A refuge for inorganic chemistry: Bunsen's Heidelberg laboratory.

Science.gov (United States)

Nawa, Christine

2014-05-01

Immediately after its opening in 1855, Bunsen's Heidelberg laboratory became iconic as the most modern and best equipped laboratory in Europe. Although comparatively modest in size, the laboratory's progressive equipment made it a role model for new construction projects in Germany and beyond. In retrospect, it represents an intermediate stage of development between early teaching facilities, such as Liebig's laboratory in Giessen, and the new 'chemistry palaces' that came into existence with Wöhler's Göttingen laboratory of 1860. As a 'transition laboratory,' Bunsen's Heidelberg edifice is of particular historical interest. This paper explores the allocation of spaces to specific procedures and audiences within the laboratory, and the hierarchies and professional rites of passage embedded within it. On this basis, it argues that the laboratory in Heidelberg was tailored to Bunsen's needs in inorganic and physical chemistry and never aimed at a broad-scale representation of chemistry as a whole. On the contrary, it is an example of early specialisation within a chemical laboratory preceding the process of differentiation into chemical sub-disciplines. Finally, it is shown that the relatively small size of this laboratory, and the fact that after ca. 1860 no significant changes were made within the building, are inseparably connected to Bunsen's views on chemistry teaching.

Smart information system for gachon university gil hospital.

Science.gov (United States)

Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

2012-03-01

In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

Maternal Mortality in Ribat University Hospital, Khartoum, Sudan ...

African Journals Online (AJOL)

Background: Maternal death is a tragedy that leaves an enormous negative impact on the family. The objectives of the study were to determine the rate and causes of maternal mortality in Ribat University Hospital Methods: This was a descriptive, hospital-based study conducted in Ribat University Hospital, Khartoum, Sudan ...

Effect of essential oil compound on shedding and colonization of Salmonella enterica serovar Heidelberg in broilers.

Science.gov (United States)

Alali, W Q; Hofacre, C L; Mathis, G F; Faltys, G

2013-03-01

The objectives of this study were to determine the effect of an essential oil blend (EO; carvacrol, thymol, eucalyptol, lemon) administered in drinking water on the performance, mortality, water consumption, pH of crop and ceca, and Salmonella enterica serovar Heidelberg fecal shedding and colonization in broiler birds following Salmonella Heidelberg challenge and feed withdrawal. Chicks were randomly assigned to water treatments containing 0.05, 0.025, or 0.0125% EO or untreated controls. Treatments were administered in drinking water on 0 to 7 and 35 to 42 d. One-half of the chicks were challenged with Salmonella Heidelberg and placed in pens with unchallenged chicks on d 1. Performance, mortality, water consumption, and pH were determined during the 42-d study. Prevalence of Salmonella Heidelberg was determined on drag swabs (0, 14, and 42 d) and in the ceca and crops (42 d). The 0.05% EO administered in drinking water significantly (P water significantly lowered the feed conversion ratio and increased weight gain compared with controls, but did not significantly reduce Salmonella Heidelberg colonization in the crops. The EO in drinking water did not significantly reduce Salmonella Heidelberg colonization in ceca or fecal shedding in broilers. The EO used in the study may control Salmonella Heidelberg contamination in crops of broilers when administered in drinking water and therefore may reduce the potential for cross-contamination of the carcass when the birds are processed.

[Issues related to national university medical schools: focusing on the low wages of university hospital physicians].

Science.gov (United States)

Takamuku, Masatoshi

2015-01-01

University hospitals, bringing together the three divisions of education, research, and clinical medicine, could be said to represent the pinnacle of medicine. However, when compared with physicians working at public and private hospitals, physicians working at university hospitals and medical schools face extremely poor conditions. This is because physicians at national university hospitals are considered to be "educators." Meanwhile, even after the privatization of national hospitals, physicians working for these institutions continue to be perceived as "medical practitioners." A situation may arise in which physicians working at university hospitals-performing top-level medical work while also being involved with university and postgraduate education, as well as research-might leave their posts because they are unable to live on their current salaries, especially in comparison with physicians working at national hospitals, who focus solely on medical care. This situation would be a great loss for Japan. This potential loss can be prevented by amending the classification of physicians at national university hospitals from "educators" to "medical practitioners." In order to accomplish this, the Japan Medical Association, upon increasing its membership and achieving growth, should act as a mediator in negotiations between national university hospitals, medical schools, and the government.

remembering the heidelberg catechism in south africa today?

African Journals Online (AJOL)

deserves to be known and studied. ... In an essay for the recent anniversary publication Power of. Faith: 450 years of the Heidelberg Catechism, Herman Selderhuis refers to Anna Maria van Schurman, the first woman to attend lectures at the.

The Heidelberg Basin Drilling Project - Sedimentology and Stratigraphy of the Quaternary succession

Science.gov (United States)

Ellwanger, Dietrich; Gabriel, Gerald; Hahne, Jürgen; Hoselmann, Christian; Menzies, John; Simon, Theo; Weidenfeller, Michael; Wielandt-Schuster, Ulrike

2010-05-01

Within the context of the Heidelberg Basin Drilling Project (Gabriel et al. 2008), a detailed sediment succession is presented here based upon deep drillings taken at Heidelberg UniNord and Mannheim Käfertal. Sediment structures, and micromorphological and pollen analyses were conducted and used to reconsider some of the climate transitions within the lower Pleistocene. A new and novel scenario is postulated regarding the preservation of Quaternary sediment packages within the Cenozoic Graben environment of the Heidelberg basin. The palynological evidence comprises the periods of warm climate of the Holsteinian (mainly Abies (fir), some Fagus (beech), Pterocarya & Azolla); the Cromerian (Pinus-Picea-QM (pine-spruce-QM)); the Bavelian (Abies, Tsuga (hemlock fir), QM & phases of increased NAP including Pinus); the Waalian (Abies, Tsuga, QM); and the Tiglian (Fagus & early Pleistocene taxa especially Sciadopytis, downward increasing Tertiary taxa). The sediment package was studied both macroscopically and microscopically. Both techniques provide evidence of fluvial, lacustrine and mass movement sedimentary processes. Some include evidence of periglacial processes (silt droplets within fine grained sands indicative of frozen ground conditions). The periglacial structures are often, not always, accompanied by pollen spectra dominated by pine and NAP. E.g. the Tiglian part of the succession shows periglacial sediment structures at its base and top but not in its middle sections. I.e. it appears not as a series of warm and cold phases but rather as a constant warm period with warm-cold-alternations at its bottom and top. All results illustrate sediment preservation in the Heidelberg basin almost throughout the Quaternary. This may be due to tectonic subsidence, but also to compaction by sediment loading of underlying fine sediments (Oligocene to Quaternary) leading to incomplete but virtually continuous sediment preservation (Tanner et al. 2009). References Gabriel, G

Chronic digitalis therapy in patients before heart transplantation is an independent risk factor for increased posttransplant mortality

Directory of Open Access Journals (Sweden)

Rivinius R

2017-10-01

Full Text Available Rasmus Rivinius,1 Matthias Helmschrott,1 Arjang Ruhparwar,2 Ann-Kathrin Rahm,1,3 Fabrice F Darche,1 Dierk Thomas,1 Tom Bruckner,4 Philipp Ehlermann,1 Hugo A Katus,1 Andreas O Doesch1,5 1Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital, Heidelberg, 2Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, 3Faculty of Medicine, University of Heidelberg, Heidelberg, 4Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, 5Asklepios Klinik Bad Salzungen GmbH, Department of Pneumology and Oncology, Bad Salzungen, Germany Objectives: Digitalis therapy (digoxin or digitoxin in patients with heart failure is subject to an ongoing debate. Recent data suggest an increased mortality in patients receiving digitalis. This study investigated the effects of chronic digitalis therapy prior to heart transplantation (HTX on posttransplant outcomes.Patients and methods: This was a retrospective, observational, single-center study. It comprised 530 adult patients who were heart-transplanted at Heidelberg University Hospital between 1989 and 2012. Patients with digitalis prior to HTX (≥3 months were compared to those without (no or <3 months of digitalis. Patients with digitalis were further subdivided into patients receiving digoxin or digitoxin. Primary outcomes were early posttransplant atrial fibrillation and mortality.Results: A total of 347 patients (65.5% had digitalis before HTX. Of these, 180 received digoxin (51.9% and 167 received digitoxin (48.1%. Patients with digitalis before HTX had a significantly lower 30-day (P=0.0148 and 2-year (P=0.0473 survival. There was no significant difference between digoxin and digitoxin in 30-day (P=0.9466 or 2-year (P=0.0723 survival. Multivariate analysis for posttransplant 30-day mortality showed pretransplant digitalis therapy as an independent risk factor (hazard ratio =2.097, CI: 1.036–4.248, P=0.0397. Regarding atrial

Anchoring interprofessional education in undergraduate curricula: The Heidelberg story.

Science.gov (United States)

Berger, Sarah; Goetz, Katja; Leowardi-Bauer, Christina; Schultz, Jobst-Hendrik; Szecsenyi, Joachim; Mahler, Cornelia

2017-03-01

The ability of health professionals to collaborate effectively has significant potential impact on patient safety and quality-care outcomes, especially given the increasingly complex and dynamic clinical practice environments of today. Educators of the health professions are faced with an immediate challenge to adapt curricula and traditional teaching methods to ensure graduates are equipped with the necessary interprofessional competencies and (inter)professional values for their future practice. The World Health Organization's "Framework for action in interprofessional education (IPE) and collaborative practice" promotes IPE as a key strategy to enhance patient outcomes by preparing a "collaborative practice-ready health workforce." Logistical and attitudinal barriers can hinder integration of IPE into curricula. Lessons learned through the implementation of a planned change to establish four interprofessional seminars (team communication, medical error communication, healthcare English, and small business management) at Heidelberg University Medical Faculty, Germany, are described. A key factor in successfully anchoring IPE seminars in the undergraduate curricula was the structured approach drawing on change management concepts.

Acute intoxications in two university hospitals in Burkina Faso ...

African Journals Online (AJOL)

Acute intoxications in two university hospitals in Burkina Faso. ... admitted to the emergency services of the two sole University Hospitals of Ouagadougou from July 1, ... followed by chemicals, animals' toxins, food, alcohol and addictive drugs.

Occupational Accidents among Clinical Staff of Tabriz University Hospitals

OpenAIRE

Leila Sahebi; Rana Gholamzadeh nikjoo; Majid Khalili

2015-01-01

​Background and Objectives : Occupational health and safety is one of the most important issues in the workplace. The purpose of this study was to explore the one –year prevalence of occupational accidents in Tabriz University hospitals. Materials and Methods : A cross-sectional study was conducted on 400 patients of seven university hospitals using researcher made questionnaire. The hospitals were selected based on their specialty of the service. Then, one hospital was selected from each s...

Perioperative nursing in public university hospitals

DEFF Research Database (Denmark)

Sørensen, Erik Elgaard; Olsen, Ida Østrup; Tewes, Marianne

2014-01-01

BACKGROUND: In recent years, perioperative nursing has received ongoing attention as part of an interprofessional collaboration. Perioperative nursing is constantly faced with new challenges and opportunities that necessitate continual updates of nursing knowledge and technical skills. In light...... of the longstanding relationship between nursing and technology, it is interesting that few studies with this focus have been performed. Therefore, our research question was: What is the content of perioperative nursing and how do nurses facilitate the interaction between nursing care and technology in highly...... specialized operating rooms in public university hospitals? METHODS: An ethnography involving participant observations and interviews was conducted during a 9-month study period. The participants comprised 24 nurses from 9 different operating wards at 2 university hospitals in different regions of Denmark...

Deutsches Krebsforschungszentrum Heidelberg. Research report 1997/1998

International Nuclear Information System (INIS)

1999-01-01

The Deutsches Krebsforschungszentrum Heidelberg (DKFZ, German Cancer Research Center) publishes alternating every year the 'Research Report' and the 'Wissenschaftlicher Ergebnisbericht' (in German). Both volumes are reports on the present state of research activities of the DKFZ as a National Research Center to the funding federal and state authorities (Federal Republic of Germany, Land (state) Baden-Wuerttemberg). Furthermore they shall inform colleagues and the scientifically interested public. Both reports are structured according to the center's eight research programs. (orig.) [de

Heidelberg Retina Tomograph for the Detection of Glaucoma

Directory of Open Access Journals (Sweden)

Barbara Cvenkel

2012-06-01

Full Text Available Heidelberg Retina Tomograph (HRT is a confocal scanning laser ophthalmoscope which acquires and analyzes 3-dimensional images of the optic nerve head. The latest instrument HRT3 includes software with larger ethinic-specific normative database. This review summarizes relevant published literature on HRT in diagnosing glaucoma, detecting glaucoma progression, the diagnostic accuracy of HRT among other imaging devices and its role in clinical practice.

Release procedure according to paragraph 29 StrlSchv on example of the nuclear research reactor TRIGA Heidelberg II; Durchfuehrung von Freigabeverfahren nach paragraph 29 am Beispiel des TRIGA Heidelberg II

Energy Technology Data Exchange (ETDEWEB)

Cremer, J. [Siempelkamp Nukleartechnik GmbH (SNT) (Germany); Sold, A. [Deutsches Krebsforschungszentrum Heidelberg (DKFZ) (Germany)

2005-07-01

The aim of this lecture is to show the schedule of a release procedure according to paragraph 29 StrlSchV on the example of the decommissioning of the nuclear research reactor TRIGA Heidelberg II. It is shown on the effort done by the radiation protection representative of this plant. Considering this example, starting with planning, application, survey and execution, the complex context of the release procedure is becomes apparent. Thereby the new applied measuring techniques that require a certain practice and the responsibility of the radiation protection representative in the radiation protection law play a relevant role. In such small facilities as the TRIGA Heidelberg II, the radiation protection staff are employed according to the plant's size and work is focussed on radiation protection research and laboratories. The decommissioning process with its wide range of radiation protection requirements represents new challenges which have to be coordinated with the present duties of the radiation protection representative. The supervision and the responsibility for the release procedure according to paragraph 29 are the largest and the most sensitive part of decommissioning of the nuclear research reactor TRIGA Heidelberg II. (orig.)

Die Britse owerheid en die onderwys op Heidelberg gedurende die ...

African Journals Online (AJOL)

The establishment of Christian National Education (CNE) Schools stimulated the concept of mother tongue education. Oor die klaskamerpraktyk en die werklike gehalte van onderrig tydens die kampskooltydperk is daar min bekend. Heidelberg wat na 1902 in 'n belangrike onderwyssentrum in Transvaal ontwikkel het, het ...

DNA sequence analysis of plasmids from multidrug resistant Salmonella enterica serotype Heidelberg isolates.

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Jing Han

Full Text Available Salmonella enterica serovar Heidelberg is among the most detected serovars in swine and poultry, ranks among the top five serotypes associated with human salmonellosis and is disproportionately associated with invasive infections and mortality in humans. Salmonella are known to carry plasmids associated with antimicrobial resistance and virulence. To identify plasmid-associated genes in multidrug resistant S. enterica serovar Heidelberg, antimicrobial resistance plasmids from five isolates were sequenced using the 454 LifeSciences pyrosequencing technology. Four of the isolates contained incompatibility group (Inc A/C multidrug resistance plasmids harboring at least eight antimicrobial resistance genes. Each of these strains also carried a second resistance plasmid including two IncFIB, an IncHI2 and a plasmid lacking an identified Inc group. The fifth isolate contained an IncI1 plasmid, encoding resistance to gentamicin, streptomycin and sulfonamides. Some of the IncA/C plasmids lacked the full concert of transfer genes and yet were able to be conjugally transferred, likely due to the transfer genes carried on the companion plasmids in the strains. Several non-IncA/C resistance plasmids also carried putative virulence genes. When the sequences were compared to previously sequenced plasmids, it was found that while all plasmids demonstrated some similarity to other plasmids, they were unique, often due to differences in mobile genetic elements in the plasmids. Our study suggests that Salmonella Heidelberg isolates harbor plasmids that co-select for antimicrobial resistance and virulence, along with genes that can mediate the transfer of plasmids within and among other bacterial isolates. Prevalence of such plasmids can complicate efforts to control the spread of S. enterica serovar Heidelberg in food animal and human populations.

are humans by birth as wicked as the heidelberg catechism

African Journals Online (AJOL)

the Catechism's view that (after alienation from God in the Fall) all human individuals ... capacities of empathy and altruism already in young children of different cultures as ... characterized by the natural right to self-preservation, which in itself ... and stabilizing the institutions of family, church and state in the Heidelberg.

Developing marketing strategies for university teaching hospitals.

Science.gov (United States)

Fink, D J

1980-07-01

University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, a rising tide of consumerism, and in many cases a declining urban population base. These problems, which may threaten the teaching hospital's ability to continue tertiary care, teaching, and research functions, may be solved with the aid of new marketing strategies. In developing its marketing strategy, a hospital must assess its strengths and weaknesses, specify its goals in measurable terms, implement tactics to achieve these goals, and evaluate its marketing program. The strategies should be directed toward achieving better relationships with institutions, practitioners, and surrounding communities and increasing patient, visitor, and employee satisfaction. A wide variety of programs can be used to reach these goals and to help teaching hospitals meet the competitive challenges of this decade.

EVALUATION OF FINANCIAL PERFORMANCE OF UNIVERSITY HOSPITALS BY RATIO ANALYSIS METHOD

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Ferda BÜLÜÇ

2017-09-01

Full Text Available This study aims to evaluate the financial performances of public university hospitals in Turkey; make contribution to the related literature in accordance with the findings and develop recommendations for the decision makers. Within the scope of the study, financial statements of revolving fund of the 43 public university hospitals for the years of 2013, 2014 and 2015 were obtained from the Ministry of Finance General Directorate of Public Accounts. Financial statements were evaluated by ratio analysis method. After analysing, it has been reached that the burden of debt of the hospitals were high,  they have been experiencing the problem of paying short term debts, stock turnover rates and turnover rates were low and the incomes of the hospitals can not cover their expenses. It is recomended that hospitals should use resources more efficiently and decision makers should consider education and research activities in budget allocation to university hospitals.

Mortality Rates of Traumatic Traffic Accident Patients at the University Hospital

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Atilla Senih MAYDA

2014-05-01

Full Text Available The aim of the study is to estimate hospitalization and mortality rates in patients admitted to the University Hospital due to traffic accidents, and to determine the mean cost of the applicants in the hospital due to traffic accident. In this retrospective study data were obtained from the records of a university research and practice hospital. There were 802 patients admitted to emergency and other outpatient clinics of the University Hospital because of traffic accidents throughout the year 2012. Out of these patients, 166 (20.7% were hospitalized, and the annual mortality rate was 0.87%. The total cost was 322,545.2 euro and 402.2 euro per patient. Road traffic accident detection reports covered only the numbers of fatal injuries and injuries that happened at the scene of accidents. Determination of the number of the dead and wounded with overall mortality rate would be supposed to reveal the magnitude of public health problem caused by traffic accidents.

Characterization of a multidrug-resistant Salmonella enterica serovar Heidelberg outbreak strain in commercial turkeys: Colonization, transmission, and host transcriptional response

Science.gov (United States)

In recent years, multidrug-resistant (MDR) Salmonella enterica serovar Heidelberg has been associated with numerous human foodborne illness outbreaks due to consumption of poultry. For example, in 2011, an MDR S. Heidelberg outbreak associated with ground turkey sickened 136 individuals and resulted...

Performance Based Supplementary Payment System at University Hospitals in Turkey

Directory of Open Access Journals (Sweden)

Vahit YÝÐÝT

2017-06-01

Results: The result of the analysis has revealed that PBSP system encourage physicians who would like to receive financial incentives. PBSP system supports the individual performance, reduces waiting times in patients, increases revenues and decreases expenditures and increases in efficiency of department. However, this payment system increases work load, number of examinations and provokes the conflict among personals. Conclusions: University hospitals are academic institutions that perform important missions such as research, medical education and health services provision. Therefore, PBSP system should be revised so as to encourage performing these missions at university hospitals. There is also shortage of financial resources at the university hospitals. This situation leads to less additional payments to physicians. [J Contemp Med 2017; 7(2.000: 126-131

[Screening for malnutrition among hospitalized patients in a Colombian University Hospital].

Science.gov (United States)

Cruz, Viviana; Bernal, Laura; Buitrago, Giancarlo; Ruiz, Álvaro J

2017-04-01

On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital. Of 295 patients included, none had been screened for malnutrition since hospital admission. Sixty one percent were at nutritional risk, with a higher prevalence among patients with HIV (85.7%), cancer (77.5%) and pneumonia. A positive MST result was associated with a 3.2 days increase in length of hospital stay (p = 0.024). The prevalence of malnutrition risk in hospitalized patients is high, but its screening is inadequate and it is underdiagnosed. The MST tool is simple, fast, low-cost, and has a good diagnostic performance.

Teleradiology and PACS - strategy of the Innsbruck University Hospital

International Nuclear Information System (INIS)

Vogl, R.

2005-01-01

Systems for management of digital imaging data are very important and widespread at the Innsbruck University Hospital and constitute a central component of the IT strategies followed by the hospital operating company TILAK (Tyrolean public hospitals). The particular goal is to integrate all imaging data into the electronic medical records and make these available online to each of the approx. 2500 clinic workstations and ensure electronic data exchange with other healthcare services. Teleradiology connections have been established at the University Clinic for Radiology since 1995; these have been continually expanded and linked to the central PACS. An eHealth web portal was recently established to facilitate transfer of images and findings from TILAK hospitals to other healthcare organizations. Registered users can be cleared for a limited time to access all radiological imaging data via this web portal. (orig.) [de

The Stuttgart-Heidelberg Model of Active Feedback Driven Quality Management: Means for the Optimization of Psychotherapy Provision

Directory of Open Access Journals (Sweden)

Hans Kordy

2003-01-01

Full Text Available La gestión de la calidad busca la evaluación del tratamiento psicoterapéutico. Un aspecto central se relaciona con el desarrollo de baterías de evaluación y criterios de evaluación adecuados. El modelo Stuttgart-Heidelberg (S-H representa un sistema que proporciona conceptos, instrumentos psicométricos y un programa informático desarrollado para la gestión de la calidad basada en el feedback activo. La información central del modelo Stuttgart-Heidelberg es el resultado individual del tratamiento. El planteamiento es que la psicoterapia puede mejorarse si proporcionamos información sobre los resultados terapéuticos (en especial los negativos, pues los procesos de solución de problemas se estimularán por el feedback recibido. El presente trabajo presenta un inventario de evaluación, la evaluación estandarizada de los resultados y las diversas herramientas de feedback del modelo SH. Un estudio sistemático incluyendo 1715 pacientes de un hospital especializado en trastornos psicosomáticos documenta la validez de este abordaje. Los resultados empíricos refuerzan una estrategia de transparencia acerca de lo que acontece en la práctica clínica – por ejemplo, acerca de los tratamientos administrados, sus resultados y costos. Implicaciones para la posterior optimización de los servicios de salud son discutidos.

Consultation clinics for complementary and alternative medicine at Japanese university hospitals: An analysis at Tokushima University Hospital

Science.gov (United States)

YANAGAWA, HIROAKI; TERAO, JUNJI; TAKEDA, EIJI; TAKAISHI, YOSHIHISA; KASHIWADA, YOSHIKI; KAWAZOE, KAZUYOSHI; FUSHITANI, SHUJI; TSUCHIYA, KOICHIRO; YAMAUCHI, AIKO; SATO, CHIHO; IRAHARA, MINORU

2010-01-01

Here, we report on a Consultation Clinic for Complementary and Alternative Medicine (CAM) which we established at Tokushima University Hospital in July of 2007 with the aim of providing person-to-person information on CAM, though not CAM therapy itself. In December of 2008, we received 55 applications for consultation, 37% concerning health foods, 37% Japanese herbal medicine (Kampo), and 26% various other topics. The consultants (nutritionists and pharmacists) communicated individually with 38 applicants; malignancies (26%) and cardiovascular disease (24%) were the main underlying concerns. To promote the quality of consultation, data was collected by means of focus group interviews concerning the perspective of the consultants. Safe and effective use of CAM requires a network of communication linking individuals, consultation teams, physicians, primary care institutions and university hospitals. To advance this goal, we plan to broaden the efforts described herein. Our findings indicate that the specific role of the consultation clinic in promoting the scientific use of CAM merits further study. PMID:22993564

A consistent magnetic polarity stratigraphy of Plio-Pleistocene fluvial sediments from the Heidelberg Basin (Germany)

Science.gov (United States)

Scheidt, Stephanie; Hambach, Ulrich; Rolf, Christian

2014-05-01

Deep drillings in the Heidelberg Basins provide access to one of the thickest and most complete successions of Quaternary and Upper Pliocene continental sediments in Central-Europe [1]. In absence of any comprehensive chronostratigraphic model, these sediments are so far classified by lithological and hydrogeological criteria. Therefore the age of this sequence is still controversially discussed ([1], [2]). In spite of the fact that fluvial sediments are a fundamental challenge for the application of magnetic polarity stratigraphy we performed a thorough study on four drilling cores (from Heidelberg, Ludwigshafen and nearby Viernheim). Here, we present the results from the analyses of these cores, which yield to a consistent chronostratigraphic framework. The components of natural remanent magnetisation (NRM) were separated by alternating field and thermal demagnetisation techniques and the characteristic remanent magnetisations (ChRM) were isolated by principle component analysis [3]. Due to the coring technique solely inclination data of the ChRM is used for the determination of the magnetic polarity stratigraphy. Rock magnetic proxies were applied to identify the carriers of the remanent magnetisation. The investigations prove the NRM as a stable, largely primary magnetisation acquired shortly after deposition (PDRM). The Matuyama-Gauss boundary is clearly defined by a polarity change in each core, as suggested in previous work [4]. These findings are in good agreement with the biostratigraphic definition of the base of the Quaternary ([5], [6], [7]). The Brunhes-Matuyama boundary could be identified in core Heidelberg UniNord 1 and 2 only. Consequently, the position of the Jaramillo and Olduvai subchron can be inferred from the lithostratigraphy and the development of fluvial facies architecture in the Rhine system. The continuation of the magnetic polarity stratigraphy into the Gilbert chron (Upper Pliocene) allows alternative correlation schemes for the cores

Deutsches Krebsforschungszentrum Heidelberg. Report on scientific results 2002-2003

International Nuclear Information System (INIS)

2004-01-01

The Deutsches Krebsforschungszentrum Heidelberg (DKFZ, German Cancer Research Center) publishes alternating every year the ''Wissenschaftlicher Ergebnisbericht'' (in German) and the ''Research Report'' (in English). Both volumes are reports on the present state of research activities of the DKFZ as a National Research Center to the funding federal and state authorities [Federal Republic of Germany, Land (state) Baden-Wuerttemberg]. The report is structured according to the center's six research programs

Outpatient admissions and hospital costs of Syrian refugees in a Turkish university hospital.

Science.gov (United States)

Tahirbegolli, Bernard; Çavdar, Sabanur; Çetinkaya Sümer, Esin; Akdeniz, Sıdıka I; Vehid, Suphi

2016-07-01

To examine the most frequent admitted polyclinics, diagnoses, and the costs of Syrian refugee patient in a Turkish university hospital in the metropolitan city of Istanbul, Western part of Turkey.  Research methodology consist of analyzing outpatient admissions to the Hospital Polyclinics of Faculty of Medicine, Istanbul University, Cerrahpasa, Istanbul, Turkey from January-June 2014. We carried out diagnosis groups as classified in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification, and analyzed the hospital cost of first admission through records based in the hospital information system.  Median age of 251 Syrian refugee patients is 19 years, inter quartile rate 7-34 years. Patients aged 65 and older compared with those until 18 years and 19 to 64 years aged groups have made statistically significant (p less than 0.001) less hospital admissions. The Most frequented clinic was the emergency clinic. On June there have been significantly (p less than 0.001) more admissions compared with other months. The most common diagnoses were diseases of the respiratory system. The costs of per admission was estimated nearly 48 US Dollar/per patient and the total amount of hospital admissions was 12,031.93 US Dollar.  On the specified dates, the clinics were mostly frequented from Syrian refugees until 18 years group. The most common presenting symptoms are respiratory diseases and most frequented clinic is emergency.

Review of thromboembolic prophylaxis in patients attending Cork University Hospital.

Science.gov (United States)

Byrne, Stephen; Weaver, Daniel Timothy

2013-06-01

Although preventable, venous thromboembolism remains a common cause of hospital acquired morbidity and mortality. Guidelines, such as the one produced by the American College of Chest Physicians (ACCP), are aimed at reducing hospital associated venous thromboemboli. Unfortunately the majority of studies have revealed inadequate adherence to these guidelines. The objective of this study was to evaluate the use of venous thromboembolism prophylaxis at Cork University Hospital. Cork University Hospital, Wilton, Cork, Ireland. Data from the patient's chart, drug kardex and laboratory results were recorded during April 2010. A Caprini score, a venous thromboembolism risk factor assessment tool, was subsequently calculated for each patient based on data collected. Appropriate prophylaxis was determined after examining data collected, Caprini score and prophylactic regime according to the ACCP 8th edition guidelines. Primary outcome was to analyse adherence to VTE prophylaxis guidelines. A total of 394 patients met the inclusion criteria and were reviewed, of which, 60% (n = 236) were medical and 37% (n = 146) were surgical patients. In total 63% of patients received some form of venous thromboembolism prophylaxis. Furthermore, 54% of medical and 76% of surgical patients received prophylaxis. However only 37% of the patients studied received appropriate thromboprophylaxis according to the ACCP 8th edition guidelines (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). Additionally 51% of surgical and 27% of medical patients received appropriate prophylaxis. Data collected from Cork University Hospital revealed poor adherence to international venous thromboembolism prophylaxis guidelines. As stated in the ACCP 8th edition guidelines, every hospital should develop a formal strategy for venous thromboembolism prevention (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). In order to improve adherence to guidelines, Cork University Hospital should develop, implement and

Risk of malnutrition of hospitalized children in a university public hospital.

Science.gov (United States)

Muñoz-Esparza, Nelly Carolina; Vásquez-Garibay, Edgar Manuel; Romero-Velarde, Enrique; Troyo-Sanromán, Rogelio

2017-02-01

The study aimed to demonstrate that the duration of hospitalization has a significant effect on the nutritional status of children treated in a university hospital. A longitudinal study was conducted during 2014, with a non-random sampling site concentration in children from birth to 19 years who were admitted to the hospital in the past 24 hours and who met the inclusion criteria and had signed informed consent. Upon entering, at 7 days, and at discharge, anthropometric indices, including weight/age, height/age, weight/height, BMI/age, head circumference/age, triceps and subscapular skin folds, and fat percentage, were obtained. Student's t-test, U Mann-Whitney, ANOVA, chi square, Wilcoxon, and odds ratios were used to analyze the data. In total, 206 patients were included: 40% infants, 25% preschoolers, 15% schoolchildren, and 20% teenagers. Infants had a significant improvement from admission to discharge in the indices weight/length (p = 0.042) and BMI (p = 0.002); adolescents showed decreased BMI from admission to discharge from the hospital (p = 0.05). Patients with longer hospitalization (more than 10 days) had an increased deficit in anthropometric indices at admission (p malnutrition and require greater monitoring of nutritional status during hospitalization.

Duration of hospital stay following orthognathic surgery at the jordan university hospital.

Science.gov (United States)

Jarab, Fadi; Omar, Esam; Bhayat, Ahmed; Mansuri, Samir; Ahmed, Sami

2012-09-01

Major oral and maxillofacial surgery procedures have been routinely performed on an inpatient basis in order to manage both, the recovery from anesthesia and any unpredictable morbidity that may be associated with the surgery. The use of inpatient beds is extremely expensive and if the surgical procedures could be done on an outpatient setting, it would reduce the costs and the need for inpatient care. The aim was to determine the length of hospital stay (LHS) and the factors which influence the LHS following orthognathic surgery at the Jordan University Hospital over 5 years (2005-2009). This was a retrospective record review of patients who underwent orthognathic surgery at Jordan University Hospital between 2005 and 2009. The variables were recorded on a data capture form which was adapted and developed from previous studies. Descriptive and analytical statistical methods were used to correlate these variables to the LHS. Ninety two patients were included in the study and 74% of them were females. The mean age was 23.7 years and the mean LHS was 4 days. The complexity of the procedure, length of operation time, intensive care unit (ICU) stay and year of operation were significantly correlated with a positive LHS (P LHS over the progressing years and this could be due to an increase in experience and knowledge of the operators and an improvement in the hospital facilities.

Electronic signature for medical documents--integration and evaluation of a public key infrastructure in hospitals.

Science.gov (United States)

Brandner, R; van der Haak, M; Hartmann, M; Haux, R; Schmücker, P

2002-01-01

Our objectives were to determine the user-oriented and legal requirements for a Public Key Infrastructure (PKI) for electronic signatures for medical documents, and to translate these requirements into a general model for a signature system. A prototype of this model was then implemented and evaluated in clinical routine use. Analyses of documents, processes, interviews, observations, and of the available literature supplied the foundations for the development of the signature system model. Eight participants of the Department of Dermatology of the Heidelberg University Medical Center evaluated the implemented prototype from December 2000 to January 2001, during the course of an intervention study. By means of questionnaires, interviews, observations and database analyses, the usefulness and user acceptance of the electronic signature and its integration into electronic discharge letters were established. Since the major part of medical documents generated in a hospital are signature-relevant, they will require electronic signatures in the future. A PKI must meet the multitude of responsibilities and security needs required in a hospital. Also, the signature functionality must be integrated directly into the workflow surrounding document creation. A developed signature model, fulfilling user-oriented and legal requirements, was implemented using hard and software components that conform to the German Signature Law. It was integrated into the existing hospital information system of the Heidelberg University Medical Center. At the end of the intervention study, the average acceptance scores achieved were mean = 3.90; SD = 0.42 on a scale of 1 (very negative attitude) to 5 (very positive attitude) for the electronic signature procedure. Acceptance of the integration into computer-supported discharge letter writing reached mean = 3.91; SD = 0.47. On average, the discharge letters were completed 7.18 days earlier. The electronic signature is indispensable for the

Hospital enterprise Architecture Framework (Study of Iranian University Hospital Organization).

Science.gov (United States)

Haghighathoseini, Atefehsadat; Bobarshad, Hossein; Saghafi, Fatehmeh; Rezaei, Mohammad Sadegh; Bagherzadeh, Nader

2018-06-01

Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals. Copyright © 2018 Elsevier B.V. All rights reserved.

Integration von Schulungsveranstaltungen der Bibliothek ins Curriculum - am Beispiel der Fakultät für Klinische Medizin Mannheim der Universität Heidelberg

Directory of Open Access Journals (Sweden)

Semmler-Schmetz, Martina

2005-09-01

Full Text Available In the winter semester 2004/05 the Faculty for Clinical Medicine Mannheim of Heidelberg University implemented the new Querschnittsschein "Epidemiology, medical biometrics and medical informatics" and integrated the first library instructional classes into its medical curriculum. In order to meet the new requirements the medical library established an instructional team that designed tailor-made courses for the student target group and put into practice the experiences gathered both in workshops (such as the continuing education course "Teaching Library" offered by the BIB in May 2004 and from the relevant literature. With a maximum participation of library staff almost all of the first clinical semster medical students finished three different instructional modules of the beginners and intermediate skill levels. Resonance to these courses was ascertained by evaluation forms completed by the participants immediately after the classes. The feedback was predominantly positive, and the members of the instructional team unanimously regarded the experiences made as new and inspiring. As a further development of the orientation and instruction classes integrated in the curriculum the medical library intends to participate in the navigation system LOTSE of the Universitäts- und Landesbibliothek Münster starting in the academic year 2005/06. Moreover, by then, one of the aforementioned classes is planned to be offered on the e-Learning platform ATHENA of Heidelberg University.

Hospitality Major Vocational High School Students' Expectations on University Education

Science.gov (United States)

Chung, Ya-Ting; Yang, Cheng-Cheng

2013-01-01

Hospitality is not a new industry in Asia, but high quality hospitality industry has become more and more important in the trend of questing service-based economy and the increasing number of tourists in Asia. Thus there are more universities opened hospitality degree programs in Asia, Taiwan is no exception. In this context, why high school…

An international course on strategic information management for medical informatics students: aim, content, structure, and experiences

NARCIS (Netherlands)

Haux, R.; Ammenwerth, E.; ter Burg, W. J.; Pilz, J.; Jaspers, M. W. M.

2004-01-01

We report on a course for medical informatics students on hospital information systems, especially on its strategic information management. Starting as course at the Medical Informatics Program of the University of Heidelberg/University of Applied Sciences Heilbronn, it is now organized as

Healthcare professionals' work engagement in Finnish university hospitals.

Science.gov (United States)

Lepistö, Sari; Alanen, Seija; Aalto, Pirjo; Järvinen, Päivi; Leino, Kaija; Mattila, Elina; Kaunonen, Marja

2017-10-10

Concerns about the sufficiency and dedication of the healthcare workforce have arisen as the baby boomer generation is retiring and the generation Y might have different working environment demands. To describe the association between work engagement of healthcare professionals' and its background factors at five Finnish university hospitals. Survey data were collected from nurses, physicians and administrative staff (n = 561) at all five university hospitals in Finland. Data were collected using an electronic questionnaire that comprised the Utrecht Work Engagement Scale (9 items) and 13 questions regarding the respondents' backgrounds. Descriptive and correlational analyses were used to examine the data. Most respondents were female (85%) and nursing staff (72%). Baby boomers (49%) were the largest generational cohort. The work engagement composite mean for the total sample was 5.0, indicating high work engagement. Significant differences in work engagement existed only among sex and age groups. The highest work engagement scores were among administrative staff. Work engagement among healthcare professionals in Finnish university hospitals is high. High work engagement might be explained by suitable job resources and challenges, as well as opportunities provided by a frontline care environment. Attention should especially be paid to meeting the needs of young people entering the workforce to strengthen their dedication and absorption. © 2017 Nordic College of Caring Science.

[Subjective Workload, Job Satisfaction, and Work-Life-Balance of Physicians and Nurses in a Municipal Hospital in a Rural Area Compared to an Urban University Hospital].

Science.gov (United States)

Körber, Michael; Schmid, Klaus; Drexler, Hans; Kiesel, Johannes

2018-05-01

Medical and nursing shortages in rural areas represent a current serious public health problem. The healthcare of the rural population is at risk. This study compares perceived workload, job satisfaction and work-life balance of physicians and nurses at a clinic in a rural area with two clinics of a University hospital. Physicians and nurses were interviewed anonymously with a standardized questionnaire (paper and pencil), including questions on job satisfaction, subjective workload and work-life balance. The response rate was almost 50% in the University hospital as well as in the municipal hospital. 32 physicians and 54 nurses from the University hospital and 18 physicians and 137 nurses from the municipal hospital participated in the survey. Nurses at the University hospital assessed the organization of the daily routine with 94.1% as better than those at the municipal hospital (82.4%, p=0.03). Physicians at the University hospital were able to better implement acquired knowledge at a University clinic with 87.5% than their counterparts at the municipal hospital (55.5%, p=0.02). In contrast to their colleagues at the municipal hospital, only 50% of the physicians at the University hospital subjectively considered their workload as just right (83.3% municipal, p=0.02). 96.9% of the physicians at the University hospital were "daily" or "several times a week" under time pressure (municipal 50%, pwork and family life (62.9% University hospital, 72.8% Municipal hospital). In contrast, only 20% of the physicians at the University Hospital but 42.9% of the physicians of the municipal hospital had sufficient opportunities to balance workload and family (p=0.13). The return rate of almost 50% can be described as good. Due to the small number of physicians, especially from the municipal hospital, it can be assumed that some interesting differences could not be detected. There were only slight differences between the nurses from the two hospitals. In contrast, subjective

Impact of the choice of reference genome on the ability of the core genome SNV methodology to distinguish strains of Salmonella enterica serovar Heidelberg.

Science.gov (United States)

Usongo, Valentine; Berry, Chrystal; Yousfi, Khadidja; Doualla-Bell, Florence; Labbé, Genevieve; Johnson, Roger; Fournier, Eric; Nadon, Celine; Goodridge, Lawrence; Bekal, Sadjia

2018-01-01

Salmonella enterica serovar Heidelberg (S. Heidelberg) is one of the top serovars causing human salmonellosis. The core genome single nucleotide variant pipeline (cgSNV) is one of several whole genome based sequence typing methods used for the laboratory investigation of foodborne pathogens. SNV detection using this method requires a reference genome. The purpose of this study was to investigate the impact of the choice of the reference genome on the cgSNV-informed phylogenetic clustering and inferred isolate relationships. We found that using a draft or closed genome of S. Heidelberg as reference did not impact the ability of the cgSNV methodology to differentiate among 145 S. Heidelberg isolates involved in foodborne outbreaks. We also found that using a distantly related genome such as S. Dublin as choice of reference led to a loss in resolution since some sporadic isolates were found to cluster together with outbreak isolates. In addition, the genetic distances between outbreak isolates as well as between outbreak and sporadic isolates were overall reduced when S. Dublin was used as the reference genome as opposed to S. Heidelberg.

Maximizing time from the constraining European Working Time Directive (EWTD): The Heidelberg New Working Time Model.

Science.gov (United States)

Schimmack, Simon; Hinz, Ulf; Wagner, Andreas; Schmidt, Thomas; Strothmann, Hendrik; Büchler, Markus W; Schmitz-Winnenthal, Hubertus

2014-01-01

The introduction of the European Working Time Directive (EWTD) has greatly reduced training hours of surgical residents, which translates into 30% less surgical and clinical experience. Such a dramatic drop in attendance has serious implications such compromised quality of medical care. As the surgical department of the University of Heidelberg, our goal was to establish a model that was compliant with the EWTD while avoiding reduction in quality of patient care and surgical training. We first performed workload analyses and performance statistics for all working areas of our department (operation theater, emergency room, specialized consultations, surgical wards and on-call duties) using personal interviews, time cards, medical documentation software as well as data of the financial- and personnel-controlling sector of our administration. Using that information, we specifically designed an EWTD-compatible work model and implemented it. Surgical wards and operating rooms (ORs) were not compliant with the EWTD. Between 5 pm and 8 pm, three ORs were still operating two-thirds of the time. By creating an extended work shift (7:30 am-7:30 pm), we effectively reduced the workload to less than 49% from 4 pm and 8 am, allowing the combination of an eight-hour working day with a 16-hour on call duty; thus, maximizing surgical resident training and ensuring patient continuity of care while maintaining EDTW guidelines. A precise workload analysis is the key to success. The Heidelberg New Working Time Model provides a legal model, which, by avoiding rotating work shifts, assures quality of patient care and surgical training.

ASSESSMENT OF BENZOPHENANTHRIDINE AND PROTOPINE ALKALOIDS IN BROILER CHALLENGED AND NOT BY SALMONELLA HEIDELBERG

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PFG Previato do Amaral

Full Text Available ABSTRACT Salmonellosis is a globally important zoonosis, and Salmonella Heidelberg is one of the most prevalent serovars in poultry production worldwide, as well as in food poisoning cases. Antimicrobial drugs were previously widely used to face health challenges in animal production; however, since their ban as performance enhancers, many alternative strategies have been proposed. One of these strategies is the use of plant extracts, such as those containing the alkaloids benzophenanthridine and protopine. These compounds have antimicrobial, anti-inflammatory, immunomodulation, and nutritional effects. The objective of the present study was to evaluate the effects of the supply of a product containing benzophenanthridine and protopine (Sangrovit(rWS 100 g/1000 L of drinking water to broilers during different rearing periods 1-21, 1-6 and 6-21 days of age challenged or not with Salmonella Heidelberg at six days of age. There was no effect of the product on the performance, jejunal morphometry, cecal goblet cell counts, or control of Salmonella spp. in broilers challenged or not with Salmonella Heidelberg. However, the group receiving the alkaloids from 1 to 21 days of age, compared with the control group, presented a numerical difference of 28 points in productive efficiency index, which directly impacts live production cost of live broiler, representing savings of R$ 0.11/kg of meat produced.

[Description of current hypnosis practice in French university hospitals].

Science.gov (United States)

Chabridon, G; Nekrouf, N; Bioy, A

2017-10-01

Hypnosis is very fashionable as an entertainment through TV shows searching for new sensational experiences. What about its practice in the medical world? The aim of this article is to answer to this question. Therefore, we contacted every French University Hospital of each region to find out if hypnosis was practiced for the care of pain (hypnoanalgesia), for chirurgical procedures (hypnosedation) and in adult psychiatry care units (hypnotherapy). For this last practice, we also questioned the type of indications. All 30 of the French University Hospitals had replied by November 2015. Hypnoanalgesia is practiced by all and two-thirds offer hypnosedation. Hypnotherapy is practiced by 40 % of the University Hospitals, 91,7 % for anxiety disorders, 66,7 % for psychotraumatic care and 25 % for mood disorders. Therefore, hypnosis seems to have found its place in the care of pain and as an anesthetic to replace standard procedures. However, the use of hypnotherapy in psychiatry is less frequent, indications for its use being variable and not very consensual. Copyright © 2016 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Genotypic relatedness and antimicrobial resistance of Salmonella Heidelberg isolated from chickens and turkeys in the midwestern United States.

Science.gov (United States)

Nisar, Muhammad; Kassem, Issmat I; Rajashekara, Gireesh; Goyal, Sagar M; Lauer, Dale; Voss, Shauna; Nagaraja, Kakambi V

2017-05-01

Salmonella is one of the most common causes of foodborne illnesses in humans in the United States, and domestic poultry is considered an important source of this pathogen. Salmonella enterica subsp. enterica serovar Heidelberg is the fourth most commonly reported Salmonella from retail meats and food animals in the United States. We assessed the genotypes and antimicrobial resistance phenotypes of Salmonella Heidelberg isolated from various chicken and turkey hatcheries and breeder farms in the Midwest. The genotypes of 33 S. Heidelberg isolates from chickens ( n = 19) and turkeys ( n = 14) were compared using pulsed-field gel electrophoresis analysis. Cluster analysis of the fingerprints showed that the majority of the chicken isolates grouped together with 87% similarity; those from turkeys clustered with 88% similarity. Similarity between chicken and turkey isolates was also high (86%). Isolates from turkeys were generally more genetically diverse than those from chickens. Antimicrobial susceptibility analysis detected resistance to sulfisoxazole (36% of the isolates), streptomycin (33%), gentamicin (27%), tetracycline (24%), ampicillin and amoxicillin-clavulanic acid (15%), cefoxitin (12%), ceftriaxone and ceftiofur (12%), and chloramphenicol (9%). None of the isolates was resistant to azithromycin, ciprofloxacin, or nalidixic acid. Although the number of the isolates was limited in our study, we conclude that S. Heidelberg isolates from the same host generally clustered together and that a considerable number of the isolates were resistant to a number of antimicrobial agents.

Pelvic Organ Prolapse in Jimma University Specialized Hospital ...

African Journals Online (AJOL)

Pelvic Organ Prolapse in Jimma University Specialized Hospital, Southwest Ethiopia. ... and there was a significant association between prolapse and residence area. ... Awareness creation on risk factors of pelvic organ prolapse and use of ...

Geneva University - Cancelled

CERN Multimedia

Université de Genève

2010-01-01

École de physique - Département de physique nucléaire et corspusculaire 24, quai Ernest-Ansermet 1211 GENEVA 4 Tel: (022) 379 62 73 - Fax: (022) 379 69 92 Monday 19 April 2010 17h00 - Stückelberg Auditorium Into the darkness: Simulating the distribution of dark matter in our Universe Prof. Volker Springel - Heidelberg Institute for Theoretical Studies   THE COLLOQUIUM IS CANCELLED. Prof. Markus Büttiker

Implementation of a radiology information system in an University Hospital

International Nuclear Information System (INIS)

Marques, Paulo Mazzoncini de Azevedo; Santos, Antonio Carlos; Elias Junior, Jorge; Trad, Clovis Simao; Goes, Wilson Moraes; Castro, Carlos Roberto de

2000-01-01

This paper describes a radiology information system (RIS) developed and in the process of implementation in an University Hospital (Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - Universidade de Sao Paulo) which integrates a plan for a 'filmless' radiology facility. (author)

Food Grade Pimenta Leaf Essential Oil Reduces the Attachment of Salmonella enterica Heidelberg (2011 Ground Turkey Outbreak Isolate on to Turkey Skin

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Divek V. T. Nair

2017-11-01

Full Text Available Salmonella attached to the poultry skin is a major source of carcass contamination during processing. Once attached to the poultry skin, it is difficult to detach and inactivate Salmonella by commonly used antimicrobial agents since the pathogen is entrapped deeply in the feather follicles and the crevices on the skin. Essential oils could be natural, safe, and effective alternatives to synthetic antimicrobial agents during commercial and organic processing setup. The present study evaluated the efficacy of pimenta (Pimenta officinalis Lindl. leaf essential oil (PEO, and its nanoemulsion in reducing Salmonella Heidelberg attachment on to turkey (Meleagris gallopavo skin during simulated scalding (65°C and chilling (4°C steps in poultry processing. A multidrug resistant S. Heidelberg isolate from the 2011 ground turkey outbreak in the United States was used in the study. Results showed that PEO and the nanoemulsion resulted in significant reduction of S. Heidelberg attachment on turkey skin. Turkey skin samples treated with 1.0% PEO for 5 min resulted in >2 log10 CFU/sq. inch reduction of S. Heidelberg at 65 and 4°C, respectively (n = 6; P < 0.05. Similarly, skin samples treated with 1.0% pimenta nanoemulsion (PNE for 5 min resulted in 1.5- and 1.8- log10 CFU/sq. inch reduction of S. Heidelberg at 65 and 4°C, respectively (n = 6; P < 0.05. In addition, PEO and PNE were effective in reducing S. Heidelberg on skin during short-term storage at 4 and 10°C (temperature abuse (n = 6; P < 0.05. No Salmonella was detected in the dipping solution containing 0.5 or 1.0% PEO or PNE, whereas a substantial population of the pathogen survived in the control dipping solution. The results were validated using scanning electron -, and confocal - microscopy techniques. PEO or PNE could be utilized as an effective antimicrobial agent to reduce S. Heidelberg attachment to turkey skin during poultry processing.

Design of a game-based pre-hospital resuscitation training for first responders

NARCIS (Netherlands)

Kalz, Marco; Schmitz, Birgit; Biermann, Henning; Klemke, Roland; Ternier, Stefaan; Specht, Marcus

2013-01-01

Kalz, M., Schmitz, B., Biermann, H., Klemke, R., Ternier, S., & Specht, M. (2013). Design of a game-based pre-hospital resuscitation training for first responders. In A. Holzinger, M. Ziefle, & V. Glavinić (Eds.), SouthCHI 2013, LNCS 7946 (pp. 363-372). Germany: Springer, Heidelberg.

Validation of cooking methods using shell eggs inoculated with Salmonella serotypes Enteritidis and Heidelberg.

Science.gov (United States)

Davis, A L; Curtis, P A; Conner, D E; McKee, S R; Kerth, L K

2008-08-01

Salmonella enterica serotype Enteritidis has long been associated with eggs, and more recently, Salmonella enterica serotype Heidelberg has also become associated with eggs. This study was undertaken to determine whether Salmonella Enteritidis and Salmonella Heidelberg are effectively eliminated from eggs by various cooking methods. Seven cooking methods were chosen--hard and soft cooked, scrambled, over easy, sunny-side up, poached, and free poached--and a pan insert and the free-flowing method were used. Shell eggs, purchased from a grocery store, were inoculated with Salmonella and cooked. The cooked eggs were analyzed by USDA-approved methods for Salmonella recovery. Findings indicated that existing cooking methods for the hard-cooked, soft-cooked, and poaching methods were safe. However, the same was not true for the current sunny-side-up, over-easy, and scrambled egg cooking methods.

The role of expectations in patients' hospital assessments: a Turkish university hospital example.

Science.gov (United States)

Bakar, Coskun; Akgün, H Seval; Al Assaf, A F

2008-01-01

This paper aims to conduct a preliminary assessment of patient attitudes regarding important aspects of service dimensions using SERVQUAL. The SERVQUAL scale is routinely used at the Baskent University Hospitals Network, Turkey. The study consisted of 550 randomly chosen patients who presented to any member of the hospital network during January and February 2006 and received treatment as inpatients or outpatients at those healthcare facilities. The patients' perceived scores were higher than expected for an ordinary hospital but lower than expected for a high-quality hospital. Young patients had a high-expected service score gap and a low adequate service score difference. Highly educated patients had a high-expected service score difference. Uninsured patients had a low adequate service score difference. Baskent University multidisciplinary healthcare teams have performed periodic patient satisfaction surveys in order to identify strengths and problem areas, formulate the quality improvement objectives and monitor progress towards achieving these objectives. However, patient satisfaction survey results are often highly positive. In these cases, improving care is not easy because measures are not sensitive enough to changes. Therefore a more sensitive measurement tool based on the SERVQUAL scale was developed. The authors believe that patient opinions are extremely important because they provide information that is not necessarily emphasized by managers or health care professionals, resulting in a more complete assessment of past performance and a clearer road map for future action.

[The role of university hospital executive board members].

Science.gov (United States)

Debatin, J F; Rehr, J

2009-09-01

Demographic changes and medical progress in combination with vastly altered regulatory and economic environments have forced considerable change in the structure of German university hospitals in recent years. These changes have affected medical care as well as research and medical school training. To allow for more flexibility and a higher level of reactivity to the changing environment German university hospitals were transferred from state agencies to independent corporate structures. All but one remains wholly owned by the respective state governments. The governing structure of these independent medical hospitals consists of an executive board, generally made up of a medical director, a financial director, a director for nursing, and the dean of the medical faculty. In most hospitals, the medical director serves as chief executive officer. The regulations governing the composition and responsibility of the members of the executive board differ from state to state. These differences do affect to some degree the interactive effectiveness of the members of the executive boards. Modalities that stress the overall responsibility for all board members seem to work better than those that define clear portfolio limits. Even more than organizational and regulatory differences, the effectiveness of the work of the executive boards is influenced by the personality of the board members themselves. Success appears to be a clear function of the willingness of all members to work together.

Health workers' ICT literacy in a Nigerian University Teaching Hospital

African Journals Online (AJOL)

This study investigated the ICT literacy among the health workers of Igbinedion University Teaching Hospital. The emergence of Internet for Telemedicine and health information revolution necessitates that issue of computer and other communication technology literacy among the health workers of Igbinedion University ...

Histopathological diagnosis of eyelid tumors in Chiang Mai University Hospital.

Science.gov (United States)

Nithithanaphat, Chanut; Ausayakhun, Sakarin; Wiwatwongwana, Damrong; Mahanupab, Pongsak

2014-10-01

To report the histopathological diagnosis ofeyelid tumors and to study the prevalence of eyelid tumors in Chiang Mai University Hospital Chiang Mai, Thailand. A retrospective review of medical and pathological records ofpatients diagnosed as eyelid tumor that underwent histopathological biopsy between January 2007 and December 2013 in Chiang Mai University Hospital was done. Three hundred sixteen cases of eyelid tumors were reviewed. The mean age at diagnosis was 54.2 +/- 19.6 years (range 1 month-99 years), women were 59.5% (n = 188) and men 40.5% (n = 128). The tumor sites were left lower eyelid (27.5%), right upper eyelid (24.4%), right lower eyelid (21.2%), and left upper eyelid (18.7%). There were 204 (64.6%) benign tumors and 112 (35.4%) malignant tumors. Nevi were the most common in benign group (16.4%) and basal cell carcinoma was the most common eyelid malignancy (18.0%). The most common histopathological diagnosis for benign eyelid tumor was nevus, while the most common malignant eyelid tumor was basal cell carcinoma at Chiang Mai University Hospital.

