an increase in winter and summer precipitation in the southern Mediterranean area. The climate reversal following the Holocene climate optimum appears to

We are family? Spanish law and lesbian normalization in Hospital Central.

Science.gov (United States)

Calvo, Mónica; Escudero, Maite

2009-01-01

After four decades of a repressive dictatorial regime during which homosexuality was banned and punished with prison sentence and electroshock, Spain became a democratic country in 1978. The social, political, and legal debates previous to the passing of the law on same-sex marriage in June 2005 fueled lesbian visibility in the media. Considering that the emergence of lesbian representation has been linked to these social and political changes, our contribution centers on the ways in which the prime time TV series Hospital Central unravels as a vehicle for the normalization of lesbian relationships and families as addressed to a mostly heterosexual audience.

Prescribing Albumin in a Central Hospital. New Standards versus Old Habits

OpenAIRE

Pasini, J; Marcelino, P

2012-01-01

O presente estudo teve como objectivo aferir a adequação da prescrição de albumina humana num hospital central à evidência científica nesta área actualmente disponível. O estudo foi retrospectivo e analisou os pedidos de albumina aos serviços farmacêuticos entre Setembro de 2007 e Agosto de 2008. Analisadas 761 requisições de 619 doentes com idade média de 58,1 +/- 14,7 anos, 510 (77%) dos quais do sexo masculino. Foram avaliados parâmetros analíticos globais (proteínas totais, album...

Geologic map of the Alamosa 30’ × 60’ quadrangle, south-central Colorado

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Thompson, Ren A.; Shroba, Ralph R.; Michael N. Machette,; Fridrich, Christopher J.; Brandt, Theodore R.; Cosca, Michael A.

2015-10-15

The Alamosa 30'× 60' quadrangle is located in the central San Luis Basin of southern Colorado and is bisected by the Rio Grande. The Rio Grande has headwaters in the San Juan Mountains of Colorado and ultimately discharges into the Gulf of Mexico 3,000 kilometers (km) downstream. Alluvial floodplains and associated deposits of the Rio Grande and east-draining tributaries, La Jara Creek and Conejos River, occupy the north-central and northwestern part of the map area. Alluvial deposits of west-draining Rio Grande tributaries, Culebra and Costilla Creeks, bound the Costilla Plain in the south-central part of the map area. The San Luis Hills, a northeast-trending series of flat-topped mesas and hills, dominate the landscape in the central and southwestern part of the map and preserve fault-bound Neogene basin surfaces and deposits. The Precambrian-cored Sangre de Cristo Mountains rise to an elevation of nearly 4,300 meters (m), almost 2,000 m above the valley floor, in the eastern part of the map area. In total, the map area contains deposits that record surficial, tectonic, sedimentary, volcanic, magmatic, and metamorphic processes over the past 1.7 billion years.

Development of nutrition standards and therapeutic diet specifications for public hospitals in New South Wales.

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Williams, Peter; Hazlewood, Tanya; Pang, Glen

2014-09-01

In New South Wales (NSW), a new suite of nutrition standards for menus and specifications for therapeutic diets to be used in hospitals has been developed. These standards were required to facilitate centralised menu planning and food production, with the move to management of most hospital food services by HealthShare NSW, a state-wide business unit of NSW Health. The standards also aim to improve communication between health professionals, particularly with the increasing use of computerised meal-ordering systems. Nutrition standards have been developed for adult, paediatric and mental health inpatients, and specifications for 147 different adult and paediatric therapeutic diets. There is still significant variation in the nutrition standards for nutrition and therapeutic diets in hospitals across the Australian states, and a move to a more nationally harmonised approach would be welcome. Further research is required to examine the impact of these standards on operating efficiency and patient care outcomes.

Specialized consultant in radiological safety to the clinical north central hospital of high speciality, PEMEX. IV. - December of 2001; Asesoria especializada en seguridad radiologica a la clinica hospital central norte de alta especialidad, PEMEX. IV.- Diciembre de 2001

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

2002-01-15

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

Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.

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Nghia Ho Dang Trung

Full Text Available Infectious diseases of the central nervous system (CNS remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52% of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24% and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%. Mycobacterium tuberculosis was confirmed in 34/617 (6% adult patients and 11/624 (2% paediatric patients. The acute case fatality rate (CFR during hospital admission was 73/617 (12% in adults and to 42/624 (7% in children.Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

OpenAIRE

Hj.Indirawaty; Syamsuddin AB

2015-01-01

ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing re...

Seroprevalence and awareness of porcine cysticercosis across different pig production systems in south-central Cambodia

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Aderosoye Adenuga

2018-02-01

Conclusions: Despite most pigs being kept confined in pens rather than raised in free-roaming systems, porcine cysticercosis appears to be endemic in south-central Cambodia and is associated with smallholder production. Further investigation is needed to identify which Taenia species are causing infections among pigs, and how seroprevalence and zoonotic risk may vary across the country, to understand the risks to public health and assess where interventions might be needed.

Depression in chronic respiratory disorders in a tertiary rural hospital of Central India

Institute of Scientific and Technical Information of China (English)

Sameer singhal; Pankaj Banode; Nitish Baisakhiya

2009-01-01

Objective: To determine prevalence of depression in chronic respiratory disorders in a tertiary rural hospital of Central India. Various studies done in past have shown that prevalence of depression in diabetes and hypertension is around 40%-57%. Few studies have been done to screen depression in chronic respiratory disorders. This study was conducted in a tertiary rural hospital of Central India to find out prevalence of depression in indoor patients suffering from chronic respiratory disorders. Methods: Total 68 patients were evaluated for depression. Patients suffering from chronic respiratory disorders (total duration of illness >3 months) were evaluated using Prime MD Questionnaire. Patients suffering from diabetes, heart diseases, stroke, having past history of psychiatric illness, drug abusers, having lack of social support and suffering from chronic upper respiratory tract infections were excluded from this study. Questionnaire was asked when treatment for acute phase of illness is over. Results: Out of 68 patients evaluated, 36 (53%) were found out to be suffering from depression. Female gender (80%) was more prone to depression, inspite of the fact that all alcoholics were male. 39% of all chronic obstructive pulmonary disease (COPD) patients were suffering from depression in comparison to 65% for pulmonary tuberculosis and 44% for other chronic respiratory illness. 54% of patients suffering from depression are 60 yrs of age, suggesting that age has no relation with depression. No association was seen between alcoholism and depression. Conclusion: Prevalence of depression in patients of chronic respiratory illness is very high, like in cases of diabetes and hypertension. Further community and hospital based studies are needed to find out exact prevalence of depression in chronic respiratory illnesses.

Financial Performance of Mixed-Age Naturally Regenerated Loblolly-Hardwood Stands in the South Central United States

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Ronald Raunikar; Joseph Buongiorno; Jeffrey P. Prestemon; Karen Lee Abt

2000-01-01

To estimate the financial performance of a natural mixed species and mixed-age management in the loblolly-pine forest type, we examined 991 FIA plots in the south central states. The plots were of the loblolly pine forest type, mixed-age, and had been regenerated naturally. We gauged the financial performance of each plot from the equivalent annual income (EAI)...

Soil respiration rate on the contrasting north- and south-facing slopes of a larch forest in central Siberia

International Nuclear Information System (INIS)

Yanagihara, Y.; Koike, T.; Matsuura, Y.; Mori, S.; Shibata, H.; Satoh, F.; Masuyagina, O.V.; Zyryanova, O.A.; Prokushkin, A.S.; Prokushkin, S.G.; Abaimov, A.P.

2000-01-01

In an attempt to evaluate global warming effects, we measured the soil respiration of the contrasting north- and south- facing slopes of a larch forest in central Siberia, located at Tura City in the Krasnoyarsk District, Russia. The north-facing slope is assumed to be the present condition while the south-facing slope may stand for the future warm condition. As a result of differences in solar radiation, there were clear differences between the north- and south- facing slopes in terms, for example, of the active layer as the growth rate of larch trees. The soil respiration rate was higher on the south-facing slope than on the north-facing slope. At the temperature of 15°C, soil respiration rate of the south-facing slope was ca. 6.2 μ mol CO 2 * m -2 s -1 , which was about 0.6 times lower than that of broad-leaved forests in Hokkaido. There was an exponential correlation between soil temperature at 10 cm depth and the efflux of CO 2 from the soil surface. Various conditions (soil temperature,. nitrogen content and soil water content) seemed to be more favorable for soil respiration on the south-facing slope. (author)

Quaternary tectonic setting of South-Central coastal California

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Lettis, William R.; Hanson, Kathryn L.; Unruh, Jeffrey R.; McLaren, Marcia; Savage, William U.; Keller, Margaret A.

2004-01-01

Recent geodetic, geologic, and seismologic studies show that the south-central coast of California is a region of active Quaternary deformation. Northeast-directed crustal shortening is occurring in a triangular-shaped region between the Hosgri-San Simeon fault system on the west, the Southern Coast Ranges on the northeast, and the western Transverse Ranges on the south. We informally call this region the Los Osos domain. In this study, we conducted detailed geological, seismological, and geophysical investigations to characterize the nature and rates of deformation in the domain. Locations of active and potentially active faults and folds are compiled at a scale of 1:250,000 for the entire domain based primarily on onshore geologic data and offshore geophysical data. Crustal shortening in the domain is accommodated by a series of prominent northwest-trending reverse faults and localized folding. The reverse faults separate distinct structural blocks that have little or no internal deformation. Hangingwall blocks are being uplifted at rates of up to 0.2 mm/yr. Footwall blocks are either static or slowly subsiding at rates of 0.1 mm/yr or less, except for localized areas of concentrated subsidence directly adjacent to some faults. The cumulative rate of crustal shortening is about 1 to 2 mm/yr across the northern part of the domain based on observed geologic deformation. Cumulative shortening across the central and southern parts of the domain is poorly constrained by geologic data and may approach 2 to 3 mm/yr. Historical and instrumental seismicity generally are spatially associated with the uplifted blocks and bordering reverse faults to depths of about 10 km. Together with near-surface geological data and deeper crustal geophysical imaging that show high-angle faulting, the seismicity data indicate that the reverse faults probably extend to the base of the seismogenic crust. The base of the seismogenic crust may correspond with a mid-crustal detachment or

Sizing and Optimization for Hybrid Central in South Algeria Based on Three Different Generators

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Chouaib Ammari

2017-11-01

Full Text Available In this paper, we will size an optimum hybrid central content three different generators, two on renewable energy (solar photovoltaic and wind power and two nonrenewable (diesel generator and storage system because the new central generator has started to consider the green power technology in order for best future to the world, this central will use all the green power resource available and distributes energy to a small isolated village in southwest of Algeria named “Timiaouine”. The consumption of this village estimated with detailed in two season; season low consumption (winter and high consumption (summer, the hybrid central will be optimized by program Hybrid Optimization Model for Electric Renewable (HOMER PRO, this program will simulate in two configuration, the first with storage system, the second without storage system and in the end the program HOMER PRO will choose the best configuration which is the mixture of both economic and ecologic configurations, this central warrants the energetic continuity of village. Article History: Received May 18th 2017; Received in revised form July 17th 2017; Accepted Sept 3rd 2017; Available online How to Cite This Article: Ammari, C., Hamouda,M., and Makhloufi,S. (2017 Sizing and Optimization for Hybrid Central in South Algeria Based on Three Different Generators. International Journal of Renewable Energy Development, 6(3, 263-272. http://doi.org/10.14710/ijred.6.3.263-272

Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China:2006-2011

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Ying Qi

2015-05-01

Full Text Available AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region. METHODS: A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed. RESULTS: This study included 5964 eyes of 5799 patients. The average age was 35.5±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59y age group. Most patients were farmers and workers (51.9%. The most common injuries were firework related (24.5%, road traffic related (24.2%, and work related (15.0%. Among the most common causative agents were firecrackers (24.5%, followed by metal/knife/scissors (21.4%. Most injuries occurred in January (14.2%, February (27.0%, and August (10.0%. There were 8.5% patients with ocular injuries combined with other injuries. The incidence of open ocular injuries (4585 eyes, 76.9% was higher than closed ocular injuries (939 eyes, 15.7%. The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score (OTS predicted final visual acuity at non light perception (NLP, 20/200-20/50 and 20/40 with a sensitivity of 100%, and light perception (LP/hand motion (HM and 1/200-19/200 with a specificity of 100%. CONCLUSIONS: This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.

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

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

2017-12-01

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

Vulnerabilities to Temperature Effects on Acute Myocardial Infarction Hospital Admissions in South Korea

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Bo Yeon Kwon

2015-11-01

Full Text Available Most previous studies have focused on the association between acute myocardial function (AMI and temperature by gender and age. Recently, however, concern has also arisen about those most susceptible to the effects of temperature according to socioeconomic status (SES. The objective of this study was to determine the effect of heat and cold on hospital admissions for AMI by subpopulations (gender, age, living area, and individual SES in South Korea. The Korea National Health Insurance (KNHI database was used to examine the effect of heat and cold on hospital admissions for AMI during 2004–2012. We analyzed the increase in AMI hospital admissions both above and below a threshold temperature using Poisson generalized additive models (GAMs for hot, cold, and warm weather. The Medicaid group, the lowest SES group, had a significantly higher RR of 1.37 (95% CI: 1.07–1.76 for heat and 1.11 (95% CI: 1.04–1.20 for cold among subgroups, while also showing distinctly higher risk curves than NHI for both hot and cold weather. In additions, females, older age group, and those living in urban areas had higher risks from hot and cold temperatures than males, younger age group, and those living in rural areas.

Geothermal heating project at St. Mary's Hospital, Pierre, South Dakota. Final report

Energy Technology Data Exchange (ETDEWEB)

1984-12-01

St. Mary's Hospital, Pierre, South Dakota, with the assistance of the US Department of Energy, drilled a 2176 ft well into the Madison Aquifer ot secure 108/sup 0/F artesian flow water at 385 gpm (475 psig shut-in pressure). The objective was to provide heat for domestic hot water and to space heat 163,768 sq. ft. Cost savings for the first three years were significant and, with the exception of a shutdown to replace some corroded pipe, the system has operated reliably and continuously for the last four years.

Prevalence of Alcohol Use and Associated Factors in Urban Hospital Outpatients in South Africa

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Hendry Van der Heever

2011-06-01

Full Text Available The aim of this study was to assess the prevalence of alcohol use and associated factors among outpatients in an urban hospital in South Africa. The sample included 1,532 (56.4% men and women 43.6% consecutively selected patients from different hospital outpatient departments. Results indicate that 41.2% of men and 18.3% of women were found to be hazardous drinkers, and 3.6% of men and 1.4% of women meet criteria for probable alcohol dependence or harmful drinking as defined by the Alcohol Use Disorder Identification Test (AUDIT. Two in five patients (40.5% were hazardous or harmful drinkers and/or had anxiety or depression. Logistic multiple regression found that for men tobacco use and not having been diagnosed with diabetes and for women tobacco use and having been diagnosed with migraine headache was associated with hazardous and harmful drinking. Although the study is cross-sectional, it does identify groups that may be at high risk of alcohol misuse and for whom intervention is urgent. Because prevalence of hazardous and harmful alcohol use is high in this population, routine screening should be introduced in hospital out-patient settings.

P and S wave Coda Calibration in Central Asia and South Korea

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Kim, D.; Mayeda, K.; Gok, R.; Barno, J.; Roman-Nieves, J. I.

2017-12-01

Empirically derived coda source spectra provide unbiased, absolute moment magnitude (Mw) estimates for events that are normally too small for accurate long-period waveform modeling. In this study, we obtain coda-derived source spectra using data from Central Asia (Kyrgyzstan networks - KN and KR, and Tajikistan - TJ) and South Korea (Korea Meteorological Administration, KMA). We used a recently developed coda calibration module of Seismic WaveForm Tool (SWFT). Seismic activities during this recording period include the recent Gyeongju earthquake of Mw=5.3 and its aftershocks, two nuclear explosions from 2009 and 2013 in North Korea, and a small number of construction and mining-related explosions. For calibration, we calculated synthetic coda envelopes for both P and S waves based on a simple analytic expression that fits the observed narrowband filtered envelopes using the method outlined in Mayeda et al. (2003). To provide an absolute scale of the resulting source spectra, path and site corrections are applied using independent spectral constraints (e.g., Mw and stress drop) from three Kyrgyzstan events and the largest events of the Gyeongju sequence in Central Asia and South Korea, respectively. In spite of major tectonic differences, stable source spectra were obtained in both regions. We validated the resulting spectra by comparing the ratio of raw envelopes and source spectra from calibrated envelopes. Spectral shapes of earthquakes and explosions show different patterns in both regions. We also find (1) the source spectra derived from S-coda is more robust than that from the P-coda at low frequencies; (2) unlike earthquake events, the source spectra of explosions have a large disagreement between P and S waves; and (3) similarity is observed between 2016 Gyeongju and 2011 Virginia earthquake sequence in the eastern U.S.

Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India – Authors’ reply

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Amar Taksande

2016-07-01

Full Text Available Dear Editor,We thank the authors for their interest and comments on our paper. They have raised some very valid points. This corrispondence refers to the following article:Taksande AM, Yeole M. Risk factors of Acute Respiratory Infection (ARI in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(1:e050105. doi: 10.7363/050105 br />Comments can be found in the following article:Mandal A, Sahi PK. Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(2:e050207. doi: 10.7363/050207

A strategy for enhancing financial performance: a study of general acute care hospitals in South Korea.

Science.gov (United States)

Choi, Mankyu; Lee, Keon-Hyung

2008-01-01

In this study, the determinants of hospital profitability were evaluated using a sample of 142 hospitals that had undergone hospital standardization inspections by the South Korea Hospital Association over the 4-year period from 1998 to 2001. The measures of profitability used as dependent variables in this study were pretax return on assets, after-tax return on assets, basic earning power, pretax operating margin, and after-tax operating margin. Among those determinants, it was found that ownership type, teaching status, inventory turnover, and the average charge per adjusted inpatient day positively and statistically significantly affected all 5 of these profitability measures. However, the labor expenses per adjusted inpatient day and administrative expenses per adjusted inpatient day negatively and statistically significantly affected all 5 profitability measures. The debt ratio negatively and statistically significantly affected all 5 profitability measures, with the exception of basic earning power. None of the market factors assessed were shown to significantly affect profitability. In conclusion, the results of this study suggest that the profitability of hospitals can be improved despite deteriorating external environmental conditions by facilitating the formation of sound financial structures with optimal capital supplies, optimizing the management of total assets with special emphasis placed on inventory management, and introducing efficient control of fixed costs including labor and administrative expenses.

Factors affecting condom usage among college students in South Central Kentucky.

Science.gov (United States)

Kanekar, Amar; Sharma, Manoj

The absence of consistent and correct usage of condoms increases the risk of sexually transmitted infections (STI) and HIV/AIDS. However, most studies done to date across the nation indicate a low usage of condoms among college students. This study identifies protective and risk factors associated with condom use among college students. The National College Health Assessment was administered to a random sample of students at a state comprehensive university in south central Kentucky. Findings revealed that among the sexually active students, approximately half never used condoms during vaginal intercourse. Further, among students engaging in oral sex, an alarmingly high proportion (95%) reported never using a condom during this act. These findings, along with differences noted in various subgroups (gender, housing, class standing), and other risk behaviors (alcohol, illicit drug use) are discussed.

Modeling Prices for Sawtimber Stumpage in the South-Central United States

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Rajan Parajuli

2016-07-01

Full Text Available The South-Central United States, which includes the states of Louisiana, Mississippi, Texas, and Arkansas, represents an important segment of the softwood sawtimber market. By using the Seemingly Unrelated Regression (SUR method to account for the linkage among the four contiguous timber markets, this study examines the dynamics of softwood sawtimber stumpage markets within the region. Based on quarterly data from 1981 to 2014, the findings reveal that both pulpwood and chip-and-saw (CNS prices have a positive influence on the Texas and Arkansas sawtimber markets. Moreover, Granger-causality tests suggest that unidirectional causality runs from pulpwood and CNS markets to the respective sawtimber market. Compared to the pre-financial crisis period, sawtimber prices in these four states are 9%–17% lower in the recent years.

Multi-year GNSS monitoring of atmospheric IWV over Central and South America for climate studies

Science.gov (United States)

Mendoza, Luciano; Bianchi, Clara; Fernández, Laura; Natali, María Paula; Meza, Amalia; Moirano, Juan

2017-04-01

Atmospheric water vapour has been acknowledged as an essential climate variable. Weather prediction and hazard assessment systems benefit from real-time observations, whereas long-term records contribute to climate studies. Nowadays, ground-based GNSS products have become widely employed, complementing satellite observations over the oceans. Although the past decade has seen a significant development of the GNSS infrastructure in Central and South America, its potential for atmospheric water vapour monitoring has not been fully exploited. With this in mind, we have performed a regional, seven-year long and homogeneous analysis, comprising 136 GNSS tracking stations, obtaining high-rate and continuous observations of column integrated water vapour and troposphere zenith total delay (Bianchi et al. 2016). As preliminary application for this data set, we have estimated local water vapour trends, their significance, and their relation with specific climate regimes. We have found evidence of drying at temperate regions in South America, at a rate of about 2% per decade, while a slow moistening of the troposphere over tropical regions is also weakly suggested by our results. Furthermore, we have assessed the regional performance of the empirical model GPT2w to blindly estimate troposphere delays. The model fairly reproduces the observed mean delays, including their annual and semi-annual variations. Nevertheless, a long-term evaluation has shown systematical biases, up to 20 mm, probably inherited form the underling atmospheric reanalysis. Additionally, the complete data set has been made openly available at a scientific repository (doi:10.1594/PANGAEA.858234). References: C. Bianchi, L. Mendoza, L. Fernandez, M. P. Natali, A. Meza, J. F. Moirano, Multi-year GNSS monitoring of atmospheric IWV over Central and South America for climate studies, Ann. Geophys., ISSN 0992-7689, eISSN 1432-0576, 34 (7), 623-639 (doi:10.5194/angeo-34-623-2016).

Safety and affordability of an elective Saturday list at Pietersburg Hospital Limpopo South Africa

Directory of Open Access Journals (Sweden)

R Mavhungu

2018-02-01

Full Text Available Background. The backlog of patients waiting for operations continues to be a problem in many public hospitals in South Africa (SA, with elective surgery procedures being postponed for up to 2 years.Objective. To determine the rate of death in hospital or out of hospital within 30 days of an elective procedure performed on a Saturday, and to determine the cost incurred by paying staff members who perform these operations.Method. A prospective, observational descriptive cohort study of all patients undergoing inpatient general surgery operations during weekdays and weekends between 1 September 2015 and 31 August 2016 (1 year at Pietersburg Hospital (PBH, Limpopo, SA. Microsoft Excel 2010 (Microsoft, USA was used to analyse and derive descriptive statistics. The finance department at the hospital calculated the overtime pay for theatre staff who operated on Saturdays.Results. The study included 1 352 operations (607 elective and 745 emergency procedures. Saturday elective operations contributed 133/607 (22%, and the rate of death for these operations was 1.5%. The most common procedures performed on a Saturday were hernia repair and amputation. The cost for 8 hours of work on a Saturday was ZAR13 900, amounting to a total of ZAR333 600 for 24 Saturdays.Conclusion. Performing minor surgery on a Saturday had a mortality rate of 1.5%, and a theatre staff cost of ~ZAR2 317 per patient, excluding surgeons’ fees. If surgeons were to be paid the costs would be ZAR3 450 per patient.

Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. III. - September of 2001

International Nuclear Information System (INIS)

Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J.

2001-12-01

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

Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. II. - August of 2001

International Nuclear Information System (INIS)

Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J.

2001-10-01

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

Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - July of 2001

International Nuclear Information System (INIS)

Angeles C, A.; Vizuet G, J.; Benitez S, J. A.

2001-09-01

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

Characteristics and Factors Associated with Death among Patients Hospitalized for Severe Fever with Thrombocytopenia Syndrome, South Korea, 2013.

Science.gov (United States)

Shin, Jaeseung; Kwon, Donghyok; Youn, Seung-Ki; Park, Ji-Hyuk

2015-10-01

In South Korea, nationwide surveillance for severe fever with thrombocytopenia syndrome (SFTS) began during 2013. Among 301 surveillance cases, 35 hospitalized case-patients in 25 areas were confirmed by using virologic testing, and 16 (46%) case-patients subsequently died. The SFTS cases occurred during May-November and peaked during June (9 cases, 26%). The incidence of SFTS was higher in the southern regions of South Korea. Age and neurologic symptoms, including decreased level of consciousness and slurred speech, were heavily associated with death; neurologic symptoms during the first week after disease onset were also associated with death. Although melena was common among patients who died, no other hemorrhagic manifestations were substantively more common among those who died. No effective treatments, including ribavirin, were identified. Expansion of SFTS surveillance to include the outpatient sector and development of an antibody test would enhance completeness of SFTS detection in South Korea.

Diagnostic, evaluation and handling of the tumors of soft tissues. Experience in the Central Military Hospital

International Nuclear Information System (INIS)

Pineda Acero, Gustavo Adolfo; Torres Quintero, Pio

2001-01-01

With the purpose of analyzing the experience of the orthopedics service and traumatology of the central military hospital in the treatment of the tumors of soft tissues, it carries out a descriptive observational study, type series of cases and retrospective. The incidence of the tumors of soft tissues compared with carcinomas and other neoplasia, constitutes less than 1% of all cancerous and the benign ones are more common than the wicked ones in a range of 100:1. The knowledge of the classification, stadification, evaluation strategies, previous biopsy, surgical treatment, radiotherapy y/o chemotherapy is vital for a good final result. 29 clinical histories were included of patient with tumoral lesions in the soft tissues, valued in the central military hospital between March of 1996 and March of 2001. The age average was of 39 years and the pursuit of 24 months. In most of the cases the anatomical commitment belonged to the inferior members (93%), 79% for benign tumors and 21% for wicked tumors. To avoid incorrect diagnoses and inappropriate treatments it is necessary the coordinated evaluation of all multidisciplinary team

Lithofacies analysis of the Simpson Group in south-central Kansas

International Nuclear Information System (INIS)

Doveton, J.H.; Charpentier, R.R.; Metzger, E.P.

1990-01-01

This book discusses detailed stratigraphy and lithofacies of the oil-productive Middle Ordovician Simpson Group in south-central Kansas. The report presents results of studies of the Simpson Group in Barber, Comanche, Kiowa, and Pratt counties. The high density of exploration holes and their associated logs allowed a detailed stratigraphic subdivision to be made of shale, sandstone, and sandy carbonate units. The lateral changes in these units are depicted in a series of maps and cross sections and show distinctive lithofacies patterns that reflect a history of northward-moving marine transgression. Working with digital data from gamma-ray logs, the geologists used computer methods to generate a series of cross sections of the Simpson Group, based on the statistical moments of the log traces. Automated mapping displayed the shapes and disposition of shale and non-shale units as continuous features in three dimensions. The ground truth information from drill cuttings further refined interpretations of stratigraphy, lithofacies, and depositional history implied by these computer models

South-South medical tourism and the quest for health in Southern Africa.

Science.gov (United States)

Crush, Jonathan; Chikanda, Abel

2015-01-01

Intra-regional South-South medical tourism is a vastly understudied subject despite its significance in many parts of the Global South. This paper takes issue with the conventional notion of South Africa purely as a high-end "surgeon and safari" destination for medical tourists from the Global North. It argues that South-South movement to South Africa for medical treatment is far more significant, numerically and financially, than North-South movement. The general lack of access to medical diagnosis and treatment in SADC countries has led to a growing temporary movement of people across borders to seek help at South African institutions in border towns and in the major cities. These movements are both formal (institutional) and informal (individual) in nature. In some cases, patients go to South Africa for procedures that are not offered in their own countries. In others, patients are referred by doctors and hospitals to South African facilities. But the majority of the movement is motivated by lack of access to basic healthcare at home. The high demand and large informal flow of patients from countries neighbouring South Africa has prompted the South African government to try and formalise arrangements for medical travel to its public hospitals and clinics through inter-country agreements in order to recover the cost of treating non-residents. The danger, for 'disenfranchised' medical tourists who fall outside these agreements, is that medical xenophobia in South Africa may lead to increasing exclusion and denial of treatment. Medical tourism in this region and South-South medical tourism in general are areas that require much additional research. Copyright © 2014. Published by Elsevier Ltd.

[Primary lymphoma of the central nervous system: 20 years' experience in a referral hospital].

Science.gov (United States)

Calderón-Garcidueñas, A L; Pacheco-Calleros, J; Castelán-Maldonado, E; Nocedal-Rustrián, F C

Primary central nervous system lymphomas (PCNSL) are rare neoplasms. AIM. To study the clinical aspects and the immuno-phenotype of all cases of PCNSL in a 20 years lapse in a referral hospital in Northeastern Mexico. From January 1986 to December 2005 all PCNSL histologically confirmed were studied. The primary lymphomas were 1% of malignant central nervous system neoplasms. 21 cases were studied (ages from 9-70 years) with male predominance (2:1). 24% patients had immuno-suppression. The more frequent clinical data were: papilledema (71%), headache (62%), paresis (48%) and seizures (33%). 33% of patients died during the first six months after diagnosis. The T lymphomas were 19% of cases and corresponded to small cell type. PCNSL are still a diagnostic challenge. Multicenter studies are required in order to determine the best treatment protocol.

'Practice what you preach': Nurses' perspectives on the Code of Ethics and Service Pledge in five South African hospitals.

Science.gov (United States)

White, Janine; Phakoe, Maureen; Rispel, Laetitia C

2015-01-01

A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. The study explored hospital nurses' perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses' Pledge of Service; and their views on contemporary ethical practice. Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA(®) 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. The mean age of survey participants (n=69) was 39 years (SD=9.2), and the majority were female (96%). The majority agreed with a statement that they will promote the human rights of individuals (98%) and that they have a duty to meet the health and social needs of the public (96%). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients' rights as opposed to nurses' rights and 32% agreeing with a statement that they would take part in strike action to improve nurses' salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses' responses to open-ended questions. Continuing education in ethics and addressing health system deficiencies will enhance nurses' professional development and their ethical decision-making and practice.

Treatment Outcomes and Costs of Providing Antiretroviral Therapy at a Primary Health Clinic versus a Hospital-Based HIV Clinic in South Africa

OpenAIRE

Long, Lawrence C.; Rosen, Sydney B.; Brennan, Alana; Moyo, Faith; Sauls, Celeste; Evans, Denise; Modi, Shookdev L.; Sanne, Ian; Fox, Matthew P.

2016-01-01

Background In 2010 South Africa revised its HIV treatment guidelines to allow the initiation and management of patients on antiretroviral therapy (ART) by nurses, rather than solely doctors, under a program called NIMART (Nurse Initiated and Managed Antiretroviral Therapy). We compared the outcomes and costs of NIMART between the two major public sector HIV treatment delivery models in use in South Africa today, primary health clinics and hospital-based HIV clinics. Methods and findings The s...

Stratigraphic framework of Cambrian and Ordovician rocks in the central Appalachian Basin from Medina County, Ohio, through southwestern and south-central Pennsylvania to Hampshire County, West Virginia

Science.gov (United States)

Ryder, Robert T.; Harris, Anita G.; Repetski, John E.; revised and digitized by Crangle, Robert D.

2003-01-01

A 275-mi-long restored stratigraphic cross section from Medina County, Ohio, through southwestern and south-central Pennsylvania to Hampshire County, W. Va., provides new details on Cambrian and Ordovician stratigraphy in the central Appalachian basin and the structure of underlying Precambrian basement rocks. From west to east, the major structural elements of the block-faulted basement in this section are (1) the relatively stable, slightly extended craton, which includes the Wooster arch, (2) the fault-controlled Ohio-West Virginia hinge zone, which separates the craton from the adjoining Rome trough, (3) the Rome trough, which consists of an east-facing asymmetric graben and an overlying sag basin, and (4) a positive fault block, named here the South-central Pennsylvania arch, which borders the eastern margin of the graben part of the Rome trough. Pre-Middle Ordovician structural relief on Precambrian basement rocks across the down-to-the-west normal fault that separates the Rome trough and the adjoining South-central Pennsylvania arch amounted to between 6,000 and 7,000 ft. The restored cross section shows eastward thickening of the Cambrian and Ordovician sequence from about 3,000 ft near the crest of the Wooster arch at the western end of the section to about 5,150 ft at the Ohio-West Virginia hinge zone adjoining the western margin of the Rome trough to about 19,800 ft near the depositional axis of the Rome trough. East of the Rome trough, at the adjoining western edge of the South-central Pennsylvania arch, the Cambrian and Ordovician sequence thins abruptly to about 13,500 ft and then thins gradually eastward across the arch to about 12,700 ft near the Allegheny structural front and to about 10,150 ft at the eastern end of the restored section. In general, the Cambrian and Ordovician sequence along this section consists of four major lithofacies that are predominantly shallow marine to peritidal in origin. In ascending stratigraphic order, the lithofacies

Evaluating Ultraviolet Radiation Exposures Determined from TOMS Satellite Data at Sites of Amphibian Declines in Central and South America

Science.gov (United States)

Middleton, Elizabeth M.; Smith, David E. (Technical Monitor)

2000-01-01

Many amphibian species have experienced substantial population declines, or have disappeared altogether, during the last several decades at a number of amphibian census sites in Central and South America. This study addresses the use of satellite-derived trends in solar ultraviolet-B (UV-B; 280-320 nm) radiation exposures at these sites over the last two decades, and is intended to demonstrate a role for satellite observations in determining whether UV-B radiation is a contributing factor in amphibian declines. UV-B radiation levels at the Earth's surface were derived from the Total Ozone Mapping Spectrometer (TOMS) satellite data, typically acquired daily since 1979. These data were used to calculate the daily erythemal (sunburning) UV-B, or UV-B(sub ery), exposures at the latitude, longitude, and elevation of each of 20 census sites. The annually averaged UV-B(sub ery) dose, as well as the maximum values, have been increasing in both Central and South America, with higher levels received at the Central American sites. The annually averaged UV-B(sub ery) exposures increased significantly from 1979-1998 at all 11 Central American sites examined (r(exp 2) = 0.60 - 0.79; P= 6750 J/sq m*d) to the annual UV-B(sub ery) total has increased from approx. 5% to approx. 15% in Central America over the 19 year period, but actual daily exposures for each species are unknown. Synergy among UV-B radiation and other factors, especially those associated with alterations of water chemistry (e.g., acidification) in aqueous habitats is discussed. These findings justify further research concerning whether UV-B(sub ery) radiation plays a role in amphibian population declines and extinctions.

COELIAC DISEASE IN CENTRAL AND SOUTH AMERICA: time for a concerted approach to its epidemiology

Directory of Open Access Journals (Sweden)

Affifa FARRUKH

2015-06-01

Full Text Available Central and South America offer an opportunity to resolve some of the current controversies that surround the epidemiology of celiac disease. Through a concerted action which brings together clinicians, researchers and patients there is an opportunity to establish robust data sets which will allow detailed analysis of environmental and genetic factors. In this review available data from the continent together with data from Spain and Italy are drawn together to give a current picture in the hope that it will stimulate further research.

The effect of social capital on job satisfaction and quality of care among hospital nurses in South Korea.

Science.gov (United States)

Shin, Ji In; Lee, Eunjoo

2016-10-01

To identify the level of social capital and its effect on job satisfaction and self-reported quality of care of nurses working in hospital settings in South Korea. There are few studies on social capital and its relationship to workplace outcomes in the nursing profession internationally. A cross-sectional, correlational design was adopted with a convenience sample of 432 nurses from two university-affiliated teaching hospitals in South Korea. Nurses' social capital was positively related to job satisfaction and self-reported quality of care. Social capital explained 50% and 24%, respectively, of the variance in job satisfaction and reported quality of care. By improving social capital, nurses' job satisfaction could be enhanced and result in better quality of care for patients. Strategies to improve social capital in nursing organisations are necessary to improve job satisfaction and the quality of care provided by nurses. Nurse managers and administrators should encourage nurse participation in organisational affairs and decision-making processes to improve social capital by developing a trusting work environment with shared values and support nurses who work with peers, superiors, and subordinates. © 2016 John Wiley & Sons Ltd.

Reduction of Risk in Exploration and Prospect Generation through a Multidisciplinary Basin-Analysis Program in the South-Central Mid-Continent Region

Energy Technology Data Exchange (ETDEWEB)

Banerjee, S.; Barker, C.; Fite, J.; George, S.; Guo, Genliang; Johnson, W.; Jordan, J., Szpakiewicz, M.; Person, M.; Reeves, T.K.; Safley, E.; Swenson, J.B.; Volk, L.; and Erickson, R.

1999-04-02

This report will discuss a series of regional studies that were undertaken within the South-Central Mid-Continent region of the U.S. Coverage is also provided about a series of innovative techniques that were used for this assessment.

South Africa : tous les projets | Page 7 | CRDI - Centre de ...

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

Sujet: Science and Technology, MEDICAL RESEARCH, HUMAN GENETICS, GENETIC ENGINEERING, BIOTECHNOLOGY. Région: Brazil, South America, China, Far East Asia, India, South Africa, North of Sahara, South of Sahara, North and Central America, Central Asia, South Asia, Canada. Programme: Économies en ...

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

Science.gov (United States)

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

2018-01-01

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

Perceptions of health care professionals on the safety and security at Odi District Hospital, Gauteng, South Africa.

Science.gov (United States)

Okeke, Sunday O; Mabuza, Langalibalele H

2017-10-27

For optimum delivery of service, an establishment needs to ensure a safe and secure environment. In 2011, the South African government promulgated the National Core Standards for Health Establishments for safety and security for all employees in all establishments. Little is known about whether these standards are being complied to.Aim and setting: To assess the perceptions of health care professionals (HCPs) on safety and security at Odi District Hospital. A sample of 181 out of a total of 341 HCPs was drawn through a systematic sampling method from each HCP category. Data were collected through a self-administered questionnaire. The SPSS® statistical software version 22 was used for data analysis. The level of statistical significance was set at < 0.05. There were more female respondents than male respondents (136; 75.10%). The dominant age group was 28-47 years (114; 57.46%). Perceptions on security personnel, their efficiency and the security system were significantly affirmed (p = 0.0001). The hospital infrastructure, surroundings and plan in emergencies were perceived to be safe (p < 0.0001). The hospital lighting system was perceived as inadequate (p = 0.0041). Only 36 (20.2%) HCPs perceived that hospital authorities were concerned about employees' safety (p < 0.0001). HCPs had positive perceptions regarding the hospital's security system. Except for the negative perceptions of the lighting system and the perceived lack of hospital authorities' concern for staff safety, perceptions of the HCPs on the hospital working environment were positive. The hospital authorities need to establish the basis of negative perceptions and enforce remedial measures to redress them.

