Sample records for jefferson university hospital

  1. 1. Title Sheet Jefferson's Academical Village, Bounded by University ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Title Sheet - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  2. Jefferson's Academical Village, Bounded by University Avenue on the north, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  3. Window Details U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Window Details - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  4. Landscape Plan U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Landscape Plan - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  5. First Floor Plan U.S. Veterans Hospital, Jefferson Barracks, Therapeutic ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  6. North and South Elevations U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    North and South Elevations - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  7. Southwest corner, looking north U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Southwest corner, looking north - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  8. North wall, looking southeast U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    North wall, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  9. Basement, bathroom, looking south U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Basement, bathroom, looking south - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  10. Northeast corner, looking southwest U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Northeast corner, looking southwest - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  11. Interior, rear sunporch, looking north U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, rear sunporch, looking north - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  12. South (front) wall, looking northwest U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    South (front) wall, looking northwest - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  13. Interior, east bedroom, looking southeast U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, east bedroom, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  14. Interior, living room, looking west U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, living room, looking west - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  15. Interior, dining room, looking southeast U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, dining room, looking southeast - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  16. Southeast corner, looking northwest U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Southeast corner, looking northwest - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  17. West wall, looking northeast U.S. Veterans Hospital, Jefferson Barracks, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West wall, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  18. Ground Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Ground Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  19. Ground Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Ground Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  20. First Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  1. First Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    First Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  2. Second Floor Plan (Section A) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Second Floor Plan (Section A) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  3. Second Floor Plan (Section B) U.S. Veterans Hospital, Jefferson ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Second Floor Plan (Section B) - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  4. U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  5. 2. 1827 Landscape Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. 1827 Landscape Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  6. 14. 2013 Landscape Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. 2013 Landscape Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  7. 5. 1880 Landscape Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. 1880 Landscape Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  8. 11. 1981 Landscape Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. 1981 Landscape Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  9. 7. 1914 Landscape Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. 1914 Landscape Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  10. 9. 1947 Landscape Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. 1947 Landscape Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  11. 3. 1860 Landscape Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. 1860 Landscape Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  12. 8. 1914 Tree Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. 1914 Tree Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  13. 6. 1880 Tree Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. 1880 Tree Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  14. 4. 1860 Tree Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. 1860 Tree Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  15. 10. 1947 Tree Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. 1947 Tree Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

  16. 12. 1981 Tree Plan Jefferson's Academical Village, Bounded by ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. 1981 Tree Plan - Jefferson's Academical Village, Bounded by University Avenue on the north, Jefferson Park Avenue on the south, Hospital Drive on the east, and McCormick Road on the west, Charlottesville, Independent City, VA

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

    PubMed

    Rees, Tom

    2002-01-01

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

  18. Strategic acquisitions by academic medical centers: the Jefferson experience as operational paradigm.

    PubMed

    Schwartz, G F; Stone, C T

    1991-01-01

    As capital investments in the health care industry have changed in popularity, mergers and acquisitions of and by hospitals have created supersystems of health care that are based on the assumption that economies of scale offer greater protection from a variety of forces. The acquisition of West Park (Jefferson Park) Hospital by Thomas Jefferson University and the infusion of Jefferson management into Methodist Hospital have provided the institution with unique opportunities to broaden its population base for acute care admissions and to permit greater diversification within the entire health care market.

  19. Thomas Jefferson's Plan for the University of Virginia: Lessons from the Lawn. Teaching with Historic Places.

    ERIC Educational Resources Information Center

    Hughes, Mary; Wilson, Sara

    This lesson is based on the National Register of Historic Places registration file, "University of Virginia Historic District," and other primary and secondary materials about Thomas Jefferson and the ctreation of the University of Virginia. Thomas Jefferson did not begin the effort of designing the University of Virginia…

  20. Teaching Jefferson

    ERIC Educational Resources Information Center

    Smith, Mark A.

    2009-01-01

    Thomas Jefferson has long fascinated Americans. Even though Jefferson biographer Merrill Peterson once termed Jefferson "impenetrable," a host of recent scholars have tried to penetrate the "inner Jefferson" in an attempt to make him "more vital to people." Trying to understand Jefferson, one could argue, is akin to trying to understand America,…

  1. Security Station and Front Entrance to hospital property, looking northeast ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Security Station and Front Entrance to hospital property, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Security Station & Front Gate, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  2. Is Jefferson a Founding Father of Democratic Education? A Response to "Jefferson and the Ideology of Democratic Schooling"

    ERIC Educational Resources Information Center

    Neem, Johann

    2013-01-01

    This response argues that it is reasonable to consider Thomas Jefferson a proponent of democratic education. It suggests that Jefferson's education proposals sought to ensure the wide distribution of knowledge and that Jefferson's legacy remains important to us today.

  3. Interior, food processing room, looking northeast U.S. Veterans Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, food processing room, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Kitchen, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  4. Building Sections and Detailed Wall Sections U.S. Veterans Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Building Sections and Detailed Wall Sections - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  5. [Emergency eye care in French university hospitals].

    PubMed

    Bourges, J-L

    2018-03-01

    The patient's request for urgent care in ophthalmology (PRUCO) at health care centers is constantly growing. In France, university hospitals are managing 75% of these cases. We sought to quantify PRUCO referred to French university hospital emergency units as well as to approach the structure and the territorial distribution of emergency eye care provided by French university hospitals. We conducted a quick cross-sectional survey sent to the 32 metropolitan and overseas French university hospitals. It inquired for each hospital whether emergency eye care units were available, whether ophthalmologists were on duty or on call overnight and how many PRUCO were managed in 2016. The 32 university hospitals completed the survey. A total of 398650 PRUCO were managed in French university hospitals in 2016. The emergency unit was exclusively dedicated to eye care for 70% of the hospitals, with 47% (15/32) of them employing an ophthalmologist on duty overnight. Every hospital but one had at least one ophthalmologist on call. The city of Paris set aside, university hospitals took care of an annual mean of 9000 PRUCO (min=500; max=32,250). The 32 French university hospitals are actively responding to patient's requests for urgent care in ophthalmology with very heterogeneous patient volumes and organizational systems. Half of them employ ophthalmologists on duty. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  6. Thomas Jefferson National Accelerator Facility

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Grames, Joseph; Higinbotham, Douglas; Montgomery, Hugh

    The Thomas Jefferson National Accelerator Facility (Jefferson Lab) in Newport News, Virginia, USA, is one of ten national laboratories under the aegis of the Office of Science of the U.S. Department of Energy (DOE). It is managed and operated by Jefferson Science Associates, LLC. The primary facility at Jefferson Lab is the Continuous Electron Beam Accelerator Facility (CEBAF) as shown in an aerial photograph in Figure 1. Jefferson Lab was created in 1984 as CEBAF and started operations for physics in 1995. The accelerator uses superconducting radio-frequency (srf) techniques to generate high-quality beams of electrons with high-intensity, well-controlled polarization. Themore » technology has enabled ancillary facilities to be created. The CEBAF facility is used by an international user community of more than 1200 physicists for a program of exploration and study of nuclear, hadronic matter, the strong interaction and quantum chromodynamics. Additionally, the exceptional quality of the beams facilitates studies of the fundamental symmetries of nature, which complement those of atomic physics on the one hand and of high-energy particle physics on the other. The facility is in the midst of a project to double the energy of the facility and to enhance and expand its experimental facilities. Studies are also pursued with a Free-Electron Laser produced by an energy-recovering linear accelerator.« less

  7. Universal Design for Learning and the Port Jefferson School District: A Needs Assessment

    ERIC Educational Resources Information Center

    Sladek-Maharg, Tara S.

    2011-01-01

    Purpose: This applied doctoral project purpose was to determine what was needed to implement UDL in the Port Jefferson school district, specifically determining district strengths and weaknesses. Data were collected with researcher-created surveys given to administrators, faculty members, and members of the parent organizations and the district's…

  8. Financial Analysis of National University Hospitals in Korea.

    PubMed

    Lee, Munjae

    2015-10-01

    This paper provides information for decision making of the managers and the staff of national university hospitals. In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.

  9. Financial Analysis of National University Hospitals in Korea

    PubMed Central

    Lee, Munjae

    2015-01-01

    Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry. PMID:26730356

  10. Smart information system for gachon university gil hospital.

    PubMed

    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.

  11. A New Era for Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    McKeown, R. D.; Montgomery, H. E.; Pennington, M. R.

    On a cool Saturday morning in late April a seemingly endless stream of cars turned off Jefferson Avenue in Newport News, Virginia, bringing 12,000 people ages 1 to 91 to the Open House to learn more about “the new era in science” at the Thomas Jefferson National Accelerator Facility. Here, the visitors were dazzled by the complex equipment, the enthusiastic staff, and the advanced technology at the Laboratory.

  12. A New Era for Jefferson Lab

    DOE PAGES

    McKeown, R. D.; Montgomery, H. E.; Pennington, M. R.

    2016-09-16

    On a cool Saturday morning in late April a seemingly endless stream of cars turned off Jefferson Avenue in Newport News, Virginia, bringing 12,000 people ages 1 to 91 to the Open House to learn more about “the new era in science” at the Thomas Jefferson National Accelerator Facility. Here, the visitors were dazzled by the complex equipment, the enthusiastic staff, and the advanced technology at the Laboratory.

  13. Latest results from FROST at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ritchie, Barry G.

    2014-06-01

    The spectrum of broad and overlapping nucleon excitations can be greatly clarified by use of a polarized photon beam incident on a polarized target in meson photoproduction experiments. At Jefferson Lab, a program of such measurements has made use of the Jefferson Lab FROzen Spin Target (FROST). An overview of preliminary results are presented.

  14. Smart Information System for Gachon University Gil Hospital

    PubMed Central

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

    2012-01-01

    Objectives In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. Methods 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. Results 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. Conclusions 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. PMID:22509476

  15. The Complexity of Thomas Jefferson. A Response to "'The Diffusion of Light': Jefferson's Philosophy of Education"

    ERIC Educational Resources Information Center

    Carpenter, James

    2014-01-01

    This response argues that Jefferson's educational philosophy must be considered in a proper historical context. Holowchak accurately demonstrates both Jefferson's obsession with education and the political philosophy on which his educational beliefs are built. However, the effort to apply modern democratic and meritocratic attributes to…

  16. Jefferson Lab Virtual Tour

    ScienceCinema

    None

    2018-01-16

    Take a virtual tour of the campus of Thomas Jefferson National Accelerator Facility. You can see inside our two accelerators, three experimental areas, accelerator component fabrication and testing areas, high-performance computing areas and laser labs.

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

    PubMed

    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.

  18. Cross-cultural adaptation of Jefferson scale of empathy-health professions students version: An experience with developing the Tamil translation.

    PubMed

    Jeyashree, Kathiresan; Kathirvel, Soundappan; Prathibha, Muthu K

    2017-01-01

    Empathy is a key cognitive attribute among healthcare professionals that fosters better patient- healthcare provider relationships. The Jefferson scale of empathy (JSE) measures self-rated empathy among various groups of healthcare professionals-health professionals, medical students and health professions students (HPS). The authors present the experience in translating the JSE-HPS version into an Indian regional language with insights into the issues faced in every step. With official permission from the Thomas Jefferson University, the authors embarked on the translation proceeding through forward translation (three rounds of modification), back translation (two independent translates), and synthesis of a final translated version. While targeting literary accuracy, the simplicity and comprehensibility of the instrument by the study population were also ensured. Variations in regional dialects and accents across the population were considered. The back-translated version was evaluated for semantic, content, cultural, and technical equivalence. It was then pretested on ten students followed by a group discussion with them to ensure the comprehensibility of the tool and the differences between written and spoken language were addressed through necessary modifications. The Tamil translation of the HPS version of JSE is now approved by and officially available with the Thomas Jefferson University.

  19. Jefferson and Democratic Education

    ERIC Educational Resources Information Center

    Holowchak, M. Andrew

    2014-01-01

    This essay is a reply to James Carpenter's "Thomas Jefferson and the Ideology of Democratic Schooling." In it, I argue that there is an apophatic strain in the essay that calls into question the motivation for the undertaking.

  20. 396. MIRACLE REVIVAL TEAM PENTECOSTAL CHURCH AT 2031 WEST JEFFERSON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    396. MIRACLE REVIVAL TEAM PENTECOSTAL CHURCH AT 2031 WEST JEFFERSON STREET, WEST SIDE - Russell Neighborhood, Bounded by Congress & Esquire Alley, Fifteenth & Twenty-first Streets, Louisville, Jefferson County, KY

  1. 75 FR 81640 - President William Jefferson Clinton Birthplace Home National Historic Site

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ... Jefferson Clinton Birthplace Home National Historic Site AGENCY: National Park Service, Interior. ACTION..., Hope, Arkansas 71801, as the ``President William Jefferson Clinton Birthplace Home National Historic... Birthplace Foundation, Inc., fee simple, unencumbered title to the William Jefferson Clinton Birthplace Home...

  2. Digital Data for Volcano Hazards in the Mount Jefferson Region, Oregon

    USGS Publications Warehouse

    Schilling, S.P.; Doelger, S.; Walder, J.S.; Gardner, C.A.; Conrey, R.M.; Fisher, B.J.

    2008-01-01

    Mount Jefferson has erupted repeatedly for hundreds of thousands of years, with its last eruptive episode during the last major glaciation which culminated about 15,000 years ago. Geologic evidence shows that Mount Jefferson is capable of large explosive eruptions. The largest such eruption occurred between 35,000 and 100,000 years ago. If Mount Jefferson erupts again, areas close to the eruptive vent will be severely affected, and even areas tens of kilometers (tens of miles) downstream along river valleys or hundreds of kilometers (hundreds of miles) downwind may be at risk. Numerous small volcanoes occupy the area between Mount Jefferson and Mount Hood to the north, and between Mount Jefferson and the Three Sisters region to the south. These small volcanoes tend not to pose the far-reaching hazards associated with Mount Jefferson, but are nonetheless locally important. A concern at Mount Jefferson, but not at the smaller volcanoes, is the possibility that small-to-moderate sized landslides could occur even during periods of no volcanic activity. Such landslides may transform as they move into lahars (watery flows of rock, mud, and debris) that can inundate areas far downstream. The geographic information system (GIS) volcano hazard data layer used to produce the Mount Jefferson volcano hazard map in USGS Open-File Report 99-24 (Walder and others, 1999) is included in this data set. Both proximal and distal hazard zones were delineated by scientists at the Cascades Volcano Observatory and depict various volcano hazard areas around the mountain.

  3. A psychometric appraisal of the Jefferson Scale of Empathy using law students.

    PubMed

    Williams, Brett; Sifris, Adiva; Lynch, Marty

    2016-01-01

    A growing body of literature indicates that empathic behaviors are positively linked, in several ways, with the professional performance and mental well-being of lawyers and law students. It is therefore important to assess empathy levels among law students using psychometrically sound tools that are suitable for this cohort. The 20-item Jefferson Scale of Empathy - Health Profession Students Version was adapted for a law context (eg, the word "health care" became "legal"), and the new Jefferson Scale of Empathy - Law Students (JSE-L-S) version was completed by 275 students at Monash University, Melbourne, Australia. Data were subjected to principal component analysis. Four factors emerged from the principal component analysis ("understanding the client's perspective", "responding to clients' experiences and emotions", "responding to clients' cues and behaviors", and "standing in clients' shoes"), which accounted for 46.7% of the total variance. The reliability of the factors varied, but the overall 18-item JSE-L-S yielded a Cronbach's alpha coefficient of 0.80. Several patterns among the item loadings were similar to those reported in studies using other versions of the Jefferson Scale of Empathy. The JSE-L-S appears to be a reliable measure of empathy among undergraduate law students, which could help provide insights into law student welfare and future performance as legal practitioners. Additional evaluation of the JSE-L-S is required to disambiguate some of the minor findings explored. Adjustments may improve the psychometric properties.

  4. Mr. Jefferson's University Breaks Up.

    ERIC Educational Resources Information Center

    Kirp, David L.; Roberts, Patrick S.

    2002-01-01

    Describes how the University of Virginia is beginning to fall apart, while the recently completed Darden Graduate School of Business Administration is moving toward self-sufficiency and is the sign of things to come in the privatization of public higher education. In its eagerness to enter the top ranks of business schools, Darden has made the…

  5. 2. GENERAL VIEW, CENTER BUILDING, WITH SIGN SAYING '1855 JEFFERSON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. GENERAL VIEW, CENTER BUILDING, WITH SIGN SAYING '1855 JEFFERSON 1907 INSURANCE BUILDING' Photocopy of April 28, 1915 photograph on file at City Archives of Philadelphia, located at Philadelphia City Hall - Jefferson Fire Insurance Company, 425 Walnut Street, Philadelphia, Philadelphia County, PA

  6. Howard University Hospital finds partner in helping children succeed.

    PubMed

    Botvin, Judith D

    2005-01-01

    Howard University Hospital, Washington, D.C., becomes the site for the launch of a national ad campaign by the nonprofit youth education organization, Communities in Schools. The hospital and university share the organization's mission of supporting young people in the community.

  7. FOREWORD: Jefferson Lab: A Long Decade of Physics

    NASA Astrophysics Data System (ADS)

    Montgomery, Hugh

    2011-04-01

    Jefferson Lab Jefferson Lab was created in 1984 and started operating in about 1996. 2011 is an appropriate time to try to take a look at the results that have appeared, what has been learned, and what has been exciting for our scientific community. Rather than attempt to construct a coherent view with a single author or at least a small number, we have, instead, invited small groups of people who have been intimately involved in the work itself to make contributions. These people are accelerator experts, experimentalists and theorists, staff and users. We have, in the main, sought reviews of the actual sub-fields. The primary exception is the first paper, which sets the scene as it was, in one person's view, at the beginning of Jefferson Lab. In reviewing the material as it appeared, I was impressed by the breadth of the material. Major advances are documented from form factors to structure functions, from spectroscopy to physics beyond the standard model of nuclear and particle physics. Recognition of the part played by spin, the helicities of the beams, the polarizations of the targets, and the polarizations of final state particles, is inescapable. Access to the weak interaction amplitudes through measurements of the parity violating asymmetries has led to quantification of the strange content of the nucleon and the neutron radius of lead, and to measurements of the electroweak mixing angle. Lattice QCD calculations flourished and are setting the platform for understanding of the spectroscopy of baryons and mesons. But the star of the game was the accelerator. Its performance enabled the physics and also the use of the technology to generate a powerful free electron laser. These important pieces of Jefferson Lab physics are given their place. As the third Director of Jefferson Lab, and on behalf of the other physicists and others presently associated with the lab, I would like to express my admiration and gratitude for the efforts of the directors, chief

  8. 76 FR 18753 - Jefferson Island Storage & Hub, L.L.C.; Notice of Filing

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-05

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. PR11-97-000] Jefferson Island Storage & Hub, L.L.C.; Notice of Filing Take notice that on March 28, 2011, Jefferson Island Storage & Hub, L.L.C. (Jefferson Island) submitted a revised Statement of Operating Conditions (SOC) for...

  9. Jefferson's Views on Education: Implications for Today's Social Studies

    ERIC Educational Resources Information Center

    Carpenter, James J.

    2004-01-01

    It is virtually impossible to find a U.S. civics or government textbook that does not cite Thomas Jefferson's faith in a well-educated citizenry as the great defense against tyranny. It is also common to open a U.S. history textbook for middle or high school students and find a reference to Jefferson and the value he put on education. Because the…

  10. A psychometric appraisal of the Jefferson Scale of Empathy using law students

    PubMed Central

    Williams, Brett; Sifris, Adiva; Lynch, Marty

    2016-01-01

    Background A growing body of literature indicates that empathic behaviors are positively linked, in several ways, with the professional performance and mental well-being of lawyers and law students. It is therefore important to assess empathy levels among law students using psychometrically sound tools that are suitable for this cohort. Participants and methods The 20-item Jefferson Scale of Empathy – Health Profession Students Version was adapted for a law context (eg, the word “health care” became “legal”), and the new Jefferson Scale of Empathy – Law Students (JSE-L-S) version was completed by 275 students at Monash University, Melbourne, Australia. Data were subjected to principal component analysis. Results Four factors emerged from the principal component analysis (“understanding the client’s perspective”, “responding to clients’ experiences and emotions”, “responding to clients’ cues and behaviors”, and “standing in clients’ shoes”), which accounted for 46.7% of the total variance. The reliability of the factors varied, but the overall 18-item JSE-L-S yielded a Cronbach’s alpha coefficient of 0.80. Several patterns among the item loadings were similar to those reported in studies using other versions of the Jefferson Scale of Empathy. Conclusion The JSE-L-S appears to be a reliable measure of empathy among undergraduate law students, which could help provide insights into law student welfare and future performance as legal practitioners. Additional evaluation of the JSE-L-S is required to disambiguate some of the minor findings explored. Adjustments may improve the psychometric properties. PMID:27524924

  11. State University of New York Stony Brook University Hospital: Selected Expenditure Controls. Report 92-S-66.

    ERIC Educational Resources Information Center

    New York State Office of the Comptroller, Albany. Div. of Management Audit.

    An audit was done of selected expenditure controls at the State University of New York (SUNY) at Stony Brook University Hospital particularly payroll costs and procurement practices. The Hospital reported an operating loss of $24 million in 1992. The audit reviewed Hospital management and staff and applicable policies and procedures as well as…

  12. 1. AERIAL VIEW, LOOKING WEST OF 'THE BIRMINGHAM MEDICAL CENTER,' ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. AERIAL VIEW, LOOKING WEST OF 'THE BIRMINGHAM MEDICAL CENTER,' WITH HILLMAN HOSPITAL, THE FIVE-STORY BUILDING (CENTER RIGHT AT 20TH STREET AND SIXTH AVENUE SOUTH), JEFFERSON TOWER (CENTER LEFT AT 20TH STREET AND SEVENTH AVENUE SOUTH, AND THE MANY HOSPITALS AND TEACHING FACILITIES OF THE UNIVERSITY OF ALABAMA AT BIRMINGHAM MEDICAL CENTER. - Hillman Hospital, 600 Block Westside Twentieth Street South, Birmingham, Jefferson County, AL

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

    PubMed

    Fedder, Jens; Nielsen, Gunnar Lauge; Petersen, Lars J; Rasmussen, Claus; Lauszus, Finn F; Frost, Lars; Hornung, Nete; Lederballe, Ole; Andersen, Jens Peter

    2011-11-01

    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. We retrieved all scientific papers published in the period 2000-2009 emanating from all seven Danish non-university hospitals in two regions, comprising 1.8 million inhabitants, and which were registered in a minimum of one of the three databases: PubMed MEDLINE, Thomson Reuters Web of Science and Elsevier's Scopus. In 878 of 1,252 papers, the first and/or last author was affiliated to a non-university hospital. Original papers made up 69% of these publications versus 86% of publications with university affiliation on first or last place. Case reports and reviews most frequently had authors from regional hospitals as first and/or last authors. The total number of publications from regional hospitals increased by 48% over the 10-year period. Publications were cited more often if the first or last author was from a university hospital and even more so if they were affiliated to foreign institutions. Cardiology, gynaecology and obstetrics, and environmental medicine were the three specialities with the largest number of regional hospital publications. A substantial number of scientific publications originate from non-university hospitals. Almost two thirds of the publications were original research published in international journals. Variations between specialities may reflect local conditions. not relevant. not relevant.

  14. Effect of a Computerized Provider Order Entry (CPOE) System on Medication Orders at a Community Hospital and University Hospital

    PubMed Central

    Wess, Mark L.; Embi, Peter J.; Besier, James L.; Lowry, Chad H.; Anderson, Paul F.; Besier, James C.; Thelen, Geriann; Hegner, Catherine

    2007-01-01

    Computerized Provider Order Entry (CPOE) has been demonstrated to improve the medication ordering process, but most published studies have been performed at academic hospitals. Little is known about the effects of CPOE at community hospitals. With a pre-post study design, we assessed the effects of a CPOE system on the medication ordering process at both a community and university hospital. The time from provider ordering to pharmacist verification decreased by two hours with CPOE at the community hospital (p<0.0001) and by one hour at the university hospital (p<0.0001). The rate of medication clarifications requiring signature was 2.80 percent pre-CPOE and 0.40 percent with CPOE (p<0.0001) at the community hospital. The university hospital was 2.76 percent pre-CPOE and 0.46 percent with CPOE (p<0.0001). CPOE improved medication order processing at both community and university hospitals. These findings add to the limited literature on CPOE in community hospitals. PMID:18693946

  15. University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians.

    PubMed

    Degen, Christiane; Kuntz, Ludwig

    2014-04-23

    German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1-2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3-4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success.

  16. University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians

    PubMed Central

    2014-01-01

    Background German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. Methods Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. Results Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1–2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3–4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. Conclusion Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success. PMID

  17. Polycystic kidney disease at Howard University Hospital.

    PubMed

    Hosten, A O; Cummings, Y

    1977-08-01

    Adult polycystic kidney disease treatment at Howard University Hospital is summarized. The cases are taken from autopsies performed between January 1955 and November 1975 and from the Hospital's dialysis population. Polycystic kidney disease was identified in six adults and four infants. Only two dialysis patients were clinically thought to have the disease. A review of the major clinical features of the disease is presented.

  18. Short Distance of Nuclei - Mining the Wealth of Existing Jefferson Lab Data - Final Report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Weinstein, Lawrence; Kuhn, Sebastian

    Over the last fifteen years of operation, the Jefferson Lab CLAS Collaboration has performed many experiments using nuclear targets. Because the CLAS detector has a very large acceptance and because it used a very open (i.e., nonspecific) trigger, there is a vast amount of data on many different reaction channels yet to be analyzed. The goal of the Jefferson Lab Nuclear Data Mining grant was to (1) collect the data from nuclear target experiments using the CLAS detector, (2) collect the associated cuts and corrections used to analyze that data, (3) provide non-expert users with a software environment for easymore » analysis of the data, and (4) to search for interesting reaction signatures in the data. We formed the Jefferson Lab Nuclear Data Mining collaboration under the auspices of this grant. The collaboration successfully carried out all of our goals. Dr. Gavalian, the data mining scientist, created a remarkably user-friendly web-based interface to enable easy analysis of the nuclear-target data by non-experts. Data from many of the CLAS nuclear target experiments has been made available on servers at Old Dominion University. Many of the associated cuts and corrections have been incorporated into the data mining software. The data mining collaboration was extraordinarily successful in finding interesting reaction signatures in the data. Our paper Momentum sharing in imbalanced Fermi systems was published in Science. Several analyses of CLAS data are continuing and will result in papers after the end of the grant period. We have held several analysis workshops and have given many invited talks at international conferences and workshops related to the data mining initiative. Our initiative to maximize the impact of data collected with CLAS in the 6-GeV era was very successful. During the hiatus between the end of 6-GeV experiments and the beginning of 12-GeV experiments, our collaboration and the physics community at large benefited tremendously from the

  19. Beyond the Schoolhouse Door: Educating the Political Animal in Jefferson's Little Republics

    ERIC Educational Resources Information Center

    Dotts, Brian W.

    2015-01-01

    Jefferson believed that citizenship must exhibit republican virtue. While education was necessary in a republican polity, it alone was insufficient in sustaining a revolutionary civic spirit. This paper examines Jefferson's expectations for citizen virtue, specifically related to militia and jury service in his "little republics."…

  20. [Evaluation of the Oran university hospital information system].

    PubMed

    Chougrani, Saada; Ouhadj, Salah; Agag, Fouzia

    2013-01-01

    Oran university hospital has been operating since 2010. It is a public institution that must assess the resources required to achieve institutional goals integrated into the strategic objectives defined in the hospital development project. Implementation of this project could be supported, among other things, by a strong and efficient hospital information system. Three investigations were conducted: 1- evaluation of the hospital information system, 2- assessment of the quality of the hospital discharge summary reports, 3- assessment of the quality of medical records. The six components of the hospital information system (resources, indicators, sources, management, quality and dissemination and use of data) were clearly present but not satisfactory with a score ranging from 25 to 50% of the total score. The scores by component were as follows: 36% for resources, 37% for indicators, 42% for patient records, 19% for data management and 27% for the dissemination of information. The overall completeness of medical records was 85.2%. Completeness by group of variables gave the following results: 66% for medical information, 54% for the patient's stay and 38% for information relating to the patient's discharge. Hospital discharge summary reports were available in 59.8% of cases, but were blank in 4% of cases. The critical variable, the principal diagnosis was found in 51% of cases. The correct principal diagnosis rate was 33.3%. The deficiencies observed for content and data management raise real questions concerning data management at Oran university hospital as part of a real managerial approach.

  1. Developing marketing strategies for university teaching hospitals.

    PubMed

    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.

  2. Data consistency checks for Jefferson Lab Experiment E00-002

    NASA Astrophysics Data System (ADS)

    Telfeyan, John; Niculescu, Gabriel; Niculescu, Ioana

    2006-10-01

    Jefferson Lab experiment E00-002 aims to measure inclusive electron-proton and electron-deuteron scattering cross section at low Q squared and moderately low Bjorken x. Data in this kinematic region will further our understanding of the transition between the perturbative and non-perturbative regimes of Quantum Chromodynamics (QCD). As part of the data analysis effort underway at James Madison University (JMU) a comprehensive set of checks and tests was implemented. These tests ensure the quality and consistency of the experimental data, as well as providing, where appropriate, correction factors between the experimental apparatus as used and its idealized computer-simulated representation. This contribution will outline this testing procedure as implemented in the JMU analysis, highlighting the most important features/results.

  3. Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis.

    PubMed

    Medin, Emma; Anthun, Kjartan S; Häkkinen, Unto; Kittelsen, Sverre A C; Linna, Miika; Magnussen, Jon; Olsen, Kim; Rehnberg, Clas

    2011-12-01

    This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.

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

    PubMed

    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.

  5. Thomas Jefferson and the Purposes of Education.

    ERIC Educational Resources Information Center

    Jewett, Thomas O.

    1997-01-01

    Thomas Jefferson was the first conspicuous U.S. advocate of free education supported by local taxation and of state aid to higher education. He believed that only an educated citizenry could assume the responsibilities of self-government. (SK)

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

    PubMed Central

    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

  7. Metamorphic Mountain, Mount Jefferson State Park: An Environmental Education Learning Experience Designed for Grades 5-7.

    ERIC Educational Resources Information Center

    Pittman, George K., II; Hubbard, William F.; Lambert, Michael D.; Beazley, Lea J.

    Mount Jefferson State Natural Area is located in the southern Blue Ridge highlands of North Carolina and covers 489 acres, which includes peaks and upper slopes to the Mount Jefferson mountain. This document introduces students to the geology of Mount Jefferson State Park and focuses on the geologic processes and rocks and minerals of Mount…

  8. DC High Voltage Conditioning of Photoemission Guns at Jefferson Lab FEL

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hernandez-Garcia, C.; Benson, S. V.; Biallas, G.

    2009-08-04

    DC high voltage photoemission electron guns with GaAs photocathodes have been used to produce polarized electron beams for nuclear physics experiments for about 3 decades with great success. In the late 1990s, Jefferson Lab adopted this gun technology for a free electron laser (FEL), but to assist with high bunch charge operation, considerably higher bias voltage is required compared to the photoguns used at the Jefferson Lab Continuous Electron Beam Accelerator Facility. The FEL gun has been conditioned above 400 kV several times, albeit encountering non-trivial challenges with ceramic insulators and field emission from electrodes. Recently, high voltage processing withmore » krypton gas was employed to process very stubborn field emitters. This work presents a summary of the high voltage techniques used to high voltage condition the Jefferson Lab FEL photoemission gun.« less

  9. Review of thromboembolic prophylaxis in patients attending Cork University Hospital.

    PubMed

    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

  10. Income Analysis of University-Owned Teaching Hospitals.

    ERIC Educational Resources Information Center

    Isaacs, Joseph C.