Assessment of Patient Safety Friendly Hospital Initiative in Three Hospitals Affiliated to Tehran University of Medical Sciences

Directory of Open Access Journals (Sweden)

Firoozeh Bairami

2016-01-01

Full Text Available Introduction: The aim of this study was to assess the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences, based on the critical standards of Patient Safety Friendly Hospital Initiative (PSFHI. Materials and Methods:In this cross-sectional study, conducted in 2014, we used PSFHI assessment tool to evaluate the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences; these general referral hospitals were selected purposefully. PSFHI assessment tool is comprised of 140 patient safety standards in five domains, categorized in 24 sub-domains. The five major domains include leadership and management, patient and public involvement, safe evidence-based clinical practices, safe environment, and lifelong learning. Results: All three hospitals met more than 70% of the critical standards. The highest score in critical standards (> 80% was related to the domain of leadership and management in all hospitals. The average score in the domain of safe evidence-based clinical practices was 70% in the studied hospitals. Finally, all the hospitals met 50% of the critical standards in the domains of patient and public involvement and safe environment. Conclusion: Based on the findings, PSFHI is a suitable program for meeting patient safety goals. The selected hospitals in this survey all had a high managerial commitment to patient safety; therefore, they could obtain high scores on critical standards.

Psychiatric comorbidities in a young man with subacute myelopathy induced by abusive nitrous oxide consumption: a case report

OpenAIRE

Mancke, Falk; Kaklauskait?, Gintar?; Kollmer, Jennifer; Weiler, Markus

2016-01-01

Falk Mancke,1,2,* Gintare Kaklauskaite,1,* Jennifer Kollmer,3 Markus Weiler1 1Department of Neurology, 2Department of General Psychiatry, Center for Psychosocial Medicine, 3Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany *These authors contributed equally to this work Abstract: Nitrous oxide (N2O), a long-standing anesthetic, is known for its recreational use, and its consumption is on the rise. Several case studies have reported neurological and psychiatric ...

Can soda fountains be recommended in hospitals?

Science.gov (United States)

Chaberny, Iris F; Kaiser, Peter; Sonntag, Hans-Günther

2006-09-01

Mineral water (soda water) is very popular in Germany. Therefore, soda fountains were developed as alternatives to the traditional deposit bottle system. Nowadays, different systems of these devices are commercially available. For several years, soda fountains produced by different companies have been examined at the University Hospital of Heidelberg. In 1998, it was possible for the first time to observe and evaluate one of these systems over a period of 320 days in a series of microbiological examinations. The evaluation was implemented on the basis of the German drinking water regulation (Anonymous, 1990. Gesetz über Trinkwasser und Wasser für Lebensmittelbetriebe (Trinkwasserverordnung - TrinkwV) vom 12. Dezember 1990. Bundesgesetzblatt 66, 2613ff). Initially, the bacteria counts exceeded the reference values imposed by the German drinking water regulation in almost 50% of the analyses. Pseudomonas aeruginosa was also detected in almost 38% of the samples. After a re-arrangement of the disinfection procedure and the removal of the charcoal filter, Pseudomonas aeruginosa was not detectable any more. However, the bacteria counts still frequently exceeded the reference values of the German drinking water regulation. Following our long-term analysis, we would not recommend soda fountains in high-risk areas of hospitals. If these devices are to be used in hospitals, the disinfection procedures should be executed in weekly or fortnightly intervals and the water quality should be examined periodically.

An induction accelerator for the Heidelberg Test Storage Ring TSR

International Nuclear Information System (INIS)

Ellert, C.; Habs, D.; Music, M.; Schwalm, D.; Wolf, A.; Jaeschke, E.; Kambara, T.; Sigray, P.

1992-01-01

An induction accelerator has been installed in the heavy ion test storage ring TSR in Heidelberg. It allows for constant acceleration or deceleration of stored coasting ion beams without affecting their velocity profile and is well suited for ion beam manipulation in cooling experiments and for measurements of velocity dependent cooling forces. The design and operation of the device and first applications to laser cooling and to measurements of laser and electron cooling forces are described. (orig.)

Search for cold and hot dark matter with the Heidelberg-Moscow experiment, HDMS, GENIUS and GENIUS-TF

International Nuclear Information System (INIS)

Klapdor-Kleingrothaus, H.V.; Dietz, A.; Krivosheina, I.V.

2003-01-01

The recent result from the Heidelberg-Moscow double beta experiment allows neutrinos still to play an important role as hot dark matter in the Universe. HDMS has started in 2001 its search for cold dark matter (WIMPS), with a HPGe crystal of enriched 73 Ge. Concerning hot dark matter, GENIUS will improve the present accuracy for the (effective) neutrino mass. At the same time GENIUS will extend the range of sensitivity in an unprecedented way to cover a wide range of the parameter space of SUSY parameters for neutralinos as cold dark matter. A GENIUS Test Facility in the Gran Sasso has been approved in 2001 and will come into operation by end of 2002. Finally some comments are given to some criticism of the result presented elsewhere

Knowledge of the mothers of hospitalized children in a university hospital regarding diarrhea

Directory of Open Access Journals (Sweden)

Ana Paula do Rego

2014-04-01

Full Text Available This qualitative research aimed at identifying the knowledge of the mothers regarding diarrhea. It was conducted with eight mothers of hospitalized children in a university hospital located in Santa Cruz, Rio Grande do Norte, Brazil, in 2012. Data were collected through open interviews and the analysis was based on Bardin. The categories emerging from the analysis were: understanding diarrhea and preventing/treating diarrhea. Regarding the understanding of diarrhea, mothers conceptualize and understand it from the symptoms, habits/eating mistakes and/or cultural beliefs. Concerning the prevention and treatment of the disease, the mothers highlight hygiene and home cleaning as preventive measures, as well the importance of home and hospital care measures. The interviewees have basic knowledge of pathology, further studies are necessary in order to define the current gap between the knowledge of mothers and recurrence of diarrhea cases, resulting in hospitalization and expenses with unnecessary treatment.

Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

Energy Technology Data Exchange (ETDEWEB)

Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

2010-10-15

The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

Quality of life at work among nurses of a university hospital

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Eliane de Fátima Almeida Lima

2013-12-01

Full Text Available The objective of this cross-sectional study was to evaluate the quality of life at work of nurses from a university hospital, between January and April of 2011. A sample of 90 nurses answered the WHOQOL-Bref and a questionnaire addressing their sociodemographic profile and working conditions. Most subjects were female, aged between 23 and 40 years, married, and holding a specialization degree. The Physical domain had the highest mean (73.05 and the Environment domain the lowest (63.12. Subjects with the best scores in the quality of life domains were male, married, public servants, holding a master’s/doctorate degree, and working three jobs or more. The chosen instrument allowed for outlining the nurses’ profile and learning the domains and variables that affect their quality of life. It is suggested that university hospitals encourage nurses to pursue a stricto sensu graduate course. Descriptors: Quality of Life; Nurses, Male; Working Conditions; Hospitals, University.

From bibliometric analysis to research policy: the use of SIGAPS in Lille University Hospital.

Science.gov (United States)

Devos, Patrick; Lefranc, Helene; Dufresne, Eric; Beuscart, Regis

2006-01-01

In French hospitals, the progressive setting up of the new rating systems has obliged the university hospitals to justify a certain amount of activities such as research, training or moreover recourse, which are specific missions of the university hospitals. In order to justify research activities, the Lille University Hospital has developed for now three years SIGAPS, a full-web bibliometric software which census and analyse, the scientific publications referenced in the Medline database. After data downloading, each article is classified on a 6 levels "quality scale derived from the impact factors. The system then performs, for a researcher or a team, a report allowing a quantitative and qualitative analysis. Started in Lille in November 2004, the inventory and analysis of data is now ending. For the period 2001-2004, 2814 articles have been published in 700 different journals. The total number of articles increased from 688 in 2001 to 757 in 2004. The mean impact factor was equal to 2.26 and 15.5 % of articles were classified as A, 20.9% as B. Those results confirm the high level of research of the University Hospital of Lille, in agreement with two other national studies which ranks our establishment at the 6th position for medical research activities among the French University Hospitals. Currently a similar evaluation has now began in the 9 other university hospital which have subscribed to the SIGAPS project. We works currently on new indicators as patents, thesis or conferences, or access to other databases as Sciencedirect or Scopus via the RIS format. The next step in the project is the implementation of a meta-base which will federate the information provided by each SIGAPS system. This meta-base will then allow us to perform comparisons between different hospitals, determine the national "sites of excellence" and create some clinical and research networks.

Abdominal Injuries in University of Port Harcourt Teaching Hospital

African Journals Online (AJOL)

operative findings, postoperative complications, and outcome of management. Data analysis was performed using the Statistical Package for Social Sciences version 16. Abdominal Injuries in University of Port Harcourt. Teaching Hospital. Amabra ...

Career path determinants of Eco-Tourism and Hospitality Management university graduates

Directory of Open Access Journals (Sweden)

Antoneta Njeri Kariru

2013-01-01

Full Text Available There has been an increase in the number of hospitality management university graduates working in non hospitality organizations in Kenya. Despite this, studies have not been undertaken to investigate the factors that influence these graduates’ career decisions. The purpose of this study was thus to investigate the career path determinants of Maseno University’s hospitality management graduates. The population of study was ecotourism, hotel and institution management graduates of Maseno University working within and outside the hospitality industry. 150 respondents, from the sampling frame consisting of students who graduated between the years 2005 and 2010, were selected through snowballing. Structured questionnaires were self-administered to the respondents. Frequencies, percentages, means, factor loadings and regressions were computed and presented using SPSS version 17. The study revealed that the graduates’ major career path determinants are unpredictable events, career satisfaction levels, chance and permanency of career.

Changing the Business Model of a Distance Teaching University

NARCIS (Netherlands)

Koper, Rob

2014-01-01

Reference: Koper, E.J.R. (2014) Changing the Business Model of a Distance Teaching University. In R. Huang, Kinshuk, Price, J.K. (eds.), ICT in Education in Global Context: emerging trends report 2013-2014, Lecture Notes in Educational Technology, Heidelberg: Springer Verlag, pp. 185-203 ISBN

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

Science.gov (United States)

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

2015-11-01

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

Overviewof Contraceptive Use In Jos University Teaching Hospital ...

African Journals Online (AJOL)

Background: Modern contraceptive methods accepted by 17,846 new clients in Jos University Teaching Hospital, a tertiary health institution, over two decades are presented. Methods: This was a review of the contraceptive trend in new clients who used the various methods of contraception over an 18-year period, ...

Outpatient waiting time in Jos University Teaching Hospital ...

African Journals Online (AJOL)

Problem Long waiting time for services has been identified as a reason people avoid presenting to for care in African countries. Design Examination of causes for long outpatient waiting time and the effect of measures to reduce waiting time. Setting Outpatient department of the Jos University Teaching Hospital.

Childhood pneumonia at the University of Ilorin Teaching Hospital ...

African Journals Online (AJOL)

owner

2013-01-09

Jan 9, 2013 ... which was significantly higher ... University of Ilorin Teaching Hospital between 1st July ..... two organisms formed more than 40% of the isolates. ... Educational Services; 2007:425-. 41. 3. ... Brazilian children in a metropoli-.

Ectopic Pregnancy in Lagos State University Teaching Hospital ...

African Journals Online (AJOL)

We set out to determine the socio-demographic factors,pattern of presentation and management of ectopic pregnancy in a University Teaching Hospital in Lagos, Nigeria. A retrospective descriptive analysis of all cases of ectopic pregnancy over a 2-year period was carried out. The case notes were retrieved from the ...

Web-based training in German university eye hospitals - Education 2.0?

Science.gov (United States)

Handzel, Daniel M; Hesse, L

2011-01-01

To analyse web-based training in ophthalmology offered by German university eye hospitals. In January 2010 the websites of all 36 German university hospitals were searched for information provided for visitors, students and doctors alike. We evaluated the offer in terms of quantity and quality. All websites could be accessed at the time of the study. 28 pages provided information for students and doctors, one page only for students, three exclusively for doctors. Four pages didn't offer any information for these target groups. The websites offered information on events like congresses or students curricular education, there were also material for download for these events or for other purposes. We found complex e-learning-platforms on 9 pages. These dealt with special ophthalmological topics in a didactic arrangement. In spite of the extensive possibilities offered by the technology of Web 2.0, many conceivable tools were only rarely made available. It was not always possible to determine if the information provided was up-to-date, very often the last actualization of the content was long ago. On one page the date for the last change was stated as 2004. Currently there are 9 functional e-learning-applications offered by German university eye hospitals. Two additional hospitals present links to a project of the German Ophthalmological Society. There was a considerable variation in quantity and quality. No website made use of crediting successful studying, e.g. with CME-points or OSCE-credits. All German university eye hospitals present themselves in the World Wide Web. However, the lack of modern, technical as well as didactical state-of-the-art learning applications is alarming as it leaves an essential medium of today's communication unused.

Universal isolation precautions for patients at an academic hospital

OpenAIRE

Maziero,Vanessa Gomes; Vannuchi,Marli Terezinha Oliveira; Vituri,Dagmar Willamourius; Haddad,Maria do Carmo Lourenço; Tada,Cristiane Nakaya

2012-01-01

OBJECTIVE: To apply universal isolation precautions for patients at an academic hospital by a nursing team. METHODS: This descriptive and prospective study used data from advice service of quality control and nursing care that were gathered in observational reports of universal isolation precautions for patients admitted in two surgical inpatient units during 2008 and 2010. RESULTS: The mean general classification for both units was between desirable and adequate in the observational analysis...

Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

Science.gov (United States)

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.

Combined PACS and intranet information system in a University Hospital

International Nuclear Information System (INIS)

Heiss, D.; Pfluger, T.; Pfeifer, K.J.; Hahn, K.; Koenig, A.; Endres, S.

2000-01-01

Purpose: The Department of Radiology at the University Hospital Innenstadt Munich provides all clinical departments of a large university hospital with several radiology units at different locations. During the last four years all units have been fully digitalized with a stepwise installation of a PACS. The PACS also processes images from the Nuclear Medicine Department. Methods: As image modalities, archive systems and review workstations, we use devices from multiple vendors, which are integrated into a consistent system using the DICOM standard. The hospital has developed its own RIS and an intranet information system, which provides access to all reports and images from radiology for all clinical departments inside the hospital. Additionally, other clinical information such as laboratory results or ECG examinations are available through the system. Results: After one year of operation, the system succeeded in the clinical routine work as the primary source for radiological reports and images as well as for laboratory values. Conclusion: The advantages of digitalization were, besides reduction of film cost, especially optimizations of work flow with access to digital images from every where at any time. (orig.) [de

QUALITY OF WORKING LIFE IN COMMODITIZED HOSPITALS AND UNIVERSITIES

Directory of Open Access Journals (Sweden)

Josep M. Blanch

2014-01-01

Full Text Available New Public Management (NPM turns public hospital and university services into market enterprises. The aim of the paper is to analyze and describe the impact of this metamorphosis on the labor subjectivity of the staff employed in such services. Empirical studies in Spanish and Latin American hospitals and universities uncover a paradoxical experience: relative manifest satisfaction with material and technical conditions allowing them to work harder and better, but also latent discomfort with the task overload, and professional and ethical dilemmas posed by new organizational demands, in the face of which staff develop ways of coping ranging from manifest obedience to latent resistance. This supports the reasons for the redesign of these services based on a better balance between commercial and social demands, managerial and professional values, and between business efficiency and quality of working life.

Hospitable Gestures in the University Lecture: Analysing Derrida's Pedagogy

Science.gov (United States)

Ruitenberg, Claudia

2014-01-01

Based on archival research, this article analyses the pedagogical gestures in Derrida's (largely unpublished) lectures on hospitality (1995/96), with particular attention to the enactment of hospitality in these gestures. The motivation for this analysis is twofold. First, since the large-group university lecture has been widely critiqued as…

The cultural heritage tourism in the city of Heidelberg, Germany: Plans, motivations and realities

Directory of Open Access Journals (Sweden)

Ferreira Pires Daniel Vítor

2014-01-01

Full Text Available In recent years, heritage has been responsible for the visibility that a large number of cities around the world have been getting as regards affirmation and differentiation of places. This also increased the number of cultural tourists that visit those cities worldwide. In this struggle for affirmation and differentiation, Heidelberg has quite an advantage, since the city's cultural heritage, as well as its unique atmosphere, have been spread by the Romantic Movement in the 19th century and it still happens nowadays, after more than two hundred years. But is Heidelberg indeed a city that receives cultural tourists? In this article, through an exploratory study, we intend to characterize the tourists that visit the city, to understand if the defined politics, actions and events taken by the different institutional authorities (like the Heidelberger Marketing and City Town hall, among others are getting the expected results. Through literature review and question­naires completed by the city's tourists, based on a probabilistic random sample and semi-structured interviews, we expect to trace the evolution of the policies defined, and compare those to the type of tourists that actually visit the city. As a preliminary result, we concluded that there is a difference between the tourist profile defined by the institutional authorities with responsibilities in the promotion and communication of the city's cultural heritage assets, comparing with the tourists that actually visit the city. This is the result not only of the motivations and effective length of the visits, but also in the lack of alternative or multiple visit narratives and routes for the cultural heritage city's assets.

Frequency and risk factors associated with emergency medical readmissions in Galway University Hospitals.

LENUS (Irish Health Repository)

Gorman, J

2010-06-01

Unplanned readmissions of medical hospital patients have been increasing in recent years. We examined the frequency and associates of emergency medical readmissions to Galway University Hospitals (GUH).

Deutsches Krebsforschungszentrum Heidelberg. Report on scientific results 2000-2001

International Nuclear Information System (INIS)

Metzler, H.

2002-01-01

The Deutsches Krebsforschungszentrum Heidelberg (DKFZ, German Cancer Research Center) publishes alternating every year the ''Wissenschaftlicher Ergebnisbericht'' (in German) and the ''Research Report'' (in English). Both volumes are reports on the present state of research activities of the DKFZ as a National Research Center to the funding federal and state authorities [Federal Republic of Germany, Land (state) Baden-Wuerttemberg]. Furthermore they shall inform colleagues and the scientifically interested public. Both reports are structured according to the center's eight research programs. The last Research Report was published in 2001. In Germany a new orthography has been accepted. Some authors used the new form others the traditional one. The orthography was not standardized. (orig.)

Activity-based costing and its application in a Turkish university hospital.

Science.gov (United States)

Yereli, Ayşe Necef

2009-03-01

Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey. Copyright (c) AORN, Inc, 2009.

Triple Gestations in Two University Teaching Hospitals in Yaounde ...

African Journals Online (AJOL)

3Department of Obstetrics & Gynecology, Central Hospital Yaounde/Faculty of Medicine and Biomedical Sciences,. University of Yaounde I, BP 337, Yaounde, Cameroon. Address correspondence to E. Nkwabong, enkwabong@yahoo.fr. Received 27 November 2010; Accepted 19 January 2011. Abstract The frequency of ...

Use of seatbelts by vehicle occupants in University College Hospital ...

African Journals Online (AJOL)

Use of seatbelts by vehicle occupants in University College Hospital, Ibadan, Nigeria. AO Sangowawa, SEU Ekanem, BT Alagh, IP Ebong, B Faseru, O Uchendu, BJ Adekunle, VHS Shaahu, A Fajola, GI Ogbole ...

Workplace violence against nursing staff in a Saudi university hospital.

Science.gov (United States)

Alkorashy, Hanan A Ezzat; Al Moalad, Fawziah Bakheet

2016-06-01

Violence against nurses is a major challenge for healthcare administrators. It is gaining more attention because it has a negative impact on nurses, the quality of health care and health organization. Common types of violence include physical harassment, sexual abuse, aggression, mobbing and bullying. Patients, their relatives and co-workers are considered the main perpetrators. To determine the prevalence rate of workplace violence against nursing professionals in a university hospital in Riyadh, Saudi Arabia, most frequent type and perpetrators as well as the contributing factors. This quantitative cross-sectional study adapted a survey questionnaire from the Massachusetts Nurses Association Survey on Workplace Violence/Abuse to collect data from a quota sample of 370 nursing personnel. Almost half of the participants had experienced violence in the professional setting during the 12 months prior to the study. The majority of subjects perceived workplace violence as verbal abuse. Nearly all nursing professionals identified patients as the leading cause. Slightly more than half mentioned understaffing, misunderstandings, long waits for service and lack of staff training and policies for preventing crisis as contributing factors. The prevalence rate is extremely high among nurses in the targeted Saudi university hospital. Saudi health as well as university hospitals' administration and policy makers should adopt and introduce a 'zero tolerance policy', set standards and develop practical measures for preventing the incidence and for controlling the prevalence of violence against nurses. Besides, healthcare organizations, particularly hospitals, can fulfil their obligations to provide both staff and patients with more secure environment. Further research on the topic is needed. © 2016 International Council of Nurses.

Heidelberg Neuro-Music Therapy for chronic-tonal tinnitus - treatment outline and psychometric evaluation.

Science.gov (United States)

Argstatter, Heike; Grapp, Miriam; Plinkert, Peter K; Bolay, Hans Volker

2012-01-01

Musical training positively influences the cortical plasticity of the brain and has proven to be effective in treating chronic tinnitus. A neuro-music therapy concept, the "Heidelberg Neuro-Music Therapy" treatment was developed and evaluated. A prospective, cross-sectional design was used. N = 135 patients (mean age 47 years) with chronic, tonal tinnitus attended a standardized protocol for Neuro-Music Therapy (either "standard therapy" ST or "compact therapy" CT). The results were compared to a cognitive behavioral placebo music therapy procedure (PT). Tinnitus distress was assessed using the German version of the Tinnitus-Questionnaire (TQ) at admission, at discharge and six months after therapy. Changes were assessed statistically and by means of clinical significance. TQ scores significantly improved - independent of group allocation. But more than 80% of the music therapy patients (both ST and CT) revealed a reliable improvement ("responder") compared to 44% in the PT group. Therapy impact seems to be lasting since TQ scores remained stable until follow-up at six months. The "Heidelberg Neuro-Music Therapy" is a method with fast onset and long lasting effect for patients with "tonal" tinnitus. A number of potential working factors accounting for the treatment success are highlighted.

Burkholderia cepacia infection at A university Teaching Hospital in ...

African Journals Online (AJOL)

Twenty five isolates of B. cepacia, representing 1.4% of all isolates, were obtained at the Microbiology Laboratory of a University Teaching Hospital in Lagos between January 1996 and December 1997. Identification of isolates was done using analytical profile index systems (Biomerieux, France) and sensitivity testing was ...

Private finance initiative hospital architecture: towards a political economy of the Royal Liverpool University Hospital.

Science.gov (United States)

Jones, Paul

2018-02-01

Sociological analysis has done much to illuminate the architectural contexts in which social life takes place. Research on care environments suggests that the built environment should not be understood as a passive backdrop to healthcare, but rather that care is conditioned by the architecture in which it happens. This article argues for the importance of going beyond the hospital walls to include the politics that underwrite the design and construction of hospital buildings. The article assesses the case of the yet-to-be-realised Liverpool Royal University Hospital, and the private finance initiative (PFI) funding that underpins the scheme, which is suggested as a salient 'external' context for understanding architecture's role in the provision of healthcare of many kinds for many years to come. PFI has major implications for democratic accountability and local economy, as well as for the architecture of the hospital as a site of care. Critical studies can illuminate these paradoxically visible-but-opaque hospital spaces by going beyond that which is immediately empirically evident, so as to reveal the ways in which hospital architecture is conditioned by political and economic forces. © 2018 Foundation for the Sociology of Health & Illness.

The challenge of tobacco control at a university hospital

Directory of Open Access Journals (Sweden)

Natália Ferreira Cruz

Full Text Available Objective: To identify the actions taken by the Commission of Tobacco Control (CTC to control smoking in the hospital environment.Methods: Descriptive and exploratory retrospective documentary research conducted at a university hospital in southern Brazil, in 2014. The content of the minutes of CTC meetings was used to create a database, and the rounds reports were descriptively analyzed. We sought to identify the most relevant actions from 2005 to 2014.Results: The CTC implemented the Tobacco-Free Environment programme restricted cigarette smoking to designated areas and subsequently deactivated these areas. The only remaining outdoor smoking area in 2014 was deactivated.Conclusion: CTC actions have contributed to tobacco control in the hospital environment. This study will hopefully serve as a model to encourage other institutions to implement similar actions.

Forceps delivery at the University College Hospital, Ibadan, Nigeria ...

African Journals Online (AJOL)

Forceps delivery at the University College Hospital, Ibadan, Nigeria. ... Ibadan, Nigeria. CO Aimakhu, O Olayemi, OO Enabor, FA Oluyemi, VE Aimakhu ... Methodology: A retrospective analysis of all forceps delivery done at this centre between the 1st of January 1997 and 31st December 2001, a 5-year period was done.

Vacuum Delivery in Jos University Teaching Hospital, Jos, Nigeria ...

African Journals Online (AJOL)

Obstetric practice continues to change, particularly assisted vaginal delivery. Vacuum delivery is a mode of delivery technique in Jos University Teaching Hospital (JUTH) in the maternity unit. The objective of the study was to determine the rate of ventouse delivery, its indications, and maternal and fetal morbidity in our ...

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

Directory of Open Access Journals (Sweden)

Renato Humberto Fabri

2002-04-01

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

[Efforts to achieve and effects of acquiring ISO 15189 in Tokushima University Hospital].

Science.gov (United States)

Shono, Kazuko; Kishi, Misako; Satou, Mituyo; Nagamine, Yasunori; Doi, Tosio

2009-12-01

The medical laboratory of Tokushima University Hospital acquired ISO 15189, an international standard for medical laboratories, on July 6th, 2007, resulting in it achieving the 24th place in Japan and 5th place among national university hospitals. The first surveillance was just performed on October 6th, 2008. Tokushima University Hospital, in which our medical laboratory is included as one section, already succeeded in acquiring ISO 9001, PrivacyMark System, and Quality Health Care ver. 5 before accomplishing ISO 15189. To achieve ISO 15189, we prepared documents based on ISO 9001 without any consultation, resulting in a review of the difference between ISO 9001 and ISO 15189 after the preliminary survey. Although achieving ISO 15189 resulted in an improvement in the reliability of laboratory results and accuracy, leading to the development of our technical skills and awareness, and sharing of knowledge, we consider that the considerable investment of time to prepare the requirements remains to be overcome.

Violence experienced by nurses at six university hospitals in Turkey.

Science.gov (United States)

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

2013-12-01

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

[Susceptibility of yeasts to antifungal agents in Kaunas University of Medicine Hospital].

Science.gov (United States)

Skrodeniene, Erika; Dambrauskiene, Asta; Vitkauskiene, Astra

2006-01-01

The aim of this study was to determine the species of yeast and their susceptibility to antifungal agents isolated from clinical specimens of patients treated in Kaunas University of Medicine Hospital. A total of 142 yeasts isolated from various clinical specimens of patients hospitalized in Kaunas University of Medicine Hospital were included in this study. All yeasts were cultivated on Sabouraud dextrose agar and identified using either CHROM agar or API 20C AUX system. The minimum inhibitory concentrations of fluconazole, itraconazole, and amphotericin B were determined by the ATB FUNGUS 2 agar microdilution test. In all clinical specimens except blood, Candida albicans was the most frequently isolated yeast (65.5%, pyeast strains showed resistance to fluconazole. Nearly one-fourth of Candida albicans strains (24.7%) and 23.2% of all isolated yeast strains showed resistance to itraconazole. Almost all of fluconazole-resistant (93.3%) and 12.6% of fluconazole-susceptible yeast were found to be resistant to itraconazole (pyeast strains were susceptible to amphotericin B. Candida albicans strains were significantly frequently resistant to fluconazole than non-albicans Candida species (15.1% and 4.1%, respectively, pyeast isolated in Kaunas University of Medicine Hospital. There was determined that yeasts resistant to fluconazole were commonly resistant to itraconazole too. All isolated yeast strains were susceptible to amphotericin B.

[Quality management according to DIN EN ISO 9001 at a university eye hospital].

Science.gov (United States)

Schönherr, U; Händel, A; Naumann, G O

2001-02-01

Quality assurance is an integral part of modern microsurgical ophthalmology. Health care laws also mandate overall quality management. In recent years we have standardized the preexisting features of quality management according DIN EN ISO 9001 and have integrated previously missing features. Establishing quality management according to ISO 9001 is possible even at a university eye hospital and department of ophthalmology. Certification according to ISO 9001 specifications was granted in April 1999. The major difficulty was in translating industrial norms to the context of an eye hospital. It was also difficult to overcome skepticism towards quality-assurance measures that lie beyond ophthalmological quality control. It is useful and feasible to establish a quality management system at German university eye hospitals and departments of ophthalmology. Certification according to ISO 9001 is one possibility to make a quality management system transparent and evaluable both inside and outside the hospital.

[Accidents with biological material at West Paraná University Hospital].

Science.gov (United States)

Murofuse, Neide Tiemi; Marziale, Maria Helena Palucci; Gemelli, Lorena Moraes Goetem

2005-08-01

It is a descriptive and retrospective study with the purpose of investigating labor accidents with biological material involving workers and trainees occurred in 2003 and 2004 in a University Hospital of Parana. For data collection, the electronic form of the Net of Occupational Accidents Prevention - REPAT has been utilized. Out of the 586 hospital workers, there was a register of 20 (3,4%) injured workers in 2003 and 23 (3,8%) in 2004, representing an increase of 15% in the notifications from one year to the other.

Evaluation and comparison of medical records department of Iran university of medical sciences teaching hospitals and medical records department of Kermanshah university of medical sciences teaching hospitals according to the international standards ISO 9001-2000 in 2008

Directory of Open Access Journals (Sweden)

maryam ahmadi

2010-04-01

Conclusion: The rate of final conformity of medical records system by the criteria of the ISO 9001-2000 standards in hospitals related to Iran university of medical sciences was greater than in hospitals related to Kermanshah university of medical sciences. And total conformity rate of medical records system in Kermanshah hospitals was low. So the regulation of medical records department with ISO quality management standards can help to elevate its quality.

Urinary tract infections at aga Khan University hospital nairobi - a ...

African Journals Online (AJOL)

2013-06-11

Jun 11, 2013 ... (Uti) are normally treated empirically and urine culture is usual ordered for as a last ... symptomatic Uti in patients at aga Khan University hospital by looking at the trends of Uti ... in the context of pyelonephritis in pregnancy(9).

Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals

NARCIS (Netherlands)

Edward, G. M.; Biervliet, J. D.; Hollmann, M. W.; Schlack, W. S.; Preckel, B.

2008-01-01

The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables:

Dimensions of the foveal avascular zone using the Heidelberg retinal angiogram-2 in normal eyes

Directory of Open Access Journals (Sweden)

John Deepa

2011-01-01

Full Text Available Purpose: The purpose was to study the dimensions of the foveal avascular zone (FAZ using Heidelberg Retinal Angiogram-2 (HRA-2; Heidelberg Engineering GmBH, Dossenheim, Germany. Materials and Methods: An observational study of the FAZ area and circumference was done with fundus fluorescein angiography (FFA using HRA-2 in 31 normal individuals. The FAZ was studied using both contrast-adjusted and nonadjusted methods. Contrast adjustment was done to obtain better visualization of the finer capillaries around the fovea enabling more precise measurements of the FAZ in normal eyes. Results: The mean area of the FAZ calculated by the contrast-adjusted method was 0.2753 mm 2 (±0.074 and the mean circumference was 2.22 mm (±0.048. By the conventional method, the area and circumference of the FAZ were 0.6241 mm 2 (±0.177 and 3.23 mm (±0.454, respectively. Conclusion: The measurements of area and circumference of FAZ using contrast-adjusted methods were significantly smaller than the conventional method.

Patients' perception of the ambulance services at Hospital Universiti Sains Malaysia.

Science.gov (United States)

Anisah, A; Chew, K S; Mohd Shaharuddin Shah, C H; Nik Hisamuddin, N A R

2008-08-01

Little is known regarding public opinion of prehospital care in Malaysia. This study was conducted to find out the public's perception and expectations of the ambulance services in one of the university hospitals in Malaysia. A six-month prospective cross-sectional study to look at patients' perception of Hospital Universiti Sains Malaysia's (HUSM) ambulance service was conducted from February 2006 to July 2006. Upon arrival at the hospital, patients or their relatives (who used our hospital's ambulances) were interviewed with a set of questions regarding their perception of the ambulance services and were asked to rate the perception on a Likert Scale from 1 to 10. A convenient sampling method was applied. A total of 87 samples were obtained. Despite the many problems faced by the ambulance service in HUSM, the mean score for each of the questions on patient's perception ranged from 9.33 to 9.70 out of 10. The questions with the highest mean score, which were both 9.70 each, were related to staff attentiveness and staff gentleness. Patients' perceptions can be very subjective, but until further similar studies could be carried out in other parts of Malaysia, this set of data merely represents a numerical measure of public perception of the ambulance services from HUSM.

Costs of the Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease in a University Hospital

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Fatma Yıldırım

2015-12-01

Full Text Available Objective: Chronic obstructive pulmonary disease (COPD, although a preventable and treatable disease continues to be a major health problem. Acute exacerbations of COPD is a major cause of hospitalization of patients and it constitutes a significant portion of COPD-related health care costs. In this study, we aimed to determine the cost of patients hospitalized with acute exacerbations of COPD in a university hospital. Methods: Data of the patients that were hospitalized due to COPD exacerbation between 1 September 2013-1 September 2014 in Hospital of Gazi University Medical Faculty were retrospectively analyzed. Cost data were gathered from data processing department. Costs were identified for drugs, laboratory tests, bed costs and other materials. Results: A total of 790 patients were hospitalized during twelve months. Among these patients 181 (23.0% patients had COPD and 99 (12.5% were hospitalized due to acute exacerbation of COPD. Of these 99 patients 77 (77.8% were male and 22 (22.2% were female. Forty-nine (49.5% patients were hospitalized from the emergency department, 50 (50.5% patients were from the outpatient clinic. The median age was 70 (64-77 years old and median length of hospital stay was 8 (6-13 days. Ninety-one (91.9% of them were discharged from the service. Eight (8.1% patients were transfered to the intensive care unit (ICU due to respiratory failure, and 7 of these patients (7.4% hospitalized back to the service after treatment at ICU, 2 (2.1% patients died. The median cost per patient was 1.064 (726-1.866 Turkish Lira (TL. Drug costs accounted the largest portion (36.0% of the median cost, followed by bed cost (26.0%. Two (2.1% of patients died in hospital. Although the number of patients without antibiotic usage is less (17.2% vs 82.8%; the median cost per patient in the antibiotic using group was higher than that were without antibiotic using (median 643 vs 1.162 TL p=0.001. Presence of a comorbidity, hypoxemia

Building new university hospital--what citizens know and policy makers should be aware of.

Science.gov (United States)

Oresković, S; Letica, S; Mastilica, M; Babić-Bosanac, S; Civljak, M; Bozicević, I; Borovecki, A

2002-12-01

Survey of citizens' attitudes in the process of strategic decision making is one of the most important methods for determining health care priorities. We describe the results of a survey carried out in December 2001, with an aim to collect and analyze the attitudes of the citizens and health care professionals toward the possibilities and strategies of construction of the University Hospital in Blato, Zagreb. The first referendum on the construction of the new hospital was conducted among Zagreb citizens in 1982, when they agreed that the new University Hospital was much needed. Zagreb citizens confirmed once again their attitudes toward and opinions on the need to continue the construction of new hospital in the city outskirts. By 1992, when the construction of the hospital was halted due to insufficient financial means, Zagreb citizens had already invested over 150 epsilon million in the project. It is interesting that today, 89.4% of the citizens and 74.5% of physicians agree that the new hospital building should be completed. Also, 66.7% of the citizens and 88% of physicians think that this hospital should be a University hospital that could offer the most complex treatments and medical education. To finish the construction of the new hospital further 200 epsilon million needs to be invested. Survey showed that 71% of citizens and 82.2% of physicians think that funds should be raised from some form of credit or budget rather than by special local tax, additional tax or voluntary tax. This project will significantly determine the future of hospital and health care system in Croatia due to its capacities in terms of space, technology, and staff. Before the decision to continue with the new hospital construction be made, the expected future needs, demands, and supply of the health care services in hospital sector in Zagreb and Croatia should be provided using SWOT analysis for each of existing the facilities.

Cardiac arrest during anesthesia at a University Hospital in Nigeria ...

African Journals Online (AJOL)

Background: We assessed the incidence and outcomes of cardiac arrest during anesthesia in the operating room at our university hospital. A previous study on intraoperative cardiac arrests covered a period from 1994-1998 and since then; anesthetic personnel, equipment, and workload have increased remarkably.

ELECTROCONVULSIVE THERAPY EXPERIENCES AT NARA MEDICAL UNIVERSITY HOSPITAL

OpenAIRE

Kishimoto, Toshifumi; Ueda, Atsushi; Noriyama, Yoshinobu; Nagai, Toshiya; Hirayama, Tomohide; Kirita, Ikuhiro; Hata, Kazuya; Ikawa, Genro

1995-01-01

We surveyed the clinical electroconvulsive therapy (ECT) treatment expe- riences between 1987 and 1992 at Nara Medical University Hospital. ECT is restrictedly applied to severely ill patients who have no response to other somatic therapies. For 5 years, 43 cases were treated with ECT, of which 27 suffered from depressive disorders, 3 from schizophrenia, 3 from somatoform disorders, and 10 from anxiety disorders. ECT was selected by psychiatrists for severe depressive states after failure of ...

Addiction research centres and the nurturing of creativity
department of addictive behaviour and addiction medicine, central institute of Mental Health, Mannheim, University of Heidelberg.

Science.gov (United States)

Mann, Karl

2010-12-01

Addictive behaviour is as prevalent in Germany as in other western countries, but in contrast to some European countries and the United States, very little money was given to this research field. Change came in the early 1990s, when the German government started to launch specific grants for addiction research. The first chair in addiction research was created in 1999 (Karl Mann) at the Central Institute of Mental Health Mannheim (CIMH; University of Heidelberg). The recruitment of a pre-clinical alcohol researcher as head of the department of psychopharmacology followed (Rainer Spanagel). This 'addiction research cluster' collaborates with several research groups at the CIMH (such as genetics). We inaugurated a clinical trial network which now comprises up to 20 treatment centres throughout Germany. Like most authors, we found effect sizes of different treatment modalities more in the low to moderate range, perhaps because of the heterogeneity of large patient samples. Therefore, we concentrated upon the biological basis of addiction in order to define more homogeneous 'subtypes' of patients for a better match with existing treatments. Results concerning genetics and neuroimaging (both animal and human) are promising, and could move our field towards a more personalized treatment approach. Our funding has been extended over the years, including involvement in several large European grants. We are studying substance-related problems as well as so-called 'behavioural addictions'. As a natural consequence of this development, we are deeply involved both in informing the general public on addiction issues as well as in counselling policy makers in Germany. © 2010 The Author, Addiction © 2010 Society for the Study of Addiction.

A substantial number of scientific publications originate from non-university hospitals

DEFF Research Database (Denmark)

Fedder, Jens; Nielsen, Gunnar Lauge; Petersen, Lars J

2011-01-01

As we found no recent published reports on the amount and kind of research published from Danish hospitals without university affiliation, we have found it relevant to conduct a bibliometric survey disclosing these research activities....

Benign breast diseases: experience at isra university hospital, hyderabad, pakistan

International Nuclear Information System (INIS)

Memon, W.; Mannan, A.; Gilani, R.

2017-01-01

To determine the frequency of Benign Breast Disease (BBD) in Isra University Hospital Hyderabad. Methodology: This prospective, descriptive study was carried out at Isra University Hospital Hyderabad, Pakistan from January 2014 and January 2016. Data including age, presenting complaints, clinical examination, histopathological examination and treatment given were all collected from patients presenting in surgery department with breast complaints and recorded. All patients with breast malignancy and trauma of breast were excluded from the study. Data were analyzed using SPSS v. 17. Results: A total of 105 patients with benign breast disease admitted during the study period. Mean age of patients was 30 years (range 13-65). Fibroadenoma was the most common diagnosis in 45(42%), followed by fibrocystic disease 25(23%), breast abscesses 15(14%), sebaceous cyst 10(9.5%), duct ectasia 4(3.8%) and Phylloides 2(1.9%) cases. Conclusion: Fibroadenoma was the most common BBD followed by fibrocystic disease with presentation of either discrete mass or mastalgia. (author)

Heidelberg’s relevance for a postmodern age: The doctrine of Scripture in the Heidelberg Catechism revisited

NARCIS (Netherlands)

van Vlastuin, W.

2015-01-01

The debate on the doctrine of Scripture is ongoing. In this article, the use of Scripture is investigated in the Heidelberg Catechism, a catechism in which there is no explicit statement about Scripture, the notion of the Word refers to the preached Word, and the focus is placed on soteriology and

Occupational Accidents among Clinical Staff of Tabriz University Hospitals

Directory of Open Access Journals (Sweden)

Leila Sahebi

2015-07-01

Full Text Available ​Background and Objectives : Occupational health and safety is one of the most important issues in the workplace. The purpose of this study was to explore the one –year prevalence of occupational accidents in Tabriz University hospitals. Materials and Methods : A cross-sectional study was conducted on 400 patients of seven university hospitals using researcher made questionnaire. The hospitals were selected based on their specialty of the service. Then, one hospital was selected from each specialty using random selection method. Univariate and multiple regression analyses were employed. The SPSS version 19 was used for data analysis. Results : The one-year prevalence of workplace accident was %21. Women were encountered in workplace accidents more than men (%31.1 vs. % 26.8. The youngest age group (20-30 years experienced the most workplace accidents (%41.5. Carelessness was the main cause of the workplace accidents (%49.3. Reporting rate of the occupational accidents was% 48.3 and the most common cause for not reporting was the fear of being recognized as a less competent individual. Sick leaves due to the severity of the accident was reported %23 (median: 5 days. Over %90 of the accident victims had experienced severe stress and job pressure within the previous year. In multiple regression models, the young staff (20-30 years with severe stress, job pressure and verbal violence victim had more chance of workplace accident.   Conclusion : In addition to the high prevalence of workplace accidents, intensity and consequences of workplace accidents should be considered as well. Providing appropriate methods including prevention of accidents and education of safety along with the assistance of technical staff, managers and attendants would be helpful.

Deutsches Krebsforschungszentrum Heidelberg (DKFZ). Report on scientific results 1998/1999

International Nuclear Information System (INIS)

Metzler, H.

2000-01-01

The Deutsches Krebsforschungszentrum Heidelberg (DKFZ, German Cancer Research Center) publishes alternating every year the 'Wissenschaftlicher Ergebnisbericht' (in German) and the 'Research Report' (in English). Both volumes are reports on the present state of research activities of the DKFZ as a National Research Center to the funding federal and state authorities (Federal Republic of Germany, Land (state) Baden-Wuerttemberg). Furthermore, they shall inform colleagues and the scientifically interested public. Both reports are structured according to the center's eight research programs. The next Research Report will be published in 2001. In Germany a new orthography has been accepted. Some authors used the new form others the traditional one. The orthography was not standardized. (orig.) [de

The Use of Operational Excellence Principles in a University Hospital.

Science.gov (United States)

Edelman, Eric R; Hamaekers, Ankie E W; Buhre, Wolfgang F; van Merode, Godefridus G

2017-01-01

The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+) has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital. The MUMC+ is the leading tertiary healthcare center for the South-East region of The Netherlands and beyond. Regional, national, and international developments encouraged the MUMC+ to start significantly reorganizing its care processes from 2009 onward. First experiments with Lean Six Sigma and Business Modeling were combined with lessons learned from other centers around the world to form the MUMC+'s own type of Operational Excellence. At the time of writing, many improvement projects of different types have been successfully completed. Every single department in the hospital now uses Operational Excellence and design thinking in general as a method to develop new models of care. An evaluation in 2014 revealed several opportunities for improvement. A large number of projects were in progress, but 75% of all projects had not been completed, despite the first projects being initiated back in 2012. This led to a number of policy changes, mainly focusing on more intensive monitoring of projects and trying to do more improvement projects directly under the responsibility of the line manager. Focusing on patient value, continuous improvement, and the reduction of waste have proven to be very fitting principles for healthcare in general and specifically for application in a university hospital. Approaching improvement at a systems level while directly involving the people on the work

The Use of Operational Excellence Principles in a University Hospital

Directory of Open Access Journals (Sweden)

Eric R. Edelman

2017-07-01

Full Text Available The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+ has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital. The MUMC+ is the leading tertiary healthcare center for the South-East region of The Netherlands and beyond. Regional, national, and international developments encouraged the MUMC+ to start significantly reorganizing its care processes from 2009 onward. First experiments with Lean Six Sigma and Business Modeling were combined with lessons learned from other centers around the world to form the MUMC+’s own type of Operational Excellence. At the time of writing, many improvement projects of different types have been successfully completed. Every single department in the hospital now uses Operational Excellence and design thinking in general as a method to develop new models of care. An evaluation in 2014 revealed several opportunities for improvement. A large number of projects were in progress, but 75% of all projects had not been completed, despite the first projects being initiated back in 2012. This led to a number of policy changes, mainly focusing on more intensive monitoring of projects and trying to do more improvement projects directly under the responsibility of the line manager. Focusing on patient value, continuous improvement, and the reduction of waste have proven to be very fitting principles for healthcare in general and specifically for application in a university hospital. Approaching improvement at a systems level while directly involving the

Organizing integrated care in a university hospital: application of a conceptual framework.

Science.gov (United States)

Axelsson, Runo; Axelsson, Susanna Bihari; Gustafsson, Jeppe; Seemann, Janne

2014-04-01

As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals. The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews. The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location. It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care.

Job satisfaction of nurses in Jimma University Specialized Teaching Hospital, Ethiopia.

Science.gov (United States)

Negussie, Nebiat

2016-03-01

In Ethiopia nurses have played a very important role in providing timely and quality health service in healthcare organizations. However, there is a limited literature in the area of nurses' job satisfaction in Ethiopian public hospitals. The objective of this research is to measure job satisfaction of nurses in Jimma University Specialized Teaching Hospital and to determine the influencing factors. A cross-sectional survey was conducted from January 2012 to June 2012 in Jimma University Specialized Teaching Hospital. All full-time nurses with nonsupervisory management position and more than 1 year of work experience were invited to participate in the study. Minnesota Satisfaction Questionnaire was used to collect the data. A total of 175 copies of the questionnaires were returned out of 186 copies distributed to the respondents. The results indicated that nurses were not satisfied by their job (mean=2.21, SD=0.52). Remuneration (r=0.71, Pjob advancement (r=0.69, Pjob satisfaction. Job security was associated with highest satisfaction (r=0.41, Pjob advancement were the most important factors for nurses' job satisfaction. Hospital administrators as well as health policy makers need to address the two major identified sources of nurses' job dissatisfaction in the study (i.e. remuneration and narrow opportunity of job advancement) and take appropriate measures to overcome their consequences.

Cognitive responses to hypobaric hypoxia: implications for aviation training

Directory of Open Access Journals (Sweden)

Neuhaus C

2014-11-01

Full Text Available Christopher Neuhaus,1,2 Jochen Hinkelbein2,31Department of Anesthesiology, Heidelberg University Hospital, Ruprecht Karls University of Heidelberg, Heidelberg, 2Emergency Medicine and Air Rescue Working Group, German Society of Aviation and Space Medicine (DGLRM, Munich, 3Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, GermanyAbstract: The aim of this narrative review is to provide an overview on cognitive responses to hypobaric hypoxia and to show relevant implications for aviation training. A principal element of hypoxia-awareness training is the intentional evocation of hypoxia symptoms during specific training sessions within a safe and controlled environment. Repetitive training should enable pilots to learn and recognize their personal hypoxia symptoms. A time span of 3–6 years is generally considered suitable to refresh knowledge of the more subtle and early symptoms especially. Currently, there are two different technical approaches available to induce hypoxia during training: hypobaric chamber training and reduced-oxygen breathing devices. Hypoxia training for aircrew is extremely important and effective, and the hypoxia symptoms should be emphasized clearly to aircrews. The use of tight-fitting masks, leak checks, and equipment checks should be taught to all aircrew and reinforced regularly. It is noteworthy that there are major differences in the required quality and quantity of hypoxia training for both military and civilian pilots.Keywords: cognitive response, aviation training, pilot, hypoxia, oxygen, loss of consciousness

Implementation of a database on drugs into a university hospital Intranet.

Science.gov (United States)

François, M; Joubert, M; Fieschi, D; Fieschi, M

1998-01-01

Several databases on drugs have been developed worldwide for drug information functions whose sources are now electronically available. Our objective was to implement one of them in our University hospitals information system. Thériaque is a database which contains information on all the drugs available in France. Before its implementation we modeled its content (chemical classes, active components, excipients, indications, contra-indications, side effects, and so on) following an object-oriented method. From this model we designed dynamic HTML pages according to the Microsoft's Internet Database Connector (IDC) technics. This allowed a fast implementation and does not imply to port a client application on the thousands of workstations over the network of the University hospitals. This interface provides end-users with an easy-to-use and natural way to access information related to drugs in an Intranet environment.

The role of expectations in patient assessments of hospital care: an example from a university hospital network, Turkey.

Science.gov (United States)

Bakar, Coskun; Akgün, H Seval; Al Assaf, A F

2008-01-01

The aim of this paper is to document a study, in which the SERVQUAL scale was used to evaluate hospital services, conducting a preliminary assessment of patient attitudes regarding the important aspects of service dimensions. The SERVQUAL scale was implemented into routine use at the Baskent University Hospitals Network in Baskent, Turkey. The study consisted of 550 randomly chosen patients who presented to any member hospital in that network during January and February 2006 and received treatment as inpatients or outpatients at those healthcare facilities. The SERVQUAL scale was utilised to evaluate hospital services. A questionnaire was completed by a total of 472 (86.0 per cent) patients. The perceived scores of the patients were higher than expected for an ordinary hospital but lower than expected for a high-quality hospital. The highest difference between the perceived service score and the expected service score was found at the Alanya Application and Research Center in Alanya, Turkey. The paper demonstrates the use of the SERVQUAL scale in measuring the functional quality of the hospitals assessed.

Occupational injury history and universal precautions awareness: a survey in Kabul hospital staff

Directory of Open Access Journals (Sweden)

Garner Paul

2010-01-01

Full Text Available Abstract Background Health staff in Afghanistan may be at high risk of needle stick injury and occupational infection with blood borne pathogens, but we have not found any published or unpublished data. Methods Our aim was to measure the percentage of healthcare staff reporting sharps injuries in the preceding 12 months, and to explore what they knew about universal precautions. In five randomly selected government hospitals in Kabul a total of 950 staff participated in the study. Data were analyzed with Epi Info 3. Results Seventy three percent of staff (72.6%, 491/676 reported sharps injury in the preceding 12 months, with remarkably similar levels between hospitals and staff cadres in the 676 (71.1% people responding. Most at risk were gynaecologist/obstetricians (96.1% followed by surgeons (91.1%, nurses (80.2%, dentists (75.4%, midwives (62.0%, technicians (50.0%, and internist/paediatricians (47.5%. Of the injuries reported, the commonest were from hollow-bore needles (46.3%, n = 361/780, usually during recapping. Almost a quarter (27.9% of respondents had not been vaccinated against hepatitis B. Basic knowledge about universal precautions were found insufficient across all hospitals and cadres. Conclusion Occupational health policies for universal precautions need to be implemented in Afghani hospitals. Staff vaccination against hepatitis B is recommended.

Effect of Various Inoculum Levels of Multidrug-Resistant Salmonella enterica Serovar Heidelberg (2011 Ground Turkey Outbreak Isolate on Cecal Colonization, Dissemination to Internal Organs, and Deposition in Skeletal Muscles of Commercial Turkeys after Experimental Oral Challenge

Directory of Open Access Journals (Sweden)

Divek V. T. Nair

2018-01-01

Full Text Available Salmonella enterica serovar Heidelberg (S. Heidelberg is a major foodborne pathogen colonizing poultry. The pathogen is associated with a significant number of foodborne outbreaks through contaminated poultry meat, including turkeys. Recently, multidrug-resistant (MDR strains of S. Heidelberg have emerged as a threat to human public health in the United States. The objective of this study was to determine the cecal colonization, dissemination to internal organs, and the potential for skeletal muscle deposition of an MDR S. Heidelberg isolate from the 2011 ground turkey outbreak in the United States after the experimental oral challenge of poults (young turkeys and adult turkey hens. In the poult study, two separate experiments using day-old, straight-run, commercial hybrid converter poults were randomly assigned to five challenge groups (0, 10∧2, 10∧4, 10∧6, 10∧8 CFU groups; 12 poults/group; N = 60/experiment and a week after, treatment groups were challenged separately with 0-, 2-, 4-, 6-, and 8- log10 CFU of S. Heidelberg orally. After 14 days post-challenge, the poults were euthanized, and samples were collected to determine MDR S. Heidelberg colonization in the cecum, dissemination to liver and spleen, and deposition in the thigh, drumstick, and breast muscles. A similar experimental design was followed for the adult turkey hens. In two separate experiments, 11-week-old commercial Hybrid Converter turkey hens (4 hens/group; N = 20/experiment were challenged with MDR S. Heidelberg and on day 16 post-challenge, birds were euthanized and samples were collected to determine Salmonella populations in the samples. The results indicated that, in turkey poults, the recovery of MDR S. Heidelberg was highest in the cecum followed by spleen, liver, thigh, drumstick, and breast. All tested inoculum levels resulted in more than 3.5 log10 CFU/g colonization in the poult cecum. The cecal colonization, dissemination to internal organs, and tissue

University/Hospital fetal dose policy experiences

International Nuclear Information System (INIS)

Wilson, B.M.; Vinson, W.R.; Deforest, W.W.; Washburn, D.B.

1991-01-01

Since at least 1981, an informal policy has existed at the authors research university and teaching hospital institution to interview, inform and assure appropriate personnel monitoring for pregnant radiation workers. Events, such as popular and technical publications (NCRP 87) and the maturation of NRC's proposed changes in 10 CFR 20 (NRC 88), brought increased attention to the subject of fetal radiation dose. The need for a formal approach to the subject became evident. By 1987, a concerted effort to promulgate a formal policy was launched. A draft policy statement was presented to each institutional radiation safety committee for review and action. There was immediate strong interest. A thorough, multilevel review, comment and redraft process developed. Well tested policy statements were then approved in 1988

Stapled hemorrhoidopexy: The Aga Khan University Hospital Experience

International Nuclear Information System (INIS)

Athar, Ali; Chawla, Tabish; Turab, Pishori

2009-01-01

Stapled hemorrhoidopexy for prolapsing hemorrhoids is conceptually different from excision hemorrhoidectomy. It does not accompany the pain that usually occurs after resection of the sensitive anoderm. This study was carried out to evaluate the clinical outcome of stapled hemorrhoidopexy at The Aga Khan University Hospital. A sample of 140 patients with symptomatic second-, third-, and fourth-degree hemorrhoids and circumferential mucosal prolapse underwent stapled hemorrhoidopexy from July 2002 to July 2007. They were evaluated for postoperative morbidity, analgesic requirement, and recurrence. Seventy-eight percent were males and the mean age was 45 (range 16-90) years. The mean operative time was 35 (15-78) min. The mean parenteral analgesic doses during the first 24 h were 2.1. All patients received oral analgesics alone after 24 h. No significant postoperative morbidity was observed. The mean in-patient hospital stay was 1.3 (0-5) days. Patients were followed-up for 24 (range, 2-48) months. Minor local recurrence of hemorrhoids was seen in four patients and was managed by band ligation. Stapled hemorrhoidopexy procedure was found safe, well tolerated by patients with minimal parenteral analgesic use and early discharge from the hospital. (author)

Hospital Coding Practice, Data Quality, and DRG-Based Reimbursement under the Thai Universal Coverage Scheme

Science.gov (United States)

Pongpirul, Krit

2011-01-01

In the Thai Universal Coverage scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group (DRG) reimbursement. Questionable quality of the submitted DRG codes has been of concern whereas knowledge about hospital coding practice has been lacking. The objectives of this thesis are (1) To explore hospital coding…

The role of university hospitals as centers of excellence for shared health-care-delivery of in- and outpatients

International Nuclear Information System (INIS)

Adelhard, K.; Matzko, M.; Bruening, R.; Holzknecht, N.; Stark, V.; Reiser, M.