Lineamientos de un plan estratégico para el mejoramiento de la calidad del servicio brindado en el Hospital Militar Central de Lima

OpenAIRE

Cabrera Rioja, Luis Alberto

2007-01-01

El presente estudio, realizado en el Hospital Militar Central (HMC) de Lima, está dirigido al diseño de los lineamientos de un plan estratégico que permita formular la misión y visión del HMC, analizar el entorno e intorno organizacional y formular objetivos estratégicos orientados al mejoramiento continuo de la calidad del servicio. A fin de superar las dificultades económicas, logísticas y de personal que afronta actualmente el Hospital Militar Central, debido a los recortes presupuestales ...

Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - May-June of 2003

International Nuclear Information System (INIS)

Angeles C, A.; Camacho V, B.; Rodriguez A, F.

2003-09-01

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

Specialized consultant in radiological safety to the clinical north central hospital of high speciality, PEMEX. IV. - December of 2001

International Nuclear Information System (INIS)

Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

2002-01-01

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

HIV-1 Genetic Diversity and Transmitted Drug Resistance Mutations among Patients from the North, Central and South Regions of Angola

Science.gov (United States)

Afonso, Joana Morais; Bello, Gonzalo; Guimarães, Monick L.; Sojka, Marta; Morgado, Mariza G.

2012-01-01

Background Angola presents a very complex HIV-1 epidemic characterized by the co-circulation of several HIV-1 group M subtypes, intersubtype recombinants and unclassified (U) variants. The viral diversity outside the major metropolitan regions (Luanda and Cabinda) and the prevalence of transmitted drug resistance mutations (DRM) since the introduction of HAART in 2004, however, has been barely studied. Methods One hundred and one individuals from the Central (n = 44), North (n = 35), and South (n = 22) regions of Angola were diagnosed as HIV-1 positive and had their blood collected between 2008 and 2010, at one of the National Referral Centers for HIV diagnosis, the Kifangondo Medical Center, located in the border between the Luanda and Bengo provinces. Angolan samples were genotyped based on phylogenetic and bootscanning analyses of the pol (PR/RT) gene and their drug resistance profile was analyzed. Results Among the 101 samples analyzed, 51% clustered within a pure group M subtype, 42% were classified as intersubtype recombinants, and 7% were denoted as U. We observed an important variation in the prevalence of different HIV-1 genetic variants among country regions, with high frequency of subtype F1 in the North (20%), intersubtype recombinants in the Central (42%), and subtype C in the South (45%). Statistically significant difference in HIV-1 clade distribution was only observed in subtype C prevalence between North vs South (p = 0.0005) and Central vs South (p = 0.0012) regions. DRM to NRTI and/or NNRTI were detected in 16.3% of patients analyzed. Conclusions These results demonstrate a heterogeneous distribution of HIV-1 genetic variants across different regions in Angola and also revealed an unexpected high frequency of DRM to RT inhibitors in patients that have reported no antiretroviral usage, which may decrease the efficiency of the standard first-line antiretroviral regimens currently used in the country. PMID:22952625

Why do some hospitals achieve better care of severely malnourished children than others? Five-year follow-up of rural hospitals in Eastern Cape, South Africa.

Science.gov (United States)

Puoane, Thandi; Cuming, Katie; Sanders, David; Ashworth, Ann

2008-11-01

Staff at 11 rural hospitals in an under-resourced region of Eastern Cape Province, South Africa, participated in an intervention to improve the quality of care of severely malnourished children through training and support aimed at implementing the WHO case-management guidelines. Despite similar intervention inputs, some hospitals reduced their case-fatality rates by at least half, whereas others did not. The aim of this study was to investigate reasons for this disparity. Two successful and two poorly performing hospitals were purposively selected based on their case-fatality rates, which were 30% in those performing poorly. Comparative data were collected during June to October 2004 through structured observations of ward procedures, compilation of hospital data on case-loads and resources, and staff interviews and discussions related to attitudes, teamwork, training, supervision, managerial support and leadership. The four study hospitals had broadly similar resources, infrastructure and child:nurse ratios, and all had made changes to their clinical and dietary management following training. Case-management was broadly in line with WHO guidelines but the study revealed clear differences in institutional culture which influenced quality of care. Staff in the successful hospitals were more attentive and assiduous than staff in the poorly performing hospitals, especially in relation to rehydration procedures, feeding and the recording of vital signs. There was a strong emphasis on in-service training and induction of incoming staff in the successful hospitals and better supervision of junior staff and carers. Nurses had more positive attitudes towards malnourished children and their carers, and were less judgmental. Underlying factors were differences in leadership, teamwork, and managerial supervision and support. We conclude that unless there are supportive structures at managerial level, the potential benefits of efficacious interventions and related training

A new geological framework for south-central Madagascar, and its relevance to the "out-of-Africa" hypothesis

Science.gov (United States)

Tucker, R.D.; Roig, J.Y.; Macey, P.H.; Delor, C.; Amelin, Y.; Armstrong, R.A.; Rabarimanana, M.H.; Ralison, A.V.

2011-01-01

The Precambrian shield of south-central Madagascar, excluding the Vohibory region, consists of three geologic domains, from north to south: Antananarivo, Ikalamavony-Itremo, and Anosyen-Androyen. The northern Antananarivo domain represents the Neoarchean sector of the Greater Dharwar Craton amalgamated at 2.52-2.48. Ga. The Greater Dharwar Craton is overlain by several groups of Meso- to Neoproterozoic supracrustal rocks (Ambatolampy, Manampotsy, Ampasary, Sahantaha, and Maha Groups) each with a common and diagnostic signature of Paleoproterozoic detrital zircons (2.2-1.8. Ga). The central domain (Ikalamavony-Itremo) consists of two distinct parts. The Itremo Sub-domain, in the east, is a structurally intercalated sequence of Neoarchean gneiss and shallow marine metasedimentary rocks of Paleo-Mesoproterozoic age (Itremo Group), the latter with Paleoproterozoic detrital zircons ranging in age between 2.2 and 1.8. Ga. The Ikalamavony Sub-domain, to the west, contains abundant volcano-clastic metasediments and lesser quartzite (Ikalamavony Group), formed between 1.03. Ga and 0.98. Ga, and intruded by igneous rocks (Dabolava Suite) of Stenian-Tonian age. Structurally intercalated with these are sheets of Neoarchean gneiss (~2.5. Ga) and Neoproterozoic metaclastic rocks (Molo Group). Like the Itremo Group, quartzite of the Ikalamavony Group has detrital zircons of Paleoproterozoic age (2.1-1.8. Ga). The southern domain of Anosyen-Androyen consists of a newly recognized suite of Paleoproterozoic igneous rocks (2.0-1.8. Ga), and stratified supracrustal rocks also having Paleoproterozoic detrital zircons (2.3-1.8. Ga). The contact between the Anosyen-Androyen and Ikalamavony-Itremo domains, formerly known as the Ranotsara-Bongolava shear zone, is a tightly folded and highly flattened boundary that was ductilely deformed in Ediacaran time. It is roughly equivalent to the Palghat-Cauvery shear zone in south India, and it defines approximately the boundary between the Archean

Prevalence and management status of urologic diseases in geriatric hospitals in South Korea: A field research

Directory of Open Access Journals (Sweden)

Sang Heon Lee

2017-01-01

Full Text Available Purpose: We aimed to investigate the current management status of urologic diseases in geriatric hospitals in South Korea. Materials and Methods: Questionnaire surveys and in-depth person-to-person interviews were conducted at 13 hospitals within the Seoul and Incheon areas. Results: The study was carried out from July to December 2014; 75.6% of patients (1,858/2,458 and 77.5% (779/1,031 of medical personnel responded to our survey. All surveys and interviews were performed by urology specialists, fellows, residents, or nurses. The hospitals included in the study had an average of 215.2 beds (range, 110–367, 189.1 patients (range, 90–345, and 40.2 nurses (range, 10–83. The average number of physicians was 6.2 (range, 3–11, but none of these were certified urologists. Only 4 hospitals provided consultation services for urological disorders. In total, 64% of patients had urological disorders, although only 20.7% of patients were receiving medication. Most patients were being treated using urological interventions; diapers (49.7%, indwelling catheters (19.5%, clean intermittent catheters (12.2%, and external collection urinary drainage (7.9%. However, most interventions were inadequately implemented, and only 17% of the patients had been examined by a certified urologist. Urological complications were found in 20.2% of patients, and secondary complications occurred in 18.8%. Excluding redundant cases, the total prevalence of urological complications was 39.0%. Conclusions: Urologic diseases are poorly managed, and no certified urologists work in geriatric hospitals. Therefore, more designated urologists are needed in geriatric hospitals.

High level of molecular and phenotypic biodiversity in Jatropha curcas from Central America compared to Africa, Asia and South America

Science.gov (United States)

2014-01-01

Background The main bottleneck to elevate jatropha (Jatropha curcas L.) from a wild species to a profitable biodiesel crop is the low genetic and phenotypic variation found in different regions of the world, hampering efficient plant breeding for productivity traits. In this study, 182 accessions from Asia (91), Africa (35), South America (9) and Central America (47) were evaluated at genetic and phenotypic level to find genetic variation and important traits for oilseed production. Results Genetic variation was assessed with SSR (Simple Sequence Repeat), TRAP (Target Region Amplification Polymorphism) and AFLP (Amplified fragment length polymorphism) techniques. Phenotypic variation included seed morphological characteristics, seed oil content and fatty acid composition and early growth traits. Jaccard’s similarity and cluster analysis by UPGM (Unweighted Paired Group Method) with arithmetic mean and PCA (Principle Component Analysis) indicated higher variability in Central American accessions compared to Asian, African and South American accessions. Polymorphism Information Content (PIC) values ranged from 0 to 0.65. In the set of Central American accessions. PIC values were higher than in other regions. Accessions from the Central American population contain alleles that were not found in the accessions from other populations. Analysis of Molecular Variance (AMOVA; P jatropha oil significantly differed (P < 0.05) between regions. Conclusions The pool of Central American accessions showed very large genetic variation as assessed by DNA-marker variation compared to accessions from other regions. Central American accessions also showed the highest phenotypic variation and should be considered as the most important source for plant breeding. Some variation in early growth traits was found within a group of accessions from Asia and Africa, while these accessions did not differ in a single DNA-marker, possibly indicating epigenetic variation. PMID:24666927

Variation of central corneal thickness in patients with diabetic retinopathy as detected by ultrasonic pachymetry in patients presenting to a tertiary care hospital

International Nuclear Information System (INIS)

Khan, S.A.

2017-01-01

To compare the central corneal thickness between patients with diabetic retinopathy and non diabetics. Study Design: A cross sectional study. Place and Duration of Study: Lahore General Hospital Lahore, from 1st Dec 2015 to 31st May 2016. Material and Methods: A cross-sectional study was conducted in the ophthalmology outpatient department of Lahore General Hospital. A total of one hundred and fifty subjects from different age groups were selected for the study. An ultrasound pachymeter was used to measure CCT. There were two groups for sample, 75 were patients with diabetic retinopathy and 75 of them were non-diabetic subjects. Results: The diabetic patients had average central corneal thickness of value 554.93 +- 33.73 microns. The average central corneal thickness found in non-diabetic patients was 520.41 +- 26.06 microns. The diabetic patients showed an increased central corneal thickness as compared to non-diabetics. The result of this study was statistically significant (p=0.001). Conclusion: The diabetic patients showed an increased central corneal thickness as compared to non-diabetic patients. (author)

The development of a national surveillance system for monitoring blood use and inventory levels at sentinel hospitals in South Korea.

Science.gov (United States)

Lim, Y A; Kim, H H; Joung, U S; Kim, C Y; Shin, Y H; Lee, S W; Kim, H J

2010-04-01

We developed a web-based program for a national surveillance system to determine baseline data regarding the supply and demand of blood products at sentinel hospitals in South Korea. Sentinel hospitals were invited to participate in a 1-month pilot-test. The data for receipts and exports of blood from each hospital information system were converted into comma-separated value files according to a specific conversion rule. The daily data from the sites could be transferred to the web-based program server using a semi-automated submission procedure: pressing a key allowed the program to automatically compute the blood inventory level as well as other indices including the minimal inventory ratio (MIR), ideal inventory ratio (IIR), supply index (SI) and utilisation index (UI). The national surveillance system was referred to as the Korean Blood Inventory Monitoring System (KBIMS) and the web-based program for KBIMS was referred to as the Blood Inventory Monitoring System (BMS). A total of 30 256 red blood cell (RBC) units were submitted as receipt data, however, only 83% of the receipt data were submitted to the BMS server as export data (25 093 RBC units). Median values were 2.67 for MIR, 1.08 for IIR, 1.00 for SI, 0.88 for UI and 5.33 for the ideal inventory day. The BMS program was easy to use and is expected to provide a useful tool for monitoring hospital inventory levels. This information will provide baseline data regarding the supply and demand of blood products in South Korea.

Isolation and molecular characterization of Chikungunya virus from the Andaman and Nicobar archipelago, India: evidence of an East, Central, and South African genotype.

Science.gov (United States)

Muruganandam, N; Chaaithanya, I K; Senthil, G S; Shriram, A N; Bhattacharya, D; Jeevabharathi, G S; Sudeep, A B; Pradeepkumar, N; Vijayachari, P

2011-12-01

Chikungunya virus (CHIKV) is an Alphavirus belonging to the family Togaviridae. In 2006, CHIKV infection struck the Andaman and Nicobar archipelago, with an attack rate of 60%. There were more than 10 cases with acute flaccid paralysis simulating the Guillian Barre Syndrome. The majority of the patients presented severe joint pain. The cause for such an explosive nature of the outbreak with increased morbidity was not known. The isolation of CHIKV was attempted and succeeded from nine subjects presenting clinical symptoms of Chikungunya fever. The cDNA of all the isolates was sequenced for partial E1 and nsP1 genes. Sequences were aligned based on the double locus sequence typing concept. The phylogenetic analysis shows that sequences of Andaman isolates grouped with the East, Central, and South African genotype of virus isolates from India, Sri Lanka, and Réunion. The genetic distance between Andaman isolates and the Réunion isolates was very small. The phylogenetic analysis confirmed the origin of the isolates responsible for the first ever confirmed CHIKV outbreak in these islands to be the East, Central, and South African genotype. In this manuscript, we discuss the involvement of the East, Central, and South African strain with the Chikungunya fever outbreak in this archipelago and double locus sequence typing as a first time approach.

Proposals to enhance thermal efficiency programs and air pollution control in south-central Chile

International Nuclear Information System (INIS)

Schueftan, Alejandra; González, Alejandro D.

2015-01-01

Major cities in South-central Chile suffer high levels of particulate matter PM 10 and PM 2.5 due to combustion of solid fuels for heating. Exposure to these air pollutants is recognized as a major contribution to ill health in the region. Here we discuss new strategies to reduce air pollution. Regulations and subsidies focusing on improved combustion by providing drier wood fuel and better stoves have been in effect since 2007. However, air pollution due to combustion of wood fuel has been steadily rising, along with reports on health consequences. The paper analyzes a survey of 2025 households in the city of Valdivia, which found that wood fuel quality, stove renewal, and awareness of programs are strongly affected by income level, and that higher consumption of wood fuel is found in households already having better stoves and drier wood fuel. The analysis suggests that regulations intended to improve combustion are influenced by user's behavior and have limited potential for lowering pollution. We conclude that thermal refurbishment has a larger potential for improvement, not yet been implemented as an energy policy for the majority. Here we propose improvements and additions to current programs to enhance effectiveness and cover the whole social spectrum. - Highlights: • High levels of PM 2.5 from wood combustion affect cities of south-central Chile. • Current programs on dry wood fuel and stoves renewal have not reduced air pollution. • Real operation of wood stoves strongly depends on user's behavior. • Buildings' energy efficiency has greater potential for reducing emissions. • Retrofit prevents degradation of native forest and improves indoor temperature

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

Science.gov (United States)

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

2015-08-01

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

Immunohistochemical localization of CYP1A, vitellogenin and Zona radiata proteins in the liver of swordfish (Xiphias gladius L.) taken from the Mediterranean Sea, South Atlantic, South Western Indian and Central North Pacific Oceans

International Nuclear Information System (INIS)

Desantis, S.; Corriero, A.; Cirillo, F.; Deflorio, M.; Brill, R.; Griffiths, M.; Lopata, A.L.; Serna, J.M. de la; Bridges, C.R.; Kime, D.E.; De Metrio, G.

2005-01-01

Cytochrome P4501A (CYP1A) monoxygenase, vitellogenin (Vtg) and Zona radiata proteins (Zrp) are frequently used as biomarkers of fish exposure to organic contaminants. In this work, swordfish liver sections obtained from the Mediterranean Sea, the South African coasts (South Atlantic and South Western Indian Oceans) and the Central North Pacific Ocean were immunostained with antisera against CYP1A, Zrp, and Vtg. CYP1A induction was found in hepatocytes, epithelium of the biliary ductus and the endothelium of large blood vessels of fish from the Mediterranean Sea and South African waters, but not from the Pacific Ocean. Zrp and Vtg were immunolocalized in hepatocytes of male swordfish from the Mediterranean Sea and from South African waters. Plasma Dot-Blot analysis, performed in Mediterranean and Pacific specimens, revealed the presence of Zrp and Vtg in males from Mediterranean but not from Pacific. These results confirm previous findings about the potential exposure of Mediterranean swordfish to endocrine, disrupting chemicals and raise questions concerning the possible presence of xenobiotic contaminants off the Southern coasts of South Africa in both the South Atlantic and South Western Indian Oceans

Assessment of relative active tectonics, south central Alborz (north Iran)

Science.gov (United States)

Khavari, R.; Ghorashi, M.; Arian, M.

2009-04-01

The paper present a method for evaluating relative active tectonics based on geomorphic indices useful in evaluating morphology and topography. Indices used include: stream length-gradient index (SL), drainage basin asymmetry (Af), hypsometric integral (Hi), ratio of valley-floor width to valley height (Vf), index of drainage basin shape (Bs), and index of mountain front sinuosity (Smf). Results from the analysis are accumulated and expressed as an index of relative active tectonics (Iat), which we divide into four classes from relatively low to highest tectonic activity. The study area along the south flank of the central Alborz mountain range in north Iran is an ideal location to test the concept of an index to predict relative tectonic activity on a basis of area rather than a single valley or mountain front. The recent investigations show that neotectonism has played a key role in the geomorphic evolution of this part of the Alborz mountain range. Geomorphic indices indicate the presence of differential uplifting in the geological past. The area surrounding the Amirkabir lake shows very high relative tectonic activity.

Acinetobacter baumannii: Epidemiological and Beta-Lactamase Data From Two Tertiary Academic Hospitals in Tshwane, South Africa

Directory of Open Access Journals (Sweden)

Michelle Lowe

2018-06-01

Full Text Available Acinetobacter baumannii is an opportunistic pathogen that is increasingly responsible for hospital-acquired infections. The increasing prevalence of carbapenem resistant A. baumannii has left clinicians with limited treatment options. Last line antimicrobials (i.e., polymyxins and glycylcyclines are often used as treatment options. The aim of this study was to determine the prevalence of selected β-lactamase genes from A. baumannii isolates obtained from patients with hospital-acquired infections and to determine the genetic relationship and epidemiological profiles among clinical A. baumannii isolates collected from two tertiary academic hospitals in the Tshwane region, South Africa (SA. Multiplex-PCR (M-PCR assays were performed to detect selected resistance genes. The collected isolates’ genetic relatedness was determined by using pulsed field gel electrophoresis (PFGE and multilocus sequence typing (MLST. The acquired oxacillinase (OXA genes, notably blaOXA-23-like were prevalent in the A. baumannii isolates. The M-PCR assays showed that the isolates collected from hospital A contained the OXA-23-like (96%; n = 69/72 genes and the isolates collected from hospital B contained the OXA-23-like (91%; n = 63/69 and OXA-58-like (4%; n = 3/69 genes. Colistin resistance was found in 1% of the isolates (n = 2/141 and tigecycline intermediate resistance was found in 6% of the isolates (n = 8/141. The A. baumannii isolates were genetically diverse. Molecular epidemiological data showed that specific sequence types (STs (ST106, ST229, ST258 and ST208 were established in both hospitals, while ST848 was established in hospital A and ST502, ST339 and the novel ST1552 were established in hospital B. ST848 (established in hospital A was predominately detected in ICU wards whereas ST208, ST339 and the novel ST1552 (established in hospital B were detected in ICUs and the general wards. The origin of the A. baumannii isolates in the hospitals may be due to

Vegetative Propagation Trial of Prosopis africana (Guill. et Perr.) Taub. by Air Layering under Sudano-Sahelian Climate in the South-Central Niger

OpenAIRE

Abdou, Laouali; Karim, Saley; Habou, Rabiou; Mahamane, Ali

2015-01-01

Prosopis africana is a species of great socioeconomic importance but threatened with extinction in Niger because of overuse and regeneration problem. This study, conducted in the Maradi (Niger) area, precisely at El Gueza in the south of Gazaoua department, aims to evaluate the vegetative propagation capacity of P. africana by air layering under the Sudano-Sahelian climate of the south-central Niger. A ring of bark was taken on each selected branch and the wound was covered with a black plast...

South Africa : tous les projets | Page 6 | CRDI - Centre de ...

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

Sujet: INTELLECTUAL PROPERTY, PATENT LAW, PHARMACEUTICALS, PHARMACEUTICAL INDUSTRY, ESSENTIAL DRUGS, ACCESS TO HEALTH CARE, SCIENCE AND TECHNOLOGY POLICY. Région: India, South Africa, North of Sahara, South of Sahara, North and Central America, South America, Central Asia, ...

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

Science.gov (United States)

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

2018-01-01

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

Chemical stratigraphy of Grande Ronde Basalt, Pasco Basin, south-central Washington

International Nuclear Information System (INIS)

Long, P.E.; Ledgerwood, R.K.; Myers, C.W.; Reidel, S.P.; Landon, R.D.; Hooper, P.R.

1980-02-01

Grande Ronde Basalt in the Pasco Basin, south-central Washington, can be subdivided into three chemical types and two chemical subtypes based on x-ray fluorescence major element analysis of samples from seven deep core holes and three surface sections. These chemical types are: (1) high-Mg Grande Ronde chemical type; (2) low-Mg Grande Ronde chemical type; (3) low-K (very high-Mg.) Grande Ronde chemical type; and (4) Umtanum Grande Ronde chemical subtype. A possible fifth subdivision is the McCoy Canyon Grande Ronde chemical subtype. The Umtanum and the McCoy Canyon subtypes are both single flows which belong to the low Mg and high-Mg chemical types, respectively. These subdivisions are all distinguished on a plot of MgO versus TiO 2 and/or MgO versus P 2 O 5 , but other major and minor elements, as well as trace elements, also reflect consistent chemical differences between the chemical types. Identification of these chemical types in the Pasco Basin subsurface shows that the high-Mg and low-Mg chemical types are ubiquitous, but the low-K chemical type is limited to the central, southern, and eastern parts of the basin. The Umtanum chemical subtype is present throughout the Pasco Basin subsurface, although it thins in the northeastern part of the basin and is apparently absent from surface exposures 40 kilometers (25 miles) north of the basin. The McCoy Canyon chemical subtype is also present throughout the basin

Etiologic Agents of Central Nervous System Infections among Febrile Hospitalized Patients in the Country of Georgia

OpenAIRE

Akhvlediani, Tamar; Bautista, Christian T.; Shakarishvili, Roman; Tsertsvadze, Tengiz; Imnadze, Paata; Tatishvili, Nana; Davitashvili, Tamar; Samkharadze, Tamar; Chlikadze, Rusudan; Dvali, Natia; Dzigua, Lela; Karchava, Mariam; Gatserelia, Lana; Macharashvili, Nino; Kvirkvelia, Nana

2014-01-01

OBJECTIVES: There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. METHODS: Children and adults patients cli...

Correlation of Helicobacter pylori genotypes with gastric histopathology in the central region of a South-European country

OpenAIRE

Almeida, N; Donato, MM; Romãozinho, JM; Luxo, C; Cardoso, O; Cipriano, MA; Marinho, C; Fernandes, A; Sofia, C

2015-01-01

BACKGROUND: Outcome of Helicobacter pylori (H. pylori) infection results from interaction of multiple variables including host, environmental and bacterial-associated virulence factors. AIM: This study aimed to investigate the correlation of cagA, cagE, vacA, iceA and babA2 genotypes with gastric histopathology and disease phenotype in the central region of a South-European country. METHODS: This prospective study involved 148 infected patients (110 female; mean age 43.5 ± 13.4...

Status and trends of land change in the Midwest–South Central United States—1973 to 2000

Science.gov (United States)

Auch, Roger F.; Karstensen, Krista A.; Auch, Roger F.; Karstensen, Krista A.

2015-12-10

U.S. Geological Survey (USGS) Professional Paper 1794–C is the third in a four-volume series on the status and trends of the Nation’s land use and land cover, providing an assessment of the rates and causes of land-use and land-cover change in the Midwest–South Central United States between 1973 and 2000. Volumes A, B, and D provide similar analyses for the Western United States, the Great Plains of the United States, and the Eastern United States, respectively. The assessments of land-use and land-cover trends are conducted on an ecoregion-by-ecoregion basis, and each ecoregion assessment is guided by a nationally consistent study design that includes mapping, statistical methods, field studies, and analysis. Individual assessments provide a picture of the characteristics of land change occurring in a given ecoregion; in combination, they provide a framework for understanding the complex national mosaic of change and also the causes and consequences of change. Thus, each volume in this series provides a regional assessment of how (and how fast) land use and land cover are changing, and why. The four volumes together form the first comprehensive picture of land change across the Nation.Geographic understanding of land-use and land-cover change is directly relevant to a wide variety of stakeholders, including land and resource managers, policymakers, and scientists. The chapters in this volume present brief summaries of the patterns and rates of land change observed in each ecoregion in the Midwest–South Central United States, together with field photographs, statistics, and comparisons with other assessments. In addition, a synthesis chapter summarizes the scope of land change observed across the entire Midwest–South Central United States. The studies provide a way of integrating information across the landscape, and they form a critical component in the efforts to understand how land use and land cover affect important issues such as the provision of

Mutations in BRCA1, BRCA2 and other breast and ovarian cancer susceptibility genes in Central and South American populations.

Science.gov (United States)

Jara, Lilian; Morales, Sebastian; de Mayo, Tomas; Gonzalez-Hormazabal, Patricio; Carrasco, Valentina; Godoy, Raul

2017-10-06

Breast cancer (BC) is the most common malignancy among women worldwide. A major advance in the understanding of the genetic etiology of BC was the discovery of BRCA1 and BRCA2 (BRCA1/2) genes, which are considered high-penetrance BC genes. In non-carriers of BRCA1/2 mutations, disease susceptibility may be explained of a small number of mutations in BRCA1/2 and a much higher proportion of mutations in ethnicity-specific moderate- and/or low-penetrance genes. In Central and South American populations, studied have focused on analyzing the distribution and prevalence of BRCA1/2 mutations and other susceptibility genes that are scarce in Latin America as compared to North America, Europe, Australia, and Israel. Thus, the aim of this review is to present the current state of knowledge regarding pathogenic BRCA variants and other BC susceptibility genes. We conducted a comprehensive review of 47 studies from 12 countries in Central and South America published between 2002 and 2017 reporting the prevalence and/or spectrum of mutations and pathogenic variants in BRCA1/2 and other BC susceptibility genes. The studies on BRCA1/2 mutations screened a total of 5956 individuals, and studies on susceptibility genes analyzed a combined sample size of 11,578 individuals. To date, a total of 190 different BRCA1/2 pathogenic mutations in Central and South American populations have been reported in the literature. Pathogenic mutations or variants that increase BC risk have been reported in the following genes or genomic regions: ATM, BARD1, CHECK2, FGFR2, GSTM1, MAP3K1, MTHFR, PALB2, RAD51, TOX3, TP53, XRCC1, and 2q35.

Multiple Sclerosis Epidemiology in East Asia, South East Asia and South Asia: A Systematic Review.

Science.gov (United States)

Eskandarieh, Sharareh; Heydarpour, Pouria; Minagar, Alireza; Pourmand, Shadi; Sahraian, Mohammad Ali

2016-01-01

Multiple sclerosis (MS) is one of the most common chronic immune-mediated diseases of the human central nervous system and an important cause of non-traumatic neurologic disability among young population in several countries. Recent reports from East Asia, South East Asia and South Asia have proposed a low to moderate prevalence of MS in these countries. A literature review search was carried out in December 2014 in Medline, Embase, Scopus and Cochrane library to recover original population-based studies on MS epidemiology in East Asia, South East Asia and South Asia countries published between January 1, 1950 and December 30, 2014. We intended search strategies using the key words: multiple sclerosis, prevalence, incidence and epidemiology. Based on our inclusion criteria, 68 epidemiologic studies were included in this systematic review. The most extensively used diagnostic criteria in the studies were McDonald's criteria. Most studies were performed in a multi-center hospital setting. The female to male ratio varied and ranged from 0.7 in India to 9.0 in China. The mean age at disease onset ranged from the lowest age of 25.3 in Iran to the highest age of 46.4 in China. MS prevalence ranged from 0.77 in 100,000 populations in Hong Kong (1999) to 85.80 in 100,000 in Iran (2013). Advances in MS registries around the globe allow nationwide population-based studies and will allow worldly comparisons between the prevalence and incidence in different regions that are provided to monitor estimation. © 2016 S. Karger AG, Basel.

Notes from a field hospital south of Mosul.

Science.gov (United States)

Quinn V, John M; Amouri, Omar F; Reed, Pete

2018-03-06

This short letter from the field is offered as a rapid communiqué of the emergency medical situation in Mosul and surrounding areas on the eve of the final onslaught to liberate the city. This letter is based on emergency medical work at two World Health Organization (WHO) and Ministry of Health (MoH) Iraq lead Role II+ Field Hospital facilities south of Mosul City from April to June 2017; these facilities are currently and temporarily managed and administered by private medical industry until full handover to MoH Iraq, with WHO support and expert facilitation. The prominence of non-state actors in the conflict, using hybrid warfare tactics that maximize casualties, makes health security a particular challenge for the global community. This challenge requires health leaders and other actors in the region to set clear strategic goals that support public health of the many millions displaced, maimed and affected by the war. Whether in clinical medicine, development, peace and stability operations, or global health diplomacy, the shared values and conviction to best serve vulnerable communities and mitigate morbidity must embrace the lessons of evidenced based practice derived from military medical experience. WHO is leading the charge in disaster response for the conflict in Iraq, and many challenges remain. This might also include developing a new process in emergency medical response that utilizes private contracting to improve efficiency in delivery and overall sustainability.

Implementing health care reform: implications for performance of public hospitals in central Ethiopia.

Science.gov (United States)

Manyazewal, Tsegahun; Matlakala, Mokgadi C

2018-06-01

Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia. The reform documents were reviewed to assess the nature and targets of the reform for interpretive analysis. Adopting dimensions of health system performance as the theoretical framework, a self-administered questionnaire was developed. Consenting health care professionals who have been involved in the reform from inception to implementation filled the questionnaire. Cronbach's alpha was measured to ensure internal consistency of the instrument. Descriptive statistics, weighted median score, χ 2 , and Mann-Whitney U and Kruskal-Wallis tests were used for data analysis. s Despite implementation of the reform, the health care system in public hospitals was still fragmented as confirmed by 50% of respondents. Limited effects were reported in favour of quality (48%), access (50%), efficiency (51%), sustainability (53%), and equity (61%) of care, while poor effects were reported in patient-provider (41%) and provider-management (32%) interactions. Though there was substantial gain in infrastructure and workspace, stewardship of health care resources was less benefited. The predominant hindrances of the reform were the working environment (adjusted Odds Ratio (aOR) = 2.27, 95% confidence interval (CI): 1.15-4.47), financial resources (aOR = 3.54, 95%CI = 1.97-6.33), management (aOR = 2.27, 95% CI = 1.15-4.47), and information technology system (aOR = 3.15, 95% CI = 1.57-6.32). s The Ethiopian

THE FIELD OF RECENT TECTONIC STRESSES IN CENTRAL AND SOUTH-EASTERN ASIA

Directory of Open Access Journals (Sweden)

Yu. L. Rebetsky

2014-01-01

Full Text Available  The publication presents results of the study aimed at reconstruction of recent crustal stresses for Central and South-Eastern Asia with application of the method of cataclastic analysis of displacements caused by ruptures, which was proposed by Yu.L. Rebetsky. Two sources of seismic data were referred to: (1 the catalog comprising data from publications covering the period from 1904 to 1992, and (2 the Global Centroid Moment Tensor (CMT Database of earthquake mechanisms (http://earthquake.usgs.gov/eqarchives/sopor, which covers the period from 1978 to 2010. The method of cataclastic analysis in its earliest version was applied in 1996 and 1997 when seismic data from the first catalog were analyzed, and it yielded only parameters of stress ellipsoids; the reconstructions were published in a Russian-Chinese journal (it does not exist now. In this paper, these reconstructions are presented in new graphical formats of GIS. Data from the Global CMT Database were analyzed by the method of cataclastic analysis in the new revision with application of its stages 1 and 2. Based on the calculations, orientations of axes of principal stresses, types of ellipsoids, correlations between spherical and deviatoric components of stress tensors, and reduced stresses were determined. The two sets of reconstructions are compared in this paper. The catalog of earthquake focal mechanisms for the period from 1904 to 1992 consolidated information provided by different authors, and thus focal data for many seismic events were highly inconsistent; therefore, the reliability of reconstructions based on such data seems to be lower than that on the basis the Global CMT Database for the period from 1978 to 2010. Some of the reconstructed stress tensor parameters are mapped. For the areas which data are given in the Global CMT Database and considered as more reliable, mapping is based on stress parameters calculated from such data. For the areas that are not covered by the

Otosclerosis among South African indigenous blacks | Tshifularo ...

African Journals Online (AJOL)

Objective: To report cases of clinical otosclerosis histologically confirmed among indigenous South African blacks. Design: A retrospective study. Setting: Referral tertiary center, MEDUNSA, Garankuwa Hospital, South Africa. Subjects: All fifteen indigenous South African blacks diagnosed with clinical otosclerosis at ...

Laboratory surveillance of influenza-like illness in seven teaching hospitals, South Korea: 2011-2012 season.

Directory of Open Access Journals (Sweden)

Ji Yun Noh

Full Text Available BACKGROUND: A well-constructed and properly operating influenza surveillance scheme is essential for public health. This study was conducted to evaluate the distribution of respiratory viruses in patients with influenza-like illness (ILI through the first teaching hospital-based surveillance scheme for ILI in South Korea. METHODS: Respiratory specimens were obtained from adult patients (≥18 years who visited the emergency department (ED with ILI from week 40, 2011 to week 22, 2012. Multiplex PCR was performed to detect respiratory viruses: influenza virus, adenovirus, coronavirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, parainfluenza virus, bocavirus, and enterovirus. RESULTS: Among 1,983 patients who visited the ED with ILI, 811 (40.9% were male. The median age of patients was 43 years. Influenza vaccination rate was 21.7% (430/1,983 during the 2011-2012 season. At least one comorbidity was found in 18% of patients. The positive rate of respiratory viruses was 52.1% (1,033/1,983 and the total number of detected viruses was 1,100. Influenza A virus was the dominant agent (677, 61.5% in all age groups. The prevalence of human metapneumovirus was higher in patients more than 50 years old, while adenovirus was detected only in younger adults. In 58 (5.6% cases, two or more respiratory viruses were detected. The co-incidence case was identified more frequently in patients with hematologic malignancy or organ transplantation recipients, however it was not related to clinical outcomes. CONCLUSION: This study is valuable as the first extensive laboratory surveillance of the epidemiology of respiratory viruses in ILI patients through a teaching hospital-based influenza surveillance system in South Korea.

Trace Element Accumulation and Tissue Distribution in the Purpleback Flying Squid Sthenoteuthis oualaniensis from the Central and Southern South China Sea.

Science.gov (United States)

Wu, Yan Yan; Shen, Yu; Huang, Hui; Yang, Xian Qing; Zhao, Yong Qiang; Cen, Jian Wei; Qi, Bo

2017-01-01

Sthenoteuthis oualaniensis is a species of cephalopod that is becoming economically important in the South China Sea. As, Cd, Cr, Cu, Hg, Pb, and Zn concentrations were determined in the mantle, arms, and digestive gland of S. oualaniensis from 31 oceanographic survey stations in the central and southern South China Sea. Intraspecific and interspecific comparisons with previous studies were made. Mean concentrations of trace elements analyzed in arms and mantle were in the following orders: Zn > Cu > Cd > Cr > As > Hg. In digestive gland, the concentrations of Cd and Cu exceed that of Zn. All the Pb concentrations were under the detected limit.