    1979-01-01

    The annual survey, undertaken by the Association of American Medical Colleges, of income, expense and general operating information for university-owned teaching hospitals is discussed. Focus is on sources of income, including state funds, Medicare, and insurance companies. (JMD)

  11. Jefferson Davis and the Failure of Confederate Military Strategy, 1861-1865

    DTIC Science & Technology

    2010-04-14

    schools in Mississippi, Samuel decided to send Jefferson to Kentucky when he was old enough to attend school. At the age of eight, he enrolled him at...alone on a steamboat at the age of ten. Back in Mississippi, Davis briefly attended Jefferson College near Natchez before entering Wilkinson Academy...the fields. Davis decided on his own that school had its merits and returned to Wilkinson.9 In 1823 at the age of fifteen Davis enrolled in

  12. Rotunda, University of Virginia. Remodeling Portfolio

    ERIC Educational Resources Information Center

    Progressive Architecture, 1976

    1976-01-01

    The recently completed restoration of Thomas Jefferson's Rotunda at the University of Virginia is criticized as being the result of compromises and, consequently, an amalgam of its three previous designers. (Author/MLF)

  13. Environmental auditing in hospitals: approach and implementation in an university hospital.

    PubMed

    Dettenkofer, M; Kümmerer, K; Schuster, A; Mühlich, M; Scherrer, M; Daschner, F D

    1997-05-01

    Medical audit in infection control today is accepted as an important element in the quality assurance of health care. In contrast, environmental auditing, which was approved in 1993 by the Council of the European Communities for industry ("Eco-Management and Audit Scheme-EMAS), has not so far been used as a tool to control and reduce environmental pollution caused by medical care in hospitals. The aim of this study was to investigate, whether environmental auditing in hospitals is useful. This process should also be cost effective. In this paper, methodological and organizational issues are described. Initially an environmental review of activities at the University Hospital, Freiburg and an eco-analysis of the input and output were performed. The first results of the study and a critical discussion will be presented in another paper.

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

    PubMed

    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.

  15. MOUNT JEFFERSON PRIMITIVE AREA, OREGON.

    USGS Publications Warehouse

    Walker, George W.; Pattee, Eldon C.

    1984-01-01

    Mineral and reconnaissance geothermal surveys of the Mount Jefferson Primitive Area in the Cascade Range of Oregon indicate little likelihood that metallic or nonmetallic mineral or energy resources exist in the area. Several mining claims, presumably located for gold, are present, but analyses of samples from the claims failed to detect the presence of gold or other valuable metals. Rock for construction purposes is abundantly present, but better and more accessible deposits are available in adjacent areas.

  16. Hospitality Major Vocational High School Students' Expectations on University Education

    ERIC Educational Resources Information Center

    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…

  17. The Economic Impact of Jefferson College on the Community and State--FY1997.

    ERIC Educational Resources Information Center

    Jefferson Coll., Hillsboro, MO.

    This document provides an estimation of the ways in which Jefferson College (Missouri) impacts the economy of Jefferson County and the state as a whole. It offers quantitative information and acts as a reference for the Board of Trustees, administrators, faculty, and staff regarding the economic significance of the college to the area it serves.…

  18. [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].

    PubMed

    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%, p<0.01). Nurses of both hospitals had sufficient opportunity to reconcile work 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

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

    PubMed

    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 < 0.05). Patients' hospital stay was directly related to the complexity of the orthognathic procedure, the operation time, time spent in ICU and the year in which the operation was done. There was a significant reduction in the 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.

  20. RadNet Air Data From Jefferson City, MO

    EPA Pesticide Factsheets

    This page presents radiation air monitoring and air filter analysis data for Jefferson City, MO from EPA's RadNet system. RadNet is a nationwide network of monitoring stations that measure radiation in air, drinking water and precipitation.

  1. Healthcare professionals' work engagement in Finnish university hospitals.

    PubMed

    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.

  2. 75 FR 11916 - Chrysler LLC, Manufacturing Truck and Activity Division, Jefferson North Assembly Plant...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ..., Manufacturing Truck and Activity Division, Jefferson North Assembly Plant, Including On-Site Leased Workers From..., Jefferson North Assembly Plant, Detroit, Michigan. The notice was published in the Federal Register on April... substantial portion of which are shipped to an affiliated plant where they are used in the assembly of...

  3. Assessing Governance Alternatives for University-Owned Public Teaching Hospitals.

    ERIC Educational Resources Information Center

    Whitley, Evangeline L.

    The governance options matrix is provided to offer a way for state and university policymakers to examine the functioning environments of specific university-owned public teaching hospitals. With it, they can consider the benefits and problems involved with different options for governance. The issues related to the environmental factors affecting…

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

    PubMed

    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.

  5. Monitoring vibrations on the Jefferson City Truss Bridge.

    DOT National Transportation Integrated Search

    2016-05-25

    The objective of the research was to determine the frequency and cause of resonant vibrations of truss verticals on bridge A4497 : over the Missouri River in Jefferson City, MO. Instrumentation to monitor the vibrations of four verticals was installe...

  6. Jefferson Lab Science: Present and Future

    DOE PAGES

    McKeown, Robert D.

    2015-02-12

    The Continuous Electron Beam Accelerator Facility (CEBAF) and associated experimental equipment at Jefferson Lab comprise a unique facility for experimental nuclear physics. Furthermore, this facility is presently being upgraded, which will enable a new experimental program with substantial discovery potential to address important topics in nuclear, hadronic, and electroweak physics. Further in the future, it is envisioned that the Laboratory will evolve into an electron-ion colliding beam facility.

  7. Going all digital in a university hospital: a unified large-scale PACS for multiple departments and hospitals

    NASA Astrophysics Data System (ADS)

    Vogl, Raimund

    2001-08-01

    In 1997, a large PACS was first introduced at Innsbruck University Hospital in the context of a new traumatology centre. In the subsequent years, this initial PACS setting covering only one department was expanded to most of the hospital campus, with currently some 250 viewing stations attached. Constantly connecting new modalities and viewing stations created the demand for several redesigns from the original PACS configuration to cope with the increasing data load. We give an account of these changes necessary to develop a multi hospital PACS and the considerations that lead us there. Issues of personnel for running a large scale PACS are discussed and we give an outlook to the new information systems currently under development for archiving and communication of general medical imaging data and for simple telemedicine networking between several large university hospitals.

  8. [The role of university hospital executive board members].

    PubMed

    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.

  9. Implementing Medical Teaching Policy in University Hospitals

    ERIC Educational Resources Information Center

    Engbers, Rik; Fluit, Cornelia Cornelia R. M. G.; Bolhuis, Sanneke; de Visser, Marieke; Laan, Roland F. J. M.

    2017-01-01

    Within the unique and complex settings of university hospitals, it is difficult to implement policy initiatives aimed at developing careers in and improving the quality of academic medical teaching because of the competing domains of medical research and patient care. Factors that influence faculty in making use of teaching policy incentives have…

  10. Histopathological diagnosis of eyelid tumors in Chiang Mai University Hospital.

    PubMed

    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.

  11. The Economic Impact of Jefferson College on the Community and the State, FY 2002.

    ERIC Educational Resources Information Center

    Jefferson Coll., Hillsboro, MO.

    The purpose of this study is to provide an estimation of the ways in which Jefferson College impacts and stimulates the economy of Jefferson County and the state of Missouri as a whole. It provides quantitative information for use by the Board of Trustees and the Administrative Cabinet in institutional planning endeavors. It is also a useful…

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

    PubMed

    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 < 0.05). Infants had a higher risk of deficit in the BMI index and height/age than preschoolers, schoolchildren, and adolescents between admission and discharge. When the nutritional condition of a child was critical at admission, the child remained hospitalized significantly longer. Infants come under the age group most vulnerable to malnutrition and require greater monitoring of nutritional status during hospitalization.

  13. A Proposed Incentive System for Jefferson County Teachers.

    ERIC Educational Resources Information Center

    Schlechty, Phillip C.; Ingwerson, Donald W.

    1987-01-01

    Outlines a teacher incentive plan developed for the Jefferson County (Kentucky) Public Schools and scheduled for pilot testing during the 1987-88 school year. The program is modeled after airline frequent flyer programs and is designed to encourage cooperative action and individual incentive among teachers. (MD)

  14. An international survey of physicians regarding clinical trials: a comparison between Kyoto University Hospital and Seoul National University Hospital

    PubMed Central

    2013-01-01

    Background International clinical trials are now rapidly expanding into Asia. However, the proportion of global trials is higher in South Korea compared to Japan despite implementation of similar governmental support in both countries. The difference in clinical trial environment might influence the respective physicians’ attitudes and experience towards clinical trials. Therefore, we designed a questionnaire to explore how physicians conceive the issues surrounding clinical trials in both countries. Methods A questionnaire survey was conducted at Kyoto University Hospital (KUHP) and Seoul National University Hospital (SNUH) in 2008. The questionnaire consisted of 15 questions and 2 open-ended questions on broad key issues relating to clinical trials. Results The number of responders was 301 at KUHP and 398 at SNUH. Doctors with trial experience were 196 at KUHP and 150 at SNUH. Among them, 12% (24/196) at KUHP and 41% (61/150) at SUNH had global trial experience. Most respondents at both institutions viewed clinical trials favorably and thought that conducting clinical trials contributed to medical advances, which would ultimately lead to new and better treatments. The main reason raised as a hindrance to conducting clinical trials was the lack of personnel support and time. Doctors at both university hospitals thought that more clinical research coordinators were required to conduct clinical trials more efficiently. KUHP doctors were driven mainly by pure academic interest or for their desire to find new treatments, while obtaining credits for board certification and co-authorship on manuscripts also served as motivation factors for doctors at SNUH. Conclusions Our results revealed that there might be two different approaches to increase clinical trial activity. One is a social level approach to establish clinical trial infrastructure providing sufficient clinical research professionals. The other is an individual level approach that would provide incentives to

  15. Changing Course in Jefferson City: Reevaluating a District Initiative to Convert Under-Enrolled Elementary Schools

    ERIC Educational Resources Information Center

    Lochmiller, Chad R.

    2018-01-01

    This case positions the reader as the superintendent of Jefferson City Public Schools (pseudonym). Like many urban school districts in the United States, Jefferson City faces a complex milieu of fiscal challenges attributed to inadequate state funding and declining student enrollment. Within this case, the superintendent must address the failing…

  16. "The Lengthened Shadow of One Man": The Public Intellectual and the Founding of Universities.

    ERIC Educational Resources Information Center

    Wyatt, John

    1998-01-01

    Identifies five intellectuals who made distinctive contributions to the founding of new universities in England, Germany, and the United States. Institutional and individual biographies profile: Thomas Jefferson (University of Virginia); Wilhelm von Humboldt (University of Berlin); Lord Brougham (University College, University of London); A.D.…

  17. Conflict management in public university hospitals in Turkey: a pilot study.

    PubMed

    Tengilimoglu, Dilaver; Kisa, Adnan

    2005-01-01

    By nature, hospitals are extremely complex organizations, combining many different professional groups within an intricate administrative structure. Conflicts therefore expectedly arise between individuals, groups, and departments. It is in the interest of health care administrators to periodically assess the major factors giving rise to these conflicts. In this study, a questionnaire designed to measure sources of conflict in the workplace was completed by 204 staff members at Gazi University Hospital. Of the participants, 30.9% were physicians, and 12.5% were administrators at various levels; 61.5% were female, and 38.5% were male. In terms of work experience, 52.6% of participants had worked less than 5 years at the hospital. The results of the study show that educational differences among the hospital staff were a major barrier to good communication and information flow between groups. Professionals in the same specialties experienced fewer conflicts. Another source of conflict was that resource allocation was considered unfair across departments. Although the hospital management provided an ombudsman for staff concerns, staff rarely resorted to the ombudsman because of the stigma associated with complaining. A lack of opportunity for career advancement was mentioned by 52% of the participants as a source of conflict. At present, job performance and rewards are not closely related in public university hospitals in Turkey because promotions and pay raises are strictly limited by law. Bureaucracy was also perceived to be a source of conflict, with 48.4% of participants saying that their performance was less than optimal because of the presence of multiple supervisors. This pilot study suggests that in Turkey, legislative reform is needed to give public university hospitals more flexibility regarding work incentives, open-door policies at the administrative level, and social interactions to improve teamwork among hospital staff.

  18. Adverse Events in Affiliated Hospitals of Mazandaran University of Medical Sciences

    PubMed Central

    Saravi, Benyamin Mohseni; Siamian, Hasan; Nezhad, Ayyob Barzegar; Asghari, Zoleleykha; Kabirzadeh, Azar

    2014-01-01

    Due to the complexity of the hospital environment, its structure faces with multiple hazards. The risks whether by providing the care and whether by hospital environment endanger patients, relatives and care providers. Therefore, a more accurate reporting and analysis of the report by focusing on access to preventative methods is essential. In this study, hospitals' adverse event that has sent by affiliated hospitals of Mazandaran University of Medical Sciences to deputy for treatment has studied. PMID:24944536

  19. [110 years--University Obstetrics and Gynecology Hospital "Maichin dom"].

    PubMed

    Zlatkov, V

    2014-01-01

    The first specialized Obstetrics and Gynecology Hospital in Bulgaria was founded based on the idea of Queen Maria Luisa (1883). Construction began in 1896 and the official opening of the hospital took place on November 19, 1903. What is unique about the University Obstetrics and Gynecology Hospital "Maichin dom" is above all the fact that the Bulgarian school of obstetrics and gynecology was founded within its institution. Currently, the hospital has nearly 400 beds and 600 employees who work at nine clinics and six laboratories, covering the entire spectrum of obstetric and gynecological activities. Its leading specialists still continue to embody the highest level of professionalism and dedication. The future development of the hospital is chiefly associated with the renovation of facilities, resources and equipment and with the enhancement of the professional competence of the staff and of the quality of hospital products to improve the health and satisfaction of the patients.

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

    PubMed

    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.

  1. 77 FR 74784 - Safety Zone for Recovery Operations for East Jefferson Street Train Derailment, Mantua Creek...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ... 1625-AA00 Safety Zone for Recovery Operations for East Jefferson Street Train Derailment, Mantua Creek... establishing a safety zone one mile north and one mile south of the East Jefferson Street Railroad Bridge... materials into Mantua Creek and the surrounding air. This regulation is necessary to provide for the safety...

  2. Transforming Our Schools: Lessons from the Jefferson County Public Schools/Gheens Professional Development Academy, 1983-1991.

    ERIC Educational Resources Information Center

    Kyle, Regina M. J.

    A school/community partnership in Louisville, Kentucky, the Jefferson County Public Schools/Gheens Professional Development Academy, is described. This report provides a framework for assessing Jefferson County School System reforms in the past 8 years or more designed to enhance student success in learning. A Spiral of Assessment was used to…

  3. Decentralization and hospital pharmacy services: the case of Iranian university affilliated hospitals.

    PubMed

    Ashna Delkhosh, Reza; Ardama, Ali; Salamzadeh, Jamshid

    2013-01-01

    The aim of this study was to evaluate the satisfaction rate of hospital managerial/clinical teams (HMCTs) including principles (chief executives), managers, supervisor pharmacists and head nurses from services presented by private sectors directing 10 pharmacy departments in hospitals affiliated to Shahid Beheshti University of Medical Sciences. This study is an observational and descriptive study in which a questionnaire containing 16 questions evaluating the satisfaction of the HMCTs from private sectors, and questions about demography of the responders was used for data collection. Collected data was applied to assign a satisfaction score (maximum 64) for each respondent. SPSS 17.0 and Microsoft Office Excel 2007 were used for statistical description and analysis of these information (where applicable). Overall, 97 people in charge of the hospitals (HMCTs) entered the study. The average satisfaction score was 26.38 ± 6.81 with the lowest satisfaction rate observed in Mofid children specialty hospital (19.5%) and the highest rate obtained for Imam Hussein (p.b.u.h) general hospital (65.3%). Generally, 59% of the HMCTs believed that the function of the private sector in the pharmacy of hospitals is satisfactory. Assuming that the satisfaction scores under 75% of the total obtainable score (i.e. 48 out of 64) could not be considered as an indicator of desired pharmacy services, our results revealed that the status of the services offered by private sectors are far behind the desired satisfactory level.

  4. Aggressive television ad campaign for Cooper University Hospital features hometown celebrity.

    PubMed

    2006-01-01

    Cooper University Hospital in Camden, NJ, features an extensive ambulatory care network that includes practice sites across eight counties of Southern New Jersey. Recently, the hospital worked with Willing Strategic Advertising to produce an award-winning television advertising campaign endorsed by New Jersey-born TV personality, Kelly Ripa.

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

    PubMed

    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.

  6. Metamorphic Mountain: Mount Jefferson State Park. An Environmental Education Learning Experience Designed for Grades 5-7.

    ERIC Educational Resources Information Center

    Pittman, George K., II

    This activity packet was designed to introduce students in grades 5-7 to the geology of the Blue Ridge Mountains through hands-on activities for the classroom and the outdoor setting of Mount Jefferson State Park (Jefferson, North Carolina). Previsit activities introduce students to the different rock types: sedimentary, igneous, and metamorphic.…

  7. NEW EPICS/RTEMS IOC BASED ON ALTERA SOC AT JEFFERSON LAB

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Yan, Jianxun; Seaton, Chad; Allison, Trent L.

    A new EPICS/RTEMS IOC based on the Altera System-on-Chip (SoC) FPGA is being designed at Jefferson Lab. The Altera SoC FPGA integrates a dual ARM Cortex-A9 Hard Processor System (HPS) consisting of processor, peripherals and memory interfaces tied seamlessly with the FPGA fabric using a high-bandwidth interconnect backbone. The embedded Altera SoC IOC has features of remote network boot via U-Boot from SD card or QSPI Flash, 1Gig Ethernet, 1GB DDR3 SDRAM on HPS, UART serial ports, and ISA bus interface. RTEMS for the ARM processor BSP were built with CEXP shell, which will dynamically load the EPICS applications atmore » runtime. U-Boot is the primary bootloader to remotely load the kernel image into local memory from a DHCP/TFTP server over Ethernet, and automatically run RTEMS and EPICS. The first design of the SoC IOC will be compatible with Jefferson Lab’s current PC104 IOCs, which have been running in CEBAF 10 years. The next design would be mounting in a chassis and connected to a daughter card via standard HSMC connectors. This standard SoC IOC will become the next generation of low-level IOC for the accelerator controls at Jefferson Lab.« less

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

    ERIC Educational Resources Information Center

    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…

  9. Brazilian version of the Jefferson Scale of Empathy: psychometric properties and factor analysis

    PubMed Central

    2012-01-01

    Background Empathy is a central characteristic of medical professionalism and has recently gained attention in medical education research. The Jefferson Scale of Empathy is the most commonly used measure of empathy worldwide, and to date it has been translated in 39 languages. This study aimed to adapt the Jefferson Scale of Empathy to the Brazilian culture and to test its reliability and validity among Brazilian medical students. Methods The Portuguese version of the Jefferson Scale of Empathy was adapted to Brazil using back-translation techniques. This version was pretested among 39 fifth-year medical students in September 2010. During the final fifth- and sixth-year Objective Structured Clinical Examination (October 2011), 319 students were invited to respond to the scale anonymously. Cronbach’s alpha, exploratory factor analysis, item-total correlation, and gender comparisons were performed to check the reliability and validity of the scale. Results The student response rate was 93.7% (299 students). Cronbach’s coefficient for the scale was 0.84. A principal component analysis confirmed the construct validity of the scale for three main factors: Compassionate Care (first factor), Ability to Stand in the Patient’s Shoes (second factor), and Perspective Taking (third factor). Gender comparisons did not reveal differences in the scores between female and male students. Conclusions The adapted Brazilian version of the Jefferson Scale of Empathy proved to be a valid, reliable instrument for use in national and cross-cultural studies in medical education. PMID:22873730

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

    PubMed

    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.

  11. Foreign Language Camps: Jefferson County Public Schools R-1.

    ERIC Educational Resources Information Center

    Trujillo, Lorenzo A.; And Others

    The planning and operation of Jefferson County (Colorado) Public Schools' foreign language camps are described. The weekend-long camps attempt to duplicate an authentic cultural experience in a foreign village through cultural activities and language immersion. French, Spanish, Russian, and German camps are conducted for county high school foreign…

  12. Inter-Organizational Research Collaboration in Education: A District-University Partnership Model

    ERIC Educational Resources Information Center

    Munoz, Marco A.; Winter, Paul A.; Ricciardi, Diane

    2006-01-01

    This paper describes a research partnership conducted between Jefferson County (Ky.) Public Schools, the University of Louisville, and the University of Kentucky. The aim of the partnership was to share resources while meeting the different institutions' needs in areas such as research and recruitment. Although effective district and university…

  13. Gateway Arch Circulator Conceptual Feasibility Study : Jefferson National Expansion Memorial

    DOT National Transportation Integrated Search

    2015-03-01

    The Jefferson National Expansion Memorial (JEFF) is undergoing major design changes as part of the City Arch River 2015 project (CAR) that will impact access for park visitors. The park and stakeholders are considering a circulator system to facilita...

  14. Saving life and brain with extracorporeal cardiopulmonary resuscitation: A single-center analysis of in-hospital cardiac arrests.

    PubMed

    Peigh, Graham; Cavarocchi, Nicholas; Hirose, Hitoshi

    2015-11-01

    Despite advances in medical care, survival to discharge and full neurologic recovery after cardiac arrest remains less than 20% after cardiopulmonary resuscitation. An alternate approach to traditional cardiopulmonary resuscitation is extracorporeal cardiopulmonary resuscitation, which places patients on extracorporeal membrane oxygenation during cardiopulmonary resuscitation and provides immediate cardiopulmonary support when traditional resuscitation has been unsuccessful. We report the results from extracorporeal cardiopulmonary resuscitation at the Thomas Jefferson University. Between 2010 and June 2014, 107 adult extracorporeal membrane oxygenation procedures were performed at the Thomas Jefferson University. Patient demographics, survival to discharge, and neurologic recovery of patients who underwent extracorporeal cardiopulmonary resuscitation were retrospectively analyzed with institutional review board approval. A total of 23 patients (15 male and 8 female; mean age, 46 ± 12 years) underwent extracorporeal cardiopulmonary resuscitation. All patients who met criteria were placed on 24-hour hypothermia protocol (target temperature 33°C) with initiation of extracorporeal membrane oxygenation. The mean duration of extracorporeal membrane oxygenation support was 6.2 ± 5.5 days. Nine patients died while on extracorporeal membrane oxygenation from the following causes: anoxic brain injury (4), stroke (4), and bowel necrosis (1). Two patients with anoxic brain injury on extracorporeal cardiopulmonary resuscitation donated multiple organs for transplant. The survival to discharge was 30% (7/23 patients) with approximately 100% full neurologic recovery. The extracorporeal cardiopulmonary resuscitation procedure provided reasonable patient recovery. Extracorporeal cardiopulmonary resuscitation also allowed for neurologic recovery and made multiorgan procurement possible. On the basis of the survival, extracorporeal cardiopulmonary resuscitation should be

  15. Superconducting Magnets for the 12 GeV Upgrade at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Fair, Ruben J.; Young, Glenn R.

    2015-06-01

    Jefferson Laboratory is embarked on an energy upgrade to its flagship continuous electron beam accelerator in order to expand the scope of its research capabilities and probe further into the structure of nuclear particles. The 12 GeV upgrade includes the design, manufacture, integration, installation and commissioning of eight different superconducting magnets in three separate experimental halls. The effort involves other national laboratories, universities and industry spanning three countries. This paper will summarize the key characteristics of these magnets, ranging in size from 0.2 to 23 MJ in stored energy, and featuring many different types and configurations. The paper will alsomore » give an overview of the specific technical challenges for each magnet, and a status report on magnet manufacture and expected delivery dates. The 12GeV upgrade at J-Lab represents the largest superconducting magnet fabrication and installation program currently ongoing in the United States and this paper will present the breadth of collaborations supporting it.« less

  16. Drug selection in French university hospitals: analysis of formularies for nine competitive pharmacological classes.

    PubMed

    Gallini, Adeline; Juillard-Condat, Blandine; Saux, Marie-Claude; Taboulet, Florence

    2011-11-01

    To give a panorama of the selectivity and agreement of French university hospitals' drug formularies (HDF) for nine competitive classes. All university hospitals were asked to send their HDF and selection criteria as of January 2009 for nine competitive pharmacological classes (proton pump inhibitors, serotonin antagonists, low molecular weight heparins, erythropoietins, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, statins, α-adrenoreceptor antagonists and selective serotonin re-uptake inhibitors). Selectivity of HDF was estimated by the percentage of drug entities selected by the hospital within the pharmacological class. Agreement between hospitals was assessed with modified kappa coefficients for multi-raters. Twenty-one out of the 29 hospitals agreed to participate. These hospitals selected between 34% and 63% of the drug entities available for the nine classes, which represented 18 to 35 agents. Regarding the nature of chosen drug entities, the overall level of agreement was 'fair' and varied with pharmacological classes. Selection criteria were sent by only 12 hospitals. The technical component was the most important element in all hospitals. The weight of the economic component varied between 20% and 40% in the tender's grade. Large variations were seen in the number and nature of drugs selected by university hospitals which can be attributable to two successive decision-making processes (evaluation by the Drug and Therapeutics Committee followed by the purchasing process). © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

  17. Workplace violence against nursing staff in a Saudi university hospital.

    PubMed

    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.

  18. Percutaneous coronary intervention in Thammasat University Hospital: the first three-year experience.

    PubMed

    Piyayotai, Dilok; Hutayanon, Pisit

    2010-12-01

    To study the results of percutaneous coronary intervention (PCI) and in-hospital outcomes in cardiac catheterization laboratory, Thammasat University Hospital since May, 2006 until April, 2009. This is the prospective, single-center study. The consecutive patients who underwent PCI in Thammasat University Hospital since May 2006 to April 2009 were recruited in the study. Clinical data, angiographic data, and in-hospital outcomes were analyzed and demonstrated. Six hundred and seventeen patients undergoing 755 PCI procedures were enrolled in the study. 62.70% were male and 37.30% were female. Mean age was 65.45 +/- 11.21 years (range 33-97 years) and 20.10% were more than 75 years old. The indications for PCI were non-ST segment-elevation acute coronary syndrome (NSTEACS) (41.72%), chronic stable angina (25.32%), acute ST segment elevation myocardial infarction (STEMI) (8.87%), staged PCI (15.76%). The other indications were heart failure, cardiomyopathy, post-cardiac arrest and etc. The procedure was single vessel PCI in 73.25% and multivessel PCI in 26.75% (double vessels PCI 24.64% and triple vessels PCI 2.11%). According to lesion locations, 45.21% were left anterior descending (LAD) artery lesions, 30.09% were right coronary artery (RCA) lesions, 23.28% were left circumflex (LCX) artery lesions, 1.19% were left main (LM) lesions and 0.24% were graft lesions. The overall angiographic success rate was 95.57%. During hospital stay the major adverse events developed as death in 0.93%, periprocedural myocardial infarction in 3.17%, emergency coronary artery bypass graft in 0.53%, and stroke in 0.26%. During the first three years of PCI experience in Thammasat University Hospital, the overall success rate was high with low in-hospital adverse outcomes.

  19. STEVENSON-WYDLER (15 USC 3710) COOPERATIVE RESEARCH AND DEVELOPMENT AGREEMENT No. JSA 2009S007 BETWEEN Jefferson ScienceAssociates, LLC under its U.S.Department of Energy Contract No. DE-AC05-060R23 177 AND Black Laboratories, L.L.C.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Crooks, Roy

    The Cooperative Research and Development agreement, No. JSA 2009S00 resulted in collaborations and conference participations on research topics related to high purity (RRR) niobium applications for superconducting radio frequency cavities used by Jefferson Lab. Documented results were shown in Reports and Publications listed below. Reports were issued to The Commonwealth of Virginia, Center for Innovative Technology; to ATI Wah-Chang and several publications were produced with DESY in Hamburg, Germany, with Jefferson Lab and with Christopher Newport University.

  20. Ornamental Planting Restoration at Jefferson's Poplar Forest Through XRF and ICP-OES Analysis of Disturbed Soils

    NASA Astrophysics Data System (ADS)

    Hatfield, M.; Low, P. C.; Devlin, S.

    2011-12-01

    Thomas Jefferson's Poplar Forest estate near Lynchburg, VA is currently attempting to restore the property to its Jeffersonian condition. Subsequent modifications to the property following its sale by Jefferson's heirs included the removal of the original trees in order to facilitate agricultural activity. One key facet of the restoration involves determining the precise location of the sixty-four paper mulberry trees that Jefferson reportedly had transplanted in 1815 from his on-site nursery to near the main house. At Monticello, it is well-documented that Jefferson used contextually innovative fertilizing techniques, including the addition of gypsum and lime "to restore the exhaustion of a single crop from the soil." Whether he used these methods in the nursery at Poplar Forest to the degree that decades of subsequent leaching, weathering, and other disturbances would not erase remains historically and analytically unclear. Since the transplantation process requires that large amounts of soil be moved with the trees, small areas of compositionally distinct soils in the suspected planting area could be used to establish the exact location of each tree through differentiating between nursery and in situ soils. Through X-ray fluorescence spectroscopy (XRF) and intercoupled plasma optical emission spectroscopy (ICP-OES) geochemical analysis, the specific composition of soil can be determined. Preliminary analysis shows slight differences in phosphorus and sulfur between the nursery and in situ soil; however, the property lies on three different distinct geological units: actinolite schist and feldspathic metagreywacke units of the Alligator Back formation, and biotite gneiss of the Ashe Formation (biotite gneiss). The location of the nursery where the sixty-four paper mulberry trees were originally grown lies on the feldspathic metagreywacke unit; whereas the relocation site where Jefferson had them planted rests on the actinolite schist unit. Percursory study

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

    PubMed

    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.

  2. Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012.

    PubMed

    Rezapour, Aziz; Ebadifard Azar, Farbod; Yousef Zadeh, Negar; Roumiani, YarAllah; Bagheri Faradonbeh, Saeed

    2015-01-01

    Assessment of hospitals' performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran. This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software. According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389. This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved.

  3. ENVIRONMENTAL AUDITING: Environmental Auditing in Hospitals: First Results in a University Hospital.

    PubMed

    Dettenkofer; Kuemmerer; Schuster; Mueller; Muehlich; S; Daschner

    2000-01-01

    / While medical audit in infection control today is one important element in the quality assurance of health care, environmental auditing, approved in 1993 by the Council of the European Communities for the industrial sector, so far has not been used as a tool to control and reduce environmental pollution caused by medical care. The aim of this study was to investigate whether environmental auditing according to the European Eco-Management and Audit Scheme (EMAS) can be implemented in hospitals as a process of improvement in protection of the environment. In a prior publication the methodological issues and the organizational steps that had to be taken were described. An environmental review of the activities of the Freiburg University Hospital and an ecoanalysis of the input and output were performed. The results of this analysis, published in an environmental report, provide a fundamental data set for the consumption of energy, water, materials, and the burdens of major pollutants and waste. Regarding the organizational structure of the hospital, the first steps towards an integrating environmental management system as demanded by EMAS could be taken. Beside supporting advantages, e.g., improvement of environmental safety, public image and staff contentment, and potential economic benefits such as less cost to be paid for energy and water consumption, there are important restrictions of environmental auditing in hospitals. Examples are the lack of basic environmental data, staff motivation (especially of physicians), cooperation of the organizational substructures, and funds for prefinancing urgently needed improvements in ecology. Based on the study findings, a textbook on environmental auditing in hospitals, including checklists covering all important environmental objectives, has been published to support hospitals in their efforts to achieve an optimized and sustainable practice of providing health care.