2002-01-01

Problem. Health care delivery in Germany has to face severe challenges that will lead to a closer integration of services for in- and out-patients. University hospitals play an important role due to their activities in research, education and health care delivery. They are requested to promote and evaluate new means and ways for health care delivery. Methods. The Institute of Clinical Radiology at the University Hospital of the Ludwig-Maximilians-University started teleradiological services for hospitals and general practices in January 1999 in the framework of the ''Imaging services - teleradiological center of excellence''. Legal, technical and organizational prerequisites were analyzed. Results. Networks between university hospitals and general practices are not likely to solve all future problems. They will, however, increase the availability of the knowledge of experts even in rural areas and contribute to a quality ensured health care at the patients home. Future developments may lead to international co-operations and such services may be available to patients abroad. Conclusion. Legal, technical and organizational obstacles have to be overcome to create a framework for high quality telemedical applications. University hospitals will play an important role in promoting and evaluating teleradiological services. (orig.) [de

Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin ...

African Journals Online (AJOL)

Obstructed Labour at the University of Ilorin Teaching Hospital. Ilorin. AAG Jimoh, OR Balogun, Abubakar Danladi. Abstract. During a five-year period between 1st January 1995 to 31st December 1999, three hundred and twenty eight cases of obstructed labour were encountered out of a total of 12,614 deliveries managed ...

New compliance management system of the University Hospital Frankfurt, Germany

OpenAIRE

Irmscher, Bettina

2016-01-01

The meaning of Corporate Governance is all values and principles guiding or regulating good and responsible business management. Clearly defined roles and responsibilities for managing compliance, risks and checks is the prerequisite for the latter. For that reason, a compliance management system was set up at the University Hospital Frankfurt in 2015.

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

Science.gov (United States)

Campbell, M L; Frank, R R

1997-01-01

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

[Prevalence of pressure sores in a university hospital in 2003].

Science.gov (United States)

Daideri, G; Berthier, F; Brocker, P; Darmon, M-J; Mignolet, F; Quaranta, J-F; Staccini, P

2006-12-01

To determine the prevalence of pressure sores in a university hospital and to assess the risk of developing a pressure sore. A one-day survey was performed in all hospitalized patients, day hospital excepted. The Garches scale was used to assess the severity of pressure sores and the Braden scale was used to measure the patient's risk for the development of pressure ulcers. One thousand six hundred and eleven patients were included, mean age was 62+/-23 years and 53.3% were over 65 years old. In hospitalized patients, 64% were in acute care, 29% in intermediate medicine and long-term care and 7% in intensive care units. We have found 675 pressure sores in 268 patients, mean age of 76 years; 263 decubitus ulcers were acquired during hospitalization. The most frequent sites were heels (46%) and sacrum (26%). Stage 1 pressure ulcers showed 33% of the total. The total prevalence was 16.6%, 95% CI (14.9-18.6), the hospital acquired pressure sores prevalence was 7.5%, all stages included. A Braden score less than or equal to 15 was found in 29.1% of hospitalized patients. Standard mattresses were used in 37% of patients with pressure sores. Multivariate analysis showed that age and a Braden score less than or equal to 15 were significantly associated with pressure sores. Pressure sores are still an important problem in hospital; occurrence must be considered as an iatrogenic event and management requires a multidisciplinary approach.

Organizing integrated care in a university hospital: application of a conceptual framework

Directory of Open Access Journals (Sweden)

Runo Axelsson

2014-06-01

Full Text Available Background and aim: As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals.Theory and methods: The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews.Results: The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location.Conclusions: It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care.

Organizing integrated care in a university hospital: application of a conceptual framework

Directory of Open Access Journals (Sweden)

Runo Axelsson

2014-06-01

Full Text Available Background and aim: As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals. Theory and methods: The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews. Results: The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location. Conclusions: It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care.

Organizing integrated care in a university hospital: application of a conceptual framework

Science.gov (United States)

Axelsson, Runo; Axelsson, Susanna Bihari; Gustafsson, Jeppe; Seemann, Janne

2014-01-01

Background and aim As a result of New Public Management, a number of industrial models of quality management have been implemented in health care, mainly in hospitals. At the same time, the concept of integrated care has been developed within other parts of the health sector. The aim of the article is to discuss the relevance of integrated care for hospitals. Theory and methods The discussion is based on application of a conceptual framework outlining a number of organizational models of integrated care. These models are illustrated in a case study of a Danish university hospital implementing a new organization for improving the patient flows of the hospital. The study of the reorganization is based mainly on qualitative data from individual and focus group interviews. Results The new organization of the university hospital can be regarded as a matrix structure combining a vertical integration of clinical departments with a horizontal integration of patient flows. This structure has elements of both interprofessional and interorganizational integration. A strong focus on teamwork, meetings and information exchange is combined with elements of case management and co-location. Conclusions It seems that integrated care can be a relevant concept for a hospital. Although the organizational models may challenge established professional boundaries and financial control systems, this concept can be a more promising way to improve the quality of care than the industrial models that have been imported into health care. This application of the concept may also contribute to widen the field of integrated care. PMID:24966806

Management of chronic orofacial pain: a survey of general dentists in german university hospitals

NARCIS (Netherlands)

Wirz, Stefan; Ellerkmann, Richard K.; Buecheler, Marcus; Putensen, Christian; Nadstawek, Joachim; Wartenberg, Hans-Christian

2010-01-01

AIM: This survey assessed procedures performed by general dentists in German university hospitals treating patients with chronic orofacial pain (COP). METHODS: A standardized questionnaire was sent to dentists at all 42 German universities. Doctors were asked to describe demographics, diagnoses,

Review of Application Development and the Patient Encounter Concept within the University of Iowa Hospital Information System

Science.gov (United States)

Wagner, James R.; Wood, David E.

1982-01-01

The logical structure of the patient data base supporting the University of Iowa Hospital Information System has produced significant management reporting capabilities. A technique is discussed for grouping information concerning the services provided by the hospital during each Patient Encounter that allows subsequent analysis by Medical Episode and Financial Account. The implementation of this data organization structure is discussed in the context of the 13 major health care applications implemented at the University of Iowa Hospitals and Clinics.

Ocular related emergencies in Zagreb University Hospital Centre--ten month analysis.

Science.gov (United States)

Skegro, Ivan; Kordić, Rajko; Kuzman, Tomislav; Perić, Sanja; Kutija, Marija Barisić; Jandroković, Sonja; Jukić, Tomislav

2013-04-01

To determine number, demographic characteristics and presenting symptoms of patients admitted to Emergency ophthalmologic department of Zagreb University hospital centre. Prospective analysis of data of 743 patients admitted to Emergency ophthalmologic department of University hospital centre Zagreb during period of 10 month. Main presenting symptoms at admission were red eye, pain and foreign body sensation. 64% of all patients admitted to emergency unit were male. Almost 40% of them were between 20 and 40 years of age. In female population majority is between 50 and 60 years old (19.33%). The study shows that the most frequent reason for admission in emergency ophthalmic unit is red eye, pain and foreign body sensation. These symptoms were present most frequently in young male patients. Considering fact of their working ability, data can suggest that they don't comply with occupational safety measures. Further research in this direction is needed.

Clinical profile of hypertension at a University Teaching Hospital in Nigeria

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Arthur C Onwuchekwa

2010-07-01

Full Text Available Arthur C Onwuchekwa, Sunday ChinenyeDepartment of Internal Medicine, University of Port Harcourt Teaching Hospital, NigeriaBackground: Hypertension in Nigeria is a widespread problem of immense social and economic importance because of its high prevalence and the severity of its complications.Aim: To define the morbidity and mortality pattern of hypertension at the University of Port Harcourt Teaching Hospital (UPTH.Method: Records of all patients admitted to the medical wards of the UPTH over a 5-year period with essential hypertension or any of its complications were retrieved from the ward and medical records and reviewed.Result: A total of 780 hypertensive patients were reviewed, constituting 28.2% of all ­medical admissions. Only 424 (15.2% had complete records and were analyzed. Record keeping was poor. There were 173 (41% males and 251 (59% females with a male to female ratio of 1:1.5. The ages ranged from 18 years to 100 years with a mean of 56.5 ± 16.2. Stroke was responsible for 169 (39.9% hypertensive complications. Heart failure occurred in 97 (22% cases while renal failure and encephalopathy accounted for 40 (9.4% and 7 (1.7% hypertensive complications respectively. There were 99 deaths out of which 51 (51.5% were due to stroke, 14 (14.12% were due to heart failure, and 12 (12.1% were due to renal failure.Conclusion: The contribution of systemic hypertension to the morbidity and mortality of adults at UPTH is quite significant.Keywords: clinical profile, hypertension, University of Port Harcourt Teaching Hospital

Satisfaction degree evaluation of the users of "Attikon" University General Hospital's library.

Science.gov (United States)

Stamouli, Maria-Aggeliki; Balis, Charalampos; Georgakopoulou, Konstantina-Maria

2013-01-01

The ability of hospital medical libraries to meet users' needs is a complicated issue and has been examined by many surveys. The aim of this study is to evaluate the satisfaction degree of the users of "Attikon" University General Hospital's medical library. A questionnaire was used to collect the necessary information Although, in general, the users seems to be satisfied, some adjustments, such as up-to-date books, journals and computers, have to be made.

Anaemia in Pregnancy in Abia State University Teaching Hospital, Aba

African Journals Online (AJOL)

A prospective study of incidence of anaemia in pregnancy at Abia state University Teaching Hospital, Aba was conducted over a six-month period spanning from 31st January 2000 to 31st July 2000. The incidence of anaemia in pregnancy was 29%. The vast majority (97.6%) had mild anaemia. The result showed that most ...

Second hip fractures at Chiang Mai University Hospital.

Science.gov (United States)

Wongtriratanachai, Prasit; Chiewchantanakit, Siripong; Vaseenon, Tanawat; Rojanasthien, Sattaya; Leerapun, Taninnit

2015-02-01

Hip fractures are a major public health problem. Patients who have suffered a hip fracture have an increased risk of a subsequent hip fracture. This study examines the incidence ofsecondhip fractures and attempts to identify underlying risk factors. To examine the incidence ofsecond hip fractures in osteoporotic patients at Chiang Mai University Hospital and to identify risk factors related to second hip fractures. A retrospective review was conducted of all low-energy mechanism hip fracture patients admitted during 2008 and 2009. Analysis of second hip fractures was conducted using survival analysis and logistic regression analysis. A total of 191 patients were observed for 391.68 person-years (mean 2.05 person-years per patient). Among that group, nine second hip fractures were identified, an overall incidence rate of 0.023 second fractures per person-year. Second hip fractures tended to occur within the first year following an initial hip fracture. There were no significant differences related to either gender or comorbid medical conditions. Logistic regression analysis revealed that increased risk of a second hip fracture was associated with age (highest between 80 to 89 years) and patients who were not treated for osteoporosis following their initial fracture. The incidence of second hip fractures at Chiang Mai University Hospital was 0.023 per person-year Careful follow-up of older patients, especially those over 80, and treatment ofosteoporosis with bisphosphonate plus vitamin D and calcium supplements was correlated with a reduction in the incidence of second hip fractures.

KAMEDO report No. 93-the power failure at Karolinska University Hospital, Huddinge, 07 April 2007.

Science.gov (United States)

Angantyr, Lars-Göran; Häggström, Eskil; Kulling, Per

2009-01-01

A sudden and extensive power failure occurred at Karolinska University Hospital in Huddinge on Easter Saturday, 07 April 2007. The power failure lasted one hour and 22 minutes, but it took a longer time for activities to return to normal. It put many patients at great risk, particularly in the intensive care unit and other departments with critically ill patients. This report details the conditions and response at Karolinska University Hospital during the power failure and provides lessons learned for future events.

A survey of the radiographic cassettes disinfection of university hospitals in seoul

International Nuclear Information System (INIS)

Kweon, Dae Cheol; Park, Peom; Kim, Moon Sun; Kim, Dong Sung

2001-01-01

The purpose of this study is to prevent nosocomial infection in patients through contact of radiographic cassettes. Data were collected from radiographers working in 29 university hospitals in Seoul in February and March 2001. Radiographic cassettes were disinfected daily in 5 hospitals, weekly in 4 hospitals, monthly in 5 hospitals, bimonthly in 1 hospital and once every three months in another hospital. 12 other hospitals do not practice regular disinfections of radiographic cassettes. Gauze soaked in disinfectant solution is used in 7 hospitals while 11 hospitals used cotton and cloth soaked in disinfectant solution to clean the radiographic cassettes. 26 hospitals used 99% alcohol based disinfectant solutions while 3 hospitals used 75% alcohol based disinfectant, 26 hospitals use of intercourse cassettes outpatients and in patients. In 26 hospitals, all patients shared the same set of radiographic cassettes used in the hospitals, or in 26 hospitals, separate sets of radiographic cassettes are used for outpatients and inpatients. Separate sets of cassettes are used for ICU and inpatients in 6 others hospitals. 23 hospitals used the same sets of radiographic cassettes for all their patients. radiographic cassettes are cleaned in wash area in the study room of the radiographic department in 17 hospitals. 12 other hospitals do not have designated cleaning areas for the cassettes. All radiographers practiced hands washing with soap. All 29 hospitals surveyed have infection control committee. However, only 9 out of the 29 hospitals surveyed provided Infection · disinfections control education to radiographers. Only 3 hospitals have radiographers sitting in the infection control committee. Infection management education is conducted in 63 hospitals annually, twice a year in 1 hospital and once every 3 months in 2 hospitals

Ludopedagogia: recreational-educational care for pediatrics University Hospital São Francisco de Paula-Pelotas / RS

Directory of Open Access Journals (Sweden)

Nivia Celoi Ferreira

2016-03-01

Full Text Available The respective project seeks to present the university extension project of the Faculty of Pedagogy of the Catholic University of Pelotas, named "Ludopedagogia: recreational-educational care for pediatrics University Hospital São Francisco de Paula - Pelotas RS". The proposal relies on the view that the play, in the context of the infant playfulness, is a relevant factor to stimulate the processes of human development, to insert the child in moments of relaxation and promote cognitive abilities, as well as, soften the tensions caused by the hospital environment. The presence of the play and everything related to it is one of the factors that facilitate and provide the adaptation of the sick to the hospital environment. Therefore, it requires the presence of a responsible (teacher to mediate ludic experiences and create a link between the magic of play and familiar environment. Besides the presence of  this professional, the proposal aims at the participation of the family to create a welfare situation and proportionate the realization of exchanges, in this way, it’s possible to soften the emotional tension in hospital environment e promote strategies to the infant development.

Compliance with carbapenem guidelines in a university hospital.

Science.gov (United States)

Van Hollebeke, M; Chapuis, C; Bernard, S; Foroni, L; Stahl, J P; Bedouch, P; Pavese, P

2016-03-01

We aimed to evaluate carbapenem prescription compliance with guidelines for nosocomial and community-acquired infections. We conducted a prospective study over a four-month period at our university hospital. We included all adult and pediatric hospitalized patients who had received at least one dose of carbapenem. Data was collected from patients' medical records (hard copy and computerized data; CristalLink software). Compliance with guidelines was assessed by two infectious disease specialists. Assessment criteria included indication, antibiotic choice, dosage, and treatment duration. We included 152 patients in the study (65.4% of men). Carbapenem prescription was appropriate for 76.3% of prescriptions. The use of carbapenems was considered appropriate for 73.9% of empirical prescriptions and for 77.8% of documented prescriptions. Non-compliance with guidelines was mainly due to prescriptions for community-acquired infections. Antibiotic de-escalation could not be initiated in 40.3% of patients and was only initiated in 51.7% of patients for whom it could be considered. Although the average treatment duration was 7.5 days, 23.7% of patients received carbapenems for more than 10 days. These results highlight the need for a strong carbapenem stewardship program in our hospital. Copyright © 2016. Published by Elsevier SAS.

Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals.

Science.gov (United States)

Edward, G M; Biervliet, J D; Hollmann, M W; Schlack, W S; Preckel, B

2008-01-01

The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables: number of patients visiting the PAC, staffing of the PAC, opening hours, scheduling, and additional preoperative diagnostic testing. The number of patients seen yearly varies from 7.000 to 13.500. In all clinics, the preoperative assessment was performed by anaesthetists and residents. In five PACs, preoperative assessment was also performed by physician assistants or nurse practitioners. Opening hours varied. Consultations are by appointment, 'walk-in', or a combination of these two. In four clinics additional testing is performed at the PAC itself. This study shows that the organisational structure of the PAC at similar university hospitals varies greatly; this can have important implications when designing a benchmarking process.

Sound and Music Interventions in Psychiatry at Aalborg University Hospital

DEFF Research Database (Denmark)

Lund, Helle Nystrup; Bertelsen, Lars Rye; Bonde, Lars Ole

2016-01-01

to their needs here-and-now. In the study, we focus on how self-selected music may lead to decrease of anxiety and pain or improved relaxation/sleep. The article describes and discusses the theory-driven development of the sound/music milieu, relevant empirical studies, the novel method of data collection......This article reports on the ongoing project development and research study called “A New Sound and Music Milieu at Aalborg University Hospital”. Based on a number of pilot studies in AUH Psychiatry, investigating how special playlists and sound equipment (“sound pillows” and portable players) can...... be used by hospital patients and administered by hospital staff supervised by music therapists, the new project aims to prepare the ground for a systematic application of sound and music in the hospital environment. A number of playlists have been developed, based on theoretical and empirical research...

[The profile urological emergencies at the Conakry University Teaching Hospital, Guinea].

Science.gov (United States)

Bobo Diallo, A; Bah, I; Diallo, T M O; Bah, O R; Amougou, B; Bah, M D; Guirassy, S; Bobo Diallo, M

2010-03-01

To stick out the profile urological emergencies at the Conakry University Teaching Hospital, Guinea. This retrospective study, carried out over a period of 3 years (January 2005-December 2007), included 757 urological emergencies admitted to the urology department of the university hospital of Conakry, Guinea. The mean age of patients was 56 years. These patients had an age equal to or higher than 60 years in 58% of the cases. The sex ratio (M/F) was 16.6. According to the social profession, the farmer (40,6%) and workers (21%) were the dominant patients. The most frequent illness was vesical urinary retention (73.9%), hematuria (9.6%) and genito-urinary system trauma (7%). The most performed procedures were the installation of a urethral catheter (55.25%) and the installation of a suprapubic catheter (24.14%). The most frequent urological emergency in our country was vesical urinary retention, the hematuria and genito-urinary system trauma are not rare there. Copyright 2009 Elsevier Masson SAS. All rights reserved.

The art of improvisation: the working process of administrators at a Federal University Hospital.

Science.gov (United States)

Littike, Denilda; Sodré, Francis

2015-10-01

The scope of this article is to analyze the working process of administrators at a Federal University Hospital (HUF). It includes research with a qualitative approach conducted through interviews with twelve administrators. The work process, the work tools and the human activity per se are understood to be under scrutiny. Work is acknowledged as a category that analyzes the management methods used by professional health workers. The HUFs are responsible for two social policies, namely education and health. The aim of the administrators' work is an organizational issue, and the administration tools used are bureaucratic and out-of-date for the current political context of hospital management. The most significant feature of this hospital administration is improvisation, which reduces the potential of the administrators in such a way that, instead of introducing innovative changes into their work process, they prefer to leave their jobs. Improvisation is caused by the production of sequential obstacles in management decision-making at this teaching hospital. In short, the transfer of administration at the HUF, from direct government administration by the University to the Brazilian Company of Hospital Services (EBSERH), was analyzed on the grounds that this would establish a "new" management model.

Physics with colder molecular ions: The Heidelberg Cryogenic Storage Ring CSR

International Nuclear Information System (INIS)

Zajfman, D; Wolf, A; Schwalm, D; Orlov, D A; Grieser, M; Hahn, R von; Welsch, C P; Lopez-Urrutia, J R Crespo; Schroeter, C D; Urbain, X; Ullrich, J

2005-01-01

A novel cryogenic electrostatic storage ring is planned to be built at the Max-Planck Institute for Nuclear Physics in Heidelberg. The machine is expected to operate at low temperatures (∼2K) and to store beams with kinetic energies between 20 to 300 keV. An electron target based on cooled photocathode technology will serve as a major tool for the study of reactions between molecular ions and electrons. Moreover, atomic beams can be merged and crossed with the stored ion beams allowing for atom molecular-ion collision studies at very low up to high relative energies. The proposed experimental program, centered around the physics of cold molecular ions, is shortly outlined

Assessment of nurses' work climate at Alexandria Main University Hospital.

Science.gov (United States)

Emam, Sanaa Abdel-aziz; Nabawy, Zeinab Mohamed; Mohamed, Azzaa Hassan; Sbeira, Walaa Hashem

2005-01-01

Work climate is indicative of how well the organization is realizing its full potential. An accurate assessment of work climate can identify the unnecessary obstacles to nurses interfering with their best performance. The present study aims to assess nurses' work climate at Alexandria Main University Hospital. The study sample included all nurses (N=400) who were working in inpatient medical and surgical units at the Alexandria Main University Hospital who were available at the time of data collection. A structured questionnaire was developed to assess nurses' perceptions regarding the dimensions of work climate. Data was collected by individual interview using the structured questionnaire. Results indicated that the highest percentages of nurses in medical and surgical units perceived that their work climate is characterized by good way of performance management, feeling of responsibility, warmth and supportive relationships, quality of communication, morale, organizational clarity and feeling of identity and belongness to the hospital. Nurses perceived that they are lacking work climate conducive to conflict resolution, participation in decision making, opportunity for training and development, fair rewards and recognition, calculated risks, sufficient resources, effective leadership and teamwork. There were no significant difference between nurses perceptions in medical and surgical units regarding all dimensions of work climate. The highest percentage of nurses in all units were satisfied only with the feeling of responsibility, way of performance management, and quality of communication. Conflict and identity were perceived as the most important areas that need improvement in the hospital. Based on the results recommendations were given to enhance work climate through designing compensation and recognition systems, and negotiate their requirements and accomplishment based on established standards and outcomes measures. Also, encouragement of and planning for

Sexual harassment against nursing staff in Tanta University Hospitals, Egypt.

Science.gov (United States)

Abo Ali, Ehab A; Saied, Shimaa M; Elsabagh, Hala M; Zayed, Hanaa A

2015-09-01

Sexual harassment against nurses is a major workplace problem causing adverse psychological effects and may affect the occupational performance of the nurses. This study aimed to assess the magnitude of this problem, and its characteristics and consequences among the nursing staff in Tanta University Hospitals, Gharbeia Governorate, Egypt. A descriptive cross-sectional study was carried out on 430 nurses at Tanta University Hospitals using a semistructured, self-administered questionnaire to collect the data concerning the exposure and characteristics of harassment situations. A representative sample of the nurses was taken randomly from the emergency, medical and surgical departments. Overall, 70.2% of the studied nurses were ever exposed to sexual harassment at the workplace; 43.7% of the harassed nurses were working in both day and night shifts. Staring in a suggestive manner emerged as the most common form of harassment, followed by hearing sexual words and comments or jokes (70.9, 58.6 and 57.3%, respectively). The relatives of the patients were the most common perpetrators, followed by the hospital staff other than the doctors (61.9, 45.4%, respectively). During the harassment situation, astonishment and shock were the most frequent responses in 65.2% of the harassed nurses, while after its occurrence 38.4% ignored the situation. About 95% of the harassed nurses were left with psychological effects, mostly in the form of disappointment and depression (76.5 and 67.9%, respectively). The prevalence of sexual harassment among nurses at the workplace was high with relation to certain occupational factors, and it led to marked psychological effects on the victims. Hence, protective legislations and measures should be taken by the hospital management for prevention of this problem in the future.

Managing out of hours clinical photography at the University Hospitals Bristol.

Science.gov (United States)

Brinkworth, Simon; Kenny, Alice; Knights, Christina

2018-04-01

In recent years, Medical Illustration at University Hospitals Bristol (UHBristol) NHS Foundation Trust has seen a steady increase in photography requests, including the need for out of hours photography provision. This paper details how Medical Illustration at UHBristol decided to manage an out of hours clinical photography service.

Clinical Engeneering Experience at the Hospital of the State University of Londrina

OpenAIRE

Ernesto Fernando Ferreyra Ramírez

2002-01-01

This paper describes the four-year experience of implementation of Clinical Engineering services at the Hospital of the State University of Londrina (HURNP/UEL). It was performed by the Electrical Engineering Department (DEEL), through a project involving lecturers and students from the Electrical and Civil Engineering Courses of the same university. The main objectives were the formation of human resources in the Clinical Engineering area and a positive contribution to the healthcare service...

A managed multidisciplinary programme on multi-resistant Klebsiella pneumoniae in a Danish university hospital

DEFF Research Database (Denmark)

Andersen, Stig Ejdrup; Knudsen, Inge Jenny Dahl

2013-01-01

BACKGROUND: Bacteria-producing extended spectrum β-lactamase (ESBL) enzymes are resistant to commonly used antimicrobials. In 2008, routine monitoring revealed a clonal hospital outbreak of ESBL-producing Klebsiella pneumoniae (ESBL-KP). METHODS: At a 510-bed Danish university hospital...... the application of a managed, multi-faceted intervention that does not require ongoing antibiotic stewardship....

Estimation of gastric residence time of the Heidelberg capsule in humans: effect of varying food composition

International Nuclear Information System (INIS)

Mojaverian, P.; Ferguson, R.K.; Vlasses, P.H.; Rocci, M.L. Jr.; Oren, A.; Fix, J.A.; Caldwell, L.J.; Gardner, C.

1985-01-01

In animal and human studies, the gastric emptying of large (greater than 1 mm) indigestible solids is due to the activity of the interdigestive migrating myoelectric complex. The gastric residence time (GRT) of an orally administered, nondigestible, pH-sensitive, radiotelemetric device (Heidelberg capsule) was evaluated in three studies in healthy volunteers. In 6 subjects, the GRT of the Heidelberg capsule was compared with the half-emptying time (t1/2) of diethylenetriaminepentaacetic acid labeled with technetium 99m after a 4-ml/kg liquid fatty meal. The mean (+/-SD) GRT (4.3 +/- 1.4 h) was significantly (p less than 0.001) longer than the mean t1/2 (1.1 +/- 0.3 h); the GRT was prolonged compared with the t1/2 in each subject. In a randomized, crossover trial in 10 subjects, frequent feeding caused a dramatic prolongation in mean GRT of the capsule compared with the fasting state (greater than 14.5 vs. 0.5 h, p less than 0.005). In another crossover study in 6 subjects, the GRT of the capsule was evaluated after an overnight fast, a standard breakfast including solid food, and a liquid meal (i.e., 200 ml of diluted light cream). The mean GRT was 2.6 +/- 0.9 h after the liquid meal vs. 1.2 +/- 0.8 h after fasting (p less than 0.025). The mean GRT after the breakfast was 4.8 +/- 1.5 h, which was significantly greater than that after fasting (p less than 0.001) and after the liquid meal (p less than 0.01). These data suggest that the GRT of the Heidelberg capsule is a marker of the interdigestive migrating myoelectric complex in humans, the interdigestive migrating myoelectric complex can be markedly delayed by frequent feedings with solids, and the interdigestive migrating myoelectric complex is delayed by both liquid and solid meals

Estimation of gastric residence time of the Heidelberg capsule in humans: effect of varying food composition

Energy Technology Data Exchange (ETDEWEB)

Mojaverian, P.; Ferguson, R.K.; Vlasses, P.H.; Rocci, M.L. Jr.; Oren, A.; Fix, J.A.; Caldwell, L.J.; Gardner, C.

1985-08-01

In animal and human studies, the gastric emptying of large (greater than 1 mm) indigestible solids is due to the activity of the interdigestive migrating myoelectric complex. The gastric residence time (GRT) of an orally administered, nondigestible, pH-sensitive, radiotelemetric device (Heidelberg capsule) was evaluated in three studies in healthy volunteers. In 6 subjects, the GRT of the Heidelberg capsule was compared with the half-emptying time (t1/2) of diethylenetriaminepentaacetic acid labeled with technetium 99m after a 4-ml/kg liquid fatty meal. The mean (+/-SD) GRT (4.3 +/- 1.4 h) was significantly (p less than 0.001) longer than the mean t1/2 (1.1 +/- 0.3 h); the GRT was prolonged compared with the t1/2 in each subject. In a randomized, crossover trial in 10 subjects, frequent feeding caused a dramatic prolongation in mean GRT of the capsule compared with the fasting state (greater than 14.5 vs. 0.5 h, p less than 0.005). In another crossover study in 6 subjects, the GRT of the capsule was evaluated after an overnight fast, a standard breakfast including solid food, and a liquid meal (i.e., 200 ml of diluted light cream). The mean GRT was 2.6 +/- 0.9 h after the liquid meal vs. 1.2 +/- 0.8 h after fasting (p less than 0.025). The mean GRT after the breakfast was 4.8 +/- 1.5 h, which was significantly greater than that after fasting (p less than 0.001) and after the liquid meal (p less than 0.01). These data suggest that the GRT of the Heidelberg capsule is a marker of the interdigestive migrating myoelectric complex in humans, the interdigestive migrating myoelectric complex can be markedly delayed by frequent feedings with solids, and the interdigestive migrating myoelectric complex is delayed by both liquid and solid meals.

Current status of diagnostic imaging in dental university hospitals in Japan

International Nuclear Information System (INIS)

Sasaki, Takehito; Fujita, Minoru; Katoh, Tsuguhisa; Kobayashi, Kaoru; Okano, Tomohiro; Sato, Kenji; Wada, Shinichi

2004-01-01

The diagnostic imaging examinations in all 29 dental university hospitals in Japan were analyzed during a 1-year period from April 1999 to March 2000. The total number of patients examined was 790859, which corresponded to 27271 patients per hospital on average, with a range from 7872 to 62904. Relative to the total number of patients, intraoral radiography was found to have been most frequently performed, 59% on average, with a range from 40% to 80%, depending on the hospital. Extraoral radiography, mostly panoramic radiography, was 36% on average with the range from 18% to 56%. A significant inverse correlation was observed between the percentages of intraoral and extraoral radiography, relative to the total number of all types of imaging examinations. Computed tomography (CT) examinations were performed with their own apparatuses in 27 hospitals with a frequency of 2.9% of patients in all imaging examinations on average and 9.1% at maximum. The scanning parameter of milliampere seconds (mAs) for individual types of routinely performed CT examinations varied widely, and thus the patient dose can be expected to be considerably reduced, without reducing the amount of diagnostic information to be obtained. Other imaging examinations performed were magnetic resonance imaging in 11 hospitals, X-ray fluoroscopy in 8 hospitals, ultrasonography in 20, nuclear medicine in 5, and bone densitometry in 1 hospital. (author)

Evaluation of the Knowledge Management Mechanisms of Brazilian Northeast Universities Hospital Portals

Directory of Open Access Journals (Sweden)

Helio Roberto Hekis

2013-12-01

Full Text Available Hospital portals that manage health related data are becoming increasingly popular since they play an important role to provide, acquire and exchange information to its users. This study aims to verify how the hospital portals are contributing to the expansion of users knowledge by the analysis of interactive features associated with three mechanisms of knowledge management: Knowledge Access (KA; Knowledge Creation (KC; and Knowledge Transfer (KT. The study is exploratory, descriptive and qualitative, classified as a survey, and involves the standardization of data collection instruments (questionnaires and interviews applied directly to people of a particular population to evaluate the knowledge management the portals present on the university hospitals from northeastern of Brazil. The results indicated that the proceeds of access to knowledge (AK prevailed over other confirming the results found on the Asians and Americans hospital portals. 

Cutaneous adverse drug reactions seen at a university hospital department of dermatology

DEFF Research Database (Denmark)

Borch, Jakob E; Andersen, Klaus E; Bindslev-Jensen, Carsten

2006-01-01

Patients with suspected cutaneous adverse drug reactions are often referred to allergy clinics or departments of dermatology for evaluation. These patients are selected compared with patients identified in prospective and cross-sectional studies of hospital populations. This explains the observed...... variation in prevalence of specific reactions and of eliciting drugs. This study investigated the prevalence of cutaneous adverse drug reactions in a university hospital department of dermatology that is specially focused on allergy. An 8-month survey was carried out during the period April-December 2003...

Western University (No. 10 Canadian Stationary Hospital and No. 14 Canadian General Hospital): a study of medical volunteerism in the First World War.

Science.gov (United States)

Istl, Alexandra C; McAlister, Vivian C

2016-12-01

The Canadian government depended on chaotic civilian volunteerism to staff a huge medical commitment during the First World War. Offers from Canadian universities to raise, staff and equip hospitals for deployment, initially rejected, were incrementally accepted as casualties mounted. When its offer was accepted in 1916, Western University Hospital quickly adopted military decorum and equipped itself using Canadian Red Cross Commission guidelines. Staff of the No. 10 Canadian Stationary Hospital and the No. 14 Canadian General Hospital retained excellent morale throughout the war despite heavy medical demand, poor conditions, aerial bombardment and external medical politics. The overwhelming majority of volunteers were Canadian-born and educated. The story of the hospital's commanding officer, Edwin Seaborn, is examined to understand the background upon which the urge to volunteer in the First World War was based. Although many Western volunteers came from British stock, they promoted Canadian independence. A classical education and a broad range of interests outside of medicine, including biology, history and native Canadian culture, were features that Seaborn shared with other leaders in Canadian medicine, such as William Osler, who also volunteered quickly in the First World War.

Regulations for the management of radioactive wastes from hospitals, universities and institutes

International Nuclear Information System (INIS)

Yao Zhiping; Sun Weiqi; Zhou Qingru

1987-01-01

One of the drafts of the regulations for the management of radioactive wastes from hospitals, universities, and institutes in China is described. The design concepts for the trucks and drums to be used for transporting and handling the wastes are also described

Risk Assessment of Physical Health Hazards in Al-Azhar University Hospital in New Damietta, Egypt

OpenAIRE

Mohammed El-Hady Imam*, Raed Mohammed Alazab**,

2013-01-01

Introduction: Personnel working in hospitals are exposed to many occupational hazards that may threaten their health and safety. Physical hazards that are encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. Objectives: The objectives of this study were to identify physical health hazards in all departments of Al-Azhar University Hospital in new Damietta, to measure risk level of these hazards, and to recognize safety me...

The Heidelberg POLYP - a flexible and fault-tolerant poly-processor

International Nuclear Information System (INIS)

Maenner, R.; Deluigi, B.

1981-01-01

The Heidelberg poly-processor system POLYP is described. It is intended to be used in nuclear physics for reprocessing of experimental data, in high energy physics as second-stage trigger processor, and generally in other applications requiring high-computing power. The POLYP system consists of any number of I/O-processors, processor modules (eventually of different types), global memory segments, and a host processor. All modules (up to several hundred) are connected by a multiple common-data-bus system; all processors, additionally, by a multiple sync bus system for processor/task-scheduling. All hard- and software is designed to be decentralized and free of bottle-necks. Most hardware-faults like single-bit errors in memory or multi-bit errors during transfers are automatically corrected. Defective modules, buses, etc., can be removed with only a graceful degradation of the system-throughput. (orig.)

[Future roles of clinical laboratories and clinical laboratory technologists in university hospitals].

Science.gov (United States)

Yokota, Hiromitsu; Yatomi, Yutaka

2013-08-01

Clinical laboratories in university hospitals should be operated with a good balance of medical practice, education, research, and management. The role of a clinical laboratory is to promptly provide highly reliable laboratory data to satisfy the needs of clinicians involved in medical practice and health maintenance of patients. Improvement and maintenance of the quality of the laboratory staff and environment are essential to achieve this goal. In order to implement these requirements efficiently, an appropriate quality management system should be introduced and established, and evaluated objectively by a third party (e.g. by obtaining ISO 15189 certification). ISO 15189 is an international standard regarding the quality and competence of clinical laboratories, and specifies a review of the efficient operational system and technical requirements such as competence in implementing practical tests and calibration. This means the results of laboratory tests reported by accredited laboratories withstand any international evaluation, which is very important to assure the future importance of the existence and management of clinical laboratories as well as internationalization of medical practice. "Education" and "research" have important implications in addition to "medical practice" and "management", as the roles that clinical laboratories should play in university hospitals. University hospital laboratories should be operated by keeping these four factors in good balance. Why are "education" and "research" required in addition to "medical practice" services? If individual clinical laboratory technologists can provide an appropriate response to this question, the importance of the existence of clinical laboratories would be reinforced, without being compromised.

[Analysis of HIV antibody positive cases in Peking University Hospital of Stomatology during 9 years].

Science.gov (United States)

Ding, Jian-fen; Qiu, Juan; Shen, Shu-ming

2016-02-01

To investigate the prevalence and characteristics of HIV patients found in Peking University Hospital of Stomatology during 9 years, and provide management strategy for early diagnosis and control of HIV in Stomatology Hospital. A retrospective study of the HIV positive patients diagnosed by HIV antibody screening was carried out. The related information about these patients found in Peking University School of Stomatology during 2005-2013 was obtained from China Disease Control Information System. 68,562 patients accepted HIV antibody screening in Peking University Hospital of Stomatology during 2005-2013. Thirty one patients were found HIV antibody positive. The ratio of HIV antibody positive was about 0.045%, which was composed of 25 males and 6 females. 61.29% patients aged between 20-40 years, and their career was mainly commercial service with a education level of junior high school. The proportion of sexual route of transmission was about 74.91%, and 34.78% of them were male homosexuality. Most of the patients with HIV antibody positive were found in the out-patient clinic, especially in the department of oral mucosal diseases, accounting for 70.97%. HIV antibody positive rate in Peking University School of Stomatology was slightly lower than that in general hospitals. Medical staff should increase their awareness of AIDS prevention and control, for higher HIV risk departments, such as oral mucosal diseases and periodontal disease, efforts should be made to increase HIV screening, expand the scope of screening, and promote provider-initiated HIV testing and counseling.

Two Belgian University Hospitals

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M. Huylebrouck

2012-01-01

Full Text Available Background. Bevacizumab (BEV, a humanized immunoglobulin G1 monoclonal antibody that inhibits VEGF has demonstrated activity against recurrent high-grade gliomas (HGG in phase II clinical trials. Patients and Methods. Data were collected from patients with recurrent HGG who initiated treatment with BEV outside a clinical trial protocol at two Belgian university hospitals. Results. 19 patients (11 M/8 F were administered a total of 138 cycles of BEV (median 4, range 1–31. Tumor response assessment by MRI was available for 15 patients; 2 complete responses and 3 partial responses for an objective response rate of 26% for the intent to treat population were observed on gadolinium-enhanced T1-weighted images; significant regressions on T2/FLAIR were documented in 10 out of 15 patients (67%. A reduced uptake on PET was documented in 3 out of 4 evaluable patients. The six-month progression-free survival was 21% (95% CI 2.7–39.5. Two patients had an ongoing tumor response and remained free from progression after 12 months of BEV treatment. Conclusions. The activity and tolerability of BEV were comparable to results from previous prospective phase II trials. Reduced uptake on PET suggests a metabolic response in addition to an antiangiogenic effect in some cases with favorable clinical outcome.

Prevalence of malnutrition and associated factors among hospitalized elderly patients in King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

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Alzahrani, Sami H; Alamri, Sultan H

2017-07-03

Malnutrition is a nutritional disorder that adversely affects the body from a functional or clinical perspective. It is very often observed in the elderly population. This study aimed to estimate the prevalence of malnutrition among hospitalized elderly patients and its associated factors and outcomes in terms of length of stay and mortality in King Abdulaziz University Hospital, Jeddah, Saudi Arabia. In a cross-sectional study, we evaluated the nutritional status of hospitalized elderly patients using the most recent version of the short form of Mini Nutritional Assessment (MNA-SF). A total of 248 hospitalized patients were included (70.0 ± 7.7 years; 60% female). According to the MNA-SF, a total of 76.6% patients were either malnourished or at risk of malnutrition. Malnourished patients had significantly lower levels of serum albumin (28.2 ± 7.7), hemoglobin (10.5 ± 1.8), and lymphocyte (1.7 ± 0.91). They had increased tendency to stay in the hospital for longer durations (IQR, 5-11 days; median = 7 days) and had a mortality rate of 6.9%. Malnutrition was highly prevalent among hospitalized elderly and was associated with increased length of stay and mortality.

[A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

Science.gov (United States)

Maisch, Bernhard

2005-03-01

1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state

A Descriptive Study Of The Burden Of Animal-Related Trauma At Cork University Hospital.

LENUS (Irish Health Repository)

Sheehan, M

2018-01-01

Farming is the most dangerous occupation in Ireland1 and the incidence of farm accidents is rising. This study examines major farm animal-related trauma treated at Cork University Hospital over a 5 year period. There were 54 patients admitted to Cork University Hospital (C.U.H.) with major farm animal-related trauma. The median age was 56 years, 85% were male and the median hospital length of stay was four days. Older patients had longer lengths of stay; 5.5 vs 4 days (p=0.026). Tibia\\/fibula fractures were the most common injuries (N=13, 24%); head injury occurred in six patients (11%). There were 32 (59%) patients who required surgery, the majority for orthopaedic injuries. There were nine patients (16.7%) admitted to the intensive care unit; their median ICU stay was four days. Injury prevention and treatment strategies require that the age profile, mechanism of injury and injury patterns of farmers sustaining animal-related trauma is recognised.

Knowledge and practices about hospital waste disposal and universal safety precautions in class IV employee.

Science.gov (United States)

Megha, Khobragade; Daksha, Pandit

2013-01-01

Norms and guidelines are formed for safe disposal of hospital waste but question is whether these guidelines are being followed and if so, to what extent. Hence, this study was conducted with objective to study the knowledge and practices about hospital waste disposal and universal safety precautions in class IV employee and to study its relationship with education, occupation and training. A cross-sectional study was carried out in a teaching hospital in Mumbai using semi-structured questionnaire in which Class IV employee were included. Questionnaire was filled by face to face interview. Data were analyzed using SPSS. 48.7% Class IV employee were not trained. More than 40% were following correct practices about disinfection of infectious waste. None of the respondents were using protective footwear while handling hospital waste. Only 25.5% were vaccinated for hepatitis B. 16% had done HIV testing due to contact with blood, body fluid, needle stick injury. Knowledge and practices about hospital waste disposal and universal precaution were statistically significant in trained respondents. Training of employees should be given top priority; those already in service should be given on the job training at the earliest.

Investigation of health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences: health-promoting hospitals.

Science.gov (United States)

Hamidi, Yadollah; Hazavehei, Seyed Mohammad Mahdi; Karimi-Shahanjarini, Akram; SeifRabiei, Mohamad Ali; Farhadian, Maryam; Alimohamadi, Shohreh; Kharghani Moghadam, Seyedeh Melika

2017-12-01

The prophecy of health promoting hospitals (HPH) is bringing about a change and transition from treatment-oriented to health-oriented attitudes. In Iran, hospitals usually play the traditional roles. The present study was aimed at the evaluation of the health promotion status in specialized hospitals associated with Hamadan University of Medical Sciences (HUMS). This applied study was conducted in two Hamadan specialized hospitals in the Hamadan city. The health promotion status was evaluated using a self-assessment checklist designed by the World Health Organization's HPH. The evaluation was done in five standards including management policy, patient assessment, patient information and intervention, promotion of a healthy workplace and continuity and cooperation. The results showed that both the hospitals studied had a poor status in terms of promoting a healthy workplace (average = 31.24%) and management policy standards (average = 35.29%) in comparison with the other relevant standards: patient assessment (53.12%), patient information and intervention (62.5%), continuity and cooperation (65.78%)). The results of the standards and sub-standards status displayed better performance in the cardiovascular hospital (53.67%) compared to the women and parturition hospital (42.64%). The findings indicated that HPH standards are very low in the studied hospitals. The reason behind this wide gap might be due to the fact that hospitals in Iran are more treatment-oriented and patient-oriented and they do not play an active part in health promoting. It was found that management policy and promoting healthy workplace standards had the worst status and must be improved.

Development of pediatric emergency medicine at Addis Ababa University/Tikuranbessa Specialized Hospital, Ethiopia.

Science.gov (United States)

Tefera, Muluwork; Bacha, Tigist; Butteris, Sabrina; Teshome, Getachew; Ross, Joshua; Hagen, Scott; Svenson, Jim; Busse, Heidi; Tefera, Girma

2014-07-01

In the world emergencies occur everywhere, and each day they consume ressources regardless of whether there are systems capable of achieving good outcomes. Low-income countries suffer the most highest rates of every category of injury--from traffic and the highest rates of acute complications of communicable diseases including tuberculosis, malaria and HIV. To describe the development of pediatrics emergency medicine at Tikur Anbesa Specialized Hospital A twinning partnership model was used in developing a pediatric emergency medicine training program helps in development of pediatrics emergency system. Strengthening the capacity of Addis Ababa University (AAU), Tikur Anbessa Hospital (TASH) to provide pediatric emergency medical services through improved organization of the pediatrics emergency department and strengthening of continuing education opportunities for faculty and staff capacity building by this improving quality of care in pediatrics patients in the country. The Addis Ababa University, University of Wiscosin and People to People partners intend to continue working together to strengthening and developing effetive systems to deliver quality pediatrics emergency medicine care troughout all regions of Ethiopia.

The Effect of Service Compact (SERVICOM) on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

OpenAIRE

Jude Kennedy Emejulu; M. C. Muo; E. E.O. Chukwuemeka

2014-01-01

This study examined the effect of service compact (Servicom Service delivery) in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that requir...

Opportunistic infection manifestation of HIV-AIDS patients in Airlangga university hospital Surabaya

Science.gov (United States)

Asmarawati, T. P.; Putranti, A.; Rachman, B. E.; Hadi, U.; Nasronudin

2018-03-01

Opportunistic infections are common in HIV-infected patients especially those who progress to acquired immunodeficiency syndrome. There are many factors involved in the prevalence of opportunistic infections. We investigated the patterns of opportunistic infection in HIV-infected patients admitted to Airlangga University Hospital Surabaya. This study was an observational study, conducted in adults patients with HIV infection from January 2016 to September 2017. Data collected from the medical records of the patients. The number of samples in this study was 58. The mean age was 42.9 years, mostly male. Most patients admitted were in clinical stadium III or IV. Heterosexual transmission is a common risk factor in patients. The most prevalent opportunistic infections found in patients were oral candidiasis (58.6%), followed by pulmonary tuberculosis (41.4%) and pneumonia/PCP (41.4%). Other infections found were toxoplasmosis, chronic diarrhea, cytomegalovirus, meningitis TB, hepatitis C, amoebiasis, and cerebritis. Opportunistic infections occurred more often in age≥40 years and increased as clinical stadium get worse. From the results, we conclude that oral candidiasis and pulmonary tuberculosis were the most common opportunistic infections found in Airlangga University Hospital. The pattern of opportunistic infections in this study could help the hospital to set priorities related to the management of patients.

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

Directory of Open Access Journals (Sweden)

Robert Robinson

2017-03-01

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

Factors associated with medication information in diabetes care: differences in perceptions between patients and health care professionals

Directory of Open Access Journals (Sweden)

Längst G

2015-10-01

Full Text Available Gerda Längst,1 Hanna Marita Seidling,2,3 Marion Stützle,2,3 Dominik Ose,1 Ines Baudendistel,1 Joachim Szecsenyi,1 Michel Wensing,1,4 Cornelia Mahler1 1Department of General Practice and Health Services Research, University Hospital of Heidelberg, Heidelberg, Germany; 2Cooperation Unit Clinical Pharmacy, University of Heidelberg, Heidelberg, Germany; 3Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany; 4Radboud University Nijmegen Medical Centre, Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands Purpose: This qualitative study in patients with type 2 diabetes and health care professionals (HCPs aimed to investigate which factors they perceive to enhance or impede medication information provision in primary care. Similarities and differences in perspectives were explored.Methods: Eight semistructured focus groups were conducted, four with type 2 diabetes patients (n=25 and four with both general practitioners (n=13 and health care assistants (n=10. Sessions were audio and video recorded, transcribed verbatim, and subjected to computer-aided qualitative content analysis.Results: Diabetes patients and HCPs broadly highlighted similar factors as enablers for satisfactory medication information delivery. Perceptions substantially differed regarding impeding factors. Both patients and HCPs perceived it to be essential to deliver tailored information, to have a trustful and continuous patient–provider relationship, to regularly reconcile medications, and to provide tools for medication management. However, substantial differences in perceptions related to impeding factors included the causes of inadequate information, the detail required for risk-related information, and barriers to medication reconciliation. Medication self-management was a prevalent topic among patients, whereas HCPs’ focus was on fulfilling therapy and medication management responsibilities

Characterization of radioactive waste from a university hospital and evaluation of the management process

International Nuclear Information System (INIS)

Silva, I.M.R.; Batista, A.S.M.

2017-01-01

Introduction: University hospitals, due to their educational nature, are generally of tertiary size with a wide availability of imaging equipment for diagnosis and / or treatment. The Hospital das Clínicas of the Federal University of Minas Gerais (HC / UFMG) has sectors of Nuclear Medicine, Conventional and Interventional Radiology, Computed Tomography and Magnetic Resonance. The Faculty of Medicine still has a Molecular Imaging Center, equipped with a Positron Emission Tomography (CT) equipment coupled to CT (PET-CT). So who makes use of radionuclide emitting equipment and equipment of different types of radiation should be considered regarding the principles of radioprotection. Methods: A survey of the radioactive waste generated by the Hospital das Clínicas of the Federal University of Minas Gerais (HC / UFMG) was carried out regarding the type, origin, treatment organization, route and destination. Results: It was observed that the sector that generates the most radioactive waste is Nuclear Medicine. The most used radionuclides are shown in the table in comparison with the most relevant ones in the management aspect of waste, taking into account the half-life and emission type. Conclusion: The management of radioactive waste at the Hospital das Clínicas of UFMG is the responsibility of the sectors that generate them until they are safe to be considered common waste, that is, after decay. They follow the guidelines of the Brazilian National Commission of Nuclear Energy (CNEN), Norm CNEN NN 8.01, ensuring safety in the handling of radioactive waste of short half-life

Logics of pre-merger decision-making processes: the case of Karolinska University Hospital.

Science.gov (United States)

Choi, Soki; Brommels, Mats

2009-01-01

The purpose of this paper is to examine how and why a decision to merge two university hospitals in a public context might occur by using an in-depth case study of the pre-merger process of Karolinska University Hospital. Based on extensive document analysis and 35 key informant interviews the paper reconstructed the pre-merger process, searched for empirical patterns, and interpreted those by applying neo-institutional theory. Spanning nearly a decade, the pre-merger process goes from idea generation through transition to decision, and took place on two arenas, political, and scientific. Both research excellence and economic efficiency are stated merger motives. By applying a neo-institutional perspective, the paper finds that the two initial phases are driven by decision rationality, which is typical for political organizations and that the final phase demonstrated action rationality, which is typical for private firms. Critical factors behind this radical change of decision logic are means convergence, uniting key stakeholder groups, and an economic and political crisis, triggering critical incidents, which ultimately legitimized the formal decision. It is evident from the paper that merger decisions in the public sector might not necessarily result from stated and/or economic drivers only. This paper suggests that a change of decision logic from decision to action rationality might promote effective decision making on large and complex issues in a public context. This is the first systematic in-depth study of a university hospital merger employing a decision-making perspective.

Prognostic Indices of Poor Nutritional Status and Their Impact on Prolonged Hospital Stay in a Greek University Hospital

Directory of Open Access Journals (Sweden)

Georgia Tsaousi

2014-01-01

Full Text Available Background. To ascertain the potential contributors to nutritional risk manifestation and to disclose the factors exerting a negative impact on hospital length of stay (LOS, by means of poor nutritional status, in a nonselected hospitalized population. Materials and Methods. NutritionDay project questionnaires were applied to 295 adult patients. Study parameters included anthropometric data, demographics, medical history, dietary-related factors, and self-perception of health status. Body Mass Index (BMI and Malnutrition Universal Screening Tool (MUST were calculated for each participant. MUST score was applied for malnutrition assessment, while hospital LOS constituted the outcome of interest. Results. Of the total cohort, 42.3% were at nutritional risk and 21.4% malnourished. Age, gender, BMI, MUST score, autonomy, health quality, appetite, quantity of food intake, weight loss, arm or calf perimeter (P7 days. Conclusion. Nutritional status and nutrition-related parameters such as weight loss, quantity of food intake, appetite, arm circumference, dietary type, and extent of dependence confer considerable prognostic value regarding hospital LOS in acute care setting.

[Perceived quality assessment in the University Hospital Authority in Sassary, Italy].

Science.gov (United States)

Virdis, A; Licheri, N; Cagnina, N; Sassu, A; Tanda, E; Soddu, M D

2010-01-01

In line with the health legislation that introduced a system to monitor and review the quality, the Hospital Authority of University of Sassari has placed among its main objectives the satisfaction of patients/clients and has made an initial assessment of customer satisfaction for users hospitalized in their facilities with the methodology of the questionnaire. It was drawn up a questionnaire to closed questions, with default value scales, divided into 4 areas: 1) Hospitality, 2) Hotel treatment, 3) Professionalism of staff-information related pathology, informed consent, 4) personal opinion of the patient upon discharge. The questionnaire was administered the day of discharge, to users hospitalized of six UO of Hospital Authority in the months of September and October 2009, and patients discharged within 2 months were given a total of 514, of them have completed the testing 290 (54% of discharged patients). The questionnaires were analyzed in the results of both the individual UO involved in both the overall result, persons responsible for each facility was sent a report with the results of its own. The survey results are satisfactory with regard to both positive aspects, that is the overall grade average of 86.23% which to criticism, to which they are planning initiatives for their solution.