Antibiotic-Related Adverse Drug Reactions at a Tertiary Care Hospital in South Korea

Directory of Open Access Journals (Sweden)

In Young Jung

2017-01-01

Full Text Available Background. Adverse drug reactions (ADRs are any unwanted/uncomfortable effects from medication resulting in physical, mental, and functional injuries. Antibiotics account for up to 40.9% of ADRs and are associated with several serious outcomes. However, few reports on ADRs have evaluated only antimicrobial agents. In this study, we investigated antibiotic-related ADRs at a tertiary care hospital in South Korea. Methods. This is a retrospective cohort study that evaluated ADRs to antibiotics that were reported at a 2400-bed tertiary care hospital in 2015. ADRs reported by physicians, pharmacists, and nurses were reviewed. Clinical information reported ADRs, type of antibiotic, causality assessment, and complications were evaluated. Results. 1,277 (62.8% patients were considered antibiotic-related ADRs based on the World Health Organization-Uppsala Monitoring Center criteria (certain, 2.2%; probable, 35.7%; and possible, 62.1%. Totally, 44 (3.4% patients experienced serious ADRs. Penicillin and quinolones were the most common drugs reported to induce ADRs (both 16.0%, followed by third-generation cephalosporins (14.9%. The most frequently experienced side effects were skin manifestations (45.1% followed by gastrointestinal disorders (32.6%. Conclusion. Penicillin and quinolones are the most common causative antibiotics for ADRs and skin manifestations were the most frequently experienced symptom.

Eruption age of permanent mandibular first molars and central incisors in the south Indian population

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Gupta Rakhi

2007-01-01

Full Text Available Objective: The existing eruption schedules for permanent and deciduous dentition are based on studies in the Western population. Since Indians differ from Westerners racially, genetically, and environmentally, these studies fail to provide relevant guidance on the eruption schedule in the Indian population. This study aims at determining the eruption pattern of permanent mandibular molars and central incisors in the south Indian population. Materials and Methods: 10,156 apparently healthy Indian children in the age-group of 6-9 years were examined with mouth mirror and probe under adequate illumination for the status of the eruption of the permanent mandibular first molar and permanent mandibular central incisor. Pearson′s Chi-square test with Yates′ continuity correction was used to calculate the P -value for comparison of proportion between girls and boys. The values obtained in our study were compared with the standard values. The Z-test with continuity correction was used to calculate the P -value. Results: As per our study, the permanent mandibular first molars and central incisors erupted one to two years later compared to the values reported in Westerners. The earlier eruption of the permanent mandibular first molars compared to the permanent mandibular central incisors, as well as the earlier eruption of both the teeth in girls compared to boys, were in accordance with the existing literature. Conclusion: The eruption age reported by us may form a standard reference for eruption age in Indians.

Appraisal of the Effectiveness of CODE; The Coordinated Delivery System for the South Central Research Library Council, January to December 1970.

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Faibisoff, Sylvia G.

A major concern of the South Central Research Library Council in establishing an interlibrary loan network was the development of a Coordinated Delivery system (CODE). Several means of delivery were considered--the U.S. mails, commercial trucking (Greyhound, United Parcel Service), and use of the public library system's delivery services. A…

An assessment of fire occurrence regime and performance of Canadian fire weather index in south central Siberian boreal region

OpenAIRE

Chu, T.; Guo, X.

2014-01-01

Wildfire is the dominant natural disturbance in Eurasian boreal region, which acts as a major driver of the global carbon cycle. An effectiveness of wildfire management requires suitable tools for fire prevention and fire risk assessment. This study aims to investigate fire occurrence patterns in relation to fire weather conditions in the remote south central Siberia region. The Canadian Fire Weather Index derived from large-scale meteorol...

Nurse Interaction With Clients In Communication Therapeutic Study Analysis Of Symbolic Interactionism Hospital South Sulawesi

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Hj.Indirawaty

2015-08-01

Full Text Available ABSTRACT This study aimed to describe briefly on the application of social interaction which made nurses to clients while performing therapeutic communication at the Hospital of South Sulawesi with frame symbolic interactionism. Result achieved against the system carried nurse interaction with clients who patterned on therapeutic communication. At the stage of pre-interaction system is applied such as before the nurse interacts with the client well in advance to prepare the way of dressing reception duties of nurse and studying the book status of each client. Introduction or orientation phase nurses visit each client and when the first met uttered a greeting before asking the clients condition when the interaction takes place he uses verbal and non-verbal language and attitude shown in full client hospitality and courtesy. Stage work nurses do an evaluation or action on the clients condition in accordance with the termination task. Midwife stage nurse re-evaluate the client and conclude the development of the clients condition and report a doctor who handles client. The fourth aspect of the application using the analysis of symbolic interactionism

Characterizing the subsurface geology in and around the U.S. Army Camp Stanley Storage Activity, south-central Texas

Science.gov (United States)

Blome, Charles D.; Clark, Allan K.

2018-02-15

Several U.S. Geological Survey projects, supported by the National Cooperative Geologic Mapping Program, have used multi-disciplinary approaches over a 14-year period to reveal the surface and subsurface geologic frameworks of the Edwards and Trinity aquifers of central Texas and the Arbuckle-Simpson aquifer of south-central Oklahoma. Some of the project achievements include advancements in hydrostratigraphic mapping, three-dimensional subsurface framework modeling, and airborne geophysical surveys as well as new methodologies that link geologic and groundwater flow models. One area where some of these milestones were achieved was in and around the U.S. Army Camp Stanley Storage Activity, located in north­western Bexar County, Texas, about 19 miles north­west of downtown San Antonio.

Time spent in sedentary activities in a pediatric population in Pretoria Central, South Africa.

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Goon, Daniel T; Nsibambi, Constance A; Chebet, Milton

2016-12-01

Scant information exist on screen time behavior of South Africa children and whether they do not meet the recommendation of American Association of Pediatrics (AAP) concerning screen time activity for children is only speculative. Therefore, the purpose of this study was to examine the time spent in sedentary activities, especially screen time of South African children with regard to gender. This cross-sectional study involved a random sample of 1136 school children (548 boys; 588 girls) aged 9-13 years attending public schools in Central Pretoria, South Africa. Questionnaire was used to collect data on the participants' sedentary behaviors. The prevalence estimates for sedentary time activity was based on the guidelines (i.e., <2 or ≥2 hours per day) of AAP. The mean age of the children was 11.1±1.4 years. Sedentary activity data were collected from 548 boys (48.2%) and 588 (51.8%) girls. The majority of children spent more than two hours per day (exceeding the AAP recommendation for sedentary activity) watching TV (3.0%), worked or played on the computer (25.4%), read (1.0%), played music (27.9%), played board games (14.7%), washing clothes (8.0%), floor sweeping (10.5%), art work (18.2%), and spent time on other unspecified activities (28.6%). Boys spent more time (2 hours, 3-4 hours) watching TV (38.3%; P=0.001), playing computer (31.8 %; P=0.024) and board games (17.4%; P=0.012) than girls. The corresponding figures for girls were 35.7%, 19.2% and 12.5% for TV, computer and board games, respectively. However, the proportion of those who spent more time playing music was higher among girls (32.7%) than boys (22.4%) (P=0.002). Overall, the time spent exceeding AAP recommendation (≥ 2 hours) was not statistically (P=0.427) different between boys and girls. The time spent in sedentary activities, particularly in screen time activity among urban primary school children in Pretoria Central is excessively higher than the recommendation (i.e., ≥2 hours per day

Allogenic bone grafts used at Central Hospital during June 1995 to July 1998

International Nuclear Information System (INIS)

Yolchai Jongjirasiri; Yongyudh Vajaradul

1999-01-01

Producing and using allogenic bone graft in Thailand began ten years ago. There are approximately 1,000 cases a year on orthopaedic surgery at Central Hospital. For using allogenic bone graft from the Bangkok Biomaterial Center, 66 cases were operated since June 1995. This was generated by 30 in males, 36 in females and by ages between 12-81 years old. After the operation, 43 cases had bone gap from injuries and 19 cases, fusion of spondylolisthesis and scoliosis were done. Four cases had tumor surgery, and 59 out of 66 cases had good bone union that is 89%. Delayed union happened in 6 cases only. Immune response to allogenic bone graft has not been found yet

Legacy K/Ar and 40Ar/39Ar geochronologic data from the Alaska-Aleutian Range batholith of south-central Alaska

Science.gov (United States)

Koeneman, Lisa L.; Wilson, Frederic H.

2018-04-06

Sample descriptions and analytical data for more than 200 K/Ar and 40Ar/39Ar analyses from rocks of the Alaska-Aleutian Range batholith of south-central Alaska are reported here. Samples were collected over a period of 20 years by Bruce R. Reed and Marvin A. Lanphere (both U.S. Geological Survey) as part of their studies of the batholith.

‘Practice what you preach’: Nurses’ perspectives on the Code of Ethics and Service Pledge in five South African hospitals

Directory of Open Access Journals (Sweden)

Janine White

2015-05-01

Full Text Available Background: A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. Objective: The study explored hospital nurses’ perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses’ Pledge of Service; and their views on contemporary ethical practice. Methods: Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA® 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. Results: The mean age of survey participants (n=69 was 39 years (SD=9.2, and the majority were female (96%. The majority agreed with a statement that they will promote the human rights of individuals (98% and that they have a duty to meet the health and social needs of the public (96%. More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients’ rights as opposed to nurses’ rights and 32% agreeing with a statement that they would take part in strike action to improve nurses’ salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses’ responses to open-ended questions. Conclusion: Continuing education in ethics and addressing health system deficiencies will enhance nurses’ professional development and their ethical decision-making and

‘Practice what you preach’: Nurses’ perspectives on the Code of Ethics and Service Pledge in five South African hospitals

Science.gov (United States)

White, Janine; Phakoe, Maureen; Rispel, Laetitia C.

2015-01-01

Background A recent focus of the global discourse on the health workforce has been on its quality, including the existence of codes of ethics. In South Africa, the importance of ethics and value systems in nursing was emphasised in the 2011 National Nursing Summit. Objective The study explored hospital nurses’ perceptions of the International Code of Ethics for Nurses; their perceptions of the South African Nurses’ Pledge of Service; and their views on contemporary ethical practice. Methods Following university ethics approval, the study was done at a convenience sample of five hospitals in two South African provinces. In each hospital, all day duty nurses in paediatric, maternity, adult medical, and adult surgical units were requested to complete a self-administered questionnaire. The questionnaire focused on their perceptions of the Code of Ethics and the Pledge, using a seven-point Likert scale. STATA® 13 and NVIVO 10 were used to analyse survey data and open-ended responses, respectively. Results The mean age of survey participants (n=69) was 39 years (SD=9.2), and the majority were female (96%). The majority agreed with a statement that they will promote the human rights of individuals (98%) and that they have a duty to meet the health and social needs of the public (96%). More nuanced responses were obtained for some questions, with 60% agreeing with a statement that too much emphasis is placed on patients’ rights as opposed to nurses’ rights and 32% agreeing with a statement that they would take part in strike action to improve nurses’ salaries and working conditions. The dilemmas of nurses to uphold the Code of Ethics and the Pledge in face of workplace constraints or poor working conditions were revealed in nurses’ responses to open-ended questions. Conclusion Continuing education in ethics and addressing health system deficiencies will enhance nurses’ professional development and their ethical decision-making and practice. PMID:25971398

Medicare charge-receipt data: results for South Dakota.

Science.gov (United States)

Lamfers, Randall; Miller, Nathan; Nettleman, Mary D

2013-10-01

The 2013 release of 2011 financial information by the Centers for Medicare and Medicaid Services (CMS) caused concern because some hospitals had charges that appeared to be exorbitantly high compared to reimbursement rates. Charges and receipts for South Dakota were compared to national data. The study was restricted to nine discharge codes likely to be seen by an adult hospitalist service. South Dakota hospitals had a lower charge-to-receipt ratio than the national average (p Dakota was 2.74 compared to 3.75 nationally. South Dakota charged 29 percent less for these discharge codes and received 3 percent lower reimbursement than the national average. The relatively low charge-to-receipt ratio and low charges in South Dakota are encouraging. Unfortunately, the only South Dakotans likely to be asked to pay full charges are the uninsured, who thus face bills that are much higher than insurance companies pay for the insured population. This leaves uninsured patients and hospitals with trying to negotiate discounts or waivers on an individual basis, which is an inefficient and problematic approach for both parties.

Prevalence of 1691G>A FV mutation in Poland compared with that in other Central, Eastern and South-Eastern European countries

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Grażyna Adler

2012-05-01

Full Text Available The 1691G>A FV variant has been described as a common genetic risk factor in venous thromboembolism. The purpose of this study was to provide a further frequency value for 1691G>A FV in Poland and to collate summary data from Central (Poland, Czech, Slovakia, Eastern (Russia, Belarus, Ukraine and South-Eastern (Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Bulgaria European countries. For this purpose in 2007 the 1691G>A FV variant was analyzed by polymerase chain reaction-restriction fragment length polymorphism from DNA collected in 2005-2006. We studied 650 subjects: 400 newborns and 250 older individuals (mean age 46.1 y from Poland and compared results with reports from other countries, as well as with the frequency trend of 845G>A HFE across South-Eastern European countries using centroid cities. From our 1691G>A FV study we identified 626 GG homozygotes, 23 GA heterozygotes, and i AA homozygote (n = 650, giving an A allele frequency of 1.9%, and a summed frequency value for Poland of 2.0% (n = 1588; the frequency in Central European countries was 3.9% (n = 4559, mostly due to the high value in the Czech Republic: 5.1% (n = 2819; the South-Eastern European countries had 2.5% (n = 2410. Among the Eastern European countries the 1691G>A FV allele frequency was 1.9% (n=791, between the South-Eastern and Eastern European countries there was no significant difference (p=0.17. We confirm that the 1691G>A FV allele frequency in Poland, as well as other countries compared, is significantly lower than that in Czech.

Prevalence of 1691G>A FV mutation in Poland compared with that in other Central, Eastern and South-Eastern European countries.

Science.gov (United States)

Adler, Grażyna; Clark, Jeremy S C; Loniewska, Beata; Czerska, Ewa; Salkic, Nermin N; Ciechanowicz, Andrzej

2012-05-01

The 1691G>A FV variant has been described as a common genetic risk factor in venous thromboembolism. The purpose of this study was to provide a further frequency value for 1691G>A FV in Poland and to collate summary data from Central (Poland, Czech, Slovakia), Eastern (Russia, Belarus, Ukraine) and South-Eastern (Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Bulgaria) European countries. For this purpose in 2007 the 1691G>A FV variant was analyzed by polymerase chain reaction-restriction fragment length polymorphism from DNA collected in 2005-2006. We studied 650 subjects: 400 newborns and 250 older individuals (mean age 46.1 y) from Poland and compared results with reports from other countries, as well as with the frequency trend of 845G>A HFE across South-Eastern European countries using centroid cities. From our 1691G>A FV study we identified 626 GG homozygotes, 23 GA heterozygotes, and 1 AA homozygote (n = 650), giving an A allele frequency of 1.9%, and a summed frequency value for Poland of 2.0% (n = 1588); the frequency in Central European countries was 3.9% (n = 4559), mostly due to the high value in the Czech Republic: 5.1% (n = 2819); the South-Eastern European countries had 2.5% (n = 2410). Among the Eastern European countries the 1691G>A FV allele frequency was 1.9% (n=791), between the South-Eastern and Eastern European countries there was no significant difference (p=0.17). We confirm that the 1691G>A FV allele frequency in Poland, as well as other countries compared, is significantly lower than that in Czech.

Geographical distribution and profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa.

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Ntuli, Samuel T; Maboya, Edwin

2017-09-27

The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.

'Waiting for' and 'waiting in' public and private hospitals: a qualitative study of patient trust in South Australia.

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Ward, Paul R; Rokkas, Philippa; Cenko, Clinton; Pulvirenti, Mariastella; Dean, Nicola; Carney, A Simon; Meyer, Samantha

2017-05-05

Waiting times for hospital appointments, treatment and/or surgery have become a major political and health service problem, leading to national maximum waiting times and policies to reduce waiting times. Quantitative studies have documented waiting times for various types of surgery and longer waiting times in public vs private hospitals. However, very little qualitative research has explored patient experiences of waiting, how this compares between public and private hospitals, and the implications for trust in hospitals and healthcare professionals. The aim of this paper is to provide a deep understanding of the impact of waiting times on patient trust in public and private hospitals. A qualitative study in South Australia, including 36 in-depth interviews (18 from public and 18 from private hospitals). Data collection occurred in 2012-13, and data were analysed using pre-coding, followed by conceptual and theoretical categorisation. Participants differentiated between experiences of 'waiting for' (e.g. for specialist appointments and surgery) and 'waiting in' (e.g. in emergency departments and outpatient clinics) public and private hospitals. Whilst 'waiting for' public hospitals was longer than private hospitals, this was often justified and accepted by public patients (e.g. due to reduced government funding), therefore it did not lead to distrust of public hospitals. Private patients had shorter 'waiting for' hospital services, increasing their trust in private hospitals and distrust of public hospitals. Public patients also recounted many experiences of longer 'waiting in' public hospitals, leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or nurses, instead blaming an underfunded system and over-worked staff. Doctors and nurses were seen to be doing their best, and therefore trustworthy. Although public patients experienced longer 'waiting for' and 'waiting in' public hospitals, it did not lead to widespread distrust

Genetic structure of Quechua-speakers of the Central Andes and geographic patterns of gene frequencies in South Amerindian populations.

Science.gov (United States)

Luiselli, D; Simoni, L; Tarazona-Santos, E; Pastor, S; Pettener, D

2000-09-01

A sample of 141 Quechua-speaking individuals of the population of Tayacaja, in the Peruvian Central Andes, was typed for the following 16 genetic systems: ABO, Rh, MNSs, P, Duffy, AcP1, EsD, GLOI, PGM1, AK, 6-PGD, Hp, Gc, Pi, C3, and Bf. The genetic structure of the population was analyzed in relation to the allele frequencies available for other South Amerindian populations, using a combination of multivariate and multivariable techniques. Spatial autocorrelation analysis was performed independently for 13 alleles to identify patterns of gene flow in South America as a whole and in more specific geographic regions. We found a longitudinal cline for the AcP1*a and EsD*1 alleles which we interpreted as the result of an ancient longitudinal expansion of a putative ancestral population of modern Amerindians. Monmonnier's algorithm, used to identify areas of sharp genetic discontinuity, suggested a clear east-west differentiation of native South American populations, which was confirmed by analysis of the distribution of genetic distances. We suggest that this pattern of genetic structures is the consequence of the independent peopling of western and eastern South America or to low levels of gene flow between these regions, related to different environmental and demographic histories. Copyright 2000 Wiley-Liss, Inc.

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

Science.gov (United States)

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

2017-10-01

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

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 ...

IK Brunel's Crimean war hospital.

Science.gov (United States)

Merridew, C G

2014-07-01

"Those wonderful huts…" (Florence Nightingale). This is the story of the British Civil Hospital, erected in 1855 at Renkioi on the south Dardanelles coast of Turkey. The spectacular hospital was a portable one designed by British engineer IK Brunel. It was his only health-related project, and it was known as a Civil Hospital because its staff were all civilians, despite its patients being military.

Domestication and human demographic history in South America.

Science.gov (United States)

Perez, S Ivan; Postillone, María Bárbara; Rindel, Diego

2017-05-01

The early groups of hunter-gatherers who peopled South America faced significant ecological changes in their trophic niche for a relatively short period after the initial peopling. In particular, the incorporation of cultigens during the Holocene led to a wider trophic niche and probably to an increased carrying capacity of the environment. Here, we study the relationship between the incorporation of domestic resources during the Holocene and the demographic dynamics of human populations at a regional scale in South America. We employ mitochondrial DNA (mtDNA), radiocarbon data and Bayesian methods to estimate differences in population size, human occupation and explore the demographic changes of human populations in three regions (i.e., South-Central Andes, Northwest, and South Patagonia). We also use archaeological evidence to infer the main diet changes in these regions. The absolute population size during the later Late Holocene was fifteen times larger in the South-Central Andes than in Northwest Patagonia, and two times larger in the latter region than in South Patagonia. The South-Central Andes display the earlier and more abrupt population growth, beginning about 9000 years BP, whereas Northwest Patagonia exhibits a more slow growth, beginning about 7000-7500 years BP. South Patagonia represents a later and slower population increase. In this work we uncovered a well-supported pattern of the demographic change in the populations from South-Central Andes and Patagonia, obtained on the basis of different data and quantitative approaches, which suggests that the incorporation of domestic resources was paramount for the demographic expansion of these populations during the Holocene. © 2017 Wiley Periodicals, Inc.

The role of skeletal scintigraphy in nuclear oncology at a medium-sized hospital in South Korea

International Nuclear Information System (INIS)

Choe, W.

2004-01-01

Full text: Skeletal scintigraphy (SS) has been a workhorse in nuclear medicine departments, whether the department is in a developed country or in a developing country. It also plays an essential role in nuclear oncology in staging or diagnosing cancers or monitoring management of cancer patients. With the availability of improved imaging modalities like positron emission tomography, the role of skeletal scintigraphy is changing accordingly. This study was performed to evaluate the role of SS in nuclear oncology at a medium-sized (900-bed) university hospital in South Korea, by reviewing hospital cases along with the statistics of recently published papers in the journal of Clinical Nuclear Medicine. The hospital does not have a PET. The study period was three years (from 2000 to 2002). The SS is requested from many specialties for various reasons. Only cancer-related cases were selected. Using PubMed database, relevant articles in the Clinical Nuclear Medicine were assessed. To retrieve the articles, the keywords 'skeletal scintigraphy' and 'bone scan' were combined by using Boolean operation. There were a total of 9707 SS out of 16429 nuclear medicine imaging cases at the hospital during the study period. The hospital had 49% of SS contributed to cancer patients, while 52% percent of the SS in the CNM dealt with cancers. During the same period, articles regarding PET were 273 of which 171 were cancer-related PET studies (62%, more often than SS). 59% of the total nuclear medicine studies performed at the hospital were SS, whereas only 9% of the total articles were SS and 5% dealt with cancer-related cases. The cases of SS and cancer-related SS at the hospital increased during the period, whereas the articles in the CNM decreased. Analytic statistics were not considered necessary. In conclusion, there is an increasing demand of SS in nuclear oncology at a medium-sized hospital with non-availability of PET and the proportions of SS and cancer-related SS to the

Depositional setting and early diagenesis of the dinosaur eggshell-bearing Aren Fm at Bastus, Late Campanian, south-central Pyrenees

OpenAIRE

Díaz Molina, Margarita; Kälin, Otto; Benito Moreno, María Isabel; López Martínez, Nieves; Vicens, Enric

2007-01-01

The Late Cretaceous Aren Fm exposed north of Bastus in the Tremp Basin (south-central Pyrenees) preserves an excellent record of dinosaur eggs laid in a marine littoral setting. Different from other cases reported in literature, at the Bastus site the preferential nesting ground was original beach sand. The coastal deposits of Aren Fm can be grouped into four facies assemblages, representing respectively shoreface, beachface, beach ridge plain and backbarrier lagoon environments. Shoreface de...

A Proposed Solution for Managing Doctor's Smart Cards in Hospitals Using a Single Sign-On Central Architecture

OpenAIRE

Mauro, Christian;Sunyaev, Ali;Leimeister, Jan Marco;Schweiger, Andreas;Krcmar, Helmut

2014-01-01

This paper describes a single sign-on solution for the central management of health care provider?s smart cards in hospitals. The proposed approach which is expected to be an improvement over current methods is made possible through the introduction of a national healthcare telematics infrastructure in Germany where every physician and every patient will automatically be given an electronic health smart card (for patients) and a corresponding health professional card (for health care provider...

Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital, Blantyre-Malawi.

Science.gov (United States)

Kalata, N L; Kamange, L; Muula, A S

2013-06-01

While communicable diseases are the leading causes of morbidity and mortality in Malawi, the contribution of nosocomial or hospital-acquired infections (HAIs) is unknown but could be substantial. The single most important method of preventing nosocomial infections is hand hygiene. We report a study which was conducted in 2011 to investigate adherence to hand hygiene protocols by clinicians and medical students working at Queen Elizabeth Central Hospital in Blantyre, Malawi. There were two parts to the study: a single blinded arm in which participants were observed without their knowledge by trained nurses; and a second arm which included self-completion of questionnaire after participant consent was obtained. The 2009 World Health Organization hand hygiene technique and recommendations which were adopted by Queen Elizabeth Central Hospital were used to define an opportunity for hand washing and effectiveness of hand washing. Hand hygiene effectiveness was defined as adherence to at least 6 out of 7 steps (80%) of the hand hygiene technique when using alcohol-based formulation or at least 8 out of 10 steps (80%) of the hand hygiene technique when using water and soap formulation before and after having direct contact with patients or their immediate surroundings. Clinicians were found to have disinfected their hands more than medical students (phand sanitizer and hand hygiene practice (p=0.3). Adherence to hand hygiene was found to be 23%. Most of the participants mentioned infection transmission prevention as a reason for disinfecting their hands. Other reasons mentioned included: a routine personal hand hygiene behaviour and discomfort if not washing hands. The top three reasons why they did not disinfect hands were forgetfulness, unavailability of sanitizers and negligence. Adherence to hand hygiene practice was found to be low, with forgetfulness and negligence being the major contributing factors. A hospital-wide multifaceted program aiming at clinicians and

Melittofauna and Other Potential Pollinators in Wetland and Uplands in South Central Nebraska (Insecta: Apoidea).

Science.gov (United States)

Park, Cynthia N; Overall, Lisa M; Smith, Loren M; Lagrange, Ted; McMurry, Scott

2017-03-10

Our objective was to document potential wild pollinating insects in south central Nebraska. This intensively cultivated region is known as the Rainwater Basin and contains some of the most endangered wetland systems in North America. We used blue vane traps to passively collect insects and insect nets to actively collect on flowering plants from April through October in 2014 and 2015. Habitat types included playa wetlands, adjacent mixed and tallgrass prairies, and agricultural fields. Over 112,000 insects were collected; Hymenoptera represented 78% of the total, and the families Apidae and Halictidae comprised 99% of the total melittofauna. Insects from 13 orders were collected, but Hymenoptera, Diptera, and Coleoptera were the most abundant potential pollinators.

Teacher Education in Central Equatoria, South Sudan

Science.gov (United States)

Hahs Brinkley, Catherine

2016-01-01

Without education, many South Sudanese will continue living in poverty. There are numerous factors that limit their educational opportunities including tribal warfare, colonialism, missionary malpractice, civil wars, a high illiteracy rate, low government funding, and threats of war. These factors have left a substantial deficiency in available…

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

Science.gov (United States)

Oborn, Eivor

2008-04-01

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

Rifampicin resistance in mycobacterium tuberculosis patients using GeneXpert at Livingstone Central Hospital for the year 2015: a cross sectional explorative study.

Science.gov (United States)

Masenga, Sepiso K; Mubila, Harrison; Hamooya, Benson M

2017-09-22

Since the recent introduction of GeneXepert for the detection of Tuberculosis (TB) drug resistance mutations in both primary resistance and acquired resistance in Zambia, little has been documented in literature on the issue of rifampicin resistance especially in the face of a high National TB burden. The study aimed to determine the prevalence of rifampicin resistance in tuberculosis patients at Livingstone Central Hospital for the year 2015. This was a cross sectional study conducted at Livingstone Central Hospital where we reviewed 152 records (from January 1, 2015 to 31st December, 2015) involving patients who presented with clinically suspected TB or documented TB, whose samples were sent to the laboratory for GeneXpert Mycobacterium tuberculosis/rifampicin testing. Statistical evaluations used a one-sample test of proportion and Fisher's exact test. The age of participants ranged from 8 months to 73 years old (median = 34). Of the participants with complete data on gender, 99 (66%) and 52 (34%) were males and females respectively. The TB co-infection with HIV prevalence was 98.3% (p < 0.001). Prevalence of rifampicin resistance was 5.9% and there was no statistical significant difference between being male or female (p = 0.721). We were able to show from our study, evidence of rifampicin resistance at Livingstone Central Hospital. Hence, there was need for further in-depth research and appropriate interventions (i.e close follow-up and patient care for drug resistance positive patients).

The household costs of health care in rural South Africa with free public primary care and hospital exemptions for the poor.

Science.gov (United States)

Goudge, Jane; Gilson, Lucy; Russell, Steve; Gumede, Tebogo; Mills, Anne

2009-04-01

To measure the direct cost burdens (health care expenditure as a percent of total household expenditure) for households in rural South Africa, and examine the expenditure and use patterns driving those burdens, in a setting with free public primary health care and hospital exemptions for the poor. Data on illness events, treatment patterns and health expenditure in the previous month were assessed from a cross-sectional survey of 280 households conducted in the Agincourt Health and Demographic Surveillance site, South Africa. On average, a household experiencing illness incurred a direct cost burden of 4.5% of total household expenditure. A visit to a public clinic generated a mean burden of 1.3%. Complex sequences of treatments led 20% of households to incur a burden over 10%, with transport costs generating 42% of this burden. An outpatient public hospital visit generated a burden of 8.2%, as only 58% of those eligible obtained an exemption; inpatient stays incurred a burden of 45%. Consultations with private providers incurred a mean burden of 9.5%. About 38% of individuals who reported illness did not take any treatment action, 55% of whom identified financial and perceived supply-side barriers as reasons. The low overall mean cost burden of 4.5% suggests that free primary care and hospital exemptions provided financial protection. However, transport costs, the difficulty of obtaining hospital exemptions, use of private providers, and complex treatment patterns meant state-provided protection had limitations. The significant non-use of care shows the need for other measures such as more outreach services and more exemptions in rural areas. The findings also imply that fee removal anywhere must be accompanied by wider measures to ensure improved access.

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Région: Brazil, South America, India, Morocco, Mexico, North and Central America, South Africa, North of Sahara, South of Sahara, Central Asia, Far East Asia, ... à l'information est à la fois un droit de la personne fondamental et universel et une pierre angulaire de la bonne gouvernance et de la lutte contre la corruption.

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

Science.gov (United States)

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

2018-01-01

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

Multiscale analyses on a massive immigration process of Sogatella furcifera (Horváth) in south-central China: influences of synoptic-scale meteorological conditions and topography

Science.gov (United States)

Wu, Qiu-Lin; Westbrook, John K.; Hu, Gao; Lu, Ming-Hong; Liu, Wan-Cai; Sword, Gregory A.; Zhai, Bao-Ping

2018-04-01

Mass landings of migrating white-backed planthopper, Sogatella furcifera (Horváth), can lead to severe outbreaks that cause heavy losses for rice production in East Asia. South-central China is the main infestation area on the annual migration loop of S. furcifera between the northern Indo-China Peninsula and mainland China; however, rice planthopper species are not able to survive in this region over winter. In this study, a trajectory analysis of movements from population source areas and a spatiotemporal dynamic analysis of mesoscale and synoptic weather conditions from 7 to 10 May 2012 were conducted using the weather research and forecasting (WRF) model to identify source areas of immigrants and determine how weather and topographic terrain influence insect landing. A sensitivity experiment was conducted with reduced topography using the WRF model to explain the associations among rainfall, topography, and light-trap catches of S. furcifera. The trajectory modeling results suggest that the source areas of S. furcifera immigrants into south-central China from 8 to 10 May were mainly southern Guangxi, northern Vietnam, and north-central Vietnam. The appearance of enormous catches of immigrant S. furcifera coincided with a period of rainstorms. The formation of transporting southerly winds was strongly associated with the topographic terrain. Additionally, the rainfall distribution and intensity over south-central China significantly decreased when topography was reduced in the model and were directly affected by wind circulation, which was associated with mountainous terrain that caused strong convection. This study indicates that migrating populations of S. furcifera were carried by the southwesterly low-level jets and that topographically induced convergent winds, precipitation, low temperatures, and wind shear acted as key factors that led to massive landings.

Multiscale analyses on a massive immigration process of Sogatella furcifera (Horváth) in south-central China: influences of synoptic-scale meteorological conditions and topography.

Science.gov (United States)

Wu, Qiu-Lin; Westbrook, John K; Hu, Gao; Lu, Ming-Hong; Liu, Wan-Cai; Sword, Gregory A; Zhai, Bao-Ping

2018-04-30

Mass landings of migrating white-backed planthopper, Sogatella furcifera (Horváth), can lead to severe outbreaks that cause heavy losses for rice production in East Asia. South-central China is the main infestation area on the annual migration loop of S. furcifera between the northern Indo-China Peninsula and mainland China; however, rice planthopper species are not able to survive in this region over winter. In this study, a trajectory analysis of movements from population source areas and a spatiotemporal dynamic analysis of mesoscale and synoptic weather conditions from 7 to 10 May 2012 were conducted using the weather research and forecasting (WRF) model to identify source areas of immigrants and determine how weather and topographic terrain influence insect landing. A sensitivity experiment was conducted with reduced topography using the WRF model to explain the associations among rainfall, topography, and light-trap catches of S. furcifera. The trajectory modeling results suggest that the source areas of S. furcifera immigrants into south-central China from 8 to 10 May were mainly southern Guangxi, northern Vietnam, and north-central Vietnam. The appearance of enormous catches of immigrant S. furcifera coincided with a period of rainstorms. The formation of transporting southerly winds was strongly associated with the topographic terrain. Additionally, the rainfall distribution and intensity over south-central China significantly decreased when topography was reduced in the model and were directly affected by wind circulation, which was associated with mountainous terrain that caused strong convection. This study indicates that migrating populations of S. furcifera were carried by the southwesterly low-level jets and that topographically induced convergent winds, precipitation, low temperatures, and wind shear acted as key factors that led to massive landings.

Arthroplasty of hip resection, handling with external fixation - Experience in the central military hospital

International Nuclear Information System (INIS)

Satizabal Azuero, Carlos E; Calderon Uribe, Oscar; Naquira Escobar, Luis F

2006-01-01

This is an observational retrospective study series of cases carried out between January 1998 and July 2004 in the central military hospital, 13 patients were treated with Girdlestone arthroplasty with external fixation, with a pursuit average of 53 months. Function, return to the daily activities and associate complications was evaluated. They were as complication; pain in the fixator site, osteitis, and fixator broke. All patients report at the end of the treatment no pain in the hip. Shortening in the patient without lenghting was 3,5 cm and in the group with lenghting was 1.5 cm. the obtained results demonstrate that Girdlestone arthroplasty with external fixation, is option, to improve the patient's pain and function of the hip

THE STRUCTURE OF THE SEED YIELD OF BROAD BEANS IN THE SOUTH CENTRAL ZONE OF THE SOUTH OF THE CENTRAL BLACK EARTH REGION

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Yu. N. Kurkina

2018-01-01

Full Text Available Rich in high quality protein, vitamins, carbohydrates, organic acids and trace elements seeds, green fruits and young leaves broad beans (Vicia faba L. var. major Harz has long been used in the food, and the culture of beans are promising in biological agriculture and horticulture. The aim of this work was to study the structure of seed production of different varieties of broad beans in the South Central zone of the region. At the Botanical garden BelSU (Belgorod to study the structure of seed production of different varieties of broad beans (Belarusiskie, Velena, Russkie chernie, Aquadul and determined the biochemical composition of seeds. Optimal height of attachment of the first fruit for mechanical harvesting (20-25 cm characteristic of plants of all studied varieties. Weight of the fetus, according to the coefficient of variability, equal to 45%, distinguished by a strong variability on grades with a maximum grade of Velena. The length of fruit ranged from 9 to 13 cm and were characterized by moderate variability (V=20%. Seeds production is determinened not only by size of fruits of beans, but and its important components such as 1000 seed weight. Protein content in the seeds at 30% different varieties of broad beans domestic breeding. Contents of nitrogen, potassium, phosphorus and iron is higher in the cotyledons than in the skin. Dark purple color of the seed varieties of Russian black is due to the biosynthesis useful for human organism anthocyanins in seed peel.

Preliminary description of hydrologic characteristics and contaminant transport potential of rocks in the Pasco Basin, south-central Washington

International Nuclear Information System (INIS)

Deju, R.A.; Fecht, K.R.

1979-03-01

This report aims at consolidating existing data useful in defining the hydrologic characteristics of the Pasco Basin within south-central Washington. It also aims at compiling the properties required to evaluate contaminant transport potential within individual subsurface strata in this basin. The Pasco Basin itself is a tract of semi-arid land covering about 2,000 square miles in south-central Washington. The regional geology of this basin is dominated by tholeiitic flood basalts of the Columbia Plateau. The surface hydrology of the basin is dominated by the Yakima, Snake, and Columbia rivers. Short-lived ephemeral streams may flow for a short period of time after a heavy rainfall or snowmelt. The subsurface hydrology of the Pasco Basin is characterized by an unconfined aquifer carrying the bulk of the water discharged within the basin. This aquifer overlies a series of confined aquifers carrying progressively smaller amounts of groundwater as a function of depth. The hydraulic properties of the various aquifers and non-water-bearing strata are characterized and reported. A summary of the basic properties is tabulated. The hydrochemical data obtained are summarized. The contaminant transport properties of the rocks in the Pasco Basin are analyzed with emphasis on the dispersion and sorption coefficients and the characteristics of the potential reactions between emplaced waste and the surrounding medium. Some basic modeling considerations of the hydrogeologic systems in the basin with a brief discussion of model input requirements and their relationship to available data are presented

Evaluation of natural gas supply options for south east and central Europe. Part 1: Indicator definitions and single indicator analysis

International Nuclear Information System (INIS)

Afgan, Naim H.; Carvalho, Maria G.; Pilavachi, Petros A.; Martins, Nelson

2007-01-01

The need for diversification of energy sources is an immanent goal in long term energy strategy. In particular, this is of great importance for the natural gas supply. In this respect, evaluation and assessment of potential natural gas resources and their relation to consumers is of great importance. The natural gas supply in Europe is one of the main issues of European energy strategy to be followed in the future. In particular, the natural gas supply in the southeast countries is important. This paper provides a framework for understanding how much natural gas is available for use in south east and central Europe as well as the links to the recent supply of natural gas and its transport. The analysis is focused on evaluation of the potential routes for natural gas supply to the south east and central European countries. The potential options included in this analysis are the Yamal Route; Nabucco Route; West Balkan Route; LNG NEUM Route and Gas by Wire Route. In this analysis, attention is focused on the following indicators for assessment of potential options: environmental indicator; NG cost indicator; NG transport and royalty indicator; investment indicator; and NG demand indicator. The first part of this paper is devoted to the definition of the indicators and to single indicator analysis. (author)

Propuesta de mejora para el Complejo Hospitalario de Navarra, Hospital D: manual de procedimientos para la Central de Esterilización

OpenAIRE

Garde Sesma, Idoia

2014-01-01

La esterilización es una ciencia en la que se emplean tecnologías muy variadas con el fin de lograr la destrucción de todos los microorganismos. Una vez que se ha esterilizado todo el material, debe mantenerse esa condición hasta el momento de “uso” de los equipos. La central de esterilización (en adelante CE o Central), es una unidad de vital importancia dentro de la estructura de un hospital. Recibe una enorme cantidad y variedad de instrumental quirúrgico que debe ser recogido, limpiad...