  4. Precision Electron Beam Polarimetry in Hall C at Jefferson Lab

    NASA Astrophysics Data System (ADS)

    Gaskell, David

    2013-10-01

    The electron beam polarization in experimental Hall C at Jefferson Lab is measured using two devices. The Hall-C/Basel Møller polarimeter measures the beam polarization via electron-electron scattering and utilizes a novel target system in which a pure iron foil is driven to magnetic saturation (out of plane) using a superconducting solenoid. A Compton polarimeter measures the polarization via electron-photon scattering, where the photons are provided by a high-power, CW laser coupled to a low gain Fabry-Perot cavity. In this case, both the Compton-scattered electrons and backscattered photons provide measurements of the beam polarization. Results from both polarimeters, acquired during the Q-Weak experiment in Hall C, will be presented. In particular, the results of a test in which the Møller and Compton polarimeters made interleaving measurements at identical beam currents will be shown. In addition, plans for operation of both devices after completion of the Jefferson Lab 12 GeV Upgrade will also be discussed.

  5. 75 FR 16700 - Special Local Regulation, Swim Across the Sound, Long Island Sound, Port Jefferson, NY to Captain...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ...-AA08 Special Local Regulation, Swim Across the Sound, Long Island Sound, Port Jefferson, NY to Captain... permanent Special Local Regulation on the navigable waters of Long Island Sound between Port Jefferson, NY and Captain's Cove Seaport, Bridgeport, CT due to the annual Swim Across the Sound event. The proposed...

  6. Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012

    PubMed Central

    Rezapour, Aziz; Ebadifard Azar, Farbod; Yousef Zadeh, Negar; Roumiani, YarAllah; Bagheri Faradonbeh, Saeed

    2015-01-01

    Background: Assessment of hospitals’ performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran. Methods: This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software. Results: According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389. Conclusion: This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved. PMID:26793657

  7. Quark Hadron Duality - Recent Jefferson Lab Results

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Niculescu, Maria Ioana

    2016-08-01

    The duality between the partonic and hadronic descriptions of electron--nucleon scattering is a remarkable feature of nuclear interactions. When averaged over appropriate energy intervals the cross section at low energy which is dominated by nucleon resonances resembles the smooth behavior expected from perturbative QCD. Recent Jefferson Lab results indicate that quark-hadron duality is present in a variety of observables, not just the proton F2 structure function. An overview of recent results, especially local quark-hadron duality on the neutron, are presented here.

  8. The Jefferson Science Fellows (JSF) program at the US Department of State

    NASA Astrophysics Data System (ADS)

    Peterson, Roy

    2014-09-01

    In 2004 the US Department of State and the National Academies established the Jefferson Science Fellows program, to bring tenured faculty in sciences, engineering, and medicine to the Department of State or USAID for a year in residence, with continuing connections. Over twenty physical scientists have been Fellows, working in a wide variety of offices on a broad range of topics. The main advantage to Fellows is the opportunity to make an impact on important national and international issues, applying skills and judgments gained through their research, teaching, and service. The JSF experience can also create broader horizons for physicists, especially beyond the laboratory. The selection process and examples, including my own, will be described. Information can be found at //sites.nationalacademies.org/PGA/Jefferson/.

  9. 33 CFR 100.121 - Swim Across the Sound, Long Island Sound, Port Jefferson, NY to Captain's Cove Seaport...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Swim Across the Sound, Long Island Sound, Port Jefferson, NY to Captain's Cove Seaport, Bridgeport, CT. 100.121 Section 100.121... SAFETY OF LIFE ON NAVIGABLE WATERS § 100.121 Swim Across the Sound, Long Island Sound, Port Jefferson, NY...

  10. Analysis of Time-of-Day Energy Demand and Supply in University and Hospital

    NASA Astrophysics Data System (ADS)

    Shimazaki, Yoichi

    The aim of this study was to estimate the time-of-day energy demand in University of Yamanashi. Our University consisted of Kofu campus (Faculty of Education & Human Sciences and Faculty of Engineering) and Faculty of Medicine campus (Faculty of Medicine and University Hospital). The energy data of 4 facilities were classified into hot water, heating, cooling and electric power demands based on electric power consumptions, city gas and heavy oil from 1996 to 2005. For 10 years, primary energy increased 1.2 times in the whole of the university. The amount of electric power consumption was 63% in the fuel classification. The amount of electric power consumption of faculty reacted to the change in temperature greatly. In 2005, it was found that thermoelectric-ratios for 4 facilities, i.e. Education, Engineering, Medicine and Hospital were 2.3, 1.5, 2.0 and 2.7 respectively. These data are very useful for the energy saving and energy management of university.

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

    PubMed

    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.

  12. Pair spectrometer hodoscope for Hall D at Jefferson Lab

    DOE PAGES

    Barbosa, Fernando J.; Hutton, Charles L.; Sitnikov, Alexandre; ...

    2015-09-21

    We present the design of the pair spectrometer hodoscope fabricated at Jefferson Lab and installed in the experimental Hall D. The hodoscope consists of thin scintillator tiles; the light from each tile is collected using wave-length shifting fibers and detected using a Hamamatsu silicon photomultiplier. Light collection was measured using relativistic electrons produced in the tagger area of the experimental Hall B.

  13. Pair spectrometer hodoscope for Hall D at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Barbosa, Fernando J.; Hutton, Charles L.; Sitnikov, Alexandre

    We present the design of the pair spectrometer hodoscope fabricated at Jefferson Lab and installed in the experimental Hall D. The hodoscope consists of thin scintillator tiles; the light from each tile is collected using wave-length shifting fibers and detected using a Hamamatsu silicon photomultiplier. Light collection was measured using relativistic electrons produced in the tagger area of the experimental Hall B.

  14. University Hospital Struck Deaf and Silent by Lightning: Lessons to Learn.

    PubMed

    Dami, Fabrice; Carron, Pierre-Nicolas; Yersin, Bertrand; Hugli, Olivier

    2015-08-01

    We describe how an electromagnetic wave after a lightning strike affected a university hospital, including the communication shutdown that followed, the way it was handled, and the lessons learned from this incident.

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

    PubMed

    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.

  16. Economic-environmental modeling of point source pollution in Jefferson County, Alabama, USA.

    PubMed

    Kebede, Ellene; Schreiner, Dean F; Huluka, Gobena

    2002-05-01

    This paper uses an integrated economic-environmental model to assess the point source pollution from major industries in Jefferson County, Northern Alabama. Industrial expansion generates employment, income, and tax revenue for the public sector; however, it is also often associated with the discharge of chemical pollutants. Jefferson County is one of the largest industrial counties in Alabama that experienced smog warnings and ambient ozone concentration, 1996-1999. Past studies of chemical discharge from industries have used models to assess the pollution impact of individual plants. This study, however, uses an extended Input-Output (I-O) economic model with pollution emission coefficients to assess direct and indirect pollutant emission for several major industries in Jefferson County. The major findings of the study are: (a) the principal emission by the selected industries are volatile organic compounds (VOC) and these contribute to the ambient ozone concentration; (b) the direct and indirect emissions are significantly higher than the direct emission by some industries, indicating that an isolated analysis will underestimate the emission by an industry; (c) while low emission coefficient industries may suggest industry choice they may also emit the most hazardous chemicals. This study is limited by the assumptions made, and the data availability, however it provides a useful analytical tool for direct and cumulative emission estimation and generates insights on the complexity in choice of industries.

  17. Recent skyshine calculations at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Degtyarenko, P.

    1997-12-01

    New calculations of the skyshine dose distribution of neutrons and secondary photons have been performed at Jefferson Lab using the Monte Carlo method. The dose dependence on neutron energy, distance to the neutron source, polar angle of a source neutron, and azimuthal angle between the observation point and the momentum direction of a source neutron have been studied. The azimuthally asymmetric term in the skyshine dose distribution is shown to be important in the dose calculations around high-energy accelerator facilities. A parameterization formula and corresponding computer code have been developed which can be used for detailed calculations of the skyshinemore » dose maps.« less

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

    PubMed

    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.

  19. Dorothy Davison (1890-1984): Manchester medical artist and her work for neurosurgeon Sir Geoffrey Jefferson (1886-1961).

    PubMed

    Mohr, Peter D

    2017-05-01

    Miss Davison was a medical artist at the Manchester Royal Infirmary and the University of Manchester from around 1918 until her retirement in 1957. She illustrated books and scientific papers on anthropology, anatomy and surgery, and became well known for her striking pictures produced by the 'Ross board technique'- a difficult process that she helped pioneer from the 1930s and which forms the bulk of the work she undertook for neurosurgeon Geoffrey Jefferson during the 1930s-1950s. His Neurosurgical Department became the main base for her work until his retirement in 1953. She was an active member of the Medical Artist Association (MAA) which she helped found in 1949.

  20. Management of Liver Trauma in Minia University Hospital, Egypt.

    PubMed

    Saleh, Abdel Fattah; Al Sageer, Emad; Elheny, Amr

    2016-12-01

    The aim of this study is to present the outcome of operative and non-operative management of patients with liver injury treated in a single institution depending on imaging. This study was conducted at the Causality Unit of Minia University Hospital, and included 60 patients with hepatic trauma from March 2012 to January 2013. In our study, males represent 80 % while females represent 20 % of the traumatized patients. The peak age for trauma found was 11-30 years. Blunt trauma is the most common cause of liver injury as it was the cause in 48 patients (80 %). Firearm injuries are the most common cause of penetrating trauma (60 %) followed by stab injuries (40 %). More than one half of our patients (34 out of 60) were treated with non-operative management (NOM) with a high success rate. The operative procedures done were suture hepatorrhaphy (20 cases), non-anatomical resection in one case, anatomical resection in one case, and damage control therapy using pads in two cases. In another two cases, nothing was done as subcapsular hematoma had resolved. Minia University Hospital is a big tertiary Hospital in Egypt at which blunt liver trauma is more common than penetrating liver trauma. Surgery is no longer the only option available. It has been reserved for extensive lesions with condition of hemodynamic instability or for the treatment of the complications. NOM is an effective treatment modality in most cases.

  1. Brief Report: The Negev Hospital-University-Based (HUB) Autism Database

    ERIC Educational Resources Information Center

    Meiri, Gal; Dinstein, Ilan; Michaelowski, Analya; Flusser, Hagit; Ilan, Michal; Faroy, Michal; Bar-Sinai, Asif; Manelis, Liora; Stolowicz, Dana; Yosef, Lili Lea; Davidovitch, Nadav; Golan, Hava; Arbelle, Shosh; Menashe, Idan

    2017-01-01

    Elucidating the heterogeneous etiologies of autism will require investment in comprehensive longitudinal data acquisition from large community based cohorts. With this in mind, we have established a hospital-university-based (HUB) database of autism which incorporates prospective and retrospective data from a large and ethnically diverse…

  2. Strategies for Effective Psychiatric Hospitalization of College and University Students

    ERIC Educational Resources Information Center

    Rockland-Miller, Harry; Eells, Gregory

    2008-01-01

    University and college counseling services face growing demands for services and self-reported increases in the level of presenting psychopathology, including need for psychiatric hospitalization. However, challenges in communication often occur between the systems of an inpatient psychiatric unit and an outpatient college and/or university…

  3. The Howard University Hospital Experience with Routineized HIV Screening: A Progress Report*

    PubMed Central

    Scott, Victor F.; Sitapati, Amy; Martin, Sayyida; Summers, Pamela; Washington, Michael; Daniels, Fernando; Mouton, Charles; Bonney, George; Apprey, Victor; Webster, Virginia; Smith, Avemaria; Mountvarner, Geoffrey; Daftary, Monica; Maxwell, Celia J.

    2009-01-01

    Background: Howard University Hospital (HUH) is the first hospital in the nation to have instituted a hospital-wide routine rapid HIV screening campaign as recommended by the CDC for healthcare settings. Methods: HUH developed a protocol and implemented a hospital-wide routine HIV screening in October 2006. Rapid oral fluid-based HIV testing was conducted throughout the hospital using the OraSure OraQuick Advance Rapid HIV-1/2 Antibody Test. Patients with a preliminarily reactive test result were either referred for confirmatory testing or offered a Western Blot confirmatory test on-site and referred for follow-up care. This is a report on the progress of this program for the first eight months. Results: Of the 9,817 patients offered HIV testing, 5,642 consented. The mean age of the screened population was 40.7 years. Ninety percent of the patients screened were black and 55% were female. A preliminarily reactive test result was identified in 139 patients for a seroprevalence rate of 2.46%. Of these patients, 136, or 98% were black; 63% were male and 37% were female. HIV prevalence in the overall sample, among blacks, and among both black males and females peaked in the 40–54 year old age group. Challenges were experienced initially in securing confirmatory tests. Conclusions: Hospital-wide routine HIV screening is both possible and productive. The routine HIV screening campaign instituted at Howard University Hospital has identified a significant number of previously unidentified HIV positive persons. Success in assuring confirmatory testing and transition to care improved as time progressed. PMID:19768195

  4. The Howard University Hospital experience with routineized HIV screening: a progress report.

    PubMed

    Scott, Victor F; Sitapati, Amy; Martin, Sayyida; Summers, Pamela; Washington, Michael; Daniels, Fernando; Mouton, Charles; Bonney, George; Apprey, Victor; Webster, Virginia; Smith, Avemaria; Mountvarner, Geoffrey; Daftary, Monica; Maxwell, Celia J

    2009-01-01

    Howard University Hospital (HUH) is the first hospital in the nation to have instituted a hospital-wide routine rapid HIV screening campaign as recommended by the CDC for healthcare settings. HUH developed a protocol and implemented a hospital-wide routine HIV screening in October 2006. Rapid oral fluid-based HIV testing was conducted throughout the hospital using the OraSure OraQuick Advance Rapid HIV-1/2 Antibody Test. Patients with a preliminarily reactive test result were either referred for confirmatory testing or offered a Western Blot confirmatory test on-site and referred for follow-up care. This is a report on the progress of this program for the first eight months. Of the 9,817 patients offered HIV testing, 5,642 consented. The mean age of the screened population was 40.7 years. Ninety percent of the patients screened were black and 55% were female. A preliminarily reactive test result was identified in 139 patients for a seroprevalence rate of 2.46%. Of these patients, 136, or 98% were black; 63% were male and 37% were female. HIV prevalence in the overall sample, among blacks, and among both black males and females peaked in the 40-54 year old age group. Challenges were experienced initially in securing confirmatory tests. Hospital-wide routine HIV screening is both possible and productive. The routine HIV screening campaign instituted at Howard University Hospital has identified a significant number of previously unidentified HIV positive persons. Success in assuring confirmatory testing and transition to care improved as time progressed.

  5. Oryza rufipogon introgressions improve yield in the U.S. cultivar Jefferson

    USDA-ARS?s Scientific Manuscript database

    An advanced backcross (BC2) population was developed to explore the breeding value of the wild ancestral species O. rufipogon (IRGC 105491) in a cross with the tropical japonica US variety, cv Jefferson. Early generation selection eliminated lines which possessed undesirable traits such as dormancy,...

  6. Microbiological Assessment of Indoor Air of Teaching Hospital Wards: A case of Jimma University Specialized Hospital.

    PubMed

    Fekadu, Samuel; Getachewu, Bahilu

    2015-04-01

    Hospital environment represents a congenial situation where microorganisms and susceptible patients are indoors together. Thus, the objective of this study is to provide fundamental data related to the microbial quality of indoor air of Jimma University Specialized Hospital wards, to estimate the health hazard and to create standards for indoor air quality control. The microbial quality of indoor air of seven wards of Jimma University Specialized Hospital was determined. Passive air sampling technique, using open Petri-dishes containing different culture media, was employed to collect sample twice daily. The concentrations of bacteria and fungi aerosols in the indoor environment of the wards ranged between 2123 - 9733 CFU/m(3). The statistical analysis showed that the concentrations of bacteria that were measured in all studied wards were significantly different from each other (p-value=0.017), whereas the concentrations of fungi that were measured in all sampled wards were not significantly different from each other (p-value=0.850). Moreover, the concentrations of bacteria that were measured at different sampling time (morning and afternoon) were significantly different (p-value =0.001). All wards that were included in the study were heavily contaminated with bacteria and fungi. Thus, immediate interventions are needed to control those environmental factors which favor the growth and multiplication of microbes, and it is vital to control visitors and students in and out the wards. Moreover, it is advisable that strict measures be put in place to check the increasing microbial load in the hospital environment.

  7. The Use of Operational Excellence Principles in a University Hospital.

    PubMed

    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

  8. The Use of Operational Excellence Principles in a University Hospital

    PubMed Central

    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

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

    PubMed

    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.

  10. EMC effect for light nuclei: New results from Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Aji Daniel

    High energy lepton scattering has been the primary tool for mapping out the quark distributions of nucleons and nuclei. Measurements of deep inelastic scattering in nuclei show that the quark distributions in heavy nuclei are not simply the sum of the quark distributions of the constituent proton and neutron, as one might expect for a weakly bound system. This modification of the quark distributions in nuclei is known as the EMC effect. I will discuss the results from Jefferson Lab (JLab) experiment E03-103, a precise measurement of the EMC effect in few-body nuclei with emphasis on the large x region.more » Data from the light nuclei suggests that the nuclear dependence of the high x quark distribution may depend on the nucleon's local environment, rather than being a purely bulk effect. In addition, I will also discuss about a future experiment at the upgraded 12 GeV Jefferson Lab facility which will further investigate the role of the local nuclear environment and the influence of detailed nuclear structure to the modification of quark distributions.« less

  11. Pharmacy component of a hospital end-product cost-accounting system.

    PubMed

    Smith, J E; Sheaffer, S L; Meyer, G E; Giorgilli, F

    1988-04-01

    Determination of pharmacy department standard costs for providing drug products to patients at Thomas Jefferson University Hospital in Philadelphia is described. The hospital is implementing a cost-accounting system (CAS) that uses software developed at the New England Medical Center, Boston. The pharmacy identified nine categories of intermediate products on the basis of labor consumption. Standard labor times for each product category are based on measurement or estimation of time for each task in the preparation and distribution of a dose. Variable-labor standard time was determined by adjusting the cumulative time for the tasks to account for nonproductive time and nonroutine activities, and a variable-labor standard cost for each category was calculated. The standard cost per dose included the costs of labor and supplies (variable and fixed) and equipment; this standard cost plus the acquisition cost of a drug line item is the total intermediate product cost. Because the CAS is based on the hospital's patient charges, clinical pharmacy services are excluded. Intermediate products that substantially affect end-product costs (costs per patient case) will be identified for inclusion in CAS reports. The CAS will give a more accurate picture of resource consumption, enabling managers to focus their efforts to improve efficiency and productivity and reduce supply use; it could also improve the accuracy of the budgeting process. The CAS will support hospital administration decisions about marketing end products and department managers' decisions about controlling intermediate-product costs.

  12. Clinical empathy in medical students in India measured using the Jefferson Scale of Empathy-Student Version.

    PubMed

    Chatterjee, Anirban; Ravikumar, Rajkrishna; Singh, Satendra; Chauhan, Pranjal Singh; Goel, Manu

    2017-01-01

    The purpose of this study was to assess the clinical empathy of a cohort of medical students spanning 4 years of undergraduate study and to identify factors associated with empathy. A cross-sectional study to assess the empathy of undergraduate medical students at the University College of Medical Sciences and GTB Hospital in Delhi, India, was conducted using the Jefferson Scale of Empathy-Student Version. Demographic data were obtained using a pre-tested, semi-open-ended questionnaire. Of the 600 students, 418 participated in the survey (69.7%). The mean empathy score was 96.01 (of a maximum of 140), with a standard deviation of 14.56. The empathy scores decreased from the first to the third semester, plateaued at the fifth semester, and rose again in the seventh semester. Empathy was found to be significantly associated with the gender of the participant, with females having higher scores (P<0.001). The age of the participant, place of residence, whose decision it was for the student to enroll in an MBBS (bachelor of medicine and bachelor of surgery) program, and the choice of future specialty were not significantly associated with students' empathy scores. The study found significant gender differences in empathy among the participants. The empathy scores tended to decline initially and then rebound over time. The mean empathy levels found in this study are lower than those reported in most similar studies around the world; therefore, further studies are needed to analyze and address the underlying factors associated with this discrepancy.

  13. An overview of recent nucleon spin structure measurements at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Allada, Kalyan

    2016-02-01

    Jefferson Lab have made significant contributions to improve our knowledge of the longitudinal spin structure by measuring polarized structure functions, g1 and g2, down to Q2 = 0.02 GeV2. The low Q2 data is especially useful in testing the Chiral Perturbation theory (cPT) calculations. The spin-dependent sum rules and the spin polarizabilities, constructed from the moments of g1 and g2, provide an important tool to study the longitudinal spin structure. We will present an overview of the experimental program to measure these structure functions at Jefferson Lab, and present some recent results on the neutron polarizabilities, proton g1 at lowmore » Q2, and proton and neutron d2 measurement. In addition to this, we will discuss the transverse spin structure of the nucleon which can be accessed using chiral-odd transversity distribution (h1), and show some results from measurements done on polarized 3He target in Hall A.« less

  14. Acute adult poisoning cases admitted to a university hospital in Tabriz, Iran.

    PubMed

    Islambulchilar, M; Islambulchilar, Z; Kargar-Maher, M H

    2009-04-01

    The aim of our study was to investigate the etiological and demographical characteristics of acute adult poisoning cases admitted to a university hospital in Tabriz, Iran. This retrospective study was performed on 1342 poisoning admissions to a university hospital from 2003 to 2005, by data collection from the medical records of patients. Poisonings were 5.40% of the total admissions. There was a predominance of female patients (55.7%) compared to male patients (44.3%) with a female-to-male ratio of 1.2:1. Most poisonings occurred in the age range of 11-20 years (38.9%). Drugs were the most common cause of poisonings (60.8%). Among the drug poisonings, benzodiazepines (40.31%) were the most frequent agents, followed by antidepressants (31.98%). The seasonal distribution in poisoning patients suggested a peak in spring (28%) and summer (27.5%). In 9.8% of cases accidental and in 90.2% intentional poisonings were evident. Most suicide attempts were made by women (58.51%) and unmarried people (51.4%).The mean duration of hospitalization was 3.02 +/- 2.8 days. There were 28 (2.3%) deaths; the majority (13 cases) was due to pesticides. This was a university hospital-based study, so these results may not be representative of the general population. Despite this drawback, these data still provide important information on the characteristics of the poisoning in this part of Iran. To prevent such poisonings, the community education about the danger of central nervous system-acting drugs and reducing the exposure period of people to pesticides are recommended.

  15. University Hospitals for Sale.

    ERIC Educational Resources Information Center

    Culliton, Barbara J.

    1984-01-01

    Although faculty opposition stopped the sale of Harvard's McLean Hospital to the Hospital Corporation of America (HCA), a partnership remains a possibility. Issues related to the proposed sale as well as those affecting hospital economics are considered. Proposed terms of the sale are included. (JN)

  16. Water resources of Jefferson Davis Parish, Louisiana

    USGS Publications Warehouse

    White, Vincent E.; Prakken, Lawrence B.

    2014-01-01

    Information concerning the availability, use, and quality of water in Jefferson Davis Parish, Louisiana, is critical for proper water-supply management. The purpose of this fact sheet is to present information that can be used by water managers, parish residents, and others for stewardship of this vital resource. Information on the availability, past and current use, use trends, and water quality from groundwater and surface-water sources in the parish is presented. Previously published reports and data stored in the U.S. Geological Survey’s National Water Information System (http://waterdata.usgs.gov/nwis) are the primary sources of the information presented here.

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

    ERIC Educational Resources Information Center

    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…

  18. 75 FR 80524 - Watercress Darter National Wildlife Refuge, Jefferson County, AL

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    ... Darter NWR, near the city of Bessemer, Jefferson County, Alabama, was established by the Service in 1980... occur in the city of Bessemer, Alabama. Watercress Darter NWR is a small system that can be greatly..., watershed, and biota exchange pathways. Extensive resource sharing and networking with other protected areas...

  19. A haemovigilance team provides both significant financial and quality benefits in a University Hospital.

    PubMed

    Decadt, Ine; Costermans, Els; Van de Poel, Maai; Kesteloot, Katrien; Devos, Timothy

    2017-04-01

    Haemovigilance is the process of surveillance of blood transfusion procedures including unexpected hazards and reactions during the transfusion pathway in both donors and recipients. The haemovigilance team aims to increase blood transfusion safety and to decrease both morbidity and mortality in donors and recipients. The team collects data about transfusion reactions and incidents, instructs the involved health workers and assures the tracing of blood components. The haemovigilance team at the University Hospitals Leuven has played a pioneering role in the development of haemovigilance in Belgium Although the literature about safety and quality improvements by haemovigilance systems is abundant, there are no published data available measuring their financial impact in a hospital. Therefore, we studied the costs and returns of the haemovigilance team at the University Hospitals Leuven. This study has a descriptive explorative design. Research of the current costs and returns of the haemovigilance team were based upon data from the Medical Administration of the hospital. Data were analyzed descriptively. The haemovigilance team of the University Hospitals Leuven is financially viable: the direct costs are covered by the annual financial support of the National Public Health Service. The indirect returns come from two important tasks of the haemovigilance team itself: correction of the electronic registration of administered blood component and improvement of the return of conform preserved blood components to the blood bank. Besides safety and quality improvement, which are obviously their main goals, the haemovigilance team also implies a financial benefit for the hospital. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Jefferson Lab Experimental Hall C

    NASA Astrophysics Data System (ADS)

    Carlini, Roger D.

    1996-10-01

    Jefferson Lab's Hall C went into initial operation in November 1995. The hall has a short orbit spectrometer (SOS) for short-lived particles such as pions and kaons and a high-momentum spectrometer (HMS) usually used for electrons. The SOS can also be used for protons. The HMS can range to 7 GeV/c. Both the SOS and HMS have typical resolutions of (10-3). Experiments for this hall range from measuring the neutron electric form factor, to color transparency, to creating strange nuclei. This paper will present the optical capabilities of the spectrometers, the parameters of the detection systems, and the overall beam line characteristics of the hall as determined from the results from the recent physics experiments along with the upcoming experimental schedule. Additional information is available at URL http://www.cebaf.gov/hallc.html.

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

    PubMed

    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.

  2. California's county hospitals and the University of California graduate medical education system. Current issues and future directions.

    PubMed

    Jameson, W J; Pierce, K; Martin, D K

    1998-05-01

    California's county hospitals train 45% of the state's graduate medical residents, including 33% of residents in the University of California system. This paper describes the interrelationships of California's county hospitals and the University of California (UC) graduate medical education (GME) programs, highlighting key challenges facing both systems. The mission of California's county health care systems is to serve all who need health care services regardless of ability to pay. Locating UC GME programs in county hospitals helps serve the public missions of both institutions. Such partnerships enhance the GME experience of UC residents, provide key primary care training opportunities, and ensure continued health care access for indigent and uninsured populations. Only through affiliation with university training programs have county hospitals been able to run the cost-effective, quality programs that constitute an acceptable safety net for the poor. Financial stress, however, has led county hospitals and UC's GME programs to advocate for reform in both GME financing and indigent care funding. County hospitals must participate in constructing strategies for GME reform to assure that GME funding mechanisms provide for equitable compensation of county hospitals' essential role. Joint advocacy will also be essential in achieving significant indigent care policy reform.

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

    PubMed

    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.

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

    PubMed Central

    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

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

    PubMed

    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.

  6. 5 MeV Mott Polarimeter Development at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Price, J. S.; Sinclair, C. K.; Cardman, L. S.

    1997-01-01

    Low energy (E{sub k}=100 keV) Mott scattering polarimeters are ill- suited to support operations foreseen for the polarized electron injector at Jefferson Lab. One solution is to measure the polarization at 5 MeV where multiple and plural scattering are unimportant and precision beam monitoring is straightforward. The higher injector beam current offsets the lower cross-sections. Recent improvements in the CEBAF injector polarimeter scattering chamber have improved signal to noise.

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

    PubMed

    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, P<0.01) and job advancement (r=0.69, P<0.01) were statically significant and strongly correlated with nurses' job satisfaction. Job security was associated with highest satisfaction (r=0.41, P<0.05) CONCLUSION AND RECOMMENDATIONS: Remuneration and job 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.

  8. Necrotizing fasciitis: the Howard University Hospital experience.

    PubMed

    Walker, M; Hall, M

    1983-02-01

    All surgical cases from 1965 to 1980 and autopsy cases from 1974 to 1980 diagnosed at Howard University Hospital as necrotizing fasciitis (NF) were reviewed. Eight patient fulfilled the criteria for NF, which included (1) fascial necrosis, (2) spreading cellulitis with undermining of fascial planes, and (3) systemic toxicity as evidenced by altered mental state and hyperthermia. Bacteroides fragilis was commonly found in our most recent cases. Poor prognostic signs included (1) documented bacteremia, (2) preoperative hypotension (systolic blood pressure lower than 80 mmHg), and (3) hypocalcemia (serum calcium less than 7.0 mg/dL). Therapy consisted of wide debridement with systemic antibiotics and delayed skin grafting when needed.

  9. Prevalence of anaesthesia information management systems in university-affiliated hospitals in Europe.

    PubMed

    Balust, Jaume; Egger Halbeis, Christoph B; Macario, Alex

    2010-02-01

    An increasing number of studies suggest that anaesthesia information management systems (AIMS) improve clinical care. The purpose of this web survey study was to assess the prevalence of AIMS in European university-affiliated anaesthesia departments and to identify the motivations for and barriers to AIMS adoption. A survey was e-mailed to 252 academic anaesthesia chairs of 294 university-affiliated hospitals in 22 European countries, with 41 e-mails returned as undeliverable, leaving the final sample equal to 211. Responders provided information on demographics, the other information technology systems available in their hospitals, and current implementation status of AIMS. Adopters were asked about motivations for installing AIMS, whereas nonadopters were asked about barriers to AIMS adoption. Eighty-six (29%) of 294 hospitals responded. Forty-four of the 86 departments (51%) were considered AIMS adopters because they were already using (n = 15), implementing (n = 13) or selecting an AIMS (n = 16). The 42 remaining departments (49%) were considered nonadopters as they were not expecting to install an AIMS owing to lack of funds (n = 27), other reasons (n = 13) such as lack of support from the information technology department, or simply did not have a plan (n = 2). The top ranked motivators for adopting AIMS were improved clinical documentation, improvement in patient care and safety, and convenience for anaesthesiologists. AIMS adopters were more likely than nonadopters to already have other information technology systems deployed throughout the hospital. At least 44 (or 15%) of the 294 university-affiliated departments surveyed in this study have already implemented, are implementing, or are currently selecting an AIMS. The main barrier identified by AIMS nonadopters is lack of funds.

  10. Segregation Increases in Jefferson County Schools. Enrollment Report for 1977-78.

    ERIC Educational Resources Information Center

    Hamilton, Douglas

    Failures of school officials in Jefferson County, Kentucky to desegregate their student bodies since 1975 are cited in this report and substantiated with charts and tables. The resegregation, rather than desegregation, of elementary schools in 1977-78 is documented. It is shown that 12 elementary schools have never been in compliance with…

  11. Second hip fractures at Chiang Mai University Hospital.

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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.

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

    PubMed

    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

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

    PubMed

    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.

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

    PubMed

    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.

  18. Case study: the Stanford University School of Medicine and its teaching hospitals.

    PubMed

    Pizzo, Philip A

    2008-09-01

    There is wide variation in the governance and organization of academic health centers (AHCs), often prompted by or associated with changes in leadership. Changes at AHCs are influenced by institutional priorities, economic factors, competing needs, and the personality and performance of leaders. No organizational model has uniform applicability, and it is important for each AHC to learn what works or does not on the basis of its experiences. This case study of the Stanford University School of Medicine and its teaching hospitals--which constitute Stanford's AHC, the Stanford University Medical Center--reflects responses to the consequences of a failed merger of the teaching hospitals and related clinical enterprises with those of the University of California-San Francisco School of Medicine that required a new definition of institutional priorities and directions. These were shaped by a strategic plan that helped define goals and objectives in education, research, patient care, and the necessary financial and administrative underpinnings needed. A governance model was created that made the medical school and its two major affiliated teaching hospitals partners; this arrangement requires collaboration and coordination that is highly dependent on the shared objectives of the institutional leaders involved. The case study provides the background factors and issues that led to these changes, how they were envisioned and implemented, the current status and challenges, and some lessons learned. Although the current model is working, future changes may be needed to respond to internal and external forces and changes in leadership.