Cross-year peer tutoring on internal medicine wards: results of a qualitative focus group analysis

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Krautter M

2014-09-01

Full Text Available Markus Krautter,1 Sven Andreesen,2 Nadja Köhl-Hackert,2 Katja Hoffmann,3 Wolfgang Herzog,2 Christoph Nikendei2 1Department of Nephrology, University of Heidelberg, 2Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Hospital, 3Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany Background: Peer-assisted learning (PAL has become a well-accepted teaching method within medical education. However, descriptions of on-ward PAL programs are rare. A focus group analysis of a newly established PAL program on an internal medicine ward was conducted to provide insights into PAL teaching from a student perspective.Purpose: To provide insights into students' experiences regarding their on-ward training with and without accompanying PAL tutors.Methods: A total of N=168 medical students in their sixth semester participated in the investigation (intervention group: N=88; control group: N=80. The intervention group took part in the PAL program, while the control group received standard on-ward training. There were seven focus groups with N=43 participants (intervention group: four focus groups, N=28 participants; control group: three focus groups, N=15 participants. The discussions were analyzed using content analysis.Results: The intervention group emphasized the role of the tutors as competent and well-trained teachers, most beneficial in supervising clinical skills. Tutors motivate students, help them to integrate into the ward team, and provide a non-fear-based working relationship whereby students' anxiety regarding working on ward decreases. The control group had to rely on autodidactic learning strategies when neither supervising physicians nor final-year students were available.Conclusion: On-ward PAL programs represent a particularly valuable tool for students' support in training clinical competencies on ward. The tutor–student working alliance

Experiences with MBSR at a university hospital

DEFF Research Database (Denmark)

Fjorback, Lone; Piet, Jacob; Pallesen, Karen Johanne

Collaboration across disciplinary boundaries, i.e. between practitioners, clinicians, researchers, and scholars, is needed to effectively run an MBSR research clinic and professional training institute. The establishment of such collaboration poses specific challenges. In this session, we...... will present some general reflections and concrete examples of the ways in which we work to realize our common vision of an MBRS research clinic and professional training institute. Our group has expertise in MBSR clinical intervention, clinical research, brain research, MBSR delivered to the community...... and integrated in these processes. In practice, we take particular interest in the application and transmission of MBSR at a university hospital and in the broader society. As we hope to show, recognizing the reality of different individual, institutional and disciplinary agendas is as important an element...

Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt.

Science.gov (United States)

Kishk, Rania Mohammed; Mandour, Mohamed Fouad; Farghaly, Rasha Mohamed; Ibrahim, Ahmed; Nemr, Nader Attia

2014-01-01

Introduction. Blood stream infection (BSI) is a common problem of newborn in neonatal intensive care units (NICUs). Monitoring neonatal infections is increasingly regarded as an important contributor to safe and high-quality healthcare. It results in high mortality rate and serious complications. So, our aim was to determine the incidence and the pattern of BSIs in the NICU of Suez Canal University Hospital, Egypt, and to determine its impact on hospitalization, mortality, and morbidity. Methods. This study was a prospective one in which all neonates admitted to the NICUs in Suez Canal University hospital between January, 2013 and June 2013 were enrolled. Blood stream infections were monitored prospectively. The health care associated infection rate, mortality rate, causative organism, and risk factors were studied. Results. A total of 317 neonates were admitted to the NICU with a mortality rate of 36.0%. During this study period, 115/317 (36.3%) developed clinical signs of sepsis and were confirmed as BSIs by blood culture in only 90 neonates with 97 isolates. The total mean length of stay was significantly longer among infected than noninfected neonates (34.5 ± 18.3 and 10.8 ± 9.9 days, resp., P value Suez Canal University Hospital was relatively high with high mortality rate (36.0%).

Clinical Engeneering Experience at the Hospital of the State University of Londrina

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Ernesto Fernando Ferreyra Ramírez

2002-01-01

Full Text Available This paper describes the four-year experience of implementation of Clinical Engineering services at the Hospital of the State University of Londrina (HURNP/UEL. It was performed by the Electrical Engineering Department (DEEL, through a project involving lecturers and students from the Electrical and Civil Engineering Courses of the same university. The main objectives were the formation of human resources in the Clinical Engineering area and a positive contribution to the healthcare services offered by the HURNP for the community in the surroundings of Londrina – Paraná State – Brazil.

Clinical and radiological outcome following pneumothorax after endoscopic lung volume reduction with valves

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Gompelmann D

2016-12-01

Full Text Available D Gompelmann,1,2 N Benjamin,1 K Kontogianni,1 FJF Herth,1,2 CP Heussel,2–4 H Hoffmann,2,5 R Eberhardt1,2 1Pneumology and Critical Care Medicine, Thoraxklinik at University of Heidelberg, 2German Center for Lung Research, 3Diagnostic and Interventional Radiology, Thoraxklinik at University of Heidelberg, 4Diagnostic and Interventional Radiology, University Hospital Heidelberg, 5Thoracic Surgery, Thoraxklinik at University of Heidelberg, Heidelberg, Germany Introduction: Valve implantation has evolved as a therapy for patients with advanced emphysema. Although it is a minimally invasive treatment, it is associated with complications, the most common being pneumothorax. Pneumothorax occurs due to the rapid target lobe volume reduction and may be a predictor of clinical benefit despite this complication. Objective: The objective of this study was to conduct an exploratory data analysis of patients who developed a pneumothorax following endoscopic valve therapy for emphysema. Materials and methods: This study performed a retrospective evaluation of pneumothorax management and the impact of pneumothorax on clinical outcomes in 70 patients following valve therapy in 381 consecutive patients. Results: Pneumothorax rate following valve therapy was 18%. Pneumothorax management consisted of chest tube insertion, valve removal, and surgical intervention in 87% (61/70, 44% (31/70, and 19% (13/70 of the patients, respectively. Despite pneumothorax, patients experienced modest but significant improvements in lung function parameters (forced expiratory volume in 1 second: 55±148 mL, residual volume: -390±964 mL, total lung capacity: -348±876; all P<0.05. Persistent lobar atelectasis 3 months after recovering from pneumothorax, which was associated with relevant clinical improvement, was observed in only 21% (15/70 of the patients. Conclusion: Pneumothorax is a frequent severe complication following valve therapy that requires further intervention

Assessment of dedicated revenue of non-educational hospitals in Guilan University of Medical Sciences (2012

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S. Asefzadeh

2015-06-01

Full Text Available Hospitals, as one of the main providers of health services, are of great importance in health and economy. The aim of this descriptive study was to assess the dedicated revenue of all non-educational hospitals in Guilan University of Medical Sciences (14 hospitals in 2012. On average, 22.35% of income was provided by cash earnings and 77.65% was provided by insurance organizations.There was 1.25% deficit by insurance. The net income of small hospitals with few available beds was very low and they were not economically affordable. The out of pocket to total income ratio was higher in the hospitals located in deprived areas due to lack of full insurance coverage.

The university hospital as centre of excellence for the production and dissemination of the advanced biomedical culture

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Romano Del Nord

2015-04-01

Full Text Available University hospitals are characterized by the coexistence of care, research and training facilities and by the mission to achieve excellent results in the healthcare services provided. These activities, which are respectively subordinate to the Hospitals and University Institutions of Medicine, reach their maximum level of efficiency when programmed and managed with the principles of maximum integration and synergy in organizational, functional and, not least, physical and spatial terms. Based on this knowledge, a group of researchers from the Interuniversity Centre TESIS developed a PRIN research project – this article summarizes its contents and results – aimed at defining the design approach principles on the basis of which to work out innovative solutions to be tested in the creation of Cities of Health, IRCCSs (Scientific Institutes for Research, Hospitalization and Health Care and Hospitals of excellence.

Muddy puddles - the microbiology of puddles located outside tertiary university teaching hospitals.

Science.gov (United States)

Furukawa, M; McCaughan, J; Stirling, J; Millar, B C; Bell, J; Goldsmith, C E; Reid, A; Misawa, N; Moore, J E

2018-04-01

In the British Isles, the frequency of rain results in the formation of puddles on footpaths and roads in/around hospitals. No data are available demonstrating the microbiological composition of such puddles and therefore a study was undertaken to examine the microbiology of puddles in the grounds of two tertiary university-teaching hospitals (18 sites) and compared with control puddles from non-hospital rural environments (eight sites), estimating (i) total viable count; (ii) identification of organisms in puddles; (iii) enumeration of Escherichia coli: (iv) detection of Extended Spectrum β-Lactamase producing organisms and (v) direct antimicrobial susceptibility testing. A mean count of 2·3 × 10 3  CFU per ml and 1·0 × 10 9  CFU per ml was obtained for hospital and non-hospital puddles respectively. Isolates (n = 77; 54 hospital and 23 non-hospital) were isolated comprising of 23 species among 17 genera (hospital sites), where the majority (10/16; 62·5%) of genera identified were Gram-negative approximately, a fifth (20·6%) were shared by hospital and non-hospital rural samples. Escherichia coli was detected in half of the hospital puddles and under-half (37·5%) of the rural puddles extended spectrum β-lactamase organisms were not detected in any samples examined. Rainwater puddles from the hospital and non-hospital environments contain a diverse range of bacteria, which are capable of causing infections. This study demonstrated the presence of a wide diversity of bacterial taxa associated with rainwater puddles around hospitals, many of which are capable of causing human disease. Of clinical significance is the presence of Pseudomonas aeruginosa isolated from a hospital puddle, particularly for patients with cystic fibrosis. The presence of potentially disease-causing bacteria in puddles in and around hospitals identifies a new potential environmental reservoir of bacteria. Furthermore work is now needed to define their potential of entering or

Compare Clinical Competence and Job Satisfaction Among Nurses Working in Both University and Non-University Hospital in Bushehr 2015

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Abdolrasoul Abbasi

2017-04-01

Full Text Available Background: Nurses are the biggest component of the health care system in the world and their job satisfaction and clinical competence affect performance and success of the organization. This study aimed to determine and compare the clinical competence and job satisfaction of nurses in both academic and non-academic hospitals in Bushehr in 2015. Materials & Methods: In this cross-sectional study, 257 nurses were studied in two hospitals of Bushehr city selected by census method. Data was collected by using valid and reliable Nurse Clinical Competence and Job Satisfaction Inventory questionnaires. Data analyzed by using SPSS- 21, and descriptive statistics, t-test, and ANOVA and Pearson correlation coefficient. Statistical significance was set at P< 0.05. Results: Findings showed that there were no significant diffrences between academic hospital nurses' job satisfaction with 126.96±29.34 and non-academic hospital with 128.31±23.26. Also, there were a significant diffrences between total score of nurses' clinical competence in academic hospital 62.18±18.09 and in non-academic hospital 67.78±17.64. There were a significant and direct association between the clinical competence and job satisfaction of nurses in both hospitals (p≤0.05. Conclusion: Although nurses clinical competence and job satisfaction in both hospitals were assessed at desirable level but both criteria were higher in non-university hospital nurses. It is nessessary that Nurse Manager’s of academic hospitals should pay attention to assessment and improvement of nurse clinical competence and job satisfaction

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

Science.gov (United States)

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

2009-06-01

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

Hand injuries in foreign labour workers in an Irish university hospital.

LENUS (Irish Health Repository)

Sattler, Thorsten

2009-01-01

The present study reports on a new, rapidly growing patient subpopulation presenting with hand injuries to the Department of Plastic Surgery in Cork University Hospital (Ireland). The impact of the 10 new European Union accession states on the trauma workload is examined. The associated growth in expenditure on interpreter services is also examined. Potential risk factors in the foreign workers\\' new working environment is explored.

Peak oxygen uptake and left ventricular ejection fraction, but not depressive symptoms, are associated with cognitive impairment in patients with chronic heart failure

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Steinberg G

2011-12-01

Full Text Available Gerrit Steinberg1,2*, Nicole Lossnitzer2*, Dieter Schellberg2, Thomas Mueller-Tasch2, Carsten Krueger3, Markus Haass4, Karl Heinz Ladwig5, Wolfgang Herzog2, Jana Juenger21University Hospital of Psychiatry, University of Bern, Bern, Switzerland; 2Department of Psychosomatic and General Internal Medicine, Medical Hospital, University of Heidelberg, Heidelberg, 3Department of Cardiology, Josefs Hospital, Heidelberg, 4Department of Cardiology, Theresien Hospital, Mannheim, 5Institute of Epidemiology, German Research Center for Environmental Health, Munich, Germany*both authors contributed equally to this paperBackground: The aim of the present study was to assess cognitive impairment in patients with chronic heart failure (CHF and its associations with depressive symptoms and somatic indicators of illness severity, which is a matter of controversy.Methods and results: Fifty-five patients with CHF (mean age 55.3 ± 7.8 years; 80% male; New York Heart Association functional class I–III underwent assessment with an expanded neuropsychological test battery (eg, memory, complex attention, mental flexibility, psychomotor speed to evaluate objective and subjective cognitive impairment. Depressive symptoms were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID and a self-report inventory (Hospital Anxiety and Depression Scale [HADS]. A comprehensive clinical dataset, including left ventricular ejection fraction, peak oxygen uptake, and a 6-minute walk test, was obtained for all patients. Neuropsychological functioning revealed impairment in 56% of patients in at least one measure of our neuropsychological test battery. However, the Mini Mental State Examination (MMSE could only detect cognitive impairment in 1.8% of all patients, 24% had HADS scores indicating depressive symptoms, and 11.1% met SCID criteria for a depressive disorder. No significant association was found

Risk factors for recurrent hospital-acquired Clostridium difficile infection in a Japanese university hospital

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Hikone M

2015-07-01

Full Text Available Mayu Hikone,1 Yusuke Ainoda,1,2 Sayaka Tago,2 Takahiro Fujita,2 Yuji Hirai,2 Kaori Takeuchi,2 Kyoichi Totsuka31Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, 2Department of Infectious Diseases, Tokyo Women's Medical University, 3Department of Internal Medicine, Kitatama Hospital, Tokyo, JapanBackground: Clostridium difficile infection (CDI is a highly prevalent hospital-associated infection. Although most patients respond well to discontinuation of antibiotics, 20%–30% of patients relapse. To initiate early therapeutic measures, the risk factors for recurrent CDI must be identified, although very few Japanese studies have used standard surveillance definitions to identify these risk factors.Methods: We retrospectively reviewed the medical records of patients with health care facility-onset CDI between August 2011 and September 2013. Patients with diarrhea who were positive for Clostridium difficile (via an enzyme immunoassay were defined as having CDI. Clinical data (eg, demographics, comorbidities, medication, laboratory results, and clinical outcomes were evaluated, and multivariate analysis was used to identify risk factors that were associated with recurrent CDI.Results: Seventy-six health care facility-onset CDI cases were identified, with an incidence rate of 0.8 cases per 10,000 patient-days. Fourteen cases (18.4% were recurrent, with 13 patients having experienced a single recurrent episode and one patient having experienced three recurrent episodes. The 30-day and 90-day mortality rates were 7.9% and 14.5%, respectively. Multivariate analysis revealed that recurrent patients were more likely to have underlying malignant disease (odds ratio: 7.98; 95% confidence interval: 1.22–52.2; P=0.03 and a history of intensive care unit hospitalization (odds ratio: 49.9; 95% confidence interval: 1.01–2,470; P=0.049.Conclusion: Intensive care unit hospitalization and malignancy are risk factors for recurrent

Universal newborn hearing screening: preliminary experience at the University Hospital of Cagliari

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Giulia Pinna

2012-10-01

Full Text Available Bilateral congenital or acquired sensorineural hearing loss is a pathological condition affecting 1-2 children per 1,000 live births; it represents a major issue in public health because its late identification can negatively affect speech and language development. The aim of hearing screening is to obtain diagnosis and management of hearing loss as soon as possible; in fact early diagnosis and treatment allow children with congenital hearing impairment to acquire adequate linguistic competence. The present study reports our preliminary experience in newborn hearing screening at Neonatology services of University of Cagliari (Italy. During the first semester of surveillance, between January 2012 and June 2012, hearing screening was performed on a total of 901 babies using two different methods, TEOAEs in healthy neonates and automated ABR in high-risk babies. All infants were screened prior to hospital discharge; in some cases, especially for preterm infants of Neonatal Intensive Care Unit and Puericulture Institute, the screening was performed after discharge, to achieve a possible better global and acoustic maturation; 5 cases of hearing impairment were found. In the present study the Authors confirmed that it is possible to start a universal hearing screening in a relatively short time reaching the percentages suggested by Joint Committee on Infant Hearing.

Evaluating a training programme at Viet Duc University Hospital in Vietnam.

Science.gov (United States)

Dung, Phan Thi; Chinh, Nguyen Duc; Hanh, Bui My; Notter, Joy

2016-06-23

Vietnam's nursing competency standards (VNCS) were issued in 2012 as the legal framework on which the continuous nursing training programme are designed and developed. The study aimed to assess the knowledge, skills, and attitudes as well as the confidence of nurses regarding wound care at Viet Duc University Hospital before and after a new educational intervention. A comparative descriptive study was carried out in 2014 at Viet Duc University Hospital. The study reviewed knowledge, skills, attitude and confidence among nurses working in seven clinical departments. The data collection tools included a 48-knowledge-item self-administered questionnaire, a sixteen-item skills set, and attitude-item observation sheet and a thirteen confidence level-item observation sheet, adapted for the field of wound care. Data were loaded into Epidata version 3.1 and analysed with SPSS version 16.0. The mean pre-training knowledge, skill, attitude and confidence scores were (117.78±24.94), (53.61±10.26), (54.39±8.02) and (1.18-3.59), respectively, while the corresponding post-training scores were (148.68±16.54), (62.33±8.40), (60.80±8.75) and (1.50-4.15) p<0.0001. This was the first cohort to undergo the new training programme and has shown promising initial results; however, it also demonstrates that the training content, while leading to positive changes, does in some areas need to be further developed and then disseminated across the hospital to all nurses who provide direct wound care for patients.

Employee Satisfaction in Hospitals with Afilasyo; Sample of Training and Research Hospital of University of Mugla Sitki Kocman

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Nazli Ülger

2016-01-01

Full Text Available Aim: To determine the factors of which affect the employee satisfaction and has a an important role in giving qualified and efficient servise in Mugla Sitki Koçman University Training and Research Hospital where affiliation is applied. Material and Method: Questionnaire form was made to Mugla Sitki Koçman University Training and Research Hospital employees. The data in the research taken from the questionnaires were transferred to SPSS for analysis. As statistical analysis; reliability analysis and comparative analysis of the average one way analysis of variance (ANOVA analysis was performed. Results: According to results, verbal, mobbing and physical every kind of effect on burn out dimensions and unsatisfied, emotional exhaustion and depersonalization. Additionally, these conditions, has directly effect on job satisfaction and working cooperation. Discussion: There is burn out syndrome between health employees’ different dimensions and levels. As a result, contribute directly to beter patient services will be, it is suggested pay attenion to improve working conditions and welfare of health employees, highlight the importance the employees in terms of institutions and community and development of social status of employees.

Indicators of pleasure/pain in hygiene and cleaning outsourced workers of a university hospital

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Liana Bohrer Berni

2016-05-01

Full Text Available Objective: to measure the indicators of pleasure and suffering of hygiene and cleaning outsourced workers of a university hospital. Methods: a quantitative study of 51 workers at a university hospital in southern Brazil. A self-administered questionnaire with socio-occupational data and Pleasure Indicators Scale and Suffering at Work were used. There was descriptive and statistical analysis of the internal consistency of the factors using statistical program Predictive Analytics Software. Results: professional achievement and freedom of expression, were evaluated respectively as satisfactory and critical pleasure indicators. Suffering indicator Lack of recognition was considered bearable and professional exhaustion as critical. Conclusion: the work context researched requires interventions that minimize the suffering of experiences, promote pleasure in work and, consequently, the health of contract workers hygiene and cleanliness.

Indicators of pleasure/pain in hygiene and cleaning outsourced workers of a university hospital

Directory of Open Access Journals (Sweden)

Liana Bohrer Berni

2016-01-01

Full Text Available Objective: to measure the indicators of pleasure and suffering of hygiene and cleaning outsourced workers of a university hospital. Methods: a quantitative study of 51 workers at a university hospital in southern Brazil. A self-administered questionnaire with socio-occupational data and Pleasure Indicators Scale and Suffering at Work were used. There was descriptive and statistical analysis of the internal consistency of the factors using statistical program Predictive Analytics Software. Results: professional achievement and Freedom of expression, were evaluated respectively as satisfactory and critical pleasure indicators. Suffering indicator Lack of recognition was considered bearable and professional exhaustion as critical. Conclusion: the work context researched requires interventions that minimize the suffering of experiences, promote pleasure in work and, consequently, the health of contract workers hygiene and cleanliness.

Heidelberg physicists report. Vol. 2. Reviews of research in physics and astronomy. Fundamental contributions to the physics of the atomic nuclei and the star atmospheres; Heidelberger Physiker berichten. Bd. 2. Rueckblicke auf Forschung in der Physik und Astronomie. Grundlegende Beitraege zur Physik der Atomkerne und der Sternatmosphaeren

Energy Technology Data Exchange (ETDEWEB)

Appenzeller, Immo; Dubbers, Dirk; Siebig, Hans-Georg; Winnacker, Albrecht (eds.)

2018-04-01

The following topics are dealt with: 50 years theoretical astrophysics, nuclear physics after the discovery of the shell model, from the small van de Graaf to the large HERA, from ''chamber physics'' to big research, reminiscences on physical research in Heidelberg. (HSI)

Incidence of falls and preventive actions in a University Hospital.

Science.gov (United States)

Luzia, Melissa de Freitas; Cassola, Talita Portela; Suzuki, Lyliam Midori; Dias, Vera Lucia Mendes; Pinho, Leandro Barbosa de; Lucena, Amália de Fátima

2018-01-01

Objective Describing the incidence of falls and its relation with preventive actions developed in a Brazilian university hospital. Method A retrospective longitudinal study. Hospitalized adult patients in the clinical, surgical, psychiatric and emergency units who suffered a fall in the institution, and who had the event notified in the period from January 2011 to December 2015 were included in the study. The data were collected from the institution's management information system and analyzed in the SPSS statistical program. Results There were 2,296 falls, with a mean incidence of 1.70 falls/1,000 patients per day. An increase in the incidence of falls was observed in the period from 2011 (1.61) to 2012 (2.03). In the following years, the incidence of falls decreased from 1.83 falls/1,000 patients per day in 2013 to 1.42 falls/1,000 patients per day in 2015. The incidence of falls accompanied an implementation of preventive actions, suggesting the impact of such interventions in reducing the event occurrence. Conclusion The findings demonstrate the importance of implementing preventive interventions in reducing the incidence of falls in hospitalized patients.

The Heidelberg CSR: Stored Ion Beams in a Cryogenic Environment

International Nuclear Information System (INIS)

Wolf, A.; Hahn, R. von; Grieser, M.; Orlov, D. A.; Fadil, H.; Welsch, C. P.; Andrianarijaona, V.; Diehl, A.; Schroeter, C. D.; Crespo Lopez-Urrutia, J. R.; Weber, T.; Mallinger, V.; Schwalm, D.; Ullrich, J.; Rappaport, M.; Urbain, X.; Haberstroh, Ch.; Quack, H.; Zajfman, D.

2006-01-01

A cryogenic electrostatic ion storage ring CSR is under development at the Max-Planck Institute for Nuclear Physics in Heidelberg, Germany. Cooling of the ultrahigh vacuum chamber is envisaged to lead to extremely low pressures as demonstrated by cryogenic ion traps. The ring will apply electron cooling with electron beams of a few eV up to 200 eV. Through long storage times of 1000 s as well as through the low wall temperature, internal cooling of infrared-active molecular ions to their rotational ground state will be possible and their collisions with merged collinear beams of electrons and neutral atoms can be detected with high energy resolution. In addition storage of slow highly charged ions is foreseen. Using a fixed in-ring gas target and a reaction microscope, collisions of the stored ions at a speed of the order of the atomic unit can be kinematically reconstructed. The layout and the cryogenic concept are introduced

[Vitamin D Level in Employees of a Swiss University Geriatric Hospital].

Science.gov (United States)

Härdi, Irene; Reinhard, Sarah; Conzelmann, Martin; Kressig, Reto W; Bridenbaugh, Stephanie A

2018-06-01

Vitamin D Level in Employees of a Swiss University Geriatric Hospital Abstract. Vitamin D plays an important role in health. The aim of this study was to determine the vitamin D level in hospital employees from different age, sex and occupational groups. 281 employees took part in the investigation. Vitamin D (25-OH) was determined by serum sample analysis, the mean value was 59.5 nmol/l. 43.1 % of participants showed a vitamin D deficiency (D levels significantly correlated with increased BMI. Women, physically active employees and those in occupations with medical content had significantly higher vitamin D levels. Sports activity and substitution were independent predictors of vitamin D level. The study illustrated that increased sun exposure and/or vitamin D supplementation are needed.

Image quality control in radiodiagnostic in an University Hospital

International Nuclear Information System (INIS)

Almeida, Claudio Domingues de; Mota, Helvecio C.; Almeida, Carlos Eduardo de

1996-01-01

The image quality criteria proposed for European Union (UE) has been used to evaluate the chest x-ray examinations in a typical Department of Radiology of an University Hospital in Rio de Janeiro. The study includes information on x-ray beam parameters, film-screen combination, doses to the patients, film processing and image quality. Lateral and PA chest examinations of 63 patients were investigated. Only 10% of the patients presented entrance doses greater than the reference level proposed for UE and adopted by International Atomic Energy Agency and World Health Organization. The image quality has been approved for 87% of the examinations. (author)

The Heidelberg circle: German inflections on the professionalization of Russian chemistry in the 1860s.

Science.gov (United States)

Gordin, Michael D

2008-01-01

The success of the "second importation" of science to Russia during the Great Reforms of the 1860s is illustrated by examining the extended postdoctoral study of chemists in Heidelberg. While there, they adapted the Russian intelligentsia institution of the "circle," or kruzhok, to cope with their alienation from the German culture they were confronting. Upon their return to Russia, they felt the lack of the communicative network they had established while abroad and reimported the kruzhok to serve as a central model for the formation of the Russian Chemical Society in 1868.

Clinical profile of patients with myasthenia gravis followed at the University Hospital, Federal University of Minas Gerais

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Aline Mansueto Mourão

2015-04-01

Full Text Available Summary Objective: to determine the clinical profile of patients with myasthenia gravis (MG; followed at the Neuromuscular Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, and to compare it with other Brazilian case series. Methods: sociodemographic and clinical data were collected from patients, and a systematic literature review performed, focusing on national studies on the clinical profile of MG patients. Results: sixty nine patients were enrolled in the study. Fifty five (91% subjects were female and the mean age (SD was 37.6 (±11.4 years. The mean disease duration was 14.1 years. Regarding treatment, prednisone was the most used strategy (64%, followed by the use of azathioprine (43%. There was no difference between thymectomized (42 and non-thymectomized (27 patients regarding disease severity and medication use. Conclusion: clinical and socio-demographic features of this MG sample from a University-based clinic resemble those reported in other Brazilian series and in the international literature.

[Drug supply chain safety in hospitals: current data and experience of the Grenoble university hospital].

Science.gov (United States)

Bedouch, P; Baudrant, M; Detavernier, M; Rey, C; Brudieu, E; Foroni, L; Allenet, B; Calop, J

2009-01-01

Drug supply chain safety has become a priority for public health which implies a collective process. This process associates all health professionals including the pharmacist who plays a major role. The objective of this present paper is to describe the several approaches proven effective in the reduction of drug-related problem in hospital, illustrated by the Grenoble University Hospital experience. The pharmacist gets involved first in the general strategy of hospital drug supply chain, second by his direct implication in clinical activities. The general strategy of drug supply chain combines risk management, coordination of the Pharmacy and Therapeutics Committee, selection and purchase of drugs and organisation of drug supply chain. Computer management of drug supply chain is a major evolution. Nominative drug delivering has to be a prior objective and its implementation modalities have to be defined: centralized or decentralized in wards, manual or automated. Also, new technologies allow the automation of overall drug distribution from central pharmacy and the implementation of automated drug dispensing systems into wards. The development of centralised drug preparation allows a safe compounding of high risk drugs, like cytotoxic drugs. The pharmacist should develop his clinical activities with patients and other health care professionals in order to optimise clinical decisions (medication review, drug order analysis) and patients follow-up (therapeutic monitoring, patient education, discharge consultation).

Speaking up behaviors and safety climate in an Austrian university hospital.

Science.gov (United States)

Schwappach, David; Sendlhofer, Gerald; Häsler, Lynn; Gombotz, Veronika; Leitgeb, Karina; Hoffmann, Magdalena; Jantscher, Lydia; Brunner, Gernot

2018-04-26

To analyze speaking up behavior and safety climate with a validated questionnaire for the first time in an Austrian university hospital. Survey amongst healthcare workers (HCW). Data were analyzed using descriptive statistics, Cronbach's alpha was calculated as a measure of internal consistencies of scales. Analysis of variance and t-tests were used. The survey was conducted in 2017. About 2.149 HCW from three departments were asked to participate. To measure speaking up behavior and safety climate. To explore psychological safety, encouraging environment and resignation towards speaking up. About 859 evaluable questionnaires were returned (response rate: 40%). More than 50% of responders perceived specific concerns about patient safety within the last 4 weeks and observed a potential error or noticed rule violations. For the different items, between 16% and 42% of HCW reported that they remained silent though concerns for safety. In contrast, between 96% and 98% answered that they did speak up in certain situations. The psychological safety for speaking up was lower for HCW with a managerial function (P speak up (P speaking up behaviors for the first time in an Austrian university hospital. Only moderately frequent concerns were in conflict with frequent speaking up behaviors. These results clearly show that a paradigm shift is needed to increase speaking up culture.

The relation between flexibility of human resources and performance indexes of selected hospitals of Tehran Medical Sciences University

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Noushin Alibakhshi

2016-12-01

Full Text Available Today, flexibility has turned to one of important issues in management theories and policies and most current discussions about flexibility patterns focus on management policies, so that these patterns are one of important aspects of human resources strategic management. This study was performed with the aim of assessing the flexibility rate of human resources and performance indexes of Tehran Medical Sciences University hospitals and determining the possible relation between these variables. The present study is descriptive – analytical which was conducted in cross-sectional form in 2015. The statistical population was selected by stratifies random sampling method as 317 persons from nursing, administrative and financial personnel of 5 hospitals of Tehran Medical Sciences University. Data collecting toll was hospitals performance indexes form and Wright & Snell flexibility questionnaire of human resources. Data analysis was performed using SPSS 18 software and with the aid of descriptive statistical indexes and linear regression analysis. The results showed that personnel ( human resources had high flexibility = 4.16.\tthere was a significant relation between total flexibility and the index of bed circulation so that by one unit increase in bed circulation space, normally, the average of total flexibility decreased 0.64 units ( p-value<0.05. The results showed that human resources of Tehran Medical Sciences University hospitals have high flexibility, so authorities and policy makers are suggested to adopt policies of human resources management for creating flexibility in human resources and improving hospitals performance and amending hospitals status.

Reference levels at diagnosis (NRD) for explorations in TC of the university Hospital Donostia

International Nuclear Information System (INIS)

Iriondo Igerabide, U.; Puertolas Hernandez, J. R.; Masso Odriozola, A.; Alonso Espinaco, M. t.; Pino Leon, C.; Lozano Flores, F. J.; Larretxea Etxarri, R.

2013-01-01

The objective of this work is the establishment of diagnostic reference levels in TC, for the anatomical regions, in the University Hospital Donostia, in order to reduce the dose to patients and without prejudice to the required diagnosis. (Author)

Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

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Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

2016-03-01

This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

Daily antibiotic cost of nosocomial infections in a Turkish university hospital

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Yalcin Ata

2005-01-01

Full Text Available Abstract Background Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibiotic treatment for these infections represents a significant part of hospital expenditure. This prospective observational study was designed to determine the daily antibiotic cost of nosocomial infections per infected adult patient in Akdeniz University Hospital. Methods All adult patients admitted to the ICUs between January 1, 2000, and June 30, 2003 who had only one nosocomial infection during their stay were included in the study. Infection sites and pathogens, antimicrobial treatment of patient and it's cost were recorded. Daily antibiotic costs were calculated per infected patient. Results Among the 8460 study patients, 817 (16.6% developed 1407 episodes of nosocomial infection. Two hundred thirty three (2.7% presented with only one nosocomial infection. Mean daily antibiotic cost was $89.64. Daily antibiotic cost was $99.02 for pneumonia, $94.32 for bloodstream infection, $94.31 for surgical site infection, $52.37 for urinary tract infection, and $162.35 for the other infections per patient. The treatment of Pseudomonas aeruginosa infections was the most expensive infection treated. Piperacillin-tazobactam and amikacin were the most prescribed antibiotics, and meropenem was the most expensive drug for treatment of the nosocomial infections in the ICU. Conclusions Daily antibiotic cost of nosocomial infections is an important part of extra costs that should be reduced providing rational antibiotic usage in hospitals.

Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

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Saperi BS

2017-02-01

Full Text Available Bin Sulong Saperi,1 Roszalina Ramli,2 Zafar Ahmed,1 Amrizal Muhd Nur,1 Mohd Ismail Ibrahim,3 Muhd Fazlynizam Rashdi,2 Rifqah Nordin,2 Normastura Abd Rahman,4 Azizah Yusoff,4 Abd Jabar Nazimi,2 Roselinda Abdul Rahman,4 Noorhayati Abdul Razak,4 Norlen Mohamed 5 1International Centre for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 2Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 3Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 4School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 5Malaysian Institute of Road Safety Research, Kuala Lumpur, Malaysia Objective: Facial injury (FI may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]. The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS were performed. Results: A total of 190 patients were enrolled in the study, of whom 83 (43.7% had FI only, and 107 (56.3% had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion: Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia. Keywords: facial

[Hypertensive emergencies at the University Hospital Center in Brazzaville, Congo].

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Ellenga, Mbolla B F; Gombet, T R; Mahoungou, Guimbi K C; Otiobanda, G F; Ossou, Nguiet P M; Ikama, M S; Kimbally-Kaky, G; Etitiele, F

2011-02-01

The purpose of this retrospective study conducted in the emergency department of the University Hospital Center in Brazzaville, Congo was to determine the prevalence and clinical characteristics of hypertensive emergencies. With a total of 76 patients admitted during the study period, the prevalence of hypertensive emergency was 4%. The sex ratio was 1 and mean patient age was 57.3 years (range, 30 to 80 years). Risk factors included obesity in 62 cases (81.6%), history of hypertension in 65 (85.5%) and low socioeconomic level in 58 (76.3%). Mean delay for consultation was 50 hours (range, 1 to 240 hours). The disease underlying the hypertensive emergency was stroke with 38 cases (50%), heart failure in 20 (26.3%), hypertensive encephalopathy in 11 (14.4%), malignant hypertension in 9 (11.8%), and renal failure in 10 (13.1%). The mean length of emergency treatment was 14.7 hours (range, 5 to 48 hours). Eight deaths (10.5%) occurred during hospitalization in the emergency department.

Radiology Online Patient Education Materials Provided by Major University Hospitals: Do They Conform to NIH and AMA Guidelines?

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Prabhu, Arpan V; Donovan, Ashley L; Crihalmeanu, Tudor; Hansberry, David R; Agarwal, Nitin; Beriwal, Sushil; Kale, Hrishikesh; Heller, Matthew

The internet creates opportunities for Americans to access medical information about imaging tests and modalities to guide them in their medical decision-making. Owing to health literacy variations in the general population, the American Medical Association and National Institutes of Health recommend patient education resources to be written between the third and seventh grade levels. Our purpose is to quantitatively assess the readability levels of online radiology educational materials, written for the public, in 20 major university hospitals. In September and October 2016, we identified 20 major university hospitals with radiology residency-affiliated hospital systems. On each hospital׳s website, we downloaded all radiology-related articles written for patient use. A total of 375 articles were analyzed for readability level using 9 quantitative readability scales that are well validated in the medical literature. The 375 articles from 20 hospital systems were collectively written at an 11.4 ± 3.0 grade level (range: 8.4-17.1). Only 11 (2.9%) articles were written at the recommended third to seventh grade levels. Overall, 126 (33.6%) were written above a full high-school reading level. University of Washington Medical Center׳s articles were the most readable with a reading level corresponding to 7.9 ± 0.9. The vast majority of websites at major academic hospitals with radiology residencies designed to provide patients with information about imaging were written above the nationally recommended health literacy guidelines to meet the needs of the average American. This may limit the benefit that patients can derive from these educational materials. Copyright © 2018 Elsevier Inc. All rights reserved.

The Heidelberg Appendicitis Score Predicts Perforated Appendicitis in Children.

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Boettcher, Michael; Günther, Patrick; Breil, Thomas

2017-10-01

In the future, surgical management of pediatric appendicitis might become limited to nonperforating appendicitis. Thus, it becomes increasingly important to differentiate advanced from simple appendicitis and to predict perforated appendicitis among a group of children with right-sided abdominal pain, which was the aim of this study. An institutionally approved, single-center retrospective analysis of all patients with appendectomy from January 2009 to December 2010 was conducted. All diagnostic aspects were evaluated to identify predictors and differentiators of perforated appendicitis. In 2 years, 157 children suffered from appendicitis. Perforation occurred in 47 (29.9%) of the patients. C-reactive protein (CRP) levels higher than 20 mg/dL ( P = .037) and free abdominal fluid on ultrasonography ( P = .031) are the most important features to differentiate perforated from simple appendicitis. Moreover, all children with perforation had a positive Heidelberg Appendicitis Score (HAS). A negative HAS excludes perforation in all cases (negative predictive value = 100%). Perforated appendicitis can be ruled out by the HAS. In a cohort with right-sided abdominal pain, perforation should be considered in children with high CRP levels and free fluids or abscess formation on ultrasound.

Identification of hospitalized elderly patients at risk for adverse in-hospital outcomes in a university orthopedics and trauma surgery environment.

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Janine Gronewold

Full Text Available As a consequence of demographic changes, hospitals are confronted with increasing numbers of elderly patients, who are at high risk of adverse events during hospitalization. Geriatric risk screening followed by comprehensive geriatric assessment (CGA and treatment has been requested by geriatric societies and task forces to identify patients at risk. Since empirical evidence on factors predisposing to adverse hospital events is scarce, we now prospectively evaluated implications of geriatric risk screening followed by CGA in a university hospital department of orthopedics and trauma surgery.Three hundred and eighty-one patients ≥75 years admitted to the Department of Orthopedics and Trauma Surgery of the University Hospital Essen received Identification of Seniors at Risk (ISAR Screening followed by CGA via a geriatric liaison service in case of positive screening results. Associations between ISAR, CGA, comorbid risk factors and diseases, length of hospital stay, number of nursing and physiotherapy hours, and falls during hospital stay were analyzed.Of 381 ISAR screenings, 327 (85.8% were positive, confirming a high percentage of patients at risk of adverse events. Of these, 300 CGAs revealed 82.7% abnormal results, indicating activities of daily living impairment combined with cognitive, emotional or mobility disturbances. Abnormal CGA resulted in a longer hospital stay (14.0±10.3 days in ISAR+/CGA abnormal compared with 7.6±7.0 days in ISAR+/CGA normal and 8.1±5.4 days in ISAR-, both p<0.001, increased nursing hours (3.4±1.1 hours/day in ISAR+/CGA abnormal compared with 2.5±1.0 hours/day in ISAR+/CGA normal and 2.2±0.8 hours/day in ISAR-, both p<0.001, and increased falls (7.3% in ISAR+/CGA abnormal, 0% in ISAR+/CGA normal, 1.9% in ISAR-. Physiotherapy hours were only significantly increased in ISAR+/CGA abnormal (3.0±2.7 hours compared with in ISAR+/CGA normal (1.6±1.4 hours, p<0.001 whereas the comparison with ISAR- (2.4±2

Assessing the Social Responsibility of Tabriz University Educational Hospitals from Managers’ Perspective, 2012

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Massumeh gholizadeh

2015-08-01

Full Text Available Background and objectives: Social responsibility is one of the most important parts of an organization’s existence. The aim of this study was assessing the social responsibility of Tabriz University educational hospitals from managers’ perspective. Material and Methods: This cross-sectional descriptive study was conducted in 2012. 40 managers of educational hospitals have been selected through census sampling method. Data were collected through Ministry of Health and Medical education (MOHME valid and reliable questionnaire and analyzed by spss software package and descriptive statistics. Results : From the managers’ perspective, patients are the most effective group on hospital activities (48.5 percent, international standards are the most important motivation for hospitals (27.5 percent, the implementation of the organization’s legal obligations is the most important definition of social responsibility (27.5 percent. To be ensured a fair and ethical behavior, hospitals have benefited greatly from the workplace and employees (30 percent. Managers (90 percent emphasized that corporate social responsibility activities have a positive effect on hospital financial performance. Conclusion: The findings indicated that managers have no unique definition of social responsibility and it is difficult for them to understand the concept of social responsibility and there is no special policy or process in hospitals to understand this concept. They have introduced social responsibility as compliance with obligations of the organization. ​

Difficult airway management patterns among anesthesiologists practicing in Cairo University Hospitals

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Neamat I. Abdel rahman

2016-01-01

Conclusion: The practice of anesthesiologists in Cairo university hospitals is close to the recommendations of the ASA guidelines for management of difficult airway. There is increased skills in fiberoptic bronchoscopes and SGA with increased frequency of difficult airway managements training courses; however, they need to improve their skills in awake fiberoptic intubations technique and they need to be trained on invasive airway management access to close the discrepancy between their theoretical choices in different situations and their actual skills.

ASSESSMENT OF MEDICAL WASTE MANAGEMENT IN EDUCATIONAL HOSPITALS OF TEHRAN UNIVERSITY MEDICAL SCIENCES

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M. H. Dehghani, K. Azam, F. Changani, E. Dehghani Fard

2008-04-01

Full Text Available The management of medical waste is of great importance due to its potential environmental hazards and public health risks. In the past, medical waste was often mixed with municipal solid waste and disposed in residential waste landfills or improper treatment facilities in Iran. In recent years, many efforts have been made by environmental regulatory agencies and waste generators to better managing the wastes from healthcare facilities. This study was carried in 12 educational hospitals of Tehran University of Medical Sciences. The goals of this study were to characterize solid wastes generated in healthcare hospitals, to report the current status of medical waste management and to provide a framework for the safe management of these wastes at the considered hospitals. The methodology was descriptive, cross-sectional and consisted of the use of surveys and interviews with the authorities of the healthcare facilities and with personnel involved in the management of the wastes. The results showed that medical wastes generated in hospitals were extremely heterogeneous in composition. 42% of wastes were collected in containers and plastic bags. In 75% of hospitals, the stay-time in storage sites was about 12-24h. 92% of medical wastes of hospitals were collected by covered-trucks. In 46% of hospitals, transferring of medical wastes to temporary stations was done manually. The average of waste generation rates in the hospitals was estimated to be 4.42kg/bed/day.

Distribution of yeast-like fungi at a university hospital in Turkey.

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Ece, Gulfem

2014-12-01

The increased life span has led to application of more invasive procedures for diagnosis and treatment of particularly immunosuppressed individuals. This situation drew more attention to fungal infections due to existence of yeast-like fungi. Candida infections have increased due to transplant in patients, prolonged intensive care unit (ICU) stays, and invasive procedures. Recently, identification of yeast-like fungi as well as antifungal susceptibility test has been gaining more importance. In our study, we aimed to evaluate the distribution of yeast-like fungi strains isolated from blood, urine, wound and respiratory specimens, which were sent from various departments of Izmir University School of Medicine University Hospital. The 262 yeast strains (of 13860 clinical specimens), isolated during 30.05.2012-20.05.2013, which were sent from various departments of Izmir University School of Medicine to Medical Microbiology Laboratory, were included in this study. Blood, wound, respiratory (sputum, tracheal secretion), and urine specimens were cultivated on blood agar and Sabouraud dextrose agar and incubated for 24-48 hours at 37°C. The isolates were cultivated on CHROMagar Candida and Cornmeal Tween 80 medium for identification. Besides, the automatized Vitek version 2.0 system was used for identification of the yeast strains as well as the antifungal susceptibility of blood culture strains. A total of 262 strains, isolated from the Anesthesiology and Reanimation Unit, as well as from the departments of Hematology, Urology, Infectious Diseases, Gynecology and Obstetrics, and Ear Nose and Throat, were included in this study. The most common isolated yeast-like species was Candida albicans. C. parapsilosis was the most common yeast-like fungus isolated from blood cultures. All the blood culture strains were susceptible to amphotericin B, flucytosine, fluconazole and voriconazole. Candida strains isolated from newborns, elderly patients, and intensive care patients

Linking up with the community: a fertile strategy for a university hospital?

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Thomas Plochg

2006-02-01

Full Text Available Purpose: To systematically identify, describe and characterise the collaborative initiatives, which have been established between the Academic Medical Centre/University of Amsterdam and local health care providers in the adjacent community. Background: The viability of university hospitals is jeopardised. Their narrowed orientation on delivering the most advanced services to the sickest patients challenges their missions in patient care, science and education. By linking up with local health care providers, university hospitals create synergistic relationships that should secure these three academic missions for the future. Methods: We conducted a multiple case study in two stages. Initially, division leaders and the director of integrated care were consulted to identify all existing collaborative initiatives of the Academic Medical Centre. Successively, face-to-face interviews were held with the leaders of these initiatives. During these interviews data were primarily collected through a questionnaire. Notes of the interviewer, and documents (if available were also collected. The analysis focused on systematically describing and characterising the initiatives using the concept of ‘community-based integrated care’. Results: Twenty-seven heterogeneous initiatives were identified. Half of these initiatives are targeted to the adjacent community of the Academic Medical Centre, but only four of them are initiated on the basis of community information and involve the community and/or patients. Furthermore, the extent of integration differed per dimension. Functional integration within the initiatives has been relatively low, clinical integration mixed, and professional integration quite advanced. Conclusions: The results indicate that a considerable number of collaborative initiatives have emerged. Still, these initiatives are loosely ‘community-based’ and hardly focus on the full integration of care services. This suggests that the community

The intensity feedback system at Heidelberg Ion-Beam Therapy Centre

Energy Technology Data Exchange (ETDEWEB)

Schoemers, Christian, E-mail: christian.schoemers@med.uni-heidelberg.de; Feldmeier, Eike; Naumann, Jakob; Panse, Ralf; Peters, Andreas; Haberer, Thomas

2015-09-21

At Heidelberg Ion-Beam Therapy Centre (HIT), more than 2500 tumour patients have been treated with charged particle beams since 2009 using the raster scanning method. The tumour is irradiated slice-by-slice, each slice corresponding to a different beam energy. For the particle dose of each raster point the pre-irradiation by more distal slices has to be considered. This leads to highly inhomogeneous dose distributions within one iso-energy slice. The particles are extracted from the synchrotron via transverse RF knock-out. A pure feed forward control cannot take into account fluence inhomogeneities or deal with intensity fluctuations. So far, fluctuations have been counteracted by a reduced scanning velocity. We now added a feedback loop to the extraction system. The dose monitoring ionisation chambers in front of the patient have been coupled to the extraction device in the synchrotron. Characterization and implementation of the intensity feedback system into the HIT facility is described here. By its implementation the treatment time has been reduced by 10% in average.

Cost awareness among doctors in an Irish university-affiliated teaching hospital

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William H.C. Tiong

2011-11-01

Full Text Available Previous studies in USA and Canada have found that physicians and physicians in training have a limited understanding of medical care costs. In this study, we set out to survey all grades of doctors in the surgical department, emergency department, and anaesthetic department in a university-affiliated, Irish teaching hospital. Open-ended questionnaires on cost of 25 routinely used items in the hospital were sent to each department. The aims of the study were to assess the present knowledge of cost among the various grades of doctors, and to evaluate the level of professional experience on cost awareness and their confidence in their estimates. We had an overall response rate of 56.8% with 68.5% of doctors admitted to have estimated more than 90% of their responses. Ninety three percent of doctors have no confidence in their estimates on cost of listed items. We found that the lack of cost awareness was universal among doctors of all grades (P = 0.236. The doctors in our study population showed a high level of inaccuracy on their estimates of cost of routinely used items with 84% of the items overestimated. Our results were discouraging and demonstrated that considerable educational activity will be necessary if doctors are to be more cost effective in meeting the national health care budget.

Pattern of Blood Stream Infections within Neonatal Intensive Care Unit, Suez Canal University Hospital, Ismailia, Egypt

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Rania Mohammed Kishk

2014-01-01

Full Text Available Introduction. Blood stream infection (BSI is a common problem of newborn in neonatal intensive care units (NICUs. Monitoring neonatal infections is increasingly regarded as an important contributor to safe and high-quality healthcare. It results in high mortality rate and serious complications. So, our aim was to determine the incidence and the pattern of BSIs in the NICU of Suez Canal University Hospital, Egypt, and to determine its impact on hospitalization, mortality, and morbidity. Methods. This study was a prospective one in which all neonates admitted to the NICUs in Suez Canal University hospital between January, 2013 and June 2013 were enrolled. Blood stream infections were monitored prospectively. The health care associated infection rate, mortality rate, causative organism, and risk factors were studied. Results. A total of 317 neonates were admitted to the NICU with a mortality rate of 36.0%. During this study period, 115/317 (36.3% developed clinical signs of sepsis and were confirmed as BSIs by blood culture in only 90 neonates with 97 isolates. The total mean length of stay was significantly longer among infected than noninfected neonates (34.5 ± 18.3 and 10.8 ± 9.9 days, resp., P value < 0.001. The overall mortality rates among infected and noninfected neonates were 38.9% and 34.8%, respectively, with a significant difference. Klebsiella spp. were the most common pathogen (27.8% followed by Pseudomonas (21.6% and Staphylococcus aureus (15.4%. Conclusion. The rate of BSIs in NICU at Suez Canal University Hospital was relatively high with high mortality rate (36.0%.

International outbreak investigation of Salmonella Heidelberg associated with in-flight catering.

Science.gov (United States)

Rebolledo, J; Garvey, P; Ryan, A; O'Donnell, J; Cormican, M; Jackson, S; Cloak, F; Cullen, L; Swaan, C M; Schimmer, B; Appels, R W; Nygard, K; Finley, R; Sreenivasan, N; Lenglet, A; Gossner, C; McKeown, P

2014-04-01

Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10.2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.

International outbreak investigation of Salmonella Heidelberg associated with in-flight catering.

LENUS (Irish Health Repository)

Rebolledo, J

2013-07-26

SUMMARY Rapid and wide dispersal of passengers after flights makes investigation of flight-related outbreaks challenging. An outbreak of Salmonella Heidelberg was identified in a group of Irish travellers returning from Tanzania. Additional international cases sharing the same flight were identified. Our aim was to determine the source and potential vehicles of infection. Case-finding utilized information exchange using experts\\' communication networks and national surveillance systems. Demographic, clinical and food history information was collected. Twenty-five additional cases were identified from Ireland, The Netherlands, Norway, USA and Canada. We conducted a case-control study which indicated a significant association between illness and consumption of milk tart (OR 10·2) and an egg dish (OR 6) served on-board the flight. No food consumed before the flight was associated with illness. Cases from countries other than Ireland provided supplementary information that facilitated the identification of likely vehicles of infection. Timely, committed international collaboration is vital in such investigations.

Low Energy Electron Cooling and Accelerator Physics for the Heidelberg CSR

International Nuclear Information System (INIS)

Fadil, H.; Grieser, M.; Hahn, R. von; Orlov, D.; Schwalm, D.; Wolf, A.; Zajfman, D.

2006-01-01

The Cryogenic Storage Ring (CSR) is currently under construction at MPI-K in Heidelberg. The CSR is an electrostatic ring with a total circumference of about 34 m, straight section length of 2.5 m and will store ions in the 20 ∼ 300 keV energy range (E/Q). The cryogenic system in the CSR is expected to cool the inner vacuum chamber down to 2 K. The CSR will be equipped with an electron cooler which has also to serve as an electron target for high resolution recombination experiments. In this paper we present the results of numerical investigations of the CSR lattice with finite element calculations of the deflection and focusing elements of the ring. We also present a layout of the CSR electron cooler which will have to operate in low energy mode to cool 20 keV protons in the CSR, as well as numerical estimations of the cooling times to be expected with this device

Molecular characterization of Salmonella Paratyphi B dT+ and Salmonella Heidelberg from poultry and retail chicken meat in Colombia by pulsed-field gel electrophoresis

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Salmonella Paratyphi B dT+ variant (also termed Salmonella Java) and Salmonella Heidelberg are human pathogens frequently isolated from poultry. As a step towards implementing the Colombian Integrated Program for Antimicrobial Resistant Surveillance (COIPARS), this study characterized molecular patt...

Occurrence of yeast bloodstream infections between 1987 and 1995 in five Dutch university hospitals

NARCIS (Netherlands)

A. Voss (Andreas); J.A.J.W. Kluytmans (Jan); J.G. Koeleman; L. Spanjaard (Lodewijk); C.M.J.E. Vandenbroucke-Grauls (Christina); H.A. Verbrugh (Henri); M.C. Vos (Margreet); A.Y.L. Weersink (A. Y L); J.A.A. Hoogkamp-Korstanje (J. A A); J.F. Meis

1996-01-01

textabstractThe aim of this study was to identify retrospectively trends in fungal bloodstream infections in The Netherlands in the period from 1987 to 1995. Results of over 395,000 blood cultures from five Dutch university hospitals were evaluated. Overall, there were more than 12 million patient

Factors Associated with Readmission of Patients with Congenital Heart Disease in a Swiss University Hospital.

Science.gov (United States)

Chave, Morgane; Marques-Vidal, Pedro

2017-04-01

Congenital heart defects (CHD) lead to extensive use of healthcare resources. Still, there is little information available regarding readmission rates or associated factors. We sought to evaluate readmission rates and their determinants among patients with CHD hospitalized in a Swiss university hospital. We conducted a retrospective study using data from all non-adult (readmissions, 83 (86.5%) were related to the CHD. Median time to readmission was 10 days (interquartile range 6-20) and median length of readmission was 12 days (interquartile range 6-20). After multivariate adjustment, foreign nationality, greater distance to hospital and length of index hospitalization readmission. Patients who underwent surgery were less likely to be readmitted (8.7%). We conclude that readmissions were frequent, almost 1 in 10 patients, and associated with several socio-clinical factors. Providing patients who live far from hospital with specialized care closer to home may help reduce the rate of readmission.