South Africa : tous les projets | Page 3 | CRDI - Centre de ...

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

Sujet: INTERNATIONAL FINANCE, INTERNATIONAL FINANCIAL MARKET, FINANCIAL POLICY, DEMOGRAPHY, DEMOGRAPHIC CHANGE, DEMOGRAPHIC TRANSITION. Région: Americas, Brazil, South America, Asia, China, Far East Asia, India, South and Central Asia, Global, Africa, South Africa, South of Sahara.

Association between value-based purchasing score and hospital characteristics

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Borah Bijan J

2012-12-01

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

The palaeobiogeography of South American gomphotheres

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Spencer G. Lucas

2013-01-01

Full Text Available Gomphotheriid proboscideans reached South America as Late Cenozoic immigrants from North America. However, disagreements over alpha taxonomy, age dating and phylogenetic relationships have produced three competing hypotheses about this immigration: (1 a single gomphothere immigration took place soon after the ~3 Ma closure of the Panamanian isthmus; (2 two separate gomphothere immigrations took place after closure of the isthmus; or (3 an earlier, Late Miocene (before 9 Ma immigration brought gomphotheres into South America. A critical re-evaluation of the alpha taxonomy, age dating and phylogenetic relationships of Neotropical gomphotheres identifies two valid genera of South American gomphotheres, Cuvieronius and Notiomastodon (= “Haplomastodon”, = “Stegomastodon” from South America and recognizes “Amahuacatherium” as an invalid genus likely based on a specimen of Notiomastodon. The oldest well-dated South American gomphothere fossil is Marplatan, ~2.5 Ma, from Argentina. The case for an age of “Amahuacatherium” older than 9 Ma is refuted by mammalian biostratigraphy and a re-evaluation of the relevant magnetostratigraphy. North American Rhynchotherium descended from Gomphotherium during the Late Hemphillian (~5–6 Ma and gave rise to Cuvieronius in North America by the end of the Blancan (~2 Ma time. Notiomastodon evolved from Cuvieronius in South America during the Pleistocene. The case for a close relationship between the Neotropical gomphotheres and Sinomastodon from China is rejected. Central America was not a center of endemic gomphothere evolution and merely acted as a pathway for the immigration of gomphotheres from north to south: Gomphotherium into Central America during the Miocene, Cuvieronius to Central America by Early Pleistocene time and on to South America. After closure of the Panamanian isthmus, Cuvieronius immigrated to South America, where it gave rise to Notiomastodon by Middle Pleistocene time. The

Prevalence of the Human Papilloma Virus (HPV genotypes in south-central Sicily: a comparative study between 2003 and 2011

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Liborio Bellomo

2013-08-01

Full Text Available This issue is about our Human Papilloma Virus (HPV DNA test. We have examined two cohorts of patients from south-central Sicily, who were tested for HPV -DNA derived from cervical sampling, respectively in 2003 and 2011. In 2003, the most represented genotypes were: 31, 16. Instead, in 2011 there was a higher prevalence for genotypes: 42, 16. It is remarkable to note that the 35 genotype, noticed in 2003, has never been found in the second most recent group.

Response to a large rotavirus outbreak on South Tarawa, Kiribati, 2013

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Teanibuaka Tabunga

2014-05-01

Full Text Available Introduction: In July 2013, during annual independence celebrations in Kiribati, staff at Tungaru Central Hospital on South Tarawa reported an increase in children presenting with severe diarrhoea. This report describes the outbreak investigation, findings and response. Method: After notification of the outbreak, all health facilities on South Tarawa began reporting cases of acute diarrhoea and/or vomiting through the early warning syndromic surveillance system on a daily basis. Community awareness was raised and the public was encouraged to present to a health facility if ill with acute gastroenteritis. Specimens were collected and sent for laboratory testing. Results: Between 10 and 24 July 2013, 1118 cases of gastroenteritis were reported; 103 were hospitalized and six died. The median age of cases was one year (range: 0–68 years; 93.4% were aged less than five years. Rotavirus was identified in 81% of specimens tested. The outbreak response included enhanced surveillance, community education, clinical training and changes to in-hospital patient management for infection control. Discussion: This outbreak was the largest diarrhoea outbreak in Kiribati in five years. Factors that may have contributed to the magnitude and severity of the outbreak included high household density, inadequate sanitation infrastructure and a mass gathering – all increasing the chance of transmission – as well as limited clinical response capacity. The current outbreak highlights the importance of clinical management to minimize severe dehydration and death. Rotavirus vaccination should be considered as an adjunct to other comprehensive enteric disease control measures as recommended by the World Health Organization.

[Risk factors for suicide attempt among college students at Central South University].

Science.gov (United States)

Xu, Hui-lan; Xiao, Shui-yuan; Feng, Shan-shan; Chen, Xi-xi

2004-04-01

To understand the prevalence and risk factors for suicidal ideation among college students and to provide a scientific basis for promoting psychological health and suicide prevention. 623 college students at Central South University were selected using stratified cluster sampling and administered a suicide ideation questionnaire, a Symptom Check List (SCL-90), an Adolescent Self-Rating Life Events Check List (ASLEC), a Social Support Rating Scale (SSRS) and a questionnaire about background information. Multivariate logistic regression analysis was employed to identify risk factors for suicide ideation. One year prior to our investigation, 14.6% of respondents had suicide ideation, 2.5% had made a specific suicide plan, and 1.8% had made a suicide attempt. The main risk factors for suicide ideation were dissatisfaction with the selected major of study, limited social support, recent negative life events and depressive tendency. The prevalence of suicide ideation among these college students was high. Appropriate measures focusing on the risk factors identified in this study should be urgently developed to prevent suicides in college students.

[Introduction of the psychoprophylactic method and its influence on the prenatal care program for institutional parturition in Japan: the practice in the Central Hospital of Maternity of the Japanese Red Cross Society and Oomori Red Cross Hospital, 1953-1964].

Science.gov (United States)

Fujihara, Satoko; Tsukisawa, Miyoko

2014-03-01

The psychoprophylactic method is one of the methods for providing 'painless childbirth without drugs' and was invented by applying I. Pavlov's theory of higher nervous activity. In 1951, it was adopted as a national policy in the Union of Soviet Socialist Republics. This method was then introduced in the People's Republic of China in 1952. In 1953, it was brought to Japan by Masatomo SUGAI, an obstetrician, and was introduced into the Central Hospital of Maternity of the Japanese Red Cross Society with the support of the director, Naotarou KUJI. The practice of this method by the research team, which consisted of the obstetricians and midwives of the Central Hospital of Maternity of the Japanese Red Cross Society and Oomori Red Cross Hospital, resulted in the initiation and characterization of the prenatal care program to encourage the autonomy of the pregnant women for normal parturition in the institutions of Japan.

Hospital Presbiteriano Valley

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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.

Stomach cancer burden in Central and South America.

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Sierra, Monica S; Cueva, Patricia; Bravo, Luis Eduardo; Forman, David

2016-09-01

Stomach cancer mortality rates in Central and South America (CSA) are among the highest in the world. We describe the current burden of stomach cancer in CSA. We obtained regional and national-level cancer incidence data from 48 population-based registries (13 countries) and nation-wide cancer deaths from WHO's mortality database (18 countries). We estimated world population age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 and estimated annual percent change to describe time trends. Stomach cancer was among the 5 most frequently diagnosed cancers and a leading cause of cancer mortality. Between CSA countries, incidence varied by 6-fold and mortality by 5-6-fold. Males had up to 3-times higher rates than females. From 2003 to 2007, the highest ASRs were in Chile, Costa Rica, Colombia, Ecuador, Brazil and Peru (males: 19.2-29.1, females: 9.7-15.1). The highest ASMRs were in Chilean, Costa Rican, Colombian and Guatemalan males (17.4-24.6) and in Guatemalan, Ecuadorian and Peruvian females (10.5-17.1). From 1997 to 2008, incidence declined by 4% per year in Brazil, Chile and Costa Rica; mortality declined by 3-4% in Costa Rica and Chile. 60-96% of all the cancer cases were unspecified in relation to gastric sub-site but, among those specified, non-cardia cancers occurred 2-13-times more frequently than cardia cancers. The variation in rates may reflect differences in the prevalence of Helicobacter pylori infection and other risk factors. High mortality may additionally reflect deficiencies in healthcare access. The high proportion of unspecified cases calls for improving cancer registration processes. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

Prostate cancer burden in Central and South America.

Science.gov (United States)

Sierra, Mónica S; Soerjomataram, Isabelle; Forman, David

2016-09-01

The incidence of prostate cancer has increased in Central and South America (CSA) in the last few decades. We describe the geographical patterns and trends of prostate cancer in CSA. We obtained regional and national-level cancer incidence data from 48 population-based registries in 13 countries and nation-wide cancer deaths from the WHO mortality database for 18 countries. We estimated world population age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 person-years for 2003-2007 and the estimated annual percent change (EAPC) to describe time trends. Prostate cancer was the most common cancer diagnosis and one of the leading causes of cancer deaths among males in most CSA countries. From 2003-2007, ASRs varied between countries (6-fold) and within countries (Brazil: 3-6-fold). French Guyana (147.1) and Brazil (91.4) had the highest ASRs whereas Mexico (28.9) and Cuba (24.3) had the lowest. ASMRs varied by 4-fold. Belize, Uruguay and Cuba (24.1-28.9) had the highest ASMRs while Peru, Nicaragua, and El Salvador (6.8-9.7) had the lowest. In Argentina, Brazil, Chile and Costa Rica prostate cancer incidence increased by 2.8-4.8% annually whereas mortality remained stable between 1997 and 2008. The geographic and temporal variation of prostate cancer rates observed in CSA may in part reflect differences in diagnostic and registration practices, healthcare access, treatment and death certification, and public awareness. The incidence of prostate cancer is expected to increase given recent early detection activities and increased public awareness; however, the impact of these factors on mortality remains to be elucidated. Copyright © 2016 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

Diabetes in South and Central America: an update.

Science.gov (United States)

Aschner, Pablo; Aguilar-Salinas, Carlos; Aguirre, Loreto; Franco, Laercio; Gagliardino, Juan Jose; de Lapertosa, Sylvia Gorban; Seclen, Segundo; Vinocour, Mary

2014-02-01

The estimated population of the South and Central America (SACA) Region is 467.6 million and 64% is in the age range of 20-79 years but the population pyramid and age distribution are changing. The average prevalence of diabetes in the Region is 8.0% and is expected to reach 9.8% by the year 2035. Prevalence is much lower in rural settings than in urban and the differences attributed to lifestyle changes may be a target for intervention. The indigenous population is a particularly vulnerable group needing special attention. On average, 24% of the adult cases with diabetes are undiagnosed but in some countries this is still as high as 50%. Health expenditure due to diabetes in the Region is around 9% of the global total. Inadequate glycemic control, defined as HbA1c >7%, is a strong predictor of chronic complications which increase resource use in the Region and less than half of the patients enrolled in diabetes care programmes are at target. Fifty percent or more of the adult population is overweight/obese and around one third of the adult population has metabolic syndrome using regional cutoffs for waist circumference. The number of people with IGT is almost equal to those with diabetes presenting an additional challenge for prevention. Children with type 1 diabetes represent only 0.2% of the total population with diabetes but the incidence may be increasing. In many places they have limited access to insulin, and even when available, it is not used appropriately. The available epidemiological data provide the background to act in developing national diabetes programmes which integrate diabetes care with cardiovascular prevention and promote diabetes prevention as well. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Perceptions of hospital managers regarding the impact of doctors ...

African Journals Online (AJOL)

South African Family Practice ... In 1997, the South African government introduced compulsory community service (CS) to ... CS has improved health services delivery, alleviated work pressure, and improved the image of hospital managers.

Organisational culture and trust as influences over the implementation of equity-oriented policy in two South African case study hospitals.

Science.gov (United States)

Erasmus, Ermin; Gilson, Lucy; Govender, Veloshnee; Nkosi, Moremi

2017-09-15

This paper uses the concepts of organisational culture and organisational trust to explore the implementation of equity-oriented policies - the Uniform Patient Fee Schedule (UPFS) and Patients' Rights Charter (PRC) - in two South African district hospitals. It contributes to the small literatures on organisational culture and trust in low- and middle-income country health systems, and broader work on health systems' people-centeredness and "software". The research entailed semi-structured interviews (Hospital A n = 115, Hospital B n = 80) with provincial, regional, district and hospital managers, as well as clinical and non-clinical hospital staff, hospital board members, and patients; observations of policy implementation, organisational functioning, staff interactions and patient-provider interactions; and structured surveys operationalising the Competing Values Framework for measuring organisational culture (Hospital A n = 155, Hospital B n = 77) and Organisational Trust Inventory (Hospital A n = 185, Hospital B n = 92) for assessing staff-manager trust. Regarding the UPFS, the hospitals' implementation approaches were similar in that both primarily understood it to be about revenue generation, granting fee exemptions was not a major focus, and considerable activity, facility management support, and provincial support was mobilised behind the UPFS. The hospitals' PRC paths diverged quite significantly, as Hospital A was more explicit in communicating and implementing the PRC, while the policy also enjoyed stronger managerial support in Hospital A than Hospital B. Beneath these experiences lie differences in how people's values, decisions and relationships influence health system functioning and in how the nature of policies, culture, trust and power dynamics can combine to create enabling or disabling micro-level implementation environments. Achieving equity in practice requires managers to take account of "unseen" but important factors such as

Fiscal 1994 survey of the base arrangement promotion for foreign coal import. Investigation on the trend of coal demand in Central and South American countries; 1994 nendo kaigaitan kiban seibi sokushin chosa. Chunanbei shokoku ni okeru sekitan jukyu doko chosa

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-03-01

Focusing on the present status and future of coal demand in Central/South American countries and the coal trade between Central/South American countries and the U.S., the paper described the present status and future of coal demand there and the effects on Japan. Export of Colombian coal will amount to approximately 30-35 million tons in 2000. Venezuelan coal 10-20 million tons. The U.S. imported good-quality general coal low in sulfur content, 3.08 tons from Columbia and 1.39 tons from Venezuela. Coal export from the U.S. to Central/South America was mostly of raw material coal, 5 million tons in 1993 and 5.39 million tons in 1994. General coal was 180,000 tons. The U.S. has no plans of increasing US coal export to Central/South America. But it is safely predicted that Columbia and Venezuela will increase coal export to Europe in the future. It will bring about decrease in export of US coal to Europe, which connects with increasing pressure for the coal trade amount of Japan. 21 figs., 47 tabs.

KNOWLEDGE AND ATTITUDE TOWARDS HUMAN PAPILLOMA VIRUS AND ITS VACCINE AMONG PHARMACY STUDENTS OF TERTIARY TEACHING UNIVERSITY HOSPITAL IN SOUTH INDIA

OpenAIRE

Raghupathi Mahitha; T. S. Arunprasath

2016-01-01

BACKGROUND Cervical cancer in women can be effectively prevented by HPV vaccine. Healthcare professionals including pharmacists have a role in creating awareness about this vaccine to public. In this context, it was decided to study awareness level about HPV among pharmacy students. The aim of the study is to study the knowledge and attitude towards human papilloma virus and it’s vaccine among pharmacy students of tertiary teaching university hospital in South India. MATERIA...

Integrating biomedical and herbal medicine in Ghana - experiences from the Kumasi South Hospital: a qualitative study.

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Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi; Tersbøl, Britt Pinkowski

2016-07-07

Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants' interviews was employed to collect data. Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

An analysis of diagnostic practices in a mammography unit in a tertiary hospital in South Africa

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Clare A. Surridge

2017-03-01

Objectives: To perform an audit of the UGCNB biopsies performed at the Grey’s Hospital Mammography Department and assess the accuracy of the radiologists’ use of the BI-RADS scoring system. Methods: Records of all patients who underwent UGCNB biopsy between 01 January 2014 and 31 October 2015 were reviewed. A retrospective study was performed. Results: A total of 304 UGCNB biopsies were performed on 291 patients. The mean age was 49.2 (s.d. = 15.9 years. Tissue samples from 303 lesions were adequate for histological assessment, and of these, 51% of the lesions were malignant whilst 49% were benign. The most common malignant and benign diagnoses were invasive ductal carcinoma and fibroadenoma respectively. The BI-RADS scoring of the radiologists demonstrated a positive predictive value of 61.6% for the identification of possible malignant lesions. Conclusion: This study describes the patient and lesion profile and unit practices in a tertiary hospital setting in South Africa. The radiologists’ application of the BI-RADS scoring largely conforms to the BI-RADS guidelines. The study highlights several challenges encountered by a breast imaging programme in an under-resourced setting as well as making recommendations in overcoming these challenges.

South African Gastroenterology Review: Editorial Policies

African Journals Online (AJOL)

Auckland Park 2006. South Africa Dr John P Wright Kingsbury Hospital 301 Fairfield Medical Suite Wilderness Road Claremont 7708. South Africa. ISSN: 1812-1659. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and ...

Birth Settings and the Validation of Neonatal Seizures Recorded in Birth Certificates Compared to Medicaid Claims and Hospital Discharge Abstracts Among Live Births in South Carolina, 1996-2013.

Science.gov (United States)

Li, Qing; Jenkins, Dorothea D; Kinsman, Stephen L

2017-05-01

Objective Neonatal seizures in the first 28 days of life often reflect underlying brain injury or abnormalities, and measure the quality of perinatal care in out-of-hospital births. Using the 2003 revision of birth certificates only, three studies reported more neonatal seizures recorded among home births ​or planned out-of-hospital births compared to hospital births. However, the validity of recording neonatal seizures or serious neurologic dysfunction across birth settings in birth certificates has not been evaluated. We aimed to validate seizure recording in birth certificates across birth settings using multiple datasets. Methods We examined checkbox items "seizures" and "seizure or serious neurologic dysfunction" in the 1989 and 2003 revisions of birth certificates in South Carolina from 1996 to 2013. Gold standards were ICD-9-CM codes 779.0, 345.X, and 780.3 in either hospital discharge abstracts or Medicaid encounters jointly. Results Sensitivity, positive predictive value, false positive rate, and the kappa statistic of neonatal seizures recording were 7%, 66%, 34%, and 0.12 for the 2003 revision of birth certificates in 547,177 hospital births from 2004 to 2013 and 5%, 33%, 67%, and 0.09 for the 1998 revision in 396,776 hospital births from 1996 to 2003, and 0, 0, 100%, -0.002 among 660 intended home births from 2004 to 2013 and 920 home births from 1996 to 2003, respectively. Conclusions for Practice Despite slight improvement across revisions, South Carolina birth certificates under-reported or falsely reported seizures among hospital births and especially home births. Birth certificates alone should not be used to measure neonatal seizures or serious neurologic dysfunction.

Mobile LiDAR Measurement for Aerosol Investigation in South-Central Hebei, China

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qin, kai; Wu, Lixin; Zheng, Yunhui; Wong Man, Sing; Wang, Runfeng; Hu, Mingyu; Lang, Hongmei; Wang, Luyao; Bai, Yang; Rao, Lanlan

2016-04-01

With the rapid industrialization and urbanization in China during the last decades, the increasing anthropogenic pollutant emissions have significantly caused serious air pollution problems which are adversely influencing public health. Hebei is one of the most air polluted provinces in China. In January 2013, an extremely severe and persistent haze episode with record-breaking PM2.5 outbreak affecting hundreds of millions of people occurred over eastern and northern China. During that haze episode, 7 of the top 10 most polluted cities in China were located in the Hebei Province according to the report of China's Ministry of Environmental Protection. To investigate and the spatial difference and to characterize the vertical distribution of aerosol in different regions of south-central Hebei, mobile measurements were carried out using a mini micro pulse LiDAR system (model: MiniMPL) in March 2014. The mobile LiDAR kit consisting of a MiniMPL, a vibration reduction mount, a power inverter, a Windows surface tablet and a GPS receiver were mounted in a car watching though the sunroof opening. For comparison, a fixed measurement using a traditional micro pulse LiDAR system (model: MPL-4B) was conducted simultaneously in Shijiazhuang, the capital of Hebei Province. The equipped car was driven from downtown Shijiazhuang by way of suburban and rural area to downtown Cangzhou, Handan, and Baoding respectively at almost stable speed around 100Km per hour along different routes which counted in total more than 1000Km. The results can be summarized as: 1) the spatial distribution of total aerosol optical depth along the measurement routes in south-central Hebei was controlled by local terrain and population in general, with high values in downtown and suburban in the plain areas, and low values in rural areas along Taihang mountain to the west and Yan mountain to the north; 2) obviously high AODs were obtained at roads crossing points, inside densely populated area and nearby

Setting up a child eye care centre: the Mercy Eye Hospital, Abak ...

African Journals Online (AJOL)

Aim: To document and share our experience in setting up a Child Eye Care Centre within a rural mission eye hospital and document subsequent development of services. Method: The location of the project was Mercy Eye Hospital (MEH) Abak, Akwa Ibom State in the South South zone of Nigeria). Consent to commence ...

Incidence of cassava mosaic disease and associated whitefly vectors in South West and North Central Nigeria: Data exploration.

Science.gov (United States)

Eni, Angela O; Efekemo, Oghenevwairhe P; Soluade, Mojisola G; Popoola, Segun I; Atayero, Aderemi A

2018-08-01

Cassava mosaic disease (CMD) is one of the most economically important viral diseases of cassava, an important staple food for over 800 million people in the tropics. Although several Cassava mosaic virus species associated with CMD have been isolated and characterized over the years, several new super virulent strains of these viruses have evolved due to genetic recombination between diverse species. In this data article, field survey data collected from 184 cassava farms in 12 South Western and North Central States of Nigeria in 2015 are presented and extensively explored. In each State, one cassava farm was randomly selected as the first farm and subsequent farms were selected at 10 km intervals, except in locations were cassava farms are sporadically located. In each selected farm, 30 cassava plants were sampled along two diagonals and all selected plant was scored for the presence or absence of CMD symptoms. Cassava mosaic disease incidence and associated whitefly vectors in South West and North Central Nigeria are explored using relevant descriptive statistics, box plots, bar charts, line graphs, and pie charts. In addition, correlation analysis, Analysis of Variance (ANOVA), and multiple comparison post-hoc tests are performed to understand the relationship between the numbers of whiteflies counted, uninfected farms, infected farms, and the mean of symptom severity in and across the States under investigation. The data exploration provided in this data article is considered adequate for objective assessment of the incidence and symptom severity of cassava mosaic disease and associated whitefly vectors in farmers' fields in these parts of Nigeria where cassava is heavily cultivated.

Management accounting for hospitals | Leyenaar | South African ...

African Journals Online (AJOL)

South African Medical Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 87, No 10 (1997) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if your ...

Acromegaly Presenting with Hemiplegia | Saffer | South African ...

African Journals Online (AJOL)

A case of acromegaly presenting with hemiplegia is described. The radiological features, including cerebral angiography, are discussed. Acromegaly is uncommon in the Black population of South Africa. Experience at Baragwanath Hospital (2400 beds) confirms the rarity of the disease, and reference to the South African ...

Acute appendicitis in the public and private sectors in Cape Town, South Africa.

Science.gov (United States)

Yang, Estin; Cook, Colin; Kahn, Delawir

2015-07-01

South Africa has a low incidence of acute appendicitis, but poor outcomes. However, South African studies on appendicitis focus solely on public hospitals, neglecting those who utilize private facilities. This study aims to compare appendicitis characteristics and outcomes in public and private hospitals in South Africa. A prospective cohort study was conducted among two public and three private hospitals in the Cape Town metropole, from September 2013 to March 2014. Hospital records, operative notes, and histology results were reviewed for patients undergoing appendectomy for acute appendicitis. Patients were interviewed during their hospitalization and followed up at monthly intervals until normal function was attained. A total of 134 patients were enrolled, with 73 in the public and 61 in the private sector. Education and employment were higher among private sector patients. Public sector patients had a higher rupture rate (30.6 vs 13.2 %, p = 0.023). Times to presentation were not statistically different between the two cohorts. Public sector patients had longer hospital stays (5.3 vs 2.9 days, p = 0.036) and longer return to work times (23.0 vs 12.1 days, p public hospitals were more severe. Public sector patients in South Africa with appendicitis have higher rupture rates, worse complications, longer hospital stays, and longer recoveries than private sector patients. Patients with perforation had longer delays in presentation than patients without perforation.

Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

Science.gov (United States)

Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

2001-12-01

Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

Leukaemia at Queen Elizabeth Central Hospital in Blantyre, Malawi.

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Mukiibi, J M; Nyirenda, C M; Adewuyi, J O; Mzula, E L; Magombo, E D; Mbvundula, E M

2001-07-01

To determine the patterns of leukaemias seen in Malawians at Queen Elizabeth Central Hospital (QECH) and to compare the findings with those from elsewhere. An overview of the problems encountered in the management of leukaemia in developing countries especially those in sub-Saharan Africa are highlighted. Retrospective descriptive analysis of consecutive leukaemia cases seen from January 1994 through December 1998. Of the 95 leukaemia patients diagnosed during the study period, childhood (0-15 years) leukaemia occurred in 27 (28.4%) patients while adulthood (above 15 years) leukaemia accounted for 68 (71.6%) patients. The main leukaemia types were: acute lymphoblastic leukaemia (ALL) 14 (14.7%), acute myeloblastic leukaemia (AML) 25 (26.3%), chronic myeloid (granulocytic) leukaemia (CML) 32 (33.7%), chronic lymphocytic (lymphatic) leukaemia (CLL) 22 (23.2%) and hairy cell leukaemia (HCL) two (2.1%) patients. Most of the acute leukaemia (AL) cases occurred in the six to 15 year age bracket with a male preponderance. In ALL, lymphadenopathy was the commonest presenting feature followed by pallor (92.9%) while in the AML group, pallor occurred in 80% of cases. Abdominal swelling (87.5%) due to splenomegaly (81.3%) were the main clinical features in the CML group whereas lymphadenopathy (63.6%) followed by splenomegaly (59.1%) were the dominant presenting features in CLL. Haematologically, although leucocytosis characterised both acute and chronic leukaemias, most cases of acute leukaemia presented with more severe anaemia (Hb charitable organisations.

Awareness and Practice of Cervical Smear as A Screening Procedure for Cervical Cancer among Female Nurses in A Tertiary Hospital in South-South Nigeria

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Imoh Unang

2011-12-01

Full Text Available AIM: Carcinoma of the cervix, the second most common cancer among women remains a public health problem. Though this preventable cancer occurs more commonly in the developing world, it is almost non-existent in developed countries where there are well established screening programs. The aim of this study is to determine the degree of awareness and practice of cervical smear as a screening procedure for cervical cancer among female nurses in a tertiary health facility in south-south Nigeria. METHOD: Semi-structured questionnaires were distributed to all the female nurses at the University of Uyo Teaching Hospital. RESULTS: The ages of the respondents were between 21 - 60 years with the modal age group being 31- 40 years (48.9%. Majority of the respondents were married (59.7% and 36.4% of them had practiced nursing for over 10 years. Majority of the respondents (94.3% had heard of the cervical smear and 79.5% of the nurses knew that cervical smears were used to detect premalignant diseases of the cervix. Only 7.4% of the nurses had undergone screening for cervical cancer. Common reasons given by the respondents who had not screened were not being a candidate for cervical cancer (31.9% and ignorance as to where screening is done (28.8%. The most common sources of information about cervical smear were the hospital (87.5% and textbooks (13.6%. CONCLUSION: The level of awareness of the cervical smear as a preventive tool for cervical cancer was high but utilization of the test was disappointingly low. Modern concepts of cancer prevention and control should be included in the curriculum of the school of nursing and nurses should be involved in the organisation of health talks to members of the community on cervical cancer and its prevention. The print and electronic media should be made to participate in the dissemination of information on the prevention of cervical cancer in our environment. [TAF Prev Med Bull 2011; 10(6.000: 675-680

Does outsourcing affect hospital profitability?

Science.gov (United States)

Danvers, Kreag; Nikolov, Pavel

2010-01-01

Organizations outsource non-core service functions to achieve cost reductions and strategic benefits, both of which can impact profitability performance. This article examines relations between managerial outsourcing decisions and profitability for a multi-state sample of non-profit hospitals, across 16 states and four regions of the United States. Overall regression results indicate that outsourcing does not necessarily improve hospital profitability. In addition, we identify no profitability impact from outsourcing for urban hospitals, but somewhat positive effects for teaching hospitals. Our regional analysis suggests that hospitals located in the Midwest maintain positive profitability effects with outsourcing, but those located in the South realize negative effects. These findings have implications for cost reduction efforts and the financial viability of non-profit hospitals.

Infecciones del sistema nervioso central por enterovirus en niños atendidos en un hospital de Lima, Perú Enteroviral central nervous system infections in children treated at a hospital in Lima, Peru

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Iván O Espinoza

2011-12-01

Full Text Available Objetivos. Determinar la frecuencia y las características clínicas de las infecciones del sistema nervioso central por enterovirus en niños atendidos en el Hospital Nacional Cayetano Heredia de Lima, Perú. Materiales y métodos. Se realizó un estudio prospectivo y descriptivo desde abril 2008 hasta marzo 2010. Se enrolaron pacientes de un mes a 14 años con diagnóstico clínico de encefalitis o meningitis asépticas. Se investigó la presencia de enterovirus, virus herpes simple 1 (VHS-1, virus herpes simple 2 (VHS-2 y virus varicela-zoster (VZV mediante reacción en cadena de polimerasa (PCR. Resultados. Se enrolaron 97 pacientes de los cuales 69 % presentaron encefalitis aguda y 31 % meningitis aguda. Se identificó enterovirus en 52,6 % del total de infecciones agudas no bacterianas del sistema nervioso central; encontrándose en 83,3 % de las meningitis y en 38,8 % de las encefalitis. No hubo casos de infección por VHS-1, VHS-2 ni VZV. Las infecciones por enterovirus alcanzaron el 82,9 % en los meses cálidos de noviembre a enero y el 28,6 % en los meses fríos de mayo a julio. Conclusiones. Los enterovirus fueron los principales agentes etiológicos en las encefalitis y meningitis asépticas agudas en pacientes pediátricos de Lima, Perú. Los enterovirus tienen un comportamiento epidemiológico estacional con un claro aumento del número de casos en los meses de verano. Resulta útil tener disponible un método de diagnóstico rápido, como una ayuda para el manejo de las infecciones agudas del sistema nervioso.Objectives. To determine the frequency and clinical features of central nervous system infections caused by enterovirus in children treated at the Hospital Nacional Cayetano Heredia in Lima, Peru. Materials and methods. A prospective, descriptive study was performed from April 2008 to March 2010. Patients aged 1 month - 14 years with clinical diagnosis of encephalitis or aseptic meningitis were included. We investigated the

Overview of Iodine Deficiency Prevention Strategies in the South-Eastern Europe and Central Asia Region: 2009–2016

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Gregory A. Gerasimov

2018-02-01

Full Text Available Universal salt iodization (USI strategies gained strong momentum in countries of the Southern Europe and Central Asia (SECA region during the 2000–2009 decade. By the end of the first decade, several countries in the region had already reached the goal of optimum iodine nutrition; other countries were quickly approaching this goal, and in only a few countries the progress toward USI had remained slow. This paper reports an overview of the two Sub-Regional workshops (for countries of Eastern Europe and Central Asia and South-Eastern Europe conducted in 2015 and 2016. Both workshops demonstrate that the SECA region remains on track in the pursuit of USI for sustainable IDD elimination. Notwithstanding the noted imperfections, none of the data or information from countries of the region suggested that the conquest of iodine deficiency is seriously threatened. However, more efforts should be made to develop and streamline USI strategies in Russia and Ukraine, two major countries that are lagging behind.

Increasing Recovery of Nontuberculous Mycobacteria from Respiratory Specimens over a 10-Year Period in a Tertiary Referral Hospital in South Korea

OpenAIRE

Koh, Won-Jung; Chang, Boksoon; Jeong, Byeong-Ho; Jeon, Kyeongman; Kim, Su-Young; Lee, Nam Yong; Ki, Chang-Seok; Kwon, O Jung

2013-01-01

Background The number of patients with pulmonary disease caused by nontuberculous mycobacteria (NTM) has been increasing worldwide. The aim of this study was to evaluate long-term trends in the NTM recovery rate from respiratory specimens over a 10-year period in a tertiary referral hospital in South Korea. Methods We retrospectively reviewed the records of mycobacterial cultures of respiratory specimens at Samsung Medical Center from January 2001 to December 2011. Results During the study pe...

ARTRODESIS TIBIOTALOCALCANEA CON PLACA PHILOS: EXPERIENCIA EN EL HOSPITAL MILITAR CENTRAL. ENERO 2007 A DICIEMBRE DE 2009

OpenAIRE

MUÑOZ FALLA, GERARDO ALEXI; DELGADO NEIRA, ALEJANDRO; ENRIQUE GAMBA, CESAR; HERNÁNDEZ PERDOMO, EDGAR

2011-01-01

Estudio descriptivo observacional, retrospectivo tipo serie de casos, realizado entre enero de 2007 y diciembre de 2009 en el Hospital Militar Central. Fueron tratados 21 pacientes con artrosis de la articulación tibio talar y subtalar de etiología diversa, con seguimiento mínimo de 6 meses. Se evaluó; la función pre operatoria y post operatoria por medio de la escala AOFAS, el dolor mediante la escala visual análoga, el tiempo de consolidación con controles radiográficos, el tipo de injerto ...

Hydrogeology and simulation of groundwater flow in the Arbuckle-Simpson aquifer, south-central Oklahoma

Science.gov (United States)

Christenson, Scott; Osborn, Noel I.; Neel, Christopher R.; Faith, Jason R.; Blome, Charles D.; Puckette, James; Pantea, Michael P.

2011-01-01

The Arbuckle-Simpson aquifer in south-central Oklahoma provides water for public supply, farms, mining, wildlife conservation, recreation, and the scenic beauty of springs, streams, and waterfalls. Proposed development of water supplies from the aquifer led to concerns that large-scale withdrawals of water would cause decreased flow in rivers and springs, which in turn could result in the loss of water supplies, recreational opportunities, and aquatic habitat. The Oklahoma Water Resources Board, in collaboration with the Bureau of Reclamation, the U.S. Geological Survey, Oklahoma State University, and the University of Oklahoma, studied the aquifer to provide the Oklahoma Water Resources Board the scientific information needed to determine the volume of water that could be withdrawn while protecting springs and streams. The U.S. Geological Survey, in coopertion with the Oklahoma Water Resources Board, did a study to describe the hydrogeology and simulation of groundwater flow of the aquifer.

Management of severe acute malnutrition in children under 5 years through the lens of health care workers in two rural South African hospitals.

Science.gov (United States)

Muzigaba, Moise; Van Wyk, Brian; Puoane, Thandi

2018-01-30

Despite the widespread implementation of the World Health Organization (WHO) guidelines for the management of severe malnutrition in South Africa, poor treatment outcomes for children under 5 years are still observed in some hospitals, particularly in rural areas. To explore health care workers' perceptions about upstream and proximal factors contributing to poor treatment outcomes for severe acute malnutrition in two district hospitals in South Africa. An explorative descriptive qualitative study was conducted. Four focus group discussions were held with 33 hospital staff (senior clinical and management staff, and junior clinical staff) using interview guide questions developed based on the findings from an epidemiological study that was conducted in the same hospitals. Qualitative data were analysed using the framework analysis. Most respondents believed that critical illness, which was related to early and high case fatality rates on admission, was linked to a web of factors including preference for traditional medicine over conventional care, gross negligence of the child at household level, misdiagnosis of severe malnutrition at the first point of care, lack of specialised skills to deal with complex presentations, shortage of patient beds in the hospital and policies to discharge patients before optimal recovery. The majority believed that the WHO guidelines were effective and relatively simple to implement, but that they do not make much difference among severe acute malnutrition cases that are admitted in a critical condition. Poor management of cases was linked to the lack of continuity in training of rotating clinicians, sporadic shortages of therapeutic resources, inadequate staffing levels after normal working hours and some organisational and system-wide challenges beyond the immediate control of clinicians. Findings from this study suggest that effective management of paediatric severe acute malnutrition in the study setting is affected by a

Neurocognitive sequelae of cerebral malaria in adults: a pilot study in Benguela Central Hospital, Angola.

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Peixoto, Bruno; Kalei, Isabel

2013-07-01

To characterize the neurocognitive sequelae of cerebral malaria (CM) in an adult sample of the city of Benguela, Angola. A neuropsychological assessment was carried out in 22 subjects with prior history of CM ranging from 6 to 12 months after the infection. The obtained results were compared to a control group with no previous history of cerebral malaria. The study was conducted in Benguela Central Hospital, Angola in 2011. CM group obtained lower results on the two last trials of a verbal learning task and on an abstract reasoning test. CM is associated to a slower verbal learning rate and to difficulties in the ability to discriminate and perceive relations between new elements.