  19. Values and strategies: management of radical organizational change in a university hospital.

    PubMed

    Orvik, Arne

    2017-04-01

    Managers' experiences of radical change were studied in a Norwegian university hospital, which was relocated from a traditional building to a new, high-tech building. The university hospital was also accredited as a health promoting hospital. Thirteen managers at different levels in the organization and a personnel safety representative were interviewed as part of a trailing research project. The aim of the study was to elucidate the managers' value orientation and strategies for dealing with value tensions. A combination of a hermeneutical, reflective method and a template for quality, efficiency and integrity guided the analysis. The template was based not only on the main findings but also on the core values of a model of organizational health. The results show that clinical managers focus on quality and top managers, not unexpectedly, focus on efficiency. Managers at both levels were concerned about their own integrity, and also about the integrity of their clinician colleagues, as well as showing concern for the hospital's mission, in terms of organizational effectiveness. The discussion was conducted in terms of dominance, cycling and balancing strategies, of which the last was the most prevalent. However, sustainable strategies for dealing with value tensions also call for value-based management and value-conscious leadership. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  20. Thomas Jefferson's Road to the White House. Teaching with Historic Places.

    ERIC Educational Resources Information Center

    Hunter, Kathleen

    This unit focuses on Thomas Jefferson's route from his home at Monticello in Virginia to the White House when he traveled to Washington in November of 1800 for the upcoming presidential election. The document traces his journey by phaeton, a four wheeled light carriage, from Monticello to: (1) James Madison's home at Montpelier, a distance of 28…

  1. Detector development for Jefferson Lab's 12GeV Upgrade

    DOE PAGES

    Qiang, Yi

    2015-05-01

    Jefferson Lab will soon finish its highly anticipated 12 GeV Upgrade. With doubled maximum energy, Jefferson Lab’s Continuous Electron Beam Accelerator Facility (CEBAF) will enable a new experimental program with substantial discovery potential, addressing important topics in nuclear, hadronic and electroweak physics. In order to take full advantage of the high energy, high luminosity beam, new detectors are being developed, designed and constructed to fit the needs of different physics topics. The paper will give an overview of various new detector technologies to be used for 12 GeV experiments. It will then focus on the development of two solenoid-based spectrometers,more » the GlueX and SoLID spectrometers. The GlueX experiment in Hall D will study the complex properties of gluons through exotic hybrid meson spectroscopy. The GlueX spectrometer, a hermetic detector package designed for spectroscopy and the associated partial wave analysis, is currently in the final stage of construction. Hall A, on the other hand, is developing the SoLID spectrometer to capture the 3D image of the nucleon from semi-inclusive processes and to study the intrinsic properties of quarks through mirror symmetry breaking. Such a spectrometer will have the capability to handle very high event rates while still maintaining a large acceptance in the forward region.« less

  2. Chemical quality of bottom sediments in selected streams, Jefferson County, Kentucky, April-July 1992

    USGS Publications Warehouse

    Moore, B.L.; Evaldi, R.D.

    1995-01-01

    Bottom sediments from 25 stream sites in Jefferson County, Ky., were analyzed for percent volatile solids and concentrations of nutrients, major metals, trace elements, miscellaneous inorganic compounds, and selected organic compounds. Statistical high outliers of the constituent concentrations analyzed for in the bottom sediments were defined as a measure of possible elevated concentrations. Statistical high outliers were determined for at least 1 constituent at each of 12 sampling sites in Jefferson County. Of the 10 stream basins sampled in Jefferson County, the Middle Fork Beargrass Basin, Cedar Creek Basin, and Harrods Creek Basin were the only three basins where a statistical high outlier was not found for any of the measured constituents. In the Pennsylvania Run Basin, total volatile solids, nitrate plus nitrite, and endrin constituents were statistical high outliers. Pond Creek was the only basin where five constituents were statistical high outliers-barium, beryllium, cadmium, chromium, and silver. Nitrate plus nitrite and copper constituents were the only statistical high outliers found in the Mill Creek Basin. In the Floyds Fork Basin, nitrate plus nitrite, phosphorus, mercury, and silver constituents were the only statistical high outliers. Ammonia was the only statistical high outlier found in the South Fork Beargrass Basin. In the Goose Creek Basin, mercury and silver constituents were the only statistical high outliers. Cyanide was the only statistical high outlier in the Muddy Fork Basin.

  3. Petabyte Class Storage at Jefferson Lab (CEBAF)

    NASA Technical Reports Server (NTRS)

    Chambers, Rita; Davis, Mark

    1996-01-01

    By 1997, the Thomas Jefferson National Accelerator Facility will collect over one Terabyte of raw information per day of Accelerator operation from three concurrently operating Experimental Halls. When post-processing is included, roughly 250 TB of raw and formatted experimental data will be generated each year. By the year 2000, a total of one Petabyte will be stored on-line. Critical to the experimental program at Jefferson Lab (JLab) is the networking and computational capability to collect, store, retrieve, and reconstruct data on this scale. The design criteria include support of a raw data stream of 10-12 MB/second from Experimental Hall B, which will operate the CEBAF (Continuous Electron Beam Accelerator Facility) Large Acceptance Spectrometer (CLAS). Keeping up with this data stream implies design strategies that provide storage guarantees during accelerator operation, minimize the number of times data is buffered allow seamless access to specific data sets for the researcher, synchronize data retrievals with the scheduling of postprocessing calculations on the data reconstruction CPU farms, as well as support the site capability to perform data reconstruction and reduction at the same overall rate at which new data is being collected. The current implementation employs state-of-the-art StorageTek Redwood tape drives and robotics library integrated with the Open Storage Manager (OSM) Hierarchical Storage Management software (Computer Associates, International), the use of Fibre Channel RAID disks dual-ported between Sun Microsystems SMP servers, and a network-based interface to a 10,000 SPECint92 data processing CPU farm. Issues of efficiency, scalability, and manageability will become critical to meet the year 2000 requirements for a Petabyte of near-line storage interfaced to over 30,000 SPECint92 of data processing power.

  4. Leprosy in a University Hospital in Southern Brazil*

    PubMed Central

    de Lima, Adma Silva; Pinto, Karin Cristine; Bona, Míryan Priscilla Santos; de Mattos, Suelen Mayara Lopes; Hoffmann, Marina Portiolli; Mulinari-Brenner, Fabiane Andrade; Ottoboni, Vanessa Cristhine Dallolmo

    2015-01-01

    BACKGROUND Leprosy is an infectious disease that may lead to irreversible nerve damage, compromising patient's quality of life and leading to loss of working years. OBJECTIVES To evaluate the epidemiological profile of patients followed at a University Hospital. MATERIALS AND METHODS This is a retrospective observational study, based on a review of medical records. We studied the clinical and epidemiological features of patients with leprosy monitored at the Hospital de Clínicas of the Federal University of Paraná between January 2005 and January 2010. RESULTS The mean age was 47.51, while 35.94% of patients were aged 41-60. The male:female rate was 1.8:1. The most prevalent occupations were: retired, students or rural workers. Patients came mainly from Curitiba or nearby areas, but there were also patients from the countryside. The mean diagnostic delay was 24.57 months. Multibacillary forms prevailed, with the lepromatous variety being the most common, closely followed by the borderline type. Neural enlargement was found in more than 50% of the patients and 48.44% of them developed reactional states. Hemolysis was the most commonly detected drug side effect. Initial functional evaluation was possible in 70% of patients, 55% of whom had disabilities upon diagnosis. The most prevalent associated disease was hypertension. CONCLUSIONS This study showed an important diagnostic delay and a high rate of sequelae in this specific population. Brazil is one of the few remaining countries that has not yet eradicated leprosy and it is important to improve health policies in order to prevent sequelae and achieve eradication. PMID:26560210

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

    PubMed

    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.

  6. Strategic planning in healthcare: the experience of the University of Wisconsin Hospital and Clinics.

    PubMed

    Sollenberger, Donna K

    2006-01-01

    In 1999, after 25 years of stable leadership from a single CEO, the University of Wisconsin Hospital and Clinics (UWHC) Authority Board named a new CEO. The 471-bed academic medical center had recently experienced significant change and challenges. In 1996, it had emerged as a public authority, a statutory designation by the state of Wisconsin that moved the hospital and clinics from the University of Wisconsin and the state of Wisconsin, and created it as a quasi-public entity with its own board. In 1999, when the new CEO was named, the hospital was experiencing a loss of revenue and market share, operating deficits, a 22 percent nurse vacancy rate, and patient satisfaction scores below the 40th percentile. The first task assigned to the new CEO by the board was the development of a new strategic plan that would reverse these trends and position UWHC as a premier academic hospital. The CEO began a strategic planning process that involved leaders, physicians, and staff from throughout the hospital and clinics, its affiliated medical school, and the physician practice plan. This article describes the collaborative, integrative, and communicative strategic planning process UWHC used; details the organization of the process; describes the results achieved by UWHC; and lists the lessons learned along the way.

  7. Proposal for a slow positron facility at Jefferson National Laboratory

    NASA Astrophysics Data System (ADS)

    Mills, Allen P.

    2018-05-01

    One goal of the JPos-17 International Workshop on Physics with Positrons was to ascertain whether it would be a good idea to expand the mission of the Thomas Jefferson National Accelerator Facility (JLab) to include science with low energy (i.e. "slow") spin polarized positrons. It is probably true that experimentation with slow positrons would potentially have wide-ranging benefits comparable to those obtained with neutron and x-ray scattering, but it is certain that the full range of these benefits will never be fully available without an infrastructure comparable to that of existing neutron and x-ray facilities. The role for Jefferson Laboratory would therefore be to provide and maintain (1) a dedicated set of machines for making and manipulating high intensity, high brightness beams of polarized slow positrons; (2) a suite of unique and easily used instruments of wide utility that will make efficient use of the positrons; and (3) a group of on-site positron scientists to provide scientific leadership, instrument development, and user support. In this note some examples will be given of the science that might make a serious investment in a positron facility worthwhile. At the same time, the lessons learned from various proposed and successful positron facilities will be presented for consideration.

  8. Results From the N* Program at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Inna Aznauryan, Volker Burkert, Tsung-Shung Lee, Viktor Mokeev

    2011-06-01

    We discuss the results on the fundamental degrees of freedom underlying the nucleon excitation spectrum and how they evolve as the resonance transitions are investigated with increasingly better space-time resolution of the electromagnetic probe. Improved photocouplings for a number of resonant states, those for the N(1720)P13 being significantly changed, have been determined and entered into the 2008 edition of the RPP. Strong sensitivity to the N(1900)P13 state, listed now as a 2-star state in the same edition of RPP, has been observed in KΛ and KΣ photoproduction. None of the earlier observations of a Θ+5(1540) was confirmed in a seriesmore » of three Jefferson Lab high statistics dedicated measurements, and stringent upper limits on production cross sections were placed in several channels. For the four lowest excited states, the Δ(1232)P33, N(1440)P11, N(1520)D13, and N(1535)S11, the transition amplitudes have been measured in a wide range in photon virtuality Q2. The amplitudes for the Δ(1232) show the importance of the pion-cloud contribution and do not show any sign of approaching the pQCD regime for Q2 < 7 GeV2. For the Roper resonance, N(1440)P11, the data provide strong evidence for this state as a predominantly radial excitation of the nucleon as a 3-quark ground state. For the N(1535)S11, comparison of the results extracted from π and η photo- and electroproduction data allowed one to specify the branching ratios of this state to the πN and ηN channels; they entered into the 2010 edition of the RPP. Measured for the first time, the longitudinal transition amplitude for the N(1535)S11 became a challenge for quark models and can be indicative of large meson-cloud contributions or alternative representations of this state. The N(1520)D13 clearly shows the rapid changeover from helicity-3/2 dominance at the real photon point to helicity-1/2 dominance at Q2 > 0.5 GeV2 confirming a long-standing prediction of the constituent quark model. The

  9. Is there a disparity in the hospital care received under a universal health insurance program in Taiwan?

    PubMed

    Hsiao, Yu-Yu; Cheng, Shou-Hsia

    2013-07-01

    To analyze the disparity in hospital care among people of various socio-economic status (SES) under a universal health insurance scheme. A survey questionnaire was mailed to discharged patients in October 2010. This study included 183 large-scale hospitals in Taiwan. A total of 3015 patients/caregivers completed the questionnaires, which yielded a response rate of 58%. Three variables were included. The two access-to-care variables were admission route and accreditation level of the hospital in which the patient stayed. A structured questionnaire, the patient-reported hospital quality (PRHQ), was included to characterize patient's experience of hospital stay. Patients with lower education were less likely to be admitted to a hospital according to a planned schedule, or to choose an Medical Center Hospital. However, SES was not associated with the PRHQ scores. Furthermore, patients with unplanned admission were associated with lower PRHQ scores than those with planned admission to the hospital. Under the universal health insurance system in Taiwan, lower education is associated with unplanned admission to a hospital, which might result in poorer perceived quality of care. Reducing unplanned admission is a challenge for health authorities in the future.

  10. Supervisory needs of research doctoral students in a university teaching hospital setting.

    PubMed

    Caldwell, Patrina Hy; Oldmeadow, Wendy; Jones, Cheryl A

    2012-10-01

    Teaching hospitals affiliated with universities are now common sites for research higher degree supervision. We hypothesised that the hospital environment poses unique challenges to supervision compared with the traditional university research institute setting. This study aimed to identify and rank important supervision issues in a clinical setting from the students' perspective. Using the Delphi method to explore issues and facilitate consensus, small group discussions were conducted with 10 research doctoral students from a tertiary teaching hospital. We identified supervision issues that are unique to the hospital-based context. These include the demands placed on supervisors combining clinical and supervisory roles, the challenges of academic medical/scientific writing and career issues for students who are already established in their professions. Other issues identified, common to all doctoral students, include differing expectations between students and supervisors (with students wanting support for their career plans, training in research skills and increasing autonomy and responsibility), supervisor access, quality and frequency of meetings, lack of training in writing and dealing with conflicts. Our research identified that postgraduate students of supervisors who combine clinical and supervisory roles report significant issues with supervision, some of which are unique to the clinical setting. Clinician researchers who supervise postgraduate students need to balance clinical and supervisory responsibilities, identify and negotiate student expectations early in candidature and provide career counselling to students who are already highly experienced. Furthermore, clinician supervisors should undertake postgraduate supervisor training programme tailored to the hospital setting to better support their students. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of

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

    PubMed

    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.

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

    PubMed

    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.

  13. Techniques for estimating the quantity and quality of storm runoff from urban watersheds of Jefferson County, Kentucky

    USGS Publications Warehouse

    Evaldi, R.D.; Moore, B.L.

    1994-01-01

    Linear regression models are presented for estimating storm-runoff volumes, and mean con- centrations and loads of selected constituents in storm runoff from urban watersheds of Jefferson County, Kentucky. Constituents modeled include dissolved oxygen, biochemical and chemical oxygen demand, total and suspended solids, volatile residue, nitrogen, phosphorus and phosphate, calcium, magnesium, barium, copper, iron, lead, and zinc. Model estimations are a function of drainage area, percentage of impervious area, climatological data, and land uses. Estimation models are based on runoff volumes, and concen- trations and loads of constituents in runoff measured at 6 stormwater outfalls and 25 streams in Jefferson County.

  14. Jefferson Lab 12 GEV Cebaf Upgrade

    NASA Astrophysics Data System (ADS)

    Rode, C. H.

    2010-04-01

    The existing continuous electron beam accelerator facility (CEBAF) at Thomas Jefferson National Accelerator Facility (TJNAF) is a 5-pass, recirculating cw electron Linac operating at ˜6 GeV and is devoted to basic research in nuclear physics. The 12 GeV CEBAF Upgrade is a 310 M project, sponsored by the Department of Energy (DOE) Office of Nuclear Physics, that will expand its research capabilities substantially by doubling the maximum energy and adding major new experimental apparatus. The project received construction approval in September 2008 and has started the major procurement process. The cryogenic aspects of the 12 GeV CEBAF Upgrade includes: doubling the accelerating voltages of the Linacs by adding ten new high-performance, superconducting radiofrequency (SRF) cryomodules (CMs) to the existing 42 1/4 cryomodules; doubling of the 2 K cryogenics plant; and the addition of eight superconducting magnets.

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

    PubMed

    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

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

    PubMed

    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.

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

    PubMed

    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.

  18. Searching for dark photon with positrons at Jefferson lab

    NASA Astrophysics Data System (ADS)

    Marsicano, Luca

    2018-05-01

    The interest in the Dark Photon (A' or U) has recently grown, since it could act as a light mediator to a new sector of Dark Matter particles. In this paradigm, the electron-positron annihilation can rarely produce a γA' pair. Various experiments (e.g. PADME@LNF [1], VEPP-3 [2]) have been proposed to detect this process using positron beams impinging on fixed targets. In such experiments, the energy of the photon from the e+e-→ γA' process is measured with an electromagnetic calorimeter and the missing mass is computed (the A' interacts weakly with Standard Model matter so it can't be detected). However, the A' mass range that can be explored with this technique is limited by the accessible energy in the center of mass frame, which goes as the square root of the beam energy. The realization of a 11 GeV positron beam at Jefferson Lab would allow to search for A' masses up to ˜ 100 MeV, reaching unexplored regions of the A' parameter space. A preliminary study on the feasibility of a PADME-like experiment at Jefferson Lab has been carried out, assuming a 11 GeV positron beam with a ˜ 100 nA current. The achievable sensitivity was estimated, studying the main sources of background (positron bremsstrahlung, annihilation into 2 gammas) using CALCHEP [3] and GEANT4 [4] simulations.

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

    NASA Astrophysics Data System (ADS)

    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.

  20. Assessment of Historic Landscape, Highway 45 Borrow Pit, Jefferson Parish, Louisiana

    DTIC Science & Technology

    2003-10-01

    Resources Survey of the Mississippi River -Gulf Outlet, Orleans and St. Bernard Parishes , Louisiana . Submitted to the New Orleans District, U.S. Army...US Army Corps of Engineers New Orleans District ASSESSMENT OF HISTORIC LANDSCAPE, HIGHWAY 45 BORROW PIT, JEFFERSON PARISH , LOUISIANA Final Report...LaFourche and Belle Pass forming the western boundary, and the Mississippi River and Red Pass forming the eastern boundary. It encompasses approximately

  1. The CLAS12 torus detector magnet at Jefferson Laboratory

    DOE PAGES

    Luongo, Cesar; Wiseman, Mark A.; Kashy, David H.; ...

    2015-12-17

    The CLAS12 Torus is a toroidal superconducting magnet, part of the detector for the 12GeV accelerator upgrade at Jefferson Lab. The coils were wound/fabricated by Fermi Lab, with Jlab responsible for all other parts of the project scope, including design, integration, cryostating the individual coils, installation, cryogenics, I&C, etc. The study provides an overview of the CLAS12 Torus magnet features, and serves as a status report of its installation in the experimental hall. Completion and commissioning of the magnet is expected in 2016.

  2. NASA Videofile of Solar Eclipse from Jefferson City, Missouri

    NASA Image and Video Library

    2017-08-21

    During the eclipse, 14 states across the U.S. were in the path of totality and experienced more than two minutes of darkness in the middle of the day – with a partial eclipse viewable all across North America. The broadcast – Eclipse Across America: Through the Eyes of NASA – covered locations along the path of totality, from Oregon to South Carolina including public reactions from all ages. During this event, NASA Glenn Research Center celebrates the eclipse at the capital eclipse event in Jefferson City, MO

  3. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    PubMed

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    PubMed

    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.

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

    PubMed

    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.

  6. [Implementation of modern operating room management -- experiences made at an university hospital].

    PubMed

    Hensel, M; Wauer, H; Bloch, A; Volk, T; Kox, W J; Spies, C

    2005-07-01

    Caused by structural changes in health care the general need for cost control is evident for all hospitals. As operating room is one of the most cost-intensive sectors in a hospital, optimisation of workflow processes in this area is of particular interest for health care providers. While modern operating room management is established in several clinics yet, others are less prepared for economic challenges. Therefore, the operating room statute of the Charité university hospital useful for other hospitals to develop an own concept is presented. In addition, experiences made with implementation of new management structures are described and results obtained over the last 5 years are reported. Whereas the total number of operation procedures increased by 15 %, the operating room utilization increased more markedly in terms of time and cases. Summarizing the results, central operating room management has been proved to be an effective tool to increase the efficiency of workflow processes in the operating room.

  7. First-line nurse managers in university hospitals--captives to their own professional culture?

    PubMed

    Viitanen, Elina; Wiili-Peltola, Erja; Tampsi-Jarvala, Tiina; Lehto, Juhani

    2007-01-01

    This study investigates whether first-line nurse managers in hospitals share common dispositions related to managerial work and leadership, what they are like, and what their relationship is with the various expectations set on them. The first data were collected by focus group interviews in the autumn of 2000 and analysed using qualitative content analysis and frame analysis. The second data set were part of a questionnaire survey addressed to the same managers in 2001 with a focus on their diverse leadership roles. Among first-line nurse managers, the management frameworks of a nurturing mother and an administrative nurse displayed the strongest prominence, and the emphasis seemed to be evolving towards the administrative. The results from the survey confirmed the findings of this study in relation to first-line nurse managers' management frameworks. The line of development found in this study may add to the permanence of operations and the stability of the operative culture at a university hospital. It may also diminish the opportunities for nursing development in university hospital wards and weaken the potential for a new kind of competence among both managers and their subordinates.

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

    PubMed

    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

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

    PubMed

    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.

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

    PubMed

    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.

  11. The experience of physicians in pharmacogenomic clinical decision support within eight German university hospitals.

    PubMed

    Hinderer, Marc; Boeker, Martin; Wagner, Sebastian A; Binder, Harald; Ückert, Frank; Newe, Stephanie; Hülsemann, Jan L; Neumaier, Michael; Schade-Brittinger, Carmen; Acker, Till; Prokosch, Hans-Ulrich; Sedlmayr, Brita

    2017-06-01

    The aim of this study was to assess the physicians' attitude, their knowledge and their experience in pharmacogenomic clinical decision support in German hospitals. We conducted an online survey to address physicians of 13 different medical specialties across eight German university hospitals. In total, 564 returned questionnaires were analyzed. The remaining knowledge gap, the uncertainty of test reimbursement and the physicians' lack of awareness of existing pharmacogenomic clinical decision support systems (CDSS) are the major barriers for implementing pharmacogenomic CDSS into German hospitals. Furthermore, pharmacogenomic CDSS are most effective in the form of real-time decision support for internists. Physicians in German hospitals require additional education of both genetics and pharmacogenomics. They need to be provided with access to relevant pharmacogenomic CDSS.

  12. Work environment and recent suicidal thoughts among male university hospital physicians in Sweden and Italy: the health and organization among university hospital physicians in Europe (HOUPE) study.

    PubMed

    Fridner, Ann; Belkić, Karen; Minucci, Daria; Pavan, Luigi; Marini, Massimo; Pingel, Birgit; Putoto, Giovanni; Simonato, Pierluigi; Løvseth, Lise T; Schenck-Gustafsson, Karin

    2011-08-01

    Male and female physicians are at elevated suicide risk. The work environment has become a focus of attention as a possible contributor to this risk. The potential association between work environment and suicidal thoughts has been examined among female physicians in several countries, and significant findings have been reported. The purpose of this study was to examine the role of the work environment in relation to suicidal thoughts among male university hospital physicians in 2 European countries. Cross-sectional multivariate analysis was performed to identify significant associations between work-related factors and suicide risk among male physicians from the Health and Organization among University Hospital Physicians in Europe (HOUPE) study. The dependent variable was termed recent suicidal thoughts, which includes having thought about suicide and/or having thought about specific ways to commit suicide within the previous year. Adjusted odds ratios (ORs) and CIs are reported. Of the 456 Swedish (56%) and 241 Italian (39%) male physicians who participated, 12% of the physicians from each country reported affirmatively regarding recent suicidal thoughts. Degrading work experiences were associated with recent suicidal thoughts for the Swedish and Italian physicians (OR = 2.1; 95% CI, 1.01-4.5; OR = 3.3; 95% CI, 1.3-8.0, respectively). Role conflict was associated with recent suicidal thoughts among the Swedish physicians (OR = 1.6; 95% CI, 1.1-2.2). Support at work when difficulties arose appeared to be protective for the Swedish physicians (OR = 0.7; 95% CI, 0.5-0.96). Italian physicians with little control over working conditions had an increased risk of recent suicidal thoughts, whereas confidential discussions about work experiences appeared to be protective (OR = 0.6; 95% CI, 0.4-0.9). Attention should be paid to the work environment as it relates to suicide risk among male university hospital physicians, particularly to bolstering social support and

  13. Occipital Neuralgia after Occipital Cervical Fusion to Treat an Unstable Jefferson Fracture

    PubMed Central

    Kong, Seong Ju; Park, Jin Hoon

    2012-01-01

    In this report we describe a patient with an unstable Jefferson fracture who was treated by occipitocervical fusion and later reported sustained postoperative occipital neuralgia. A 70-year-old male was admitted to our center with a Jefferson fracture induced by a car accident. Preoperative lateral X-ray revealed an atlanto-dens interval of 4.8mm and a C1 canal anterior-posterior diameter of 19.94mm. We performed fusion surgery from the occiput to C5 without decompression of C1. The patient reported sustained continuous pain throughout the following year despite strong analgesics. The pain dermatome was located mainly in the great occipital nerve territory and posterior neck. Magnetic resonance images revealed no evidence of cord compression, however a C1 lamina compressed dural sac and C2 root compression could not be excluded. We performed bilateral C2 root decompression via a C1 laminectomy. After decompression, bilateral C2 root redundancy was identified by palpation. After decompression surgery, pain was reduced. This case indicates that occipital neuralgia, suggesting the need for diagnostic block, should be considered in the differential diagnosis of patients with sustained occipital headache after occipitocervical fusion surgery. PMID:25983846

  14. The BDX experiment at Jefferson Laboratory

    NASA Astrophysics Data System (ADS)

    Celentano, Andrea

    2015-06-01

    The existence of MeV-GeV dark matter (DM) is theoretically well motivated but remarkably unexplored. The Beam Dump eXperiment (BDX) at Jefferson Laboratory aims to investigate this mass range. Dark matter particles will be detected trough scattering on a segmented, plastic scintillator detector placed downstream of the beam-dump at one of the high intensity JLab experimental Halls. The experiment will collect up to 1022 electrons-on-target (EOT) in a one-year period. For these conditions, BDX is sensitive to the DM-nucleon elastic scattering at the level of a thousand counts per year, and is only limited by cosmogenic backgrounds. The experiment is also sensitive to DM-electron elastic and inelastic scattering, at the level of 10 counts/year. The foreseen signal for these channels is an high-energy (> 100 MeV) electromagnetic shower, with almost no background. The experiment, has been presented in form of a Letter of Intent to the laboratory, receiving positive feedback, and is currently being designed.

  15. New integrated information system for pusan national university hospital.

    PubMed

    Kim, Hyung Hoi; Cho, Kyung-Won; Kim, Hye Sook; Kim, Ju-Sim; Kim, Jung Hyun; Han, Sang Pil; Park, Chun Bok; Kim, Seok; Chae, Young Moon

    2011-03-01

    This study presents the information system for Pusan National University Hospital (PNUH), evaluates its performance qualitatively, and conducts economic analysis. Information system for PNUH was designed by component-based development and developed by internet technologies. Order Communication System, Electronic Medical Record, and Clinical Decision Support System were newly developed. The performance of the hospital information system was qualitatively evaluated based on the performance reference model in order to identify problem areas for the old system. The Information Economics approach was used to analyze the economic feasibility of hospital information system in order to account for the intangible benefits. Average performance scores were 3.16 for input layer, 3.35 for process layer, and 3.57 for business layer. In addition, the cumulative benefit to cost ratio was 0.50 in 2011, 1.73 in 2012, 1.76 in 2013, 1.71 in 2014, and 1.71 in 2015. The B/C ratios steadily increase as value items are added. While overall performance scores were reasonably high, doctors were less satisfied with the system, perhaps due to the weak clinical function in the systems. The information economics analysis demonstrated the economic profitability of the information systems if all intangible benefits were included. The second qualitative evaluation survey and economic analysis were proposed to evaluate the changes in performance of the new system.

  16. An Inventory of Cocurricular Drama Programs in the Secondary Schools of Jefferson County, Kentucky.

    ERIC Educational Resources Information Center

    Hoover, Nancy Roahrig

    In order to compile an inventory of secondary school cocurricular dramatics programs in the Jefferson County, Kentucky, public schools, eleven principals, eighteen teachers, and eighty students were randomly selected from thirteen high schools, five junior high schools, and five middle schools. Respondents completed questionnaires concerning the…

  17. Scintillating fiber-based photon beam profiler for the Jefferson Lab tagged photon beam line

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Zorn, C.; Barbosa, F.J.; Freyberger, A.

    2000-10-01

    A scintillating fiber hodoscope has been built for use as a photon beam profiler in the bremsstrahlung tagged photon beam in Hall B of the Thomas Jefferson National Accelerator Facility (Jefferson Lab). The device consists of a linear array of 64 2-2 mm2 scintillating fibers glued to a corresponding set of light guide fibers. Both fiber types use double-clad technology for maximum intensity. The light guide fibers are gently bent into a square array of holes and air-gap coupled to four compact position-sensitive photomultipliers (16 channel Hamamatsu R5900-M16). Custom electronics amplifies and converts the analog outputs to ECL pulses whichmore » are counted by VME-based scalars. The device consisting of the fibers, photomultipliers, and electronics is sealed within a light-tight aluminum box. Two modules make up a beam imaging 2-D system. The system has been tested successfully during an experimental run« less

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

    PubMed

    Gorman, J; Vellinga, A; Gilmartin, J J; O'Keeffe, S T

    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). Readmissions during the calendar year 2006 were examined using hospital in-patient enquiry data. Associations with clinical and demographic factors were determined using univariate and multivariate analyses. The medical emergency readmission rate to GUH, after correction for death during the index admission, was 19.5%. Age 65 years or more, male gender, length of stay more than 7 days and primary diagnoses of chronic obstructive pulmonary disease, myocardial infarction, alcohol-related disease and heart failure during the index admission were significantly associated with readmission in univariate and multivariate analyses. The medical emergency readmission rate in GUH is comparable to other acute hospitals in Ireland and Britain. Further evaluation is needed to estimate the proportion of readmissions that are potentially avoidable.

  19. Incidence of rotavirus gastroenteritis hospitalizations and genotypes, before and five years after introducing universal immunization in Israel.

    PubMed

    Muhsen, Khitam; Kassem, Eias; Rubenstein, Uri; Goren, Sophy; Ephros, Moshe; Cohen, Dani; Shulman, Lester M

    2016-11-21

    Uncertainty exists about the sustainability of the reduction in rotavirus gastroenteritis (RVGE) following the introduction of rotavirus vaccines into national immunization programs, and on its potential impact on circulating genotypes. RotaTeq was introduced into the Israeli national immunization program in December 2010, and vaccination coverage is around 80%. To examine the change in incidence of RVGE hospitalization and rotavirus genotypes, during the five years after introduction of RotaTeq into the Israeli national immunization program. Data were obtained prospectively on hospitalization of children aged 0-59months due to acute gastroenteritis (N=7346) from three hospitals in northern Israel. Stool samples were tested for rotavirus by immunochromatography. Rotavirus was genotyped (N=506) by RT-PCR and/or sequencing. The average incidence of RVGE hospitalization declined by 61.0% (95% CI 49.0-73.4%), from 5.6 per 1000 (95% CI 5.0-6.2) in the pre-universal immunization period (2008-2010) to 2.2 per 1000 (95% CI 1.8-2.5) during the universal immunization period (2012-2015), but yearly fluctuations were still observed. The most common genotypes in the pre-universal immunization period were G1P[8] (35.3%) followed by G2P[4] (15.5%), G3P[8] (8.8%), G4P[8] (4.3%) and G9P[8] (4.3%), and 19.5% were mixed infections. The dominance of G1P[8] continued into the universal immunization period (48.6%), followed by G3P[8] (21.5%), G9P[8] (15.9%) and G12P[8] (4.7%), while mixed rotavirus infections were no longer detected. Universal immunization with RotaTeq in Israel was associated a sustained reduction in RVGE hospitalization. It is unclear whether changes in the circulating rotavirus genotypes are due to vaccine-induced selective pressure. Assessment of the long-term impact of rotavirus vaccination on the incidence of rotavirus gastroenteritis and continued strain surveillance is warranted. Copyright © 2016. Published by Elsevier Ltd.