Cortical reorganization in recent-onset tinnitus patients by the Heidelberg Model of Music Therapy

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Christoph Maria Krick

2015-02-01

Full Text Available Pathophysiology and treatment of tinnitus still are fields of intensive research. The neuroscientifically motivated Heidelberg Model of Music Therapy, previously developed by the German Center for Music Therapy Research, Heidelberg, Germany, was applied to explore its effects on individual distress and on brain structures. This therapy is a compact and fast application of nine consecutive 50-minutes sessions of individualized therapy implemented over one week. Clinical improvement and long-term effects over several years have previously been published. However the underlying neural basis of the therapy’s success has not yet been explored. In the current study, the therapy was applied to acute tinnitus patients (TG and healthy active controls (AC. Non-treated patients were also included as passive controls (PTC. As predicted, the therapeutic intervention led to a significant decrease of tinnitus-related distress in TG compared to PTC. Before and after the study week, high-resolution MRT scans were obtained for each subject. Assessment by repeated measures design for several groups (two-way ANOVA revealed structural gray matter (GM increase in TG compared to PTC, comprising clusters in precuneus, medial superior frontal areas, and in the auditory cortex. This pattern was further applied as mask for general GM changes as induced by the therapy week. The therapy-like procedure in AC also elicited similar GM increases in precuneus and frontal regions. Comparison between structural effects in TG versus AC was calculated within the mask for general GM changes to obtain specific effects in tinnitus patients, yielding GM increase in right Heschl's gyrus, right Rolandic operculum, and medial superior frontal regions. In line with recent findings on the crucial role of the auditory cortex in maintaining tinnitus-related distress, a causative relation between the therapy-related GM alterations in auditory areas and the long-lasting therapy effects can be

Cortical reorganization in recent-onset tinnitus patients by the Heidelberg Model of Music Therapy

Science.gov (United States)

Krick, Christoph M.; Grapp, Miriam; Daneshvar-Talebi, Jonas; Reith, Wolfgang; Plinkert, Peter K.; Bolay, Hans Volker

2015-01-01

Pathophysiology and treatment of tinnitus still are fields of intensive research. The neuroscientifically motivated Heidelberg Model of Music Therapy, previously developed by the German Center for Music Therapy Research, Heidelberg, Germany, was applied to explore its effects on individual distress and on brain structures. This therapy is a compact and fast application of nine consecutive 50-min sessions of individualized therapy implemented over 1 week. Clinical improvement and long-term effects over several years have previously been published. However, the underlying neural basis of the therapy's success has not yet been explored. In the current study, the therapy was applied to acute tinnitus patients (TG) and healthy active controls (AC). Non-treated patients were also included as passive controls (PTC). As predicted, the therapeutic intervention led to a significant decrease of tinnitus-related distress in TG compared to PTC. Before and after the study week, high-resolution MRT scans were obtained for each subject. Assessment by repeated measures design for several groups (Two-Way ANOVA) revealed structural gray matter (GM) increase in TG compared to PTC, comprising clusters in precuneus, medial superior frontal areas, and in the auditory cortex. This pattern was further applied as mask for general GM changes as induced by the therapy week. The therapy-like procedure in AC also elicited similar GM increases in precuneus and frontal regions. Comparison between structural effects in TG vs. AC was calculated within the mask for general GM changes to obtain specific effects in tinnitus patients, yielding GM increase in right Heschl's gyrus, right Rolandic operculum, and medial superior frontal regions. In line with recent findings on the crucial role of the auditory cortex in maintaining tinnitus-related distress, a causative relation between the therapy-related GM alterations in auditory areas and the long-lasting therapy effects can be assumed. PMID:25745385

Depression in diabetic patients attending University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia

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Birhanu AM

2016-05-01

Full Text Available Anteneh Messele Birhanu,1 Fekadu Mazengia Alemu,2 Tesfaye Demeke Ashenafie,3 Shitaye Alemu Balcha,4 Berihun Assefa Dachew5 1School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, 2Department of Midwifery, 3Department of Nursing, 4Department of Internal Medicine, College of Medicine and Health Sciences, 5Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia Background: Diabetes mellitus, frequently associated with comorbid depression, contributes to the double burden of individual patients and community. Depression remains undiagnosed in as many as 50%–75% of diabetes cases. This study aimed to determine the prevalence and associated factors of depression among diabetic patients attending the University of Gondar Hospital Diabetic Clinic, Northwest Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to May 2014 among 422 sampled diabetic patients attending the University of Gondar Hospital Diabetic Clinic. The participants were selected using systematic random sampling. Data were collected by face-to-face interview using a standardized and pretested questionnaire linked with patient record review. Depression was assessed using the Patient Health Questionnaire-9. Data were entered to EPI INFO version 7 and analyzed by SPSS version 20 software. Binary logistic regression analysis was performed to identify factors associated with depression. Results: A total of 415 diabetic patients participated in the study with a response rate of 98.3%. The prevalence of depression among diabetic patients was found to be 15.4% (95% confidence interval (CI: 11.7–19.2. Only religion (adjusted odds ratio [AOR] =2.65 and 95% CI: 1.1–6.0 and duration of diabetes (AOR =0.27 and 95% CI: 0.07–0.92 were the factors associated with depression among diabetic patients. Conclusion: The prevalence of depression was low as compared to other

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

Science.gov (United States)

Ippolito, Adelaide; Viggiani, Vincenzo

2014-01-01

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

Treatment cost of patients with maxillofacial fractures at the University Hospital in Mostar 2002-2006.

Science.gov (United States)

Jurić, Mario; Novakovic, Josip; Carapina, Mirela; Kneiević, Ervin

2010-03-01

The aim of this study was to establish the costs structure of medical treatment for the patients with maxillofacial fractures, to perform a treatment cost evaluation, describe the factors which considerably influence the costs and discover the ways of achieving financial savings in treated patients. The study group consisted of patients with maxillofacial fractures who were admitted and treated at the Department of Maxillofacial Surgery of the University Hospital Mostar in the period from January 2002 until December 2006. Data for the study were collected from the patients' databases, case histories and data obtained on the basis of individual payments for the treatment that was collected by Finance Department of the University Hospital of Mostar Most patients in this study were men (83%), of average age 34 +/- 19 years. Zygomatic bone fracture was the commonest injury. Open surgical procedure was performed in 84.7% of treated cases. The costs for the open procedure were considerably higher than conservative treatment. Medication cost made up a total of 37.9% and cost of hospital accommodation 27.3% out of total hospital charge. Cost reduction in treated patients with maxillofacial fractures should be achieved through protocols of urgent treatment of maxillofacial trauma patients immediately after sustaining an injury and with earlier discharge of the patients when postoperative complications are not expected.

Identifying and Ranking the Factors Affecting Virtuousness in Yazd University-Affiliated Hospitals

OpenAIRE

H Shekari; N Jalalian

2015-01-01

Abstract Introduction: Recently virtue has become a topic of serious examination among organizational researchers. In other words, organizations are moving toward virtuous organization. The purpose of this paper is determining and prioritizing the principal factors of a virtuous organization in Yazd University-Affiliated Hospitals in order to put virtues into practice. Methods: The procedure we proposed to reach the research aim consists of three steps. In the first Step, we extracted...

Tertiary-care facility's seniors association attracts its highest number of referrals through word-of-mouth. University Hospital, Denver, CO.

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Lewicki, G

1999-01-01

University Hospital, Denver, has started its University Seniors Assn. to promote health and wellness to people 50 and older. Within four months the organization had 500 members. Now the association is 3,500 members strong.

Comparative Assessment of Patients’ Rights Observance in the Hospitalization Wards of Shahid Beheshti University of Medical Sciences’ Hospitals

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M. Sharifi

2017-06-01

Full Text Available Background: Patients are one of the most vulnerable social groups. Respecting patients’ rights will lead in advantages like “decrease in hospitalization time” and “increase in patients’ satisfaction”. This study is performed to assess the patients' rights observance in the hospitalization wards of educational hospitals of Shahid Beheshti University of Medical Sciences. Methods: In this descriptive-cross sectional study 137 medical student (intern were selected by convenience sampling method. We used a questionnaire with 12 questions. Reliability of questionnaire was confirmed by experts of the field and validity was confirmed by Cronbach’s Alpha coefficient (81%. The obtained data were analyzed by SPSS (v21 using descriptive statistics, analysis of variance and Tukey test. Findings: In this study the observance rate of patients’ rights was at a good level in 41.6% of cases, at an average level in 55.5% of cases and at a low level in 2.9% of cases. There was a significant difference between several hospitalization wards in the observance rate of patients’ rights. (p = 0.001. The observance rate of patients’ rights in infectious disease ward and gynecology ward was at a lower level in comparison with other wards. Conclusion: The observance rate of patients’ rights was at an average to good level in most of hospitalization ward. However this observance rate is at a low level in some wards. More studies about the causes of these differences can help us in planning about improvement of patients’ rights observance.

Comparison of Patient Costs in Internal Medicine and Anaesthesiology Intensive Care Units in a Tertiary University Hospital.

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Kara, İskender; Yıldırım, Fatma; Başak, Dilek Yumuş; Küçük, Hamit; Türkoğlu, Melda; Aygencel, Gülbin; Katı, İsmail; Karabıyık, Lale

2015-06-01

The allocation of the Gross Domestic Product (GDP) to health is limited, therefore it has made a need for professional management of health business. Hospital managers as well as employees are required to have sufficient knowledge about the hospital costs. Hospital facilities like intensive care units that require specialization and advanced technology have an important part in costs. For this purpose, cost analysis studies should be done in the general health business and special units separately. In this study we aimed to compare the costs of anaesthesiology and internal medicine intensive care units (ICU) roughly. After approval of this study by Gazi University Faculty of Medicine Ethics Committee, the costs of 855 patients that were hospitalized, examined and treated for at least 24 hours in internal medicine and anaesthesiology ICUs between January 2012-August 2013 (20 months period) were taken and analyzed from chief staff of the Department of Information Technology, Gazi University Hospital. At the end of the study, we observed clear differences between internal medicine and anaesthesiology ICUs arising from transactions and patient characteristics of units. We stated that these differences should be considered by Social Security Institution (SSI) for the reimbursement of the services. Further, we revealed that SSI payments do not meet the intensive care expenditure.

Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay

OpenAIRE

Bentancor, Ana; Hernández, Ana Laura; Godoy, Yamile; Dapueto, Juan J

2016-01-01

ABSTRACT OBJECTIVE To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team. METHODS In this case study, the following aspects were analyzed: 1) historical background; 2) implementation of Law 18,897 of October 22, 2012; and 3) functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay), taking into account three dimensions: str...

Evaluation of antimicrobial resistance among Salmonella and Shigella isolates in the University Hospital "St. George," Plovdiv, Bulgaria.

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Petrov, Michael M; Petrova, Atanaska; Stanimirova, Irina; Mircheva-Topalova, Marina; Koycheva, Lalka; Velcheva, Rayna; Stoycheva-Vartigova, Mariana; Raycheva, Ralitsa; Asseva, Galina; Petrov, Petar; Kardjeva, Velichka; Murdjeva, Marianna

2017-03-01

The aim of this work is to study the epidemiology and antimicrobial resistance to the most commonly used antibiotics for the treatment of acute gastroenteritis caused by Salmonella and Shigella at the largest Bulgarian hospital-University Hospital "St. George," Plovdiv-for the period 2009-2013. Two hundred ninety strains were in vitro tested for resistance to 15 antimicrobial agents. The presence of extended-spectrum beta-lactamases (ESBLs) was demonstrated by a variety of specialized tests. For comparison, a collection of 28 strains submitted by the National Reference Laboratory (NRL) "Enteric Infections" at the National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, was also tested for the production of ESBLs. In isolates, phenotypically demonstrated as ESBL producers, polymerase chain reaction (PCR) detection of the genes bla-CTX-M, bla-SHV, and bla-TEM was performed. Among the 290 tested isolates, only two- Salmonella serotype Livingstone and Shigella flexneri-were phenotypically proven to be ESBL producers. Only 4 strains from the collection of 28, submitted from the NRL "Intestinal Infections" in NCIPD, Sofia, were phenotypically confirmed as ESBL producers. The presence of the bla-CTX-M gene was detected in all of the tested strains (4 from NRL, NCIPD, Sofia, and 2 from the University Hospital St. George, Plovdiv), the bla-SHV gene only in strain S. Livingstone from Plovdiv, and the bla-TEM gene in two from Sofia and one (again S. Livingstone) from Plovdiv. In conclusion, Salmonella and Shigella isolates from patients hospitalized at the University Hospital St. George, Plovdiv, with acute gastroenteritis demonstrate good susceptibility to the most commonly used antibiotic agents, including azithromycin.

IMPACT OF CLINICAL-TRIALS ON THE ADOPTION OF NEW DRUGS WITHIN A UNIVERSITY HOSPITAL

NARCIS (Netherlands)

DENIG, P; HAAIJER-RUSKAMP, FM; WESSELING, H

1991-01-01

To assess the influence that clinical trials may have on the introduction of new drugs into prescribing routines, the adoption of drugs has been studied in a university hospital in the Netherlands. A significant relation was found between the testing of semi-innovative drugs in clinical trials in

Radiotherapy of Teikyo University. Second report. Experience and the current status at Itabashi Hospital. Brachytherapy

International Nuclear Information System (INIS)

Ogata, Hitoshi; Yokokawa, Tokuzo; Shirai, Tatsuo; Furui, Shigeru

2005-01-01

To answer the big trend of information disclosure, we are trying to report the experience and the current status of Radiotherapy in Teikyo University. Since 1974, Teikyo University has installed a High-Dose-Rate Remote Afterloading System (HDR RALS) at Itabashi Hospital for brachytherapy. We analyzed the total cases comprehensively in this paper. There were 421 cases treated by Ralstron (Shimazu Co.) between 1974 and 1995 and 128 cases treated additionally between the renewal by Microselectron (Nucletron Co.) and the end of 2002. For several years from the beginning, the number of cases treated by Ralstron had been 30-35 cases annually, but since 1987, the number decreased markedly to fewer than 10 cases per year. After the installation of Microselectron, the number increased gradually to 15 cases per year. Gynecologic tumors accounted for 88.5% of the total cases, namely 96.9% by Ralstron and 60.1% by Microselectron. The others treated by Microselectron were 27 cases with Head and Neck tumors, and 21 cases with digestive tract tumors. To increase the number of the patients for brachytherapy, we should continue to open our current status, and make close relationships between the neighbor hospitals and Teikyo Hospital. (author)

Hospital services quality assessment: hospitals of Kerman University of Medical Sciences, as a tangible example of a developing country.

Science.gov (United States)

Nekoei-Moghadam, Mahmood; Amiresmaili, Mohammadreza

2011-01-01

Although quality orientation is one of the main priorities of any progressive organization, quality evaluation in organizations providing services such as hospitals is one of the key challenges, because in this sector quality is determined by many intangible factors. Applying the service quality gap model is one of the common tools for quality evaluation in the service sector. This paper seeks to evaluate this issue. The present descriptive study was carried out through a cross-sectional method in 2008. The participants of this study were patients who had been referred to Kerman University of Medical Sciences hospitals. The sample comprised 385 patients, the data were collected by SERVQUAL as a standard questionnaire, and data analysis was carried out on 385 completed questionnaires. In all five dimensions of quality, a gap was observed between patients' perceptions and expectations as follows: Assurance: -1.28, Empathy: -1.36, Responsiveness: -1.80, Tangibles: -1.86 and Reliability: -1.69. A paired T-test showed that the differences between quality perceptions and expectations are significant (p value SERVQUAL approach to hospital services of a developing country.

Die Fachbibliothek Medizin (FBMed am Universitätsklinikum Essen / The Medical Branch Library at the University Hospital Essen

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Wibker, Katrin

2009-09-01

Full Text Available The branch library ‘Medizin’ provides the faculty of medicine and the university hospital (about 943 professors and scientific assistants; about 1665 medical students with literature and information and fulfils important tasks regarding research, teaching and patient care.Along with matters of use of the library (lending, advice, interlibrary loan, reserved semester collections, training courses, there is also certain work concerning the processing of literature (for example acquisition and binding of journals that is carried out on the spot. Furthermore the branch library ‘Medizin’ looks after and advises several libraries in various institutes of the university hospital.

Pelvic organ prolapse in jimma university specialized hospital, southwest ethiopia.

Science.gov (United States)

Akmel, Menur; Segni, Hailemariam

2012-07-01

Pelvic organ prolapse is the down ward descent of female organs including the bladder, small and large bowel resulting in protrusion of the vagina, uterus or both. It is a disorder exclusive to women and one of the most common indications for gynecologic surgery. This hospital based retrospective descriptive study was conducted to assess the magnitude of pelvic organ prolapse and risk factors for it. All cases of pelvic organ prolapse admitted and treated in Jimma University Specialized Hospital from July 1, 2008 to June 30, 2011 were included. The collected data were analyzed using SPSS computer software version 16.0. Chi-square test was used and was considered to be significant when presidence area. Farmers accounted for 68.2% of the patients and there was a significant association between prolapse and occupation (p creation on risk factors of pelvic organ prolapse and use of contraception to reduce parity is recommended. Health institution delivery should be advocated to minimize the rate of home deliveries and hence of prolonged labor.

Primary hyperparathyroidism: King Khalid University Hospital experience

International Nuclear Information System (INIS)

Fouda, Mona A.

1999-01-01

This study was conducted to examine the prevalence, mode of presentationand management of primary hyperparathyroidism in one of the major hospitalsin Saudi Arabia. This was a retrospective analysis of 24 cases of primaryhyperparathyroidism comprising of 21 females and three males, who were seenat King Khalid University Hospital over a period of 16 years from 1982 untilDecember 1997. The prevalence of disease was estimated to be estimated to be11.34 per 100,000 hospital population. The majority of patients presentedwith musculoskeletal complaints (62%-67%) and/or renal complications were(58%). Hyperclacemia was seen in 92% of the cases. Serum PTH was availablefor 21 patients and 20 had significantly elevated levels. Fifty percent ofthe patients had features of hyperparathyroid bone disease on plane x-ray,while 79% showed osteopenia of the femoral neck and dual x-rayabsorptiometry, and almost all the patients had lumbar osteopenia. Fiftypercent of the patients had features of metabolic bone disease on bone scan.Thallium -technetium subtraction studies proved to be the most reliable tool,with 83% sensitivity of 55%. CT scan of the neck was attempted in only inseven patients (29%), with a sensitivity of 86%. Twenty-one patients (87.5%)underwent surgical exploration and removal of the parathyroid adenoma. Singleparathyroid adenoma was identified in 85% of the cases, 5% had multipleadenomas and 5% had hyperplasia of the parathyroid gland. Our results showedthat primary hyperparathyroidism is not rare disease in Saudi Arabia. It hastendency for late presentation with complications. We believe that routinescreening for calcium, and early identification of such cases, are warrantedto reduce the morbidity of this easily treatable disorder. (author)

Knowledge, awareness and compliance with universal precautions among health care workers at the University Hospital of the West Indies, Jamaica.

Science.gov (United States)

Vaz, K; McGrowder, D; Alexander-Lindo, R; Gordon, L; Brown, P; Irving, R

2010-10-01

Universal precautions are not well understood or implemented by health care practitioners, though crucial in the prevention and transmission of blood-borne pathogens like HIV. To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica. A cross-sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to 200 health care workers including medical doctors, medical technologists, nurses and porters to assess their knowledge, awareness and practice towards universal precautions. Almost two-thirds (64.0%) of the respondents were very knowledgeable of universal precautions with significantly more females (75.4%) than males (42.9%) (p<0.0001). More nurses (90.0%), medical doctors (88.0%) and medical technologists (70%) were very knowledgeable of universal precautions (p<0.0001). More respondents (92.9%) who were employed in the health sector for 16 years and over reported high levels of awareness of universal precautions than those who were employed for less than five years (p<0.0001). 28.6% of males and only 6.2% of females reported that they do not use protective gear. More nurses reported frequent use of protective equipment followed by medical technologists and medical doctors (p<0.0001). There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

Laser spectroscopy with a cooler ring at the ESR (GSI) and the TSR (MPI Heidelberg)

International Nuclear Information System (INIS)

Kuehl, T.; Borneis, S.; Greten, G.; Marx, D.; Neumann, R.; Schroeder, S.; Grieser, R.; Hoog, I.; Huber, G.; Klaft, I.; Klein, R.; Merz, P.; Balykin, V.; Bock, M.; Ellert, C.; Forck, P.; Grieser, M.; Grimm, R.; Habs, D.; Miesner, H.J.; Petrich, W.; Wanner, B.; Becker, C.; Schwalm, D.; Wolf, A.

1992-01-01

At the TSR cooler ring at Heidelberg, laser studies were carried out using singly charged lithium and beryllium ions. Laser spectroscopy of relativistic lithium ions (υ = 0.04c) yielded signals with a narrow linewidth, suitable for an experimental test of special relativity. A dramatic reduction of the beam temperature, as defined by the longitudinal velocity spread, was achieved via laser cooling in both cases. At the ion energies available at ESR it will become possible to prepare and store bare ions up to U 92+ . Electron cooling was successfully demonstrated for hydrogen-like Bi 82+ ions, where a laser experiment is scheduled to study the ground-state hyperfine splitting. (orig.)

The prevalence of suspected and challenge-verified penicillin allergy in a university hospital population

DEFF Research Database (Denmark)

Borch, Jacob Eli; Andersen, Klaus Ejner; Bindslev-Jensen, Carsten

2006-01-01

patterns and public economy as a consequence. We performed a cross-sectional case-control study with two visits to all clinical departments of a large university hospital in order to find in-patients with medical files labelled "penicillin allergy" or who reported penicillin allergy upon admission. Patient....... In a cohort of 3642 patients, 96 fulfilled the inclusion criteria giving a point-prevalence of alleged penicillin allergy of 5% in a hospital in-patient population. Mean time elapsed since the alleged first reaction to penicillin was 20 years. The skin was the most frequently affected organ (82.2%), maculo...

Stenotrophomonas maltophilia in a university hospital of traditional Chinese medicine: molecular epidemiology and antimicrobial resistance.

Science.gov (United States)

Zhao, S; Yang, L; Liu, H; Gao, F

2017-07-01

Stenotrophomona maltophilia has emerged as an important opportunistic pathogen that is highly antibiotic resistant. Analysis of antibiotic susceptibilities, drug-resistant gene profiles and molecular typing of S. maltophilia was undertaken in a university hospital of traditional Chinese medicine in East China. Resistance to sulphamethoxazole (SXT) was found to be an indicator of multi-drug resistance. SXT resistance was mediated by sul and dfrA genes in integrons, especially class 1. Some evidence of clonal dissemination was found, indicating the occurrence of cross-transmission of antibiotic-resistant strains within the hospital. This underscores the need for effective control and prevention measures in hospitals. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Long-term effects of the “Heidelberg Model of Music Therapy” in patients with chronic tinnitus

Science.gov (United States)

Argstatter, Heike; Grapp, Miriam; Hutter, Elisabeth; Plinkert, Peter; Bolay, Hans Volker

2012-01-01

Objective The “Heidelberg Model of Music Therapy for Chronic Tinnitus” is a manualized short term treatment (nine 50-minutes sessions of individualized therapy on five consecutive days). It has proven to be efficient in reducing tinnitus symptoms in the short run. Now the long-term impact of the treatment after up to 5.4 years should be explored. Materials and methods 206 patients who had attended the neuro-music therapy were addressed in a structured follow-up questionnaire survey. 107 complete questionnaires entered analysis. Follow-up time was 2.65 (SD 1.1) years. Results 76% of the patients achieved a reliable reduction in their tinnitus scores, the overall tinnitus distress as measured by the Mini-TQ diminished from 11.9 (SD = 4.9) to 7.4 (SD = 5.2) points, 87% of the patients were satisfied by the way they were treated during therapy, and 71% of the patients did not undergo any further treatment after. Evaluation of therapeutic elements displays, that only music therapy specific interventions were rated helpful by the patients. Tinnitus related factors (such as tinnitus pitch or loudness, time since onset) did not influence therapy outcome but female gender, positive therapeutic relationship, and higher initial Mini-TQ scores became apparent as factors predicting better chances for greater therapy success. Discussion The “Heidelberg Model of Music Therapy for Chronic Tinnitus” seems to be effective in the long run. The outcome effect size of d’ = 0.89, can be accounted for as “large” effect and falls into the upper range value compared to established treatments. PMID:22993646

A hermeneutical reflection on the resurrection of Jesus Christ in question and answer 45 of the Heidelberg Catechism

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Kobus Labuschagne

2013-10-01

Full Text Available This article is an attempt to elaborate hermeneutically on the different historical contexts, related the one to the other and to the centre point of the resurrection of Jesus Christ, in question and answer 45 of the Heidelberg Catechism. The aim is not only to find the true meaning that the Heidelberg Catechism intends to convey in the mentioned question and answer, but also to explain the underlying hermeneutical thinking as well as to bring to the surface and explain alternative assumptions that ordinary church-going Christians experience as the unusual outcome of an unknown and different kind of approach. Different hermeneutical processes lead to different outcomes of understanding − sometimes worlds apart. Vanuit die sentrale punt van die opstanding van Jesus Christus in vraag en antwoord 45 van die Heidelbergse Kategismus, wil hierdie artikel in ’n hermeneutiese besinning oor die verskillende verbandhoudende historiese kontekste uitbrei. Die doel is nie slegs om die ware betekenis te vind van wat die Heidelbergse Kategismus in genoemde vraag en antwoord poog om weer te gee nie, maar ook om die onderliggende hermeneutiese denke te verduidelik en alternatiewe aannames, wat gewone Christen-kerkgangers as ’n vreemde en verskillende benaderings ervaar, na die oppervlakte te bring en te verduidelik. Verskillende hermeneutiese prosesse lei tot verskillende uitkomste van verstaan – soms wêrelde van mekaar verwyderd.

A "Prepaid Package" for Obstetrics: Effect on Teaching and Patient Care in a University Hospital

Science.gov (United States)

Young, Philip E.

1976-01-01

The changing social milieu has removed the charity patient but not the need for a teaching population. The University Hospital's program is described, in which patients prepaid a fixed, single fee for all obstetrics-related care through the third post partum day. (LBH)

The medicine selection process in four large university hospitals in Brazil: Does the DTC have a role?

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Elisangela da Costa Lima-Dellamora

2015-03-01

Full Text Available Knowledge about evidence-based medicine selection and the role of the Drug and Therapeutics Committee (DTC is an important topic in the literature but is scarcely discussed in Brazil. Our objective, using a qualitative design, was to analyze the medicine selection process performed in four large university hospitals in the state of Rio de Janeiro. Information was collected from documents, interviews with key informants and direct observations. Two dimensions were analyzed: the structural and organizational aspects of the selection process and the criteria and methods used in medicine selection. The findings showed that the DTC was active in two hospitals. The structure for decision-making was weak. DTC members had little experience in evidence-based selection, and their everyday functions did not influence their participation in DTC activities. The methods used to evaluate evidence were inadequate. The uncritical adoption of new medicines in these complex hospital facilities may be hampering pharmaceutical services, with consequences for the entire health system. Although the qualitative approach considerably limits the extent to which the results can be extrapolated, we believe that our findings may be relevant to other university hospitals in the country.

UV-treatment in dermatology. Equipment and methods in Norwegian university hospitals

International Nuclear Information System (INIS)

Christensen, T.; Johnsen, B.; Johnsson, M.; Nordal, E.; Thune, P.; Kjeldstad, B.; Reitan, J.B.

1994-12-01

The use of phototherapy and the phototherapy-equipment were studied in five Norwegian university hospitals. The indications and the methods used were relatively similar, as well as the equipment used for dosimetry. The spectra and irradiance from the phototherapy lamps were measured and the variations in these parameters were evaluated. It is discussed whether there is a need for closer control and standardization of these parameters. The UVA-irradiance that could be experienced by the persons employed in the departments was found to be lower than the recommended limits. 12 refs., 7 figs., 6 tabs

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

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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

Outbreak of OXA-48-Producing Klebsiella pneumoniae Involving a Sequence Type 101 Clone in Batna University Hospital, Algeria.

Science.gov (United States)

Loucif, Lotfi; Kassah-Laouar, Ahmed; Saidi, Mahdia; Messala, Amina; Chelaghma, Widad; Rolain, Jean-Marc

2016-12-01

Seven nonredundant ertapenem-resistant Klebsiella pneumoniae isolates were collected between May 2014 and 19 January 2015 in the nephrology and hematology units of Batna University Hospital in Algeria. All strains coproduced the bla OXA-48 , bla CTX-M-15 , bla SHV-1 , and bla TEM-1D genes. Six of these isolates belonged to the pandemic clone sequence type 101 (ST101). The bla OXA-48 gene was located on a conjugative IncL/M-type plasmid. This is the first known outbreak of OXA-48-producing K. pneumoniae isolates involving an ST101 clone in Batna University Hospital. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

CMS penalizes 758 hospitals for safety incidents

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Robbins RA

2015-12-01

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

Knowledge, Awareness and Compliance with Universal Precautions among Health Care Workers at the University Hospital of the West Indies, Jamaica

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K Vaz

2010-09-01

Full Text Available Background: Universal precautions are not well understood or implemented by health care practitioners, though crucial in the prevention and transmission of blood-borne pathogens like HIV. Objective: To assess knowledge, awareness and compliance of universal precautions among health care workers at the University Hospital of the West Indies, Jamaica. Method: A cross-sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to 200 health care workers including medical doctors, medical technologists, nurses and porters to assess their knowledge, awareness and practice towards universal precautions. Results: Almost two-thirds (64.0% of the respondents were very knowledgeable of universal precautions with significantly more females (75.4% than males (42.9% (p<0.0001. More nurses (90.0%, medical doctors (88.0% and medical technologists (70% were very knowledgeable of universal precautions (p<0.0001. More respondents (92.9% who were employed in the health sector for 16 years and over reported high levels of awareness of universal precautions than those who were employed for less than five years (p<0.0001. 28.6% of males and only 6.2% of females reported that they do not use protective gear. More nurses reported frequent use of protective equipment followed by medical technologists and medical doctors (p<0.0001. Conclusions: There was adequate knowledge and a fair level of awareness among medical doctors, medical technologists, and nurses towards universal precautions.

Oral candidiasis as clinical manifestation of HIV/AIDS infection in Airlangga University hospital patients

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Putranti, A.; Asmarawati, T. P.; Rachman, B. E.; Hadi, U.; Nasronudin

2018-03-01

The purpose of this study was to determine the characteristics of HIV/AIDS patients with oral candidiasis as its clinical manifestation at Airlangga University Hospital Surabaya. This is a descriptive analytic research with cross-sectional design using Chi-Square statistic test. Samples of this study consist of 34 patients using total sampling methods. Those patients were all HIV/AIDS infected patients with oral candidiasis clinical manifestations, who were admitted to Airlangga University Hospital Surabaya from January 2016 to September 2017. Results showed that mostly HIV/AIDS patients with oral candidiasis are male (79.4%), old age (40-75years) total amounted to 58.8%, heterosexual as main risk factor (70%), clinical stadium mostly in stage IV (61.8%), 26% of patients with chronic diarrhea and 56% with pulmonary TB, clinical stages of patients have a significant relation to the incidence of oral candidiasis infection (p=0.024). The most common oral lesions found in people with HIV are Candidiasis. The best management is through routine dental examination and dental precautions to maintain health and achieve a better quality of life.

[Evaluation of the management of soft tissue sarcomas in Franche-Comté since the establishment of a multidisciplinary meeting at University Hospital. About 47 cases].

Science.gov (United States)

Haddad, J; Kalbacher, E; Piccard, M; Aubry, S; Chaigneau, L; Pauchot, J

2017-02-01

A multidisciplinary meeting (RCP) dedicated to the treatment of sarcoma was established in Franche-Comte in 2010. The goals of the study are: (a) To evaluate the treatment of sarcomas by confrontation with the existing literature; (b) To evaluate the influence of the multidisciplinary meeting on the management of sarcomas by hospitals at the regional level. This is a retrospective single center study from 2010 to 2015 on patients with sarcoma and peripheral soft tissue drawn from a Netsarc database (National Network of sarcomas) and communicating cancer record. A database Cleanweb especially dedicated is created. Forty-seven patients were included: ten sarcomas at the upper member 26 to the lower limbs, 11 on the trunk. Forty patients were operated on: ten out of the university hospital, 28 at the university hospital and two in a coordinating center. Ninety percent of patients treated at the university hospital were in accordance with the recommandations. None of the patients operated out of the university hospital benefited from medical care in accordance to the recommendations. There is an increase in the number of files sent by the hospitals out of the university hospital discussed in multidisciplinary meeting, before treatment. The creation of a dedicated multidisciplinary meeting sarcoma improves the medical management of these tumors and decreases inappropriate medical managements thanks to a better education of the regional physicians. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Using business process redesign to reduce wait times at a university hospital in the Netherlands

NARCIS (Netherlands)

Elkhuizen, Sylvia G.; Burger, Matthe P. M.; Jonkers, Rene E.; Limburg, Martien; Klazinga, Niek; Bakker, Piet J. M.

2007-01-01

BACKGROUND: Business process redesign (BPR) has been applied to implement more customer-focused and cost-effective care. In 2002, two pilot projects to improve patient care processes for two specific patient groups were conducted at the Academic Medical Center, a 1,000-bed university hospital in

Profile of neurological admissions at the University of Nigeria Teaching Hospital Enugu.

Science.gov (United States)

Ekenze, O S; Onwuekwe, I O; Ezeala Adikaibe, B A

2010-01-01

The burden of Neurological diseases may be on the increase especially in developing countries. Improved outcome in these settings may require appreciation of the spectrum of Neurological diseases and the impediments to their management. We aim to determine the profile of neurological admissions and the challenges of managing these diseases at the University of Nigeria Teaching Hospital Enugu South East Nigeria. Analysis of Neurological admissions into the medical wards of the University of Nigeria Teaching Hospital Enugu from January 2003 to December 2007. Neurological admissions comprise about 14.8% of medical admissions. There were 640 (51%) males and 609 (49%) females. The spectrum of neurological diseases were stroke 64.9%, central nervous system infections (21.8% ), HIV related neurological diseases 3.5%, hypertensive encephalopathy (3.4%), dementia (3%), subarachnoid haemorrhage (2.2%), Guillian Barre syndrome (1.2%), Parkinson's disease (1.1%), myasthenia gravis (1.0%), motor neurone disease and peripheral neuropathy and accounted for 0.8% and 0.6% respectively. Overall, noninfectious disease accounted for 78.2% of neurological admissions while infectious diseases accounted for 11.8%. A wide spectrum of neurological diseases occurs in our setting. The high incidence of CNS infections indicates that efforts should be geared towards preventive measures. A major challenge to be addressed in the management of neurological diseases in our setting is the lack of specialized facilities.

A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage scheme.

Science.gov (United States)

Pongpirul, Krit; Walker, Damian G; Winch, Peter J; Robinson, Courtland

2011-04-08

In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large), location (urban/rural), and type (public/private). Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1) Discharge Summarization, 2) Completeness Checking, 3) Diagnosis and Procedure Coding, 4) Code Checking, 5) Relative Weight Challenging, 6) Coding Report, and 7) Internal Audit. The hospital coding practice can be affected by at least five main factors: 1) Internal Dynamics, 2) Management Context, 3) Financial Dependency, 4) Resource and Capacity, and 5) External Factors. Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors.

Patient education process in teaching hospitals of Tehran University of Medical Sciences.

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Seyedin, Hesam; Goharinezhad, Salime; Vatankhah, Soodabeh; Azmal, Mohammad

2015-01-01

Patient education is widely recognized as a core component of nursing. Patient education can lead to quality outcomes including adherence, quality of life, patients' knowledge of their illness and self-management. This study aimed to clarify patient education process in teaching hospitals affiliated to Tehran University of Medical Sciences (TUMS) in Iran. This cross-sectional study was conducted in 2013. In this descriptive quantitative study, the sample covered 187 head nurses selected from ten teaching hospitals through convenience sampling. Data were collected with a questionnaire developed specifically for this study. The questionnaire measured patient education process in four dimensions: need assessment, planning, implementing and evaluating. The overall mean score of patient education was 3.326±0.0524. Among the four dimensions of the patient education process, planning was in the highest level (3.570±0.0591) and the lowest score belonged to the evaluation of patient education (2.840 ±0.0628). Clarifying patient education steps, developing standardized framework and providing easily understandable tool-kit of the patient education program will improve the ability of nurses in delivering effective patient education in general and specialized hospitals.

Subsequent Oophorectomy and Ovarian Cancer after Hysterectomy for Benign Gynecologic Conditions at Chiang Mai University Hospital.

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Jitkunnatumkul, Aurapin; Tantipalakorn, Charuwan; Charoenkwan, Kittipat; Srisomboon, Jatupol

2016-01-01

This study was undertaken to determine the incidence of subsequent oophorectomy due to ovarian pathology or ovarian cancer in women with prior hysterectomy for benign gynecologic conditions at Chiang Mai University Hospital. Medical records of women who underwent hysterectomy for benign gynecologic diseases and pre-cancerous lesions between January 1, 2004 and December 31, 2013 at Chiang Mai University Hospital were retrospectively reviewed. The incidence and indications of oophorectomy following hysterectomy were analyzed. During the study period, 1,035 women had hysterectomy for benign gynecologic conditions. Of these, 590 women underwent hysterectomy with bilateral salpingo-oophorectomy and 445 hysterectomy with bilateral ovarian preservation or unilateral salpingo-oophorectomy. The median age was 47 years (range, 11-75 years). Ten women (2.45 %) had subsequent oophorectomy for benign ovarian cysts. No case of ovarian cancer was found. The mean time interval between hysterectomy and subsequent oophorectomy was 43.1 months (range, 2-97 months) and the mean follow-up time for this patient cohort was 51 months (range, 1.3-124.9 months). According to our hospital-based data, the incidence of subsequent oophorectomy in women with prior hysterectomy for benign gynecologic conditions is low and all present with benign conditions.

Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

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Pasquini, T.A.S. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Neder, H.D. [Instituto de Economia, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Araújo-Junqueira, L. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); De-Souza, D.A. [Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil); Departamento de Clínica Médica e Curso de Nutrição, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG (Brazil)

2012-12-17

Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant.

Clinical outcome of protein-energy malnourished patients in a Brazilian university hospital

International Nuclear Information System (INIS)

Pasquini, T.A.S.; Neder, H.D.; Araújo-Junqueira, L.; De-Souza, D.A.

2012-01-01

Protein-energy malnutrition (PEM) is a treatable disease with high prevalence among hospitalized patients. It can cause significant increases in the duration of hospitalization and costs. PEM is especially important for health systems since malnourished patients present higher morbidity and mortality. The objective of the present study was to assess the evolution of nutritional status (NS) and the effect of malnutrition on clinical outcome of patients at a public university hospital of high complexity in Brazil. Patients hospitalized in internal medicine (n = 54), oncology (n = 43), and infectious diseases (n = 12) wards were included. NS was evaluated using subjective global assessment up to 48 h after admission, and thereafter at intervals of 4-6 days. On admission, patients (n = 109) were classified as well-nourished (n = 73), moderately malnourished or at risk of malnutrition (n = 28), and severely malnourished (n = 8). During hospitalization, malnutrition developed or worsened in 11 patients. Malnutrition was included in the clinical diagnosis of only 5/36 records (13.9% of the cases, P = 0.000). Nutritional therapy was administered to only 22/36 of the malnourished patients; however, unexpectedly, 6/73 well-nourished patients also received commercial enteral diets. Complications were diagnosed in 28/36 malnourished and 9/73 well-nourished patients (P = 0.000). Death occurred in 12/36 malnourished and 3/73 well-nourished patients (P = 0.001). A total of 24/36 malnourished patients were discharged regardless of NS. In summary, malnutrition remains a real problem, often unrecognized, unappreciated, and only sporadically treated, even though its effects can be detrimental to the clinical course and prognosis of patients. The amount of public and private funds unnecessarily dispersed because of hospital malnutrition is significant

Tools in a clinical information system supporting clinical trials at a Swiss University Hospital.

Science.gov (United States)

Weisskopf, Michael; Bucklar, Guido; Blaser, Jürg

2014-12-01

Issues concerning inadequate source data of clinical trials rank second in the most common findings by regulatory authorities. The increasing use of electronic clinical information systems by healthcare providers offers an opportunity to facilitate and improve the conduct of clinical trials and the source documentation. We report on a number of tools implemented into the clinical information system of a university hospital to support clinical research. In 2011/2012, a set of tools was developed in the clinical information system of the University Hospital Zurich to support clinical research, including (1) a trial registry for documenting metadata on the clinical trials conducted at the hospital, (2) a patient-trial-assignment-tool to tag patients in the electronic medical charts as participants of specific trials, (3) medical record templates for the documentation of study visits and trial-related procedures, (4) online queries on trials and trial participants, (5) access to the electronic medical records for clinical monitors, (6) an alerting tool to notify of hospital admissions of trial participants, (7) queries to identify potentially eligible patients in the planning phase as trial feasibility checks and during the trial as recruitment support, and (8) order sets to facilitate the complete and accurate performance of study visit procedures. The number of approximately 100 new registrations per year in the voluntary trial registry in the clinical information system now matches the numbers of the existing mandatory trial registry of the hospital. Likewise, the yearly numbers of patients tagged as trial participants as well as the use of the standardized trial record templates increased to 2408 documented trial enrolments and 190 reports generated/month in the year 2013. Accounts for 32 clinical monitors have been established in the first 2 years monitoring a total of 49 trials in 16 clinical departments. A total of 15 months after adding the optional feature of

Universal isolation precautions for patients at an academic hospital Precauciones universales en el aislamiento de pacientes en un hospital universitario Precauções universais em isolamentos de pacientes em hospital universitário

OpenAIRE

Vanessa Gomes Maziero; Marli Terezinha Oliveira Vannuchi; Dagmar Willamourius Vituri; Maria do Carmo Lourenço Haddad; Cristiane Nakaya Tada

2012-01-01

OBJECTIVE: To apply universal isolation precautions for patients at an academic hospital by a nursing team. METHODS: This descriptive and prospective study used data from advice service of quality control and nursing care that were gathered in observational reports of universal isolation precautions for patients admitted in two surgical inpatient units during 2008 and 2010. RESULTS: The mean general classification for both units was between desirable and adequate in the observational analysis...

Bacteriology of hospital-acquired infection and antibiotic resistance in a hospital university of Bushehr Port Fatemeh Zahra (s in 2002-2003

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Katayoon Vahdat

2005-02-01

Full Text Available Nosocomial infection is an increasing problem. The global problem of antimicrobial resistance is particularly pressing in developing countries, where the infectious disease burden is high and cost constraints prevent the widespread application of newer, more expensive agents. In a prospective study, 203 consecutive cases with hospital-acquired infection in a university hospital in Bushehr port were evaluated. The most common hospital-acquired infection was urinary (76 cases, conjunctivitis (16 cases, bacteremia (8 cases, meningitis (5 cases, wound (3 cases, empyema (2 cases and peritonitis (1 case. The patients with hospital-acquired infection were from surgical and internal medicine I.C.Us (53.2% & 15.6%, respectively. The most frequent isolated organisms were Pseudomonas aeruginosa (25.6%, Acinetobacter baumannii (19.7%, E. coli (13.3%, Klebsiella pneumoniae (11.3%, Staphylococcus aureus (8.4%, Staphylococcus epidermidis (7.9%, Enterobacter species (7%, Streptococcus species (6.4%, and Proteus mirabilis (0.5%. The most resistant organisms to antimicrobial agents were Acinetobacter baumannii and Pseudomonas aeruginosa 97 & 93.3% of these bacteria were resistant to third generation cephalosporins. The isolated Staphylococcal species were resistant to amikacin (94%. In conclusion, gram negative bacteria were the most common etiologic agent of hospital-acquired infection and had a high level of resistance to amikacin and third generation cephalosporins. Therefore, new therapeutic strategies should be designed to combat these microorganisms.

Performance Analysis of Hospitals Affiliated to Mashhad University of Medical Sciences Using the Pabon Lasso Model: A Six-Year-Trend Study

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Kalhor

2016-08-01

Full Text Available Background Nowadays, productivity and efficiency are considered a culture and a perspective in both life and work environments. This is the starting point of human development. Objectives The aim of the present study was to investigate the performance of hospitals affiliated to Mashhad University of Medical Sciences using the Pabon Lasso Model. Methods The present study was a descriptive-analytic research, with a cross-sectional design, conducted during six years (2009 - 2014, at selected hospitals. The studied hospitals of this study were 21 public hospitals affiliated to Mashhad University of Medical Sciences. The data was obtained from the treatment Deputy of Khorasan Razavi province. Results Results from the present study showed that only 19% of the studied hospitals were located in zone 3 of the diagram, indicating a perfect performance. Twenty-eight percent were in zone 1, 19% in zone 2, and 28% in zone 4. Conclusions According to the findings, only a few hospitals are at the desirable zone (zone 3; the rest of the hospitals fell in other zones, which could be a result of poor performance and poor management of hospital resources. Most of the hospitals were in zones 1 and 4, whose characteristics are low bed turnover and longer stay, indicating higher bed supply than demand for healthcare services or longer hospitalization, less outpatient equipment use, and higher costs.

[MEOPA use practices in a university hospital: Which conformity?

Science.gov (United States)

Victorri-Vigneau, Caroline; Paille, Cécile; Joyau, Caroline; Veyrac, Gwenaëlle; Cosset, Claire; Le Pelletier, Aline; Jolliet, Pascale; Nizard, Julien; Kuhn, Emmanuelle

2017-12-01

MEOPA (equimolar mixture of oxygen and nitrous oxide) is used for its analgesic and anxiolytic properties in order to obtain conscious sedation of the patient when performing painful care. It is subject to an enhanced pharmacovigilance and addictovigilance monitoring. In this context, it is important to dispose of hospital utilization data. This work aims to assess the compliance of the use of nitrous oxide regarding the recommendations of the summary of product characteristics, in a French university hospital (Nantes) and consider possible improvements. Transversal descriptive study, conducted in 2014 with all health professionals using MEOPA. Two thousand thirty-four health professionals answered the questionnaire ; durations of administrations are in conformity and the premises are generally appropriate but almost 60% of professionals have the feeling of inhaling the drug. The systematization of the prescription (always or almost always prescribed for 67% of professionals) and traceability of use (always or almost always in the patient's file for 71% of professionals) are potential source of improvement, particularly since 18% of professional health reported "abuse demands" from patients. The formation and information of health professionals are major issues of good use of nitrous oxide. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Economic impact of an integrated RIS/PACS system in a university hospital

International Nuclear Information System (INIS)

Kroeger, M.; Wetekam, V.; Nissen-Meyer, S.; Reiser, M.

1999-01-01

Problem: The goal of the current article is to demonstrate how qualitative and monetary effects resulting from an integrated RIS/PACS installation can be evaluated. Results: The sample analysis of a RIS/PACS solution specially designed for a university hospital demonstrates positive qualitative and monetary effects of the system. Under ideal conditions the payoff time of the investments is reached after 4 years of an assumed 8 years effective life of the system. Furthermore, under conservative assumptions, the risk analysis shows a probability of 0% for realising a negative net present value at the end of the payoff time period. Conclusion: It should be pointed out that the positive result of this sample analysis will not necessarily apply to other clinics or hospitals. However, the same methods may be used for the individual evaluation of the qualitative and monetary effects of a RIS/PACS installation in any clinic. (orig.) [de

Depressive symptoms and overwork among physicians employed at a university hospital in Japan

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Toru Maruyama

2017-11-01

Full Text Available Introduction: The excessive workload of Japanese hospital physicians is a serious social problem due to effects on their mental health status, as well as the potential for medical errors and lawsuits. The extent of overwork among resident physicians employed at national university hospitals in Japan is unknown and needs to be investigated. Methods: This study used a questionnaire recommended by the Japanese Ministry of Health for hospital physicians working overtime, administered through an interview carried out by an occupational physician during the health surveillance to evaluate: 1 the severity of chronic fatigue; 2 the burden of work; 3 an overwork score derived from these two measures; and 4 presence of depressive symptoms. After the feasibility of the questionnaire was confirmed, both a cross-sectional and a longitudinal study were performed, while statistics analysis included multiple linear regression analysis and chi-square test set at P < 0.05. Results: Most of the overworked physicians were young medical staffs (48%, whereas postgraduate residents formed a small group (10%. In the cross-sectional study (n = 135; mean age 32.7 years ± 5.6, the histograms of scores for the four factors investigated showed a strong positive skewness, while overtime histograms showed a negative skewness at 4, 3, and 2 months prior to the interview with occupational physician, but positive skewness 1 month prior to the interview. The longitudinal study (n = 26 showed an increase or reduction of overtime respectively having a significant impact on exacerbation or improvement of the overwork score (P = 0.028 and depressive symptoms (P = 0.025. Discussion and Conclusions: A strong positive skewness of the histograms for items related to overwork might indicate fear of stigma of mental illness amongst young physicians. Physicians employed at Japanese national university hospitals should be protected by the institution, and the roles of occupational physician

Workplace violence against emergency versus non-emergency nurses in Mansoura university hospitals, Egypt.

Science.gov (United States)

Abou-ElWafa, Hala Samir; El-Gilany, Abdel-Hady; Abd-El-Raouf, Samar E; Abd-Elmouty, Samia Mahmoud; El-Sayed, Rabab El-Sayed Hassan

2015-03-01

Workplace violence (WPV) against nurses is a common but neglected problem in Egypt. The objectives are to estimate the prevalence and associated risk factors of different types of violence against nurses working in the emergency hospital compared with those working in non-emergency clinics, circumstances of violence, type of perpetrators, and victims' response. This cross-sectional comparative study was carried out at Mansoura University Hospitals, Egypt, during January 2013. The data were collected through the adapted version of a self-administered questionnaire developed by the International Labor Office/International Council of Nurses/World Health Organization/Public Services International on WPV in the health sector. All types of WPV are common among nurses. Precipitating factors for violent incidents identified by respondents are emergency specialty, having work shift, and younger age. Violent incidents result in work dissatisfaction and consequently impair work productivity. Nurses working in emergency hospital experienced a higher level of different types of WPV. There is an urgent need to formulate and implement a policy for dealing with violent events. © The Author(s) 2014.

A qualitative study of DRG coding practice in hospitals under the Thai Universal Coverage Scheme

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Winch Peter J

2011-04-01

Full Text Available Abstract Background In the Thai Universal Coverage health insurance scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group-based retrospective payment, for which quality of the diagnosis and procedure codes is crucial. However, there has been limited understandings on which health care professions are involved and how the diagnosis and procedure coding is actually done within hospital settings. The objective of this study is to detail hospital coding structure and process, and to describe the roles of key hospital staff, and other related internal dynamics in Thai hospitals that affect quality of data submitted for inpatient care reimbursement. Methods Research involved qualitative semi-structured interview with 43 participants at 10 hospitals chosen to represent a range of hospital sizes (small/medium/large, location (urban/rural, and type (public/private. Results Hospital Coding Practice has structural and process components. While the structural component includes human resources, hospital committee, and information technology infrastructure, the process component comprises all activities from patient discharge to submission of the diagnosis and procedure codes. At least eight health care professional disciplines are involved in the coding process which comprises seven major steps, each of which involves different hospital staff: 1 Discharge Summarization, 2 Completeness Checking, 3 Diagnosis and Procedure Coding, 4 Code Checking, 5 Relative Weight Challenging, 6 Coding Report, and 7 Internal Audit. The hospital coding practice can be affected by at least five main factors: 1 Internal Dynamics, 2 Management Context, 3 Financial Dependency, 4 Resource and Capacity, and 5 External Factors. Conclusions Hospital coding practice comprises both structural and process components, involves many health care professional disciplines, and is greatly varied across hospitals as a result of five main factors.

[Herpetological data and management of ophidian envenomation at university hospitals in Abidjan, Côte d'Ivoire].

Science.gov (United States)

Djohan, V; Menan, E I H; Yavo, W; Barro, P C K; Vanga, H; Dempah, J A; N'Dri, D K; Mignonsin, D; Akaffou, M H; Koné, K

2010-02-01

This study was carried in the intensive care units of Abidjan university hospitals and in the herpetology department of Pasteur Institute between January 2001 and April 2003. The purpose was to identify ophidian species that were dangerous for man and to document cases of snakebite in Abidjan. The study was carried out in two phases, i.e., collection and identification of snake species followed by review of case records involving snake envenomation at Cocody and Treichville university hospitals. A total of 5 snake families, 14 genera and 17 species including some that were dangerous for man were identified. All species except Naja nigricollis live in forest areas. Most snakebites led to simple clinical signs that regressed within 72 hours with only symptomatic treatment. However, a few cases required immunotherapy. Traditional methods of snakebite treatment were used for first line treatment in 50% of cases.

Heidelberg physicists report. Vol. 2. Reviews of research in physics and astronomy. Fundamental contributions to the physics of the atomic nuclei and the star atmospheres

International Nuclear Information System (INIS)

Appenzeller, Immo; Dubbers, Dirk; Siebig, Hans-Georg; Winnacker, Albrecht

2018-01-01

The following topics are dealt with: 50 years theoretical astrophysics, nuclear physics after the discovery of the shell model, from the small van de Graaf to the large HERA, from ''chamber physics'' to big research, reminiscences on physical research in Heidelberg. (HSI)

Varicella zoster virus related deaths and hospitalizations before the introduction of universal vaccination with the tetraviral vaccine

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Alessandra de Martino Mota

2016-08-01

Full Text Available Abstract Objective: To characterize varicella zoster virus-related deaths and hospitalizations in Brazil before universal vaccination with the tetravalent (measles, mumps, rubella, and varicella vaccine, attempting to collect baseline data on varicella morbidity and mortality in order to evaluate the impact of the varicella vaccination program. Methods: Varicella-associated mortality data were evaluated between 1996 and 2011 and varicella zoster virus-associated hospitalizations between 1998 and 2013. Data were gathered from the Informatics Department of the Unified Health System, considering the International Classification of Diseases, 10th Revision, code B01. All age groups were assessed. Varicella-specific mortality rates were calculated and seasonality of varicella-zoster virus-associated hospitalizations was described. Results: There were 2334 varicella deaths between 1996 and 2011, 19.3% in infants aged less than 1 year and 36% in children from 1 to 4 years. In infants under 1 year, varicella mortality rates reached 3.2/100,000/year. In children aged 1–4 years, varicella mortality rates reach 1.64/100,000/year. Average annual mortality rates for varicella in Brazil are 0.88/100,000 in infants under 1 year and 0.40/100,000 in children aged 1–4 years. The total number of hospitalizations associated with varicella zoster virus was 62,246 from 2008 to 2013. Varicella-associated hospitalizations have a seasonal distribution in children, peaking in November. In the elderly, monthly averages of herpes zoster-associated hospitalizations present no significant seasonal variation. Conclusions: Varicella is associated, in the pre-vaccine period, to significant morbidity and mortality in Brazil. The universal vaccination program is expected to decrease the disease burden from varicella.

Practical radiation protection in hospitals. A view at the nuclear medicine departement of the University Hospital of Cologne

International Nuclear Information System (INIS)

Sudbrock, Ferdinand

2011-01-01

Radiation protection plays a predominant role in nuclear medicine departments as they are installations dealing with open radioactive substances. Many experts in radiation protection who are not directly involved in nuclear medicine may only have a vague insight into the daily routine of such installations. This contribution would like to give an impression by making a virtual tour through the nuclear medicine department of the University Hospital of Cologne - a department that covers a large part of the ability spectrum of this discipline. This tour will show some specialities concerning radiation protection in diagnostic and therapeutic procedures. (orig.)

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

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

2016-04-01

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

Workplace physical violence, verbal violence, and mobbing experienced by nurses at a university hospital.

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Aksakal, Fatma Nur Baran; Karaşahin, Emine Füsun; Dikmen, Asiye Uğraş; Avci, Emine; Ozkan, Seçil

2015-01-01

The aim of this study was to determine the frequency of and risk factors for physical violence, verbal violence, and mobbing experienced by nurses in a university hospital. This was a cross-sectional study conducted at Gazi University Medical Faculty Hospital. A questionnaire form recommended by the WHO and the International Labor Organization was administered through face-to-face interviews to determine the violence experienced in the past 12 months by nurses. The prevalence of physical violence, verbal violence, and mobbing was 13.9%, 41.8%, and 17.1%, respectively. Working more than 40 h per week increased the risk of physical violence by 1.86 times. The majority of nurses who experienced verbal violence and mobbing were significantly more willing to change their work, their institution, and their profession if given the opportunity. Fewer than one-fourth of the victims indicated they reported any incident. We knew that the prevalence of physical violence, verbal violence, and mobbing were high among nurses and that incidents were underreported, and the study corroborated this information. What this study adds to the topic is that long working hours increased the prevalence of physical violence and was defined as an important contributory factor.

[Pediatric victims of traffic accidents admitted to a university hospital: epidemiological and clinical aspects].

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Feitas, Juliana Pontes Pinto; Ribeiro, Lindioneza Adriano; Jorge, Miguel Tanús

2007-12-01

This study analyzes epidemiological and clinic characteristics of victims of traffic accidents. Data were obtained from medical records of children under 15 years of age (n = 1,123) admitted to a university hospital in Uberlândia, Minas Gerais State, Brazil, from 1999 to 2003. Mean age was eight years, 65.7% were boys, 76.6% were cyclists or pedestrians, 45.9% suffered head injuries, and 9% remained in hospital for more than two weeks. Fourteen (1.2%) died, 78.6% of these within 48 hours of hospitalization, and 85.7% with brain injuries. Among the passengers of motorcycles and larger vehicles, 58.8% were not using security devices properly at the time of the accident. Among the cyclists, 61% suffered isolated limb injuries. Meanwhile, pedestrians tended to suffer multiple lesions (57.5%) and be admitted to intensive care (7.1%), and represented 66.7% of the deaths. Epidemiological data on pediatric traffic victims can be useful for accident prevention programs.