Midwives’ knowledge and use of partographs at Juba Teaching Hospital, South Sudan

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Clara Roba Alfred

2017-11-01

Full Text Available Background: Evidence shows that good knowledge of partographs and proper application of this knowledge results in a remarkable reduction in prolonged and obstructed labour and reduces maternal mortality. Obstructed labour can be prevented by a simple and cost-effective health intervention tool, the partograph. A partograph is a graphical record of the progress of labour and salient conditions of the mother and foetus plotted against time in hours. This provides an opportunity for early identification of deviation from normal progress. Early detection of prolonged labour greatly contributes to prevention of obstructed labour and related complications. Objective: To assess midwives’ knowledge and use of partographs in the maternity ward of Juba Teaching Hospital, South Sudan. Methods: A cross-sectional descriptive study was conducted to assess utilisation of partographs among healthcare providers in Juba Teaching Hospital. All providers working at the time of the study were included. An interviewer administered questionnaire prepared in English was used to assess socio-demographic and other related variables of respondents as well as knowledge and practice. Ethical procedures were followed at every step. Results: Only 20% of the 30 respondents were registered midwives, 67% knew the components -of a partograph, and 93% could differentiate between normal and abnormal labour with the use of a partograph. The factors affecting the use of partographs included; shortage of partographs in the ward, lack of protocols on partograph use, understanding semantics of the English language, absence of refresher training, late reporting of mothers to the ward, and a shortage of staff. Conclusions: Despite good knowledge of the partograph, about half of the providers do not use them. We recommend training and recruitment of more qualified midwives, a continuous supply of partographs to improve use of partographs continuous supportive supervision, mentoring of

Cold episodes in the Peruvian Central Andes: Composites, Types, and their Impacts over South America (1958-2014)

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Sulca, J. C.; Vuille, M. F.; Roundy, P. E.; Trasmonte, G.; Silva, Y.; Takahashi, K.

2015-12-01

The Mantaro basin (MB) is located in the central Peruvian Andes. Occasionally, cold episodes are observed during austral summer (January-March), that strongly damage crops. However, little is known about the causes and impacts of such cold episodes. The main goal of this study is thus to characterize cold episodes in the MB and assess their large-scale circulation and teleconnections over South America (SA) during austral summer. To identify cold events in the MB daily minimum temperature (Tmin) for the period 1958-2014 from Huayao station, located within the MB was used. A cold episode is defined when daily minimum temperature drops below its 10-percentile for at least one day. Additionally, to study the sensitivity between physical mechanisms associated with cold episodes and temperature, cold episodes are classified in three groups: Weak cold episodes (7.5 ≤ Tmin ≤ 10 percentile), strong cold episodes (Tmin ≤ 2.5 percentile), but excluding the 9 coldest events (Tmin ≤ 0 ͦ C), henceforth referred to as extraordinary cold episodes. Several gridded reanalysis were used to characterize the large-scale circulation, cloud cover and rainfall over SA associated with these events. Weak and strong cold episodes in the MB are mainly associated with a weakening of the Bolivian High-Nordeste Low system by tropical-extratropical interactions. Both types of cold episodes are associated with westerly wind anomalies at mid- and upper-tropospheric levels aloft the Peruvian Central Andes, which inhibit the influx of humid air masses from the lowlands to the east and hence limit the development of cloud cover (e.g., positive OLR anomalies over MB). The resulting clear sky conditions cause nighttime temperatures to drop, leading to cold extremes below 10-percentile. Simultaneously, northeastern Brazil (NEB) registers negative OLR anomalies, strong convection and enhanced cloud cover because displacement of the South Atlantic Convergence Zone (SACZ) toward the northeast of

Disparities in acute in-hospital cardiovascular care for Aboriginal and non-Aboriginal South Australians.

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Tavella, Rosanna; McBride, Katharine; Keech, Wendy; Kelly, Janet; Rischbieth, Amanda; Zeitz, Christopher; Beltrame, John F; Tideman, Philip A; Brown, Alex

2016-09-05

To assess differences in the rates of angiography and subsequent revascularisation for Aboriginal and non-Aboriginal South Australians who presented with an acute coronary syndrome (ACS); to explore the reasons for any observed differences. Analysis of administrative data with logistic regression modelling to assess the relationship between Aboriginal status and the decision to undertake diagnostic angiography. A detailed medical record review of Aboriginal admissions was subsequently undertaken. Emergency ACS admissions to SA cardiac catheterisation hospitals, 2007-2012. 13 701 admissions of patients with an ACS, including 274 Aboriginal patients (2.1%). Rates of coronary angiography and revascularisation; documentation of justification for non-invasive management. After adjustment for age, comorbidities and remoteness, Aboriginal patients presenting with an ACS were significantly less likely than non-Aboriginal patients to undergo angiography (odds ratio [OR], 0.4; 95% CI, 0.3-0.5; P Aboriginal and non-Aboriginal patients who had undergone angiography. Reasons for Aboriginal patients not undergoing angiography included symptoms being deemed non-cardiac (16%), non-invasive test performed (8%), and discharge against medical advice (11%); the reasons were unclear for 36% of Aboriginal patients. After controlling for age and other factors, the rate of coronary angiography was lower among Aboriginal patients with an ACS in SA. The reasons for this disparity are complex, including patient-related factors and their preferences, as well as the appropriateness of the intervention. Improved consideration of the hospital experience of Aboriginal patients must be a priority for reducing health care disparities.

Similar speleothem δ18O signals indicating diverging climate variations in inland central Asia and monsoonal south Asia during the Holocene

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Jin, Liya; Zhang, Xiaojian

2017-04-01

High-resolution and precisely dated speleothem oxygen isotope (δ18O) records from Asia have provided key evidence for past monsoonal changes. It is found that δ18O records of stalagmites from Kesang Cave (42°52'N, 81°45'E, Xinjiang, China) in inland central Asia were very similar to those from Qunf Cave (17°10'N, 54°18'E, southern Oman) in South Asia, shifting from light to heavy throughout the Holocene, which was regarded as a signal that strong Asian summer monsoon (ASM) may have intruded into the Kesang Cave site and/or adjacent areas in inland central Asia to produce heavy rainfall during the high insolation times (e.g. the early Holocene). However, this is in contrast to conclusions based on other Holocene proxy records and modeling simulations, showing a persistent wetting trend in arid central Asia during the Holocene with a dryer condition in the early Holocene and the wettest condition in the late Holocene. With an analysis of model-proxy data comparison, we revealed a possible physical mechanism responsible for the Holocene evolution of moisture/precipitation in Asian summer monsoon (ASM)-dominated regions and that in the inland central Asia. It is revealed that a recurrent circumglobal teleconnection (CGT) pattern in the summertime mid-latitude circulation of the Northern Hemisphere was closely related to the ASM and the climate of inland central Asia, acting as a bridge linking the ASM to insolation, high-latitude forcing (North Atlantic sea surface temperature (SST)), and low-latitude forcing (tropical Ocean SST). Also, the CGT influence speleothem δ18O values in South Asia via its effect on the amount of precipitation. In addition, the moisture source from the Indian Ocean is associated with relatively high δ18O values compared with that from the North Atlantic Ocean, leading to increased precipitation δ18O values. Hence, the CGT has probably been the key factor responsible for the in-phase relationship in speleothem δ18O values (Kesang Cave

The South African Surgical Outcomes Study: a seven-day ...

African Journals Online (AJOL)

LR Mathivha, TR Mokoena, S Monokoane, Rui Moreno, David ... Method: A seven-day national, multicentre, prospective, observational cohort study was conducted in 50 government-funded hospitals in South .... Dr George Mukhari Hospital.

Water resources of the Kodiak-Shelikof subregion, south-central Alaska

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Jones, Stanley H.; Madison, R.J.; Zenone, Chester

1978-01-01

Hydrologic data for the Kodiak-Shelikof subregion of south-central Alaska are summarized to provide a basis for planning water resources development, identifying water problems and evaluating existing water quality and availability. Average annual precipitation, measured at a few coastal locations in this maritime climatic zone, ranges from 23 to 127 inches. Mean annual runoff for the Kodiak Island group ranges from 4 to 8 cfs/sq mi. A maximum instantaneous runoff of 457 cfs/sq mi has been determined from a small basin on Kodiak Island. Lowest measured stream discharges range from no flow to 0.91 cfs/sq mi. Surface water is the primary source of water supplies for the city of Kodiak and other communities. The geology of the subregion is characterized by metamorphosed sedimentary and volcanic rocks with only a thin mantle of unconsolidated material. A few small, alluvium-filled coastal valleys offer the most favorable conditions for ground-water development, but moderate yields (50-100 gal/min) have been obtained from wells in fractured bedrock. Water in streams and lakes generally has a dissolved-solids concentration less than 60 mg/L, and the water varies from a calcium-bicarbonate type to a sodium-chloride type. The chemical composition of ground waters has a dilute calcium-bicarbonate type in unconsolidated materials and a sodium-bicarbonate type in bedrock. The dissolved solids in the groundwater ranges from 170 to 250 mg/L. (Woodard-USGS)

Risk factors associated with postpartum haemorrhage at Juba Teaching Hospital, South Sudan, 2011

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Thomas Tako Akim Ujjiga

2014-08-01

Full Text Available Objective: To study risk factors associated with post partum haemorrhage (PPH in Juba Teaching Hospital, South Sudan. Method: An unmatched case control study was conducted in which 44 cases and 88 Controls were involved, from September to December 2011. Data was collected using a structured questionnaire in face to face interviews, and analyzed using Epi-info 3.5.3 statistical programme to determine if there was a correlation. Results: Maternal demographic and obstetric characteristics were found to be associated with the risk of bleeding during Bivariate analysis. However, age was found to confound emergency admission, uterotonic use (Oxytocin and Misoprostol use and delivery type, the latter being modified, in the development of post partum haemorrhage. Conclusion: These results indicate that active management of the third stage of labour (AMTSL and prompt intervention reduced the risk of developing PPH. Understanding the factors that cause PPH will allow us to better strengthen and effect pre delivery and emergency obstetric care which may help us reduce maternal mortality due to post partum haemorrhage.

Dizziness in a community hospital: central neurological causes, clinical predictors, and diagnostic yield and cost of neuroimaging studies.

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Ammar, Hussam; Govindu, Rukma; Fouda, Ragai; Zohdy, Wael; Supsupin, Emilio

2017-03-01

Objectives : Neuroimaging is contributing to the rising costs of dizziness evaluation. This study examined the rate of central neurological causes of dizziness, relevant clinical predictors, and the costs and diagnostic yields of neuroimaging in dizziness assessment. Methods : We retrospectively reviewed the records of 521 adult patients who visited the hospital during a 12-month period with dizziness as the chief complaint. Clinical findings were analyzed using Fisher's exact test to determine how they correlated with central neurological causes of dizziness identified by neuroimaging. Costs and diagnostic yields of neuroimaging were calculated. Results : Of the 521 patients, 1.5% had dizziness produced by central neurological causes. Gait abnormalities, limb ataxia, diabetes mellitus, and the existence of multiple neurological findings predicted central causes. Cases were associated with gait abnormalities, limb ataxia, diabetes mellitus, and the existence of multiple neurological findings . Brain computed tomography (CT) and magnetic resonance imaging (MRI) were performed in 42% and 9.5% of the examined cases, respectively, with diagnostic yields of 3.6% and 12%, respectively. Nine cases of dizziness were diagnosed from 269 brain scans, costing $607 914. Conclusion : Clinical evaluation can predict the presence of central neurological causes of dizziness, whereas neuroimaging is a costly and low-yield approach. Guidelines are needed for physicians, regarding the appropriateness of ordering neuroimaging studies. Abbreviations : OR: odds ratio; CI: confidence interval; ED: emergency department; CT: computed tomography; MRI: magnetic resonance imaging; HINTS: Head impulse, Nystagmus, Test of skew.

Bald eagle site management plan for the Hanford Site, south-central Washington

International Nuclear Information System (INIS)

Fitzner, R.F.; Weiss, S.G.

1994-12-01

The CERCLA remedial investigations of waste sites on the Hanford Site will involve lands containing or adjacent to a bald eagle nest, winter concentration areas, or communal night roost. Because these CERCLA investigations may affect bald eagles, the DOE has prepared this Bald Eagle Site Management Plan (BESMP). However, it is intended that this BESMP be used or updated so as to be also applicable to future activities that affect bald eagles on the Hanford Site. Bald eagles regularly use the US Department of Energy's (DOE) Hanford Site in south-central Washington State during winter months for roosting, perching, and foraging. Each of these activities requires buffer zones to protect eagles from human disturbances. Buffer zones developed in this plan follow recommended guidelines and are intended to be used in planning. If Hanford Site activities in the vicinity of identified bald eagle use areas are carried out in accordance with this plan, such actions are not likely to adversely affect the eagles or their habitat. Activities that may be exceptions will involve informal or formal (whichever is appropriate) consultation with the US Fish and Wildlife Service as required by the Endangered Species Act

Central Diabetes Insipidus, Central Hypothyroidism, Renal Tubular ...

African Journals Online (AJOL)

readmitted to the hospital because of jaundice and failure to thrive, for which he was investigated and diagnosed to have central congenital hypothyroidism. Shortly thereafter, he was admitted to our institute with a history of vomiting, decreased oral intake, polyuria, and dehydration having lasted 5 days. He was investigated ...

Management of incomplete abortions at South African public hospitals

African Journals Online (AJOL)

Journal Home > Vol 87, No 4 (1997) > ... Length of hospital stay, details of medical management, details of surgical ... Of these, 767 (95.9%) were in hospital for 1 day or more, and 753 (95.3%) women underwent evacuation of the uterus.

What are key determinants of hospital admissions, readmission rate and day case rate within the South African medical schemes population?

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Nondumiso Gugu Khumalo

2012-06-01

Full Text Available  BACKGROUND: In South Africa, private hospitals absorb a high proportion of the total health expenditure on private health care. Between 2008-2010 private hospital expenditure which includes ward fees, theatre fees, consumables, medicines and per diem arrangements consumed between 40.5% and 40.9% of the total benefits paid by medical schemes from the risk pool, whilst in-hospital managed care fees ranged between 1.8% and 2.8% for the equivalent years.OBJECTIVE: The aim of this paper is to highlight key factors contributing to utilisation of hospital services within the medical schemes population and to recommend “appropriate” and cost effective strategies on hospital utilisation management.METHODS: A cross sectional survey informed by retrospective analysis of quantitative data was used. Researchers also triangulated quantitative data with systematic review of literature.RESULTS: The results show that demographic indicators such as age profile, dependency ratio, pensioner ratio and prevalence of chronic conditions are not the only key factors influencing hospital admissions, but rather the effectiveness of each medical scheme in containing hospital admissions is also influenced by available technical capacity on utilisation review and audit as well as the managed care methodology including the philosophy underpinning benefit option design.CONCLUSION: This study highlights the importance of “value based” managed care programs linked to benefit option design in health care utilisation management. The choice of one managed care program over the other often leads to tradeoffs whereby unintended consequences emanate. Medical schemes are therefore encouraged to continuously review their managed care programs to ensure value for money as well as better access and health outcomes.http://dx.doi.org/10.7175/fe.v13i2.207

Effects of dietary pattern and education on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Yogyakarta.

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Sinorita, Hemi; Saádah; Jazakillah, Setyowati

2008-04-01

to recognize the effect of education and diet on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Jogjakarta. a cross-sectional study was conducted in 88 patients with type 2 DM who had routine visit to the outpatient clinic in Endocrinology Division of Dr. Sardjito Central General Hospital, Jogjakarta. As inclusion criteria, patients who had routine visit in 3 month continuously with fasting plasma glucose (GDN) 126 mg/dl as poor glycemic control group. Data were recorded which included age, sex, period of DM, daily diet pattern, and education received. we found that glycemic control was not affected by sex (p=0.52) and age (p=0.38), but it was affected by period of DM (p=0.02). Glycemic control in the present study was affected by dietary pattern (p=0.01), but not by education (p=1.00). the present study has found significant correlation between regulation of dietary pattern and glycemic control (p=0.01).

Twin deliveries in Sacred Heart Catholic Hospital Obudu ...

African Journals Online (AJOL)

Background: Twin pregnancy is associated with increased risk of obstetric complications as well as increased perinatal mortality rate. The study aims to determine the incidence and outcome of twin pregnancy in a rural/semi urban hospital which provide secondary level obstetric services in South- south Nigeria. Method: ...

Little Ice Age glacial geomorphology and sedimentology of Portage Glacier, South-Central Alaska

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Carlos Córdova

2009-06-01

Full Text Available The study of glacial landforms and deposits is important, as it isdifficult to observe processes under modern glaciers and ice-sheets. Thus landscapes and sediments that are the product of present glaciation can give insight into processes that occurred during Pleistocene times. This study investigates the genesis of little ice age glacial landforms present in Portage Glacier, South-Central Alaska. The present day moraine morphology and sedimentology in Portage Glacier valley reveals the presence of two types of till and moraines. The clast-rich sandy diamicton present on the 1852 moraine is interpreted to be a basal till indicating this feature is a pushmoraine representing an advance or a standstill position of Portage Glacier in 1852. The moderately sorted gray sandy boulder gravel present on the 1900 and 1922 moraines is interpreted to be an ice-marginal deposit (ablation till with a mixture of supraglacial and glaciofluvial sediments deposited by slumping and stream sortingprocesses. All of these features are interpreted to be ablation moraines representing glacier retreat and moraine building in 1900 and1922.

Genetic diversity of Hepatozoon spp. in coyotes from the south-central United States.

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Starkey, Lindsay A; Panciera, Roger J; Paras, Kelsey; Allen, Kelly E; Reiskind, Michael H; Reichard, Mason V; Johnson, Eileen M; Little, Susan E

2013-04-01

To better define the strains and species of Hepatozoon that infect coyotes in the south-central United States, whole blood and muscle samples were collected from 44 coyotes from 6 locations in Oklahoma and Texas. Samples were evaluated by a nested polymerase chain reaction (PCR) using primers amplifying a variable region of the apicomplexan 18S rRNA gene as well as histopathology (muscle only) for presence of tissue cysts. Hepatozoon spp. infections were identified in 79.5% (35/44) of coyotes tested including 27 of 44 (61.4%) whole blood samples and 17 of 44 (38.6%) muscle samples tested by PCR and 23 of 44 (52.3%) muscle samples evaluated by histological examination. Analysis revealed 19 distinct sequences comprising 3 major clusters of Hepatozoon spp., i.e., 1 most closely related to Hepatozoon americanum, another most closely related to Hepatozoon canis , and the third an intermediate between the 2 groups. The diversity of Hepatozoon spp. in wild canids appears greater than previously recognized and warrants further investigation.

Establishing a multi-proxy approach to alpine blockfield evolution in south-central Norway

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Philipp Marr

2017-11-01

Full Text Available Blockfields in high latitude mountain areas are a wide spread proxy for glaciation history. Their origin is debated since decades, especially in south-central Norway, where glaciation had a major global climate implication. Some authors explain old blockfield features by protection of cold-based ice, others claim they persisted as nunataks during the LGM (~20 kyr, or were formed throughout the Holocene. In order to clarify the origin of alpine blockfields we established a multi-method approach to combining lichenometry, stratigraphy, granulometry, and geochemistry (XRD, XRF. Our lichenometric dating results in conjunction with our factors indicate landscape stability for at least ~12.5 kyr. Frequent climatic shifts are evident in our profiles by varying color, LOI content and grain sizes. On the basis of geochemical analyses we were able to identify a long-term (chemical weathering history and in situ blockfield formation. The field evidences and the climatic setting of the study area leave the possibility that our location was not covered by cold-based ice during the Late-Quaternary.

Ground beetles (Coleoptera, Carabidae) of the Hanford Nuclear Site in south-central Washington State.

Science.gov (United States)

Looney, Chris; Zack, Richard S; Labonte, James R

2014-01-01

Carabidae) collected from the Hanford Nuclear Reservation and Hanford National Monument (together the Hanford Site), which is located in south-central Washington State. The Site is a relatively undisturbed relict of the shrub-steppe habitat present throughout much of the western Columbia Basin before the westward expansion of the United States. Species, localities, months of capture, and capture method are reported for field work conducted between 1994 and 2002. Most species were collected using pitfall traps, although other capture methods were employed. Trapping results indicate the Hanford Site supports a diverse ground beetle community, with over 90% of the 92 species captured native to North America. Four species collected during the study period are newly recorded for Washington State: Bembidion diligens Casey, Calosoma obsoletum Say, Pseudaptinus rufulus (LeConte), and Stenolophus lineola (Fabricius). Based on these data, the Site maintains a diverse ground beetle fauna and, due to its size and diversity of habitats, is an important repository of shrub-steppe biodiversity.

Methane occurrence in groundwater of south-central New York State, 2012: summary of findings

Science.gov (United States)

Heisig, Paul M.; Scott, Tia-Marie

2013-01-01

A survey of methane in groundwater was undertaken to document methane occurrence on the basis of hydrogeologic setting within a glaciated 1,810-square-mile area of south-central New York that has not seen shale-gas resource development. The adjacent region in northeastern Pennsylvania has undergone shale-gas resource development from the Marcellus Shale. Well construction and subsurface data were required for each well sampled so that the local hydrogeologic setting could be classified. All wells were also at least 1 mile from any known gas well (active, exploratory, or abandoned). Sixty-six domestic wells and similar purposed supply wells were sampled during summer 2012. Field water-quality characteristics (pH, specific conductance, dissolved oxygen, and temperature) were measured at each well, and samples were collected and analyzed for dissolved gases, including methane and short-chain hydrocarbons. Carbon and hydrogen isotopic ratios of methane were measured in 21 samples that had at least 0.3 milligram per liter (mg/L) methane.

Anthropometry of south Indian industrial workmen.

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Fernandez, J E; Uppugonduri, K G

1992-11-01

This paper presents the results of an anthropometric survey conducted on South Indian male workers in the electronic industry. The data were collected as part of a project to modify work stations that utilized equipment from other countries. A set of 27 body dimensions were taken from a sample of 128 workmen (aged 18-35 years). The anthropometric measurements are compared with those of Indian men from Central, Western, and Northern parts of India and with those of the American, German, and Japanese men. The results indicate that in general the South Indian man is smaller than Central, Western, and Northern Indian men, as well as smaller than men in America, Germany, Japan, and Africa. This difference needs to be allowed for when considering buying and subsequently using imported equipment for the electronics industry in South India.

Clinical and endoscopic profile of the patients with upper gastrointestinal bleeding in central rural India: A hospital-based cross-sectional study

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Jyoti Jain

2018-01-01

Full Text Available Introduction: Acute Upper Gastrointestinal bleeding (UGIB is one of the common causes with which the patients present to emergency. The upper gastrointestinal (UGI endoscopy remains a crucial tool in identification of UGIB. The aim of the present study was to determine the endoscopic profile of UGIB in adult population of rural central India admitted with history of UGIB (hemetemesis and/or malena. Methods: This prospective, cross sectional study was conducted in rural hospital in central India and we enrolled all consecutive patients aged 18 years and above who were admitted in the hospital ward with the history of UGIB. After obtaining the demographic data, all patients underwent clinical examination, laboratory investigations and video-endoscopy. We used Student's t test to compare means, Chi-square test to compare proportions and Mann-Whitney test to compare medians. P value <0.05 will be considered significant. Results: The mean age of our study population (N = 118 was 46.2 years. Among 118 patients who underwent endoscopy, 47.4% had esophageal varices, 27.1% had portal hypertensive gastropathy, 14.4% had gastric erosions, 5.9% each had duodenal ulcers and esophagitis, 5% had gastric ulcer disease, 4.2% each had Mallory-Weiss tear and had gastric malignancy, 1.7% had esophageal malignancy and 16.1% had normal endoscopic findings. Conclusion: Esophageal varices were the most common cause of UGIB in the adult population of rural central India presenting with UGIB, when diagnosed by video-endoscopy.

High Resolution Airborne InSAR DEM of Bagley Ice Valley, South-central Alaska: Geodetic Validation with Airborne Laser Altimeter Data

Science.gov (United States)

Muskett, R. R.; Lingle, C. S.; Echelmeyer, K. A.; Valentine, V. B.; Elsberg, D.

2001-12-01

Bagley Ice Valley, in the St. Elias and Chugach Mountains of south-central Alaska, is an integral part of the largest connected glacierized terrain on the North American continent. From the flow divide between Mt. Logan and Mt. St. Elias, Bagley Ice Valley flows west-northwest for some 90 km down a slope of less than 1o, at widths up to 15 km, to a saddle-gap where it turns south-west to become Bering Glacier. During 4-13 September 2000, an airborne survey of Bagley Ice Valley was performed by Intermap Technologies, Inc., using their Star-3i X-band SAR interferometer. The resulting digital elevation model (DEM) covers an area of 3243 km2. The DEM elevations are orthometric heights, in meters above the EGM96 geoid. The horizontal locations of the 10-m postings are with respect to the WGS84 ellipsoid. On 26 August 2000, 9 to 18 days prior to the Intermap Star-3i survey, a small-aircraft laser altimeter profile was acquired along the central flow line for validation. The laser altimeter data consists of elevations above the WGS84 ellipsoid and orthometric heights above GEOID99-Alaska. Assessment of the accuracy of the Intermap Star-3i DEM was made by comparison of both the DEM orthometric heights and elevations above the WGS84 ellipsoid with the laser altimeter data. Comparison of the orthometric heights showed an average difference of 5.4 +/- 1.0 m (DEM surface higher). Comparison of elevations above the WGS84 ellipsoid showed an average difference of -0.77 +/- 0.93 m (DEM surface lower). This indicates that the X-band Star-3i interferometer was penetrating the glacier surface by an expected small amount. The WGS84 comparison is well within the 3 m RMS accuracy quoted for GT-3 DEM products. Snow accumulation may have occurred, however, on Bagley Ice Valley between 26 August and 4-13 September 2000. This will be estimated using a mass balance model and used to correct the altimeter-derived surface heights. The new DEM of Bagley Ice Valley will provide a reference

Pituitary abscess: report of two cases and review of the literature

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Liu Y

2017-06-01

Full Text Available Yu Liu,1 Feng Liu,2 Qi Liang,3 Yexin Li,4 Zhifei Wang5 1Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, 2Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, 3Department of Radiology, The Third Xiangya Hospital, Central South University, Changsha, 4Department of Neurosurgery, The Central Hospital of Shaoyang, Shaoyang, 5Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China Abstract: Pituitary abscess is a rare but critical disorder caused by an infectious process where purulent material accumulates inside the sella turcica. Since symptoms, signs and radiographic characteristics of pituitary abscess are similar to several other pituitary lesions, correct diagnosis before surgery is challenging. In this article, two cases of pituitary abscess treated in our department are reported, followed by a literature review. In these two cases, both patients presented with intermittent fever. Magnetic resonance imaging revealed a suprasellar lesion with rim enhancement after contrast injection. After transsphenoidal surgery, the diagnosis of pituitary abscess was confirmed. The patients were then given antibiotic treatment and recovered fully in less than 2 months. Findings of this article support timely diagnosis and proper treatment including transsphenoidal surgery and antibiotic therapy for pituitary abscess, leading to lower mortality rates and higher probability of pituitary hormone function recovery. Keywords: pituitary abscess, transsphenoidal resection, antibiotic therapy, diagnosis 

Stakeholder influence in public sector information systems strategy implementation-The case of public hospitals in South Africa.

Science.gov (United States)

Hwabamungu, Boroto; Brown, Irwin; Williams, Quentin

2018-01-01

Recent literature on organisational strategy has called for greater emphasis on individuals (stakeholders) and what they do in the process of strategizing. Public sector organisations have to engage with an array of heterogeneous stakeholders in fulfilling their mandate. The public health sector in particular needs to engage with a diversity of stakeholders at local, regional and national levels when strategising. The purpose of this study is to investigate the influence of stakeholder relations on the implementation of Information Systems (IS) strategy in public hospitals in South Africa. An interpretive approach using two provinces was employed. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis, physical artefacts and observation. The collected data was analysed using thematic analysis. Findings reveal that IS strategy implementation in public hospitals involves a large and complex network of stakeholder groups at different levels, and over different time periods. These stakeholder groups act in accordance with formal and informal roles, rules and modalities. Various contextual conditions together with the actions of, and interactions between stakeholder groups give rise to the situationality of stakeholder relations dynamics and strategy implementation. The multiple actions and interactions over time lead to the realisation of some aspects of the IS strategy in public hospitals. Given the complexity and dynamism of the context there are also certain unplanned implementations as well. These relationships are captured in a Stakeholder Relations Influence (SRI) framework. The SRI framework can be assistive in the assessment and mapping of stakeholders and stakeholder relations, and the assessment of the implications of these relations for effective IS strategy implementation in public hospitals. The

Comparision between bed side testing of blood glucose by glucometer vs centralized testing in a tertiary care hospital.

Science.gov (United States)

Baig, Ayaz; Siddiqui, Imran; Jabbar, Abdul; Azam, Syed Iqbal; Sabir, Salman; Alam, Shahryar; Ghani, Farooq

2007-01-01

To determine the accuracy, turnaround time and cost effectiveness of bedside monitoring of blood glucose levels by non-laboratory health care workers and centralized testing of blood glucose by automated analyzer in a tertiary care hospital. The study was conducted in Section of Chemical Pathology, Department of Pathology and Microbiology and Section of Endocrinology Department of Medicine, Aga Khan University and Hospital Karachi, from April 2005 to March 2006. One hundred and ten patients were included in the study. The blood glucose levels were analyzed on glucometer (Precision Abbott) by finger stick, using Biosensor Technology. At the same time venous blood was obtained to analyze glucose in clinical laboratory on automated analyzer (SYNCHRON CX7) by glucose oxidase method. We observed good correlation between bed side glucometer and laboratory automated analyzer for glucose values between 3.3 mmol/L (60 mg/dl) and 16.7 (300 mg/dl). A significant difference was observed for glucose values less than 3.3 mmol/L (p = 0.002) and glucose values more than 16.67 mmol/l (p = 0.049). Mean Turnaround time for glucometer and automated analyzer were 0.08 hours and 2.49 hours respectively. The cost of glucose testing with glucometer was 48.8% lower than centralized lab based testing. Bedside glucometer testing, though less expensive does not have good accuracy in acutely ill patient with either very high or very low blood glucose levels.

Groundwater quality on dairy farms in central South Africa

African Journals Online (AJOL)

Keywords: Water quality, groundwater, E. coli, coliforms, nitrate, hardness, dairy farms. INTRODUCTION ... a major contributor to the South African economy through ..... co.za/milk-procurement-model (Accessed 1 November 2013). DAHIYA S ...

Nurses experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng South Africa

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Moloko Malatji

2017-12-01

Purpose: The purpose of this study was to explore and describe nurses' experiences regarding staffing patterns in the surgical wards of a private hospital in Gauteng in order to develop recommendations for staffing patterns in these wards. Methodology: A qualitative, exploratory, descriptive and contextual research design was used. Data was collected by means of in-depth semi structured individual interviews from a purposive sample of professional nurses working in the surgical wards of this hospital. Data was analysed using Tesch's method of qualitative thematic analysis. Principles of trustworthiness and ethical principles to ensure the protection of human rights were applied throughout the study. Results: The findings of the study revealed one central theme which reflected that participants experienced the staffing patterns of the surgical wards negatively. Two main themes emerged as, nurses had negative experiences in the surgical wards as well as negative emotional experiences related to the staffing patterns. Conclusion: It is evident from the findings of the study that nurses are experiencing staffing patterns negatively.

Factors Related to Healthcare Service Quality in Long-term Care Hospitals in South Korea: A Mixed-methods Study.

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Sohn, Minsung; Choi, Mankyu

2017-10-01

The environment of long-term care hospitals (LTCHs) is critical to the management of the quality of their services and to patient safety, as highlighted by international studies. However, there is a lack of evidence on this topic in South Korea. This study aimed to examine the factors affecting healthcare quality in LTCHs and to explore the effectiveness of their quality management. This study used a mixed methods approach with quantitative data collected in a national survey and qualitative data from semi-structured interviews with practice-based managers. The samples included 725 nationally representative LTCHs in South Korea for the quantitative analysis and 15 administrators for the in-depth interviews. A higher installation rate of patient-safety and hygiene-related facilities and staff with longer-tenures, especially nurses, were more likely to have better healthcare quality and education for both employees and patients. The need for patient-safety- and hygiene-related facilities in LTCHs that serve older adults reflects their vulnerability to certain adverse events (e.g., infections). Consistent and skillful nursing care to improve the quality of LTCHs can be achieved by developing relevant educational programs for staff and patients, thereby strengthening the relationships between them.

Validation of administrative hospital data for identifying incident pancreatic and periampullary cancer cases: a population-based study using linked cancer registry and administrative hospital data in New South Wales, Australia.

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Creighton, Nicola; Walton, Richard; Roder, David; Aranda, Sanchia; Currow, David

2016-07-01

Informing cancer service delivery with timely and accurate data is essential to cancer control activities and health system monitoring. This study aimed to assess the validity of ascertaining incident cases and resection use for pancreatic and periampullary cancers from linked administrative hospital data, compared with data from a cancer registry (the 'gold standard'). Analysis of linked statutory population-based cancer registry data and administrative hospital data for adults (aged ≥18 years) with a pancreatic or periampullary cancer case diagnosed during 2005-2009 or a hospital admission for these cancers between 2005 and 2013 in New South Wales, Australia. The sensitivity and positive predictive value (PPV) of pancreatic and periampullary cancer case ascertainment from hospital admission data were calculated for the 2005-2009 period through comparison with registry data. We examined the effect of the look-back period to distinguish incident cancer cases from prevalent cancer cases from hospital admission data using 2009 and 2013 as index years. Sensitivity of case ascertainment from the hospital data was 87.5% (4322/4939), with higher sensitivity when the cancer was resected (97.9%, 715/730) and for pancreatic cancers (88.6%, 3733/4211). Sensitivity was lower in regional (83.3%) and remote (85.7%) areas, particularly in areas with interstate outflow of patients for treatment, and for cases notified to the registry by death certificate only (9.6%). The PPV for the identification of incident cases was 82.0% (4322/5272). A 2-year look-back period distinguished the majority (98%) of incident cases from prevalent cases in linked hospital data. Pancreatic and periampullary cancer cases and resection use can be ascertained from linked hospital admission data with sufficient validity for informing aspects of health service delivery and system-level monitoring. Limited tumour clinical information and variation in case ascertainment across population subgroups are

Towards a smoke-free hospital: how the smoking status of health professionals influences their knowledge, attitude and clinical activity. Results from a hospital in central Italy.

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Giorgi, E; Marani, A; Salvati, O; Mangiaracina, G; Prestigiacomo, C; Osborn, J F; Cattaruzza, M S

2015-01-01

In Italy, the prevalence of smoking among health professionals is higher than in the general population and this might hamper their role in the promotion of health. This study aimed to investigate how the smoking status of healthcare professionals might influence knowledge, attitudes and clinical practice in a hospital in central Italy in order to enforce effective tobacco control measures. Physicians and professionals of the hospital were asked to complete an anonymous questionnaire which yielded epidemiological and environmental information on knowledge, attitude, clinical practice and quality of the hospital environments, in relation to smoking. Overall, among the employees of the hospital, the smoking prevalence was 47%, (42% among physicians and 43% among nurses); 30% admitted smoking in the hospital and three quarters of the smokers would like to quit. Some knowledge, opinions and attitudes differ statistically among the smoking categories. For example, only 35% of the smokers admitted that smoking is more dangerous to health than atmospheric and car pollution compared with 60% of the ex or never smokers (p=0.04). Fewer smokers realize that their behavior is seen as a role model by patients. A greater percentage of smokers state that patients (34%) and visitors (43%) often smoke in hospital and these percentages are significantly higher than those reported by ex or never smokers (p≤0.05). All smokers claim that they never smoke in patient rooms, infirmaries and clinics, whereas over 20% of ex or never smokers report that smoking sometimes occurs in these places (p=0.015). The mean concentration of PM 2.5 in the 25 rooms was 2.4 μg/m3 with a range from 1 to 7 μg/m3. This study implies that the prevalence of smoking among health professionals may be very high, and might be twice the rate observed in the general population. Generally, smokers report less knowledge compared with ex and never-smokers and it seems that they systematically underestimate the

Geopolitics, economy and international solidarity in the new South-South cooperation: the case of Bolivarian

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Daniele BENZI

2013-06-01

Full Text Available This article aims to show an overview of the energy cooperation scheme called PETROCARIBE, proposed in 2005 by the Bolivarian Republic of Venezuela to the Caribbean and Central American countries. It argues that the emergence of this project, like other South-South cooperation initiatives, is clearly linked to several strategic foreign policy goals, which basically refer to geopolitical, economic, security and, last but not least, international solidarity parameters. The first section outlines some general characteristics of South-South cooperation and current trends and debates. The following presents the peculiar features of the Bolivarian foreign and energy policies. The next presents a general description of the PETROCARIBE framework, working mechanisms and its most important projects. Finally, after a discussion on PETROCARIBE as a South-South cooperation initiative, by highlighting its scopes, problems and vulnerabilities, some conclusions are drawn.

Burden of colorectal cancer in Central and South America.

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Sierra, Monica S; Forman, David

2016-09-01

The colorectal cancer (CRC) burden is increasing in Central and South American due to an ongoing transition towards higher levels of human development. We describe the burden of CRC in the region and review the current status of disease control. We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries, as well as cancer deaths from the WHO mortality database for 18 countries. We estimated world population age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 person-years for 2003-2007 and the estimated annual percentage change for 1997-2008. The CRC rate in males was 1-2 times higher than that in females. In 2003-2007, the highest ASRs were seen in Uruguayan, Brazilian and Argentinean males (25.2-34.2) and Uruguayan and Brazilian females (21.5-24.7), while El Salvador had the lowest ASR in both sexes (males: 1.5, females: 1.3). ASMRs were<10 for both sexes, except in Uruguay, Cuba and Argentina (10.0-17.7 and 11.3-12.0). CRC incidence is increasing in Chilean males. Most countries have national screening guidelines. Uruguay and Argentina have implemented national screening programs. Geographic variation in CRC and sex gaps may be explained by differences in the prevalence of obesity, physical inactivity, diet, smoking and alcohol consumption, early detection, and cancer registration practices. Establishing optimal CRC screening programs is challenging due to lack of healthcare access and coverage, funding, regional differences and inadequate infrastructure, and may not be feasible. Given the current status of CRC in the region, data generated by population-based cancer registries is crucial for cancer control planning. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.