  20. Evaluation of cores from Jefferson Highway near Airline Highway : technical assistance report 16-03TA-C.

    DOT National Transportation Integrated Search

    2016-09-01

    This technical assistance report documents the investigation conducted by the Louisiana Transportation Research Center (LTRC) of the cored concrete from Westbound Jefferson Highway near Airline Highway in Baton Rouge, LA. The petrographic analysis sh...

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

    PubMed

    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).

  2. The Reverend Thomas Jefferson Bowen: An Introductory Background to His Linguistic Works, 1850-1856

    ERIC Educational Resources Information Center

    Awoniyi, Timothy A.

    1974-01-01

    A historical narrative background for the linguistic works of Thomas Jefferson Bowen, an American missionary who was the first non-Nigerian to publish a grammar of Yoruba (1858). The author points up a need for further scholarly review of Bowen's pioneering work and contribution to Yoruba studies. (JT)

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

    PubMed

    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 < 0.01). The one university hospital executives should promote the pay, promotion and supervision factors which encourage personnel to be satisfied and demonstrate their OCB as their reciprocal reaction.

  4. [Device-vigilance at University Hospital in Central Eastern Tunisia: a survey conducted among physicians].

    PubMed

    Mahjoub, Mohamed; Jedidi, Maher; Masmoudi, Tasnim; Bouafia, Nabiha; Njah, Mansour

    2016-01-01

    The University Hospital Farhat Hached Sousse (Tunisia), has implemented a device-vigilance (DV) system, according to ANCSEP (National Agency of the Sanitary and Environmental Control of Products) guidelines, in order to manage the risk more effectively in hospital and to improve the quality and safety of patient care. In Tunisia the lack of regulation regarding device vigilance is the major obstacle to caregiver vigilance. The objective of this study is to establish the knowledge, attitudes, and clinical practice of University Hospital physicians regarding the implementation of the DV system. We conducted a descriptive cross-sectional study of KAP (knowledge, attitudes and practices) among all the physicians working at the University Hospital Farhat Hached Sousse (Tunisia) who were users of medical devices (MDs) in the practice of their profession. A self-administered, pre-established and pre-testing questionnaire was developed. Data were collected and analyzed using SPSS20.0 software. The response rate was 51.9 % (183/95). A lack of knowledge about DV has been reported. More than half of the respondents didn't know the local correspondent of health establishment and the existence of a standardized vigilance reporting form. Regarding the attitudes, 89,5% express their interest in setting up a DV system and 37,5% acknowledged that the vigilance reporting form should be filled by the caregiver notifying the incident. Regarding the procedures, the majority of physicians confirmed the absence of an organized maintenance management of the MDs in the practice of their services. 90.5% express their wishes to receive information but few of them express their wishes to receive proper training (57.9%). A lack of information and training in a sensitive field which need to be heavily regulated has been a topic of discussion. The promulgation of regulatory texts is necessary in order to promote MD sector and guarantee the safety of patient and their users.

  5. RICH Detector for Jefferson Labs CLAS12

    NASA Astrophysics Data System (ADS)

    Trotta, Richard; Torisky, Ben; Benmokhtar, Fatiha

    2015-10-01

    Jefferson Lab (Jlab) is performing a large-scale upgrade to its Continuous Electron Beam Accelerator Facility (CEBAF) up to 12GeV beams. The Large Acceptance Spectrometer (CLAS12) in Hall B is being upgraded and a new hybrid Ring Imaging Cherenkov (RICH) detector is being developed to provide better kaon - pion separation throughout the 3 to 8 GeV/c momentum range. This detector will be used for a variety of Semi-Inclusive Deep Inelastic Scattering experiments. Cherenkov light can be accurately detected by a large array of sophisticated Multi-Anode Photomultiplier Tubes (MA-PMT) and heavier particles, like kaons, will span the inner radii. We are presenting our work on the creation of the RICH's geometry within the CLAS12 java framework. This development is crucial for future calibration, reconstructions and analysis of the detector.

  6. Congenital lobar emphysema: 30-year case series in two university hospitals*

    PubMed Central

    Cataneo, Daniele Cristina; Rodrigues, Olavo Ribeiro; Hasimoto, Erica Nishida; Schmidt, Aurelino Fernandes; Cataneo, Antonio José Maria

    2013-01-01

    OBJECTIVE: To review the cases of patients with congenital lobar emphysema (CLE) submitted to surgical treatment at two university hospitals over a 30-year period. METHODS: We reviewed the medical records of children with CLE undergoing surgical treatment between 1979 and 2009 at the Botucatu School of Medicine Hospital das Clínicas or the Mogi das Cruzes University Hospital. We analyzed data regarding symptoms, physical examination, radiographic findings, diagnosis, surgical treatment, and postoperative follow-up. RESULTS: During the period studied, 20 children with CLE underwent surgery. The mean age at the time of surgery was 6.9 months (range, 9 days to 4 years). All of the cases presented with symptoms at birth or during the first months of life. In all cases, chest X-rays were useful in defining the diagnosis. In cases of moderate respiratory distress, chest CT facilitated the diagnosis. One patient with severe respiratory distress was misdiagnosed with hypertensive pneumothorax and underwent chest tube drainage. Only patients with moderate respiratory distress were submitted to bronchoscopy, which revealed no tracheobronchial abnormalities. The surgical approach was lateral muscle-sparing thoracotomy. The left upper and middle lobes were the most often affected, followed by the right upper lobe. Lobectomy was performed in 18 cases, whereas bilobectomy was performed in 2 (together with bronchogenic cyst resection in 1 of those). No postoperative complications were observed. Postoperative follow-up time was at least 24 months (mean, 60 months), and no late complications were observed. CONCLUSIONS: Although CLE is an uncommon, still neglected disease of uncertain etiology, the radiological diagnosis is easily made and surgical treatment is effective. PMID:24068262

  7. [Cost analysis of dialysis treatment at the Odense University Hospital and the Sønderborg Hospital].

    PubMed

    Maschoreck, T R; Sørensen, M C; Andresen, M; Høgsberg, I M; Rasmussen, P; Søgaard, J

    1998-12-14

    The major purpose of this paper is to investigate the treatment costs of dialysis treatment by modality. In this study Odense University Hospital (OUH) and Sønderborg Hospital were chosen as cases. The costs of haemodialysis (HD) treatment are estimated to DKK 341-392,000 per patient during the first year, and DKK 328-379,000 per year the following years. The costs of continuous ambulatory peritoneal dialysis (CAPD) treatment are estimated to DKK 262-291,000 per patient during the first year, and DKK 251-277,000 per year the following years. The costs of CCPD (peritoneal dialysis with the aid of a machine), treatment are estimated to DKK 312-325,000 per patient during the first year, and DKK 296-308,000 per year the following years. The treatment costs of HD are lower than expected, while the treatment costs of PD are higher than expected. As a result of this the differences in treatment costs (HD versus PD) are much lower than expected, DKK 130,000 at the most.

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

    PubMed

    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.

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

    PubMed

    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 (<50 nmol/l). Low vitamin 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.

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

    PubMed

    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.

  11. Surgery for oesophageal cancer at Galway University Hospital 1993-2008.

    PubMed

    Chang, K H; McAnena, O J; Smith, M J; Salman, R R; Khan, M F; Lowe, D

    2010-12-01

    Surgical volume and outcome remain controversial in the management of oesophageal cancer. To assess the outcome of oesophagectomy for cancer at Galway University Hospital (GUH). Between 1994 and 2008, patients who underwent oesophagectomy were analysed. During the study period, 126 oesophagectomies were performed for cancer. The average surgeon volume was 9 cases per year. The 30-day and overall in-hospital mortality rates were 6.3 and 7.9%, respectively. Restructuring of our critical care services has led to a reduction in 30-day mortality from 8.2 to 5.1%. The use of neoadjuvant chemoradiotherapy has increased from 17 to 35% during the study period. In patients who underwent resection, the 3 and 5-year overall survival rates were 45 and 29%, respectively. Operative morbidity and mortality at GUH are comparable with worldwide outcomes. Improved resources and national restructuring of cancer services have significantly improved the quality of care and outcomes of patients.

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

    PubMed

    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.

  13. A network of web multimedia medical information servers for a medical school and university hospital.

    PubMed

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

    1997-08-01

    Modern medicine requires a rapid access to information including clinical data from medical records, bibliographic databases, knowledge bases and nomenclature databases. This is especially true for University Hospitals and Medical Schools for training as well as for fundamental and clinical research for diagnosis and therapeutic purposes. This implies the development of local, national and international cooperation which can be enhanced via the use and access to computer networks such as Internet. The development of professional cooperative networks goes with the development of the telecommunication and computer networks and our project is to make these new tools and technologies accessible to the medical students both during the teaching time in Medical School and during the training periods at the University Hospital. We have developed a local area network which communicates between the School of Medicine and the Hospital which takes advantage of the new Web client-server technology both internally (Intranet) and externally by access to the National Research Network (RENATER in France) connected to the Internet network. The address of our public web server is http:(/)/www.med.univ-rennesl.fr.

  14. Production of Charmonium at Threshold in Hall A and C at Jefferson Lab

    DOE PAGES

    Hafidi, K.; Joosten, S.; Meziani, Z. -E.; ...

    2017-05-27

    Here, we describe in this paper two approved experiments in Hall A and Hall C at Jefferson Lab that will investigate the pure gluonic component of the strong interaction of Quantum ChromoDynamics by measuring the elastic J/ψ electro and photo-production cross section in the threshold region as well as explore the nature of the recently discovered LHCb charmed pentaquarks.

  15. Cycle-Based Budgeting and Continuous Improvement at Jefferson County Public Schools: Year 1 Report

    ERIC Educational Resources Information Center

    Yan, Bo

    2016-01-01

    This report documents the first-year of implementing Cycle-based Budgeting at Jefferson County Public Schools (Louisville, KY). To address the limitations of incremental budgeting and zero-based budgeting, a Cycle-based Budgeting model was developed and implemented in JCPS. Specifically, each new program needs to submit an on-line budget request…

  16. The Search for Missing Baryons with Linearly Polarized Photons at Jefferson Lab

    NASA Astrophysics Data System (ADS)

    Cole, Philip

    2006-05-01

    The set of experiments forming the g8 run took place in Hall B of Jefferson Lab during the summers of 2001 and 2005 These experiments made use of a beam of linearly-polarized photons produced through coherent bremsstrahlung and represent the first time such a probe has been employed at Jefferson Lab. The scientific purpose of g8 is to improve the understanding of the underlying symmetry of the quark degrees of freedom in the nucleon, the nature of the parity exchange between the incident photon and the target nucleon, and the mechanism of associated strangeness production in electromagnetic reactions. With the high-quality beam of the tagged and collimated linearly-polarized photons and the nearly complete angular coverage of the Hall-B spectrometer, we seek to extract the differential cross sections and attendant polarization observables for the photoproduction of vector mesons and kaons at photon energies ranging between 1.3 and 2.2 GeV. We achieved polarizations exceeding 90% and collected over six billion events, which, after our data cuts and analysis, should give us well over 100 times the world's data set. I shall report on the experimental details of establishing the Coherent Bremsstrahlung Facility and present some preliminary results from our first run.

  17. Pressure ulcer knowledge among nurses in a Brazilian university hospital.

    PubMed

    Chianca, Tânia Couto Machado; Rezende, Jomara Figueiredo Pinto; Borges, Eline Lima; Nogueira, Vera Lucia; Caliri, Maria Helena Larcher

    2010-10-01

     To facilitate the implementation of evidence-based skin and pressure ulcer (PU) care practices and related staff education programs in a university hospital in Brazil, a cross-sectional study was conducted to evaluate nurses' knowledge about PU prevention, wound assessment, and staging. Of the 141 baccalaureate nurses (BSN) employed by the hospital at the time of the study, 106 consented to participate. Using a Portuguese version of Pieper's Pressure Ulcer Knowledge Test (PUKT), participants were asked to indicate whether 33 statements about PU prevention and eight about PU assessment and staging were true or false. For the 33 prevention statements, the average number answered correctly was 26.07 (SD 4.93) and for the eight assessment statements the average was 4.59 (SD 1.62). Nurses working on inpatient clinical nursing units had significantly better scores (P = 0.000). Years of nursing experience had a weak and negative correlation with correct PUKT scores (r = -0.21, P = 0.033) as did years of experience working in the university hospital (r = -.179, P <.071). Incorrect responses were most common for statements related to patient positioning, massage, PU assessment, and staging definitions. The results of this study confirm that nurses have an overall understanding of PU prevention and assessment principles but important knowledge deficits exist. Focused continuing education efforts are needed to facilitate the implementation of evidence-based care.

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

    PubMed

    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

  19. Colorectal carcinoma in young persons: experience at Howard University Hospital, 1955--1977.

    PubMed

    Mosley, E L; Chung, E B; Cornwell, E E; Anderson, J; Leffall, L D

    1979-05-01

    Case records of all patients 30 years of age and under with a proven pathological diagnosis of colorectal cancer at Howard University Hospital between January 1955 and December 1977 were reviewed. Over this 23-year period, 14 cases were documented. All patients were black. This study reaffirms the poor prognosis which accompanies colorectal carcinoma in the young, particularly in those patients with mucinous carcinoma.

  20. First report of Jefferson's ground sloth (Megalonyx jeffersonii) in North Dakota: Paleobiogeographical and paleoecological significance

    USGS Publications Warehouse

    Hoganson, J.W.; McDonald, H. Gregory

    2007-01-01

    A well-preserved ungual of a pes documents the presence of Jefferson's ground sloth (Megalonyx jeffersonii) at the end of the Wisconsinan in North Dakota. This is the 1st report of M. jeffersonii in North Dakota, and one of few records from the upper Great Plains. An accelerator mass spectrometer radiocarbon age of 11,915 ?? 40 years ago was obtained from the specimen, suggesting that the sloth resided in North Dakota during the Rancholabrean Land Mammal Age, just before extinction of the species. Palynological records from sites near the sloth occurrence and of the same age indicate that it resided in a cool, moist, spruce-dominated forest habitat in a riparian setting along the Missouri River. Its presence in that setting corroborates the notion that Jefferson's ground sloth was a browsing inhabitant of gallery forests associated with rivers. It is likely that M. jeffersonii used river valleys, such as the Missouri River valley, as migration routes. ?? 2007 American Society of Mammalogists.

  1. Cycle-Based Budgeting and Continuous Improvement at Jefferson County Public Schools: Year 2 Report

    ERIC Educational Resources Information Center

    Yan, Bo

    2017-01-01

    This report documents the second year of implementing Cycle-based Budgeting at Jefferson County Public Schools (Louisville, KY). In addition to aligning another $24.3 million new spending with the district's strategic plan, $20.3 million of existing spending was rolled into the process. Next, the challenges faced by the district to review 105…

  2. Nurses' readiness for evidence-based practice at Finnish university hospitals: a national survey.

    PubMed

    Saunders, Hannele; Stevens, Kathleen R; Vehviläinen-Julkunen, Katri

    2016-08-01

    The aim of this study was to determine nurses' readiness for evidence-based practice at Finnish university hospitals. Although systematic implementation of evidence-based practice is essential to effectively improving patient outcomes and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' individual and organizational readiness for evidence-based practice. Although nurses' evidence-based practice competencies have been widely studied in countries leading the evidence-based practice movement, less is known about nurses' readiness for evidence-based practice in the non-English-speaking world. A cross-sectional descriptive survey design. The study was conducted in November-December 2014 in every university hospital in Finland with a convenience sample (n = 943) of practicing nurses. The electronic survey data were collected using the Stevens' Evidence-Based Practice Readiness Inventory, which was translated into Finnish according to standardized guidelines for translation of research instruments. The data were analysed using descriptive and inferential statistics. Nurses reported low to moderate levels of self-efficacy and low levels of evidence-based practice knowledge. A statistically significant, direct correlation was found between nurses' self-efficacy in employing evidence-based practice and their actual evidence-based practice knowledge level. Several statistically significant differences were found between nurses' socio-demographic variables and nurses' self-efficacy in employing evidence-based practice, and actual and perceived evidence-based practice knowledge. Finnish nurses at university hospitals are not ready for evidence-based practice. Although nurses are familiar with the concept of evidence-based practice, they lack the evidence-based practice knowledge and self-efficacy in employing evidence-based practice required for integrating best evidence into clinical care delivery. © 2016 John Wiley

  3. Di-hadron production at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Anefalos Pereira, Sergio; et. al.,

    Semi-inclusive deep inelastic scattering (SIDIS) has been used extensively in recent years as an important testing ground for QCD. Studies so far have concentrated on better determination of parton distribution functions, distinguishing between the quark and antiquark contributions, and understanding the fragmentation of quarks into hadrons. Hadron pair (di-hadron) SIDIS provides information on the nucleon structure and hadronization dynamics that complement single hadron SIDIS. Di-hadrons allow the study of low- and high-twist distribution functions and Dihadron Fragmentation Functions (DiFF). Together with the twist-2 PDFs ( f1, g1, h1), the Higher Twist (HT) e and hL functions are very interesting becausemore » they offer insights into the physics of the largely unexplored quark-gluon correlations, which provide access into the dynamics inside hadrons. The CLAS spectrometer, installed in Hall-B at Jefferson Lab, has collected data using the CEBAF 6 GeV longitudinally polarized electron beam on longitudinally polarized solid NH3 targets. Preliminary results on di-hadron beam-, target- and double-spin asymmetries will be presented.« less

  4. Beamline Insertions Manager at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Johnson, Michael C.

    2015-09-01

    The beam viewer system at Jefferson Lab provides operators and beam physicists with qualitative and quantitative information on the transverse electron beam properties. There are over 140 beam viewers installed on the 12 GeV CEBAF accelerator. This paper describes an upgrade consisting of replacing the EPICS-based system tasked with managing all viewers with a mixed system utilizing EPICS and high-level software. Most devices, particularly the beam viewers, cannot be safely inserted into the beam line during high-current beam operations. Software is partly responsible for protecting the machine from untimely insertions. The multiplicity of beam-blocking and beam-vulnerable devices motivates us tomore » try a data-driven approach. The beamline insertions application components are centrally managed and configured through an object-oriented software framework created for this purpose. A rules-based engine tracks the configuration and status of every device, along with the beam status of the machine segment containing the device. The application uses this information to decide on which device actions are allowed at any given time.« less

  5. Di-hadron production at Jefferson Laboratory

    NASA Astrophysics Data System (ADS)

    Anefalos Pereira, Sergio; CLAS Collaboration

    2015-04-01

    Semi-inclusive deep inelastic scattering (SIDIS) has been used extensively in recent years as an important testing ground for QCD. Studies so far have concentrated on better determination of parton distribution functions, distinguishing between the quark and antiquark contributions, and understanding the fragmentation of quarks into hadrons. Pair of hadrons (di-hadron) SIDIS provides information on the nucleon structure and hadronization dynamics that complements single-hadron SIDIS. The study of di-hadrons allow us to study higher twist distribution functions and Dihadron Fragmentation Functions (DiFF). Together with the twist-2 PDFs (f 1, g 1, h 1), the Higher Twist (HT) e and hL functions are very interesting because they offer insights into the physics of the largely unexplored quark-gluon correlations which provide direct and unique insights into the dynamics inside hadrons. The CLAS spectrometer, installed in Hall-B at Jefferson Lab, has collected data using the CEBAF 6 GeV longitudinally polarized electron beam on longitudinally polarized solid NH3 targets. Preliminary results on beam-, target- and double-spin asymmetries will be presented.

  6. Hydrogeologic Factors Affecting Base-Flow Yields in the Jefferson County Area, West Virginia, October-November 2007

    USGS Publications Warehouse

    Evaldi, Ronald D.; Paybins, Katherine S.; Kozar, Mark D.

    2009-01-01

    Base-flow yields at approximately the annual 75-percent-duration flow were determined for watersheds in the Jefferson County area, WV, from stream-discharge measurements made during October 31 to November 2, 2007. Five discharge measurements of Opequon Creek defined increased flow from 29,000,000 gallons per day (gal/d) at Carters Ford to 51,400,000 gal/d near Vanville. No flow was observed at 45 of 110 additional stream sites inspected, and discharge at the 65 flowing stream sites ranged from 1,940 to 17,100,000 gallons per day (gal/d). Discharge at 28 springs ranged from no flow to 2,430,000 gal/d. Base-flow yields were computed as the change in stream-channel discharge between measurement sites divided by the change in drainage area between the sites. Yields were negative for losing (influent) channel reaches and positive for gaining (effluent) reaches. Channels in 14 watersheds were determined to have lost flow ranging from -9.6 to -1,770 gallons per day per acre (gal/d/acre). Channels in 51 watersheds were determined to have gained flow ranging from 3.4 to 235,000 gal/d/acre. Water temperature at the stream sites ranged from 5.0 to 16.3 deg C (quarry pumpage), and specific conductance ranged from 51 to 881 microsiemens per centimeter (uS/cm). Water temperature at the springs ranged from 11.5 to 15.0 deg C, and specific conductance ranged from 22 to 958 uS/cm. Large springs in some watersheds in western Jefferson County are adjacent to other watersheds with little or no surface-water discharge; this is probably the result of interbasin transfer of groundwater along faults that dissect the area. Most watersheds located adjacent to the Potomac River in northeastern Jefferson County were not flowing during this study; this is most likely because the Potomac River is deeply incised, and groundwater flows directly to it rather than to the local stream systems in these areas. Except for one watershed with a yield of 651 gal/d/acre, no watersheds in northeastern

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

    PubMed

    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 < 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%).

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

    PubMed Central

    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 < 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%). PMID:25389439

  9. Patient attitudes towards medical students at Damascus University teaching hospitals

    PubMed Central

    2012-01-01

    Background The cooperation of patients and their consent to involve medical students in their care is vital to clinical education, but large numbers of students and lack of experience as well as loss of privacy may evoke negative attitudes of patients, which may sometimes adversely affect the clinical teaching environment. This study aimed to explore the attitudes of patients towards medical students at Damascus University hospitals, and to explore the determinants of those attitudes thus discussing possible implications applicable to clinical teaching. Methods This cross-sectional study was conducted at three teaching hospitals affiliated to the Faculty of Medicine at Damascus University. Four hundred patients were interviewed between March and April 2011 by a trained sociologist using a structured questionnaire. Results Of the patients interviewed, 67.8% approved the presence of medical students during the medical consultation and 58.2% of them felt comfortable with the presence of students, especially among patients with better socio-economic characteristics. 81.5% of the patients agreed to be examined by students in the presence of the supervisor, while 40.2% gave agreement even in the absence of the supervisor. Privacy was the most important factor in the patients' reticence towards examination by the students, whilst the relative safety and comfort if a supervisor was available determined patients' agreement. Conclusions The study concluded overall positive attitudes to the medical students' involvement in medical education. However, it is essential that students and clinical supervisors understand and adhere to professional and ethical conduct when involving patients in medical education. PMID:22439893

  10. Patient attitudes towards medical students at Damascus University teaching hospitals.

    PubMed

    Sayed-Hassan, Rima M; Bashour, Hyam N; Koudsi, Abir Y

    2012-03-22

    The cooperation of patients and their consent to involve medical students in their care is vital to clinical education, but large numbers of students and lack of experience as well as loss of privacy may evoke negative attitudes of patients, which may sometimes adversely affect the clinical teaching environment. This study aimed to explore the attitudes of patients towards medical students at Damascus University hospitals, and to explore the determinants of those attitudes thus discussing possible implications applicable to clinical teaching. This cross-sectional study was conducted at three teaching hospitals affiliated to the Faculty of Medicine at Damascus University. Four hundred patients were interviewed between March and April 2011 by a trained sociologist using a structured questionnaire. Of the patients interviewed, 67.8% approved the presence of medical students during the medical consultation and 58.2% of them felt comfortable with the presence of students, especially among patients with better socio-economic characteristics. 81.5% of the patients agreed to be examined by students in the presence of the supervisor, while 40.2% gave agreement even in the absence of the supervisor. Privacy was the most important factor in the patients' reticence towards examination by the students, whilst the relative safety and comfort if a supervisor was available determined patients' agreement. The study concluded overall positive attitudes to the medical students' involvement in medical education. However, it is essential that students and clinical supervisors understand and adhere to professional and ethical conduct when involving patients in medical education.

  11. [Measures taken by a university hospital for the prevention and control of the 2009 H1N1 influenza].

    PubMed

    Hayashi, Jun; Murata, Masayuki; Furusyo, Norihiro; Hoshina, Takayuki; Shimono, Nobuyuki

    2010-09-01

    After extensive discussion with the Fukuoka City government of measures for the prevention and control of the 2009 H1N1 influenza pandemic, Kyushu University Hospital organized the infection control teams of 39 hospitals in the Fukuoka City area in preparation for a possible outbreak. A facility was set up at Kyushu University Hospital for the screening of outpatients with fever, and those with influenza and an underlying disease or severe symptoms were admitted to the hospital. 37 (22%) of the 171 outpatients with fever were infected with the new strain of influenza, confirmed by rapid influenza antigen test and PCR: Of these 37 patients, 17 (45.9%) were negative by influenza antigen test. Other 37 patients (5 adults, 32 children) were admitted, all of whom were successfully treated with neuraminidase inhibitors and discharged with no aftereffects.

  12. Basic instrumentation for Hall A at Jefferson Lab

    NASA Astrophysics Data System (ADS)

    Alcorn, J.; Anderson, B. D.; Aniol, K. A.; Annand, J. R. M.; Auerbach, L.; Arrington, J.; Averett, T.; Baker, F. T.; Baylac, M.; Beise, E. J.; Berthot, J.; Bertin, P. Y.; Bertozzi, W.; Bimbot, L.; Black, T.; Boeglin, W. U.; Boykin, D. V.; Brash, E. J.; Breton, V.; Breuer, H.; Brindza, P.; Brown, D.; Burtin, E.; Calarco, J. R.; Cardman, L. S.; Carr, R.; Cates, G. D.; Cavata, C.; Chai, Z.; Chang, C. C.; Chant, N. S.; Chen, J.-P.; Choi, S.; Chudakov, E.; Churchwell, S.; Coman, M.; Cisbani, E.; Colilli, S.; Colombel, N.; Crateri, R.; Dale, D. S.; Degrande, N.; de Jager, C. W.; De Leo, R.; Deur, A.; Dezern, G.; Diederich, B.; Dieterich, S.; di Salvo, R.; Djawotho, P.; Domingo, J.; Ducret, J.-E.; Dutta, D.; Egiyan, K.; Epstein, M. B.; Escoffier, S.; Esp, S.; Ewell, L. A.; Finn, J. M.; Fissum, K. G.; Folts, E.; Fonvieille, H.; Frois, B.; Frullani, S.; Gao, H.; Gao, J.; Garibaldi, F.; Gasparian, A.; Gavalya, A.; Gayou, O.; Gilad, S.; Gilman, R.; Giuliani, F.; Glamazdin, A.; Glashausser, C.; Gomez, J.; Gorbenko, V.; Gorringe, T.; Gricia, M.; Griffioen, K.; Hamilton, D.; Hansen, J.-O.; Hersman, F. W.; Higinbotham, D. W.; Holmes, R.; Holmgren, H.; Holtrop, M.; d'Hose, N.; Hovhannisyan, E.; Howell, C.; Huber, G. M.; Hughes, E.; Hyde-Wright, C. E.; Ibrahim, H.; Incerti, S.; Iodice, M.; Iommi, R.; Ireland, D.; Jaminion, S.; Jardillier, J.; Jensen, S.; Jiang, X.; Jones, C. E.; Jones, M. K.; Joo, K.; Jutier, C.; Kahl, W.; Kato, S.; Katramatou, A. T.; Kelly, J. J.; Kerhoas, S.; Ketikyan, A.; Khandaker, M.; Khayat, M.; Kino, K.; Kominis, I.; Korsch, W.; Kox, S.; Kramer, K.; Kumar, K. S.; Kumbartzki, G.; Kuss, M.; Lagamba, L.; Laveissière, G.; Leone, A.; LeRose, J. J.; Marie, F.; Levchuk, L.; Leuschner, M.; Lhuillier, D.; Liang, M.; Livingston, K.; Lindgren, R. A.; Liyanage, N.; Lolos, G. J.; Lourie, R. W.; Lucentini, M.; Madey, R.; Maeda, K.; Malov, S.; Manley, D. M.; Margaziotis, D. J.; Markowitz, P.; Marroncle, J.; Martine, J.; Mayilyan, S.; McCarthy, J. S.; McCormick, K.; Mclntyre, J.; McKeown, R. D.; Meekins, D.; van der Meer, R. L. J.; Meziani, Z.-E.; Michaels, R.; Milbrath, B.; Miller, J. A.; Miller, W.; Mitchell, J.; Mougey, J.; Nanda, S.; Nathan, A.; Neyret, D.; Offermann, E. A. J. M.; Papandreou, Z.; Perdrisat, C. F.; Perrino, R.; Petratos, G. G.; Petrosyan, A.; Pierangeli, L.; Platchkov, S.; Pomatsalyuk, R.; Pripstein, D.; Prout, D. L.; Punjabi, V. A.; Pussieux, T.; Quéméner, G.; Ransomez, R. D.; Ravel, O.; Reitz, B.; Roblin, Y.; Roche, R.; Roedelbronn, M.; Rondon-Aramayo, O. A.; Roos, P. G.; Rosner, G.; Rowntree, D.; Rutledge, G. A.; Rutt, P. M.; Rvachev, M.; Sabatavenere, F.; Saha, A.; Saito, T.; Santavenere, F.; Sarty, A. J.; Schneider, W. J.; Segal, J. P.; Serdarevic-Offermann, A.; Shahinyan, A.; Slifer, K.; Smith, T. P.; Soldi, A.; Sorokin, P.; Souder, P.; Spiegel, S. L.; Stevens, M. A.; Strauch, S.; Suleiman, R.; Templon, J. A.; Terasawa, T.; Todor, L.; Tsubota, H.; Ueno, H.; Ulmer, P. E.; Urciuoli, G. M.; Van Hoorebeke, L.; Van de Vyver, R.; van Verst, S.; Vernin, P.; Vlahovic, B.; Voskanyan, H.; Voutier, E.; Walter, R.; Watson, J. W.; Watts, D. P.; Weinstein, L. B.; Wijesooriya, K.; Wojtsekhowski, B.; Xiang, H.; Xiong, F.; Xu, W.; Zainea, D. G.; Zeps, V.; Zhao, J.; Zheng, X.; Zhou, Z.-L.; Zhu, L.; Zolnierczuk, P. A.

    2004-04-01

    The instrumentation in Hall A at the Thomas Jefferson National Accelerator Facility was designed to study electro- and photo-induced reactions at very high luminosity and good momentum and angular resolution for at least one of the reaction products. The central components of Hall A are two identical high resolution spectrometers, which allow the vertical drift chambers in the focal plane to provide a momentum resolution of better than 2×10 -4. A variety of Cherenkov counters, scintillators and lead-glass calorimeters provide excellent particle identification. The facility has been operated successfully at a luminosity well in excess of 10 38 cm-2 s-1. The research program is aimed at a variety of subjects, including nucleon structure functions, nucleon form factors and properties of the nuclear medium.