The Influence of Leadership in The Conduct of the Implementation Process of Strategic Planning: A Case Study at the University Hospital of the University of St Catherine

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Giselly Rizzatti

2012-09-01

Full Text Available Teaching hospitals are undergoing profound and fast changes, especially resulting from the implementation of new policies for health. To achieve their goals and remain competitive, these organizations have been forced to adopt more effective management tools, among which are the elaboration of a strategic plan. The goal of this study is to analyze the influence of leadership in driving the implementation process of strategic planning in a teaching hospital. The study was conducted in the university hospital Prof. Polydoro Ernani de São Thiago from Federal University of Santa Catarina - HU / UFSC, where a semi-structured interview was conducted with the coordinator of the Strategic Planning Team HU / UFSC. Authors Hersey et al (1986, Northouse (2004, Schein (1997 Senge (1999, among others, were grounded theoretically in the theme of leadership. The theory of strategic planning was primarily based on works by authors Ansoff (l991, Hrebiniak (2006 and Pereira (2010. With the research results, we can conclude the great influence that leadership plays in driving the implementation process of strategic planning.

The Assessment of the Applications to University Hospital Urology Outpatient Clinic

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Adnan Gucuk

2013-04-01

Full Text Available Introduction: Provision of health care services to persons where it is needed required for the production of quality service in the organization of health services. The purpose of this study, determine the reason for admission and factors affecting admission and evaluate the current status for the patients admitted to a tertiary health care center. Materials and methods: The study was planned descriptive. Participants were determined among the patients were admitted to urology clinic between December 2011-March 2012 for any reason on a voluntary basis. Fourteen item questionnaire was completed by the physician. The survey asked the age, educational status, initial complaint, elapsed time from the beginning of complaints, whether was the previous treatment from another institution, reasons for choosing a university hospital polyclinics for participants. Results: A total of 337 participants attended, and their gender were 23.7% female, 76.3% male. 61.7% participants had received earlier medical attention because of complaints, 38.3% of had not received previously medical attention in any health institution and had to apply directly to the tertiary health care center. Apply directly to the university hospital outpatient clinic was significantly higher in men (p:0.11(table 1. Direct applications are increasing significantly in participant has higher education level. Compared to complexity of required investigations for patients had received and had not received earlier medical attention were no significant differences (p:0.134. Conclusion: For more effective use of health resources and results-oriented, training must be relevant to users of health care services to increase health literacy as well as a number of legal arrangements. [TAF Prev Med Bull 2013; 12(2.000: 165-168

Hospitals; hospitals13

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

Presentation and analysis of work at the emergency department – of the University children’s Hospital Ljubljana

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Tina Bregant

2013-05-01

Conclusions: Since 2010, the paediatric emergency department of the University Children’s Hospital Ljubljana has functioned in compliance wtih the guidelines used in similar international tertiary centres. However, there is still room for improvement in organization and staffing.

Healthcare-associated vancomycin resistant Enterococcus faecium infections in the Mansoura University Hospitals intensive care units, Egypt

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Dalia Moemen

2015-09-01

Full Text Available Vancomycin resistant Enterococcus faecium (VREF ia an emerging and challenging nosocomial pathogen. This study aimed to determine the prevalence, risk factors and clonal relationships between different VREF isolates in the intensive care units (ICUs of the university hospitals in our geographic location. This prospective study was conducted from July, 2012 until September, 2013 on 781 patients who were admitted to the ICUs of the Mansoura University Hospitals (MUHs, and fulfilled the healthcare-associated infection (HAI criteria. Susceptibility testing was determined using the disk diffusion method. The clonal relationships were evaluated with pulsed field gel electrophoresis (PFGE. Out of 52 E. faecium isolates, 12 (23.1% were vancomycin resistant. The significant risk factors for the VREF infections were: transfer to the ICU from a ward, renal failure, an extended ICU stay and use of third-generation cephalosporins, gentamicin, or ciprofloxacin. PFGE with the 12 isolates showed 9 different patterns; 3 belonged to the same pulsotype and another 2 carried a second pulsotypes. The similar pulsotypes isolates were isolated from ICUs of one hospital (EICUs; however, all of the isolates from the other ICUs had different patterns. Infection control policy, in conjunction with antibiotic stewardship, is important to combat VREF transmission in these high-risk patients.

Osteoporosis among hospitalized patients with proximal femoral fractures in Assiut University Trauma Unit, Egypt.

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Farouk, Osama; Mahran, Dalia G; Said, Hatem G; Alaa, Mohamed M; Eisa, Amr; Imam, Hisham; Said, G Z

2017-12-01

The study was done to investigate osteoporosis prevalence in 275 hip fracture admissions at the Trauma Unit of Assiut University Hospitals and associated factors, which are understudied in our locality. Prevalence was 74.9%. Female sex, older age, low body mass index, and fall on the ground were associated with osteoporosis. This study aims to identify osteoporosis prevalence in hip fracture admissions at the Trauma Unit of Assiut University Hospitals and to study the independent correlates of osteoporosis-related fracture. A prospective cross-sectional study was carried out in 275 hip fracture patients admitted to the Trauma Unit of Assiut University Hospitals from January through December 2014 of both sexes aged 50 years and older. Exclusion criteria were polytrauma, major accidents, and history of chronic conditions and long-term medication associated with osteoporosis risk increase and bilateral hip fractures. For every patient, weight, height, and bone mineral density by dual-energy x-ray absorptiometry (DEXA) were recorded. Tests of significance for non-parametric data were used. The questionnaire included sociodemographic characteristics, dietary habits, lifestyle factors such as smoking and physical activity, and female obstetric and gynecological factors. Mean age was 70.82 ± 11.02 SD; 51.6% were males and 8.4% were obese. Fall on ground was in 81.1% of fractures. Osteoporosis (femoral neck T score ≤ -2.5 SD) prevalence was 74.9%. By univariable analysis, significant correlates were female gender, older age, normal BMI, and fall on the ground. Milk and cheese daily intake was significantly associated with lower prevalence of osteoporosis. In a multivariable logistic regression model, female sex, older age, low BMI, and fall on the ground were associated with osteoporosis. Osteoporosis prevalence is high among hip fracture patients and associated with female sex, increase in age, low BMI, and fall on ground. Strategies to prevent osteoporosis are

[Anaesthesia education at german university hospitals: the teachers' perspective -- results of a nationwide survey].

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Goldmann, K; Steinfeldt, T; Wulf, H

2006-04-01

The principle purpose of this study was to collect data on the conditions and practice of anaesthesia education as well as the teaching qualification of consultants at German university hospitals. Based upon the collected data, areas of weakness and strength as well as measures required to improve anaesthesia training are described. A questionnaire containing 26 items was mailed to 607 consultants employed at 41 German university hospitals in June 2003. A total of 255 questionnaires was analysed (response rate: 43 %). Genuine training activities account for 14 % of the working hours of the participating consultants. On average, at the institutions of participating consultants, novices work for a duration of 1 month together with a consultant anaesthetist before they give anaesthetics without direct and constant supervision. When asked to describe the predominant method of training at their institution 71 % indicated "case-oriented teaching"; however, 53 % chose "see one, do one, teach one" and 49 % "learning by doing" as method of training as well (multiple choice). According to 63 % of respondents, departmental educational activities usually happen after their regular working hours. "Daily workload" (96 %), "time pressure" (96 %), "lack of time" (96 %) and "lack of personnel" (90 %) were indicated as the main obstacles of teaching. According to 80 % of respondents, a dedicated financial budget for education does not exist; instead, financial resources of third parties (industry) (58 %), of the state (for research und undergraduate education) (60 %) and of patients service (66 %) are used to ensure training of anaesthesia residents. Due to a lack of a dedicated financial budget for resident training and an increasing economic pressure, "lack of time" and "lack of personnel" are the main factors leading to the situation at German university hospitals that consultants can only spend 14 % of their working hours for teaching purposes despite of sufficient qualification

A survey on postanesthetic patient satisfaction in a university hospital

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Adel Ali Alshehri

2015-01-01

Full Text Available Background and Objectives: Patient satisfaction after anesthesia is an important outcome of hospital care. The aim is to evaluate the postoperative patient satisfaction during the patient stay at King Khalid University Hospital in Riyadh, Saudi Arabia. Patients and Methods: Three hundred and fifty-three patients who underwent surgery under general/regional anesthesia were surveyed. They were interviewed face to face on the first postoperative day. We recorded pain and pain controls in addition to some common complication of anesthesia like nausea and vomiting (postoperative nausea and vomiting as a parameter to assess the rate of patient′s satisfaction. Results: The overall level of satisfaction was high (95.2%; 17 (4.8% patients were dissatisfied with their anesthetic care. There was a strong relation between patient dissatisfaction and: (i Patients with poor postoperative pain control 13 (12.4%, (ii patients with moderate nausea 8 (11.1% and (iii patients with static and dynamic severe pain 6 (21.4. Several factors were associated with dissatisfaction can be prevented, or better treated. Conclusion: We concluded that the patient satisfaction was high. Postoperative visit should be routinely performed in order to assess the quality and severity of postoperative pain, nausea and vomiting and the other side-effects postoperatively.

Analysis of clinical records of dental patients attending Jordan University Hospital: Documentation of drug prescriptions and local anesthetic injections

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Najla Dar-Odeh

2008-08-01

Full Text Available Najla Dar-Odeh1, Soukaina Ryalat1, Mohammad Shayyab1, Osama Abu-Hammad21Department of Oral and Maxillofacial Surgery Oral Medicine and Periodontics, Faculty of Dentistry, University of Jordan, Jordan; 2Department of Prosthetic Dentistry, Faculty of Dentistry, University of Jordan, JordanObjectives: The aim of this study was to analyze clinical records of dental patients attending the Dental Department at the University of Jordan Hospital: a teaching hospital in Jordan. Analysis aimed at determining whether dental specialists properly documented the drug prescriptions and local anesthetic injections given to their patients.Methods: Dental records of the Dental Department at the Jordan University Hospital were reviewed during the period from April 3rd until April 26th 2007 along with the issued prescriptions during that period.Results: A total of 1000 records were reviewed with a total of 53 prescriptions issued during that period. Thirty records documented the prescription by stating the category of the prescribed drug. Only 13 records stated the generic or the trade names of the prescribed drugs. Of these, 5 records contained the full elements of a prescription. As for local anesthetic injections, the term “LA used” was found in 22 records while the names and quantities of the local anesthetics used were documented in only 13 records. Only 5 records documented the full elements of a local anesthetic injection.Conclusion: The essential data of drug prescriptions and local anesthetic injections were poorly documented by the investigated group of dental specialists. It is recommended that the administration of the hospital and the dental department implement clear and firm guidelines for dental practitioners in particular to do the required documentation procedure.Keywords: dental records, documentation, prescriptions, local anesthesia

To see or not to see. Perceptions of equality in a Swedish university hospital.

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Oresland, S; Jakobsson, A; Segesten, K

1999-01-01

In order to examine the perceptions of sex equality among medical doctors (MDs) and registered nurses (RNs), a survey was conducted in a Swedish University Hospital in May 1995. A questionnaire was sent to 475 MDs and RNs of three different age groups. The results showed that women tend to have similar opinions irrespective of occupation and age, which differed significantly from those of men. Men believed that equality in general exists in the hospital, while women think the values and conditions in the workplace mainly benefit men. No evidence was found to indicate a change in the sex hierarchy within the health care system. Rather, the status quo will be maintained and gender stereotypes reinforced from one generation to the next.

[Impact of sugammadex on neuromuscular blocking agents use: a multicentric, pharmaco-epidemiologic study in French university hospitals and military hospitals].

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Beny, K; Piriou, V; Dussart, C; Hénaine, R; Aulagner, G; Armoiry, X

2013-12-01

Seven Neuromuscular Blocking Agents (NMBA) are commercialized in France. Four of them have an intermediate duration of action. Sugammadex required the use of NMBA slightly employed in clinical practice in France. Its introduction in routine practice could have an impact on NMBA use in clinical practice. This study was then conducted to assess and compare NMBA use before and after the commercialization of sugammadex. A longitudinal, retrospective, observational study was conducted between 2008 and 2011 in French university hospitals and military hospitals. The consumption data for sugammadex and NMBA were collected using a collection grid which was filled by pharmacists or anesthesiologists. Drug use was measured by the number of vials used divided by the annual number of hospitalizations in surgery and obstetrics (HSO). An overall analysis of the annual frequency of NMBA use was firstly performed, then individual data of each hospital were analyzed. Descriptive statistical analysis including mean, standard deviation, median, minimum and maximum was achieved. Thirty-four out of 39 hospitals participated in the study (87%) and analysis was performed on 26 of them (7%). The data of eight institutions were excluded due to missing values or because of the non-admission of sugammadex in their formulary. The NMBA mostly used were non-steroidal NMBA (75% of market share) with an increased use between 2008 and 2011 concerning atracurium (from 41 to 51 vials of 50mg atracurium used per 100 HSO). The overall analysis revealed an increase of the occurrence of rocuronium (between 2008 and 2011: from 1 to 4.8 vials of 50mg rocuronium used per 100 HSO). Individual analyses on each hospital showed a possible effect of sugammadex introduction on NMBA use in nine hospitals. The commercialization of sugammadex seems to have induced a discrete increase of steroidal NMBA but non-steroidal NMBA remain the leading agent in France. A long-term follow-up is deserved. Copyright © 2013 Soci

Hospital staffing and hospital costs.

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Andrew, R R

1976-08-07

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

A Study of Rate and Predictors of Fall Among Elderly Patients in a University Hospital.

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al Tehewy, Mahi Mahmoud; Amin, Ghada Essam; Nassar, Nahla Wassem

2015-12-01

Falls represent a serious problem facing hospital-admitted patients, and the severity of fall-related complications rises steadily after the age of 65 years. The aims of this study were (a) to calculate the rate of falls among elderly patients in the internal medicine departments in Ain Shams University Hospital, (b) to identify different predictors and characteristics of falls, and (c) to assess clinical consequences and hospitalization outcomes of falls. An observational longitudinal study has been conducted in Ain Shams University Hospital, where 411 elderly patients admitted to the internal medicine departments were included. Upon admission, the patients were assessed for their risk for falling using the Morse Fall Scale (MFS). Information about their medical condition and drugs administered was obtained. Functional assessment of the patients regarding their ability to perform different daily activities was also performed. The patients were followed up during their stay, and once a fall event occurred, complete details regarding the circumstances and consequences of that event were obtained. The incidence rate of falls was found to be 16.9 per 1000 patient days. The fallers had a significantly high risk for falling according to the MFS (P = 0.02). The MFS was able to predict patients at risk for falling and identified correctly 82.6% of the fallers. The most common medical conditions associated with falls were diabetes (48.7%), hypertension (58.7%), and visual impairment (41.3%). Anemia (P = 0.05) and osteoporosis (P = 0.02) showed a statistically significant difference between the fallers and the nonfallers. Presence of a history of a fall and increased length of hospital stay were highly significant (P = 0.01) factors that predisposed to falls. Logistic regression analysis showed that anemia, osteoporosis, and history of a fall were independent predictors of falls. Most falls had no serious consequences, approximately 18% had contusions, 2% had subdural

Complexity of care and strategies of self-management in patients with colorectal cancer

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Ose D

2017-04-01

Full Text Available Dominik Ose,1,2 Eva C Winkler,3 Sarah Berger,1 Ines Baudendistel,1 Martina Kamradt,1 Felicitas Eckrich,1 Joachim Szecsenyi1 1Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany; 2Department of Population Health, Health System Innovation and Research, University of Utah, Salt Lake City, UT, USA; 3Program for Ethics and Patient-oriented Care in Oncology, National Centre for Tumour Diseases, University Hospital Heidelberg, Heidelberg, Germany Purpose: Given the inherent complexity of cancer care, in which personal, social, and clinical aspects accumulate and interact over time, self-management support need to become more comprehensive. This study has the following two aims: 1 to analyze and describe the complexity of individual patient situations and 2 to analyze and describe already established self-management strategies of patients to handle this complexity.Methods: A qualitative study was conducted. Ten focus groups were performed collecting perspectives of the following three user groups: patients with colorectal cancer (n=12 and representatives from support groups (n=2, physicians (n=17, and other health care professionals (HCPs; n=16. Data were analyzed using qualitative content analysis.Results: The results showed that cancer patients are struggling with the complexity of their individual situations characterized by the 1 “complexity of disease”, 2 “complexity of care”, and 3 “complexity of treatment-related data”. To deal with these multifaceted situations, patients have established several individual strategies. These strategies are “proactive demanding” (eg, to get support and guidance or a meaningful dialog with the doctor, “proactive behavior” (eg, preparation of visits, and “proactive data management” (eg, in terms of merging treatment-related data and to disseminate these to their health care providers.Conclusion: Patients with colorectal cancer

Commissioning of the Cryogenic Plant for the Cryogenic Storage Ring (CSR) at Heidelberg

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von Hahn, R; Grieser, M; Haberstroh, C; Kaiser, D; Lange, M; Laux, F; Menk, S; Orlov, D A; Repnow, R; Sieber, T; Quack, H; Varju, J; Wolf A

2009-01-01

At the Max-Planck-Institute for Nuclear Physics in Heidelberg a next generation electrostatic storage ring for low velocity atomic and molecular ion beams is under construction. In contrast to existing electrostatic storage rings, the Cryogenic Storage Ring CSR will be cooled down to temperatures below 2 K. Thus acting as a large cryopump it will provide long storage times and, in addition, open a new field of quantum state controlled molecular physics due to a low heat radiation background from space-like environment. A concept for cooling the storage ring has been developed and is presently tested by means of a linear trap as a prototype with a length of 1/10 of the planned ring. A commercial refrigerator with 21 W at 2 K has been successfully commissioned and was connected to the prototype. This paper presents the status of the cryogenic plant after the commissioning and one year of operation.

Leech management before application on patient: a nationwide survey of practices in French university hospitals

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Delphine Grau

2018-02-01

Full Text Available Abstract Background Leech therapy in plastic/reconstructive microsurgery significantly improves a successful outcome of flap salvage but the drawback is a risk of severe infection that results in a drop of the salvage rates from 70-80% to below 30%. We report the results of a national survey conducted in all the French university hospitals to assess the current extent of use of leech for medical practices in the hospital and to investigate maintenance, delivery practices and prevention of the risk of infection. Methods Data concerning conditions of storage, leech external decontamination, microbiological controls, mode of delivery and antibiotic prophylaxis were collected from all the French university hospitals in practicing leech therapy, on the basis of a standardized questionnaire. Results Twenty-eight of the 32 centers contacted filled the questionnaire, among which 23 practiced leech therapy, mostly with a centralized storage in the pharmacy; 39.1% of the centers declared to perform leech external decontamination and only 2 centers recurrent microbiological controls of the water storage. Leech delivery was mostly nominally performed (56.5%, but traceability of the leech batch number was achieved in only 39.1% of the cases. Only 5 centers declared that a protocol of antibiotic prophylaxis was systematically administered during leech therapy: either quinolone (2, sulfamethoxazole/trimethoprim (2 or amoxicillin/clavulanic acid (1. Conclusions Measures to prevent infectious complications before application to patient have to be better applied and guidelines of good practices are necessary.

[A multimodal strategy to improve adherence to hand hygiene in a university hospital].

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Fariñas-Alvarez, C; Portal-María, T; Flor-Morales, V; Aja-Herrero, A; Fabo-Navarro, M; Lanza-Marín, S; Lobeira-Rubio, R; Polo-Hernández, N; Sixto-Montero, M; Moreta-Sánchez, R; Ballesteros-Sanz, M Á; Yañez-San Segundo, L; Bartalome-Pacheco, M J; Armiñanzas-Castillo, C

Within the framework of the PaSQ (Patient Safety and Quality care) Project, this hospital decided to implement a multifaceted hospital-wide Hand Hygiene (HH) intervention based on a multimodal WHO approach over one year, focusing on achieving a sustained change in HH cultural change in this hospital. Setting: University Hospital Marqués de Valdecilla, Santander (Spain), a tertiary hospital with 900 beds. Intervention period: 2014. An action plan was developed that included the implementation of activities in each component of the 5-step multimodal intervention. An observation/feedback methodology was used that included the provision of performance and results feedback to the staff. A 3/3 strategy (non-blinded direct observation audits performed during 3 randomised days every 3 weeks with pro-active corrective actions at the end of each observation period). HH compliance, alcohol-based hand-rub (ABHR) consumption, and rate of MRSA infection, were monitored during the intervention. Hospital ABHR consumption increased during the study period: from 17.5 to 19.7mL/patient-days. In the intervention units, this consumption was 24.8mL pre-intervention, 42.5mL during the intervention, and 30.4mL two months post-intervention. There were 137 evaluation periods in 30 different days, in which a total of 737 health-care workers were observed and 1,870 HH opportunities. HH compliance was 54.5%, ranging between 44.8% and 69.9%. The incidence of MRSA infection decreased during the intervention in the selected units, from 13.2 infections per 10,000 patient-days pre-intervention to 5.7 three months post-intervention. Our HH strategy, supported by a 3/3 strategy increased alcohol-based hand-rub consumption and compliance. A reduction in MRSA infections was observed. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Bioethics and University: The University Hospital, Private or Public Institution?

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José Nel Carreño R., MD, esp.

2007-12-01

Full Text Available In order to acquire a real and useful knowledgeof medicine, the practice in the hospital setting is indispensable. Public, former charity hospitals have been the scenary for student practice. In a paternalistic model of medicine this was understandable.Nevertheless now that the model has changed to a more respectful of autonomy and justice this discrimination appears as unethical. There are no real reasons to discriminate educationin such a way. Medical education should happen in both the public and private sector.

Chemical Characterization of the Indoor Air Quality of a University Hospital: Penetration of Outdoor Air Pollutants

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Scheepers, P.T.J.; Wel, L. van; Beckmann, G.; Anzion, R.B.M.

2017-01-01

For healthcare centers, local outdoor sources of air pollution represent a potential threat to indoor air quality (IAQ). The aim of this study was to study the impact of local outdoor sources of air pollution on the IAQ of a university hospital. IAQ was characterized at thirteen indoor and two

Chemical Characterization of the Indoor Air Quality of a University Hospital : Penetration of Outdoor Air Pollutants

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Scheepers, Paul T J; Van Wel, Luuk; Beckmann, Gwendolyn; Anzion, Rob B M

2017-01-01

For healthcare centers, local outdoor sources of air pollution represent a potential threat to indoor air quality (IAQ). The aim of this study was to study the impact of local outdoor sources of air pollution on the IAQ of a university hospital. IAQ was characterized at thirteen indoor and two

Prevalence of Diabetes Mellitus in the Surgical Population of the University of Puerto Rico Affiliated Hospitals: A Study using the Surgery Database.

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Cruz, Norma I; Santiago, Elvis; Abdul-Hadi, Anwar

2016-09-01

To evaluate the prevalence of diabetes mellitus in the surgical population of the University of Puerto Rico (UPR)-affiliated hospitals. We examined all the surgical cases that were entered into the Surgical Database from April 1, 2014 through September 30, 2014. This database collects patient and procedural information from different surgical services of various UPR-affiliated hospitals (the University District Hospital, the University Pediatric Hospital, the UPR Carolina Hospital, the Dr. Isaac Gonzalez Oncologic Hospital, the PR Cardiovascular Center [thoracic service], the Pavia Hospital [colorectal service], and the Auxilio Mutuo Hospital [colorectal and oncological services]). The prevalence of diabetes mellitus (types 1 and 2 combined) was estimated, and the nondiabetic and diabetic groups were compared. The difference between groups was evaluated using a Chi2 test, Student's t-test, or ANOVA, whichever was appropriate, with a p-value of less than 0.05 being considered significant. Information from 2,603 surgical patients was available. The mean age of the group was 49 (±23) years. The gender distribution indicated that 56% were women and 44% were men. Diabetes was present in 21% of the surgical population, increasing to 40% in patients aged 65 and over. The surgical procedures most frequently required by diabetic patients were in the categories of general surgery (36%), colorectal surgery (22%), vascular surgery (16%) and oncologic surgery (14%). Complications (5%, diabetic group vs. 2%, nondiabetic group; p diabetic group vs. 0.2%, nondiabetic group; p diabetic group than in the nondiabetic group. Our surgical population has a high prevalence of diabetes, and these diabetic patients showed higher complication and mortality rates from surgery than did the non-diabetic patients. Surgeons must consider the specific needs of these diabetic patients in order to provide optimal care.

Surveillance for hospital-acquired infections on surgical wards in a Dutch university hospital

NARCIS (Netherlands)

Kamp-Hopmans, Titia E. M.; Blok, Hetty E. M.; Troelstra, Annet; Gigengack-Baars, Ada C. M.; Weersink, Annemarie J. L.; Vandenbroucke-Grauls, Christina M. J. E.; Verhoef, Jan; Mascini, Ellen M.

2003-01-01

OBJECTIVES: To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections. METHODS: Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and

Case series of child sexual abuse: Abia State University Teaching Hospital experience.

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Okoronkwo, N C; Ejike, O

2014-01-01

Child sexual abuse remains a serious infringement on the rights of the child. Though it appears to be viewed less seriously among adolescents, the consequences may be more severe and less obvious for the younger child. Age of the child appears notto be a deterrent. There is paucity of local data in the sub-region on this important social problem. The circumstance surrounding child sexual abuse in our environment needs to be reviewed. This study sets out to evaluate the characteristics of victims of child sexual abuse and to proffer solutions on how to stem the tide of the crime. To examine the characteristics of sexually abused children presenting to the paediatrics department of Abia State UniversityTeaching hospital, Aba. The case records of 10 consecutive cases of sexually abused children that presented to the Children Outpatient Department of Abia State University Teaching Hospital (ABSUTH) Aba, from January to June 2006 were prospectively reviewed and the parents/child/abuser interviewed where possible. All the victims were females aged 3-11 yrs, while all the abusers were males 14-29 yrs. Both parties were of low socio-economic class. 50% of the victims reported the incident. Mental and psychological state of the perpetrators appears to be a factor. Physical injuries to the vulva-vaginal areas were common. This study shows that child sexual abuse may not be uncommon in our environment. The exact prevalence remains unknown.The perpetrators of child sexual abuse should be prosecuted as a deterrent and rehabilitated whenever possible.

[Pressure sores in a university hospital].

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Barbut, Frédéric; Parzybut, Bérengère; Boëlle, Pierre-Yves; Neyme, Denis; Farid, Rachida; Kosmann, Marie-Jeanne; Luquel, Laurence

2006-05-01

To determine the prevalence of pressure sores, their risk factors, and the responsible microbial agents in an acute-care hospital and to evaluate their management. A prevalence survey was conducted from 5 July through 9 July 2004. Investigators completed a standardized questionnaire for each hospitalized patient, including demographic data (age, sex, previous hospitalizations, etc.) and Braden scale risk factors (sensory perception, humidity, activity, mobility, nutrition, and friction and shear). Two experts in skin care detected pressure sores by physical examination of the patients. Each pressure sore was swabbed and inoculated on selective media. Management was evaluated by reviewing the clinical charts of each patient with a pressure sore. The study included 535 adult patients (aged 59 +/- 19 years): 75 ulcer sores were observed in 37 patients (prevalence=6.9%). Stage I sores accounted for 24% of the total, stage II for 29%, stage III 31%, and stage IV 16%. The most frequent site was the heel (41%), followed by the sacrum (20%), elbow (11%), back (7%) and ischial tuberosities (7%). Sixty (80%) were acquired while hospitalized. Age-adjusted multivariate analyses found that the risk factors significantly associated with pressure sores were Braden scorepressure sores (OR=5.0 95% CI: 2.2-11.6, psores (24.5%), mostly stage III and IV, were colonized by multiple-drug-resistant bacteria (i.e., methicillin resistant Staphylococcus aureus, extended spectrum beta-lactamase Enterobacteriaceae). Seven (9.3%) of the 75 ulcers were diagnosed only during the survey, by the experts; of the 68 diagnosed before the survey, 57 (83.8%) had been under treatment. Treatment was considered inappropriate according to French guidelines in 31.6% of the cases. This prospective prevalence study resulted in better awareness of the patients at risk for pressure sores. It also made the recently created mobile geriatrics unit better known within the hospital.

Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

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Mekonnen AB

2013-03-01

Full Text Available Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods: The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist using a standardized method for categorizing drug related problems (DRPs. Results: A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3% were clinical pharmacists initiated interventions and 16(10.7% interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%; needs additional drug therapy, 34(22.8% and noncompliance, 29(19.5%. The most frequent intervention type was change of dosage/instruction for use, 23(15.4%. Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9% and 25(26.6% had major and moderate clinical importance respectively. Conclusion: Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This

Medicine utilization review at a university teaching hospital in New Delhi

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M Aqil

2012-01-01

Full Text Available Objective: A prospective medicine usage evaluation based on prescription monitoring was conducted in the medicine OPD of our university teaching hospital to know prescribing trends of different categories of medicines. Materials and Methods: A total of 600 patients were included in the study comprising of 339 (56.5% males and 261 (43.5% females. The data were recorded within the OPD by a registered pharmacist on a medicine usage evaluation form, approved by The University Institutional Review Board (IRB. Results: A total of 2365 medicines were prescribed to 600 patients during the 3 months study period. The mean number of medicines per prescription were found to be 3.94. Medicines were most frequently prescribed as solid dosage forms (85.62%, especially tablets (70.82%, and liquid formulations (14.12%. Oral route (96.17% was the most preferred mode of administration, followed by topical (2.11% and parenteral (1.60% routes. Combination therapy (94.33% was more prevalent than monotherapy (5.66%. An overwhelming tendency for prescribing medicines by brand names (99% was observed by the physicians. The most frequently prescribed class of medicines were antimicrobials > analgesics > cardiovascular > gastrointestinal agents. The most prescribed individual medicines among various therapeutic classes included isoniazid (antimicrobial, amlodipine (cardiovascular, metformin (hypoglycemic, cetirizine (antiallergic, rabeprazole (GI medicine, atorvastatin (hypolipidemic, dextromethorphan (respiratory medicine, alprazolam (sedative-hypnotic, paracetamol (analgesic. Conclusions: There is a considerable scope of improvement in the existing prescribing practice, especially prescribing by generic names, needs to be encouraged and a hospital formulary has to be developed for the purpose. The number of medicines to be included per prescription should be judged rationally and polypharmacy ought to be curbed. Use of antimicrobial also needs to be rationalized as over

Hysterectomy for benign conditions in a university hospital in Saudi Arabia

International Nuclear Information System (INIS)

Sait, K.; Al-Khattabi, M.; Boker, A.; Al-Hashemi, J.

2008-01-01

Hysterectomy is a common surgical procedure among women with a lifetime prevalence of 10%. The indications and complications of this procedure have not been previously reported from a teaching institution in Saudi Arabia. We examined the indications for hysterectomy and the surgical morbidity for women undergoing hysterectomy at a university hospital in Saudi Arabia. We reviewed the records of women who underwent hysterectomies for benign gynecological conditions between January 1990 and December 2002, at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, comparing patient characteristics, indications for hysterectomy and the rate of complications in women undergoing abdominal hysterectomy (AH) versus vaginal hysterectomy (VH). Of 251 women 199 (79%) underwent AH and 52 (21%) underwent VH. An estimated blood loss of >=500 mL occurred in 104 patients (52.3%) in the AH group and in 20 patients (38.5%) in the VH group (difference not statistically significant). The most common indications for hysterectomy were uterine fibroids (n=107, 41.6%) and dysfunctional uterine bleeding (n=68, 27.1%). The most common indication for VH was uterine prolapsed (n=45, 86.5%). The overall complication rates were 33.5%, 15.4% and 30.4% in women who underwent the AH group and in 51 patients in the VH group (20.3%). Postoperative infection occurred in 42/199 (21.6%) in the AH group and 5/52 (9.6%) in the VH group (difference not statistically significant). We describe a large series of hysterectomies, which provides information for surgeons on the expected of complications following hysterectomy for benign conditions. We describe a large series of hysterectomies, which provides information for surgeons on the expected rate of complications following hysterectomy for benign conditions. We found that the rate of complications was not significantly higher than other centers internationally. (author)

Occupational Radiation Dose for Medical Workers at a University Hospital

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M.H. Nassef

2017-11-01

Full Text Available Occupational radiation doses for medical workers from the departments of diagnostic radiology, nuclear medicine, and radiotherapy at the university hospital of King Abdul-Aziz University (KAU were measured and analysed. A total of 100 medical radiation workers were monitored to determine the status of their average annual effective dose. The analysis and the calibration procedures of this study were carried out at the Center for Radiation Protection and Training-KAU. The monitored workers were classified into subgroups, namely, medical staff/supervisors, technicians, and nurses, according to their responsibilities and specialties. The doses were measured using thermo luminescence dosimeters (TLD-100 (LiF:Mg,Ti placed over the lead apron at the chest level in all types of workers except for those in the cath lab, for whom the TLD was placed at the thyroid protective collar. For nuclear medicine, a hand dosimeter was used to measure the hand dose distribution. The annual average effective doses for diagnostic radiology, nuclear medicine, and radiotherapy workers were found to be 0.66, 1.56, and 0.28 mSv, respectively. The results of the measured annual dose were well below the international recommended dose limit of 20 mSv. Keywords: Occupational radiation dose, radiation workers, TLD, radiation protection

[The strategic research areas of a University Hospital: proposal of a quali-quantitative method.

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Iezzi, Elisa; Ardissino, Diego; Ferrari, Carlo; Vitale, Marco; Caminiti, Caterina

2018-02-01

This work aimed to objectively identify the main research areas at the University Hospital of Parma. To this end, a multidisciplinary working group, comprising clinicians, researchers, and hospital management, was formed to develop a shared quali-quantitative method. Easily retrievable performance indicators were selected from the literature (concerning bibliometric data and grant acquisition), and a scoring system developed to assign weights to each indicator. Subsequently, Research Team Leaders were identified from the hospital's "Research Plan", a document produced every three years which contains information on the main research themes carried out at each Department, involved staff and available resources, provided by health care professionals themselves. The selected performance indicators were measured for each Team Leader, and scores assigned, thus creating a ranking list. Through the analyses of the research themes of top Team Leaders, the Working Group identified the following five strategic research areas: (a) personalized treatment in oncology and hematology; (b) chronicization mechanisms in immunomediate diseases; (c) old and new risk factors for cardiovascular diseases; (d) nutritional disorders, metabolic and chronic-degenerative diseases; (e) molecular diagnostic and predictive markers. We have developed an objective method to identify a hospital's main research areas. Its application can guide resource allocation and can offer ways to value the work of professionals involved in research.

Evaluation of the implementation of the knowledge management processes in Shiraz University of Medical Sciences teaching hospitals, 2014

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Roxana Sharifian

2015-01-01

Full Text Available Introduction: Recognition and implementation of knowledge management have an important effect on improving the quality of hospital activities. According to the direct relationship with the society’s health, health and treatment departments need knowledgeable and skillful staff. Thus, this research investigated different dimensions of the knowledge management processes in teaching hospitals of Shiraz University of Medical Sciences in 2014. Method: This cross-sectional analytical study was performed on 103 top and middle-ranked managers of Shiraz University of Medical Sciences hospitals. The instrument was a valid and reliable questionnaire containing six knowledge management dimensions. Data were analyzed in SPSS software version 16, using the one-sample t-test and ANOVA. Results: The results of the study showed that among the processes of knowledge management dimensions, “acquisition and knowledge creation”(mean=3.2 and “strategy and policy of knowledge” (mean=3.13 had the highest ranks and “assessment and feedback of knowledge” (mean=2.86 and “knowledge sharing” (mean=2.61 were at the lowest levels. The comparison between these six dimensions demonstrated that there were significant relationships among “strategy and policy of knowledge” and “acquisition and knowledge creation” (p=0.047,“strategy and policy of knowledge” and “organizing and documenting of knowledge” (p=0.206, “organizing and documenting of knowledge” and “knowledge sharing” (p=0.259, “organizing and documenting of knowledge” and “use and reuse of knowledge” (p=0.325, “use and reuse of knowledge”, and “knowledge sharing” (p=0.100. Conclusion: According to the results, the conditions of “strategy and policy of knowledge” and “acquisition and knowledge creation” dimensions are at the average level and other dimensions of knowledge management processes are poor in teaching hospitals of Shiraz University of Medical

Healthcare-associated infections in a tunisian university hospital: from analysis to action

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Mahjoub, Mohamed; Bouafia, Nebiha; Bannour, Waadia; Masmoudi, Tasnim; Bouriga, Rym; Hellali, Radhia; Cheikh, Asma Ben; Ezzi, Olfa; Abdeljellil, Amel Ben; Mansour, Njah

2015-01-01

Introduction Our study was conducted, in university hospital center (UHC) Farhat Hached of Sousse (city in Tunisian center-east), within healthcare-associated infections (HAI) epidemiological surveillance (ES) program, based, among others, on HAI regular prevalence surveys. Our objectives are to resituate HAI prevalence rate and to identify their risk factors (RF) in order to adjust, in our hospital, prevention programs. Methods It is a transversal descriptive study, including all patients who had been hospitalized for at least 48 hours, measuring prevalence of HAI a “given day”, with only one passage by service. Risk factors were determined using Epiinfo 6.0, by uni-varied analysis, then, logistic regression stepwise descending for the variables whose p Results The study focused on 312 patients. Infected patients prevalence was 12.5% and that of HAI was 14.5%. Infections on peripheral venous catheter (PVC) dominated (42.2%) among all HAI identified. HAI significant RF were neutropenia (p < 10−4) for intrinsic factors, and PVC for extrinsic factors (p = 0,003). Conclusion Predominance of infections on PVC should be subject of specific prevention actions, including retro-information strategy, prospective ES, professional practices evaluation and finally training and increasing awareness of health personnel with hygiene measures. Finally, development of a patient safety culture with personnel ensures best adherence to hygiene measures and HAI prevention. PMID:26113928

Methodical and critical analysis of the determination of target volumes in case of hypopharyngeal and epiglottic tumors and the adaptation of the dose distribution to their dimensions. Pt. 1

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Gauwerky, J; Kuttig, H

1981-04-01

After having discussed the problem of optimization with regard to the dose distribution in space, the authors enter into the particulars of the classification of hypopharyngeal and epiglottic tumors according to the TNM system. Taking into consideration the communications of literature and the cases of the Radiologic Hospital of the University of Heidelberg, the authors describe the clinical manifestations of these tumors, their histology, their distribution to age and sex, their symptomatology and time of anamnesis as well as the therapeutic results.

Homologous stress adaptation, antibiotic resistance, and biofilm forming ability of Salmonella enterica serovar Heidelberg (ATCC8326) on different food-contact surfaces following exposure to sub-lethal chlorine concentrations

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Salmonella enterica serovar Heidelberg (American Type Culture Collection; ATCC 8326) was examined for the ability to adapt to the homologous stress of chlorine through exposure to increasing chlorine concentrations (25 ppm daily increments) in tryptic soy broth (TSB). The tested strain exhibited an ...

Time trends in pediatric hospitalizations for hepatitis A in Greece (1999–2013): Assessment of the impact of universal infant immunization in 2008

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Papaevangelou, V.; Alexopoulou, Z.; Hadjichristodoulou, C.; Kourlamba, G.; Katsioulis, A.; Theodoridou, K.; Spoulou, V.; Theodoridou, M.

2016-01-01

ABSTRACT Hepatitis A vaccine was introduced in the Greek National Immunization Program in 2008. To estimate possible impact of the universal vaccination implementation, time trends of hospitalizations for hepatitis A at the Infectious Diseases Unit of a Tertiary Pediatric Hospital in Athens during 1999–2013 were analyzed. Hepatitis A hospitalizations were recorded from the discharge database and were expressed as frequencies and rate of annual departmental hospitalizations. Time series analysis (ARIMA) was used to explore trends and the impact of the vaccination. Moreover, changes in patient age, population group distribution and the duration of hospitalization were also examined. Hepatitis A hospitalizations rate significantly decreased between pre-vaccination (1999–2008) and post-vaccination (2009–2013) era from 50.5 to 20.8/1000 hospitalizations (p = 0.005). A 3-year periodicity and a trend of reduction on hepatitis A hospitalizations rates across years were noted. Roma children had significant higher rates of hepatitis A hospitalization, followed by immigrant children. Importantly, possibly due to preceding vaccine availability with considerable uptake in private market and unvaccinated group/pockets of children (Roma), overall vaccination effect was less apparent when compared to data from other countries that implemented universal vaccination. No significant change in patient age, population group distribution, or duration of hospitalization was observed. High risk groups such as Roma children should be targeted for vaccination to reduce future outbreaks. PMID:27141813

Variation in Annual Volume at a University Hospital Does Not Predict Mortality for Pancreatic Resections

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Rita A. Mukhtar

2008-01-01

Full Text Available Annual volume of pancreatic resections has been shown to affect mortality rates, prompting recommendations to regionalize these procedures to high-volume hospitals. Implementation has been difficult, given the paucity of high-volume centers and the logistical hardships facing patients. Some studies have shown that low-volume hospitals achieve good outcomes as well, suggesting that other factors are involved. We sought to determine whether variations in annual volume affected patient outcomes in 511 patients who underwent pancreatic resections at the University of California, San Francisco between 1990 and 2005. We compared postoperative mortality and complication rates between low, medium, or high volume years, designated by the number of resections performed, adjusting for patient characteristics. Postoperative mortality rates did not differ between high volume years and medium/low volume years. As annual hospital volume of pancreatic resections may not predict outcome, identification of actual predictive factors may allow low-volume centers to achieve excellent outcomes.

Assessing the impact of privatizing public hospitals in three American states: implications for universal health coverage.

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Villa, Stefano; Kane, Nancy

2013-01-01

Many countries with universal health systems have relied primarily on publicly-owned hospitals to provide acute care services to covered populations; however, many policymakers have experimented with expansion of the private sector for what they hope will yield more cost-effective care. The study provides new insight into the effects of hospital privatization in three American states (California, Florida, and Massachusetts) in the period 1994 to 2003, focusing on three aspects: 1) profitability; 2) productivity and efficiency; and 3) benefits to the community (particularly, scope of services offered, price level, and impact on charity care). For each variable analyzed, we compared the 3-year mean values pre- and postconversion. Pre- and postconversion changes in hospitals' performance were then compared with a nonequivalent comparison group of American public hospitals. The results of our study indicate that following privatization, hospitals increased operating margins, reduced their length of stay, and enjoyed higher occupancy, but at some possible cost to access to care for their communities in terms of higher price markups and loss of beneficial but unprofitable services. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Profile of motorcycle victims from the emergency service of a university hospital

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José Luís Amim Zabeu

2013-06-01

Full Text Available OBJECTIVE: Epidemiological survey of motorcycle accidents occurring in a city with over one million inhabitants and treated at university hospital of reference between the months of July and November 2010. METHODS: Cross sectional study using structured interview (standardized form to document the data collection: age, gender, income, using time and capacity of the motorcycle. RESULTS: From 114 cases, it was observed that the profile of the victim of motorcycle accident treated at this hospital is a young person, male, possessing a driver's license for less than five years, with a monthly income average around one thousand reais (local currency, owner of a motorcycle with low capacity (less than 150 cc and low educational attainment. The accidents occurred predominantly in the urban area, in the afternoons and one third of them were considered work-related accidents, death generated in 3 per cent of cases and open fractures in 11 per cent of them. CONCLUSION: The incidence of motorcycle accidents involved mainly young men with little experience in traffic and low level of education.

Demandas de atendimento psiquiátrico em um hospital universitário Demandas de lo atendimiento psiquiátrico en un hospital universitario Demands of psychiatric care in a university hospital

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Naiara Gajo Silva

2011-09-01

la necesidad de la interconsulta de enfermería psiquiátrica en este hospital.This is a cross-sectional study that aimed to describe the psychiatric demand in a university hospital in the city of Cuiabá, state of Mato Grosso, Brazil, and to know the current situation of the service to this demand. The data were collected from the inpatient medical records in a university hospital, from June to August, 2009, in a total of 551 records. Despite being considered by the literature as unprepared, nursing is the professional category that most identifies the psychiatric demand in this hospital. The treatment plan to this demand was restricted to medication, nine evaluations of psychology and thirteen consultation-liaison psychiatric service, without a significant involvement of nursing. The approach of emotional and/or mental aspects results in the improvement in the quality of nursing care, and there is a need for the nurses to qualify for that. To make it happen, we propose a reflection on the need for the consultation-liaison psychiatric service in this hospital.

Work-related stress and work ability among Croatian university hospital midwives.

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Knezevic, Bojana; Milosevic, Milan; Golubic, Rajna; Belosevic, Ljiljana; Russo, Andrea; Mustajbegovic, Jadranka

2011-04-01

to explore the sources and levels of stress at work and work ability among Croatian midwives. midwives are subjected to multiple stressors. Among health-care professionals, psychological distress for a prolonged period of time has negative effects on the worker's health, work ability and quality of patient care. 'Work ability' is a term describing a worker's resources related to physical, mental and social demands at work. As a measure of work ability in midwifery, the Work Ability Index (WAI) is considered to be a very predictive instrument; midwives with a poor WAI score usually leave their current job within five years. university hospitals in Zagreb, Croatia. cross-sectional design survey. 300 health-care workers (105 qualified midwives and 195 paediatric nurses) were invited to complete the questionnaire. The total response rate was 53% (158/300). The sample included 14.7% of all hospital-based midwives in Zagreb hospitals. the Occupational Stress Assessment Questionnaire (OSAQ) for health-care workers and the WAI questionnaire. over three-quarters of the midwives (46/60, 76.7%) believed that their job was stressful, and considered that insufficient work resources caused the most stress. More than half of the midwives associated an insufficient number of coworkers, unexpected situations, inadequate income, night work, incurable patients and poor organisation at work with a high level of stress. The perceived specific stressors differed between midwives and paediatric nurses in the same hospital. Insufficient work resources and poor organisation at work were more common stressors among midwives than paediatric nurses (pworkplace compared with paediatric nurses (pability. After adjusting for age, the difference in WAI score between the groups of workers was not significant. Croatian midwives experienced work-related stress due to: insufficient work resources, insufficient number of coworkers, poor organisation at work, communication with superiors and emotional

Trends and causes of maternal mortality in Jimma University Specialized Hospital, southwest Ethiopia: a matched case–control study

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Legesse T

2017-05-01

Full Text Available Tegene Legesse,1 Misra Abdulahi,2 Anteneh Dirar2 1Department of Public Health, Collage of Health Science, Mizan-Tepi University, Mizan Teferi, Ethiopia; 2Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Oromia Regional State, Ethiopia Introduction: Measures of maternal death are fundamental to a country’s health and development status. In developing countries, it remains a daunting and largely unmet public health challenge. There were two studies completed over 10 years ago in Jimma University Specialized Hospital to identify trends, but recently there have been many changes in Ethiopia to reduce maternal death. Therefore, it is important to track the achievements made in Ethiopia in the context of Jimma University Specialized Hospital. No study undertaken in the country has quantified deaths of women from specific causes after controlling confounders.Objective: To assess trends and causes of maternal death in Jimma University Specialized Hospital, southwest Ethiopia.Methods: A time-matched case–control study was conducted on 600 (120 cases and 480 controls females who utilized obstetrics and gynecology services from January 2010 to December 2014. To observe trends in maternal death, maternal mortality ratio was calculated for each year. Stata version 13 was used to analyze causal inference using propensity score matching method.Results: Maternal mortality ratio was 857/100,000 and had a decreasing trend from it’s highest in 2010 of 1,873/100,000 to it’s lowest of 350/100,000 in 2014. The leading cause of maternal death was hemorrhage (54% (β=0.477, 95% confidence interval [CI]: 0.307, 0.647, followed by pregnancy-induced hypertension (20% (β=0.232, 95% CI: 0.046, 0.419, and anemia (12% (β=0.110, 95% CI: 0.017, 0.204.Conclusion: There is a decreasing trend of maternal death. Hemorrhage was the major cause of death identified in each year of study. Keywords: maternal death, maternal

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

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Aussadavut Dumrongsiri

2018-02-01

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

Patient’s Satisfaction of Emergency Department Affiliated Hospital of Babol University of Medical Sciences in 2013 -14

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H Datobar

2016-04-01

Full Text Available BACKGROUND AND OBJECTIVE: Patient satisfaction in emergency departments is an indicator of healthcare quality, evaluation of which can promote awareness of the relevant authorities regarding its status. This study aimed to evaluate patient satisfaction in emergency departments in hospitals affiliated to Babol University of Medical Sciences. METHODS: This cross-sectional study was performed in patients admitted to emergency departments in hospitals affiliated to Babol University of Medical Sciences, Babol, Iran, during a period of eight months (2013-2014. The participants were chosen through convenience sampling. Information regarding hospital environment, facilities, and nursing team was collected using a standard questionnaire. Standard questionnaire responses were classified to” don’t happen, dissatisfied, low, medium and high satisfaction”. Then medium and high responses classified to favorable satisfaction (above average and low or dissatisfied responses were classified to unfavorable satisfaction. In case the patients were unable to fill-out the questionnaire, their companion completed it for them. FINDINGS: Overall, 444 (87.9% patients expressed optimum satisfaction. The highest rate of dissatisfaction (14.8%, n=74 was related to environment and services, while the highest rate of satisfaction (49.3%, n=246 was pertinent to nursing staff. The results indicated that the rate of satisfaction in residents of rural areas was 0.55 times higher than in urban residents (OR: 1.55, 95% CI: 1.12-2.70, p=0.02, 50% lower in patients compared to companions (OR: 0.55, 95% CI: 0.36-0.83, p=0.05,and  in the evening shift was 0.65 times higher than in those admitted in the morning (OR: 1.65, 95% CI: 1.06-2.58, p=0.03. Moreover, this rate in patients admitted at night shift was 0.74 times higher than in those admitted in the morning (OR: 1.74, 95% CI: 1.12-2.70, p=0.01. CONCLUSION: This study demonstrated optimum patient satisfaction in emergency

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

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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...

Performance management of nuclear medical apparatuses in Osaka University Hospital

International Nuclear Information System (INIS)

Ikehara, Katsuhiro; Kusumi, Yoshimi; Hayashi, Makoto; Miharu, Tomoyoshi; Masuda, Kazutaka

1975-01-01

Nuclear medical out side-body measuring equipments in Osaka University Hospital consist of scinticamera, scintiscanner and movement-measuring equipment as measuring equipments, and central processing equipment, CRT attached with Polaroid camera, data typewriter, X-Y recorder, and high speed tape reader as data processing equipments. Daily and monthly management items are set up to maintain the best function of these equipments. The data processing room is air-conditioned to keep temperature at 25 0 C and humidity at 60% constantly, and they are confirmed with a temperature and humidity self-recorder. Computer system is used for the homogeneity control and the correction to counting failure of the scinticamera. As the repair of nuclear medical apparatuses needs long period and because of the special circumstances of radioactive drugs, very close cooperation among technicians, doctors and equipment makers is required. (Kobatake, H.)

Acute appendicitis in Olabisi Onabanjo University Teaching Hospital ...

African Journals Online (AJOL)

The hospital is a tertiary care facility in competition with a large number of private hospitals with different levels of competence. Objective: The objective of the study is to review the outcome of the surgical management of acute appendicitis in our hospital. Method: A retrospective study of subjects who had appendectomy for ...

The effect of polytrauma as a possible confounder in the outcome of monotraumatic vs polytraumatic paraplegic patients: a clinical cohort study.

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Putz, C; Schuld, C; Gantz, S; Grieser, T; Akbar, M; Moradi, B; Wiedenhöfer, B; Fürstenberg, C H; Gerner, H J; Rupp, R

2011-06-01

Clinical cohort study. To evaluate if the impact of the severity of the trauma as a possible confounding factor influences the neurological and functional recovery in paraplegia during the course of a 6-month follow-up period after injury. Spinal Cord Injury Center, Heidelberg University Hospital, Germany. A retrospective monocentric analysis, from 2002 to 2008, of the Heidelberg European Multicenter Study about spinal cord injury database was performed. We included 31 paraplegic patients (neurological level T1-T12) who were assigned either to a monotrauma (polytraumaschluessel (PTS) 1) or to a polytrauma (PTS≥2) group. The American Spinal Injury Association Impairment Scale, lower extremity motor score, pin prick, light touch and the spinal cord independence measure (SCIM) were obtained at five distinct time points after trauma. Data were analyzed using Mann-Whitney U-test (αpressure sores between 3 and 6 months (P=0.031). The mean length of primary rehabilitation in the polytrauma group was 5.5 vs 3.6 months in monotrauma. The prognosis of polytraumatic paraplegics in terms of neurological recovery is not inferior to those with monotrauma. Multiple-injured patients need a prolonged hospital stay to reach the functional outcome of monotraumatic patients.

[History of the 4th Department of Internal Medicine of the First Faculty of Medicine at Charles University and the General University Hospital in Prague].

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Bartůněk, Petr

In 2015, the doctors and nurses of the 4th Department of Internal Medicine of the First Faculty of Medicine, Charles University and the General University Hospital in Prague celebrated the 70th anniversary of its founding. The article summarizes the clinics contribution to the field of internal medicine, and particularly to angiology, hepatogastroenterology and lipidology. It comments the clinics current activities and the possibilities of its further development. Attention is also paid to the tradition of high ethical and professional standards of medical care in accordance with the norms established by the clinic's founder, prof. MUDr. Bohumil Prusík.

Teleradiology and PACS - strategy of the Innsbruck University Hospital; Teleradiologie und PACS - das Konzept des Universitaetsklinikums Innsbruck

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Vogl, R. [HITT - Health Information Technologies Tirol, Innsbruck (Austria)

2005-08-01

Systems for management of digital imaging data are very important and widespread at the Innsbruck University Hospital and constitute a central component of the IT strategies followed by the hospital operating company TILAK (Tyrolean public hospitals). The particular goal is to integrate all imaging data into the electronic medical records and make these available online to each of the approx. 2500 clinic workstations and ensure electronic data exchange with other healthcare services. Teleradiology connections have been established at the University Clinic for Radiology since 1995; these have been continually expanded and linked to the central PACS. An eHealth web portal was recently established to facilitate transfer of images and findings from TILAK hospitals to other healthcare organizations. Registered users can be cleared for a limited time to access all radiological imaging data via this web portal. (orig.) [German] Die Systeme zum digitalen Bilddatenmanagement haben grosse Bedeutung und weite Verbreitung an der Universitaetsklinik Innsbruck und sind zentraler Bestandteil der IT-Strategie der Krankenhausbetreibergesellschaft TILAK (Tiroler Landeskrankenanstalten). Ziel dabei ist es insbesondere, saemtliche Bilddaten in die elektronische Krankengeschichte zu integrieren und von jedem der ca. 2500 klinischen Arbeitsplaetze aus online zugreifbar zu machen sowie den elektronischen Datenaustausch mit anderen Gesundheitsdiensteanbietern zu gewaehrleisten. Seit 1995 bestehen Teleradiologieverbindungen der Universitaetsklinik fuer Radiologie; diese wurden laufend ausgebaut und die Einbindung in das zentrale PACS hergestellt. Zur Kommunikation von Bild- und Befunddaten aus den Krankenhaeusern der TILAK an andere Gesundheitseinrichtungen wurde kuerzlich ein eHealth WebPortal geschaffen, ueber das saemtliche radiologischen Bilddaten durch zeitbefristete Freigaben fuer registrierte Benutzer zugaenglich gemacht werden koennen. (orig.)