LENUS (Irish Health Repository)

O’Brien, C

2018-01-01

Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely. The ability to deliver outpatient intravenous treatment is facilitated by the placement of PICCs allowing safe and targeted treatment of patients over a prolonged period of time. We carried out a retrospective study of 2,404 patients referred for PICCs from 2009 to 2015 in a university teaching hospital. There was an exponential increase in the number of PICCs requested from 2011 to 2015 with a 64% increase from 2012 to 2013. The clear increase in demand for PICCs in our institution is directly linked to the advent of outpatient intravenous antibiotic services. In this paper, we assess the impact that the use of PICCs combined with intravenous outpatient treatment may have on cost and hospital bed demand. We advocate that a more widespread implementation of this service throughout Ireland may result in significant cost savings as well as decreasing the number of patients on hospital trollies.

Intracranial suppuration: Review of an 8-year experience at Umtata General Hospital and Nelson Mandela Academic Hospital, Eastern Cape, South Africa.

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Anwary, M A

2015-09-21

Intracranial suppuration (ICS) is a life-threatening condition caused by various disease processes and consisting of brain abscess and extradural and subdural empyema. The major causes have changed over the decades. To the author's knowledge, the incidence of ICS in South Africa (SA) has not been established. To determine the incidence of ICS, overall and according to age and gender, and to identify the source and distribution of ICS. The archive of the radiology departments at Umtata General Hospital and Nelson Mandela Academic Hospital in the Transkei region, Eastern Cape Province, SA, was searched retrospectively for computed tomography (CT) reports of patients diagnosed with ICS. Cases in which the CT images, patients' clinical information and CT reports were available for an uninterrupted period of at least 1 year were included. Five time frames were established, encompassing 8 years of data. The first time frame established an incidence of ICS of 1/100,000/year for the Transkei region. All the time frames were utilised to determine the incidence according to gender and age, and the source and distribution of ICS. The incidence of ICS was higher among males than females, and highest in the age groups 0-10 and 11-20 years. A seasonal variation in the incidence of sinusitis- and meningitis-related ICS was noted. Numbers of cases declined during the last 3 years of the study period. Sinusitis, head trauma, ear infection and meningitis were the major sources of ICS. A pulmonary source was not a major feature. In the last 4 years, trauma became the commonest source of ICS. A steady decline in ear infection- and meningitis-related ICS was noted.

China’s foreign policy towards Central and Eastern Europe: The “16+1” format in the South–South cooperation perspective. Cases of the Czech Republic and Hungary

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Bartosz Kowalski

2017-04-01

Full Text Available This article discusses the “16+1” format initiated in 2012 as a platform for economic, trade, and cultural cooperation between Central and Eastern Europe (CEE and China. As Chinese authorities claim, the “16+1” initiative is complementary to the “New Silk Road” strategy, being a pragmatic formula without political goals, whose main rationale is to bring mutual benefits to all of its participants (win–win. However, despite the Chinese narratives concerning cooperation with the CEE countries as an economic bridgehead of the “One Road, One Belt” (OBOR initiative, some signs of the political dimension of the project can be noticed. Since at least the 1950s, active participation and promotion of the South–South cooperation has become an important component of China’s foreign relations. Although for Chinese policy makers Sino–South relations have been traditionally defined within the frame of, mostly postcolonial, developing countries of Southeast Asia, Central Asia, Africa, and Latin America, this article tries to examine the “South–South” pattern of China’s diplomacy towards Central and Eastern European states with a focus on the Czech Republic and Hungary.

Morphological diversity of cassava accessions of the south-central mesoregion of the State of Mato Grosso, Brazil.

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Zago, B W; Barelli, M A A; Hoogerheide, E S S; Corrêa, C L; Delforno, G I S; da Silva, C J

2017-08-17

Genetic variability of cassava (Manihot esculenta Crantz) in Brazil is wide, being this the result of natural and cultural selection during pre- and post-domestication of the species in different environments. Given the number of species of the genus found in the region (38 of a total of 98 species), the central region of Brazil was defined as the primary center of cassava diversity. Therefore, genetic diversity characterization of cassava accessions is fundamental, both for farmers and for plant breeders, because it allows the organization of genetic resources and better utilization of available genetic diversity. This research aims to assess genetic divergence of cassava accessions from the south-central region of the State of Mato Grosso, based on multi-categorical morphological traits. For this purpose, 38 qualitative and quantitative morphological descriptors were used. Genetic diversity was expressed by the genetic similarity index, with subsequent clustering of accessions by the modified Tocher's procedure and UPGMA. Of 38 descriptors, only growth habit of stem showed no variability. Tocher and UPGMA methods were efficient and corroborated on group composition. Both methods were able to group accessions of different localities in distinct group consistency.

South African Medical Journal - Vol 106, No 6 (2016)

African Journals Online (AJOL)

South African Medical Journal. ... Central Drug Authority's position statement on cannabis · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... An overview of cancer research in South African academic and research institutions, 2013 - 2014 ...

Right care, right place, right time: improving the timeliness of health care in New South Wales through a public-private hospital partnership.

Science.gov (United States)

Saunders, Carla; Carter, David J

2017-10-01

Objective The overall aim of the study was to investigate and assess the feasibility of improving the timeliness of public hospital care through a New South Wales (NSW)-wide public-private hospital partnership. Methods The study reviewed the academic and professional grey literature, and undertook exploratory analyses of secondary data acquired from two national health data repositories informing in-patient access and utilisation across NSW public and private hospitals. Results In 2014-15, the NSW public hospital system was unable to deliver care within the medically recommended time frame for over 27400 people who were awaiting elective surgery. Available information indicates that the annual commissioning of 15% of public in-patient rehabilitation bed days to the private hospital system would potentially free up enough capacity in the NSW public hospital system to enable elective surgery for all public patients within recommended time frames. Conclusions The findings of the study justify a strategic whole-of-health system approach to reducing public patient wait times in NSW and highlight the need for research efforts aimed at securing a better understanding of available hospital capacity across the public and private hospital systems, and identifying and testing workable models that improve the timeliness of public hospital care. What is known about the topic? There are very few studies available to inform public-private hospital service partnerships and the opportunities available to improve timely health care access through such partnerships. What does this paper add? This paper has the potential to open and prompt timely discussion and debate, and generate further fundamental investigation, on public-private hospital service partnerships in Australia where opportunity is available to address elective surgery wait times in a reliable and effective manner. What are the implications for practitioners? The NSW Ministry of Health and its Local Health Districts

Diversity and effective population size of four horse breeds from microsatellite DNA markers in South-Central Mexico

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J. F. Vázquez-Armijo

2017-06-01

Full Text Available The South-Central region of Mexico has experienced a sizeable introduction of purebred horses for recreational aims. A study was designed to assess effective population sizes and genetic diversity and to verify the genetic integrity of four horse breeds. Using a 12-microsatellite panel, Quarter Horse, Azteca, Thoroughbred and Creole (CRL horses were sampled and analysed for diversity and genetic structure. Genetic diversity parameters showed high numbers of heterozygous horses but small effective population sizes in all breeds. Population structure results suggested some degree of admixture of CRL with the other reference breeds. The highly informative microsatellite panel allowed the verification of diversity in introduced horse populations and the confirmation of small effective population sizes, which suggests a risk for future breed integrity.

Bibliographic Control in South Africa

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Musiker, Reuben

1972-01-01

The author sets as his task the consideration of the present state of bibliographical control of South Africa's bookstock with special reference to centralization and decentralization. (20 references) (Author/SJ)

South African metropolis

African Journals Online (AJOL)

South Africa's formal employment growth rate has been declining steadily since the ... the institutions, political processes and social networks of society. Barriers to .... central business district, as well as to other white residential areas like Phillip .... during this time by maintaining frequent contact between field workers,.

Short-term incentive schemes for hospital managers

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Lucas Malambe

2013-10-01

Full Text Available Orientation: Short-term incentives, considered to be an extrinsic motivation, are commonly used to motivate performance. This study explored hospital managers’ perceptions of short term incentives in maximising performance and retention. Research purpose: The study explored the experiences, views and perceptions of private hospital managers in South Africa regarding the use of short-term incentives to maximise performance and retention, as well as the applicability of the findings to public hospitals. Motivation for the study: Whilst there is an established link between performance reward schemes and organisational performance, there is little understanding of the effects of short term incentives on the performance and retention of hospital managers within the South African context. Research design, approach, and method: The study used a qualitative research design: interviews were conducted with a purposive sample of 19 hospital managers, and a thematic content analysis was performed. Main findings: Short-term incentives may not be the primary motivator for hospital managers, but they do play a critical role in sustaining motivation. Participants indicated that these schemes could also be applicable to public hospitals. Practical/managerial implications: Hospital managers are inclined to be more motivated by intrinsic than extrinsic factors. However, hospital managers (as middle managers also seem to be motivated by short-term incentives. A combination of intrinsic and extrinsic motivators should thus be used to maximise performance and retention. Contribution/value-add: Whilst the study sought to explore hospital managers’ perceptions of short-term incentives, it also found that an adequate balance between internal and external motivators is key to implementing an effective short-term incentive scheme.

The prevalence of HIV among blood donors at Juba Teaching Hospital Blood Bank, South Sudan

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Kenneth L L Sube

2014-11-01

Full Text Available Objectives The aim of this study is to determine the prevalence of HIV among blood donors in Juba Teaching Hospital Blood Bank, South Sudan in 2013. Method and Materials This is a retrospective study that involved the abstraction of data from registers at the blood bank. Data were collected onto data sheets and entered into a computer database. Statistical analysis was performed using SPSS Version 20 Software. A p value of <0.05 was considered statistically significant. Results Out of 1095 blood donors, 1074 (98.1% were males and 21 (1.9% were females. The mean age and the range for the whole group was 29+7.16 (15-69 yrs. The prevalence of HIV was higher among males than females 85 (7.9% vs 1 (4.8% respectively but this was not statistical significant (p=0.6. The 20 to 29 year age group had the highest prevalence of 49 (57% with no statistical significance (p=0.3.The prevalence of HIV was 7.0 % (86 and there were co-infections between HIV and HBV, HCV and syphilis of 14 (50%, 5 (18%, 9 (32% with p=0.7, p=0.1, p=0.8 respectively. Blood group O positive had the highest percentage 58.1 % (n=50 and was the commonest group. Conclusion In this study, HIV prevalence is very high among blood donors at the Juba Teaching Hospital blood bank.

Development of a Geologic Exploration Model foe the Permo-Pennsylvanian Petroleum System in South-Central Montana

Energy Technology Data Exchange (ETDEWEB)

David A. Lopez

2007-06-30

presented: migration occurred (1) before mid-Jurassic erosion produced a major regional unconformity or (2) about 82 million years ago. Migration pre-Laramide occurred because oil in both the Bighorn Basin and the Powder River Basin are part of the same petroleum system. Geochemical analyses of oils from producing fields across the region show the oils are all similar and have the same source and generation history. No Phosphoria source rocks exist in the project area of south-central Montana, requiring that oil migrated from distant source areas, probably in central and southwestern Wyoming. Oil shows and production in the Tensleep are absent in the northern part of the project area. This appears to be controlled by the merging of the top of the Tensleep Sandstone and the Jurassic unconformity (top of the Triassic Chugwater Formation). There should be potential for the discovery of oil in Tensleep stratigraphic traps or combination traps everywhere south of the Jurassic-Pennsylvanian Isopach zero contour except where the Tensleep has been exposed by uplift and erosion. Known Tensleep fields in south-central Montana are generally small in area, which agrees with outcrop studies that show eolian dune sequences are generally quite small in lateral extent, on the order of 10 to 40 acres. Although existing fields are small in area, they are very productive; individual wells will probably make 300,000 to 500,000 barrels of oil. In the project area, hydrodynamic considerations are important. All the existing Tensleep fields have active water drives. In many cases, the reservoir pressure today is as it was when initially discovered. In areas of high structural complexity, such as the Lodge Grass-Crow Agency fault and the Lake Basin fault zone, significant structural closure may be necessary to trap oil because of the strong hydrodynamic influence exerted by the underlying Madison Formation aquifer.

Sedating children in South Africa

African Journals Online (AJOL)

bRed Cross War Memorial Children's Hospital, Cape Town, South Africa. cSedation and Pain ... As the authors indicate, there is increasing pressure from practitioners, funders and patients or parents for procedures to take place outside the ...

Do South African universities provide the required training platforms ...

African Journals Online (AJOL)

Background. Concern exists about the quality of specialist training platforms at South African universities and teaching hospitals. Method. We conducted an audit of the quality of training at South African otolaryngology (ENT) training institutions from the perspective of the registrars. Results. Some institutions were deficient in ...

Specialized consulting in radiological safety to the North Central Hospital of high specialty, PEMEX. V. November of 2001; Asesoria especializada en seguridad radiologica al Hospital Central Norte de alta especialidad, PEMEX. V. Noviembre de 2001

Energy Technology Data Exchange (ETDEWEB)

Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

2002-01-15

It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the North Central Hospital of High Specialty, to maintain the sanitary license for the use of X ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of November of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

Typical occupational accidents with employees of a university hospital in the south of Brazil: epidemiology and prevention.

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Sêcco, Iara Aparecida de Oliveira; Robazzi, Maria Lúcia do Carmo Cruz; Shimizu, Denise Sayuri; Rúbio, Márcia Maria da Silva

2008-01-01

Descriptive epidemiologic study that aimed to analyze the typical occupational accidents notified by employees of a university hospital in the South of Brazil from 1997 to 2002, and to estimate their risk indicators. A total of 717 accidents were registered; 86% of them (616) were typical and presented an annual average risk coefficient of 6.0 per 100 employees. The groups that presented more risks for accidents were cooks, woodworkers and nursing auxiliaries, while hands were the most affected area. Regarding the accidents nature, the greatest risks involved biological material. Hence, it is necessary to orient personnel about the legal aspects of occupational accidents and review work processes, especially those related to employees who perform activities at greater risk of transmissible diseases like AIDS and hepatitis B and C.

Management of snakebites at a rural South African hospital

African Journals Online (AJOL)

antivenom, inappropriate first aid, the regional effects of envenomation ... is crucial for primary care physicians to be familiar with the most common venomous snakes in South Africa and the ..... Pediatric and Neonatal Emergency Care.

Cave-dwelling bats (Mammalia: Chiroptera and conservation concerns in South central Mindanao, Philippines

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Krizler C. Tanalgo

2015-12-01

Full Text Available The stable microclimate in caves provides a relatively constant habitat for many bat species in the Philippines, but human encroachment continues to disrupt this habitat and imperil many of the species roosting in the caves.  In South central Mindanao, the diversity and conservation status of cave bats remain undocumented and unexplored.  We employed mist-netting to capture bats from five different caves within the town of Kabacan, northern Cotabato, Philippines.  A total of 14 bat species were identified including the Philippine endemics Hipposideros pygmaeus and Ptenochirus jagori and the threatened Megaerops wetmorei. However, despite the declining conservation status of the bats, local disturbance such as bat hunting for bush meat and unregulated tourism are currently taking place in the caves.  Large species such as Eonycteris spelaea and Rousettus amplexicaudatus are killed almost every day for food and trade.  Therefore, the high species richness, and the presence of endemic and threatened species coupled with the occurrence of anthropogenic disturbances in caves suggests the need for an urgent and effective conservation intervention involving the local government and public community. 

Greenhouse gas fluxes of a shallow lake in south-central North Dakota, USA

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Tangen, Brian; Finocchiaro, Raymond; Gleason, Robert A.; Dahl, Charles F.

2016-01-01

Greenhouse gas (GHG) fluxes of aquatic ecosystems in the northern Great Plains of the U.S. represent a significant data gap. Consequently, a 3-year study was conducted in south-central North Dakota, USA, to provide an initial estimate of GHG fluxes from a large, shallow lake. Mean GHG fluxes were 0.02 g carbon dioxide (CO2) m−2 h−1, 0.0009 g methane (CH4) m−2 h−1, and 0.0005 mg nitrous oxide (N2O) m−2 h−1. Fluxes of CO2 and CH4 displayed temporal and spatial variability which is characteristic of aquatic ecosystems, while fluxes of N2O were consistently low throughout the study. Comparisons between results of this study and published values suggest that mean daily fluxes of CO2, CH4, and N2O fromLong Lakewere low, particularly when compared to the well-studied prairie pothole wetlands of the region. Similarly, cumulative seasonal CH4 fluxes, which ranged from 2.68–7.58 g CH4 m−2, were relatively low compared to other wetland systems of North America. The observed variability among aquatic ecosystems underscores the need for further research.

The skills gap in nursing management in the South African public health sector.

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Pillay, Rubin

2011-01-01

Nurse managers are central to health delivery in South Africa. However, there is a paucity of research that analyzes their competence to successfully discharge their managerial role. To identify the competencies perceived to be important for effective nursing management in the South African public sector and the managers' self-assessed proficiency in these. A cross-sectional survey using a self-administered questionnaire. 215 senior nursing managers at South African public sector hospitals. Respondents rated the level of importance that 51 proposed competencies had in their job and indicated their proficiency in each. Public sector managers ranked controlling as the most important competency, followed by leading, organizing, and self-management. Health/clinical skills, planning, and legal/ethical competencies were ranked as being relatively less important. They assessed themselves as being most competent in self-management, followed by planning, controlling, leading, and specific health skills. The competency gap was the largest for legal/ethical issues, organizing, and controlling. The competency gap for planning and self-management was relatively smaller. This research confirms that there is a lack of management capacity within the public health sector and also identifies the areas in which the lack of knowledge or skills is most significant. © 2011 Wiley Periodicals, Inc.

Benefiting from networks by occupying central positions: an empirical study of the Taiwan health care industry.

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Peng, Tzu-Ju Ann; Lo, Fang-Yi; Lin, Chin-Shien; Yu, Chwo-Ming Joseph

2006-01-01

At issue is whether network resources imply some resources available to all members in networks or available only to those occupying structurally central positions in networks. In this article, two conceptual models, the additive and interaction models of the firm, are empirically tested regarding the impact of hospital resources, network resources, and centrality on hospital performance in the Taiwan health care industry. The results demonstrate that: (1) in the additive model, hospital resources and centrality independently affect performance, whereas network resources do not; and (2) no evidence supports the interaction effect of centrality and resources on performance. Based on our findings in Taiwanese practices, the extent to which the resources are acquired externally from networks, we suggest that while adopting interorganizational strategies, hospitals should clearly identify those important resources that reside in-house and those transferred from network partners. How hospitals access resources from central positions is more important than what network resources can hospitals acquire from networks. Hospitals should improve performance by exploiting its in-house resources rather than obtaining network resources externally. In addition, hospitals should not only invest in hospital resources for better performance but should also move to central positions in networks to benefit from collaborations.

Epidemiology of respiratory syncytial virus-associated acute lower respiratory tract infection hospitalizations among HIV-infected and HIV-uninfected South African children, 2010-2011.

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Moyes, Jocelyn; Cohen, Cheryl; Pretorius, Marthi; Groome, Michelle; von Gottberg, Anne; Wolter, Nicole; Walaza, Sibongile; Haffejee, Sumayya; Chhagan, Meera; Naby, Fathima; Cohen, Adam L; Tempia, Stefano; Kahn, Kathleen; Dawood, Halima; Venter, Marietjie; Madhi, Shabir A

2013-12-15

There are limited data on respiratory syncytial virus (RSV) infection among children in settings with a high prevalence of human immunodeficiency virus (HIV). We studied the epidemiology of RSV-associated acute lower respiratory tract infection (ALRTI) hospitalizations among HIV-infected and HIV-uninfected children in South Africa. Children aged infection among HIV-infected and uninfected children were examined. The relative risk of hospitalization in HIV-infected and HIV-uninfected children was calculated in 1 site with population denominators. Of 4489 participants, 4293 (96%) were tested for RSV, of whom 1157 (27%) tested positive. With adjustment for age, HIV-infected children had a 3-5-fold increased risk of hospitalization with RSV-associated ALRTI (2010 relative risk, 5.6; [95% confidence interval (CI), 4.5-6.4]; 2011 relative risk, 3.1 [95% CI, 2.6-3.6]). On multivariable analysis, HIV-infected children with RSV-associated ALRTI had higher odds of death (adjusted odds ratio. 31.1; 95% CI, 5.4-179.8) and hospitalization for >5 days (adjusted odds ratio, 4.0; 95% CI, 1.5-10.6) than HIV-uninfected children. HIV-infected children have a higher risk of hospitalization with RSV-associated ALRTI and a poorer outcome than HIV-uninfected children. These children should be targeted for interventions aimed at preventing severe RSV disease.

Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care Hospital.

Science.gov (United States)

Dolscheid-Pommerich, Ramona C; Dolscheid, Sarah; Grigutsch, Daniel; Stoffel-Wagner, Birgit; Graeff, Ingo

2016-01-01

Fulfilling the requirements of point-of-care testing (POCT) training regarding proper execution of measurements and compliance with internal and external quality control specifications is a great challenge. Our aim was to compare the values of the highly critical parameter hemoglobin (Hb) determined with POCT devices and central laboratory analyzer in the highly vulnerable setting of an emergency department in a supra maximal care hospital to assess the quality of POCT performance. In 2548 patients, Hb measurements using POCT devices (POCT-Hb) were compared with Hb measurements performed at the central laboratory (Hb-ZL). Additionally, sub collectives (WHO anemia classification, patients with Hb 85y.) were analyzed. Overall, the correlation between POCT-Hb and Hb-ZL was highly significant (r = 0.96, p2.5g/dl occurred. McNemar´s test revealed significant differences regarding anemia diagnosis according to WHO definition for male, female and total patients (♂ phemoglobin concentration measurement methods, i.e. POCT devices and at the central laboratory. The results confirm the successful implementation of the presented POCT concept. Nevertheless some limitations could be identified in anemic patients stressing the importance of carefully examining clinically implausible results.

Cephalopods and cetaceans as indicators of offshore bioavailability of cadmium off Central South Brazil Bight

Energy Technology Data Exchange (ETDEWEB)

Dorneles, Paulo Renato [Laboratorio de Radioisotopos Eduardo Penna Franca, Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), 21941-900 Rio de Janeiro, RJ (Brazil) and Laboratorio de Mamiferos Aquaticos, Dept. Oceanografia, UERJ, 20550-013 Rio de Janeiro, RJ (Brazil)]. E-mail: dorneles@biof.ufrj.br; Lailson-Brito, Jose [Laboratorio de Radioisotopos Eduardo Penna Franca, Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), 21941-900 Rio de Janeiro, RJ (Brazil) and Laboratorio de Mamiferos Aquaticos, Dept. Oceanografia, UERJ, 20550-013 Rio de Janeiro, RJ (Brazil)]. E-mail: lailson@uerj.br; Aguiar dos Santos, Roberta [Centro de Pesquisa e Gestao de Recursos Pesqueiros do Litoral Sudeste e Sul, IBAMA, 88301-700 Itajai, SC (Brazil)]. E-mail: gibteuthis@yahoo.com.br; Silva da Costa, Paulo Alberto [Laboratorio de Dinamica de Populacoes Marinhas, UNIRIO, 22290-240 Rio de Janeiro, RJ (Brazil)]. E-mail: pauloascosta@uol.com.br; Malm, Olaf [Laboratorio de Radioisotopos Eduardo Penna Franca, Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), 21941-900 Rio de Janeiro, RJ (Brazil)]. E-mail: olaf@biof.ufrj.br; Azevedo, Alexandre Freitas [Laboratorio de Mamiferos Aquaticos, Dept. Oceanografia, UERJ, 20550-013 Rio de Janeiro, RJ (Brazil)]. E-mail: azevedo.alex@uol.com.br; Machado Torres, Joao Paulo [Laboratorio de Radioisotopos Eduardo Penna Franca, Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (UFRJ), 21941-900 Rio de Janeiro, RJ (Brazil)]. E-mail: jptorres@biof.ufrj.br

2007-07-15

Regarding Brazilian coast, industrial and urban developments are concentrated along Central South Brazil Bight. Samples from inshore and offshore species from the concerned area were analyzed, comprising 24 cetaceans (9 species) and 32 squids (2 species). Cadmium was determined by GFAAS and our results were in agreement with certified values (DOLT-2, NRCC). Mean cadmium concentration (in {mu}g/g, wet weight) observed in the digestive gland of sexually mature Argentine short-finned squids (Illex argentinus) was 1002.9. To our knowledge this is the highest cadmium level ever reported for a cephalopod. Concerning cetaceans, our results include one of the highest renal cadmium concentrations described for striped dolphins (71.29 {mu}g/g, wet weight). Anthropogenic action, upwelling and cannibalism of Argentine short-finned squid on the studied area are possible reasons for such remarkable cadmium concentrations. - Cd levels in ommastrephid squids from Brazil are the highest ever reported for cephalopods.

Cephalopods and cetaceans as indicators of offshore bioavailability of cadmium off Central South Brazil Bight

International Nuclear Information System (INIS)

Dorneles, Paulo Renato; Lailson-Brito, Jose; Aguiar dos Santos, Roberta; Silva da Costa, Paulo Alberto; Malm, Olaf; Azevedo, Alexandre Freitas; Machado Torres, Joao Paulo

2007-01-01

Regarding Brazilian coast, industrial and urban developments are concentrated along Central South Brazil Bight. Samples from inshore and offshore species from the concerned area were analyzed, comprising 24 cetaceans (9 species) and 32 squids (2 species). Cadmium was determined by GFAAS and our results were in agreement with certified values (DOLT-2, NRCC). Mean cadmium concentration (in μg/g, wet weight) observed in the digestive gland of sexually mature Argentine short-finned squids (Illex argentinus) was 1002.9. To our knowledge this is the highest cadmium level ever reported for a cephalopod. Concerning cetaceans, our results include one of the highest renal cadmium concentrations described for striped dolphins (71.29 μg/g, wet weight). Anthropogenic action, upwelling and cannibalism of Argentine short-finned squid on the studied area are possible reasons for such remarkable cadmium concentrations. - Cd levels in ommastrephid squids from Brazil are the highest ever reported for cephalopods

Satellite-based detection of volcanic sulphur dioxide from recent eruptions in Central and South America

Directory of Open Access Journals (Sweden)

D. Loyola

2008-01-01

Full Text Available Volcanic eruptions can emit large amounts of rock fragments and fine particles (ash into the atmosphere, as well as several gases, including sulphur dioxide (SO₂. These ejecta and emissions are a major natural hazard, not only to the local population, but also to the infrastructure in the vicinity of volcanoes and to aviation. Here, we describe a methodology to retrieve quantitative information about volcanic SO₂ plumes from satellite-borne measurements in the UV/Visible spectral range. The combination of a satellite-based SO₂ detection scheme and a state-of-the-art 3D trajectory model enables us to confirm the volcanic origin of trace gas signals and to estimate the plume height and the effective emission height. This is demonstrated by case-studies for four selected volcanic eruptions in South and Central America, using the GOME, SCIAMACHY and GOME-2 instruments.

Strain distribution and model for formation of eastern Umtanum Ridge anticline, south-central Washington

Energy Technology Data Exchange (ETDEWEB)

Price, E.H.

1979-10-01

Umtanum Ridge in south-central Washington is the topographic expression of a complex anticline within the Yakima Fold system in the Miocene Columbia River Basalt Group. The Yakima Fold system, which is partly contained within the Hanford Site, is an example of a layered basalt sequence folded near the surface of the earth. The Pasco Basin stratigraphic nomenclature is used in this repot. Rockwelll Hanford Operations, under contract to the US Department of Energy, is investigating the feasibility of therminal high-level nuclear waste storage in mined repositories in basalt beneath the Hanford Site. Because thereis essentially no basalt within the Site that has not been involved in some folding, any potential location for a repository will be either on the limbs or near the hinge zone of a Yakima Fold structure. Umtanum Ridge is the best exposed Yakima Fold structure in the vicinity of the Site for studying the nature and three-dimensional style of deformation of a multilayered basalt sequence. The structural geometry, distribution of strain within the Umtanum structure and deformational mechanisms of the Umtanum Ridge are discussed.

Ground beetles (Coleoptera, Carabidae of the Hanford Nuclear Site in south-central Washington State

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Chris Looney

2014-04-01

Full Text Available In this paper we report on ground beetles (Coleoptera: Carabidae collected from the Hanford Nuclear Reservation and Hanford National Monument (together the Hanford Site, which is located in south-central Washington State. The Site is a relatively undisturbed relict of the shrub-steppe habitat present throughout much of the western Columbia Basin before the westward expansion of the United States. Species, localities, months of capture, and capture method are reported for field work conducted between 1994 and 2002. Most species were collected using pitfall traps, although other capture methods were employed. Trapping results indicate the Hanford Site supports a diverse ground beetle community, with over 90% of the 92 species captured native to North America. Four species collected during the study period are newly recorded for Washington State: Bembidion diligens Casey, Calosoma obsoletum Say, Pseudaptinus rufulus (LeConte, and Stenolophus lineola (Fabricius. Based on these data, the Site maintains a diverse ground beetle fauna and, due to its size and diversity of habitats, is an important repository of shrub-steppe biodiversity.

Strain distribution and model for formation of eastern Umtanum Ridge anticline, south-central Washington

International Nuclear Information System (INIS)

Price, E.H.

1979-10-01

Umtanum Ridge in south-central Washington is the topographic expression of a complex anticline within the Yakima Fold system in the Miocene Columbia River Basalt Group. The Yakima Fold system, which is partly contained within the Hanford Site, is an example of a layered basalt sequence folded near the surface of the earth. The Pasco Basin stratigraphic nomenclature is used in this repot. Rockwelll Hanford Operations, under contract to the US Department of Energy, is investigating the feasibility of therminal high-level nuclear waste storage in mined repositories in basalt beneath the Hanford Site. Because thereis essentially no basalt within the Site that has not been involved in some folding, any potential location for a repository will be either on the limbs or near the hinge zone of a Yakima Fold structure. Umtanum Ridge is the best exposed Yakima Fold structure in the vicinity of the Site for studying the nature and three-dimensional style of deformation of a multilayered basalt sequence. The structural geometry, distribution of strain within the Umtanum structure and deformational mechanisms of the Umtanum Ridge are discussed

Ubuntu and the law in South Africa | Mokgoro | Potchefstroom ...

African Journals Online (AJOL)

The new constitutional dispensation, like the idea of freedom in South Africa, is also not ... In an attempt to define it, the concept has generally been described as a ... Ubuntu can therefore become central to a new South African jurisprudence ...

Compositional data supports decentralized model of production and circulation of artifacts in the pre-Columbian south-central Andes.

Science.gov (United States)

Lazzari, Marisa; Pereyra Domingorena, Lucas; Stoner, Wesley D; Scattolin, María Cristina; Korstanje, María Alejandra; Glascock, Michael D

2017-05-16

The circulation and exchange of goods and resources at various scales have long been considered central to the understanding of complex societies, and the Andes have provided a fertile ground for investigating this process. However, long-standing archaeological emphasis on typological analysis, although helpful to hypothesize the direction of contacts, has left important aspects of ancient exchange open to speculation. To improve understanding of ancient exchange practices and their potential role in structuring alliances, we examine material exchanges in northwest Argentina (part of the south-central Andes) during 400 BC to AD 1000 (part of the regional Formative Period), with a multianalytical approach (petrography, instrumental neutron activation analysis, laser ablation inductively coupled plasma mass spectrometry) to artifacts previously studied separately. We assess the standard centralized model of interaction vs. a decentralized model through the largest provenance database available to date in the region. The results show: ( i ) intervalley heterogeneity of clays and fabrics for ordinary wares; ( ii ) intervalley homogeneity of clays and fabrics for a wide range of decorated wares (e.g., painted Ciénaga); ( iii ) selective circulation of two distinct polychrome wares (Vaquerías and Condorhuasi); ( iv ) generalized access to obsidian from one major source and various minor sources; and ( v ) selective circulation of volcanic rock tools from a single source. These trends reflect the multiple and conflicting demands experienced by people in small-scale societies, which may be difficult to capitalize by aspiring elites. The study undermines centralized narratives of exchange for this period, offering a new platform for understanding ancient exchange based on actual material transfers, both in the Andes and beyond.

The invasive species Ulex europaeus (Fabaceae) shows high dynamism in a fragmented landscape of south-central Chile.

Science.gov (United States)

Altamirano, Adison; Cely, Jenny Paola; Etter, Andrés; Miranda, Alejandro; Fuentes-Ramirez, Andres; Acevedo, Patricio; Salas, Christian; Vargas, Rodrigo

2016-08-01

Ulex europaeus (gorse) is an invasive shrub deemed as one of the most invasive species in the world. U. europaeus is widely distributed in the south-central area of Chile, which is considered a world hotspot for biodiversity conservation. In addition to its negative effects on the biodiversity of natural ecosystems, U. europaeus is one of the most severe pests for agriculture and forestry. Despite its importance as an invasive species, U. europaeus has been little studied. Although information exists on the potential distribution of the species, the interaction of the invasion process with the spatial dynamic of the landscape and the landscape-scale factors that control the presence or absence of the species is still lacking. We studied the spatial and temporal dynamics of the landscape and how these relate to U. europaeus invasion in south-central Chile. We used supervised classification of satellite images to determine the spatial distribution of the species and other land covers for the years 1986 and 2003, analysing the transitions between the different land covers. We used logistic regression for modelling the increase, decrease and permanence of U. europaeus invasion considering landscape variables. Results showed that the species covers only around 1 % of the study area and showed a 42 % reduction in area for the studied period. However, U. europaeus was the cover type which presented the greatest dynamism in the landscape. We found a strong relationship between changes in land cover and the invasion process, especially connected with forest plantations of exotic species, which promotes the displacement of U. europaeus. The model of gorse cover increase presented the best performance, and the most important predictors were distance to seed source and landscape complexity index. Our model predicted high spread potential of U. europaeus in areas of high conservation value. We conclude that proper management for this invasive species must take into account

Satisfaction and adherence of patients with amputations to physiotherapy service at public hospitals in KwaZulu-Natal, South Africa.

Science.gov (United States)

Verusia, Chetty; Tanuja, Dunpath; Simira, Meghnath; Sarisha, Mothalal; Varuna, Sewmungal; Ursula, Kunene; Thalente, Ntshakala

2015-06-01

Individuals who have undergone a lower limb amputation require comprehensive rehabilitation from the multidisciplinary team to ensure optimal treatment outcomes and social integration. Physiotherapists play a pivotal role within the multidisciplinary team and offer patients physical and psychosocial rehabilitative care. Determining patients' satisfaction levels and exploring factors affecting adherence to physiotherapy interventions can inform practice and improve service delivery of rehabilitation within resource poor settings such as South Africa. To determine the level of satisfaction with physiotherapy services rendered to acute and sub-acute in-patients with lower limb amputations and to explore factors affecting adherence to physiotherapy intervention. A prospective survey of 35 patients with lower limb amputations from four public hospitals in South Africa was undertaken. A modified version of the Hampstead rehabilitation centre patient satisfaction questionnaire was utilised. Majority of participants were satisfied with the physiotherapy services whilst a few reported dissatisfaction. Three themes emerged whilst exploring the patients' experience relating to adherence to physiotherapy programmes. Themes included service delivery, patient-therapist interaction and participation barriers and facilitators. Recommendations aimed to improve quality of care and healthcare outcomes thereby enhancing the participants' adherence to the physiotherapy programme.

Seismic stratigraphy and late Quaternary shelf history, south-central Monterey Bay, California

Science.gov (United States)

Chin, J.L.; Clifton, H.E.; Mullins, H.T.

1988-01-01

The south-central Monterey Bay shelf is a high-energy, wave-dominated, tectonically active coastal region on the central California continental margin. A prominent feature of this shelf is a sediment lobe off the mouth of the Salinas River that has surface expression. High-resolution seismic-reflection profiles reveal that an angular unconformity (Quaternary?) underlies the entire shelf and separates undeformed strata above it from deformed strata below it. The Salinas River lobe is a convex bulge on the shelf covering an area of approximately 72 km2 in water depths from 10 to 90 m. It reaches a maximum thickness of 35 m about 2.5 km seaward of the river mouth and thins in all directions away from this point. Adjacent shelf areas are characterized by only a thin (2 to 5 m thick) and uniform veneer of sediment. Acoustic stratigraphy of the lobe is complex and is characterized by at least three unconformity-bounded depositional sequences. Acoustically, these sequences are relatively well bedded. Acoustic foresets occur within the intermediate sequence and dip seaward at 0.7?? to 2.0??. Comparison with sedimentary sequences in uplifted onshore Pleistocene marine-terrace deposits of the Monterey Bay area, which were presumably formed in a similar setting under similar processes, suggests that a general interpretation can be formulated for seismic stratigraphic patterns. Depositional sequences are interpreted to represent shallowing-upwards progradational sequences of marine to nonmarine coastal deposits formed during interglacial highstands and/or during early stages of falling sea level. Acoustic foresets within the intermediate sequence are evidence of seaward progradation. Acoustic unconformities that separate depositional sequences are interpreted as having formed largely by shoreface planation and may be the only record of the intervening transgressions. The internal stratigraphy of the Salinas River lobe thus suggests that at least several late Quaternary

Multidisciplinary Observations of Subduction (MOOS) Experiment in South-Central Alaska

Science.gov (United States)

Christensen, D.; Abers, G.; Freymueller, J.

2008-12-01

Seismic and geodetic data are being collected in the Kenai Peninsula and surrounding area of south central Alaska as part of the PASSCAL experiment MOOS. A total of 34 broadband seismic stations were deployed between the summers of 2007 and 2008. Seventeen of these stations continue to operate for an additional year and are scheduled to be removed in the summer of 2009. Numerous GPS campaign sites have and will be visited during the same time period. The MOOS seismic deployment provides coverage across the interplate coupled zone and adjacent transition zone in the shallow parts of the Alaskan subduction zone. It is a southern extension of an earlier broadband deployment BEAAR (Broadband Experiment Across the Alaska Range) to the north. When integrated with the previous BEAAR experiment, these data will allow high-resolution broadband imaging along a 600 km long transect over the Alaska subduction zone, at 10-15 km station spacing. The MOOS deployment allows us to test several hypotheses relating to the postulated subduction of the Yakutat Block and the nature of the coupled zone which ruptured in the great 1964 earthquake. The seismic and geodetic stations cover an area that includes part of the 1964 main asperity and the adjacent, less coupled, region to the southwest. Data gathered from this experiment will shed light on the nature of this boundary from both a geodetic and seismic (or earth structure) perspective. Shallow seismicity recorded by this network greatly improves the catalog of events in this area and helps to delineate active features in the subduction complex. Preliminary results from this project will be presented.