  13. NASA Provides Coast-to-Coast Coverage of Aug. 21 Solar Eclipse (Jefferson City, MO)

    NASA Image and Video Library

    2017-08-21

    On Monday, Aug. 21, NASA provided coast-to-coast coverage of the solar eclipse across America – featuring views of the phenomenon from unique vantage points, including from the ground, from aircraft, and from spacecraft including the ISS, during a live broadcast seen on NASA Television and the agency’s website. This is footage from Jefferson City, Missouri.

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

    PubMed

    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.

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

    PubMed

    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.

  16. 75 FR 51098 - Protection Island and San Juan Islands National Wildlife Refuges, Jefferson, Island, San Juan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-18

    ..., Washington Maritime National Wildlife Refuge Complex, 715 Holgerson Drive, Sequim, WA 98382. FOR FURTHER...] Protection Island and San Juan Islands National Wildlife Refuges, Jefferson, Island, San Juan, Skagit, and Whatcom Counties, WA AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of availability: draft...

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

    PubMed

    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.

  18. East and West Elevations and Entrance Details U.S. Veterans ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    East and West Elevations and Entrance Details - U.S. Veterans Hospital, Jefferson Barracks, Therapeutic Exercise Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  19. Perception of the nursing team of a Surgical Center regarding Hospital Accreditation at a University Hospital.

    PubMed

    Fernandes, Hellen Maria de Lima Graf; Peniche, Aparecida de Cássia Giani

    2015-02-01

    Objective To analyze the perception of nursing teams at a surgical center regarding the process of hospital accreditation, in the evaluative aspects of structure, process, and result. Method The study takes a quantitative and exploratory-descriptive approach, carried out at a university hospital. Result The population consisted of 69 nursing professionals, and the data collection was performed in the months of January and February 2014 by way of a questionnaire, utilizing the Likert scale. The methodology used a Cronbach's Alpha equal to 0.812. In the comparison of the three aspects, the one with the highest favorability score was "result", with an average of 47.12 (dp±7.23), and the smallest was "structure," with an average of 40.70 (dp±5.19). Conclusion This situational diagnostic can assist in the restructuring of the vulnerable areas evaluated in these three aspects, mainly in the aspect of structure, with a goal of level 2 accreditation by the ONA (Brazilian's National Organization for Accreditation) defended by the Institution.

  20. Patient satisfaction questionnaire and quality achievement in hospital care: the case of a Greek public university hospital.

    PubMed

    Matis, Georgios K; Birbilis, Theodossios A; Chrysou, Olga I

    2009-11-01

    The scope of this research has been to investigate the satisfaction of Greek patients hospitalized in a tertiary care university public hospital in Alexandroupolis, Greece, in order to improve medical, nursing and organizational/administrative services. It is a cross-sectional study involving 200 patients hospitalized for at least 24 h. We administered a satisfaction questionnaire previously approved by the Greek Health Ministry. Four aspects of satisfaction were employed (medical, hotel facilities/organizational, nursing, global). Using principal component analysis, summated scales were formed and tested for internal consistency with the aid of Cronbach's alpha coefficient. The non-parametric Spearman rank correlation coefficient was also used. The results reveal a relatively high degree of global satisfaction (75.125%), yet satisfaction is higher for the medical (89.721%) and nursing (86.432%) services. Moreover, satisfaction derived from the hotel facilities and the general organization was found to be more limited (76.536%). Statistically significant differences in participant satisfaction were observed (depending on age, gender, citizenship, education, number of previous admissions and self-assessment of health status at the first and last day of patients' stay) for the medical, nursing and hotel facilities/organizational dimension, but not for global satisfaction. The present study confirms the results of previously published Greek surveys.

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

    PubMed

    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.

  2. Community-onset candidemia at a university hospital, 1995-2005.

    PubMed

    Kung, Hsiang-Chi; Wang, Jiun-Ling; Chang, Shan-Chwen; Wang, Jann-Tay; Sun, Hsin-Yun; Hsueh, Po-Ren; Chen, Yee-Chun

    2007-08-01

    Although not all candidemias are hospital-acquired, data on clinical epidemiology for the community-onset candidemia are limited. This retrospective study was conducted to describe predisposing factors and outcomes of community-onset candidemias. Medical records of patients who were admitted to the National Taiwan University Hospital between January 1, 1995 and May 31, 2005 and had Candida isolated from their blood in the outpatient setting and/or within 48 h of hospitalization (community-onset) were reviewed. A total of 56 episodes of candidemia were reviewed, which included 8 episodes (14.3%) of true community-acquired candidemia occurring in patients with no record of hospitalization within the previous 30 days and without histories of invasive procedures either just before or at the time of admission, and 48 episodes (85.7%) that were health care-associated. The latter included 24 episodes (42.9%) in patients recently discharged from hospitals (within 2-30 days of current admission), 23 episodes (41.1%) associated with invasive procedures and/or central intravascular lines placed for outpatient therapy, and 1 episode (1.8%) in patients admitted from nursing homes. Gastrointestinal bleeding (46.4%), immunosuppressive therapy (42.9%) and previous antibiotics use (37.5%) were the most common predisposing factors. Diabetes was the single most important predisposing factor in true community-acquired candidemia (62.5%) and had a significantly higher prevalence among these patients than in those with health care-associated candidemias (p=0.035). Candida albicans was the most common isolate (39.7%), followed by Candida tropicalis (22.4%) and Candida glabrata (17.2%). The overall case fatality rate was 55.4% (31/56), and 58.1% (18/31) of this was attributable to candidemia. Multivariate analysis identified higher severity score and lack of antifungal therapy as having an independent and adverse influence on outcome. Up to 85.7% of community-onset candidemias are health

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

    PubMed

    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.

  4. Jefferson Lab CLAS12 Superconducting Solenoid magnet Requirements and Design Evolution

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Rajput-Ghoshal, Renuka; Hogan, John P.; Fair, Ruben J.

    2014-12-01

    As part of the Jefferson Lab 12GeV accelerator upgrade project, one of the experimental halls (Hall B) requires two superconducting magnets. One is a magnet system consisting of six superconducting trapezoidal racetrack-type coils assembled in a toroidal configuration and the second is an actively shielded solenoidal magnet system consisting of 5 coils. In this presentation the physics requirements for the 5 T solenoid magnet, design constraints, conductor decision, and cooling choice will be discussed. The various design iterations to meet the specification will also be discussed in this presentation.

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

    PubMed Central

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

    2016-01-01

    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 blaOXA-48, blaCTX-M-15, blaSHV-1, and blaTEM-1D genes. Six of these isolates belonged to the pandemic clone sequence type 101 (ST101). The blaOXA-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. PMID:27645236

  6. 76 FR 19781 - Protection Island and San Juan Islands National Wildlife Refuges, Jefferson, San Juan, Skagit...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-08

    ...., Lopez Island, WA 98261. North Olympic Public Library..... 630 N. Sequim Ave., 360-683-1161 Sequim, WA...] Protection Island and San Juan Islands National Wildlife Refuges, Jefferson, San Juan, Skagit, Island, and Whatcom Counties, WA; Final Comprehensive Conservation Plan, Wilderness Stewardship Plan, and Finding of...

  7. [Empathy, inter-professional collaboration, and lifelong medical learning in Spanish and Latin-American physicians-in-training who start their postgraduate training in hospitals in Spain. Preliminary outcomes].

    PubMed

    San-Martín, Montserrat; Roig-Carrera, Helena; Villalonga-Vadell, Rosa M; Benito-Sevillano, Carmen; Torres-Salinas, Miquel; Claret-Teruel, Gemma; Robles, Bernabé; Sans-Boix, Antonia; Alcorta-Garza, Adelina; Vivanco, Luis

    2017-01-01

    To identify similarities and differences in empathy, abilities toward inter-professional collaboration, and lifelong medical learning, between Spanish and Latin-American physicians-in-training who start their posgraduate training in teaching hospitals in Spain. Observational study using self-administered questionnaires. Five teaching hospitals in the province of Barcelona, Spain. Spanish and Latin-American physicians-in-training who started their first year of post-graduate medical training. Empathy was measured using the Jefferson scale of empathy. Abilities for inter-professional collaboration were measured using the Jefferson scale attitudes towards nurse-physician collaboration. Learning was measured using the Jefferson scale of medical lifelong learning scale. From a sample of 156 physicians-in-training, 110 from Spain and 40 from Latin America, the Spanish group showed the highest empathy (p<.05). On the other hand, Latin-American physicians had the highest scores in lifelong learning abilities (p<.001). A positive relationship was found between empathy and inter-professional collaboration for the whole sample (r=+0.34; p<.05). These results confirm previous preliminary data and underline the positive influence of empathy in the development of inter-professional collaboration abilities. In Latin-American physicians who start posgraduate training programs, lifelong learning abilities have a positive influence on the development of other professional competencies. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  8. [Workflow management in the operating room. Analysis of potentials for optimizing efficiency at a university hospital].

    PubMed

    Welker, A; Wolcke, B; Schleppers, A; Schmeck, S B; Focke, U; Gervais, H W; Schmeck, J

    2010-10-01

    The introduction of the diagnosis-related groups reimbursement system has increased cost pressures. Due to the interaction of many different professional groups, analysis and optimization of internal coordination and scheduling in the operating room (OR) is mandatory. The aim of this study was to analyze the processes at a university hospital in order to optimize strategies by identifying potential weak points. Over a period 6 weeks before and 4 weeks after intervention processes time intervals in the OR of a tertiary care hospital (university hospital) were documented in a structured data collection sheet. The main reason for lack of efficiency of labor was underused OR utilization. Multifactorial reasons, particularly in the management of perioperative interfaces, led to vacant ORs. A significant deficit was in the use of OR capacity at the end of the daily OR schedule. After harmonization of working hours of different staff groups and implementation of several other changes an increase in efficiency could be verified. These results indicate that optimization of perioperative processes considerably contribute to the success of OR organization. Additionally, the implementation of standard operating procedures and a generally accepted OR statute are mandatory. In this way an efficient OR management can contribute to the economic success of a hospital.

  9. [State of development of the role of academic nursing staff at German university hospitals in 2015].

    PubMed

    Tannen, Antje; Feuchtinger, Johanna; Strohbücker, Barbara; Kocks, Andreas

    2017-02-01

    In order to meet the requirements of the increasing complexity of patient care it is recommended to promote more differentiated nursing staff structures and to integrate academic nurses, which is international standard and recommended by the German Science Council. The implementation level is unclear. What is the percentage of nurses with an academic degree at German university hospitals, and what are their task profiles? Standardised written survey by nursing directors of all 32 German university hospitals and medical universities in 2015. The response rate was 75 %. The ratio of nurses with an academic degree amounted to 1.7 % overall, and to 1.0 % in direct patient care. The activities of nurses with an academic degree correspond to international Advanced Nursing Practice approaches including conceptual development (76 %), support of evidence-based care (72 %), practice projects (64 %) and patient counselling (56 %). There were significant variations among hospitals nationwide concerning pay rates with a current lack of reliable pay structures. This is the first national survey to determine the quota of nurses with an academic degree in direct patient care. The ratio of 1 % is well below the 10 to 20 % recommended by the German Science Council - hence the need for immediate action and comprehensive reforms. A follow-up survey is planned for 2017. Copyright © 2016. Published by Elsevier GmbH.

  10. South wall, looking northwest, with scale bar U.S. Veterans ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    South wall, looking northwest, with scale bar - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

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

    PubMed

    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.

  12. Analysis of ESBL- and AmpC-positive Enterobacteriaceae at the Department of Neonatology, University Hospital Olomouc.

    PubMed

    Husičková, Vendula; Chromá, Magdaléna; Kolář, Milan; Hricová, Kristýna; Stosová, Taťána; Kantor, Lumír; Dubrava, Lubomír

    2011-06-01

    Bacterial infections are an important issue in current clinical medicine. The severity of infectious diseases has increased dramatically in recent years, which is also due to increasing numbers of resistant bacteria, including strains producing broad-spectrum beta-lactamases. The study aimed at determining the prevalence of ESBL- and AmpC-positive Enterobacteriaceae at the Department of Neonatology, University Hospital Olomouc. Enterobacteriaceae were isolated from clinical samples from infants hospitalized at the Department of Neonatology, University Hospital Olomouc over a period of 2 years. ESBL- and AmpC-positive isolates were subjected to basic genetic analysis. In the study period, a total of 1,526 isolates of the Enterobacteriaceae family were identified, including 55 (3.6%) cases of the ESBL phenotype and 17 (1.1%) AmpC-positive isolates. Genetic analysis of ESBL-positive isolates revealed a majority of CTX-M enzymes. Among AmpC beta-lactamases, the EBC, CIT, DHA, and MOX types were detected. An Escherichia coli strain was isolated with mutations in the promoter region of the ampC chromosomal gene that are associated with overproduction of the relevant enzyme.

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

    ERIC Educational Resources Information Center

    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)

  14. Interior, central sunporch behind living room, looking northeast U.S. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, central sunporch behind living room, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

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

    PubMed

    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 < 0.001). HCW with managerial functions perceived the environment as less encouraging to speak up (P < 0.05) than HCW without managerial function. We identified 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.

  16. Translational science and the hidden research system in universities and academic hospitals: a case study.

    PubMed

    Lander, Bryn; Atkinson-Grosjean, Janet

    2011-02-01

    Innovation systems (IS) and science policy scholarship predominantly focus on linkages between universities and industry, and the commercial translation of academic discoveries. Overlooked in such analyses are important connections between universities and academic hospitals, and the non-commercial aspects of translational science. The two types of institutions tend to be collapsed into a single entity-'the university'-and relational flows are lost. Yet the distinctions and flows between the two are crucial elements of translational science and the biomedical innovation system. This paper explores what has been called the 'hidden research system' that connects hospitals, universities, and their resources, with the clinical and scientific actors who make the linkages possible. Then, using a novel conceptual model of translational science, we examine the individual interactions and dynamics involved in a particular example of the biomedical innovation system at work: the diagnosis of IRAK-4 deficiency, a rare immunological disorder, and the translational flows that result. Contra to conventional IS analyses, we are able to point to the strong role of public-sector institutions, and the weak role of the private-sector, in the translational processes described here. Our research was conducted within a Canadian network of scientists and clinician-scientists studying the pathogenomics of immunological disorders and innate immunity. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. The Oregon Health and Science University-Oregon State Hospital Collaboration: Reflections on an Evolving Public-Academic Partnership.

    PubMed

    Chien, Joseph; Novosad, David; Mobbs, Karl E

    2016-03-01

    This column describes the conceptualization and implementation of an innovative collaboration between Oregon State Hospital and Oregon Health and Science University that was created to address understaffing and improve the quality of care. The hospital created a forensic evaluation rotation to address the growing population of forensic patients, which created a valuable recruiting tool for the hospital. One of the authors, a recent recruit, provides a first-person account of his experience working within the collaboration. The model could be emulated by other public-sector facilities facing similar challenges with psychiatrist recruitment and retention.

  18. Distribution of Yeast-Like Fungi at a University Hospital in Turkey

    PubMed Central

    Ece, Gulfem

    2014-01-01

    Background: 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. Objectives: 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. Materials and Methods: 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. Results: 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. Conclusions: Candida strains

  19. A SYNCHRONIZED FIR/VUV LIGHT SOURCE AT JEFFERSON LAB

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Stephen Benson, David Douglas, George Neil, Michelle D. Shinn, Gwyn Williams

    We describe a dual free-electron laser (FEL) configuration on the UV Demo FEL at Jefferson Lab that allows simultaneous lasing at FIR/THz and UV wavelengths. The FIR/THz source would be an FEL oscillator with a short wiggler providing nearly diffraction-limited pulses with pulse energy exceeding 50 microJoules. The FIR source would use the exhaust beam from a UVFEL. The coherent harmonics in the VUV from the UVFEL are out-coupled through a hole. The FIR source uses a shorter resonator with either hole or edge coupling to provide very high power FIR pulses. Simulations indicate excel-lent spectral brightness in the FIRmore » region with over 100 W/cm-1 output.« less

  20. A significant and consistent reduction in rotavirus gastroenteritis hospitalization of children under 5 years of age, following the introduction of universal rotavirus immunization in Israel.

    PubMed

    Muhsen, Khitam; Rubenstein, Uri; Kassem, Eias; Goren, Sophy; Schachter, Yaakov; Kremer, Adi; Shulman, Lester M; Ephros, Moshe; Cohen, Dani

    2015-01-01

    Universal rotavirus vaccination with RotaTeq was introduced in Israel in December 2010. We examined hospitalization rates of children under 5 years of age due to all-cause and rotavirus gastroenteritis, both before and 3 years after universal introduction of the vaccination. An ongoing hospital-based surveillance network that was established in November 2007, accessed information regarding hospitalization of children due to gastroenteritis (n = 6205) in 3 hospitals in northern Israel, with an annual average of about 60,000 children under 5 years of age living in the catchment area of these hospitals. Stool samples were tested for rotavirus by immunochromatography. Compared to the period preceding implementation of the universal rotavirus vaccination (2008-2010), hospitalizations due to rotavirus gastroenteritis in children <5 years of age decreased significantly, by 55% (95% CI 43%-67%) during the period of universal vaccination (2011-2013), a decrease that was sustained throughout the 3 year period. This reduction was greater in children aged 0-23 months (60-61%) than in toddlers aged 24-59 months (36%). A 32% (95% CI 21%-45%) decrease in the incidence of all-cause gastroenteritis was also observed. During the period preceding universal vaccination, rotavirus diarrhea showed typical winter seasonality, with highest incidence in December. However, the winter peak was substantially blunted during the period of universal immunization. Surveillance of rotavirus gastroenteritis should continue to assess the long-term impact of such a program. Our findings are of relevance to high and middle-income countries considering the introduction of a universal rotavirus immunization program.

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

    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.

  3. West wall, detail of main entrance, looking northeast U.S. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West wall, detail of main entrance, looking northeast - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  4. West (front) wall, looking southeast, showing main entrance U.S. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West (front) wall, looking southeast, showing main entrance - U.S. Veterans Hospital, Jefferson Barracks, Spinal Cord Injury Unit and Tuberculosis Neuropsychiatric Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  5. Interior, first floor, central lobby, detail of dedication plaque of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Interior, first floor, central lobby, detail of dedication plaque of terrazzo floor, looking west - U.S. Veterans Hospital, Jefferson Barracks, Admissions Building, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  6. Silent reminders: geologic wonders of the George Washington and Jefferson National Forests

    USGS Publications Warehouse

    ,; ,

    2001-01-01

    The iron industry played a vital role in the industrialization of the United States and in the development of the U.S. economy and society. Much of the early history of the iron industry took place in Virginia. The remains of 11 iron furnaces and nearby mines in the George Washington and Jefferson National Forests in Virginia and West Virginia are silent reminders of a time when iron mines and furnaces operated along a belt that extended through the Appalachian Mountains from New York State to Alabama.

  7. Cost effective Internet access and video conferencing for a community cancer network.

    PubMed Central

    London, J. W.; Morton, D. E.; Marinucci, D.; Catalano, R.; Comis, R. L.

    1995-01-01

    Utilizing the ubiquitous personal computer as a platform, and Integrated Services Digital Network (ISDN) communications, cost effective medical information access and consultation can be provided for physicians at geographically remote sites. Two modes of access are provided: information retrieval via the Internet, and medical consultation video conferencing. Internet access provides general medical information such as current treatment options, literature citations, and active clinical trials. During video consultations, radiographic and pathology images, and medical text reports (e.g., history and physical, pathology, radiology, clinical laboratory reports), may be viewed and simultaneously annotated by either video conference participant. Both information access modes have been employed by physicians at community hospitals which are members of the Jefferson Cancer Network, and oncologists at Thomas Jefferson University Hospital. This project has demonstrated the potential cost effectiveness and benefits of this technology. Images Figure 1 Figure 2 Figure 3 PMID:8563397

  8. An Analysis of Deaths Due to Tuberculosis at the Lagos University Teaching Hospital

    PubMed Central

    Bandele, E.O.; Olude, I.O.

    1985-01-01

    An analysis was made of deaths from tuberculosis in the Lagos University Teaching Hospital from 1976 to 1980. Of the 320 patients assessed, 240 were determined to have died from tuberculosis. Tuberculous meningitis was the main cause of death. Forty-two percent of the deaths occurred in the age group of 0 to 10 years old, and 47.5 percent of the patients died within one week of diagnosis. Potentially avoidable factors contributing to death include late reporting by patients to medical personnel, lack of bacillus of Calmette and Guerin (BCG) vaccine, irregular taking of medications by patients, and late referral of patients to specialized hospitals. There is a need for improved education of patients and medical personnel about the management of tuberculosis in Lagos. PMID:4046063

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

    PubMed

    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.

  10. Spectroscopic Study of L Hypernuclei with Electron Beams at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Nakamura, Satoshi; Gogami, Toshiyuki; Tang, Liguang

    The missing mass spectroscopy of L hypernuclei with the (e, e'K^+) reaction was started from 2000 at Jefferson Lab. In this fifteen years, various hypernuclei (A = 7 - 52) including hyperon (L, S^0) productions have been studied with newly developed experimental techniques. The (e, e'K^+) reaction spectroscopy of L hypernuclei features its capability of absolute missing mass calibration and production of new species of hypernuclei which are the isospin partners of well studied hypernuclei by (K^-, pi-) and (pi^+, K^+) reactions. In this paper, we will review how we established the (e, e'K^+) spectroscopic study of hypernuclei.

  11. 76 FR 70110 - Foreign-Trade Zone 109-County of Jefferson, NY; Application for Reorganization and Expansion...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-10

    ... Coffeen Street, Watertown; and, Site 2 (16 acres)--Dexter Sulphite Mill, 349 Lakeview Dr. & Stockton Avenue, Dexter. The grantee's proposed service area under the ASF would be the County of Jefferson, New..., NYS Route 12F, 22529 Airport Drive, Dexter. The ASF allows for the possible exemption of one magnet...

  12. [The anaesthesia and critical care specialty and new hospital management in France: an inquiry in university and general hospitals].

    PubMed

    Fusciardi, J; Remérand, F; Landais, A; Brodeur, J; Journois, D; Laffon, M

    2010-03-01

    To know: (1) how French public services of anaesthesia and critical care (ACC) have applied the new principles of hospital management and (2) whether or not it has impacted the different components of ACC. National questionnaire at the end of 2008, i.e., after 2 years of new hospital management. Heads of ACC services in general (GH) and university hospitals (UH). Eighteen closed questions and open opinions analyzed. Comparisons of percentages (Chi(2) - Yates): linear correlation. Percentages of responses were 70% (n=51) for UH and 37% (n=146) for GH. The new management principles were mainly applied. The different clinical and academic components of the ACC specialty (ACC, emergency medicine, pain management) mainly remained associated in UH. In GH, the new management induced constant and various changes. They were mainly judged as defeating the object of the ACC speciality in GH, especially in those of lower and mild sizes. The general tendency is that the ACC specialty was able to maintain the family ties of its different components in the UH. However, this principle was not a cornerstone of the new management in the GH. Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.

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

    PubMed

    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.

  14. [Tinea capitis in the University Hospital of Constantine (Algeria)].

    PubMed

    Benmezdad, A; Moulahem, T; Benyezzar, M; Djaballah, M; Beldjoudi, W; Fendri, A H

    2012-12-01

    Although benign, tinea capitis are a public health problem and a frequent complaint in children. In Algeria, these disorders have long been known; their high frequency was related to unfavorable social conditions of people both in cities than in rural areas. Our aim is the study of tinea capitis diagnosed in the laboratory of Parasitology and Mycology of the University Hospital of Constantine through a retrospective review of 15 consecutive years from 1997 to 2011. Currently the clinical and biological differ from those described by ancient authors; dermatophytic flora has evolved significantly and favus, once quite common in our country, is hardly ever found. In addition, we are witnessing a resurgence of zoophilic tinea particularly those caused by Microsporum canis. Copyright © 2012. Published by Elsevier SAS.

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

    PubMed Central

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

    2015-01-01

    Background: 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. Methods: 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. Results: 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). Conclusion: 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. PMID:26478878

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

    PubMed

    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.

  17. Impact of a new palliative care consultation team on opioid prescription in a University Hospital.

    PubMed

    Centeno, Carlos; Portela, María Angustias; Noguera, Antonio; Idoate, Antonio; Rubiales, Alvaro Sanz

    2009-01-16

    There are no validated measuring tools to gauge the effectiveness of a Hospital Palliative Care Consultation Team (PCCT). One way would be to consider its effect on the consumption of opioids expressed in total amounts and different formulations administered. We perform this study to evaluate the impact of a hospital PCCT on the trends of opioid prescription in a University Hospital. A seven year retrospective study on opioid prescription was carried out in the Clínica Universidad de Navarra. The period includes three years before and three years after the PCCT was implemented. Prescription was analysed calculating yearly the Defined Daily Dose (DDD) adjusted to 1000 hospital stays (DDD/1000HS). Indicators considered were the proportion of patients treated using opioids compared to the total estimated in need of treatment (rate of effectiveness) and the proportion of patients potentially requiring opioids but not treated who were incorporated into the treatment group (rate of improvement). From 2001 to 2007, total opioid prescription was low in non-oncology Departments (range: 69-110 DDD/1000HS) while parenteral morphine and fentanyl did not register any changes. In the same period of time, total opioid prescription increased in the Oncology Department from 240 to 558 DDD/1000HS. The rate of effectiveness in the three years prior to the implantation of the consultation team was 64% and in the three following years rose to 87%. The rate of improvement prior to the palliative care consultation team was 43% and in the three following years was 64%. A change in opioid prescription was registered after the implementation of the PCCT resulting in an increase in the prescription of parenteral morphine and methadone and a decrease in transdermal fentanyl. Implementation of a PCCT in a University Hospital is associated with a higher and more adequate use of opioids.

  18. Impact of a new palliative care consultation team on opioid prescription in a University Hospital

    PubMed Central

    Centeno, Carlos; Portela, María Angustias; Noguera, Antonio; Idoate, Antonio; Rubiales, Álvaro Sanz

    2009-01-01

    Background There are no validated measuring tools to gauge the effectiveness of a Hospital Palliative Care Consultation Team (PCCT). One way would be to consider its effect on the consumption of opioids expressed in total amounts and different formulations administered. We perform this study to evaluate the impact of a hospital PCCT on the trends of opioid prescription in a University Hospital. Methods A seven year retrospective study on opioid prescription was carried out in the Clínica Universidad de Navarra. The period includes three years before and three years after the PCCT was implemented. Prescription was analysed calculating yearly the Defined Daily Dose (DDD) adjusted to 1000 hospital stays (DDD/1000HS). Indicators considered were the proportion of patients treated using opioids compared to the total estimated in need of treatment (rate of effectiveness) and the proportion of patients potentially requiring opioids but not treated who were incorporated into the treatment group (rate of improvement). Results From 2001 to 2007, total opioid prescription was low in non-oncology Departments (range: 69–110 DDD/1000HS) while parenteral morphine and fentanyl did not register any changes. In the same period of time, total opioid prescription increased in the Oncology Department from 240 to 558 DDD/1000HS. The rate of effectiveness in the three years prior to the implantation of the consultation team was 64% and in the three following years rose to 87%. The rate of improvement prior to the palliative care consultation team was 43% and in the three following years was 64%. A change in opioid prescription was registered after the implementation of the PCCT resulting in an increase in the prescription of parenteral morphine and methadone and a decrease in transdermal fentanyl. Conclusion Implementation of a PCCT in a University Hospital is associated with a higher and more adequate use of opioids. PMID:19149875

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

    PubMed

    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

  20. CLAS+FROST: new generation of photoproduction experiments at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Eugene Pasyuk

    2009-12-01

    A large part of the experimental program in Hall B of the Jefferson Lab is dedicated to baryon spectroscopy. Photoproduction experiments are essential part of this program. CEBAF Large Acceptance Spectrometer (CLAS) and availability of circularly and linearly polarized tagged photon beams provide unique conditions for this type of experiments. Recent addition of the Frozen Spin Target (FROST) gives a remarkable opportunity to measure double and triple polarization observables for different pseudo-scalar meson photoproduction processes. For the first time, a complete or nearly complete experiment becomes possible and will allow model independent extraction of the reaction amplitude. An overview ofmore » the experiment and its current status is presented.« less

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

    PubMed

    Woo, Jeng-Chung; Lin, Yi-Ling

    2016-01-01

    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.

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

    PubMed

    Woo, Jeng-Chung; Lin, Yi-Ling

    2016-01-01

    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. © 2016 J.-C. Woo and Y.-L. Lin.

  3. Prevalence of Multidrug-Resistant Organisms in Hospitalized Pediatric Refugees in an University Children's Hospital in Germany 2015-2016.

    PubMed

    Tenenbaum, Tobias; Becker, Klaus-Peter; Lange, Bettina; Martin, Anka; Schäfer, Peter; Weichert, Stefan; Schroten, Horst

    2016-11-01

    OBJECTIVE To determine the prevalence of multidrug-resistant organisms (MDROs) colonizing in pediatric refugees admitted to a University Children Hospital in Germany. DESIGN Retrospective observational study. SETTING General pediatric and pediatric surgery units. PATIENTS In Germany, recommendations for MDRO screening of pediatric refugees were recently published. According to these and institutional recommendations, all hospitalized pediatric refugees were screened for MDROs between October 2015 and March 2016. METHODS Using electronic surveillance data, we performed a chart review to identify the prevalence of MDROs among and the clinical diagnoses of pediatric refugees. RESULTS Among 325 patients hospitalized for various causes, most frequently gastroenteritis (30.9%), MDROs were detected in 33.8%. Most of these patients were colonized with multidrug-resistant Gram-negative (MRGN) bacteria (113 isolates), mostly 2MRGN/ESBL (87 isolates); some patients were colonized with methicillin-resistant Staphylococcus aureus (MRSA, 22 isolates); and 1 patient was colonized with vancomycin-resistant enterococci (VRE). Among 110 refugee patients, we detected single colonization with an MDRO in 84 patients (76.4%), co-colonization with 2 pathogens in 23 patients (20.9%), and triple colonization in 3 patients (2.7%). However, infections with MDROs occurred in only 3.6% of pediatric refugees. The peak of positive MDRO screening results in 2015 correlated with an increased hospitalization rate. CONCLUSION Implementation of infection control measures among pediatric refugees is challenging. Due to the high frequency of MDROs in these patients, current screening, isolation, and treatment strategies may have to be adapted. Infect Control Hosp Epidemiol 2016;1-5.

  4. Candidiasis in pediatric patients with cancer interned in a university hospital

    PubMed Central

    De Carvalho Parahym, Ana Maria Rabelo; De Melo, Luciana Resende Bandeira; De Morais, Vera Lúcia Lins; Neves, Rejane Pereira

    2009-01-01

    Fungi are common causes of infection in immunocompromised patients. Candida species are frequently involved in these cases. In order to investigate candidiasis in pediatric patients with cancer, clinical samples were collected from one hundred and twenty two patients interned in the Oswaldo Cruz University Hospital in Recife, Brazil. Yeasts were isolated from thirty-four clinical samples. The species isolated were: Candida albicans (fourteen isolates), C. parapsilosis (nine isolates), C. guilliermondii (two isolates) and C. tropicalis (two isolates). We found that candidemia was most frequent in patients with malignant hematology and that C. parapsilosis infections caused the highest mortality. PMID:24031365

  5. Transgressive variation for yield components and dynamic traits in Jefferson (Oryza sativa) x O. rufipogon introgression lines

    USDA-ARS?s Scientific Manuscript database

    Alleles from wild progenitors of crops can be a source of transgressive variation in modern cultivars. Introgressions from the Oryza rufipogon donor (IRGC104591) in an O. sativa tropical japonica cultivar (Jefferson) were shown to confer a yield advantage in multi-location field trials. Yield loci...