Kids’ Perceptions toward Children’s Ward Healing Environments: A Case Study of Taiwan University Children’s Hospital

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Jeng-Chung Woo

2016-01-01

Full Text Available This paper summarizes the opinions of experts who participated in designing the environment of a children’s hospital and reports the results of a questionnaire survey conducted among hospital users. The grounded theory method was adopted to analyze 292 concepts, 79 open codes, 25 axial codes, and 4 selective codes; in addition, confirmatory factor analysis and reliability analysis were performed to identify elements for designing a healing environment in a children’s hospital, and 21 elements from 4 dimensions, namely, emotions, space design, interpersonal interaction, and pleasant surroundings, were determined. Subsequently, this study examined the perceptions of 401 children at National Taiwan University Children’s Hospital. The results revealed that, regarding the children’s responses to the four dimensions and their overall perception, younger children accepted the healing environment to a significantly higher degree than did older children. The sex effect was significant for the space design dimension, and it was not significant for the other dimensions.

Will there be room for the teaching of internal medicine in a university hospital?

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Junod, Alain F

2002-01-12

To answer the question addressed, two working groups, one made of the staff of a University clinic, the other one composed of practising general internists, have discussed the assets and weaknesses of a University service of Internal Medicine for postgraduate training. The groups agreed on a number of points: patients' characteristics (complexity and co-morbidities), quality of teaching, method acquisition for clinical reasoning, as well as absence of exposure to ambulatory patients and of follow-up. The groups differed in their views related to the lack of training in psychiatry and psychosocial problems or to hospital dysfunctions. Opening of internal medicine to primary care appears to be necessary at the same time as individual qualities among the senior staff are to be developed, such as critical analysis and self-questioning.

Job satisfaction and organizational citizenship behavior of personnel at one university hospital in Thailand.

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Intaraprasong, Bhusita; Dityen, Warunee; Krugkrunjit, Peera; Subhadrabandhu, Thanya

2012-06-01

To investigate the relationship between job satisfaction and Organizational Citizenship Behavior (OCB) of the personnel at one university hospital in Thailand. This cross-sectional descriptive study was conducted on 296 respondents who worked in the Office of the Dean, 13 departments and 2 Offices of Research Center and Office of Community Medicine Center. All of them were personnel in one university hospital in Thailand. The Organizational Citizenship Behavior Questionnaire of Niehoff and Moorman using the five dimensions scale developed by Podsakoff and Mackenzie and Job Descriptive Index (JDI) were used for assessing job satisfaction. For inferential statistics, Pearson's product moment correlation coefficient was used for correlation. The percentage mean score of job satisfaction was 58.67 and subscale of job satisfaction was found that satisfaction with supervision held the highest of the mean score, while satisfaction with pay and promotion had the lowest and low of the mean score. The mean score of OCB was high and the facets of OCB was found that conscientiousness had the highest mean score and sportsmanship had the lowest. By using Pearson's Product Moment Correlation Coefficient to analyze the relationships between satisfaction and OCB, it showed that there were statistically significant low positive correlations between job satisfaction and OCB (r = 0.173, p pay, promotion and supervision factors which encourage personnel to be satisfied and demonstrate their OCB as their reciprocal reaction.

Economic analysis of an epilepsy outreach model of care in a university hospital setting.

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Maloney, Eimer; McGinty, Ronan N; Costello, Daniel J

2017-07-01

The prevalence of epilepsy in people with intellectual disability is higher than in the general population and prevalence rates increase with increasing levels of disability. Prevalence rates of epilepsy are highest among those living in residential care. The healthcare needs of people with intellectual disability and epilepsy are complex and deserve special consideration in terms of healthcare provision and access to specialist epilepsy clinics, which are usually held in acute hospital campuses. This patient population is at risk of suboptimal care because of significant difficulties accessing specialist epilepsy care which is typically delivered in the environs of acute hospitals. In 2014, the epilepsy service at Cork University Hospital established an Epilepsy Outreach Service providing regular, ambulatory outpatient follow up at residential care facilities in Cork city and county in an effort to improve access to care, reduce the burden and expense of patient and carer travel to hospital outpatient appointments, and to provide a dedicated specialist phone service for epilepsy related queries in order to reduce emergency room visits when possible. We present the findings of an economic analysis of the outreach service model of care compared to the traditional hospital outpatient service and demonstrate significant cost savings and improved access to care with this model. Ideally these cost savings should be used to develop novel ways to enhance epilepsy care for persons with disability. We propose that this model of care can be more suitable for persons with disability living in residential care who are at risk of losing access to specialist epilepsy care. Copyright © 2017 Elsevier Inc. All rights reserved.

Four minutes for a patient, twenty seconds for a relative - an observational study at a university hospital

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Xander Carola J

2010-04-01

Full Text Available Abstract Background In the modern hospital environment, increasing possibilities in medical examination techniques and increasing documentation tasks claim the physicians' energy and encroach on their time spent with patients. This study aimed to investigate how much time physicians at hospital wards spend on communication with patients and their families and how much time they spend on other specific work tasks. Methods A non-participatory, observational study was conducted in thirty-six wards at the University Medical Center Freiburg, a 1700-bed academic hospital in Germany. All wards belonging to the clinics of internal medicine, surgery, radiology, neurology, and to the clinic for gynaecology took part in the study. Thirty-four ward doctors from fifteen different medical departments were observed during a randomly chosen complete work day. The Physicians' time for communication with patients and relatives and time spent on different working tasks during one day of work were assessed. Results 374 working hours were analysed. On average, a physician's workday on a university hospital ward added up to 658.91 minutes (10 hrs 58 min; range 490 - 848 min. Looking at single items of time consumption on the evaluation sheet, discussions with colleagues ranked first with 150 minutes on average. Documentation and administrative requirements took an average time of 148 minutes per day and ranked second. Total time for communication with patients and their relatives was 85 minutes per physician and day. Consequently, the available time for communication was 4 minutes and 17 seconds for each patient on the ward and 20 seconds for his or her relatives. Physicians assessed themselves to communicate twice as long with patients and sevenfold with relatives than they did according to this study. Conclusions Workload and time pressure for physicians working on hospital wards are high. To offer excellent medical treatment combined with patient centred care and

Leadership in health care: developing a post-merger strategy for Europe's largest university hospital.

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Geisler, B P; Widerberg, K F; Berghöfer, A; Willich, S N

2010-01-01

This paper's aim is to identify existing and developing new concepts of organization, management, and leadership at a large European university hospital; and to evaluate whether mixed qualitative-quantitative methods with both internal and external input can provide helpful views of the possible future of large health care providers. Using the Delphi method in semi-structured, semi-quantitative interviews, with managers and employees as experts, the authors performed a vertical and a horizontal internal analysis. In addition, input from innovative faculties in other countries was obtained through structured power questions. These two sources were used to create three final scenarios, which evaluated using traditional strategic planning methods. There is found a collaboration scenario in which faculty and hospital are separated; a split scenario which divides the organization into three independent hospitals; and a corporation scenario in which corporate activities are bundled in three separate entities. In complex mergers of knowledge-driven organizations, the employees of the own organization (in addition to external consultants) might be tapped as a knowledge resource to successful future business models. The paper uses a real world consulting case to present a new set of methods for strategic planning in large health care provider organizations.

Case report: cranioplasty infection due to Roseomonas gilardii at a university hospital in Turkey.

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Ece, Gulfem; Ruksen, Mete; Akay, Ali

2013-01-01

Roseomonas is a pink-pigmented, nonfermentative, oxidative, Gram-negative coccobacilli that has clinical importance as opportunistic pathogen which can lead to infections especially in immunosuppressed individuals. It is relatively less reported in many centers. These microorganisms are detected after several days growth in culture environment, and typical pink, mucoid colonies are detected. We are reported a case of cranioplasty infection that took place in a patient with with cranial abscess formation due to Roseomonas gilardii at Izmir University School of Medicine Medicalpark Hospital.

Evaluation of hospital information systems of the teaching hospitals affiliated to Shiraz University of Medical Sciences, based on the American College of Physicians Criteria

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E Emami

2014-01-01

Full Text Available Introduction: Hospital information system (HIS is a computerized system used for management of hospital information as an electronic device and has an indispensible role in the field of qualified healthcare services. Nevertheless, compared to other industrial and commercial systems, this information system is lagged in using the information technology and applying the controlling standards for satisfying the customers. Therefore, the present study aimed to evaluate HIS, identify its strength and weak points, and improve it in the teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Method: The present descriptive, cross-sectional study was conducted in the 8 teaching hospitals of Shiraz University of Medical Sciences which used HIS in 2011. The study data were collected through interview and direct observation using the criteria of American Physician College check-list. Finally, SPSS statistical software was used to analyze the data through descriptive statistics. Results: The study results showed that laboratory and medical records had respectively the most %43.5 and the least %21.03 conformity to the criteria of American College of Physicians. Also, Faghihi and Zeinabiye hospitals respectively had the most %41.8 and the least %25.2 conformity to the American College of Physicians’ criteria. In pharmacy, data entrance mechanism and presentation of reports had complete conformity to the scales of American College of Physicians, while drug interactions showed no conformity. In laboratory, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. The possibility of receiving information from centers out of laboratory had no conformity to the desired criteria. In the radiology department, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. Besides, the possibility

Pediatric computed tomography practice in Japanese university hospitals from 2008–2010: did it differ from German practice?

International Nuclear Information System (INIS)

Yoshida, Koji; Krille, Lucian; Dreger, Steffen; Hoenig, Lars; Merzenich, Hiltrud; Yasui, Kiyotaka; Kumagai, Atsushi; Ohtsuru, Akira; Uetani, Masataka; Mildenberger, Peter; Takamura, Noboru; Yamashita, Shunichi; Zeeb, Hajo; Kudo, Takashi

2017-01-01

Computed tomography (CT) is an essential tool in modern medicine and is frequently used to diagnose a wide range of conditions, particularly in industrial countries, such as Japan and Germany. However, markedly higher doses of ionizing radiation are delivered during CT imaging than during conventional X-ray examinations. To assess pediatric CT practice patterns, data from three university hospital databases (two in Japan and one in Germany) were analyzed. Anonymized data for patients aged 0 to 14 years who had undergone CT examinations between 2008 and 2010 were extracted. To assess CT practice, an interdisciplinary classification scheme for CT indications, which incorporated the most common examination types and radiosensitive tissues, was developed. The frequency of CT examinations was determined according to sex, age at examination, and indications. A total of 5182 CT examinations were performed in 2955 children. Overall, the frequency of CT examinations at the Japanese university hospitals did not differ significantly from that at the German hospital. However, differences were detected in the age distribution of the patients who underwent CT examinations (the proportion of patients <5 years of age was significantly higher in Japan than in Germany) and in the indications for CT. Substantial practice differences regarding the use of CT in pediatric health care were detected between the three hospitals. The results of this study point towards a need for approaches such as clinical guidelines to reduce unwarranted medical radiation exposures, particularly abdominal and head CT, in the Japanese health system.

Data Science Priorities for a University Hospital-Based Institute of Infectious Diseases: A Viewpoint.

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Valleron, Alain-Jacques

2017-08-15

Automation of laboratory tests, bioinformatic analysis of biological sequences, and professional data management are used routinely in a modern university hospital-based infectious diseases institute. This dates back to at least the 1980s. However, the scientific methods of this 21st century are changing with the increased power and speed of computers, with the "big data" revolution having already happened in genomics and environment, and eventually arriving in medical informatics. The research will be increasingly "data driven," and the powerful machine learning methods whose efficiency is demonstrated in daily life will also revolutionize medical research. A university-based institute of infectious diseases must therefore not only gather excellent computer scientists and statisticians (as in the past, and as in any medical discipline), but also fully integrate the biologists and clinicians with these computer scientists, statisticians, and mathematical modelers having a broad culture in machine learning, knowledge representation, and knowledge discovery. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

The joy at the Last Judgement according to the Heidelberg Catechism Question 52

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Eberhard Busch

2014-12-01

Full Text Available In this contribution, the author reflects on Question 52 of the Heidelberg Catechism where it asks: ‘What comfort is it to you that Christ “shall come to judge the living and the dead”?’ The author points out possible sources from which this formulation stems, that is, Articles 86 and 87 in John Calvin’s Catechism from 1545. God is described as a compassionate judge. Even more: the One who is the last judge, was also judged and had paid for our sins. In a dialectical fashion we discover a God who is just, but also merciful. The Reformed tradition did not follow a dead-end where it is taught that God shows us grace instead of righteousness. Had God proceeded in this way, he would only mean things well, but he would not make them well. The realisation of God being just and merciful leads to joy and repentance. The contribution ends with a discussion of the final separation of the just and evil.

Grimstone v Epsom and St Helier University Hospitals NHS Trust: (It's Not) Hip To Be Square.

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Austin, Louise V

2017-11-24

In Montgomery v Lanarkshire Health Board [2015] UKSC 11 the Supreme Court redefined the standard of disclosure in informed consent to medical treatment, rejecting the application of the doctor-focused Bolam standard in favour of one focused on what was significant to patients. In Grimstone v Epsom and St Helier University Hospitals NHS Trust [2015] EWHC 3756 (QB), despite acknowledging a new standard now applied, McGowan J nevertheless used the Bolam test to determine liability for non-disclosure. This illustrates ongoing judicial deference to the medical profession and this case commentary explores that decision and its implications. © The Author 2017. Published by Oxford University Press.

Knowledge Practice and Outcome of Quality Nursing Care among Nurses in University of Calabar Teaching Hospital (UCTH)

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Oyira, Emilia James; Ella, R. E.; Chukwudi, Usochukwu Easter; Paulina, Akpan Idiok

2016-01-01

Objectives: The main purpose of this study was to determine knowledge practice and outcome of quality nursing care among nurses in University of Calabar Teaching Hospital (UCTH). Three research questions and one hypothesis were formulated to guide this study. Literature related to the variables under study was reviewed according to the research…

[Document management systems to support quality management systems at university hospitals - an interview-based study].

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Holderried, Martin; Bökel, Ann-Catrin; Ochsmann, Elke

2018-05-01

In order to save and control the processes and quality of medical services, a suitable steering system of all relevant documents is essential from the point of view of clinical quality management. Systems supporting an automated steering system of documents are called document management systems (DMS), and they also enter the healthcare sector. The use of DMS in the German healthcare sector has hardly been investigated so far. To close this knowledge gap, interviews were carried out with German university hospitals over a six-month period and subjected to a qualitative content analysis according to Mayring. In total, 25 university hospitals agreed to participate in this study, 19 of which have been working with a digital DMS for about six years on average. There was a great variety among the IT systems used. Document management and usability of the DMS as well as its integration into existing IT structures were key decision-making criteria for the selection of a digital DMS. In general, the long-term usability of the DMS is supported by regular evaluation of one's own requirements for the system, administration and training programs. In addition, DMS have a positive effect on patient safety and the quality of medical care. Copyright © 2018. Published by Elsevier GmbH.

Heart Surgery Experience in Hitit University Faculty of Medicine Corum Research and Training Hospital: First Year Results

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Adem Diken

2014-03-01

Full Text Available Aim: We aimed to assess the clinical outcomes of our department of cardiac surgery which was newly introduced in Hitit University Corum Education and Research Hospital. Material and Method: Between November 2012 and November 2013, a total of 110 open-heart surgeries were performed. Ten out of these (9.1% were emergency operations for acute ST elevation myocardial infarction Off-pump technique was used in 31 (29.2% patients and cardiopulmonary bypass was used in 75 (70.8%. A total of 106 patients received coronary artery bypass grafting, 1 received mitral reconstruction, 1 received Bentall procedure, 1 received tricuspid valve repair, 1 received mitral valve replacement, 1 received aortic valve replacement with aortic root enlargement and 1 received aortic supracoronary graft replacement. Results: Hospital mortality occurred in 1 (0.9% patient. Four patients (3.6% who were on dual antiaggregants underwent a revision for bleeding on the day of the operation. Morbidities occurred in 3 (2.7% patients. Atrial fibrillation occurred in 11 (10% patients and the normal sinus rhythm was achieved by amiodarone. Intraaortic balloon counterpulsation was used in 5 (4.5% patients. Discussion: The newly introduced cardiac surgery department of the Hitit University Corum Education and Research Hospital, which provides tertiary care to a wide rural community, serves with low morbidity and mortality.

Radiation doses in angiography in the University Hospital of Caracas

International Nuclear Information System (INIS)

Diaz Aponte, Angel R.

2001-01-01

In the present work is evaluated, in angiography procedures carried out in the Radiology Department of the University Hospital of Caracas, the radiation dose received by the exposed professional when they carry out these explorations invasive and the followed norms of radiological protection during the exploration. The measurement was carried out on the exposed professional conformed by a medical interventionist, a medical assistant (resident), a nurse and a technical radiologist. Dosimeters TL was placed in the inter-orbital line at level of the crystalline lens, on thyroid, on the hands, thorax, breast, and on the gonads. The maximum values of dose (in mGy) that were measured: 1,84 at level of the crystalline lens; 1,24 on thyroid; 9,04 on the right hand; 65,04 on hand left; 0,07 on thorax; 0,07 on Breast; 0,07 for ovaries; and smaller than 0,04 for testicle. (author)

Decisions to Perform Emergency Caesarean Sections at a University Hospital; Do obstetricians agree?

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Gowri Vaidyanathan

2016-02-01

Full Text Available Objectives: This study was undertaken to assess the degree of agreement amongst obstetricians regarding decisions to perform emergency Caesarean section (CS procedures at a university hospital. Methods: This retrospective clinical audit was carried out on 50 consecutive emergency CS procedures performed between November 2012 and March 2013 on women with singleton pregnancies at the Sultan Qaboos University Hospital in Muscat, Oman. Data on each procedure were collected from electronic patient records and independently reviewed by six senior obstetricians to determine agreement with the decision. Results: Of the 50 women who underwent CS procedures, the mean age was 28.9 ± 5.1 years and 48% were primigravidae. A total of 65% of the CS procedures were category I. The most common indications for a CS was a non-reassuring fetal heart trace (40% and dystocia (32%. There was complete agreement on the decision to perform 62% of the CS procedures. Five and four obstetricians agreed on 80% and 95% of the procedures, respectively. The range of disagreement was 4–20%. Disagreement occurred primarily with category II and III procedures compared to category I. Additionally, disagreement occurred in cases where the fetal heart trace pattern was interpreted as an indication for a category II CS. Conclusion: The majority of obstetricians agreed on the decisions to perform 94% of the emergency CS procedures. Obstetric decision-making could be improved with the implementation of fetal scalp pH testing facilities, fetal heart trace interpretation training and cardiotocography review meetings.

A complete image management and communications network for the neuroradiology service at Georgetown University Hospital

International Nuclear Information System (INIS)

Horii, S.C.; Muraki, A.; Mun, S.K.; Clark, L.; Schellinger, M.D.; Mallon-Ingeholm, M.L.

1989-01-01

A complete image management and communications system has been installed at Georgetown University Hospital (GUH). The network is based on the AT ampersand T CommView System. In the Neuroradiology Division, this network supports a multiscreen workstation with access to multiple imaging modalities such as CT and MRI from both the hospital and a remote imaging center. In addition, the radiologist can access these images from various workstations located throughout the hospital as well as from remote sites such as the home. Among the radiology services supported by the network, neuroradiology has the greatest need for such a system with extensive daily requirements involving the remote imaging center and on-line consultation around the clock. By providing neuroradiology with all available communication links, the radiologist can monitor, diagnose, and consult. The efficiency and effectiveness of the system's capabilities with regard to remote and teleradiology (RVS) operations have been studied for the neuroradiology service. This paper discusses the current clinical acceptance and use, problems in implementation, and ways these difficulties are being surmounted

The effectiveness of the installation of a mobile voice communication system in a university hospital.

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Hanada, Eisuke; Fujiki, Tadayoshi; Nakakuni, Hideaki; Sullivan, Corbet Vernon

2006-04-01

In large hospitals, collaborative clinical practice is currently emphasized, with members of various departments expected to work as a team. The importance of accurate communication among the team members is of utmost importance. To improve such communication, the introduction of mobile voice communication systems has received much attention in Japan. Shimane University Hospital also introduced a Personal Handy-phone System (PHS) for doctors. In the traditional setting, much time was wasted searching for doctors through multiple calls on fixed-line telephones. In order to measure the effectiveness of our system, the change in the number of calls made on fixed-line telephones before and after PHS installation was compared. The total number of calls was reduced by more than 35%, and the number of calls to the wards on weekdays was reduced by half. Mobile telecommunication systems with small output power, such as PHS, are known to cause little interference with medical devices which makes it possible to use mobile voice communication safely in hospitals. The improvement in communication by this systems resulted in an improvement in labor efficiency.

Nasal Carriage of Uncommon Coagulase-Negative Staphylococci in Nurses and Physicians of Tehran University Hospitals

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Elaheh Salimi

2016-05-01

Full Text Available Coagulase-negative staphylococci (CoNS have been identified as a major cause of nosocomial infections. Nasal carriage of CoNS in nurses and physicians is known to be an important risk factor for potential hospital infections. This study was carried out to investigate the prevalence of nasal carriage of uncommon coagulase-negative staphylococci among nurse and physician staffs of Tehran University Hospitals. A total of 116 CoNS were isolated from anterior nares of the study participants working in different wards of the hospitals. Thirteen uncommon CoNS were identified using phenotypic and biochemical methods, were subsequently confirmed by API kits. Staphylococcus xylosus, Staphylococcus haemolyticus, and Staphylococcus capitis species accounted for 53.85%, 30.77%, and 15.38% from the isolates, respectively. Six isolates (46.15% were found to be resistant to methicillin. In conclusion, screening of healthcare workers for uncommon CoNS colonization along with identification and testing for susceptibility of cultured isolates is of paramount importance in strengthening effective nosocomial infection control and prevention measures.

[Organization analysis and health technology assessment: an experiment in San Giovanni Battista University Hospital-Turin].

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Minniti, D; Chiadò Piat, S; Barbaro, S; Galzerano, M; Siliquini, R

2010-01-01

Recent Italian laws emphasise Clinical Governance model as a priority for hospitals and Health Technology Assessment as one of the major tools in order to support local and hospital decisions as far as new health technologies are concerned. Our reported experience suggests managing solutions and appraises clinical issues in terms of effectiveness, efficiency and security of new and emerging technologies in order to plan and to create a system according to up to date Health Technology Assessment principles in San Giovanni Battista University Hospital-Turin. Mini-HTA reports have been realised on "Technology Intelligence" in prostate cancer treatment, percutaneous implantation of aortic valve prosthesis in high-risk patients with aortic valve disease and experimental Home Radiology project. In addition, 1167 health technologies have been evaluated through a database created ad hoc. 65% of the evaluations have been positive, less than 5% negative and the other 30% have been suspended waiting for deeper assessments. The future perspectives predict the realization of further Mini-HTA reports even through a revision of the managing model used.

Combining multi-criteria decision analysis and mini-health technology assessment: A funding decision-support tool for medical devices in a university hospital setting.

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Martelli, Nicolas; Hansen, Paul; van den Brink, Hélène; Boudard, Aurélie; Cordonnier, Anne-Laure; Devaux, Capucine; Pineau, Judith; Prognon, Patrice; Borget, Isabelle

2016-02-01

At the hospital level, decisions about purchasing new and oftentimes expensive medical devices must take into account multiple criteria simultaneously. Multi-criteria decision analysis (MCDA) is increasingly used for health technology assessment (HTA). One of the most successful hospital-based HTA approaches is mini-HTA, of which a notable example is the Matrix4value model. To develop a funding decision-support tool combining MCDA and mini-HTA, based on Matrix4value, suitable for medical devices for individual patient use in French university hospitals - known as the IDA tool, short for 'innovative device assessment'. Criteria for assessing medical devices were identified from a literature review and a survey of 18 French university hospitals. Weights for the criteria, representing their relative importance, were derived from a survey of 25 members of a medical devices committee using an elicitation technique involving pairwise comparisons. As a test of its usefulness, the IDA tool was applied to two new drug-eluting beads (DEBs) for transcatheter arterial chemoembolization. The IDA tool comprises five criteria and weights for each of two over-arching categories: risk and value. The tool revealed that the two new DEBs conferred no additional value relative to DEBs currently available. Feedback from participating decision-makers about the IDA tool was very positive. The tool could help to promote a more structured and transparent approach to HTA decision-making in French university hospitals. Copyright © 2015 Elsevier Inc. All rights reserved.

Current and future strategy for breast cancer treatment at Nagasaki University Hospital

International Nuclear Information System (INIS)

Morishita, Mariko; Hayashi, Tomayoshi; Maeda, Shigeto

2005-01-01

Breast cancer has emerged as the most frequent malignant neoplasm among Japanese women in recent years, raising awareness in society of the issue of breast cancer, including good screening and therapies. In fact, the establishment of breast cancer screening program with mammography in the United States and Western Europe has contributed to improve the diagnosis of breast cancer at early stage, and proper management, including various options of evidence-based treatment has not only reduced mortality but also enhanced patients' quality of life. However, the mortality rate due to breast cancer in Japan has continued to increase, and the number of patients is also increasing rapidly. It is therefore very urgent to develop a good system of breast care in all medical facilities as well as the provision of a national scheme in Japan. In this report, we review the situations of breast surgery at Nagasaki University Hospital from 1975 to 2004 and current management practices for breast disease, and evaluate the possibility of establishing a better system for breast care at our hospital, which could then act as a core medical institute in Nagasaki. (author)

A first evaluation of a pedagogical network for medical students at the University Hospital of Rennes.

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Fresnel, A; Jarno, P; Burgun, A; Delamarre, D; Denier, P; Cleret, M; Courtin, C; Seka, L P; Pouliquen, B; Cléran, L; Riou, C; Leduff, F; Lesaux, H; Duvauferrier, R; Le Beux, P

1998-01-01

A pedagogical network has been developed at University Hospital of Rennes from 1996. The challenge is to give medical information and informatics tools to all medical students in the clinical wards of the University Hospital. At first, nine wards were connected to the medical school server which is linked to the Internet. Client software electronic mail and WWW Netscape on Macintosh computers. Sever software is set up on Unix SUN providing a local homepage with selected pedagogical resources. These documents are stored in a DBMS database ORACLE and queries can be provided by specialty, authors or disease. The students can access a set of interactive teaching programs or electronic textbooks and can explore the Internet through the library information system and search engines. The teachers can send URL and indexation of pedagogical documents and can produce clinical cases: the database updating will be done by the users. This experience of using Web tools generated enthusiasm when we first introduced it to students. The evaluation shows that if the students can use this training early on, they will adapt the resources of the Internet to their own needs.

Use of transcutaneous electrical nerve stimulation in the Unit of Pain Management of the Alcorcón Foundation University Hospital

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Andrea Isabel Martínez Tapia

2014-08-01

Full Text Available Transcutaneous electrical nerve stimulation (TENS is a non-pharmacological therapy (TNF used to alleviate pain and is among the current available treatments offered by the Units of Pain Management (Unidades del Dolor in Spanish Hospitals. The goal of this study was to identify the characteristics of portable electro-stimulator use, and its costs in the Unit of Pain Management of the Alcorcón Foundation University Hospital (Hospital Universitario Fundación Alcorcón. A retrospective descriptive study was carried out between January, 1999, and October, 2010, in the Unit of Pain Management of the Alcorcón Foundation University Hospital. The information on TENS delivery forms and its supplies was collected, and the characteristics of use and the associated costs were calculated. It was observed that the longest period of time used was less than a year. The cost of delivery for the portable equipment was 148 050 euros and the average annual cost for the use of TENS by a patient was 854 euros. From the information gathered, it can be concluded that the use of electro-analgesia is a valid option in terms of expenses for long periods of use, thereby allowing a reduction in costs and decreasing the use of other healthcare treatments.

Prevalence of anaemia among patients with heart failure at the Brazzaville University Hospital.

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Ikama, Méo Stéphane; Nsitou, Bernice Mesmer; Kocko, Innocent; Mongo, Ngamami Solange; Kimbally-Kaky, Gisèle; Nkoua, Jean Louis

2015-01-01

Heart failure (HF) is a frequent cause of ospitalisation in cardiology. Its prognosis depends on several risk factors, one of which is anaemia. We aimed to determine the prevalence of anaemia in patients with heart failure, and evaluate its impact on their prognosis. This article describes a cross-sectional study with prospective collection of data, carried out from 1 January to 31 December 2010 in the Department of Cardiology at Brazzaville University Hospital, Congo. Patients admitted for heart failure were included. Anaemia was defined as a haemoglobin level failure, and it had a negative effect on the prognosis.

Methicillin-Resistant Staphylococcus aureus nosocomial infection trends in Hospital universiti sains Malasia during 2002-2007

International Nuclear Information System (INIS)

Al-Talib, Hasnain I.; Yean, Chan Y

2010-01-01

Methicillin-resistant staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide.The aim of the present study was to assess the burden of MRSA nosocomial infection,its association with factors of interest, and its antimicrobial susceptibility.This was a retrospective analysis of a database of all s aureus that were cultured from patients admitted to the defferent wards of hospital universiti sains malasia(HUSM) over a aperiod of 6 years.The MRSA infections rate was 10.0 Per 1000 hospital admissions.The incidence density rate of MRSA infections during the study period was 1.8 per 1000 patient-days,with annual rates ranging from 0.95 to 3.47 per 1000 patients-days.Duration of hospitalization,previous antibiotic use,and bedside invasive proceures of MRSa infections were found in orthopedic wards (25.3%) followed by surgical wards (18.2%) amd omtensive care units(ICU) (16.4%).All MRSA isolates were resistant to erythromycin (98.0%),co-trimoxazole (94.0%)and gentamicin (92.0%)clindamycin was the best antibiotic with only 6% resistance.All MRSA isolates were sensitive to vancomycin.The rate of the noscomial MRSA infection per 1000 admissions was higher than that in other studies.The three factors associated most signaficantly with acquired MRSA infections included duration of hospitalization,antibiotic use,and bedside invasive procedures.This study confirmed that vancomycin-resistant s aureus has not yet been established in HUSM (Author).

Pattern of thyroid malignancy at a University Hospital in Western Saudi Arabia

International Nuclear Information System (INIS)

Qari, Faiza A.

2004-01-01

The aim is to study the incidence of thyroid cancer in surgically treated nodular thyroid disease, clinicopathological characteristics and treatment results. A retrospective review of 45 patients with thyroid malignancy at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia during a 3-years period between January 2000 through to December 2003 was carried out. Analysis of clinicopathologic characteristics, age correlation to different risk factors, outcome of surgery and radioiodine treatment. A total of 120 thyroidectomies were performed during the 3-years period, January 2000 through to December 2003 at King Abdul-Aziz University Hospital. Forty-five (37.5%) patients had histopathology confirmed diagnosis of thyroid cancer. Eighty-two point two percent cases of papillary carcinoma, 4.4% follicular type and 6.7% anaplastic and medullary carcinoma of thyroid. Mean age was 40.5 +/- 14.8 years. Male preponderance was seen in this study with males: females ratio is 1.1:1. Nodular goiter was the most frequent presentation, observed in 30 (66.7%) cases. Fine needle aspiration cytology was suggestive of malignancy in 76% of cases. Ninety-seven patients with papillary carcinoma received ablative dose of radioiodine with average dose of 100-200 mCi. One female patient with follicular carcinoma of thyroid with bone, lung, and brain metastases received 4 doses of radioiodine with total dose of 800 mCi. Mortality rate was (2.2%), one patient died of complication of invasive anaplastic carcinoma with invasion of the trachea. There is a lot of controversy regarding thyroid malignancy investigations and management. We recommend that thyroid cancer patients should be treated by a team of endocrinologist, pathologist, experience thyroid surgeon, nuclear medicine and external radiotherapy physician to achieve an optimum care and good prognosis. (author)

Immunological Response of Hiv-Infected Children to Highly Active Antiretoviral Therapy at Gondar University Hospital, North-Western Ethiopia.

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Kokeb, Mehretie; Degu, Getu

2016-01-01

The effectiveness of highly active antiretroviral therapy (HAART) in children has not been well studied specially in developing countries where the burden of HIV is high. This study was aimed to assess the immunologic response of HIV-infected children to HAART at Pediatric ART Clinic Gondar University Hospital. Institution based cross-sectional study was conducted at the Pediatric ART Clinic Gondar University Hospital from March 01-April 30, 2014. The study included 283 HIV-infected children who were on HAART for 6 months and above. Medical records of HIV-infected children were reviewed using pre-tested questionnaire. CD4 count/percent was collected every 6 months retrospectively. For all statistical significance tests, the cut-off value was pimmunological response. The study revealed that there was good Immunological response to ART, and that the maximum response was in the 1(st) 6 months of ART. Low CD4 count at initiation, undisclosed HIV status and lack of good adherence were found to cause low immunological response to HAART.

Association between burnout syndrome, harmful use of alcohol and smoking in nursing in the ICU of a university hospital.

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Fernandes, Larissa Santi; Nitsche, Maria José Trevizani; Godoy, Ilda de

2018-01-01

The article aims to determine the presence of burnout syndrome among professionals in the field of Nursing in the Intensive Care Unit in a university hospital and a possible association with consumption of alcohol and tobacco. Participants were 160 nursing professionals from 04 intensive care unit of a university hospital in the period from March 2013 to February 2014. We used a structured questionnaire, plus the smoking history, Maslach Burnout Inventory, Alcohol Use Disorders Identification Test, Fagerström Dependence Questionnaire and the measurement of carbon monoxide. We used Fisher's chi-square or Fisher exact test. Syndrome was found in 34 professionals, most of them female, married and young adults. 18 professionals reported being smokers. 6,4% of Nursing Assistants, 50% Practical Nurses and Nurses 71,4% drank moderate; 5,4% Nursing Assistant and 14,3% Nurses scored default risk drinking and only 01 Practical Nurses had possible alcohol dependence. There was a positive association of the syndrome with smoking in 01 ICU. Final considerations: Hospital Intensive Care services need assistance from the managers of services for the purpose of caring for the health of their caregivers.

A comparison of the universal TOR Guideline to the absence of prehospital ROSC and duration of resuscitation in predicting futility from out-of-hospital cardiac arrest.

Science.gov (United States)

Drennan, Ian R; Case, Erin; Verbeek, P Richard; Reynolds, Joshua C; Goldberger, Zachary D; Jasti, Jamie; Charleston, Mark; Herren, Heather; Idris, Ahamed H; Leslie, Paul R; Austin, Michael A; Xiong, Yan; Schmicker, Robert H; Morrison, Laurie J

2017-02-01

The Universal Termination of Resuscitation (TOR) Guideline accurately identifies potential out-of-hospital cardiac arrest (OHCA) survivors. However, implementation is inconsistent with some Emergency Medical Service (EMS) agencies using absence of return of spontaneous circulation (ROSC) as sole criterion for termination. To compare the performance of the Universal TOR Guideline with the single criterion of no prehospital ROSC. Second, to determine factors associated with survival for patients transported without a ROSC. Lastly, to compare the impact of time to ROSC as a marker of futility to the Universal TOR Guideline. Retrospective, observational cohort study. Non-traumatic, adult (≥18 years) OHCA patients of presumed cardiac etiology treated by EMS providers. ROC-PRIMED and ROC-Epistry post ROC-PRIMED databases between 2007 and 2011. Primary outcome was survival to hospital discharge and the secondary outcome was functional survival. We used multivariable regression to evaluate factors associated with survival in patients transported without a ROSC. 36,543 treated OHCAs occurred of which 9467 (26%) were transported to hospital without a ROSC. Patients transported without a ROSC who met the Universal TOR Guideline for transport had a survival of 3.0% (95% CI 2.5-3.4%) compared to 0.7% (95% CI 0.4-0.9%) in patients who met the Universal TOR Guideline for termination. The Universal TOR Guideline identified 99% of survivors requiring continued resuscitation and transportation to hospital including early identification of survivors who sustained a ROSC after extended durations of CPR. Using absence of ROSC as a sole predictor of futility misses potential survivors. The Universal TOR Guideline remains a strong predictor of survival. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Process of care and prescription in pneumonia acquired in the community in university hospitals in Colombia

International Nuclear Information System (INIS)

Martinez, Carlos Eli; Jaimes, Fabian A; Montufar, Franco E; Hincapie, Gustavo A; Morales, Alvaro; Acero, Rafael; Muneton, David; Gomez, Sujey; Cuenca, Diana Maria; Salinas, Juan Carlos; Zabaleta Joel E

2003-01-01

The objective is to describe the process of care and prescription practices for CAP patients in four university hospitals in Colombia. Patients older than 15 years with a diagnosis of CAP during the two years study period. Collection of demographic and clinical status data and management during the first day of consult, classification in severity groups according to fine's prediction rule. Evaluation of the frequency of use of ancillary diagnostic tests antimicrobials prescription and agreement with ATS guidelines according to severity group and hospital. 734 patients were included, mean age 56 years old, 50.5% males, mean length of stay 8.6 days, 39% fine's classes IV to V. Frequency of sputum sampling (overall cohort between hospitals rank) was 46% (10 - 67%), chest x-ray 95% (57-100%), blood cultures 34% (0 -63%) and arterial blood gas analysis 71% (10-88%). the use of ancillary diagnostic test had wide variation between hospitals and severity classes, specially for sputum and blood gases. At least 45 different antimicrobial protocols were used in the cohort. Overall agreement between actual prescription and guidelines recommendations was variable (mean 44%, range 22 to 72%) between groups and hospitals, but without significant impact on mortality. There are many differences between actual clinical practice and guidelines for the management of CAP and wide variations between hospitals, but the precise effect of the lack of guideline-adherence on mortality is unclear

Prevalence of injuries and reporting of accidents among health care workers at the University Hospital of the West Indies.

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Vaz, Kurt; McGrowder, Donovan; Crawford, Tazhmoye; Alexander-Lindo, Ruby Lisa; Irving, Rachael

2010-01-01

This study investigated the knowledge, awareness and practices of health care workers towards universal precautions at the University Hospital of the West Indies. The study also examined the prevalence of injuries experienced by health care workers, as well as incidence of accidents and compliance with post-exposure prophylaxis. A cross sectional survey was conducted in September and October 2007. A 28-item self-administered questionnaire was provided to two hundred health care workers including medical doctors, medical technologists, nurses and porters to assess knowledge and practices regarding universal precautions, prevalence of injuries and incidence of accidents. Almost two-thirds (62.3%) of the respondents were aware of policies and procedures for reporting accidents while one-third (33.2%) were unsure. All nurses were aware of policies and procedures for reporting accidents, followed by medical doctors (88%) and medical technologists (61.2%). The majority (81.5%) of the respondents experienced splashes from bodily fluid. Over three-quarters of medical doctors (78%) and two-thirds of nurses (64%) reported having experienced needle stick injuries, while the incidence among medical technologists was remarkably lower (26%). The majority of the respondents (59%) experienced low accident incidence while just over one-tenth (14%) reported high incidence. Eighty four respondents reported needle stick injuries; just under two-thirds (59.5%) of this group received post-exposure treatment. The study found that majority of health care workers were aware of policies and procedures for reporting accidents. Splashes from body fluids, needle stick injuries and cuts from other objects were quite prevalent among health care workers. There is a need for monitoring systems which would provide accurate information on the magnitude of needle stick injuries and trends over time, potential risk factors, emerging new problems, and the effectiveness of interventions at The

Routine clinical heart examinations using SQUID magnetocardiography at University of Tsukuba Hospital

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Inaba, T.; Nakazawa, Y.; Yoshida, K.; Kato, Y.; Hattori, A.; Kimura, T.; Hoshi, T.; Ishizu, T.; Seo, Y.; Sato, A.; Sekiguchi, Y.; Nogami, A.; Watanabe, S.; Horigome, H.; Kawakami, Y.; Aonuma, K.

2017-11-01

A 64-channel Nb-based DC-SQUID magnetocardiography (MCG) system was installed at the University of Tsukuba Hospital (UTH) in March 2007 after obtaining Japanese pharmaceutical approval and insurance reimbursement approval. In the period between 2008 and 2016, the total number of patients was 10 085. The heart diseases diagnosed in fetuses as well as adults are mainly atrial arrhythmia, abnormal repolarization, ventricular arrhythmia, and fetal arrhythmia. In most cases of insufficient diagnostic accuracy with electrocardiography, SQUID MCG precisely revealed these heart diseases as an abnormal electrical current distribution. Based on success in routine examinations, SQUID MCG is now an indispensable clinical instrument with diagnostic software tuned up during routine use at UTH.

A Study of the Readiness of Hospitals for Implementation of High Reliability Organizations Model in Tehran University of Medical Sciences.

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Mousavi, Seyed Mohammad Hadi; Dargahi, Hossein; Mohammadi, Sara

2016-10-01

Creating a safe of health care system requires the establishment of High Reliability Organizations (HROs), which reduces errors, and increases the level of safety in hospitals. This model focuses on improving reliability through higher process design, building a culture of accreditation, and leveraging human factors. The present study intends to determine the readiness of hospitals for the establishment of HROs model in Tehran University of Medical Sciences from the viewpoint of managers of these hospitals. This is a descriptive-analytical study carried out in 2013-2014. The research population consists of 105 senior and middle managers of 15 hospitals of Tehran University of Medical Sciences. The data collection tool was a 55-question researcher-made questionnaire, included six elements of HROs to assess the level of readiness for establishing HROS model from managers' point of view. The validity of the questionnaire was calculated through the content validity method using 10 experts in the area of hospitals' accreditation, and its reliability was calculated through test-retest method with a correlation coefficient of 0.90. The response rate was 90 percent. The Likert scale was used for the questions, and data analysis was conducted through SPSS version 21 Descriptive statistics was presented via tables and normal distributions of data and means. Analytical methods, including t-test, Mann-Whitney, Spearman, and Kruskal-Wallis, were used for presenting inferential statistics. The study showed that from the viewpoint of senior and middle managers of the hospitals considered in this study, these hospitals are indeed ready for acceptance and establishment of HROs model. A significant relationship was showed between HROs model and its elements with demographic details of managers like their age, work experience, management experience, and level of management. Although the studied hospitals, as viewed by their managers, are capable of attaining the goals of HROs, it

Biggest challenges in bioinformatics.

Science.gov (United States)

Fuller, Jonathan C; Khoueiry, Pierre; Dinkel, Holger; Forslund, Kristoffer; Stamatakis, Alexandros; Barry, Joseph; Budd, Aidan; Soldatos, Theodoros G; Linssen, Katja; Rajput, Abdul Mateen

2013-04-01

The third Heidelberg Unseminars in Bioinformatics (HUB) was held on 18th October 2012, at Heidelberg University, Germany. HUB brought together around 40 bioinformaticians from academia and industry to discuss the 'Biggest Challenges in Bioinformatics' in a 'World Café' style event.

Biggest challenges in bioinformatics

OpenAIRE

Fuller, Jonathan C; Khoueiry, Pierre; Dinkel, Holger; Forslund, Kristoffer; Stamatakis, Alexandros; Barry, Joseph; Budd, Aidan; Soldatos, Theodoros G; Linssen, Katja; Rajput, Abdul Mateen

2013-01-01

The third Heidelberg Unseminars in Bioinformatics (HUB) was held in October at Heidelberg University in Germany. HUB brought together around 40 bioinformaticians from academia and industry to discuss the ‘Biggest Challenges in Bioinformatics' in a ‘World Café' style event.

Nursing staff turnover at a Swedish university hospital: an exploratory study.

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Sellgren, Stina F; Kajermo, Kerstin N; Ekvall, Göran; Tomson, Göran

2009-11-01

The aim was to explore opinions on individual needs and other factors that may influence nursing staff turnover. High staff turnover is a great problem for many hospitals. It is shown to have a negative effect on the quality of nursing care and to increase hospital costs. In 2004 in a large university hospital in Sweden five focus group discussions (FGDs) including department heads (1), nursing managers (2) and members of nursing staff (2) were carried out. The questions to be addressed were 'Why do nurses leave?' and 'Why do nurses stay?' In addition, register data of staff turnover for 2002-2003 were analysed in relation to different facts about the units, such as number of employees, type of care and medical specialty. Categories of opinions identified in the FGDs were compared with results of the statistical analyses on the relationship between staff turnover and unit parameters to identify overall factors that may influence on nurse staff turnover. Four major factors were identified as having a possible influence on staff turnover: 'intrinsic values of motivation', 'work load', 'unit size 'and 'leadership'. Smaller units had lower staff turnover as well as outpatient units and day care. It was not possible to compare statements from participants from smaller units with those from participants from larger units. Two factors had diverging data, 'salary' and 'spirit of the time'. A surprising finding was the little mention of patient care in relation to staff turnover. It is important for managers to ensure that intrinsic values of nurses are met to minimise the risk for high turnover rates. Inpatient care must receive adequate staffing and nursing care could be organised into smaller units or work teams to avoid dissatisfaction and high turnover.

Indoor air quality levels in a University Hospital in the Eastern Province of Saudi Arabia

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Mahmoud F El-Sharkawy

2014-01-01

Full Text Available Aim of the Study: The complex hospital environment requires special attention to ensure a healthy indoor air quality (IAQ to protect patients and healthcare workers against hospital-acquired infections and occupational diseases. Poor hospital IAQ may cause outbreaks of building-related illness such as headaches, fatigue, eye, and skin irritations, and other symptoms. The general objective for this study was to assess IAQ inside a large University hospital at Al-Khobar City in the Eastern Province of Saudi Arabia. Materials and Methods: Different locations representing areas where most activities and tasks are performed were selected as sampling points for air pollutants in the selected hospital. In addition, several factors were studied to determine those that were most likely to affect the IAQ levels. The temperature and relative percent humidity of different air pollutants were measured simultaneously at each location. Results: The outdoor levels of all air pollutant levels, except volatile organic compounds (VOCs, were higher than the indoor levels which meant that the IAQ inside healthcare facilities (HCFs were greatly affected by outdoor sources, particularly traffic. The highest levels of total suspended particulates (TSPs and those less than 10 microns (PM 10 inside the selected hospital were found at locations that are characterized with m4ore human activity. Conclusions:Levels of particulate matter (both PM 10 and TSP were higher than the Air Quality Guidelines (AQGs. The highest concentrations of the fungal species recorded were Cladosporium and Penicillium. Education of occupants of HCF on IAQ is critical. They must be informed about the sources and effects of contaminants and the proper operation of the ventilation system.

A multidisciplinary intervention to reduce infections of ESBL- and AmpC-producing, gram-negative bacteria at a University Hospital

DEFF Research Database (Denmark)

Knudsen, Inge Jenny Dahl; Andersen, Stig Ejdrup

2014-01-01

aeruginosa and Enterococcus faecium infections increased (p'sproducing bacteria significantly decreased (p = 0.023). The unadjusted, all-cause 30-day mortality rates of K. pneumoniae and E. coli were unchanged over......In response to a considerable increase in the infections caused by ESBL/AmpC-producing Klebsiella pneumonia in 2008, a multidisciplinary intervention, with a main focus on antimicrobial stewardship, was carried out at one university hospital. Four other hospitals were used as controls. Stringent...... guidelines for antimicrobial treatment and prophylaxis were disseminated throughout the intervention hospital; cephalosporins were restricted for prophylaxis use only, fluoroquinolones for empiric use in septic shock only, and carbapenems were selected for penicillin-allergic patients, infections due to ESBL/AmpC-producing...

Geneva University - Particle Physics seminar

CERN Multimedia

Université de Genève

2011-01-01

UNIVERSITE DE GENEVE Ecole de physique Département de physique nucléaire et corspusculaire 24, quai Ernest-Ansermet 1211 Geneva 4 Tel. (022) 379 62 73 Fax (022) 379 69 92 Wednesday 8 June 2011 PARTICLE PHYSICS SEMINAR at 17.00 hrs – Stückelberg Auditorium A Novel Experiment for the Search muon -> eee Prof. Andre Schoening, University of Heidelberg The absence of lepton-flavor changing processes, like the non-observation of the radiative decay mu -> e gamma, has been a miracle since the dawn of the Standard Model of Particle Physics and lead to the introduction of the concept of lepton family numbers. Several experiments in the last decade have shown clear evidence for neutrino oscillations. The neutrino mixing angles measured are known to be large. However, the discovery of lepton flavor violating (LFV) effects in the charged lepton sector is yet owing. After motivating the search for LFV in general I will discuss the physics potential of a search m...

From customer satisfaction survey to corrective actions in laboratory services in a university hospital.

Science.gov (United States)

Oja, Paula I; Kouri, Timo T; Pakarinen, Arto J

2006-12-01

To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction. and Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.

[Medico-economic analysis of a neurosurgery department at a university hospital].

Science.gov (United States)

Lemaire, J-J; Delom, C; Coste, A; Khalil, T; Jourdy, J-C; Pontier, B; Gabrillargues, J; Sinardet, D; Chabanne, A; Achim, V; Sakka, L; Coste, J; Chazal, J; Salagnac, A; Coll, G; Irthum, B

2015-02-01

Economic and societal constraints require to take into account the economic dimension and medical performance of hospital departments. We carried out a self-assessment study, which we thought could be useful to share with the neurosurgical community. Care and research activities were assessed from 2009 to 2013. We used institutional and assessment-body parameters in order to describe activities and perform a financial evaluation. It was a retrospective descriptive study based on the guidelines of the DHOS/O4 circular No. 2007/390 of October 29, 2007. The average annual, analytic income statement was +1.39 millions euros, for 63 beds with a 92% occupancy rate, including 6.7 full-time equivalent neurosurgeons (and assistants), for 2553 patients and 1975 surgeries. The average mortality rate was 2.74%. The annual mean length of stay was 6.82 days. Per year, on average 15.6% of patients were admitted in emergency and 76.9% returned home. The annual, act-related-pricing and publication-related incomes represented 77% and 0.6%, respectively of the total funding. Difficulties to find downstream beds for the most severe patients induced 1401 "waiting days" in 2012. Medico-economic analysis of a neurosurgery department at a university hospital was useful in order to take into account the care, teaching and research activities, as well as its related financial value. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Early experience with the da Vinci® surgical system robot in gynecological surgery at King Abdulaziz University Hospital

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Sait KH

2011-07-01

Full Text Available Khalid H SaitObstetrics and Gynecology Department, Faculty of Medicine, Gynecology Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaBackground: The purpose of this study was to review our experience and the challenges of using the da Vinci® surgical system robot during gynecological surgery at King Abdulaziz University Hospital.Methods: A retrospective study was conducted to review all cases of robot-assisted gynecologic surgery performed at our institution between January 2008 and December 2010. The patients were reviewed for indications, complications, length of hospital stay, and conversion rate, as well as console and docking times.Results: Over the three-year period, we operated on 35 patients with benign or malignant conditions using the robot for a total of 62 surgical procedures. The docking times averaged seven minutes. The mean console times for simple hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy were 125, 47, and 62 minutes, respectively. In four patients, laparoscopic procedures were converted to open procedures, giving a conversion rate of 6.5%. All of the conversions were among the first 15 procedures performed. The average hospital stay was 3 days. Complications occurred in five patients (14%, and none were directly related to the robotic system.Conclusion: Our early experience with the robot show that with proper training of the robotic team, technical difficulty with the robotic system is limited. There is definitely a learning curve that requires performance of gynecological surgical procedures using the robot.Keywords: da Vinci robot, gynecological surgery, laparoscopy

Do hospital physicians really want to go digital? Acceptance of a picture archiving and communication system in a university hospital

International Nuclear Information System (INIS)

Duyck, P.; Pynoo, B.; Devolder, P.; Voet, T.; Adang, L.; Vercruysse, J.

2008-01-01

Purpose: radiology departments are making the transition from analog film to digital images by means of PACS (Picture Archiving and Communication System). It is critical for the hospital that its physicians adopt and accept the new digital work method regarding radiological information. The aim of this study is to investigate hospital physicians' acceptance of PACS using questionnaires pre- and post-implementation and to identify main influencing factors. Materials and methods: the study was conducted in an 1169 bed university hospital. The UTAUT (Unified Theory of Acceptance and Use of Technology) questionnaire was administered at two times: one month pre-implementation (T1) and 1.5 years post-implementation (T2) of PACS, targeting all hospital physicians with the exemption of radiologists. The UTAUT scales (Behavioral Intention BI; Facilitating Conditions FC; Effort Expectancy EE; Performance Expectancy PE; Anxiety ANX; Social Influence SI; System Use USE; Attitude toward technology ATT; Self-Efficacy SE) were used to assess questions regarding: (a) PACS' usefulness, (b) PACS' ease of learning/using, (c) PACS support availability, (d) the perceived pressure to use PACS, (e) physicians' attitude towards PACS and (f) physicians' intention to use and actual use of PACS. Results: at T1 scale ratings were positive toward the PACS implementation. The ratings on all scales with the exception of self-efficacy improved at T2. Regression analysis revealed that the key factor for intention to use PACS at T1 was the usefulness of PACS, while the availability and awareness of support was its most important predictor at T2. Overall, PE was the best predictor of BI, but all four UTAUT-determinants (PE, FC, EE and SI) were salient for its prediction. Variance explained in BI ranged from 31 to 37% while variance explained in USE was very low (3%). (orig.)

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

Science.gov (United States)

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

Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

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Amilton dos Santos Jr.

2013-01-01

Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

Trends in maternal mortality at the University of Calabar Teaching Hospital, Nigeria, 1999–2009

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TU Agan

2010-08-01

Full Text Available TU Agan1, EI Archibong1, JE Ekabua1, EI Ekanem1, S E Abeshi1, TA Edentekhe2, EE Bassey21Department of Obstetrics and Gynecology and 2Department of Anesthesia, College of Medical Sciences, University of Calabar Teaching Hospital, NigeriaBackground: Maternal mortality remains a major public health challenge, not only at the University of Calabar Teaching Hospital, but in the developing world in general.Objective: The objective of this study was to assess trends in maternal mortality in a tertiary health facility, the maternal mortality ratio, the impact of sociodemographic factors in the deaths, and common medical and social causes of these deaths at the hospital.Methodology: This was a retrospective review of obstetric service delivery records of all maternal deaths over an 11-year period (01 January 1999 to 31 December 2009. All pregnancy-related deaths of patients managed at the hospital were included in the study.Results: A total of 15,264 live births and 231 maternal deaths were recorded during the period under review, giving a maternal mortality ratio of 1513.4 per 100,000 live births. In the last two years, there was a downward trend in maternal deaths of about 69.0% from the 1999 value. Most (63.3% of the deaths were in women aged 20–34 years, 33.33% had completed at least primary education, and about 55.41% were unemployed. Eight had tertiary education. Two-thirds of the women were married. Obstetric hemorrhage was the leading cause of death (32.23%, followed by hypertensive disorders of pregnancy. Type III delay accounted for 48.48% of the deaths, followed by Type I delay (35.5%. About 69.26% of these women had no antenatal care. The majority (61.04% died within the first 48 hours of admission.Conclusion: Although there was a downward trend in maternal mortality over the study period, the extent of the reduction is deemed inadequate. The medical and social causes of maternal deaths identified in this study are preventable, especially

Positive predictive value and impact of misdiagnosis of a heart failure diagnosis in administrative registers among patients admitted to a University Hospital cardiac care unit

DEFF Research Database (Denmark)

Mard, Shan; Nielsen, Finn Erland

2010-01-01

To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF.......To evaluate the positive predictive value (PPV) of a diagnosis of heart failure (HF) in the Danish National Registry of Patients (NRP) among patients admitted to a University Hospital cardiac care unit, and to evaluate the impact of misdiagnosing HF....

Inpatient Management of Diabetes Mellitus among Noncritically Ill Patients at University Hospital of Puerto Rico.