Prevalence of malaria infection in Butajira area, south-central Ethiopia

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Woyessa Adugna

2012-03-01

Full Text Available Abstract Background In 2005, the Ethiopian government launched a massive expansion of the malaria prevention and control programme. The programme was aimed mainly at the reduction of malaria in populations living below 2,000 m above sea level. Global warming has been implicated in the increase in the prevalence of malaria in the highlands. However, there is still a paucity of information on the occurrence of malaria at higher altitudes. The objective of this study was to estimate malaria prevalence in highland areas of south-central Ethiopia, designated as the Butajira area. Methods Using a multi-stage sampling technique, 750 households were selected. All consenting family members were examined for malaria parasites in thick and thin blood smears. The assessment was repeated six times for two years (October 2008 to June 2010. Results In total, 19,207 persons were examined in the six surveys. From those tested, 178 slides were positive for malaria, of which 154 (86.5% were positive for Plasmodium vivax and 22 (12.4% for Plasmodium falciparum; the remaining two (1.1% showed mixed infections of Plasmodium falciparum and Plasmodium vivax. The incidence of malaria was higher after the main rainy season, both in lower lying and in highland areas. The incidence in the highlands was low and similar for all age groups, whereas in the lowlands, malaria occurred mostly in those of one to nine years of age. Conclusion This study documented a low prevalence of malaria that varied with season and altitudinal zone in a highland-fringe area of Ethiopia. Most of the malaria infections were attributable to Plasmodium vivax.

Antimicrobial resistance patterns of Staphylococcus species isolated from cats presented at a veterinary academic hospital in South Africa.

Science.gov (United States)

Qekwana, Daniel Nenene; Sebola, Dikeledi; Oguttu, James Wabwire; Odoi, Agricola

2017-09-15

Antimicrobial resistance is becoming increasingly important in both human and veterinary medicine. This study investigated the proportion of antimicrobial resistant samples and resistance patterns of Staphylococcus isolates from cats presented at a veterinary teaching hospital in South Africa. Records of 216 samples from cats that were submitted to the bacteriology laboratory of the University of Pretoria academic veterinary hospital between 2007 and 2012 were evaluated. Isolates were subjected to antimicrobial susceptibility testing against a panel of 15 drugs using the disc diffusion method. Chi square and Fisher's exact tests were used to assess simple associations between antimicrobial resistance and age group, sex, breed and specimen type. Additionally, associations between Staphylococcus infection and age group, breed, sex and specimen type were assessed using logistic regression. Staphylococcus spp. isolates were identified in 17.6% (38/216) of the samples submitted and 4.6% (10/216) of these were unspeciated. The majority (61.1%,11/18) of the isolates were from skin samples, followed by otitis media (34.5%, 10/29). Coagulase Positive Staphylococcus (CoPS) comprised 11.1% (24/216) of the samples of which 7.9% (17/216) were S. intermedius group and 3.2% (7/216) were S. aureus. Among the Coagulase Negative Staphylococcus (CoNS) (1.9%, 4/216), S. felis and S. simulans each constituted 0.9% (2/216). There was a significant association between Staphylococcus spp. infection and specimen type with odds of infection being higher for ear canal and skin compared to urine specimens. There were higher proportions of samples resistant to clindamycin 34.2% (13/25), ampicillin 32.4% (2/26), lincospectin 31.6% (12/26) and penicillin-G 29.0% (11/27). Sixty three percent (24/38) of Staphylococcus spp. were resistant to one antimicrobial agent and 15.8% were multidrug resistant (MDR). MDR was more common among S. aureus 28.6% (2/7) than S. intermedius group isolates 11.8% (2

Map Showing Geologic Terranes of the Hailey 1°x2° Quadrangle and the western part of the Idaho Falls 1°x2° Quadrangle, south-central Idaho

Data.gov (United States)

Department of the Interior — The paper version of Map Showing Geologic Terranes of the Hailey 1°x2° Quadrangle and the western part of the Idaho Falls 1°x2° Quadrangle, south-central Idaho was...

The accuracy of nurse performance of the triage process in a tertiary hospital emergency department in Gauteng Province, South Africa

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L N Goldstein

2017-03-01

Full Text Available Background. Triage in the emergency department (ED is necessary to prioritise management according to the severity of a patient’s condition.The South African Triage Scale (SATS is a hospital-based triage tool that has been adopted by numerous EDs countrywide.Many factors can influence the outcome of a patient’s triage result, and evaluation of performance is therefore pivotal. Objectives. To determine how often patients were allocated to the correct triage category and the extent to which they were incorrectly promoted or demoted, and to determine the main reasons for errors in a nurse-led triage system. Methods. Triage forms from a tertiary hospital ED in Gauteng Province, South Africa, were collected over a 1-week period and reviewed retrospectively. Results. A total of 1 091 triage forms were reviewed. Triage category allocations were correct 68.3% of the time. Of the incorrect category assignments, 44.4% of patients were promoted and 55.6% demoted. Patients in the green category were most commonly promoted (29.4% and patients who should have been in orange were most commonly demoted (35.0%. Trauma patients were more likely to be incorrectly promoted and non-trauma patients to be incorrectly demoted. Mistakes were mainly due to discriminator errors (57.8%, followed by numerical miscalculations (21.5%. The leading omitted discriminators were ‘abdominal pain’, ‘chest pain’ and ‘shortness of breath’. Conclusions. Mis-triaging using the SATS can be attributed to incorrect or lack of discriminator use, numerical miscalculations and other human errors. Quality control and quality assurance measures must target training in these areas to minimise mis-triage in the ED.

Dioxin-like chemicals in soil and sediment from residential and industrial areas in central South Africa.

Science.gov (United States)

Nieuwoudt, Claudine; Quinn, Laura P; Pieters, Rialet; Jordaan, Ilse; Visser, Maret; Kylin, Henrik; Borgen, Anders R; Giesy, John P; Bouwman, Henk

2009-08-01

Persistent organic pollutants (POPs) are a global concern due to their ubiquitous presence and toxicity. Currently, there is a lack of information regarding POPs from South Africa. Here we report and interpret concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), -dibenzofurans (PCDFs) and co-planar-biphenyls (PCBs) in soils and sediments collected from central South Africa. High resolution gas chromatography-high resolution mass spectrometry (HRGC/HRMS) and the H4IIE-luc bio-assay were used to identify and quantify individual PCDD/F congeners and to report the total concentration of 2,3,7,8-tetrachloro dibenzo-p-dioxin equivalents (TCDD-EQ), respectively. TCDD-EQs determined by use of the bio-assay, and concentrations of WHO(2005)-TEQ (toxic equivalents) determined by chemical analysis, were similar. The limit of detection (LOD) for the bio-assay was 0.82 and 2.8 ng TCDD-EQ kg(-1), dw for sediment and soil, respectively. EQ20 concentrations determined by use of the bio-assay ranged from industrial area of Vanderbijlpark and the residential area of Klerksdorp contained the greatest concentrations. Based on the congener-specific HRGC/HRMS analyzes, concentrations of WHO(2005)-TEQ ranged from 0.12 to 32 ng WHO(2005)-TEQ kg(-1), dw in sediments, and between 0.34 and 20 ng WHO(2005)-TEQkg(-1), dw in soils. The sources, processes and threats that govern and are associated with the lesser concentrations in sediment and greater concentrations in soils need further investigation.

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

NARCIS (Netherlands)

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

2013-01-01

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

Frontier areas and exploration techniques. Frontier uranium exploration in the South-Central United States

International Nuclear Information System (INIS)

Campbell, M.D.; Biddle, K.T.

1977-01-01

Selected areas of the South-Central United States outside the known U trends of South Texas have a largely untested potential for the occurrence of significant U mineralization. These areas, underlain by Tertiary and older sediments, include parts of Texas, Oklahoma, Arkansas, Louisiana, Mississippi and Alabama. The commonly accepted criteria employed in U exploration are applicable to these frontier areas but special consideration must also be given to the atypical geologic aspects of such areas as they may apply to relatively unique types of U mineralization or to the development of special exploration criteria for common types of roll-front and fault-and dome-related uranium mineralization. The procedures used in evaluating frontier areas should be based on comprehensive evaluations involving: (1) location and analysis of potential source rocks (e.g., intrusive igneous rocks, bentonitic sediments, unique complexes, etc.); (2) definition of regional variations in the potential host sediments (e.g. marginal marine to nonmarine environments of deposition); (3) review of all available radiometric data in Tertiary or older rocks; (4) local groundwater sampling; (5) widely spaced reconnaissance (or stratigraphic) drilling, coring and borehole geophysical logging to define favorable sedimentary facies and to establish the specific lithologic character of the sediments; and (6) detailed petrographic evaluation of all available samples to define the environment of deposition and diagenetic history of ''favorable'' sediments. If procedures produce favorable results, an expanded exploration program is justified. Depths up to 3,000 feet should be anticipated if up-dip information is favorable. Selected areas are discussed that have: (1) favorable source and host rocks;(2) favorable age; (3) favorable regional and local structure; and (4) radiometric characteristics favorable for U mineralization of potentially economic grade and reserves in the areas

Multiproxy approach revealing climate and cultural changes during the last 26kyrs in south-central Chile

Science.gov (United States)

Abarzua, Ana M.; Jarpa, Leonora; Martel, Alejandra; Vega, Rodrigo; Pino, Mario

2010-05-01

Multiproxy approach from Purén Lumaco Valley (38°S) describes the paleonvironmental history during the Last Maximum Glacial (LGM) in south-central Chile. Three sediment cores and severals AMS 14C dates were used to perform a complete pollen, diatoms, chironomids, and sedimentological records demonstrating the existence of a large and non profundal paleolake, between 25 and 20kyr BP. Some of these evidence are laminated silty-clay sediments (lacustrine rhythmites), associated with the presence of siderite mineral (FeCO3), besides biological proxies like Fragilaria construens and Stauroforma inermes (planctonic diatoms), and Dicrotendipes sp. and Tanytarsini tribe (littoral chironomids). The pollen ensemble reveals the first glacial refuge of Araucaria araucana forests in the low lands during the LGM. The lake was drained abruptly into a swamp/bog at 12kyr BP and colonized by Myrtaceae wet forest. This evidence suggest the dry/warm climate period of early Holocene in south-central Chile. Later, the sediments indicate variable lacustrine levels, and increase of charcoal particles, associated to current climatic conditions. The pollen spectrum dominated by Myrtaceae and Nothofagus contrasts with a strongly disturb current landscape. Actually, Purén-Lumaco valley constitutes a complex peat-bog system dominated by exotic grasses and forest species (Tritricum aestivum, Pinus radiata and Eucalyptus spp.). Some archaeological antecedents in the area document the human development at ca. 7yrs BP. The greatest archaeological characteristic present in the valley is the kuel, a Mapuche earth accumulation. The presence and extension of almost 300 kuel in the valley reflect the social/economic development, and partly explains why the region was the major resistance area for Spanish colonizer during XVI-XVII centuries. Also the archaeological findings reveal the presence of maize pollen (Zea mays) within their food consumption. The influence of climate and human impact in

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

Directory of Open Access Journals (Sweden)

Klapalova Alena

2013-06-01

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

The role ofprivate hospitals in South Africa

African Journals Online (AJOL)

effect in April 1980, and were implemented subse- quent to the .... cannot be left to the workings of the market, but will require a ... able to plan in advance and would have strong in- centives to .... ered by the basic package of goods and may be allowed to take out .... of these hospitals might remain to provide luxury care.

Decentralization or centralization: striking a balance.

Science.gov (United States)

Dirschel, K M

1994-09-01

An Executive Vice President for Nursing can provide the necessary link to meet diverse clinical demands when encountering centralization--decentralization decisions. Centralized communication links hospital departments giving nurses a unified voice. Decentralization acknowledges the need for diversity and achieves the right balance of uniformity through a responsive communications network.

Perceptions of the hospital ethical environment among hospital social workers in the United States.

Science.gov (United States)

Pugh, Greg L

2015-01-01

Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.

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.

south africa : tous les projets | Page 5 | CRDI - Centre de recherches ...

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

Sujet: BIOLOGY, BIODIVERSITY, ECOLOGY. Région: Argentina, South America, Costa Rica, North and Central America, Kenya, Peru, South Africa, North of Sahara, South of Sahara, Mexico, Canada. Programme: Agriculture et sécurité alimentaire. Financement total : CA$ 2,158,187.00. Vulnérabilité et adaptation face aux ...

Impressions of health in the new South Africa: a period of convalescence.

Science.gov (United States)

Kale, R

1995-04-29

The White minority population in South Africa long oppressed and disenfranchised the country's Black majority. The apartheid system, however, was finally put to rest with the election of Nelson Mandela as President of South Africa during April 27-29, 1994. During apartheid, the White minority enjoyed the best health care available among developed countries, while Blacks were forced to receive some of the worst care provided in the Third World. The doctor/patient ratios in 1981 for White and Black patients, respectively, were 330 and 91,000. In 1985, infant mortality for White infants was 13.1/1000 compared to 70/1000 for Blacks. The existence of fourteen separate health departments caused major duplication and waste. South Africa now has the opportunity to effect revolutionary changes in its health care. To that end, President Mandela announced free health care for pregnant women and children younger than age six years on May 24, 1994. A subsequent uptake in health service utilization was quickly observed in small towns. Structurally, a central health department with a provincial department for each of the four provinces replaced the redundant predemocracy system of fourteen health departments. This change, however, for now, exists only on paper and net financial gains from the reorganization have yet to be realized. Finally, there have been frequent strikes in hospitals throughout the country by health workers demanding better pay and working conditions.

40 CFR 81.143 - Central Virginia Intrastate Air Quality Control Region.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Central Virginia Intrastate Air Quality Control Region. 81.143 Section 81.143 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY..., Lynchburg, Martinsville, South Boston. Towns—Blackstone, Farmville, Rocky Mount, South Hill. ...

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 ...

Maternal and perinatal mortality figures in 249 South African ...

African Journals Online (AJOL)

the PMR for the black population is considerably hi9her than for the other ethnic groups. That said, perinatal mortality levels in South African blacks still compare favourably with figures from other African cQuntries.12. In conclusion, the MMRs and PMRs found in our survey of. 249 South African hospitals - though not truly.

Energy integration experiences at the Europe, at the Nordic countries and at the Central America: considerations relevant to the South America integration process; Experiencias de integracao energetica na Europa, nos paises nordicos e na America Central: consideracoes relevantes ao processo de integracao Sul-Americana

Energy Technology Data Exchange (ETDEWEB)

Campos, Adriana Fiorotti; Andreza, Fernanda Marques Pereira; Soares, Jeferson Borghetti; Pinheiro, Maria Fernanda Bacile; Oliveira, Ricardo Gorini de [Empresa de Pesquisa Energetica (EPE), Rio de Janeiro, RJ (Brazil)], Emails: adriana.campos@epe.gov.br, fernanda.andreza@epe.gov.br; jeferson.soares@epe.gov.br, maria.pinheiro, ricardo.gorini@epe.gov.br

2010-07-01

In view of institutional/contractual regulatory problems at the South America, some experiences of energy integration at the electrical sectors and natural gas (Nordic countries. European Union and Central America), identifying related vantages and advantageous. Besides, there is an attempt of characterization of the process step of energy integration, and the fitting of regions in these steps, observing that the process of energy integration in the South America it is found in a initial step yet if it is considered the used methodology by the Colombian enterprise Interconexion Electrica S.A.E.S.P. - ISA (2007)

The phylogeography and spatiotemporal spread of south-central skunk rabies virus.

Directory of Open Access Journals (Sweden)

Natalia A Kuzmina

Full Text Available The south-central skunk rabies virus (SCSK is the most broadly distributed terrestrial viral lineage in North America. Skunk rabies has not been efficiently targeted by oral vaccination campaigns and represents a natural system of pathogen invasion, yielding insights to rabies emergence. In the present study we reconstructed spatiotemporal spread of SCSK in the whole territory of its circulation using a combination of Bayesian methods. The analysis based on 241 glycoprotein gene sequences demonstrated that SCSK is much more divergent phylogenetically than was appreciated previously. According to our analyses the SCSK originated in the territory of Texas ~170 years ago, and spread geographically during the following decades. The wavefront velocity in the northward direction was significantly greater than in the eastward and westward directions. Rivers (except the Mississippi River and Rio Grande River did not constitute significant barriers for epizootic spread, in contrast to deserts and mountains. The mean dispersal rate of skunk rabies was lower than that of the raccoon and fox rabies. Viral lineages circulate in their areas with limited evidence of geographic spread during decades. However, spatiotemporal reconstruction shows that after a long period of stability the dispersal rate and wavefront velocity of SCSK are increasing. Our results indicate that there is a need to develop control measures for SCSK, and suggest how such measure can be implemented most efficiently. Our approach can be extrapolated to other rabies reservoirs and used as a tool for investigation of epizootic patterns and planning interventions towards disease elimination.

Preliminary geology of eastern Umtanum Ridge, South-Central Washington

Energy Technology Data Exchange (ETDEWEB)

Goff, F.E.

1981-01-01

The basalt stratigraphy and geologic structures of eastern Umtanum Ridge have been mapped and studied in detail to help assess the feasibility of nuclear waste terminal storage on the Hanford Site in southeastern Washington State. Eastern Umtanum Ridge is an asymmetric east-west-trending anticline of Columbia River basalt that plunges 5 degrees eastward into the Pasco Basin. Geologic mapping and determination of natural remanent magnetic polarity and chemical composition reveal that flows of the Pomona and Umatilla Members (Saddle Mountains Basalt), Priest Rapids and Frenchman Springs Members (Wanapum Basalt), and Grande Ronde Basalt were erupted as fairly uniform sheets. The Wahluke and Huntzinger flows (Saddle Mountains Basalt) fill a paleovalley cut into Wanapum Basalt. No evidence was found to indicate Quaternary-age movement on any structures in the map area. The basalt strata on the south limb of the Umtanum anticline display relatively little tectonic deformation since Miocene-Pliocene time. Thus, the buried south flank of Umtanum Ridge may provide an excellent location for a nuclear waste repository beneath the Hanford Site.

Preliminary geology of eastern Umtanum Ridge, South-Central Washington

International Nuclear Information System (INIS)

Goff, F.E.

1981-01-01

The basalt stratigraphy and geologic structures of eastern Umtanum Ridge have been mapped and studied in detail to help assess the feasibility of nuclear waste terminal storage on the Hanford Site in southeastern Washington State. Eastern Umtanum Ridge is an asymmetric east-west-trending anticline of Columbia River basalt that plunges 5 degrees eastward into the Pasco Basin. Geologic mapping and determination of natural remanent magnetic polarity and chemical composition reveal that flows of the Pomona and Umatilla Members (Saddle Mountains Basalt), Priest Rapids and Frenchman Springs Members (Wanapum Basalt), and Grande Ronde Basalt were erupted as fairly uniform sheets. The Wahluke and Huntzinger flows (Saddle Mountains Basalt) fill a paleovalley cut into Wanapum Basalt. No evidence was found to indicate Quaternary-age movement on any structures in the map area. The basalt strata on the south limb of the Umtanum anticline display relatively little tectonic deformation since Miocene-Pliocene time. Thus, the buried south flank of Umtanum Ridge may provide an excellent location for a nuclear waste repository beneath the Hanford Site

Evaluación de las causas de los eventos adversos o incidentes que afectan la seguridad del paciente, en el hospital central de la policía de enero 2012 a diciembre 2013

OpenAIRE

Alarcon Ruiz, Diego Jesus; Gil Vargas, Luis Fabio

2016-01-01

TITULO DEL TRABAJO: Evaluación de las causas de los eventos adversos o incidentes que afectan la seguridad del paciente, en el hospital central de la policía de enero 2012 a diciembre 2013. OBJETIVO: Determinar y analizar la causa raíz de los principales factores de riesgo que afectan la seguridad del paciente que puedan ocasionar eventos adversos en la atención de los pacientes, con el uso de la teoría de restricciones TOC en el Hospital Central de la Policía HOCEN. MATERIALES Y METODO: Se r...

Reduction of firewood consumption by households in south-central Chile associated with energy efficiency programs

International Nuclear Information System (INIS)

Schueftan, Alejandra; González, Alejandro D.

2013-01-01

Cities in the central-southern area of Chile face serious environmental pollution due to extensive use of firewood for heating. Low energy efficiency of constructions and cold climate increase the problem, which also affects native forests. The aims of this study are to characterize energy consumption in dwellings of this region, investigate the reduction potential, and study social and environmental consequences of high consumption of firewood. Actual energy consumption is studied with information from surveys, potential for reduction is modeled with software and other consequences are analyzed from previous studies. Results for the city of Valdivia show high firewood consumption per household, with a media bulk volume near 12 m 3 /year. Thermal regulations are softer compared with other countries. Moreover, around 85% of buildings were built before enforcing codes in 2007, and has almost no thermal protection. The reduction potential due to thermal improvements is found to be very high (62%) if buildings are refurbished to comply with the present Chilean Norm of 2007, but it reaches a 77% reduction if refurbished according to stricter foreign regulations. Therefore, an energy efficiency program strongly addressing existing buildings has the largest potential for reducing firewood use, and therefore mitigate environmental and health impacts. - Highlights: • High firewood consumption and environmental pollution in cities of south-central Chile. • High use of firewood due to inefficient constructions and soft thermal regulations. • Potential reduction of energy consumption up to 77% with more demanding regulations. • Policies should address building stock before thermal regulation, corresponding to 85%

Cross border hospital use: analysis using data linkage across four Australian states.

Science.gov (United States)

Spilsbury, Katrina; Rosman, Diana; Alan, Janine; Boyd, James H; Ferrante, Anna M; Semmens, James B

2015-06-15

To determine the quality and effectiveness of national data linkage capacity by performing a proof-of-concept project investigating cross-border hospital use and hospital-related deaths. Analysis of person-level linked hospital separation and death registration data of all public and private hospital patients in New South Wales, Queensland and Western Australia and of public hospital patients in South Australia, totalling 7.7 million hospital patients from 1 July 2004 to 30 June 2009. Counts and proportions of hospital stays and patient movement patterns. 223 262 patients (3.0%) travelled across a state border to attend hospitals, in particular, far northern and western NSW patients travelling to Queensland and SA hospitals, respectively. A further 48 575 patients (0.6%) moved their place of residence interstate between hospital visits, particularly to and from areas associated with major mining and tourism industries. Over 11 000 cross-border hospital transfers were also identified. Of patients who travelled across a state border to hospital, 2800 (1.3%) died in that hospital. An additional 496 deaths recorded in one jurisdiction occurred within 30 days of hospital separation from another jurisdiction. Access to person-level data linked across jurisdictions identified geographical hot spots of cross-border hospital use and hospital-related deaths in Australia. This has implications for planning of health service delivery and for longitudinal follow-up studies, particularly those involving mobile populations.

Pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South East Nigeria.

Science.gov (United States)

Osuji, Charles Ukachukwu; Onwubuya, Emmanuel Ikechukwu; Ahaneku, Gladys Ifesinachi; Omejua, Emeka Godwin

2014-01-01

Cardiovascular disease (CVD) is one of the top killer diseases in the world sparing neither developed or developing countries. The study was carried out to determine the pattern of cardiovascular admissions at Nnamdi Azikiwe University Teaching Hospital Nnewi South East Nigeria. The study was a retrospective study covering the period January 2007 to December 2009. SPSS version 13 software was used to analyze data. 537 (15%) patients were admitted into the study out of 3546 patients {females 1756 and 1790} admitted into medical wards. 322 (60%) of study population were males and 215 (40%) females. 359(67.5%) were discharged, 170 (32%) died and 8 (0.5%) were discharged against medical advice. The majority of the deaths 105(61.8%), were in patients with CVA. Most of the deaths (111 or 65.3%) occurred within the first seven days of admission. The mean age of the population was 60.7 years ±15.9 with a range of 18 to 110 years. The length of stay in hospital ranged between 1 and 140 days with a mean of 13.5 ± 13.9 days and a median of 10 days. 33 of the subjects were single, 406 were married, 94 were widowed (11 males and 83 females) and 4 were divorced. 46.7% (251) were admitted for CVA and 30.9% (166) for heart failure. Cardiomyopathy/valvular heart diseases (clinical diagnosis due to absence of echocardiography) constituted 3.9%, hypertension 20.5% and pre-existing hypertension with uremia 1.9%. The study has shown that cardiovascular disease contributed significantly to medical admissions the elderly accounting for a significant proportion. There is thus the need for intensification of primary preventive strategies for cardiovascular diseases.

Regional and Seasonal Diet of the Western Burrowing Owl in South-Central Nevada

Energy Technology Data Exchange (ETDEWEB)

Derek B. Hall, Paul D. Greger, Jeffrey R. Rosier

2009-04-01

We examined diets of Western Burrowing Owls (Athene cunicularia hypugaea) based on contents of pellets and large prey remains collected year-round at burrows in each of the 3 regions in south central Nevada (Mojave Desert, Great Basin Desert, and Transition region). The most common prey items, based on percent frequency of occurrence, were crickets and grasshoppers, beetles, rodents, sun spiders, and scorpions. The most common vertebrate prey was kangaroo rats (Dipodomys spp.). True bugs (Hemiptera), scorpions, and western harvest mice (Reithrodontomys megalotis) occurred most frequently in pellets from the Great Basin Desert region. Kangaroo rats (Dipodomys spp.) and pocket mice (Perognathinae) were the most important vertebrate prey items in the Transition and Mojave Desert regions, respectively. Frequency of occurrence of any invertebrate prey was high (>80%) in samples year-round but dropped in winter samples, with scorpions and sun spiders exhibiting the steepest declines. Frequency of occurrence of any vertebrate prey peaked in spring samples, was intermediate for winter and summer samples, and was lowest in fall samples. With the possible exception of selecting for western harvest mice in the Great Basin Desert region, Western Burrowing Owls in our study appeared to be opportunistic foragers with a generalist feeding strategy.

Compliance with the guidelines of prescription writing in a central hospital in the West Bank.

Science.gov (United States)

Tayem, Y I; Ibrahim, M A; Qubaja, M M; Shraim, R K; Taha, O B; Abu Shkhedem, E

2013-09-01

This retrospective, cross-sectional study was carried out to evaluate the quality of 2208 outpatient prescriptions in a central hospital in the West Bank, Palestine. The physicians' handwriting was poorly readable or illegible in one-third of the prescriptions. The prescriber's name and signature and patient's name were mentioned in almost all orders whereas the patient's age was stated in 54.9%. The vast majority of physicians (95.5%) prescribed drugs using their trade (brand) names. Drug strength, quantity and dose/frequency were stated in 61.1%, 76% and 73.8% of prescriptions respectively. Only 33 prescriptions (1.5%) contained full directions for use for all drugs. Correlation analysis revealed that the presence of certain prescription elements was statistically significantly associated with the clinic of origin and the number of drugs prescribed. The overall poor legibility and incompleteness of the prescriptions is of concern.

Toilet training practices in Nigerian children | Solarin | South African ...

African Journals Online (AJOL)

Background. This study reports on toilet training with a focus on the effect of age, methods used, and factors that can affect urinary incontinence in Nigerian children. Methods. This was a cross-sectional hospital-based study carried out in public and private hospitals in South-Western Nigeria. A questionnaire was used to ...

Objects of Worship in South Asian Religions

DEFF Research Database (Denmark)

Objects of worship are an aspect of the material dimension of lived religion in South Asia. The omnipresence of these objects and their use is a theme which cuts across the religious traditions in the pluralistic religious culture of the region. Divine power becomes manifest in the objects and fo...... objects of worship, the book contributes to an understanding of the central significance of these objects in the religious and social life of South Asia. It will be of interest to students and scholars of Religious Studies and South Asian Religion, Culture and Society....

TB infection prevention and control experiences of South African nurses - a phenomenological study

Science.gov (United States)

2011-01-01

Background The tuberculosis (TB) epidemic in South Africa is characterised by one of the highest levels of TB/HIV co-infection and growing multidrug-resistant TB worldwide. Hospitals play a central role in the management of TB. We investigated nurses' experiences of factors influencing TB infection prevention and control (IPC) practices to identify risks associated with potential nosocomial transmission. Methods The qualitative study employed a phenomenological approach, using semi-structured interviews with a quota sample of 20 nurses in a large tertiary academic hospital in Cape Town, South Africa. The data was subjected to thematic analysis. Results Nurses expressed concerns about the possible risk of TB transmission to both patients and staff. Factors influencing TB-IPC, and increasing the potential risk of nosocomial transmission, emerged in interconnected overarching themes. Influences related to the healthcare system included suboptimal IPC provision such as the lack of isolation facilities and personal protective equipment, and the lack of a TB-IPC policy. Further influences included inadequate TB training for staff and patients, communication barriers owing to cultural and linguistic differences between staff and patients, the excessive workload of nurses, and a sense of duty of care. Influences related to wider contextual conditions included TB concerns and stigma, and the role of traditional healers. Influences related to patient behaviour included late uptake of hospital care owing to poverty and the use of traditional medicine, and poor adherence to IPC measures by patients, family members and carers. Conclusions Several interconnected influences related to the healthcare system, wider contextual conditions and patient behavior could increase the potential risk of nosocomial TB transmission at hospital level. There is an urgent need for the implementation and evaluation of a comprehensive contextually appropriate TB IPC policy with the setting and

Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

Directory of Open Access Journals (Sweden)

Torbica Aleksandra

2010-05-01

Full Text Available Abstract Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases and patients without CLABSI (controls were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143; 56% of the cases and 57% of the controls were females (p = 0.922. The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

Dental caries among children visiting a mobile dental clinic in South Central Kentucky: a pooled cross-sectional study.

Science.gov (United States)

Dawkins, Erika; Michimi, Akihiko; Ellis-Griffith, Gregory; Peterson, Tina; Carter, Daniel; English, Gary

2013-05-02

Dental caries is one of the most common chronic childhood diseases affecting a large portion of children in the United States. The prevalence of childhood dental caries in Kentucky is among the highest in the nation. The purposes of this study are to (1) compare sociodemographic differences between caries and no caries groups and (2) investigate factors associated with untreated dental caries among children who visited a mobile dental clinic in South Central Kentucky. Study subjects were children aged 6 to 15 years who participated in the school-based dental sealant program through the mobile dental clinic operated by the Institute for Rural Health at Western Kentucky University between September 2006 and May 2011 (n = 2,453). Descriptive statistics were calculated for sociodemographic factors (age, gender, race/ethnicity, insurance status, and urban versus rural residential location) and caries status. We used chi-square tests to compare sociodemographic differences of children stratified by caries and no caries status as well as three levels of caries severity. We developed a logistic regression model to investigate factors associated with untreated dental caries while controlling for sociodemographic characteristics. The proportion of children having untreated dental caries was 49.7% and the mean number of untreated dental caries was 2.0. The proportion of untreated dental caries was higher in older children, children with no insurance and living in rural residential locations, and caries severity was also higher in these groups. Odds ratio indicated that older ages, not having private insurance (having only public, government-sponsored insurance or no insurance at all) and rural residential location were associated with having untreated dental caries after controlling for sociodemographic characteristics of children. Untreated dental caries was more likely to be present in older children living in rural areas without insurance. Health interventionists may use

System delays in breast cancer | Dalwai | South African Journal of ...

African Journals Online (AJOL)

Background: Centralised multidisciplinary management of breast cancer occurs in KwaZulu-Natal, South Africa, and requires a diagnostic and staging pathway at the referring hospital. Delays in this pathway are unknown. This study, conducted at a referring hospital, R K Khan (RKK), quantifies and analyses these delays.

Accretionary and collisional orogenesis in the south domain of the western Central Asian Orogenic Belt (CAOB)

Science.gov (United States)

Cai, Keda; Long, Xiaoping; Chen, Huayong; Sun, Min; Xiao, Wenjiao

2018-03-01

The Central Asian Orogenic Belt (CAOB) was the result of long-lived multi-stage tectonic evolution, including Proterozoic to Paleozoic accretion and collision, Mesozoic intracontinental modification, and Cenozoic rapid deformation and uplift. The accretionary and collisional orogenesis of its early history generated a huge orogenic collage consisting of diverse tectonic units including island arcs, ophiolites, accretionary prisms, seamounts, oceanic plateaus and micro-continents. These incorporated orogenic components preserved valuable detailed information on orogenic process and continental crust growth, which make the CAOB a key region to understanding of continental evolution, mantle-crust interaction and associated mineralization. The western CAOB refers to the west region in North Xinjiang of China and circum-Balkash of Kazakhstan, with occurrences of the spectacular Kazakhstan orocline and its surrounding mountain belts. Because orogenic fabrics of this part mostly preserve their original features caused by the interactions among the southern Siberian active margin in the north and the Tarim Craton in the south, the western CAOB can be regarded as an ideal region to study the processes of the accretionary and collisional orogenesis and associated mineralization. Since a large number of researchers have been working on this region, research advances bloom strikingly in a short-time period. Therefore, we, in this special issue, focus on these new study advances on the south domain of the western CAOB, including the Kazakhstan collage system, Tianshan orogenic belt and Beishan region, and it is anticipated that this issue can draw more attention from the international research groups to be interested in the studies on orogenesis of the CAOB.

Hospital-Based Coalition to Improve Regional Surge Capacity

Directory of Open Access Journals (Sweden)

James M. Learning

2012-12-01

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

Geology of the State of Morelos and contiguous areas in south-central Mexico

Science.gov (United States)

Fries, Carl F.

1959-01-01

The area described lies in south-central Mexico and embraces all but the southeastern corner and easternmost border of the State of Moreles, the second smallest State in the Mexican Republic. It includes small contiguous parts of the State of Mexico, in the northeastern corner, and of the State of Guerrero in the southwestern corner. Limiting geographic coordinates are 98 45 to 99 39 west longitude and 18 18 to 19 08 north latitude, the northern boundary being only 35 km south of Mexico City, capital of the Republic. The geological map does not cover the entire rectangle outlined, but is irregular in form and measures roughly 4150 sq. km, three-quarters of it representing two0thirds of the State of Moreles and the rest lying outside the State. The region ranges in altitude from 730 m above sea level at Iguala near the south edge of the map, to a general level of about 3000 m at the north edge, although individual peaks rise to 3900 m and Popocatepetl Volcano, a few kilometers east of the northeastern border of the map, rises to 5452 m above sea level. Annual rainfall ranges from a minimum of about 640 mm in the low country, to 1200 mm and more at altitudes above 2000 m. Most of it falls in summer between June and September. Winter frosts are rare below 1800 m. The climate is of savanna to steppe type; soils are thin and may be classified as belonging to the tachernoses group, with strong development of calcareous evaporates (caliche) at altitudes below 1800 m. The northern border of the area forms the southern half of the late Pliocene to Recent Neo-volcanic Belt of basic volcanism that crosses Mexico in the direction N. 80 W., and thus has constructional topography. The rest of the area belongs to the Balsas Basin physiographic province, which is characterized by maturely dissected terrain tributary to the large Balsas River. All but the southwestern corner of the area drains southward via the Amacuzac River into the Mexcala-Balsas River, and thence westward into

Paleozoogeography of the Wine Mouse (Akodon oenos & Late Holocene Paleoenvironments in South-Central Mendoza, Argentina

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Fernando Julián Fernández

2011-02-01

Full Text Available Cranial remains of the wine mouse (Akodon oenos are documented from an archaeological site in south-central Mendoza, Argentina (Agua de La Mula, 35º22' S, 68º15' W, which dates to the end of the late Holocene (1610 ± 60; 1260 ± 60; 1000 ± 50 C14 yr B.P.. The taxonomic status of this small rodent is currently being assessed, but these remains represent the first fossil record for the morphotaxon A. oenos. The species’ present distribution is restricted to a few records from Mendoza province. Analysis of the remains supports paleoenvironmental reconstruction using the small mammal assemblage recovered from this site. From the late Holocene into modernity temperature decreased and winter precipitation increased, resulting in advance of Patagonian steppe grading with altitude into Monte desert. Holocene climatic conditions may explain the relatively late human occupation of ecologically marginal environments in this region, which probably favored effective human occupation of the Payunia region at sites such as Agua de La Mula between 1600 and 1000 years B.P.

Paleozoic-involving thrust array in the central Sierras Interiores (South Pyrenean Zone, Central Pyrenees): regional implications

Science.gov (United States)

Rodriguez, L.; Cuevas, J.; Tubía, J. M.

2012-04-01

This work deals with the structural evolution of the Sierras Interiores between the Tena and Aragon valleys. The Sierras Interiores is a WNW-trending mountain range that bounds the South Pyrenean Zone to the north and that is characterized by a thrust-fold system with a strong lithological control that places preferably decollements in Triassic evaporites. In the studied area of the Sierras Interiores Cenomanian limestones cover discordantly the Paleozoic rocks of the Axial Zone because there is a stratigraphic lacuna developed from Triassic to Late Cretaceous times. A simple lithostratigraphy of the study area is made up of Late Cenomanian to Early Campanian limestones with grey colour and massive aspect in landscape (170 m, Lower calcareous section), Campanian to Maastrichtian brown coloured sandstones (400-600 m, Marboré sandstones) and, finally, Paleocene light-coloured massive limestones (130-230 m), that often generate the higher topographic levels of the Sierras Interiores due to their greater resistance to erosion. Above the sedimentary sequence of the Sierras Interiores, the Jaca Basin flysch succession crops out discordantly. Based on a detailed mapping of the studied area of the Sierras Interiores, together with well and structural data of the Jaca Basin (Lanaja, 1987; Rodríguez and Cuevas, 2008) we have constructed a 12 km long NS cross section, approximately parallel to the movement direction deduced for this region (Rodríguez et al., 2011). The main structure is a thrust array made up of at least four Paleozoic-involving thrusts (the deeper thrust system) of similar thickness in a probably piggyback sequence, some of which are blind thrusts that generate fold-propagation-folds in upper levels. The higher thrust of the thrust array crops out duplicating the lower calcareous section all over the Sierras Interiores. The emplacement of the deeper thrust system generated the tightness of previous structures: south directed piggyback duplexes (the upper

Postoperative Central Nervous System Infection After Neurosurgery in a Modernized, Resource-Limited Tertiary Neurosurgical Center in South Asia.