  6. Medical school hotline: A History of the University of Hawai'i Postgraduate Medical Education Program at Okinawa Chubu Hospital, 1966-2012.

    PubMed

    Maeshiro, Masao; Izutsu, Satoru; Connolly, Kathleen Kihmm

    2014-06-01

    The University of Hawai'i (UH) has been collaborating with Okinawa Prefectural Chubu Hospital for over 46 years. This collaboration started as a post-World War II effort to increase the physician workforce. At the initiation of the US Army and State Department, the University of Hawai'i was recruited, in cooperation with the government of the Ryukyus and USCAR, to initiate a US style postgraduate clinical training program. The Postgraduate Medical Training Program of University of Hawai'i at Okinawa Chubu Hospital introduced a style of training similar to that in the US by offering a rotating internship. The initial contract had UH establish and run the Postgraduate Medical Training Program of University of Hawaii at Okinawa Central Hospital. After Okinawa's reversion to Japan, under a new contract, UH physicians participated as consultants by providing lectures at "grand rounds" and guidance to faculty, staff, and students. To date, 895 physicians have completed the University of Hawai'i Postgraduate Medical Training Program with 74 currently training. Approximately 662 (74%) of the trainees have remained in Okinawa Prefecture to practice medicine. As a result, the program has enhanced the physician workforce for the islands of Okinawa and neighbor archipelagos of Miyako and Yaeyama Islands.

  7. Information-seeking behavior of cardiovascular disease patients in Isfahan University of Medical Sciences hospitals

    PubMed Central

    Zamani, Maryam; Soleymani, Mohammad Reza; Afshar, Mina; Shahrzadi, Leila; Zadeh, Akbar Hasan

    2014-01-01

    Background: Patients, as one of the most prominent groups requiring health-based information, encounter numerous problems in order to obtain these pieces of information and apply them. The aim of this study was to determine the information-seeking behavior of cardiovascular patients who were hospitalized in Isfahan University of Medical Sciences hospitals. Materials and Methods: This is a survey research. The population consisted of all patients with cardiovascular disease who were hospitalized in the hospitals of Isfahan University of Medical Sciences during 2012. According to the statistics, the number of patients was 6000. The sample size was determined based on the formula of Cochran; 400 patients were randomly selected. Data were collected by researcher-made questionnaire. Two-level descriptive statistics and inferential statistics were used for analysis. Results: The data showed that the awareness of the probability to recover and finding appropriate medical care centers were the most significant informational needs. The practitioners, television, and radio were used more than the other informational resources. Lack of familiarity to medical terminologies and unaccountability of medical staff were the major obstacles faced by the patients to obtain information. The results also showed that there was no significant relationship between the patients’ gender and information-seeking behavior, whereas there was a significant relationship between the demographic features (age, education, place of residence) and information-seeking behavior. Conclusion: Giving information about health to the patients can help them to control their disease. Appropriate methods and ways should be used based on patients’ willingness. Despite the variety of information resources, patients expressed medical staff as the best source for getting health information. Information-seeking behavior of the patients was found to be influenced by different demographic and environmental factors

  8. Evaluation of the Department of Neurosurgery of the Seoul National University Hospital

    PubMed Central

    2013-01-01

    The Department of Neurosurgery (DNS) of the Seoul National University Hospital (SNUH), belongs to the largest and oldest such institutions in Korea. Because of its growing reputation it is hardly surprising that the DNS draws visitor and scholars for clinical education and academic exchange from far beyond Korea. I myself visited the SNUH in February and March 2013. During this time I composed this evaluation in which I compare the DNS to my home Department at the Johannes Gutenberg-University in Mainz/Germany, as well as the situation of Neurosurgery in Korea and Germany in general. In the first part this evaluation summarizes data concerning equipment, staff and organizational structure, as well as educational and scientific issues of the DNS. In the second part some issues of interest are discussed in special regard to the corresponding practices in Germany. PMID:23908698

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

    PubMed Central

    2011-01-01

    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. PMID:21477310

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

    PubMed

    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.

  11. [Self-assessment of patterns of antibiotic use in a university hospital].

    PubMed

    Gómez, J; García-Vázquez, E; Bonillo, C; Hernández, A; Bermejo, M; Canteras, M

    2014-10-01

    A questionnaire was used to determine the knowledge, attitudes and practices of antibiotic prescribing among doctors at a university hospital. An anonymous questionnaire was directly distributed by a staff member of the Infectious Diseases Department. A total of 316 questionnaires were distributed with 100% response rate; antibiotic dose, route of administration, and treatment duration were always adjusted according to site of infection and underlying conditions in 65, 68 and 45%, respectively. Antibiotic de-escalation was recognized as usual practice in 20%; 31 and 10% considered potential microbiological resistances and economical-cost when taking prescription decisions, respectively; 16% admitted often prescribing antibiotics with no clinical indication. There were no major significant differences between staff and training physicians, or between surgical or medical specialists. The self-perception of physicians and residents in our hospital is that they make improper use of antimicrobials. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  12. Dependence to legally prescribed opioid analgesics in a university hospital in Medellin-Colombia: an observational study.

    PubMed

    Garcia-Orjuela, Maria G; Alarcon-Franco, Lineth; Sanchez-Fernandez, Juan C; Agudelo, Yuli; Zuluaga, Andres F

    2016-09-14

    In some countries the misuse and diversion of prescribed opioid analgesic is increasing considerably, but there is no official data regarding the situation in Colombia. The aim of this study was to identify all dependent to opioid analgesics legally prescribed patients that were treated in a University Hospital in Medellin, Colombia during 4 years and to characterize this population. Observational study in a University Hospital in Medellin, Colombia, searching for patients with ICD-10 codes related with opioid related disorders, adverse events or pain and treated between January 2011 and December 2014. Sixty patients with opioid dependence according to DSM-IV criteria were found from 3332 clinical charts reviewed. The median age was 43 years. Although all patients met the DSM-IV criteria, 33 % of patients were wrongly diagnosed by other ICD-10 codes. Almost all patient (88 %) initiated opioids after medical prescription although the adherence to pain scale was low (25 %). The median time of consumption was 48 months. Tramadol was the opioid more frequently used by patients, followed by morphine and oxycodone. A statistically significant higher consumption of other psychotropic substances was observed in male than female (P = 0.005 by Fisher's test). After be diagnosed, 55 % of patients gone a methadone-based replacement therapy. Legally prescribed opioid dependence was belatedly diagnosed in 60 patients in a University hospital, after prolonged use of drugs to treat chronic pain and with low adherence to pain scale or guidelines. This is the first report in Colombia.

  13. Context view, Building Nos. 2728, looking north from a spot ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Context view, Building Nos. 27-28, looking north from a spot south of Building No. 28 - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  14. A Comparison of Jefferson Medical College Graduates Who Chose Emergency Medicine with Those Who Chose Other Specialties.

    ERIC Educational Resources Information Center

    Xu, Gang; Veloski, J. Jon

    1991-01-01

    Data on 53 Jefferson Medical College (Pennsylvania) graduates specializing in emergency medicine (EM) found they had the highest senior year debt and expected the highest income among nonsurgeons, compared favorably in academic performance and examination scores and were very willing to treat low-income patients. Implications are discussed.…

  15. [University clinics in the competitive hospital market].

    PubMed

    Schmidt, C E; Möller, J; Hesslau, U; Bauer, M; Gabbert, T; Kremer, B

    2005-07-01

    In recent years Germany has faced a growing economization and competition among hospitals. To protect their interests hospitals have to operate similarly to other commercial businesses. Academic hospitals face difficult circumstances in this competition. They have to facilitate research and education activities which require additional financial and personnel resources but also provide maximum acute care treatment at all times. This causes additional disadvantages in terms of financial resources, compared to private hospital chains. Such examples of financial shortcomings have led to the privatization of academic research centres in Germany. An alternative strategy to privatization of academic acute care hospitals is the change of their legal status into a capital company or into a foundation, according to US experiences. Public private partnerships (PPPs) may also represent a potential alternative, as they have already produced a growing number of successful examples in the public sector in Germany. Academic acute care hospitals can also choose a strategic reorganization of their targets, similar to their privately held competitors in the market. Potential economies in scale may be achieved in areas such as medical treatment, research and personnel planning.However, it is vital that academic acute care hospitals start to act productively and also individually. This article provides a number of managerial pathways and options to maintain and strengthen operational competitiveness.

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

    PubMed

    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

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

    PubMed

    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.

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

    PubMed

    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.

  19. Using a capture–recapture method to assess the frequency of adverse drug reactions in a French university hospital

    PubMed Central

    Lugardon, Stephanie; Desboeuf, Karine; Fernet, Pierre; Montastruc, Jean-Louis; Lapeyre-Mestre, Maryse

    2006-01-01

    Aims There is evidence that different methods used to identify and quantify adverse drug reactions (ADR) in hospitals are not exhaustive (spontaneous reporting or computerized medical databases). The combination of these different sources of data could improve knowledge about ADR frequency in hospitals. The aim of this study was to estimate the incidence of serious ADRs handled in medical wards of a French university hospital using data from the Programme de Medicalization des Systemes d’Information (PMSI) and spontaneous reports recorded in the French Pharmacovigilance Database. Methods The study period was the first semester of 2001. From PMSI, all hospitalization summaries including an ICD-10th code related to a potential ADR were selected. From the French Pharmacovigilance Database, all serious ADRs which occurred during the study period and were reported by physicians working in the University Hospital were collected. After identification of common cases, the capture–recapture method was applied in order to estimate the real number of ADRs occurring during the first semester of 2001. Results From PMSI, we identified 274 different hospital stays related to an ADR. Out of 241 reports selected from the French Pharmacovigilance Database, we retained 151 ADRs for analysis. Fifty-two ADRs were common in the two databases, giving an estimated number of serious ADRs of 796 [95% confidence interval (CI) 638, 954], corresponding to 2.9% of inpatients (95% CI 2.3, 3.5). Conclusions This study shows the lack of exhaustiveness of ADR reporting whatever the sources of data and underlines the interest of merging data from different databases to identify fully the real impact of ADR in hospitals. PMID:16842398

  20. A Checklist of Common Plants of the Appalachian Trail in the Jefferson National Forest, Virginia

    Treesearch

    Arnold Krochmal; Connie Krochmal

    1981-01-01

    This Note lists the plants that a hiker is likely to notice on the Appalachian Trail in the Jefferson National Forest, Virginia. The list is one of the results of an inventory of plant life along the Trail as it passes through Southern National Forests. Only plants that were conspicuous because of their size, large population, or leaf or flower color are listed. Fungi...

  1. [Predictive factors of all-cause mortality in patients attending the medical emergency unit of Kinshasa University Hospital].

    PubMed

    Mbutiwi Ikwa Ndol, F; Dramaix-Wilmet, M; Meert, P; Lepira Bompeka, F; Nseka Mangani, N; Malengreau, M; Makaula, P

    2014-02-01

    The management of medical emergencies is poorly organized in the Democratic Republic of Congo. In addition, the mortality of patients attending the medical emergency unit of Kinshasa University Hospital is relatively high, with death of patients occurring rather early. To date, factors associated with this mortality have been poorly elucidated. This study aimed to identify predictive factors of all-cause mortality in patients admitted to the medical emergency unit of the Kinshasa University Hospital. Analytical prospective study of all patients admitted from 15th January to 15th February 2011 in the emergency unit of the internal medicine department of Kinshasa University Hospital (427 patients). Among these patients, 13 were dead at arrival and were excluded from this study. The 414 patients included were followed until discharge from the hospital. Demographic, clinical, biological, diagnostic, therapeutical and evolutive data were collected. Four multivariate logistic regression models were used to identify risk factors associated with mortality. Patients' median age was 40 years (interquartile range, 28-58 years), 54.5% were male, and 15.9% had a life-threatening pathological condition on admission. The overall mortality was 12.3%. According to multivariate analyses, transfer from other health care structures (OR: 3.5; 95% CI: 1.7-7.1), Glasgow Coma Scale score less than 14 on admission (OR: 11.1; 95% CI: 4.7-26.3), high creatinine level (OR: 4.2; 95% CI: 1.8-9.7), presence of cardiovascular (OR: 2.9; 95% CI: 1.5-5.7), renal (OR: 7.4; 95% CI: 3.2-17.3), hematologic and/or respiratory (OR: 6.1; 95% CI: 1.7-21.4) diseases, presence of sepsis and/or meningitis and encephalitis (OR: 5.2; 95% CI: 1.6-17.0) were significantly associated with a high risk of death. However, the Glasgow Coma Scale score less than 14 on admission and renal disease were the only predictive factors of mortality remaining after including demographic, clinical, diagnostic and therapeutical

  2. Postoperative Pain Relief in Major Gynaecological Surgery by Perioperative Parecoxib Administration: Thammasat University Hospital Study.

    PubMed

    Arponrat, Pawat; Pongrojpaw, Densak; Tanprasertkul, Chamnan; Suwannarurk, Komsun; Bhamarapravatana, Kornkarn

    2015-07-01

    To study postoperative pain relief in major gynaecological surgery by perioperative parecoxib administration in Thammasat University Hospital. This double-blind randomized controlled clinical trial was conducted in Thammasat University Hospital, Pathumthani, Thailand from October 2013 to May 2014. One hundred and twenty patients who underwent elective gynaecological surgery were randomized assigned to study and control groups. Study group (n = 60) received 40 mg parecoxib and control group (n = 60) received placebo at 1 hour before surgery. The postoperative visual analog scale (VAS) at 3, 6, 12 and 24 hours, frequency of meperidine consumption in 24 hours and side effects of parecoxib were recorded. VAS of study group after operation at 3, 6, 12 and 24 hours was significantly lower than control group. Meperidine consumption in placebo group was significantly higher than study group (27.50 ± 19.36 and 48.75 ± 28.15 mg, respectively; p < 0.001). There was no side effect from parecoxib in this study. Intravenous postoperativeparecoxib injection could relief pain and reduced meperidine consumption. Parecoxib could be safely used in gynaecological surgery for postoperative pain relief

  3. [Pharmacist's interventions on outpatient prescriptions in a university hospital drugs sales service].

    PubMed

    Chappuy, M; Garcia, S; Uhres, A-C; Janoly-Dumenil, A; Dessault, J; Chamouard, V; Bréant, V; Leboucher, G; Pivot, C; Carpentier, I

    2015-07-01

    For public health reasons, some drugs are only available in hospital drugs sales service. This activity takes place in a specific risk context of organization, patients and/or drugs. A systematic prescription analysis by pharmacist contributes to securise treatment dispensed. The aim of this paper is to present the main drugs problems in the analysis of outpatient prescriptions and pharmaceutical interventions in three units of hospital drugs sales service belong to university hospital. Throughout the year 2013, drug problems detected were recorded prospectively and systematically. Of the 22,279 prescriptions analyzed, 247 pharmaceutical interventions (1.1%) were detected including 27.6% of problems concerning the dosages, 15.4% the unconformity, 6.9% contraindications. Regarding ATC drugs classes, we found 43.7% for anti-infectives and 17.4% for antineoplatics. The overall acceptance rate is 81.8%. These results show the importance of the analysis of outpatient prescriptions before dispensing and the need to have all prescriptions, clinical and biological elements and to develop interprofessionality. The implementation of a platform for dematerialized data exchanges between professionals, including data from the pharmaceutical patient record should contribute to improving drug management of the patient. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

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

    PubMed

    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

  5. Antimicrobial susceptibility pattern of Klebsiella species from Ebonyi State University Teaching Hospital Abakaliki, Nigeria.

    PubMed

    Akujobi, C N

    2005-12-01

    Klesiella specie isolated from clinical specimens from Ebonyi State University Teaching Hospital (EBSUTH). Abakakliki were studied to determine the antimicrobial susceptibility pattern. Between January, 2003 and September 2004 a total of 3.600 specimens processed in the routine Medical Microbiology laboratory of EBSUTH, of which 245(6.8%) yielded Klebsiella species, with 84 from out - patients and 161 from in - patients. The number of isolates from various samples were: Urine 126, Sputum 37 Endocervical swab 13, Aspirates 8, High Vaginal Swab 7, Blood 3, Eye Swab, Ear Swab and Cerebrospinal fluid were 2 samples each. Organisms were identified by conventional methods. Antimicrobial susceptibility was done by the disk diffusion methods. The antimicrobial disk used include: Ceftazidime, Cefuroxime, Cefotaxine, Augmentin, Pefloxacin (30ug), Doxycyline (25ug) Genticin (10 ug) Ciprofloacin and Ofloxacin (5ug) each and Erythromycin (15ug). All were Oxoid products. Results were interpreted according to NCCLS criteria. Klebsilla species were isolated mostly from urine specimens (51.4%) followed by wound swabs (18.4%). Antimicrobial susceptibility to various groups drugs used was generally poor. The most sensitive antimicrobial was Ciprofloxacin with 121(49.4%) isolates susceptible to it, followed by Gentamicin with 95 (38.8%) and Ceftazidime with 90(36.7%). Seventeen isolates were multiresistant to all the antimicrobial agents used. The result of this study will help in the empiric therapy of infection caused by Klebsiella species in Ebonyi State University Teaching Hospital, Abakaliki, Nigeria but continuous surverillance of antimicrobial resistance of the organnisn is very necessary in the formulation of a sound antibiotic policy in the hospital.

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

    PubMed

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

    2016-07-02

    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.

  7. Substantial reduction in hospital stay of children and adolescents with diabetic ketoacidosis after implementation of Clinical Practice Guidelines in a university hospital in Saudi Arabia.

    PubMed

    Al Nemri, Abdulrahman; Amer, Yasser Sami; Gasim, Hala; Osman, Mohamed Elfaki; Aleyadhy, Ayman; Al Otaibi, Hessah; Iqbal, Shaikh Mohammed; Aljurayyan, Nasir Abdullah; Assiri, Asaad M; Babiker, Amir; Mohamed, Sarar

    2017-02-01

    We aimed to determine the effect of Clinical Practice Guideline (CPG) implementation on length of hospital stay of children and adolescents with diabetic ketoacidosis (DKA). This was a 6-year (2008-2014) case-control retrospective study conducted at King Khalid University Hospital, Riyadh, that compared patients with DKA managed using CPG with those treated before CPG implementation. There were 63 episodes of DKA in 41 patients managed using CPG compared with 40 episodes in 33 patients treated before implementation of CPG. Baseline characteristics of the 2 groups were similar (age, sex, newly diagnosed patients, recurrent DKA, DKA severity, and mean glycosylated hemoglobin). The mean length of hospital stay (±SD) was 68.6 ± 53.1 hours after implementation of CPG compared with 107.4 ± 65.6 hours before implementation (P < .001). The reduction in length of hospital stay equals to 1700 bed days saved per year per 1000 patients. Implementation of CPG for DKA decreased the length of hospital stay. © 2016 John Wiley & Sons, Ltd.

  8. Distinctiveness of management in a university psychiatric hospital as a public health institution.

    PubMed

    Koncina, Miroslav

    2008-06-01

    The distinctiveness of management of a university psychiatric hospital which has the status of a public health institution is manifested in the following ways: * Distinctive features and characteristics of managing service provider organizations compared to those whose operational results involve tangible products; * Distinctive features of management which originate from its role as a regional hospital and a tertiary research and educational institution in the field of psychiatry, with special importance for the Republic of Slovenia as a whole; * Distinctive features of management that are defined by the social and legal framework of operation of public health institutions and their special social mission. This paper therefore discusses the specific theoretical and practical findings regarding management of service provider organizations from the viewpoint of their social mission and significance, as well as their legal organization, internal structure and values.

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

    PubMed

    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.

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

    PubMed

    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

  11. PACS in the Utrecht University Hospital: final conclusions of the clinical evaluation

    NASA Astrophysics Data System (ADS)

    Wilmink, J. B.; ter Haar Romeny, Bart M.; Barneveld Binkhuysen, Frits H.; Achterberg, A. J.; Zuiderveld, Karel J.; Calkoen, P.; Kouwenberg, Jef M.

    1990-08-01

    In the past three years, a clinical evaluation of a PACS has been performed in the Utrecht University Hospital as part of the Dutch PACS project. The clinical evaluation focussed on the following aspects: technical evaluation of the prototype PACS equipment coupled to the HIS; diagnostic accuracy studies; studies concerning the impact on the organization of the radiology-department and the referring wards; and cost-savings analysis. Some of the results of these subprojects have already been presented at previous SPIE conferences. In this paper the general condusions are presented about the usefulness of the evaluated PAC-System in the daily routine of radiology department and clinic. By making available the images of radiological examinations fast, complete, reliable and continously on the ward, concrete improvements with regard to the current process could be realized. The possibilities of PACS caused an increasing enthousiasm among the clinicians. By the easier access to all images of their patients during 24 hours/day, they saw more images on the day of the examination and images could be more easily used at consultations of other specialists. The overall conclusion is positive, but a lot of work has to be done to transform PACS from an experimental setup into a routine production system on which a flimless hospital can be based. A complete PACS needs an inteffigent Image Management System, which indudes prefetching algorithms based on data from the Hospital Information System and automated procedures for removing obsolete images from the local buffers in the workstations. As yet PACS is very expensive, and the direct savings in the hospital cannot compensate for the high costs of investment. Possibly PACS can contribute to a shorter stay of patients in the hospital. This will lead to savings for government and health insurance companies and they can be expected to contribute to PAS implementation studies.

  12. [Information from the invoicing sector as support for decision-making: a case study at the University Hospital of the Federal University of Grande Dourados (UFGD)].

    PubMed

    Cintra, Renato Fabiano; Vieira, Saulo Fabiano Amâncio; Hall, Rosemar José; Fernandes, Cristiano Rodrigues

    2013-10-01

    The public sector is the main financing agent of hospital admissions and the information generated constitutes the input for the hospital information network of the Unified Health System (SUS). This paper seeks to design a report template to be used for decision-making in both public and university hospitals. The theoretical approach sought inspiration in discussions about the SUS, hospital institutions, hospital information systems and decision-making. The methodological procedures used are characterized as qualitative-descriptive methods and were conducted in a single case study and action research. The primary data analysis was carried out in two stages from January through December 2007 and from January through December 2008. Based on these periods, the findings were described and the elaboration of new reports was presented, with the importance and need for each being duly emphasized. Lastly, a structured report template was created for the case study that includes information discussed in the article. The conclusion reached is that the hospital information system can become a potential support tool, as the necessary adjustments are made and the report is structured to furnish the institution with an objective communication tool for decision-making.

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

    PubMed

    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.

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

    PubMed

    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 < 0.05) and postoperative mortality (2%, diabetic group vs. 0.2%, nondiabetic group; p < 0.05) were significantly higher in the 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

  15. A composite thin vacuum window for the CLAS photon tagger at Jefferson lab

    NASA Astrophysics Data System (ADS)

    Matthews, S. K.; Crannell, Hall; O'Brien, J. T.; Sober, D. I.

    1999-01-01

    The construction of a thin vacuum window, currently in use on the CLAS photon tagging system at the Thomas Jefferson National Accelerator Facility, is described. A layer of woven Kevlar cloth supports a much thinner membrane of aluminized Mylar. Notable features of this particular window include its overall length (9.6 m), and the fact that the entire load is supported by the epoxy seal with no mechanical clamping around the edges. Results from a diverse program of materials testing, including a clear dependence of leak rate on relative humidity, are also reported.

  16. Large-Scale Production of Carbon Nanotubes Using the Jefferson Lab Free Electron Laser

    NASA Technical Reports Server (NTRS)

    Holloway, Brian C.

    2003-01-01

    We report on our interdisciplinary program to use the Free Electron Laser (FEL) at the Thomas Jefferson National Accelerator Facility (J-Lab) for high-volume pulsed laser vaporization synthesis of carbon nanotubes. Based in part on the funding of from this project, a novel nanotube production system was designed, tested, and patented. Using this new system nanotube production rates over 100 times faster than conventional laser systems were achieved. Analysis of the material produced shows that it is of as high a quality as the standard laser-based materials.

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

    PubMed

    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.

  18. One-year audit of complaints made against a University Hospital Surgical Department.

    PubMed

    Mann, Chris D; Howes, Jennifer A; Buchanan, Alex; Bowrey, David J

    2012-10-01

    There is relatively little in the medical literature relating to complaints about the healthcare process. The aim of this study was to report the frequency and content of patient complaints against a University Hospital Surgical Department. In particular, the study aimed to relate the number of complaints to the number of health-care episodes and to determine the frequency of patient safety incidents and subsequent medico-legal action. Retrospective interrogation of a prospectively maintained Complaints Department database at a University Hospital for the calendar year 2009. Complaints relating to 360 aspects of the health-care journey in 113 patients were made. This translated into one complaint per 400 health-care episodes. Concerns about clinical care were cited in 31%, delays in the health-care process in 30%, communication issues in 19%, the institutional environment in 8% and poor discharge planning in 6%. Overall, 16 complaints (4%) were raised as patient safety incidents. Eighty-three per cent of complaints were addressed by a telephone conversation or a single letter response, 13% by a face-to-face meeting. Two per cent resulted in subsequent medico-legal action. Although perceived in a negative way by health-care professionals, only 1 in 400 health-care episodes resulted in a complaint. Only a small number related to patient safety incidents or resulted in medico-legal instructions. Attention should focus on developing effective strategies to improve patient satisfaction with all aspects of the patient journey. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  19. Beam Diagnostics of the Compton Scattering Chamber in Jefferson Lab's Hall C

    NASA Astrophysics Data System (ADS)

    Faulkner, Adam; I&C Group Collaboration

    2013-10-01

    Upcoming experimental runs in Hall C will utilize Compton scattering, involving the construction and installation of a rectangular beam enclosure. Conventional cylindrical stripline-style Beam Position Monitors (BPMs) are not appropriate due to their form factor; therefore to facilitate measurement of position, button-style BPMs are being considered due to the ease of placement within the new beam enclosure. Button BPM experience is limited at JLAB, so preliminary measurements are needed to characterize the field response, and guide the development of appropriate algorithms for the Analog to Digital receiver systems. -field mapping is performed using a Goubau Line (G-Line), which employs a surface wave to mimic the electron beam, helping to avoid problems associated with vacuum systems. Potential algorithms include simplistic 1/r modeling (-field mapping), look-up-tables, as well as a potential third order power series fit. In addition, the use of neural networks specifically the multi-layer Perceptron will be examined. The models, sensor field maps, and utility of the neural network will be presented. Next steps include: modification of the control algorithm, as well as to run an in-situ test of the four Button electrodes inside of a mock beam enclosure. The analysis of the field response using Matlab suggests the button BPMs are accurate to within 10 mm, and may be successful for beam diagnostics in Hall C. More testing is necessary to ascertain the limitations of the new electrodes. The National Science Foundation, Old Dominion University, The Department of Energy, and Jefferson Lab.

  20. Factors of importance for work satisfaction among nurses in a university hospital in Sweden.

    PubMed

    Gardulf, Ann; Orton, Marie-Louise; Eriksson, Lars E; Undén, Maria; Arnetz, Bengt; Kajermo, Kerstin Nilsson; Nordström, Gun

    2008-06-01

    The shortage of registered nurses in the healthcare sector is a problem in most countries. Swedish nurses tend to leave or seek new positions. However, few Swedish studies have addressed questions regarding what factors are of importance for nurses to perceive work satisfaction although satisfied nurses are linked to many positive organizational outcomes, e.g. improved quality of patient care. The aim of this study was to investigate what factors are of importance for nurses at a university hospital to perceive work satisfaction. Eight hundred and thirty-three nurses responded to the mailed Quality Work Competence questionnaire and the Huddinge University Hospital Model Questionnaire. Regression analyses identifies five factors linked to the head nurses leadership contributing to the nurses' feelings of work satisfaction: 'professional competence is made good use of', 'feeling of satisfaction with immediate superior regarding support for nursing research and development', 'opportunities for developing one's own competence for the current job', 'career opportunities in one's own profession' and 'yearly dialogue for performance appraisal with immediate superior'. The nurses also reported work-related exhaustion. Few saw opportunities for making a career as a nurse. In conclusion, the study identified specific amenable factors linked to the head nurses leadership that are of importance in creating attractive workplaces for nurses.

  1. Quality of nursing documentation before and after the Hospital Accreditation in a university hospital.

    PubMed

    Nomura, Aline Tsuma Gaedke; Silva, Marcos Barragan da; Almeida, Miriam de Abreu

    2016-11-21

    to analyze the quality of nursing documentation by comparing the periods before and after the preparation for the hospital accreditation, using the Quality of Nursing Diagnoses, Interventions and Outcomes - Brazilian version (Q-DIO- Brazilian version). observational study of interventions conducted in a university hospital. Nursing documentation of 112 medical records for the period before and 112 for the period after the hospital accreditation were compared using the Q-DIO instrument - Brazilian version. Data were statistically analyzed. there was a significant improvement in the quality of nursing documentation. When the total score of the instrument was evaluated, a significant improvement was observed in 24 out of the 29 items (82.8%). there was commitment to the shift of culture by means of the interventions carried out, which resulted in the conquest of the quality seal ensured by the Joint Commission International. analisar a qualidade dos registros de enfermagem, comparando o período antes e depois do preparo para a acreditação hospitalar, fazendo uso do Quality of Nursing Diagnoses, Interventions and Outcomes - Versão brasileira (Q-DIO-Versão brasileira). estudo observacional de intervenções realizado em um hospital universitário. Comparados os registros de enfermagem em 112 prontuários referentes ao período anterior a acreditação hospitalar e 112 ao período posterior, por meio do instrumento Q-DIO - Versão brasileira. Os dados foram analisados estatisticamente. houve melhora significativa da qualidade dos registros de enfermagem. Quando avaliado o escore total do instrumento evidenciou melhora significativa em 24 dos 29 itens (82,8%). houve empenho à mudança de cultura por meio das intervenções realizadas, refletida na conquista do selo de qualidade da Joint Commission Internacional. analizar la calidad de los registros de enfermería, comparando los períodos antes y después de la preparación para la acreditación hospitalaria

  2. The performance implications of pharmacy information system at the university teaching hospitals of Shiraz, Iran: Cluster approach

    PubMed Central

    Bayati, Saeede; Bastani, Peivand; Sagheb, Zahra Mahmoodzade; Jamalabadi, Sara; Samadbeik, Mahnaz

    2017-01-01

    Pharmacy information system (PIS) is becoming vital in assisting pharmacists to do their responsibilities. The aim of this study was to identify the current PIS implications in teaching hospitals affiliated with Shiraz University of Medical Science. This cross-sectional study was conducted in teaching hospitals affiliated with Shiraz University of Medical Science over the year 2016. Data were collected by observing the PIS as well as interviewing its users based on the researcher-made checklist. The checklist was prepared based on reviewing the Persian and English literature and its content validity was approved by the experts. To determine the reliability of the checklist, inter-rater reliability was used. Data were analyzed using SPSS16, and hospitals were clustered using SK-means method. In this study, the least conformity to the standards was shown in smart clinical features (4.54%), pharmaceutical companies' relationship (32.6%), and optimization of drug therapy (34.6%). In contrast, the highest conformity to the standards was shown in reporting capabilities (77.3%) and entry information and input (70.4%). Medication stock checking and optimization of drug therapy were effective features that have made a distinction between hospitals and lead to 95% variance between clusters. Based on the results, the current PIS design pays less attention to clinical features. Besides, clinical information for pharmacists and outside organization relationship were not provided by the current system. Thus, emphasis should be placed on the implementation of corrective actions to eliminate the current system's deficiencies. PMID:29184843

  3. Patients' satisfaction with inpatient services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, during 2011-2013

    PubMed Central

    Makarem, Jalil; Larijani, Bagher; Joodaki, Kobra; Ghaderi, Sahar; Nayeri, Fatemeh; Mohammadpoor, Masoud

    2016-01-01

    Implementation of patient feedback is considered as a critical part of effective and efficient management in developed countries. The main objectives of this study were to assess patient satisfaction with the services provided in hospitals affiliated to Tehran University of Medical Sciences, Iran, identify areas of patient dissatisfaction, and find ways to improve patient satisfaction with hospital services. This cross-sectional study was conducted in 3 phases. After 2 initial preparation phases, the valid instrument was applied through telephone interviews with 21476 participants from 26 hospitals during August, 2011 to February, 2013.Using the Satisfaction Survey tool, information of patient's demographic characteristics were collected and patient satisfaction with 15 areas of hospital services and the intent to return the same hospitals were assessed. The mean score of overall satisfaction with hospital services was 16.86 ± 2.72 out of 20. It was found that 58% of participants were highly satisfied with the services provided. Comparison of mean scores showed physician and medical services (17.75 ± 4.02), laboratory and radiology services (17.67 ± 3.66), and privacy and religious issues (17.55 ± 4.32) had the highest satisfaction. The patients were the most dissatisfied with the food services (15.50 ± 5.54). It was also found that 83.7% of the participants intended to return to the same hospital in case of need, which supported the measured satisfaction level. Patient satisfaction in hospitals affiliated to Tehran University of Medical Sciences was high. It seems that the present study, with its large sample size, has sufficient reliability to express the patient satisfaction status. Moreover, appropriate measures should be taken in some areas (food, cost, and etc.) to increase patient satisfaction. PMID:27471589

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

    PubMed Central

    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

  5. 75 FR 34634 - Special Local Regulation; Swim Across the Sound, Long Island Sound, Port Jefferson, NY to Captain...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-18

    ...-AA08 Special Local Regulation; Swim Across the Sound, Long Island Sound, Port Jefferson, NY to Captain... Guard is establishing a permanent Special Local Regulation on the navigable waters of Long Island Sound... Sound event. This special local regulation is necessary to provide for the safety of life by protecting...