Science.gov (United States)

Allende-Vigo, Myriam Zaydee; González-Rosario, Rafael A; González, Loida; Sánchez, Viviana; Vega, Mónica A; Alvarado, Milliette; Ramón, Raul O

2014-05-01

To describe the state of glycemic control in noncritically ill diabetic patients admitted to the Puerto Rico University Hospital and adherence to current standard of care guidelines for the treatment of diabetes. This was a retrospective study of patients admitted to a general medicine ward with diabetes mellitus as a secondary diagnosis. Clinical data for the first 5 days and the last 24 hours of hospitalization were analyzed. A total of 147 noncritically ill diabetic patients were evaluated. The rates of hyperglycemia (blood glucose ≥180 mg/dL) and hypoglycemia (blood glucose diabetic patients is suboptimal, probably due to clinical inertia, manifested by absence of appropriate modification of insulin regimen and intensification of dose in uncontrolled diabetic patients. A comprehensive educational diabetes management program, along with standardized insulin orders, should be implemented to improve the care of these patients.

The relationship between subjective perception and the psychological effects of patients in spatial isolation.

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Ibert, Fabienne; Eckstein, Monika; Günther, Frank; Mutters, Nico T

2017-01-01

Background: Spatial isolation is a common infection control measure, but negative psychological effects are often neglected. We investigated which factors influence the perception of single room isolated patients. Methods: In the present correlative cross-sectional study, 32 isolated patients have been interviewed within three departments of the Heidelberg University Hospital, one of Germany's largest hospitals. The following questionnaires were used: 10-Item Big Five Inventory (BFI-10), Positive and Negative Affect Schedule (PANAS), Hospital Anxiety and Depression Scale (HADS) and a self-developed questionnaire to evaluate the individual experience of isolation. Data were analysed using correlation and regression analysis. Results: A significant positive correlation was found between the isolation period and anxiety (r=.42, pSurfing the internet had a positive relationship with thinking about beautiful things (r=.41, pwell-being of the patient.

Prevalence and factors associated with pregnancy loss among physicians in King Abdul-Aziz University Hospital, Saudi Arabia.

Science.gov (United States)

Alshora, Weam Bashier I; Mohammad Kalo, Bakr

2018-04-01

Medical profession is a stressful occupation as it carries potential risk for pregnancy outcome. There is lack of researches regarding the pregnancy loss among physicians working in hospitals in Saudi Arabia. The current study aims at estimating the prevalence and factors associated with pregnancy loss among female physicians working at King Abdul-Aziz University Hospital in Jeddah, September, 2015. A cross sectional study has been conducted, which included all the female physicians working at King Abdul-Aziz University Hospital in Jeddah by filling a self-administered online questionnaire. Out of all responding physicians (n = 92), the majority were Saudis (93.5%), who were mostly married (89.1%) and rest were either divorced (8.7%) or widowed (2.2%). Seventeen female physicians had pregnancy loss before (18.5%) with a total of 25 losses, which were mostly occurred during first trimester, especially while working as residents (40%), the average monthly working hours in the first pregnancy loss was (median; IQR, 160, 110-198 h). No statistically significant difference could be detected regarding the variation in pregnancy losses according to nationality marital status nor specialty. Most of the pregnancy losses in physicians occurred in first trimester during residency with a relatively longer monthly working hours. Further researches are needed on a larger sample and wider scale with inclusion of other pertinent factors to enable judging on the independent relationship of pregnancy loss and medical profession. Copyright © 2018. Published by Elsevier B.V.

Report of the procedure of voluntary interruption of pregnancy at a university hospital in Uruguay

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Ana Bentancor

2016-01-01

Full Text Available ABSTRACT OBJECTIVE To describe the constitution and operation of a voluntary interruption of pregnancy team of a university hospital, from the outlook of the mental health team. METHODS In this case study, the following aspects were analyzed: 1 historical background; 2 implementation of Law 18,897 of October 22, 2012; and 3 functioning of the program at the Hospital de Clínicas of the Facultad de Medicina (Universidad de la República, Uruguay, taking into account three dimensions: structure, process, and results. RESULTS Between December 2012 and November 2013, a total of 6,676 voluntary interruptions of pregnancy were reported in Uruguay; out of these, 80 were conducted at the Hospital de Clínicas. The patients’ demographic data agreed with those reported at the national level: Of the total patients, 81.0% were aged over 19 years; 6.2% decided to continue with the pregnancy; and only 70.0% attended the subsequent control and received advice on contraception. CONCLUSIONS In its implementation year in Uruguay, we can assess the experience as positive from the point of view of women’s health. Our experience as a mental health team at the Hospital de Clínicas, inserted into the multidisciplinary voluntary interruption of pregnancy team, is in the process of assessment and reformulation of practices.

TEMPOROMANDIBULAR PAIN DYSFUNCTION SYNDROME IN PATIENTS ATTENDING LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA.

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Eweka, O M; Ogundana, O M; Agbelusi, G A

2016-01-01

Temporomandibular joint pain dysfunction syndrome (TMJPDS) is the most common temporomandibular disorder. This condition presents with symptoms of pain, restricted jaw movement and joint noise. Other symptoms include otalgia, headache, neck pain and trismus. To determine the pattern of Temporomandibular joint pain dysfunction syndrome patients managed at the Lagos University Teaching Hospital, Lagos, Nigeria. A descriptive study of patients with signs and symptoms of Temporomandibular joint pain dysfunction syndrome attending the Oral Medicine Clinic of Lagos University Teaching Hospital. Twenty-one patients with Temporomandibular joint pain dysfunction syndrome were enrolled into the study, out of which 10(48%) were females and 11(52%) were males. The age range was 23-81years with a mean of 45.2 ± 18.9 years. Majority of the patients 20(95.2%) complained of pain around the joint, in the pre-auricular region, in the muscles of mastication and the ear. While 7(35%) complained of clicking sounds, 10(47.6%) complained of pain on mouth opening and during mastication only. In all 5(23.8%) had impaired movement of the jaws, mouth opening was normal in 18(85.7%) but reduced in 3(14.3%) patients. Over half of patients 12(57%) experienced clicking sounds, there was tenderness around the temporomandibular joint in 16(76.2%) cases, pain in the ear of 7(33.3%) patients and 13(61.9%) people presented with tenderness of the muscles of mastication. Conservative management of all the cases resulted in resolution of the symptoms. Temporomandibular joint pain dysfunction syndrome has diverse clinical presentation and though distressing, it responds to prompt and effective conservative management.

Initial experience of Da Vinci robotic thoracic surgery at the First Affiliated Hospital of Zhejiang University

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He, Zhehao; Zeng, Liping; Zhang, Chong; Wang, Luming; Wang, Zhitian; Rustam, Azmat; Du, Chengli; Lv, Wang

2017-01-01

Robot-assisted thoracic surgery (RATS) is a relatively new but rapidly adopted technique, pioneered by the urological and gynecological departments. The primary objective of this study is to present the current status, a series of improvement and innovation of Da Vinci robotic surgery in the Department of Thoracic Surgery at First Affiliated Hospital of Zhejiang University. In addition, we discuss the prospect of robotic surgical technology. PMID:29302429

Distribution of Reproductive Cases Presented at the University Of Ibadan Veterinary Teaching Hospital, Nigeria (1995-2009)

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Oluwatoyin O. Ajala; Adetunji P. Fayomi

2011-01-01

We studied the distribution of reproductive cases presented at the University of Ibadan Veterinary Teaching Hospital, Nigeria for 15 years (1995 to 2009). Records of presented cases were sourced from the case files and subjected to descriptive analysis. The recorded reproduction cases were distributed by the reproductive condition, species, breed, sex and year of occurrence. Dystocia>pregnancy diagnosis>mastitis>transmissible venereal tumor>metritis were the most frequently presented conditio...

Maternal mortality at Nnamdi Azikiwe University Teaching Hospital, Southeast Nigeria: a 10-year review (2003?2012)

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Obiechina, NJ; Okolie, VE; Okechukwu, ZC; Oguejiofor, CF; Udegbunam, OI; Nwajiaku, LSA; Ogbuokiri, C; Egeonu, R

2013-01-01

NJ Obiechina, VE Okolie, ZC Okechukwu, CF Oguejiofor, OI Udegbunam, LSA Nwajiaku, C Ogbuokiri, R Egeonu Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria Background: Maternal mortality is high the world over, especially in sub-Saharan Africa, including Nigeria. Nigeria has consistently demonstrated one of the most abysmally poor reproductive health indices in the world, maternal mortality inclusive. This is a sad reminder that, unless thing...

Pain prevalence in hospitalized children

DEFF Research Database (Denmark)

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

2017-01-01

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

Radiotherapy of Teikyo University. (3rd report) Experience and the current status at Ichihara Hospital

International Nuclear Information System (INIS)

Ogata, Hitoshi; Furui, Shigeru; Machida, Namio; Uchiyama, Katsuhiro

2006-01-01

Information disclosure is becoming a big trend these days, especially in the medical environment. To deal with the associated demands, the Department of Radiology, Teikyo University is continuing to report the experience and current status of radiotherapy. This report analyzed the total cases treated at Ichihara Hospital between the beginning of radiotherapy practice and the end of 2002. The basic items (age, sex, primary disease, primary organ, initial date of radiotherapy, initial department before radiotherapy, etc) of each case were studied. The accumulative numbers of the new patients and the overall treated patients were 1384 cases (278 from Surgery, 235 from Internal Medicine, 203 from Head and Neck (H and N), 143 from Ophthalmology, 134 from gynecology, etc) and 1795 cases (337 from Surgery, 321 from Internal Medicine, 271 from head and Neck (H and N), 180 from ophthalmology, 134 from Gynecology, etc) respectively. The sites of the primary lesions were 213 in digestive, 182 in respiratory, 171 in H and N, 159 in breast, 156 in central nervous system (CNS), 149 in hematologic, 131 in gynecologic, and 124 in urological organs. There are 60 cases of retinoblastoma in CNS tumors. It was thought that Ichihara Hospital of Teikyo University was very typical with regard to the patients referred to the Radiotherapy division. We will update this report periodically. (author)

Studies on occupational exposure to external radiation at Fukuoka University Hospital

International Nuclear Information System (INIS)

Miyauchi, Teiichi; Oshima, Yoshio; Ono, Yo

1982-01-01

This is a report of the yearly changes of exposure received by workers in radiological occupations at Fukuoka University Hospital from August 1973 to December 1980. The total number of the workers during this period involving diagnostic radiology, radiotherapy and the other related fields included 153 physicians, 27 technicians, 29 nurses and 16 assistants. Out of 225 workers, only two angiographers and two involved in intracavitary radiation therapy received more than 500 mrem of the annual exposure dose. The highest dose was 610 mrem. The exposure doses have gradually decreased each year. The exposure of the workers has remarkably decreased to almost negligible since a remote afterloading system was installed for intracavitary radiation therapy. In no worker was any somatic effect of radiation detected in the periodical physical examinations, even in the number of lymphocytes in the peripheral blood. (author)

Studies on occupational exposure to external radiation at Fukuoka University Hospital

Energy Technology Data Exchange (ETDEWEB)

Miyauchi, Teiichi; Oshima, Yoshio; Ono, Yo [Fukuoka Univ. (Japan)

1982-09-01

This is a report of the yearly changes of exposure received by workers in radiological occupations at Fukuoka University Hospital from August 1973 to December 1980. The total number of the workers during this period involving diagnostic radiology, radiotherapy and the other related fields included 153 physicians, 27 technicians, 29 nurses and 16 assistants. Out of 225 workers, only two angiographers and two involved in intracavitary radiation therapy received more than 500 mrem of the annual exposure dose. The highest dose was 610 mrem. The exposure doses have gradually decreased each year. The exposure of the workers has remarkably decreased to almost negligible since a remote afterloading system was installed for intracavitary radiation therapy. In no worker was any somatic effect of radiation detected in the periodical physical examinations, even in the number of lymphocytes in the peripheral blood.

Pediatric chronic patients at outpatient clinics: a study in a Latin American University Hospital.

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Alveno, Renata A; Miranda, Caroline V; Passone, Caroline G; Waetge, Aurora R; Hojo, Elza S; Farhat, Sylvia C L; Odone-Filho, Vicente; Tannuri, Uenis; Carvalho, Werther B; Carneiro-Sampaio, Magda; Silva, Clovis A

2017-10-02

To describe the characteristics of children and adolescentes with chronic diseases of outpatient clinics at a tertiary university hospital. A cross-sectional study was performed with 16,237 patients with chronic diseases followed-up in one year. The data were collected through the electronic system, according to the number of physician appointments in 23 pediatric specialties. Patients were divided in two groups: children (0-9 years) and adolescents (10-19 years). Early (10-14 years) and late (15-19 years) adolescent groups were also analyzed. Of the total sample, 56% were children and 46% were adolescents. The frequencies of following pediatric specialties were significantly higher in adolescents when compared with children: cardiology, endocrinology, hematology, nephrology/renal transplantation, neurology, nutrology, oncology, palliative and pain care, psychiatry, and rheumatology (p<0.05). The frequencies of emergency service visits (30% vs. 17%, p<0.001), hospitalizations (23% vs. 11%, p<0.001), intensive care unit admissions (6% vs. 2%, p<0.001), and deaths (1% vs. 0.6%, p=0.002) were significantly lower in adolescents than in children. However, the number of physician appointments (≥13) per patient was also higher in the adolescent group (5% vs. 6%, p=0.018). Further analysis comparison between early and late adolescents revealed that the first group had significantly more physician appointments (35% vs. 32%, p=0.025), and required more than two pediatric specialties (22% vs. 21%, p=0.047). Likewise, the frequencies of emergency service visits (19% vs. 14%, p<0.001) and hospitalizations (12% vs. 10%, p=0.035) were higher in early adolescents. This study evaluated a large population in a Latin American hospital and suggested that early adolescents with chronic diseases required many appointments, multiple specialties and hospital admissions. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Job satisfaction and the work situation of physicians: a survey at a German university hospital.

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Laubach, Wilfried; Fischbeck, Sabine

2007-01-01

Job demands and workload of hospital physicians are increasing. The object of this survey was to examine the factors that constitute job satisfaction and to analyse physicians' work situation in the area of in-patient care. 447 physicians at a German University Hospital received questionnaires with regard to work situation, job satisfaction and personal health. Data were analysed by MANOVA and multiple regression models. A first regression model explained 53% of the variance in satisfaction with "work and profession". Among the explanatory variables "superiors and hierarchy" showed the highest beta-weight (beta = -0.49). "Personal health" also determined job satisfaction, for female physicians stronger (beta = -0.31) than for male physicians (beta = -0.11). In a second regression model on satisfaction with "Financial situation" only 18% of the variance was explained, whereby "work condition on the ward", "personal health" and "collaboration between occupational groups" showed the highest beta-weights. Among resident physicians, work conditions, superiors, hierarchy, transparency and participation in decisions are very important variables for job satisfaction. Improvements in these aspects may improve job satisfaction and help to reduce physician shortage in hospitals.

Patterns of Ocular Trauma Presenting to the University Hospital of the West Indies in Jamaica

OpenAIRE

JC Nelson-Imoru; L Mowatt; CA Walters

2014-01-01

Objective: The purpose of this study is to identify the causes of ocular trauma, determine the groups at risk and types of injuries presenting to the Eye Unit at the University Hospital of the West Indies. Method: A prospective observational study was done over a 14-month period on trauma related referrals to the ophthalmology department. A questionnaire was administered and data were collected on the patient’s age, gender, affected eye, aetiology and location of trauma, visual acuity and ...

Evaluation of dizziness at Jordan University Hospital.

Science.gov (United States)

Abdul-Baqi, Khader J; Mohammed, Faisal I; Shubair, Kandil S; Sarhan, Yusef S; Tawalbeh, Mohamed I

2004-05-01

This study was performed prospectively to evaluate the dizzy patients in the Neurotology Outpatient clinic at Jordan University Hospital, Amman, Jordan during the period 1993-2000 and to discuss the prevalence and etiology of dizziness. Data were collected from 108 patients (52 males and 56 females) with a mean age of 45.6-years. Diagnosis was made on the basis of history, physical, otolaryngological and neurological examination and confirmed by relevant investigation including laboratory, radiological and audio vestibular tests. Secure diagnosis were made in 98% of patients (14% had one cause alone and 84% had multiple causes). Cardiovascular disorders accounted for 31.5% of primary and 49% of secondary causes, peripheral vestibular disorders, 25% of primary and 3% of secondary causes, central vestibular disorders 17% of primary and 9% of secondary causes, metabolic endocrine 13% of primary and 38% of secondary causes, cervical osteoarthritis 5.5% of primary and 28% of secondary causes and psychogenic 4.6% of primary and 6.5% of secondary causes. Our findings demonstrate that vertigo is the most common subtype of dizziness (50%). Multiple causes are more prevalent in older age and the single cause is more prevalent in younger age. Cardiovascular was the most common cause of dizziness followed by vestibular disorders, metabolic and cervical osteoarthritis. Vestibular disorders are primary causes and non vestibular are predominantly secondary causes of dizziness. Hyperlipidemia, diabetes and cervical causes are major secondary contributors to dizziness. We recommend a multi disciplinary setting and application of a comprehensive diagnostic and treatment approach without unnecessary protracted investigative scheme and installment of rehabilitation facilities.

Evaluation of dizziness at Jordan University Hospital

International Nuclear Information System (INIS)

Abdul-Baqi, Khader J.; Moamed, Faisal I.; Shubair, Kandil S.; Sarhan, Yusuf S.; Tawalbeh, Mohmed I.

2004-01-01

This study was performed prospectively to the dizzy patients in the Neurotology Outpatient Clinic at Jordan University Hospital, Amman, Jordan during the period 1993-2000 and to discuss the prevalence and and etiology of dizziness. Data were collected from 108 patients (52 male and 56 female) with a mean age of 45.6-years. diagnosis was made on the basis of history, physical, otolarygological and neurological examination and confirmed by relevant investigation including laboratory, radiological and audio vestibular tests. Secure diagnosis was made in 98% of patients (14% had one cause alone and 84% had multiple causes). Cardivascular disorders accounted for 31.5% of primary and 49% of secondary causes, perpheral vestibular disorders, 25% of primary and 3% of secondary causes, central vestibular disorders 17% of primary and 9% of secondary causes, metabolic endocrine 13% of primary and 38% of secondary causes and psychogenic 4.6% of primary and 6.5% of secondary causes.Our findings demonstrate that vertigo is most common subtype of dizziness (50%). Multiple causes are more prevalent in older age and single cause is more prevalent in younger age. Cardiovascular was the most common cause of dizziness followed by vestibular disorders, metabolic and cervical osteoarthritis. Vestibular disorders are primary causes and non vestibular are predominantly secondary causes of dizziness. Hyperlipidemia, diabetes and cervical causes are major secondary contributionsto dizziness. We recommend a a multi disciplinary setting and application of a comprehensive diagnostic and treatment approach without unnecessary protracted investigative schemeand installment of rehabilitatioon facilities. (author)

Nasal Colonization rate of Staphylococcus aureus strains among Health Care Service Employee’s of Teaching University Hospitals in Yazd

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Khalili Mohammad Bagher

2009-10-01

Full Text Available This study was carried out to find the extent of staphylococcal carriages including Methicillin resistant Staphylococcus aureus MRSA in employee's of teaching university hospitals in Yazd. Nasal swabs of 742 employees in four different medical teaching hospitals in Yazd were collected, and tested for detection of staphylococci strains. Out of 742 employees, 94 (12.7% were carrier of staphylococcus aurus and 57 (11.38% for methicillin resistant Staphylococcus aureus (MRSA respectively. Prevalence of Staphylococci aureus and MRSA in individual hospitals and wards were different. In general the highest carriers were personnel of dialysis ward and the lowest pediatrics wards. Resistance rate of MRSA against Ciprofloxacin, Vancomycin, and Rifampin were found to be as 28.1%, 10.5% and 35.1% respectively.

Prevalence of hearing loss among high risk newborns hospitalized in hospitals affiliated to Tehran University of Medical Sciences

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Ali Zamani

2010-04-01

Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: American pediatric Association proposes to screen all neonates with Oto-Acoustic Emission (OAE. In developing countries, because of several limitations, health policy makers recommend to screen only in high risk patients. This study is performed with the aim to screen hearing loss in 950 high risk newborns hospitalized in hospitals affiliated to Tehran University using the OAE test."n"nMethods: A total of 950 neonates hospitalized in the Neonatal and NICU wards of Vali-e-Asr, Shariati, Medical Center and Bahrami Hospitals during the years 2004-2006 who showed at least one risk factor using TEOAE hearing test were enrolled into this cross-sectional descriptive analytical study and were diagnosed with mild deafness and total deafness. Blood exchange due to hyperbillirubinemia, septicemia, congenital heart disease, the fifth minute apgar scores below six, PROM more than six hours, epilepsia, need to NICU more than five hours, pneumonia and Oto-Toxic drugs were considered as risk factors. Data was past medical history, current disease, admission cause, sign & symptoms and complications of disease."n"nResults: Multivariate logistic regression and paired t-test showed that blood exchange, low birth weight and low

Analysis of Nurses’ Organizational Deviant Behaviour: An Example of a University Hospital

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Gamze Bayın

2014-09-01

Full Text Available Organizational deviant behavior is defined as intentionally behavior which is damaging both employees and organization and unsuitable to organization rules, norms, values, expectations and legal regulations.The aim of this study is to determine the level of organizational deviance of nurses, to expose differentiates of this level. according to the descriptive characteristics, to detect the dimensions of organizational deviance and to evaluate the relationship between these dimensions. Population of the study is nurses working at a University Hospital in Ankara. The sample is not selected and tried to reach all the nurses working at this hospital. However, 244 nurses were reached (%48,12. To measure organizational deviance, “Measure of Workplace Deviance Items”which was developed by Bennett and Robinson (2000was used. This scale consists from 15 expressions and 2 dimensions and its’ Cronbach's alpha coefficient was 0,94. As a result of the study, the mean score of nurses’ organizational deviance was found 1.85 ± 0.718. In addition, statistically significant, positive and moderately strong correlation was found between the two dimensions of organizational deviance (R= 0.701 . It can be suggested that health care managers should identify reasons and the ways of preventing of individual deviant behaviour. Thus, managers may prevent behaviour of deviation to the organization.

Contraceptive choices among women attending the fertility research unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto

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Constance E Shehu

2013-01-01

Full Text Available Background: One of the most sensitive and intimate decisions made by any individual or couple is that of fertility control . The knowledge of the factors which influence contraceptive choices may increase its acceptance and uptake. This study determines the choice and reason for contraception among new clients attending the Fertility Research Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto. Materials and Methods: In this prospective study a structured questionnaire was administered to 251 consecutive clients, who attended the Fertility Research Unit of Usmanu Danfodiyo University Teaching Hospital, Sokoto between 1 July 2008 and 31 December 2008. Results: Most (58.2% of the clients were between 21 and 30 years of age. Many (42.6% were grand multipara. Majority (76.9% of the clients were married. The main source of knowledge of contraception and referral (45.8% was the physicians. Child spacing (87.7% was the most common reason given for contraceptive use. Majority (55.8% of the clients chose Implanon and the least preferred method of contraception was the condom (2.0%. Conclusion: Our data shows that the most commonly chosen contraceptive method in the study population was the Implanon. Child spacing was the main reason for seeking family planning while the source of contraceptive knowledge was the physicians.

Equity in health personnel financing after Universal Coverage: evidence from Thai Ministry of Public Health's hospitals from 2008-2012.

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Ruangratanatrai, Wilailuk; Lertmaharit, Somrat; Hanvoravongchai, Piya

2015-07-18

Shortage and maldistribution of the health workforce is a major problem in the Thai health system. The expansion of healthcare access to achieve universal health coverage placed additional demand on the health system especially on the health workers in the public sector who are the major providers of health services. At the same time, the reform in hospital payment methods resulted in a lower share of funding from the government budgetary system and higher share of revenue from health insurance. This allowed public hospitals more flexibility in hiring additional staff. Financial measures and incentives such as special allowances for non-private practice and additional payments for remote staff have been implemented to attract and retain them. To understand the distributional effect of such change in health workforce financing, this study evaluates the equity in health workforce financing for 838 hospitals under the Ministry of Public Health across all 75 provinces from 2008-2012. Data were collected from routine reports of public hospital financing from the Ministry of Public Health with specific identification on health workforce spending. The components and sources of health workforce financing were descriptively analysed based on the geographic location of the hospitals, their size and the core hospital functions. Inequalities in health workforce financing across provinces were assessed. We calculated the Gini coefficient and concentration index to explore horizontal and vertical inequity in the public sector health workforce financing in Thailand. Separate analyses were carried out for funding from government budget and funding from hospital revenue to understand the difference between the two financial sources. Health workforce financing accounted for about half of all hospital non-capital expenses in 2012, about a 30 % increase from the level of spending in 2008. Almost one third of the workforce financing came from hospital revenue, an increase from only one

[Evaluation of fundus autofluorescence in hereditary retinal diseases using Heidelberg Retina Angiograph2].

Science.gov (United States)

Côco, Monique; Baba, Natalia Tamie; Sallum, Juliana Maria Ferraz

2007-01-01

To define characteristics of the fundus autofluorescence examination, verifying usefulness in the diagnosis and care of hereditary retinal diseases. 28 patients, adults, divided equally into four groups with diagnoses of Stargardt macular dystrophy, cone dystrophy, retinitis pigmentosa and healthy volunteers for the establishment of the normality pattern. An average of nine images with the filter for fluorescein angiography was obtained for the formation of the image autofluorescence using Heidelberg Retina Angiograph2. The images of each group of patients were analyzed to verify common characteristics. The fundus autofluorescence of healthy volunteers showed the foveal area darker than the surrounding retina. The images of Stargardt macular dystrophy, in general, presented an oval central lesion, with reduced autofluorescence. The main alterations of the autofluorescence in patients with cone dystrophy were reduced foveal autofluorescence with a parafoveal ring of increased autofluorescence. In general, the images of retinitis pigmentosa showed outlying pigments with reduced autofluorescence, and of the foveal area, in some cases disorganization or reduced autofluorescence. The study showed the existence of patterns of fundus autofluorescence in the hereditary retinal diseases that allow the diagnosis and better interpretation of the pathogenesis of these diseases.

Evaluation of Patients Visiting the Dermatology Emergency Unit of a University Dermatology Hospital in Tehran, Iran.

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Abedini, Robabeh; Matinfar, Amin; Sasani, Pardis; Salehi, Anahita; Daneshpazhooh, Maryam

2017-11-01

Published studies on dermatological emergencies are limited in the literature. To our knowledge, no study has previously explored this subject in Iran. Our aim was to ascertain the characteristics of patients visiting the dermatologic emergency (DE) unit of a university skin hospital in Tehran, Iran. We studied the files of all the patients seen in the DE unit over a 3-month period, collecting data on age, sex, referral mode, duration of consultation, status (true emergency or non-emergency), and diagnosis. A total of 2539 patients were evaluated; 53% of them were female. Infection and infestation (41.9%), urticaria (16.7%), and dermatitis (13.2%) were the most prevalent entities. Almost 1% of the patients were referred by another physician and psoriasis was their most frequent diagnosis. Almost 2.6% of the patients were hospitalized; psoriasis was once again the most frequent cause. The hospitalization rate was significantly higher in referred patients (Pdermatologic disorders. This data could also help in tailoring the educational curriculum for medical students more appropriately in order to increase their knowledge of the most prevalent skin disorders.

The Effect of Service Compact (SERVICOM on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

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Jude Kennedy Emejulu

2014-12-01

Full Text Available This study examined the effect of service compact (Servicom Service delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that required re-evaluation and attention based on the submissions of every service unit and department, after an analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT of each of the service areas. A pre-SERVICOM Charter workshop which was supervised by the Federal Government was held in the various institutions nationwide to enable care providers enumerate their current service capacity and identify their impediments. In the light of the foregoing, some of the recommendations proffered are that the SERVICOM Charter project should be sustained and supervision and control of the SERVICOM Charter project should be intensified in order to ensure that the Nigerian factor of service-fatigue would not supervene in care delivery in the near future.

Effectiveness of a simplified cardiopulmonary resuscitation training program for the non-medical staff of a university hospital.

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Hirose, Tomoya; Iwami, Taku; Ogura, Hiroshi; Matsumoto, Hisatake; Sakai, Tomohiko; Yamamoto, Kouji; Mano, Toshiaki; Fujino, Yuji; Shimazu, Takeshi

2014-05-10

The 2010 Consensus on Science and Treatment Recommendations Statement recommended that short video/computer self-instruction courses, with minimal or no instructor coaching, combined with hands-on practice can be considered an effective alternative to instructor-led basic life support courses. The purpose of this study was to examine the effectiveness of a simplified cardiopulmonary resuscitation (CPR) training program for non-medical staff working at a university hospital. Before and immediately after a 45-min CPR training program consisting of instruction on chest compression and automated external defibrillator (AED) use with a personal training manikin, CPR skills were automatically recorded and evaluated. Participants' attitudes towards CPR were evaluated by a questionnaire survey. From September 2011 through March 2013, 161 participants attended the program. We evaluated chest compression technique in 109 of these participants. The number of chest compressions delivered after the program versus that before was significantly greater (110.8 ± 13.0/min vs 94.2 ± 27.4/min, p CPR training program on chest compression and AED use improved CPR quality and the attitude towards CPR and AED use of non-medical staff of a university hospital.

Hotel-based ambulatory care for complex cancer patients: a review of the University College London Hospital experience.

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Sive, Jonathan; Ardeshna, Kirit M; Cheesman, Simon; le Grange, Franel; Morris, Stephen; Nicholas, Claire; Peggs, Karl; Statham, Paula; Goldstone, Anthony H

2012-12-01

Since 2005, University College London Hospital (UCLH) has operated a hotel-based Ambulatory Care Unit (ACU) for hematology and oncology patients requiring intensive chemotherapy regimens and hematopoietic stem cell transplants. Between January 2005 and 2011 there were 1443 patient episodes, totaling 9126 patient days, with increasing use over the 6-year period. These were predominantly for hematological malignancy (82%) and sarcoma (17%). Median length of stay was 5 days (range 1-42), varying according to treatment. Clinical review and treatment was provided in the ACU, with patients staying in a local hotel at the hospital's expense. Admission to the inpatient ward was arranged as required, and there was close liaison with the inpatient team to preempt emergency admissions. Of the 523 unscheduled admissions, 87% occurred during working hours. An ACU/hotel-based treatment model can be safely used for a wide variety of cancers and treatments, expanding hospital treatment capacity, and freeing up inpatient beds for those patients requiring them.

Parapneumonic pleural effusion: reality and strategies in an Amazon university hospital

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CLAUDIA GISELLE SANTOS ARÊAS

Full Text Available ABSTRACT Objective: to define the profile and analyze the postoperative evolution of children with parapneumonic pleural effusion (PPE, and to evaluate strategies used in the presence of diagnostic and therapeutic limitations, emphasizing the open thoracic drainage (OTD . Methods: we conducted a cross-sectional, prospective, analytical study in which we followed children admitted in an Amazon university hospital with surgically addressed PPE, from October 2010 to October 2011. Results: we studied 46 patients, most children under three years of age (74%, with no gender predominance. A significant portion of the sample (28% had inappropriate body mass index. We found short stature in five patients (11%, which tended, in general, to a worst postoperative outcome when compared with children of normal height (p=0.039. The average duration of symptoms till admission was 16.9 days. Empyema was a common diagnosis in the first surgery (47.8%, and its bearers had longer duration of chest tube drainage (p=0.015. Most children (80.4% were operated only once. The mean length of hospital stay was 25.9 days. Thoracic drainage (water-sealed was the most common procedure (85%, with conversion to OTD in 24% of the sample, thoracotomy being rare (4%. There were no deaths. Conclusion: the studied individuals often had advanced disease and nutritional disorders, affecting outcome. OTD remains a valid option for specific situations, and further studies are needed for confirmation.

A biblioterapia na humanização da assistência hospitalar do Hospital Universitário da Universidade Federal de Santa Catarina – HU/UFSC/Bibliotherapy for the hospital care humanization in the university hospital of Santa Catarina Federal University – HU/UFSC

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Eva Seitz

2008-01-01

Full Text Available Este artigo tem por finalidade apresentar resultados do estudo realizado com pacientes, acompanhantes e funcionários das Unidades de Internação Cirúrgica do Hospital Universitário da Universidade Federal de Santa Catarina (UIC/HU/UFSC. O foco central foi o de verificar até que ponto a prática biblioterapêutica e as atividades de lazer contribuem no processo de Humanização da Assistência Hospitalar dos pacientes internados nas (UIC/HU/UFSC, na percepção dos pacientes, acompanhantes, funcionários da enfermagem e assistentes sociais da referida unidade de internação. Foram entrevistados 16 pacientes, 11 acompanhantes e 13 funcionários da enfermagem e assistentes sociais. As atividades de lazer analisadas neste estudo foram a prática biblioterapêutica, as atividades do grupo Reaja e a dança. Trata-se de uma pesquisa quantitativa e qualitativa. Quanto ao procedimento técnico, a presente pesquisa é classificada como estudo de caso, no qual, utilizou-se, para a coleta dos dados a entrevista estruturada e, cujos resultados demonstram que as atividades contribuem muito na Humanização da Assistência Hospitalar dos pacientes internados na UIC/HU/UFSC. This article has for purpose to present resulted of the study carried through with patients, companions and employees of the Units of Surgical Internment of the University Hospital of the Federal University of Santa Catarina (UIC/HU/UFSC. The central focus was to verify until point the practical library-therapy and the activities of leisure contribute in the process of Humanization of the Hospital Assistance of the patients interned in (UIC/HU/UFSC, in the perception of the patients, companions, employees of the nursing and social assistants of the related unit of internment. 16 patients, 11 companions and 13 social employees of the nursing and assistants had been interviewed. The analyzed activities of leisure in this study had been the practical library-therapy, the activities of

Prospective Audit of Colonoscopy Practice in a Lebanese University Hospital

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Rita Slim

2008-01-01

Full Text Available Background Colonoscopy has a great impact on diagnosis and management of the diseases of the colon. In general it's a safe and accurate procedure. No evaluation has been done of any endoscopic practices in a country where the practice of medicine is totally private. Objectives Prospective audit of technical success and complication rates of both therapeutic and diagnostic colonoscopy. Setting One endoscopy unit of a Lebanese university hospital. Patients and design 407 consecutive colonoscopies were evaluated over a 6-month period. Data were recorded for age and sex of the patients, indication of the colonoscopy, presence of comorbidities, patients risk stratification, administrated dose of anesthetic drugs. Data concerning the procedure itself were also monitored. Intervention Completion rate as well as complications reported during or post colonoscopy. All patients were called back by phone 48 hours and 1 month later to identify any related post-procedural complication. Results 407 patients underwent colonoscopy. All patients were sedated with midazolam, propofol and fentanyl. The overall caecal intubation rate was 99.99%. 70 snare polypectomies and 29 cold forceps excision were performed as well as 5 coagulations with Argon Plasma Coagulation. The most important post-procedural complication was chemical colitis in 2 cases. Limitations Patients and endoscopists satisfaction was not evaluated. It's an audit of a single tertiary French affiliated hospital. It does not necessarily reflect what's really happening on a national level. Conclusion This audit enabled us to change some of our practices; i.e. rinsing method of endoscopes. It stimulated the team to keep a high performance level without neglecting the risk of potential complications.

Culture-Based Methods and Molecular Tools for Azole-Resistant Aspergillus fumigatus Detection in a Belgian University Hospital

OpenAIRE

Montesinos, I.; Argudín, M. A.; Hites, M.; Ahajjam, F.; Dodémont, M.; Dagyaran, C.; Bakkali, M.; Etienne, I.; Jacobs, F.; Knoop, C.; Patteet, S.; Lagrou, K.

2017-01-01

Azole-resistant Aspergillus fumigatus is an increasing worldwide problem with major clinical implications. Surveillance is warranted to guide clinicians to provide optimal treatment to patients. To investigate azole resistance in clinical Aspergillus isolates in our institution, a Belgian university hospital, we conducted a laboratory-based surveillance between June 2015 and October 2016. Two different approaches were used: a prospective culture-based surveillance using VIPcheck on unselected...

Bacteriospermia and Sperm Quality in Infertile Male Patient at University of Benin Teaching Hospital, Benin City, Nigeria

OpenAIRE

Ibadin, O. K.; Ibeh, I. N.

2008-01-01

Male Urogenital tract infection plays an important role in men infertility. Asymptomtic bacteriospermia has been regarded as of the contributing factor to male infertility. In this study, 87 semen samples of infertile men attending the Human Reproduction Research Programme and Invitrofertilization unit (HRRP/IVF) of University Benin Teaching Hospital were evaluated Bacteriologically using standard Bacterial culture method. Standard semen analysis was performed according to WHO guidelines. Amo...

Oral care for patients with head and neck cancer in Hokkaido University Hospital

International Nuclear Information System (INIS)

Hata, Hironobu; Yamazaki, Yutaka; Imamachi, Kenji

2011-01-01

We have been providing oral care for patients with head and neck cancer in Hokkaido University Hospital since 2007. In this paper, we report clinical statistics of the 254 head and neck cancer patients who received oral care. About 80 percent of these patients were treated with radiation therapy, so it is important to cope with adverse events related to such therapy. Oral care is helpful for cancer patients when it is started as soon as possible (at least 1 week before radiation therapy is started). The percentage of patients who could start oral care 4 days before radiation therapy gradually increased to about 60 percent by fiscal 2009. In fiscal 2010, the percentage decreased to its lowest level of 37.9 percent. To start oral care for all patients 7 days before irradiation, we are going to change our system and start oral care in the outpatient period. In their hometowns, oral care was continued for only 19 (27.0 percent) of the 74 patients who could not visit our hospital. An important task for our project is to establish a medical cooperation system for discharged patients treated for head and neck cancer. (author)

Screening program for prostate cancer at a university hospital in eastern Saudi Arabia

International Nuclear Information System (INIS)

Taha, Saud A.; Kamal, Baher A.

2005-01-01

Implementation of a pilot screening program for prostate cancer among Saudi patients that would serve as a nucleus for a Kingdom-wide screening program. A prospective study on 1,213 Saudi males between 50-80 years of age who attended the Outpatient Department at King Fahd Hospital of King Faisal University, Al-Khobar, Kingdom of Saudi Arabia during a period of 18 months (April 2001-October 2002). They were included at random from different clinics including the urology clinic. Free and total prostate specific antigen (PSA) and digital rectal examination (DRE) of the prostate were performed in all patients. Patients with abnormal DRE or PSA were scheduled for transrectal ultrasound (TRUS) and ultrasound guided biopsy of the prostate. Abnormal DRE or PSA were present in 84 out of 1,213 patients. Only 63 patients agreed to have TRUS and ultrasound guided biopsies. Prostate cancer was confirmed in 14 out of 1,192 patients who completed the study (1.17%). The incidence of prostate cancer among Saudi men in this hospital based study is low. A population based screening for prostate cancer may reveal the incidence of this disease. (author)

Maternal mortality at Nnamdi Azikiwe University Teaching Hospital, Southeast Nigeria: a 10-year review (2003–2012

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Obiechina NJ

2013-07-01

Full Text Available NJ Obiechina, VE Okolie, ZC Okechukwu, CF Oguejiofor, OI Udegbunam, LSA Nwajiaku, C Ogbuokiri, R Egeonu Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria Background: Maternal mortality is high the world over, especially in sub-Saharan Africa, including Nigeria. Nigeria has consistently demonstrated one of the most abysmally poor reproductive health indices in the world, maternal mortality inclusive. This is a sad reminder that, unless things are better organized, Southeast Nigeria, which Nnamdi Azikiwe University Teaching Hospital (NAUTH represents, may not join other parts of the world in attaining Millennium Development Goal 5 to improve maternal health in 2015. Objectives: This study was conducted to assess NAUTH'S progress in achieving a 75% reduction in the maternal mortality ratio (MMR and to identify the major causes of maternal mortality. Materials and methods: This was a 10-year retrospective study, conducted between January 1, 2003 and December 31, 2012 at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Southeast Nigeria. Results: During the study period, there were 8,022 live births and 103 maternal deaths, giving an MMR of 1,284/100,000 live births. The MMR was 1,709 in 2003, reducing to 1,115 in 2012. This is to say that there was a 24.86% reduction over 10 years, hence, in 15 years, the reduction should be 37%. This extrapolated reduction over 15 years is about 38% less than the target of 75% reduction. The major direct causes of maternal mortality in this study were: pre-eclampsia/eclampsia (27%, hemorrhage (22%, and sepsis (12%. The indirect causes were: anemia, anesthesia, and HIV encephalopathy. Most of the maternal deaths occurred in unbooked patients (98% and within the first 48 hours of admission (76%. Conclusion: MMRs in NAUTH are still very high and the rate of reduction is very slow. At this rate, it will take this health facility 30 years, instead of 15 years, to

Characterisation, dissemination and persistence of gentamicin resistant Escherichia coli from a Danish university hospital to the waste water environment

DEFF Research Database (Denmark)

Jakobsen, Lotte; Sandvang, Dorthe; Hansen, Lars H

2008-01-01

The aim of the study was to investigate the potential spread of gentamicin resistant (GEN(R)) Escherichia coli isolates or GEN(R) determinants from a Danish university hospital to the waste water environment. Waste water samples were collected monthly from the outlets of the hospital bed wards...... (aac(3)-II, aac(3)-IV, ant(2'')-I, armA), phenotypic resistance pattern, and virulence genes (hlyA, chuA, sfaS, fogG, malX, traT, iutA, fyuA, iroN, cnf1) to investigate if the hospital and waste water could be reservoirs of antimicrobial resistance and virulence. The ability for GEN(R) determinants......, indicating a potential spread of the gene from patient isolates to waste water isolates. Regardless of origin, most isolates exhibited multi-resistance and contained several virulence genes. In conclusion, our study showed a possible spread of aac(3)-II from the hospital to the waste water. Most of the GEN...

Geographic variations in avoidable hospitalizations in the elderly, in a health system with universal coverage

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Alberquilla Angel

2008-02-01

Full Text Available Abstract Background The study of Hospitalizations for ambulatory care sensitive conditions (ACSH has been proposed as an indirect measure of access to and receipt of care by older persons at the entryway to the Spanish public health system. The aim of this work is to identify the rates of ACSH in persons 65 years or older living in different small-areas of the Community of Madrid (CM and to detect possible differences in ACSH. Methods Cross-sectional, ecologic study, which covered all 34 health districts of the CM. The study population consisted of all individuals aged 65 years or older residing in the CM between 2001 and 2003, inclusive. Using hospital discharge data, avoidable ACSH were selected from the list of conditions validated for Spain. Age- and sex-adjusted ACSH rates were calculated for the population of each health district and the statistics describing the data variability. Point graphs and maps were designed to represent the ACSH rates in the different health districts. Results Of all the hospitalizations, 16.5% (64,409 were ACSH. Globally, the rate was higher among men: 33.15 per 1,000 populations vs. 22.10 in women and these differences were statistically significant (p Conclusion A significant variation is demonstrated in "preventable" hospitalizations between the different districts. In all the districts the men present rates significantly higher than women. Important variations in the access are observed the Primary Attention in spite of existing a universal sanitary cover.

Does medicine still show an unresolved discrimination against women? Experience in two European university hospitals.

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Santamaría, A; Merino, A; Viñas, O; Arrizabalaga, P

2009-02-01

Have invisible barriers for women been broken in 2007, or do we still have to break through medicine's glass ceiling? Data from two of the most prestigious university hospitals in Barcelona with 700-800 beds, Hospital Clínic (HC) and Hospital de la Santa Creu i Sant Pau (HSCSP) address this issue. In the HSCSP, 87% of the department chairs are men and 85% of the department unit chiefs are also men. With respect to women, only 5 (13%) are in the top position (department chair) and 4 (15%) are department unit chiefs. Similar statistics are also found at the HC: 87% of the department chairs and 89% of the department unit chiefs are men. Currently, only 6 women (13%) are in the top position and 6 (11%) are department unit chiefs. Analysis of the 2002 data of internal promotions in HC showed that for the first level (senior specialist) sex distribution was similar. Nevertheless, for the second level (consultant) only 25% were women, and for the top level (senior consultant) only 8% were women. These proportions have not changed in 2007 in spite of a 10% increase in leadership positions during this period. Similar proportions were found in HSCSP where 68% of the top promotions were held by men. The data obtained from these two different medical institutions in Barcelona are probably representative of other hospitals in Spain. It would be ethically desirable to have males and females in leadership positions in the medical profession.

[Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

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Kawanishi, Chiaki

2016-01-01

In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate

Assessment of Service Quality in Teaching Hospitals of Yazd University of Medical Sciences: Using Multi-criteria Decision Making Techniques.

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Shafii, Milad; Rafiei, Sima; Abooee, Fatemeh; Bahrami, Mohammad Amin; Nouhi, Mojtaba; Lotfi, Farhad; Khanjankhani, Khatere

2016-08-01

Hospitals as integrated parts of the wide-ranging health care systems have dominant focus on health care provision to meet, maintain and promote people's health needs of a community. This study aimed to assess the service quality of teaching hospitals of Yazd University of Medical Sciences using Fuzzy Analytical Hierarchy Process (FAHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). A literature review and a qualitative method were used to obtain experts' viewpoints about the quality dimensions of hospital services to design a questionnaire. Then, using a self-made questionnaire, perceptions of 300 patients about the quality of delivered services were gathered. Finally, FAHP was applied to weigh each quality dimension and TOPSIS method to rank hospital wards. Six dimensions including responsiveness, assurance, security, tangibles, health communication and Patient orientation were identified as affecting aspects of hospital services quality among which, security and tangibles got the highest and lowest importance respectively (0.25406, 0.06883). Findings also revealed that in hospital A, orthopedics and ophthalmology wards obtained the highest score in terms of quality while cardiology department got the lowest ranking (0.954, 0.323). In hospital B, the highest and the lowest ranking was belonged to cardiology and surgical wards (0.895, 0.00) while in hospital C, surgical units were rated higher than internal wards (0.959, 0.851). Findings emphasized that the security dimension got the lowest ranking among SERVQUAL facets in studied hospitals. This requires hospital executives to pay special attention to the issue of patients' security and plan effectively for its promotion.

[Part-time concepts in anaesthesia -example of a department of anaesthesiology at a university hospital in Germany].

Science.gov (United States)

Höltje, Maike; Osthaus, W Alexander; Koppert, Wolfgang

2015-05-01

Part-time work concepts are requested for different reasons from an increasing number of employees. Despite this fact there are no systematic part-time work concepts published in the German literature, especially for physicians working in hospitals. This article describes background and circumstances of a part-time work concept which was established two years ago in a department of anaesthesiology at a university hospital in Germany. This concept considers needs of young families as well as older employees. We are convinced that a transparent part-time work concept is a good argument for job-seeking physicians when deciding for an employer. The benefit for the already employed colleagues has at least the same value. © Georg Thieme Verlag Stuttgart · New York.

Involvement and emancipation of the worker. Action research in a university hospital.

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Bolis, Ivan; Brunoro, Claudio; Sznelwar, Laerte Idal

2012-01-01

The present action research article is linked to an ergonomics project in a university hospital. The author's proposal is to focus action on the effective worker involvement required for the creation of spaces/mechanisms within organizations where people can enhance cooperation and deliberation on matters relating to work. For this purpose, a committee was introduced to assist in finding problems and solutions directly in work situations, so that workers could experience relative autonomy allowing them to develop procedures and choose tools appropriate to their own real needs. Based on this organizational implementation and on subsequent interviews, the practical results are analyzed and related to employee involvement. One can conclude that workers in all areas of the organization can be active elements for improving working conditions and productivity in companies.

Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

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Rosenberg, Christian; Kroos, Kristin; Rosenberg, Britta; Hosten, Norbert; Flessa, Steffen

2013-08-01

Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.

Physical hazard safety awareness among healthcare workers in Tanta university hospitals, Egypt.

Science.gov (United States)

El-Sallamy, Rania M; Kabbash, Ibrahim Ali; El-Fatah, Sanaa Abd; El-Feky, Asmaa

2017-05-17

Hospital workers are exposed to many occupational hazards that may threaten their health and safety. Physical hazards encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. To assess the awareness of healthcare workers (HCWs) about physical hazards in Tanta university hospitals, this cross-sectional study included 401 HCWs (physicians, nurses, technicians, and workers) from seven departments (general surgery, orthopedics, radiology, ophthalmology, kitchen, incinerator, and laundry). Data were collected through interview questionnaire to assess six types of physical hazards (noise, electric hazards, temperature, radiation, fire, and lighting,). Most of the physicians (63.7%) were aware of the level of noise. All physicians, nurses, technicians, and majority of workers reported that hearing protective devices were not available, and all HCWs reported that periodic hearing examination was not performed. Most of the nurses (75.2%) and workers (68.5%) did not attended emergency training, and more than two thirds of all HCWs were not briefed about emergency evacuation. Most HCWs were not given appropriate radiation safety training before starting work (88% of workers, 73.7% of nurses, 65.7% of physicians, and 68.3% of technicians). The majority of physicians, nurses, and technicians (70.5, 65.4, and 53.7%) denied regular environmental monitoring for radiation level inside work place. Health education programs on health and safety issues regarding physical hazards should be mandatory to all healthcare workers to improve their awareness and protect them from undue exposures they may face due to lack of adequate awareness and knowledge. There is urgent need of expanding the occupational healthcare services in Egypt to cover all the employees as indicated by the international recommendations and the Egyptian Constitution, legislation, and community necessity.

[Assessing research productivity in Department of Internal Medicine, University of Zagreb, School of Medicine and University Hospital Centre Zagreb].

Science.gov (United States)

Petrak, Jelka; Sember, Marijan; Granić, Davorka

2012-01-01

Bibliometric analysis may give an objective information about publishing activity, citation rate and collaboration patterns of individuals, groups and institutions. The publication productivity of the present medical staff (79 with specialist degree and 22 residents) in Department of Internal Medicine, University of Zagreb School of Medicine in University Hospital Centre Zagreb was measured by the number of papers indexed by Medline, their impact was measured by the number of times these papers had subsequently been cited in the medical literature, while the collaboration pattern was estimated by the authors' addresses listed in the papers. PubMed database was a source for verifying the bibliographic data, and the citation data were searched via Thomson Web of Scence (WoS) platform. There were a total of 1182 papers, published from 1974 to date. The number of papers per author ranged from 0 to 252. Sixty of papers were published in English, and 39% in Croatian language. The roughly equal share was published in local and foreign journals. The RCT studies and practice guidelines were among the most cited papers and were at the same time published by the highly ranked journals. The collaboration analysis confirmed the extensive involment in the international multicentric clinical trials as well as in the development of international/local practice guidelines.

Questionnaire survey of working relationships between nurses and doctors in University Teaching Hospitals in Southern Nigeria

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Adebamowo Clement A

2006-02-01

Full Text Available Abstract Background Smooth working relationships between nurses and doctors are necessary for efficient health care delivery. However, previous studies have shown that this is often absent with negative impact on the quality of health care delivery. In 2002, we studied factors that affect nurse-doctor working relationships in University Teaching Hospitals (UTH in Southern Nigeria in order to characterize it and identify managerial and training needs that might be used to improve it. Method Questionnaire survey of doctors and nurses working in four UTH in Southern Nigeria was done in 2002. The setting and subjects were selected by random sampling procedures. Information on factors in domains of work, union activities, personnel and hospital management were studied using closed and open-ended questionnaires. Results Nurse-doctor working relationships were statistically significantly affected by poor after-work social interaction, staff shortages, activist unionism, disregard for one's profession, and hospital management and government policies. In general, nurses had better opinion of doctors' work than doctors had about nurses' work. Conclusion Working relationships between doctors and nurses need to be improved through improved training and better working conditions, creation of better working environment, use of alternative methods of conflict resolution and balanced hospital management and government policies. This will improve the retention of staff, job satisfaction and efficiency of health care delivery in Nigeria.

Outcomes from the first mouth cancer awareness and clinical check-up day in the Dublin Dental University Hospital.

LENUS (Irish Health Repository)

MacCarthy, Denise

2012-04-01

To increase public awareness about mouth cancer, the Dublin Dental University Hospital (DDUH) hosted an awareness day and free mouth check-up in September 2010. The messages of information, self-examination and risk management, and the importance of early detection, were available to all attendees. The role of general dental and medical practitioners in examination of the mouth was stressed.

Integrated Specialized Early-Course Psychosis Treatment Services - University Psychiatric Hospital Vrapce Model.

Science.gov (United States)

Ostojić, DraŽenka; Čulo, Ilaria; Silić, Ante; Kos, Suzana; Savić, Aleksandar

2018-06-01

First episode of psychosis presents a critical period in terms of numerous associated risks, but also possibilities for effective therapeutic interventions. There is a continued focus on early interventions in prodromal states and early course of frank psychosis, aimed at ensuring faster remission, reducing relapses, achieving better long-term functioning, and preventing adverse outcomes linked to untreated psychosis and chronic psychotic disorders. A number of different specialized treatment models and services exist trying to close knowledge gaps and provide clinical interventions to first-episode psychosis (FEP) patients, but there is still no generally accepted standard of care informing our every-day practice. FEP and early-course psychosis specialized treatment model developed in 2004 in University Psychiatric Hospital Vrapce rests on integration of care across different organization units and clinical presentation acuity levels and patient needs (intensive care, FEP inpatient unit, FEP outpatient services including day hospital). Such integration of FEP services allows for flexible entry point on multiple levels, earlier structuring of therapeutic alliance for those requiring inpatient care, reduction of risks associated with FEP, quicker formation of long-term treatment plans, reduction of delay in accessing specialized services, and a more coordinated diagnostic process and recruitment of FEP patient population. Detailed evaluations of outcomes and comparisons with different treatment models are necessary in order to assess strengths and weaknesses of each specific model and inform modifications to current practice models.

[Evaluation of the activity of a urological emergency unit in university hospital].

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Martin, L; Pillot, P; Bardonnaud, N; Lillaz, J; Chabannes, E; Bernardini, S; Guichard, G; Bittard, H; Kleinclauss, F

2014-01-01

To determine the epidemiology of urological emergencies in a university hospital and the interest of a dedicated urological emergency unit. In 2008, a dedicated urological emergency unit was individualized in our department of urology. We conducted a retrospective study including all patients consulting in this unit in 2009 with epidemiological, clinical and therapeutic data. During 2009, 1257 patients consulted in this unit. Main diagnoses were acute urinary retention (303, 24.11%), renal colic (219, 17.42%), urinary infections (278, 22.11%), postoperative complications (141, 11.22%), symptomatic benign prostate hyperplasia (65, 5.17%), genitourinary cancers (61, 4.85%), trauma of urinary apparel (41, 3.26%), and spermatic cords torsion (10, 0.8%). In 99 cases (7.88%) diagnosis did not involved the urinary system. The treatment was surgical in 213 (17.7%) cases, technical procedure under local anesthesia in 368 (29.3%) and a medical treatment in 675 (53.7%) cases. Six hundred and sixty (52.5%) patients were managed ambulatory whereas 596 (47.5%) needed hospitalization. The opening of a dedicated urological emergency unit lead to 1257 emergency consultations. Frequent etiologies were acute urinary retention, renal colic and urinary infection. The creation of this unit allowed to register and to valorize this emergency activity through the ATU emergency amount. Copyright © 2013. Published by Elsevier Masson SAS.

Nursing care documentation practice: The unfinished task of nursing care in the University of Gondar Hospital.

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