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Chidambaram, Swathi; Nair, M Nathan; Krishnan, Shyam Sundar; Cai, Ling; Gu, Weiling; Vasudevan, Madabushi Chakravarthy

2015-12-01

Postoperative central nervous system infections (PCNSIs) are rare but serious complications after neurosurgery. The purpose of this study was to examine the prevalence and causative pathogens of PCNSIs at a modernized, resource-limited neurosurgical center in South Asia. A retrospective analysis was conducted of the medical records of all 363 neurosurgical cases performed between June 1, 2012, and June 30, 2013, at a neurosurgical center in South Asia. Data from all operative neurosurgical cases during the 13-month period were included. Cerebrospinal fluid (CSF) analysis indicated that 71 of the 363 surgical cases had low CSF glucose or CSF leukocytosis. These 71 cases were categorized as PCNSIs. The PCNSIs with positive CSF cultures (9.86%) all had gram-negative bacteria with Pseudomonas aeruginosa (n = 5), Escherichia coli (n = 1), or Klebsiella pneumoniae (n = 1). The data suggest a higher rate of death (P = 0.031), a higher rate of CSF leak (P < 0.001), and a higher rate of cranial procedures (P < 0.001) among the infected patients and a higher rate of CSF leak among the patients with culture-positive infections (P = 0.038). This study summarizes the prevalence, causative organism of PCNSI, and antibiotic usage for all of the neurosurgical cases over a 13-month period in a modernized yet resource-limited neurosurgical center located in South Asia. The results from this study highlight the PCNSI landscape in an area of the world that is often underreported in the neurosurgical literature because of the paucity of clinical neurosurgical research undertaken there. This study shows an increasing prevalence of gram-negative organisms in CSF cultures from PCNSIs, which supports a trend in the recent literature of increasing gram-negative bacillary meningitis. Copyright © 2015 Elsevier Inc. All rights reserved.

Ecological Study on Hospitalizations for Cancer, Cardiovascular, and Respiratory Diseases in the Industrial Area of Etang-de-Berre in the South of France

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Laurence Pascal

2013-01-01

Full Text Available The Etang-de-Berre area is a large industrialized area in the South of France, exposing 300,000 inhabitants to the plumes of its industries. The possible associated health risks are of the highest concern to the population, who asked for studies investigating their health status. A geographical ecological study based on standardized hospitalizations ratios for cancer, cardiovascular, and respiratory diseases was carried out over the 2004–2007 period. Exposure to air pollution was assessed using dispersion models coupled with a geographic information system to estimate an annual mean concentration of sulfur dioxide (SO2 for each district. Results showed an excess risk of hospitalization for myocardial infarction in women living in districts with medium or high SO2 exposure, respectively, 38% [CI 95% 4 : 83] and 54% [14 : 110] greater than women living in districts at the reference level exposure. A 26% [2 : 57] excess risk of hospitalization for myocardial infarction was also observed in men living in districts with high SO2 levels. No excess risk of hospitalization for respiratory diseases or for cancer was observed, except for acute leukemia in men only. Results illustrate the impact of industrial air pollution on the cardiovascular system and call for an improvement of the air quality in the area.

Clinical, immunologic and insulin secretory characteristics of young black South African patients with diabetes: Hospital based single centre study.

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Ekpebegh, C O; Longo-Mbenza, B

2013-03-01

To classify and characterize the clinical features of various diabetes classes among young black South Africans. Cross sectional study of 60 black patients with diabetes, all less than 30 years of age and attending Nelson Mandela Academic Hospital, Mthatha, South Africa. Diabetes was classified as Types 1A, 1B and 2 based on the anti-glutamic acid decarboxylase status and serum C-peptide response to intravenous injection of glucagon. Mean age was 19.6±4.8 years (n=60) with similar gender distribution. The mean duration of diabetes was 24.2±45.1 months. Type 1A was the class of diabetes in 55% (n=33/60) of patients. Type 1B and 2 accounted for 30% (n=18/60) and 15% (n=9/60) of patients respectively. Patients classified as Type 2 had higher waist circumference and higher prevalence of acanthosis nigricans than Types 1A and 1B groups. History of diabetes in a first degree relative and hypertension were found in similar proportions of patients with Types 1A, 1B and 2 diabetes. Five Type 1A diabetes patients had body mass index of 26.2-41kg/m(2) and this included two newly diagnosed patients with body mass index of 26.7kg/m(2) and 33.2kg/m(2). The majority of our young black South Africans with diabetes are of the Type 1A class. Acanthosis nigricans was not found in any patient with Type 1 A diabetes. A minority of Type 1 A diabetes patients were obese at initial diagnosis. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Uranium Districts Defined by Reconnaissance Geochemistry in South Greenland

DEFF Research Database (Denmark)

Armour-Brown, A.; Steenfelt, A.; Kunzendorf, Helmar

1983-01-01

A reconnaissance exploration survey over 14 000 km2 of Precambrian terrain in South Greenland using stream-sediment and stream-water samples delineated a central uranium district of 2000 km2 with enhanced uranium levels and smaller anomalous zones in the south of the field area. The area is under...

Strategic planning in hospitals in two Australian states: an exploratory study of its practice using planning documentation.

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Jayasuriya, R; Sim, A B

1998-01-01

Hospitals are under pressure to respond to new challenges and competition. Many hospitals have used strategic planning to respond to these environmental changes. This exploratory study examines the extent of strategic planning in hospitals in two Australian States, New South Wales and Victoria, using a sample survey. Based on planning documentation, the study indicated that 47% of the hospitals surveyed did not have a strategic or business plan. A significant difference was found in the comprehensiveness of the plans between the two States. Plans from Victorian hospitals had more documented evidence of external/internal analysis, competitor orientation and customer orientation compared with plans from New South Wales hospitals. The paper discusses the limitations of the study and directions for future research.

Marksmen and the bush: The affective micro-politics of landscape, sex and technology in precolonial South-Central Africa

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Kathryn M. de Luna

Full Text Available This essay explores what we can know about the micro-politics of knowledge production using the history of bushcraft as a case study. In many societies in central, eastern and southern Africa, practitioners of technologies undertaken away from the village, in the bush, enjoy a special status. Among the Botatwe-speaking societies of south-central Africa, the status accorded hunters, smelters and other technicians of the bush was crafted in the centuries around the turn of the first millennium by combining old ideas about the blustery character of fame and spirits, and the talk that engendered both with the observation that technicians working in the bush shared a kinesthetic experience of piercing, poking and prodding into action during the generative activities of working smelts and taking down game. Yet the micro-politics of bushcraft knowledge also involved the bodies and feelings of spearmen and metallurgists' wives, lovers, mothers, sisters, and sometimes those of the entire neighbourhood. The invention of a new landscape category, isokwe, and the novel status of these seasonal technicians marks the development of a new kind of virile masculinity available to some men; it was a status with deeply sensuous, material and social meanings for women as well.

Rate of electronic health record adoption in South Korea: A nation-wide survey.

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Kim, Young-Gun; Jung, Kyoungwon; Park, Young-Taek; Shin, Dahye; Cho, Soo Yeon; Yoon, Dukyong; Park, Rae Woong

2017-05-01

The adoption rate of electronic health record (EHR) systems in South Korea has continuously increased. However, in contrast to the situation in the United States (US), where there has been a national effort to improve and standardize EHR interoperability, no consensus has been established in South Korea. The goal of this study was to determine the current status of EHR adoption in South Korean hospitals compared to that in the US. All general and tertiary teaching hospitals in South Korea were surveyed regarding their EHR status in 2015 with the same questionnaire as used previously. The survey form estimated the level of adoption of EHR systems according to 24 core functions in four categories (clinical documentation, result view, computerized provider order entry, and decision supports). The adoption level was classified into comprehensive and basic EHR systems according to their functionalities. EHRs and computerized physician order entry systems were used in 58.1% and 86.0% of South Korean hospitals, respectively. Decision support systems and problem list documentation were the functions most frequently missing from comprehensive and basic EHR systems. The main barriers cited to adoption of EHR systems were the cost of purchasing (48%) and the ongoing cost of maintenance (11%). The EHR adoption rate in Korean hospitals (37.2%) was higher than that in US hospitals in 2010 (15.1%), but this trend was reversed in 2015 (58.1% vs. 75.2%). The evidence suggests that these trends were influenced by the level of financial and political support provided to US hospitals after the HITECH Act was passed in 2009. The EHR adoption rate in Korea has increased, albeit more slowly than in the US. It is logical to suggest that increased funding and support tied to the HITECH Act in the US partly explains the difference in the adoption rates of EHRs in both countries. Copyright © 2017 Elsevier B.V. All rights reserved.

Nurses and care workers’ perceptions of their nurse-patient therapeutic relationship in private general hospitals, Gauteng, South Africa

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Anna E. van den Heever

2013-09-01

Full Text Available Facilitation of a therapeutic relationship is an essential skill in nursing, particularly in mental-health care. Nurses and care workers in private general hospitals are exposed to the emotional effects of physical illness as well as the increase in admission of patients with mental-health needs. Poor nurse-patient relationships have been reported by patients and in the media. The researchers experienced incidents of apparent misunderstandings during nurse-patient interactions whilst working in private general hospitals. No studies have been done regarding how nurses and care workers perceive a therapeutic relationship with patients in terms of the patients’ emotional and mental-health needs. A quantitative, contextual and deductive study was conducted in three private general hospitals in Gauteng, South Africa with a purposive sample of 154 nurses and 30 care workers. Based on the concepts of a therapeutic relationship, empathy, positive regard, genuineness, concreteness and self-exploration, nurses and care workers’ perceptions of facilitating a therapeutic relationship were self-assessed using five-point scales in a questionnaire. Data were analysed using descriptive statistics and non-parametric statistical techniques. Specific hypotheses were tested to identify whether statistically-significant differences existed between the perceptions of two or more groups of nurses and care workers. Results showed a general insensitivity and lack of awareness and reflection on the part of nurses and care workers with regard to the patients’ emotional needs. When categories of nurses were compared, no statistically-significant differences were found between the perceptions of the various groups tested. There is a need for self-awareness, continued interpersonal skills training and supervision of nurses and care workers. A large percentage of the participants were younger than 40 years, subprofessional, with less than 10 years’ experience as

Glaciolacustrine deposits formed in an ice-dammed tributary valley in the south-central Pyrenees: New evidence for late Pleistocene climate

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Sancho, Carlos; Arenas, Concha; Pardo, Gonzalo; Peña-Monné, José Luis; Rhodes, Edward J.; Bartolomé, Miguel; García-Ruiz, José M.; Martí-Bono, Carlos

2018-04-01

Combined geomorphic features, stratigraphic characteristics and sedimentologic interpretation, coupled with optically stimulated luminescence (OSL) dates, of a glacio-fluvio-lacustrine sequence (Linás de Broto, northern Spain) provide new information to understand the palaeoenvironmental significance of dynamics of glacier systems in the south-central Pyrenees during the Last Glacial Cycle (≈130 ka to 14 ka). The Linás de Broto depositional system consisted of a proglacial lake fed primarily by meltwater streams emanating from the small Sorrosal glacier and dammed by a lateral moraine of the Ara trunk glacier. The resulting glacio-fluvio-lacustrine sequence, around 55 m thick, is divided into five lithological units consisting of braided fluvial (gravel deposits), lake margin (gravel and sand deltaic deposits) and distal lake (silt and clay laminites) facies associations. Evolution of the depositional environment reflects three phases of progradation of a high-energy braided fluvial system separated by two phases of rapid expansion of the lake. Fluvial progradation occurred during short periods of ice melting. Lake expansion concurred with ice-dam growth of the trunk glacier. The first lake expansion occurred over a time range between 55 ± 9 ka and 49 ± 11 ka, and is consistent with the age of the Viu lateral moraine (49 ± 8 ka), which marks the maximum areal extent of the Ara glacier during the Last Glacial Cycle. These dates confirm that the maximum areal extent of the glacier occurred during Marine Isotope Stages 4 and 3 in the south-central Pyrenees, thus before the Last Glacial Maximum. The evolution of the Linás de Broto depositional system during this maximum glacier extent was modulated by climate oscillations in the northern Iberian Peninsula, probably related to latitudinal shifts of the atmospheric circulation in the southern North-Atlantic Ocean, and variations in summer insolation intensity.

A Computerized Hospital Patient Information Management System

Science.gov (United States)

Wig, Eldon D.

1982-01-01

The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

Discovery of Jurassic ammonite-bearing series in Jebel Bou Hedma (South-Central Tunisian Atlas): Implications for stratigraphic correlations and paleogeographic reconstruction

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Bahrouni, Néjib; Houla, Yassine; Soussi, Mohamed; Boughdiri, Mabrouk; Ali, Walid Ben; Nasri, Ahmed; Bouaziz, Samir

2016-01-01

Recent geological mapping undertaken in the Southern-Central Atlas of Tunisia led to the discovery of Jurassic ammonite-bearing series in the Jebel Bou Hedma E-W anticline structure. These series represent the Southernmost Jurassic rocks ever documented in the outcrops of the Tunisian Atlas. These series which outcrop in a transitional zone between the Southern Tunisian Atlas and the Chott basin offer a valuable benchmark for new stratigraphic correlation with the well-known Jurassic series of the North-South Axis of Central Tunisia and also with the Jurassic subsurface successions transected by petroleum wells in the study area. The preliminary investigations allowed the identification, within the most complete section outcropping in the center of the structure, of numerous useful biochronological and sedimentological markers helping in the establishment of an updated Jurassic stratigraphic framework chart of South-Western Tunisia. Additionally, the Late Jurassic succession documents syn-sedimentary features such as slumping, erosion and reworking of sediments and ammonite faunas that can be considered as strong witnesses of an important geodynamic event around the Jurassic-Cretaceous boundary. These stratigraphic and geodynamic new data make of the Jurassic of Jebel Bou Hedma a key succession for stratigraphic correlation attempt between Atlas Tunisian series and those currently buried in the Chott basin or outcropping in the Saharan platform. Furthermore, the several rich-ammonite identified horizons within the Middle and Upper Jurassic series constitute reliable time lines that can be useful for both paleogeographic and geodynamic reconstructions of this part of the North African Tethyan margin but also in the refinement of the potential migration routes for ammonite populations from the Maghrebian Southern Tethys to Arabia.

Who's out there? A profile of informal traders in four South African ...

African Journals Online (AJOL)

A profile of informal traders in four South African city central business districts. ... Town and Regional Planning ... By using data gathered among street traders in four major metropolitan areas of South Africa, this article seeks to provide a current profile of individuals that are involved in street trading in South African cities.

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

Science.gov (United States)

Shwekerela, Byera

2014-01-01

Although hospital reforms are being advocated internationally as part of a solution to hospital management problems in developing countries, studies have shown that they do give rise to some challenges. A study was undertaken that used in-depth interviews, focus group discussion and document review to examine hospital reforms. The article examines the effects of reforms on the management of Level II public hospitals in Tanzania and documents the related challenges and lessons Learnt. It is shown that hospital reforms have mixed effects in resource-strained hospitals, and that hospital reform actions may have replaced the bureaucratic inefficiencies associated with hospitals being managed from the central level (MoHSW) with the equally bureaucratic inefficiencies that characterize the management of these hospitals from a supposedly local level, the office of the Regional Administrative Secretary (RAS). Managing hospitals from this level seems to cause many hospital management problems to be left unattended.

Management of physical child abuse in South Africa: literature review and children's hospital data analysis.

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Janssen, T L; van Dijk, M; Al Malki, I; van As, A B

2013-11-01

The reason for this review is the lack of data on the management of physical abused children in Africa. The primary goal of the first part is to outline the management of physical child abuse in (South) Africa and provide suggestions for other governments in Africa on which to base their management of physical child abuse, at both governmental and hospital management level. The main aim of the second part is to outline the extent of the problem as seen at the Red Cross Memorial Children's Hospital (RCH) in Cape Town. The National Library of Medicine's PubMed database was searched for articles specifically about the management of physical child abuse. Hospital data were analysed in two phases: one addressed various types of assault in order to assess the number of patients admitted to the trauma unit of RCH between 1991 and 2009, and the other to identify all children with suspected non-accidental injury (NAI) presenting to the trauma unit at RCH from January 2008 until December 2010. Information on physical abuse of children in Africa in the English scientific literature remains disappointing with only two articles focusing on its management. RCH data for the period 1991-2009 recorded a total number of 6415 children hospitalised with injuries following assault, who accounted for 4.2% of all trauma admissions. Types of abuse included assault with a blunt or sharp instrument, rape/sexual assault and human bite wounds. Over the last 2 decades, there has been a minor decline in the number of cases of severe abuse requiring admission; admissions for other injuries have remained stable. More detailed analysis of hospital data for 2008-2010, found that boys were far more commonly assaulted than girls (70.5% vs 29.5%). Physical abuse appeared to be the most common cause of abuse; 89.9% of all boys and 60.5% of all girls presented after physical abuse. In order to eradicate child abuse, awareness of it as to be promoted in the community at large. Because the types of child

Incidence of thrombosis in children with tunneled central venous access devices versus peripherally inserted central catheters (PICCs).

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Kanin, Maralee; Young, Guy

2013-11-01

The recent proliferation of deep vein thrombosis in children has been attributed to the increased use of central venous catheters, specifically tunneled lines and peripherally inserted central catheters. A formal comparison of the incidence rate for deep vein thrombosis between tunneled lines and peripherally inserted central catheters has not been undertaken. Children inclusion. Data were extracted from the hospital discharge database which includes data on all procedures and up to 20 diagnoses per admission. Diagnoses and procedures were identified by International Classification of Disease, Ninth Revision coding. Patients were excluded if they received more than one central line. Data collected included type of central line, deep vein thrombosis event, and underlying medical illnesses classified according to chronic complex conditions. Over the seven year study period there was an overall rate of 73 deep vein thromboses per 10,000 hospital discharges. Of the 6915 eligible subjects, 181 had a deep vein thrombosis for an overall incidence rate of 2.6%. There were 152 thrombi (2.6%) in subjects with peripherally inserted central catheters and 29 thrombi (3.1%) in subjects with tunneled lines [OR=.83 (0.55, 1.29), p=0.38]. Despite the relative ease and simplicity of use of peripherally inserted central catheters leading to a substantial rise in their use, this study demonstrates that such lines pose a substantial risk for venous thrombosis and no difference in incidence was detected between such lines and tunneled lines. © 2013.

Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

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Iyoke CA

2014-01-01

Full Text Available Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries. Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria. Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software. Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the

Rotavirus vaccination within the South African Expanded Programme on Immunisation.

Science.gov (United States)

Seheri, L Mapaseka; Page, Nicola A; Mawela, Mothahadini P B; Mphahlele, M Jeffrey; Steele, A Duncan

2012-09-07

Diarrhoeal diseases are ranked the third major cause of childhood mortality in South African children less than 5 years, where the majority of deaths are among black children. Acute severe dehydrating rotavirus diarrhoea remains an important contributor towards childhood mortality and morbidity and has been well documented in South Africa. As the preventive strategy to control rotavirus diarrhoea, South Africa became the first country in the WHO African Region to adopt the rotavirus vaccine in the national childhood immunisation programme in August 2009. The rotavirus vaccine in use, Rotarix, GSK Biologicals, is given at 6 and 14 weeks of age, along with other vaccines as part of Expanded Programme on Immunisation (EPI). Studies which facilitated the introduction of rotavirus vaccine in South Africa included the burden of rotavirus disease and strain surveillance, economic burden of rotavirus infection and clinical trials to assess the safety and efficacy of vaccine candidates. This paper reviews the epidemiology of rotavirus in South Africa, outlines some of the steps followed to introduce rotavirus vaccine in the EPI, and highlights the early positive impact of vaccination in reducing the rotavirus burden of disease based on the post-marketing surveillance studies at Dr George Mukhari hospital, a sentinel site at University of Limpopo teaching hospital in Pretoria, South Africa, which has conducted rotavirus surveillance for >20 years. Copyright © 2012 Elsevier Ltd. All rights reserved.

Awareness and Use of South Asian Tobacco Products Among South Asians in New Jersey.

Science.gov (United States)

Hrywna, Mary; Jane Lewis, M; Mukherjea, Arnab; Banerjee, Smita C; Steinberg, Michael B; Delnevo, Cristine D

2016-12-01

South Asians are the third largest Asian group in the US and among the fastest growing racial groups in New Jersey. Tobacco consumption among South Asians is characterized by several smoked and smokeless tobacco products indigenous to the Indian subcontinent. However, there is a paucity of research on tobacco use behaviors among South Asians in the US. The goal of this study was to examine the awareness and use of South Asian tobacco products such as bidis, gutkha, paan, paan masala, and zarda as well as other potentially carcinogenic products such as supari, their context of use, and their cultural significance among South Asians living in the US. Eight focus groups were conducted with South Asian adults living in Central New Jersey. Overall, participants were aware of a wide variety of foreign and American tobacco products with older South Asians identifying a greater variety of indigenous products compared to younger South Asians. Hookah was consistently recognized as popular among the younger generation while products such as paan or paan masala were more commonly identified with elders. Use of tobacco-related products such as paan and supari were described as common at social gatherings or after meals. In addition, light or social users of South Asian tobacco products, including products not consistently defined as tobacco, may not report tobacco use on a survey. Better understanding of the use of these products among South Asians and how some may classify tobacco usage can inform future research and public health interventions in these communities.

Patient Satisfaction at America’s Lowest Performing Hospitals

Science.gov (United States)

Girotra, Saket; Cram, Peter; Popescu, Ioana

2012-01-01

BACKGROUND Previous studies have identified hospitals with poor performance on cardiac process measures. How these hospitals fare in other domains such as patient satisfaction remains unknown. METHODS We used Hospital Compare data to identify hospitals that reported acute myocardial infarction (AMI) and heart failure (HF) process measures for 2006–2008 and calculated respective composite performance scores. Using these scores, we classified hospitals as low-performing (bottom decile for all three years), top-performing (top decile for all three years), and intermediate (all others). We used Hospital Consumer Assessment of Healthcare Providers and Systems 2008 data to compare overall satisfaction between low, intermediate, and top-performing hospitals. RESULTS Low-performing hospitals had fewer beds, fewer nurses per-patient, and were more likely rural, safety-net hospitals located in the South, compared to intermediate and top-performing hospitals (Ppatient satisfaction (kappa statisticpatient satisfaction on average suggesting that these hospitals have overall poor quality of care. However, there is discordance between the two measures in profiling hospital quality. PMID:22496113

Poor long-term outcomes for cryptococcal meningitis in rural South ...

African Journals Online (AJOL)

Objectives. To explore linkage to and retention in HIV care after an episode of cryptococcal meningitis (CM) in rural South Africa. Design. A retrospective case series of adult individuals (≥16 years old) with laboratory-confirmed CM from January - December 2007 at Hlabisa Hospital – a district hospital in northern KwaZulu- ...

South Blackwater Coal`s maintenance program

Energy Technology Data Exchange (ETDEWEB)

Nash, J. [South Blackwater Coal Limited, Blackwater, Qld. (Australia)

1998-09-01

The South Blackwater operation consists of two opencut mining areas and two underground mines (Laleham and Kenmure) near Blackwater in central Queensland, all of which supply coal to a central coal preparation plant. South Blackwater Coal Ltd. recently developed a maintenance improvement programme, described in this article. The programme involved implementation systems of key performance indicators (KPIs), benchmaking, condition monitoring, work planning and control, failure analysis and maintenance audit. Some improvements became almost immediately apparent, others were quite gradual. Major results included: improved availability (and reliability) of all opencast fleets, improvements in rear dump availability; reduced maintenance man-hours for opencast fleets; and increased availability of the coal handling and preparation plant. The paper is an edited version of that presented at the `Maintenance in mining conference` 16-19 March 1998, held in Bali, Indonesia. 4 figs., 2 photos.

Seasonal variation and trends in stroke hospitalizations and mortality in a South American community hospital.

Science.gov (United States)

Díaz, Alejandro; Gerschcovich, Eliana Roldan; Díaz, Adriana A; Antía, Fabiana; Gonorazky, Sergio

2013-10-01

Numerous studies have reported the presence of temporal variations in biological processes. Seasonal variation (SV) in stroke has been widely studied, but little data have been published on this phenomenon in the Southern Hemisphere, and there have been no studies reported from Argentina. The goals of the present study were to describe the SV of admissions and deaths for stroke and examine trends in stroke morbidity and mortality over a 3-year period in a community hospital in Argentina. Hospital discharge reports from the electronic database of vital statistics between 1999 and 2001 were examined retrospectively. Patients who had a main discharge diagnosis of stroke (ischemic or hemorrhagic) or cerebrovascular accident (International Classification of Diseases, Ninth Revision codes 431, 432, 434, and 436) were selected. The study sample included 1382 hospitalizations by stroke (3.5% of all admissions). In-hospital mortality demonstrated a winter peak (25.5% vs 17% in summer; P = .001). The crude seasonal stroke attack rate (ischemic and hemorrhagic) was highest in winter (164 per 100,000 population; 95% CI, 159-169 per 100,000) and lowest in summer (124 per 100,000; 95% CI, 120-127 per 100,000; P = .008). Stroke admissions followed a seasonal pattern, with a winter-spring predominance (P = .008). Our data indicate a clear SV in stroke deaths and admissions in this region of Argentina. The existence of SV in stroke raises a different hypothesis about the rationale of HF admissions and provides information for the organization of care and resource allocation. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Granuloma central de células gigantes Giant cells central granuloma

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Ayelén María Portelles Massó

2011-03-01

Full Text Available El granuloma reparativo central de células gigantes es una lesión proliferativa no neoplásica de etiología desconocida. Se presenta un paciente masculino de 40 años de edad, portador de prótesis parcial superior. Fue remitido al Servicio de Cirugía Maxilofacial del Hospital "V. I. Lenin" por presentar aumento de volumen en reborde alveolar superior, de color rojo grisáceo y que provocaba expansión de corticales óseas. Una vez analizados los exámenes clínicos, radiográficos e histopatológicos se diagnosticó un granuloma reparativo central de células gigantes Se realizó exéresis quirúrgica de la lesión y extracción de dientes adyacentes con una evolución satisfactoria sin señales de recidivas luego de tres años del tratamiento. El granuloma reparativo central de células gigantes se presentó como respuesta a un trauma. La correcta interpretación de los datos clínicos, radiográficos e histopatológicos nos permitió llegar al correcto diagnóstico y plan de tratamiento.Giant-cell central reparative granuloma is non neoplastic proliferative lesion of unknown etiology. We report a 40 years old male patient who was admitted at the Maxillofacial Service of the "V. I. Lenin" Hospital. The patient had partial upper prosthesis and was complaining of red-grey volume increase lesion in upper alveolar ridge which led to the expansion of cortical bone. Having analyzed clinical, radiographic and histopathological findings the case was concluded as a giant-cell central reparative granuloma. Surgical exeresis and adjunct tooth extraction were done. After three years of treatment, satisfactory follow up without recurrence is reported.

Credit risk determinants in Sub-Saharan banking systems: Evidence from five countries and lessons learnt from Central East and South East European countries

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Eftychia Nikolaidou

2017-06-01

Full Text Available Banking systems in Sub-Saharan Africa (SSA have grown notably over the past decades due to benign macroeconomic, regulatory and financial trends. Nonetheless, downside risks remain elevated by structural issues, commodity price fluctuations, reversal of capital flows and spill-over effects from external shocks in a manner similar to the Central East and South East European (CESEE countries. In the light of the 2008–2009 Global Financial Crisis, great attention has been given to understanding the causes of banking instability with most of the research focusing on advanced economies and, to a lesser extent, large emerging markets while little attention has been paid to the bank-based financial sectors of Sub-Saharan Africa. Furthermore, there is scarcity of studies aiming at knowledge-sharing among different emerging economies. This paper aims to identify the determinants of bank credit risk by focusing on five SSA countries: Kenya, Namibia, South Africa, Zambia and Uganda. Using the ARDL approach to cointegration, findings indicate that increased money supply conditions have a decreasing effect on NPLs in all counties, banking industry-specific variables play a significant role in the case of South Africa and Uganda while NPLs are driven by country-specific variables in the case of Kenya, South Africa and Zambia. The effect of the Global Financial Crisis is evidenced indirectly. Drawing on evidence from CESEE countries with long experience in banking crises, reforms and financial deepening process, the paper provides lessons for SSA countries and offers policy recommendations in the direction of strengthening banks’ balance sheets to ensure financial stability.

Vegetative Propagation Trial of Prosopis africana (Guill. et Perr. Taub. by Air Layering under Sudano-Sahelian Climate in the South-Central Niger

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Laouali Abdou

2015-01-01

Full Text Available Prosopis africana is a species of great socioeconomic importance but threatened with extinction in Niger because of overuse and regeneration problem. This study, conducted in the Maradi (Niger area, precisely at El Gueza in the south of Gazaoua department, aims to evaluate the vegetative propagation capacity of P. africana by air layering under the Sudano-Sahelian climate of the south-central Niger. A ring of bark was taken on each selected branch and the wound was covered with a black plastic filled with a damp mixture of soil and wood debris. The chosen parameters are the diameter class and the position on the branch. In all, 60 branches were treated and followed for 130 days: 28.33% produced shoots and there was no significant difference between the diameter classes and between the positions. These results show that propagating trees of the species by air layering is possible and this technique can be used to multiply and keep this species, which will reduce the regeneration problem linked to a low seed germination rate.

Utilization of institutional delivery service at Wukro and Butajera districts in the Northern and South Central Ethiopia

Science.gov (United States)

2014-01-01

Background Ethiopia has one of the highest maternal mortality in the world. Institutional delivery is the key intervention in reducing maternal mortality and complications. However, the uptake of the service has remained low and the factors which contribute to this low uptake appear to vary widely. Our study aims to determine the magnitude and identify factors affecting delivery at health institution in two districts in Ethiopia. Methods A community based cross sectional household survey was conducted from January to February 2012 in 12 randomly selected villages of Wukro and Butajera districts in the northern and south central parts of Ethiopia, respectively. Data were collected using a pretested questionnaire from 4949 women who delivered in the two years preceding the survey. Results One in four women delivered the index child at a health facility. Among women who delivered at health facility, 16.1% deliveries were in government hospitals and 7.8% were in health centers. The factors that significantly affected institutional delivery in this study were district in which the women lived (AOR: 2.21, 95% CI: 1.28, 3.82), women age at interview (AOR: 1.96, 95% CI: 1.05, 3.62), women’s education (AOR: 3.53, 95% CI: 1.22, 10.20), wealth status (AOR: 16.82, 95% CI: 7.96, 35.54), women’s occupation (AOR: 1.50, 95% CI: 1.01, 2.24), antenatal care (4+) use (AOR: 1.77, 95% CI: 1.42, 2.20), and number of pregnancies (AOR: 0.25, 95% CI: 0.18,0.35). We found that women who were autonomous in decision making about place of delivery were less likely to deliver in health facility (AOR: 0.38, 95% CI: 0.23,0.63). Conclusions Institutional delivery is still low in the Ethiopia. The most important factors that determine use of institutional delivery appear to be women education and household economic status. Women’s autonomy in decision making on place of delivery did not improve health facility delivery in our study population. Actions targeting the disadvantaged, improving

Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

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Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

2016-08-01

The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

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.

Adverse Drug Reactions Causing Admission to Medical Wards: A Cross-Sectional Survey at 4 Hospitals in South Africa.

Science.gov (United States)

Mouton, Johannes P; Njuguna, Christine; Kramer, Nicole; Stewart, Annemie; Mehta, Ushma; Blockman, Marc; Fortuin-De Smidt, Melony; De Waal, Reneé; Parrish, Andy G; Wilson, Douglas P K; Igumbor, Ehimario U; Aynalem, Getahun; Dheda, Mukesh; Maartens, Gary; Cohen, Karen

2016-05-01

Limited data exist on the burden of serious adverse drug reactions (ADRs) in sub-Saharan Africa, which has high HIV and tuberculosis prevalence. We determined the proportion of adult admissions attributable to ADRs at 4 hospitals in South Africa. We characterized drugs implicated in, risk factors for, and the preventability of ADR-related admissions.We prospectively followed patients admitted to 4 hospitals' medical wards over sequential 30-day periods in 2013 and identified suspected ADRs with the aid of a trigger tool. A multidisciplinary team performed causality, preventability, and severity assessment using published criteria. We categorized an admission as ADR-related if the ADR was the primary reason for admission.There were 1951 admissions involving 1904 patients: median age was 50 years (interquartile range 34-65), 1057 of 1904 (56%) were female, 559 of 1904 (29%) were HIV-infected, and 183 of 1904 (10%) were on antituberculosis therapy (ATT). There were 164 of 1951 (8.4%) ADR-related admissions. After adjustment for age and ATT, ADR-related admission was independently associated (P ≤ 0.02) with female sex (adjusted odds ratio [aOR] 1.51, 95% confidence interval [95% CI] 1.06-2.14), increasing drug count (aOR 1.14 per additional drug, 95% CI 1.09-1.20), increasing comorbidity score (aOR 1.23 per additional point, 95% CI 1.07-1.41), and use of antiretroviral therapy (ART) if HIV-infected (aOR 1.92 compared with HIV-negative/unknown, 95% CI 1.17-3.14). The most common ADRs were renal impairment, hypoglycemia, liver injury, and hemorrhage. Tenofovir disoproxil fumarate, insulin, rifampicin, and warfarin were most commonly implicated, respectively, in these 4 ADRs. ART, ATT, and/or co-trimoxazole were implicated in 56 of 164 (34%) ADR-related admissions. Seventy-three of 164 (45%) ADRs were assessed as preventable.In our survey, approximately 1 in 12 admissions was because of an ADR. The range of ADRs and implicated drugs reflect South Africa's high HIV

An investigation of diverticular disease among black patients undergoing colonoscopy at Dr George Mukhari Academic Hospital, Pretoria, South Africa.

Science.gov (United States)

Vally, M; Koto, M Z; Govender, M

2017-01-30

Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease. To report on the profile and current prevalence of diverticular disease in the black South African (SA) population at Dr George Mukhari Academic Hospital, Pretoria, SA. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease - a prevalence of 13.50% (95% confidence interval 10.30 - 17.50). The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67) years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96%) indication for colonoscopy. The left colon was most commonly involved (72.34%), followed by the right colon (55.31%). A substantial number of patients had pancolonic involvement (27.65%). This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status.

An investigation of diverticular disease among black patients undergoing colonoscopy at Dr George Mukhari Academic Hospital, Pretoria, South Africa

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M Vally

2017-02-01

Full Text Available Background. Diverticular disease was previously thought to be non-existent in the black African population. Studies over the past four decades, however, have shown a steady increase in the prevalence of the disease. Objective. To report on the profile and current prevalence of diverticular disease in the black South African (SA population at Dr George Mukhari Academic Hospital, Pretoria, SA. Methods. A retrospective descriptive study was performed in black SA patients who were diagnosed with diverticular disease by colonoscopy between 1 January and 31 December 2015. Results. Of 348 patients who had undergone colonoscopies and who were eligible for inclusion in this study, 47 were diagnosed with diverticular disease – a prevalence of 13.50% (95% confidence interval 10.30 - 17.50. The greatest number of patients diagnosed were in their 7th and 8th decades, with an age range of 46 - 86 (mean 67 years. There was a female predominance of 57.45%. Lower gastrointestinal bleeding was the most common (65.96% indication for colonoscopy. The left colon was most commonly involved (72.34%, followed by the right colon (55.31%. A substantial number of patients had pancolonic involvement (27.65%. Conclusion. This retrospective study suggests that there has been a considerable increase in the prevalence of diverticular disease among black South Africans, possibly owing to changes in dietary habits and socioeconomic status.

The role of print advertising in clinical trial recruitment: Lessons from a South African site

OpenAIRE

Burgess, Lesley J

2010-01-01

Lesley J Burgess, Nicky U SulzerTREAD Research/Cardiology Unit, Department of Internal Medicine, Tygerberg Hospital and Stellenbosch University, Parow, South AfricaObjective: To evaluate the effectiveness of print advertising in our setting in enrolling patients into a study and whether the associated costs are justified.Methods: This study was carried out by TREAD Research, based within an academic hospital in the Western Cape, South Africa, between January 2006 and June 2007. Newspaper adve...

Childhood liver diseases in Ga-Rankuwa Hospital, South Africa ...

African Journals Online (AJOL)

Rankuwa Hospital Histopathology Laboratory. Design: A retrospective study. Setting: Ga-Rankuwa Histopathology Laboratory. Subjects: Seventy two patients who underwent a liver biopsy during the study period. Methods: Laboratory records ...

Commitment and the emigration intentions of South African ...

African Journals Online (AJOL)

2013-03-11

Mar 11, 2013 ... 500 South African registered nurses working abroad, whilst 32 000 ... nurses (N= 419), working within public sector tertiary hospitals in the Western Cape, responded ..... Managers do, however, have control over the culture.

Hospital pharmacy services in teaching hospitals in Nepal: Challenges and the way forward

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P Ravi Shankar

2016-01-01

Full Text Available In Nepal, a developing country in South Asia, hospital pharmacies in teaching hospitals faces a number of challenges. Design and location of the pharmacy is inadequate, the pharmacy is often rented out to private parties, there may be a lack of separation of outpatient and inpatient pharmacy services, medicines are not selected based on objective criteria, too many brands are stocked, pharmaceutical care services are not provided, and pharmaceutical promotion is not regulated within the hospital premises. Furthermore, there is often a lack of pharmacy management software to help dispensing, continuing pharmacy education is not provided, medicines are not compounded or packaged in house, there are problems with medicines availability and medicine quality, and drug utilization studies are not linked with initiatives to promote the rational use of medicines. In this article, the authors examine these challenges and put forward possible solutions.