  6. A study of tubo-ovarian abscess at Howard University Hospital (1965 through 1975).

    PubMed

    Clark, J F; Moore-Hines, S

    1979-11-01

    Unruptured tubo-ovarian abscess was diagnosed in 40 patients over ten years. This was three percent of 1,154 patients admitted to Howard University Hospital for pelvic inflammatory disease. The admitting diagnosis was 33 percent correct.The treatment was individualized with 23 percent receiving total abdominal hysterectomy with bilateral salpingo-oophorectomy. Twelve young women received unilateral salpingo-oophorectomy.We feel that early detection and aggressive medical treatment for pelvic inflammatory disease will decrease the incidence of tubo-ovarian abscess and the necessity for surgery.

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

    PubMed Central

    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

  8. Hospital Universiti Sains Malaysia (HUSM): 25 Years Of Excellent Service

    PubMed Central

    Kamari, Zaidun

    2009-01-01

    Our Hospital University Sains Malaysia (HUSM) was given the Cabinet approval to exist under the Ministry of Education on 23 November 1982. The Deputy Prime Minister during that period, Yang Berhormat Tun Musa Hitam announced this after the cabinet meeting was held together with the presence of the Yang Berhormat Ministers of Health; and Education, Director of the Public Works Department and the Implementation and Coordinating Unit, Prime Minister’s Department. The first patients moved in on 14 March 1983 and the inauguration of HUSM was done on 26 August 1984 by the Duli Yang Maha Mulia Tuanku Ismail Petra Ibni Al-Marhum Sultan Yahya Petra, the Sultan of Kelantan Darul Naim. HUSM celebrated it’s 25th anniversary at the Dewan Utama, USM Health Campus on the 15th December 2008 which was inaugurated by Yang Berhormat, Minister of Higher Education Dato’ Seri Mohamed Khaled Nordin. USM’s Vice Chancellor Professor Tan Sri Dato’ Dzulkifli Abdul Razak, Chairman of the USM Board of Directors Tan Sri Dato’ Haji Dr. Ani bin Arope, Health Campus Director Professor Dato’ Dr. Mafauzy Mohamed, former Campus Director, Dato’ Prof Mohd Roslani Abdul Majid, the current and previous Hospital Directors and Deputy Directors since 1983 were present. The achievements of HUSM since its establishment and its vision to fulfil the University’s Accelerated Programme for Excellence (APEX) are elaborated. PMID:22589644

  9. Clinical effect of a multidisciplinary team approach to the initial treatment of patients with hospital-acquired bloodstream infections at a Japanese university hospital.

    PubMed

    Tsukamoto, Hitoshi; Higashi, Takashi; Nakamura, Toshiaki; Yano, Ryoichi; Hida, Yukio; Muroi, Yoko; Ikegaya, Satoshi; Iwasaki, Hiromichi; Masada, Mikio

    2014-09-01

    Hospital-acquired bloodstream infections (BSIs) are significant causes of mortality, and strategies to improve outcomes are needed. We aimed to evaluate the clinical efficacy of a multidisciplinary infection control team (ICT) approach to the initial treatment of patients with hospital-acquired BSI. A before-after quasiexperimental study of patients with hospital-acquired BSI was performed in a Japanese university hospital. The ICT provided immediate recommendations to the attending physician about appropriate antimicrobial therapy and management after reviewing blood cultures, Gram's stain, final organism, and antimicrobial susceptibility results. The sample included 469 patients with hospital-acquired BSI (n = 210, preintervention group; n = 259, postintervention group). There were no significant differences between the groups in background or microbiologic characteristics. The 30-day mortality was significantly lower and significantly more patients received appropriate antimicrobial therapy in the postintervention group (22.9% vs 14.3%; P = .02 and 86.5% vs 69.0%; P < .001, respectively). Multivariate analysis confirmed that the ICT intervention was significantly associated with appropriate antimicrobial therapy (odds ratio, 2.22; 95% confidence interval, 1.27-3.89) and 30-day mortality (odds ratio, 0.49; 95% confidence interval, 0.25-0.95). A timely multidisciplinary team approach decreases the delay of appropriate antimicrobial treatment and may improve HABSI patient outcomes. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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

    PubMed

    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.

  11. Medical experience of a university hospital in Turkey after the 1999 Marmara earthquake

    PubMed Central

    Bulut, M; Fedakar, R; Akkose, S; Akgoz, S; Ozguc, H; Tokyay, R

    2005-01-01

    Objectives: This study aimed to provide an overview of morbidity and mortality among patients admitted to the Hospital of the Medicine Faculty of Uludag University, Bursa, Turkey, after the 1999 Marmara earthquake. Methods: Retrospective analysis of the medical records of 645 earthquake victims. Patients' demographic data, diagnosis, dispositions, and prognosis were reviewed. Results: A total of 330 patients with earthquake related injuries and illness admitted to our hospital were included and divided into three main groups: crush syndrome (n = 110), vital organ injuries (n = 57), and non-traumatic but earthquake related illness (n = 55). Seventy seven per cent of patients were hospitalised during the first three days after the earthquake. The rate of mortality associated with the crush syndrome, vital organ injury, and non-traumatic medical problems was 21% (23/110), 17.5% (10/57), and 9% (5/55), respectively. The overall mortality rate was 8% (50/645). Conclusions: In the first 24–48 hours after a major earthquake, hospital emergency departments are flooded with large numbers of patients. Among this patient load, those patients with crush syndrome or vital organ injuries are particularly at risk. Proper triage and prompt treatment of these seriously injured earthquake victims may decrease morbidity and mortality. It is hoped that this review of the challenges met after the Marmara earthquake and the lessons learned will be of use to emergency department physicians as well as hospital emergency planners in preparing for future natural disasters. PMID:15983085

  12. Jefferson Lab Mass Storage and File Replication Services

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Ian Bird; Ying Chen; Bryan Hess

    Jefferson Lab has implemented a scalable, distributed, high performance mass storage system - JASMine. The system is entirely implemented in Java, provides access to robotic tape storage and includes disk cache and stage manager components. The disk manager subsystem may be used independently to manage stand-alone disk pools. The system includes a scheduler to provide policy-based access to the storage systems. Security is provided by pluggable authentication modules and is implemented at the network socket level. The tape and disk cache systems have well defined interfaces in order to provide integration with grid-based services. The system is in production andmore » being used to archive 1 TB per day from the experiments, and currently moves over 2 TB per day total. This paper will describe the architecture of JASMine; discuss the rationale for building the system, and present a transparent 3rd party file replication service to move data to collaborating institutes using JASMine, XM L, and servlet technology interfacing to grid-based file transfer mechanisms.« less

  13. Context view, Building Nos. 2729, with Building No. 28 in ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Context view, Building Nos. 27-29, with Building No. 28 in the center, looking west at front of buildings, from a spot south of Building No. 29 - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

  14. [Pressure sores in a university hospital].

    PubMed

    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 score< or =15 (OR=5.9, 95% CI: 2.4-13.7, p<0.0001) and previous pressure sores (OR=5.0 95% CI: 2.2-11.6, p<0.0001). Eleven sores (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

  15. Development of the Kisiizi hospital health insurance scheme: lessons learned and implications for universal health coverage.

    PubMed

    Baine, Sebastian Olikira; Kakama, Alex; Mugume, Moses

    2018-06-15

    Kisiizi Hospital Health Insurance scheme started in 1996 to; improve access to health services, and provide a stable source of funding and reduce bad debts to Kisiizi hospital. Objectives of this study were; to describe Kisiizi Hospital Health Insurance scheme and to document lessons learned and implications for universal health coverage. This was a descriptive cross-sectional study. Data from different sources were triangulated and thematically analysed. Most households (96%) were organized in Engozi societies (e-Societies), met monthly, and made financial contributions. Cultural solidarity in e-Societies provided a platform for the Kisiizi hospital health insurance scheme establishment, operation and made it compulsory for members. e-Societies disciplinary measures and fear of high out-of-pocket payment for health care enforced enrolment, retention and increased membership. Community sensitisation and community participation in setting premiums and co-payments provided for better understanding of health insurance and rendered them acceptable, affordable and equitable. Membership increased from 330 in 1996 to 38,400 families in 2017. Kisiizi hospital health insurance scheme covered only health services obtained from Kisiizi hospital. Kisiizi hospital health insurance scheme offered no exemption, credit and referral facilities. e-Societies sometimes paid premiums for members from savings and offered them loans to. Kisiizi hospital provided good quality health services, which were easily accessed by insured members. Kisiizi hospital got a stable source of funding and reduced debt burden. Kisiizi hospital health insurance scheme improved access to health services, provided a stable source of funding and reduced bad debts to the hospital. Internal and external factors to e-Society enforced enrolment and retention of members in Kisiizi hospital health insurance scheme. Good quality health services at Kisiizi hospital demonstrated value for money and offered incentives

  16. Multidrug-resistant bacteria infection control: study of compliance with isolation precautions in a Paris university hospital.

    PubMed

    Vidal-Trecan, G M; Delamare, N; Tcherny-Lessenot, S; Lamory, J; Baudin, F; de Prittwitz, M; Salmon-Ceron, D

    2001-02-01

    Isolation practices in a university hospital were analyzed for 137 patients with multidrug-resistant bacteria. Isolation was ordered in writing by physicians for 40% and instituted by nurses for 60%; 74% were isolated. Compliance depended on physician ordering in writing (odds ratio, 36.3; 95% confidence interval, 4.8-274.9). Nurses complied best with hand washing.

  17. Cultural resource applications for a GIS: Stone conservation at Jefferson and Lincoln Memorials

    USGS Publications Warehouse

    Joly, Kyle; Donald, Tony; Comer, Douglas

    1998-01-01

    Geographical information systems are rapidly becoming essential tools for land management. They provide a way to link landscape features to the wide variety of information that managers must consider when formulating plans for a site, designing site improvement and restoration projects, determining maintenance projects and protocols, and even interpreting the site. At the same time, they can be valuable research tools.Standing structures offer a different sort of geography, even though a humanly contrived one. Therefore, the capability of a geographical information system (GIS) to link geographical units to the information pertinent to the site and resource management can be employed in the management of standing structures. This was the idea that inspired the use of a GIS software, ArcView, to link computer aided design CAD) drawings of the Jefferson and Lincoln Memorials with inventories of the stones in the memorials. Both the CAD drawings and the inventory were in existence; what remained to be done was to modify the CAD files and place the inventory in an appropriately designed computerized database, and then to link the two in a GIS project. This work was carried out at the NPS Denver Service Center, Resource Planning Group, Applied Archaeology Center (DSC-RPG-AAC), in Silver Spring, Maryland, with the assistance of US/ICOMOS summer interns Katja Marasovic (Croatia) and Rastislav Gromnica (Slovakia), under the supervision of AAC office manager Douglas Comer. Project guidance was provided by Tony Donald, the Denver Service Center (DSC) project architect for the restoration of the Jefferson and Lincoln Memorials, and GIS consultation services by Kyle Joly.

  18. Maylard incision in gynecologic surgery: 4-year experience in Thammasat University Hospital.

    PubMed

    Manusook, Sakol; Suwannarurk, Komsun; Pongrojpaw, Densak; Bhamarapravatana, Kornkarn

    2014-08-01

    To present the results of Maylard incisionfor gynecologic surgery in Thammasat University Hospital during the past four years. A retrospective study of gynecologic surgery performed via the Maylard muscle cutting incision compare to Pfannenstiel muscle splitting and midline incision. Data came from subjects who underwent gynecologic surgey at Thammasat University Hospital, Pathumthani, Thailand friom January 2010 to December 2013. In the period of 4 years, there were 283 cases of elective surgery that performed via Maylard, Pfannenstiel and midline incision by the single experience gynecologic surgeon team. One hundred and six cases were performed via Maylard incision technique. The remaining 59 and 118 cases were performed via Pfannenstiel and midline incision technique, respectively. Two-thirds and one-thirds of cases underwent hysterectomy and conservative surgery, respectively. Benign conditions were the major indicationfor surgery at the percentage of 83.4. Operative results were not significantly different from well-known midline and Pfannenstiel incision in terms of blood loss, time to first meal and postoperative pain. Operative time in Maylard incision was longer than in Pfannenstiel incision. Length of stay in Maylard incision was longer than Pfannenstiel but shorter than midline incision. Overall complications (eoperation, bowel injuries, urinary bladder injuries and blood transfusion rate) were not significantly different. Maylard incision provides similar operative results with midline and Pfannenstiel technique. Even though it takes more time for abdominal entry but it gives more operative exposure than Pfannenstiel incision. In the woman with previous low transverse scar and gynaecologic surgery is needed, Maylard incision could be an optional technique that provides cosmetic and successfud results. Hand on training for Maylard incision from their mentors should be encouraged to more practice.

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

    PubMed

    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.

  20. Isolation of Escherichia coli Strains with AcrAB–TolC Efflux Pump-Associated Intermediate Interpretation or Resistance to Fluoroquinolone, Chloramphenicol and Aminopenicillin from Dogs Admitted to a University Veterinary Hospital

    PubMed Central

    SATO, Toyotaka; YOKOTA, Shin-ichi; ICHIHASHI, Risa; MIYAUCHI, Tomoka; OKUBO, Torahiko; USUI, Masaru; FUJII, Nobuhiro; TAMURA, Yutaka

    2014-01-01

    ABSTRACT Understanding the prevalence of antimicrobial-resistance and the relationship between emergence of resistant bacteria and clinical treatment can facilitate design of effective treatment strategies. We here examined antimicrobial susceptibilities of Escherichia coli isolated from dogs admitted to a university hospital (University hospital) and companion animal clinics (Community clinics) in the same city and investigated underlying multidrug-resistance mechanisms. The prevalence of E. coli with intermediate and resistant interpretations to ampicillin (AMP), enrofloxacin (ENR) and chloramphenicol (CHL) was higher in the University hospital than in the Community clinics cases. Use of antimicrobials, including fluoroquinolone, was also significantly higher in the University hospital than in the Community clinics cases. Upon isolation using ENR-supplemented agar plates, all ENR-resistant isolates had 3–4 nucleotide mutations that accompanied by amino acid substitutions in the quinolone-resistance-determining regions of gyrA, parC and parE, and 94.7% of all isolates derived from the University hospital showed AMP and/or CHL resistance and possessed blaTEM and/or catA1. The average mRNA expression levels of acrA, acrB and tolC and the prevalence of organic solvent tolerance, in isolates derived from ENR-supplemented agar plates were significantly higher in the University hospital than in the Community clinics isolates. Thus, E. coli derived from the University hospital cases more often showed concomitant decreased susceptibilities to aminopenicillins, fluoroquinolones and CHL than did those derived from the Community clinics; this was related to an active AcrAB–TolC efflux pump, in addition to acquisition of specific resistance genes and genetic mutations. PMID:24646457

  1. Experiment E89-044 on the Quasielastic 3He(e,e'p) Reaction at Jefferson Laboratory

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Penel-Nottaris, Emilie

    The Jefferson Lab Hall A E89-044 experiment has measured the 3He(e,e'p) reaction cross-sections. The extraction of the longitudinal and transverse response functions for the two-body break-up 3He(e,e'p)d reaction in parallel kinematics allows the study of the bound proton electromagnetic properties inside the 3He nucleus and the involved nuclear mechanisms beyond plane wave approximations.

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

    PubMed

    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.

  3. Analysis of maxillofacial prosthetics at university dental hospitals in the capital region of Korea

    PubMed Central

    Lee, Jong-Ho

    2016-01-01

    PURPOSE The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required. PMID:27350859

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

    PubMed

    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.

  5. [Study of the infectivity of Candida on peripheral vascular catheters collected from the University Hospital of Tlemcen].

    PubMed

    Seghir, A; Boucherit-Otmani, Z; Boucherit, K; Sari-Belkharroubi, L

    2017-12-01

    Yeasts can adhere to medical implants and cause infections responsible for high morbidity and mortality among hospitalized patients. The objective of this study is to investigate the infectivity on peripheral vascular catheters collected from general surgery and cardiology in University Hospital of Tlemcen. The results showed that from 29 samples altered by yeast, 35 Candida sp. strains were isolated. However, Candida albicans is the most isolated species in an infectious context. Risk factors that accompanied the infections are the duration of implantation, male gender, and bacterial presence. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Screening and Brief Intervention for Alcohol Problems among College Students Treated in a University Hospital Emergency Department

    ERIC Educational Resources Information Center

    Helmkamp, James C.; Hungerford, Daniel W.; Williams, Janet M.; Manley, William G.; Furbee, Paul M.; Horn, Kimberly A.; Pollock, Daniel A.

    2003-01-01

    The authors evaluated a protocol to screen and provide brief interventions for alcohol problems to college students treated at a university hospital emergency department (ED). Of 2,372 drinkers they approached, 87% gave informed consent. Of those, 54% screened positive for alcohol problems (Alcohol Use Disorders Identification Test score [less…

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

    PubMed Central

    2010-01-01

    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 to meet the needs of

  8. Direct variable cost of the topical treatment of stages III and IV pressure injuries incurred in a public university hospital.

    PubMed

    Chacon, Julieta M F; Blanes, Leila; Borba, Luis G; Rocha, Luis R M; Ferreira, Lydia M

    2017-05-01

    to estimate the direct variable costs of the topical treatment of stages III and IV pressure injuries of hospitalized patients in a public university hospital, and assess the correlation between these costs and hospitalization time. Forty patients of both sexes who had been admitted to the São Paulo Hospital, São Paulo, SP, Brazil, from 2011 to 2012, with pressure injuries in the sacral, ischial or trochanteric region were included. The patients had a total of 57 pressure injuries in the selected regions, and the lesions were monitored daily until patient release, transfer or death. The quantities and types of materials, as well as the amount of professional labor time spent on each procedure and each patient were recorded. The unit costs of the materials and the hourly costs of the professional labor were obtained from the hospital's purchasing and human resources departments, respectively. Spearman's correlation coefficient and the Mann-Whitney and Kruskal-Wallis tests were used for the statistical analyses. The mean topical treatment costs for stages III and IV PIs were significantly different (US$ 854.82 versus US$ 1785.35; p = 0.004). The mean topical treatment cost of stages III and IV pressure injuries per patient was US$ 1426.37. The mean daily topical treatment cost per patient was US$ 40.83. There was a significant correlation between hospitalization time and the total costs of labor and materials (p < 0.05). There was no significant difference between hospitalization time periods for stages III and IV pressure injuries (40.80 days and 45.01 days, respectively; p = 0.834). The mean direct variable cost of the topical treatment for stages III and IV pressure injuries per patient in this public university hospital was US$ 1426.37. Copyright © 2016. Published by Elsevier Ltd.

  9. Serum 25 hydroxyvitamin D in employees of a Middle Eastern university hospital.

    PubMed

    Gannagé-Yared, M-H; Helou, E; Zaraket, V; Abi Akl, S; Antonios, L; Moussalli, M-L; Wakim, S

    2014-06-01

    The Middle East registers the highest rate of vitamin D deficiency worldwide. In Lebanon, previous studies looked at this deficiency in schoolchildren, university students, young adults and postmenopausal women. However, no previous study was performed in hospital workers. The objective of our study was to evaluate vitamin D status in a Beirut hospital center and to look at the potential factors influencing these measurements. This cross-sectional study was performed on hospital employees who came for a regular checkup at the primary health-care department. 25(OH)D measurements were performed using the Dia-Sorin chemiluminescent assay. 392 subjects (318 women and 74 men) were included in the study. The mean age of the participants was 41.02 ± 11.3 years. The mean 25(OH)D level was 15.61 ± 7.91 ng/ml, with no significant difference according to gender. There were no significant correlations between 25(OH)D and both BMI and age, but 25(OH)D was significantly associated with educational level (p = 0.03). There was a significant difference in 25(OH)D levels according to season (p < 0.001) and a significant association between 25(OH)D and the reported weekly hours of sun exposure (r = 0.1, p = 0.032), but not with the reported sunscreen use. Fish consumption was positively associated with 25(OH)D levels (p = 0.018), while milk, dairy product or egg consumption did not achieve any significant relationship. In a stepwise linear regression analysis, fish consumption and season were the only independent predictors of 25(OH)D levels (p = 0.007 and p = 0.0001 respectively). Vitamin D deficiency is common among hospital workers. This finding reinforces the need for vitamin D supplementation in these high-risk populations.

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

    PubMed

    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.

  11. Causes of gas gangrene seen at the University of Nigeria Teaching Hospital, Enugu, Nigeria.

    PubMed

    Nwankwo, Okechukwu Emmanuel

    2008-04-01

    Gas gangrene (clostridial myonecrosis) is rarely seen and this rarity, coupled with its dramatic presentation and often devastating outcome, makes each case of gas gangrene a spectacular and memorable experience. This study analyses the cases managed, the causes and outcome. Gunshot wounds, compounded by late presentation with its accompanying florid infections, were seen as the causes in 14 cases of gas gangrene seen at the University of Nigeria Teaching Hospital, Enugu during the four-year study period from July 2000 to June 2004.

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

    PubMed

    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.

  13. Petrographic and geochemical investigation of magma chamber processes beneath small Quaternary volcanic centers between Mt. Jefferson and Mt. Hood volcanoes, Cascade Range Volcanic Arc

    NASA Astrophysics Data System (ADS)

    Cunningham, E.; Cribb, J. W.

    2017-12-01

    The northern Oregon Cascade Range has been dominated by andesite to rhyodacite lavas at both Mt. Jefferson (Conrey, 1991) and at Mt. Hood (Cribb and Barton, 1996) during the Quaternary period. Eruptive sequences at both Mt. Hood and Mt. Jefferson have been attributed to open-system mama mixing (Kent et al., 2010) (Ferrell et al., 2015), and the narrow range of lavas erupted at both centers has been derived from repeated cycles of magma mixing-fractionation (Cribb and Barton, 1996). This research examines major and trace element geochemistry as well as the petrographic characteristics of Clear Lake Butte (CLB), Pinhead Butte (PB), and Olallie Butte (OB), all of which are located between Mt. Hood and Mt. Jefferson, and have ben active in the Quaternary period. The research investigates whether the same type of open-system magma mixing known to have occurred at Mt. Hood and Mt. Jefferson has also occurred at CLB, PB, or OB, or whether those systems were closed to mixing and dominated by fractional crystallization. One of the main goals of this project is to highlight the similarities and differences exhibited by neighboring magmatic systems of similar age, but different scale. Disequilibrium textures observed in thin sections from CLB, OB, and PB suggest open-system magma mixing is likely occurring beneath all three buttes. This petrographic evidence includes plagioclase and pyroxene zoning, embayed margins, sieving, and reaction rims. Major element oxide trends at all three buttes are consistent with fractional crystallization, but show narrow concentrations and non-overlapping compositions between PB, CLB, and OB. All three buttes are characterized by narrow ranges of incompatible and compatible trace element concentrations. CLB, PB, and OB all exhibit LREE enrichment and lack significant HFSE depletions, with PB exhibiting greatest enrichment in REE.

  14. Upgraded photon calorimeter with integrating readout for Hall A Compton Polarimeter at Jefferson Lab

    DOE PAGES

    Friend, M.; Parno, D.; Benmokhtar, F.; ...

    2012-06-01

    The photon arm of the Compton polarimeter in Hall A of Jefferson Lab has been upgraded to allow for electron beam polarization measurements with better than 1% accuracy. The data acquisition system (DAQ) now includes an integrating mode, which eliminates several systematic uncertainties inherent in the original counting-DAQ setup. The photon calorimeter has been replaced with a Ce-doped Gd 2SiO 5 crystal, which has a bright output and fast response, and works well for measurements using the new integrating method at electron beam energies from 1 to 6 GeV.

  15. Comparison of occipitocervical and atlantoaxial fusion in treatment of unstable Jefferson fractures.

    PubMed

    Hu, Yong; Yuan, Zhen-Shan; Kepler, Christopher K; Dong, Wei-Xin; Sun, Xiao-Yang; Zhang, Jiao

    2017-01-01

    Controversy exists regarding the management of unstable Jefferson fractures, with some surgeons performing reduction and immobilization of the patient in a halo vest and others performing open reduction and internal fixation. This study compares the clinical and radiological outcome parameters between posterior atlantoaxial fusion (AAF) and occipitocervical fusion (OCF) constructs in the treatment of the unstable atlas fracture. 68 consecutive patients with unstable Jefferson fractures treated by AAF or OCF between October 2004 and March 2011 were included in this retrospective evaluation from institutional databases. The authors reviewed medical records and original images. The patients were divided into two surgical groups treated with either AAF ( n = 48, F/M 30:18) and OCF ( n = 20, F/M 13:7) fusion. Blood loss, operative time, Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, atlanto-dens interval, lateral mass displacement, complications, and the bone fusion rates were recorded. Five patients with incomplete paralysis (7.4%) demonstrated postoperative improvement by more than 1 grade on the American Spinal Injury Association impairment scale. The JOA score of the AAF group improved from 12.5 ± 3.6 preoperatively to 15.7 ± 2.3 postoperatively, while the JOA score of the OCF group improved from 11.2 ± 3.3 preoperatively to 14.8 ± 4.2 postoperatively. The VAS score of AAF group decreased from 4.8 ± 1.5 preoperatively to 1.0 ± 0.4 postoperatively, the VAS score of the OCF group decreased from 5.4 ± 2.2 preoperatively to 1.3 ± 0.9 postoperatively. The OCF or AAF combined with short-term external immobilization can establish the upper cervical stability and prevent further spinal cord injury and nerve function damage.

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

    PubMed

    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.

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

    PubMed

    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.

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

    ERIC Educational Resources Information Center

    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…

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

    PubMed

    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.

  20. Pseudospread of the atlas: false sign of Jefferson fracture in young children

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Suss, R.A.; Zimmerman, R.D.; Leeds, N.E.

    Jefferson fractures are rare prior to teen-age. Three young children examined after trauma exhibited the characteristic spread appearance of the atlas, but fractures were excluded radiographically and clinically. A retrospective study demonstrated a similar appearance, termed pseudospread, in most children aged 3 months to 4 years, including over 90% during the second year. Pseudospread results from a discrepancy between the neural growth pattern of the atlas and the somatic pattern of the axis. An atlas spread index is defined and a normal range presented. When an atlas fracture is suggested by apparent lateral spread of the lateral atlas masses, computedmore » tomography is useful to demonstrate an intact atlas ring.« less

  1. Trails through time: A geologist's guide to Jefferson County open space parks

    USGS Publications Warehouse

    Reed, John C.

    2014-01-01

    Jefferson County Open Space Parks, as well as other nearby parks and National Forest lands, offer marvelousopportunities to explore the geologic story behind this singular landscape. At first the distribution of rocks of differentages and types seems almost random, but careful study of the rocks and landscape features reveals a captivatinggeologic story, a history that tells of the building of the foundations of the continent, the rise and destruction of longvanishedmountain ranges, the ebb and flow of ancient seas, and the constant shaping and reshaping of the landscape inresponse to the never-ending interplay between uplift and erosion. This historical account is constantly being improvedand expanded as new evidence accumulates and new interpretations evolve.

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

    PubMed

    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.

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

    PubMed

    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.

  4. Bacterial contamination, bacterial profile and antimicrobial susceptibility pattern of isolates from stethoscopes at Jimma University Specialized Hospital.

    PubMed

    Shiferaw, Teklu; Beyene, Getenet; Kassa, Tesfaye; Sewunet, Tsegaye

    2013-12-13

    Hospital acquired infections are recognized as critical public health problems. Infections are frequently caused by organisms residing in healthcare environment, including contaminated medical equipment like Stethoscopes. To determine bacterial contamination, bacterial profile and anti-microbial susceptibility pattern of the isolates from stethoscopes at Jimma University Specialized Hospital. Cross-sectional study conducted from May to September 2011 at Jimma University Specialized Hospital. One hundred seventy-six stethoscopes owned by Health Care Workers (HCWs) and Medical students were randomly selected and studied. Self-administered structured questionnaire was used to collect socio-demographic data. Specimen was collected using moisten sterile cotton swab and 1 ml normal saline was used to transport the specimen, all laboratory investigations were done following standard microbiological techniques, at Microbiology Laboratory, Jimma University. SPSS windows version 16 used for data analysis and P <0.05 was considered statistically significant. A total, of 151 (85.8%) stethoscopes were contaminated. A total of 256 bacterial strains and a mean of 1.44×104 CFUs/diaphragm of stethoscopes was isolated. Of the 256 isolates, 133 (52%) were potential pathogens like S. aureus, Klebsiella spp., Citrobacter spp., Salmonella spp., Proteus spp., Enterobacter spp., P. aeruginosa and E. coli. All strains were resistant to multiple classes of antibiotics (two to eight classes of antibiotics). Disinfection practice was poor. Disinfection practice was found to be associated with bacterial contamination of stethoscopes (P < 0.05). High contamination rate 100 (90.9%) was observed among stethoscopes that had never been disinfected; while the least contamination 29 (72.2%) was found on those disinfected a week or less before the survey. Bacterial contamination of the stethoscope was significant. The isolates were potential pathogens and resistant to multiple classes of

  5. Management of a severe thoracoabdominal injury from motorized sawing machine in a temporary semi-urban university teaching hospital: a case report.

    PubMed

    Fente, B G; Nwagwu, C C; Ogulu, B N; Orukari, G I B; Okere, E O; Miss Ouserigha, O E

    2012-01-01

    Report of our experience and outcome of a case of severe thoracoabdominal injuries by motorized sawing machine (a rare cause) in a Semi-Urban temporary University Teaching Hospital. Literature review on the topic was done using Pubmed. Relevant journals and topics were also reviewed. Textbooks on relevant topics were also searched. A 25 year old male timber-cutter was traumatized by motorized sawing machine injuring the left half of the chest, upper abdomen, the left shoulder and left hand. It is an unusual presentation of penetrating thoracoabdominal injury. There was open pneumotharax, 3th-8th ribs fractures, diaphragmatic laceration, and eviscerations of abdominal contents without affecting other thoraco-abdominal organs. Urgent surgical intervention done was the only option. The challenges posed by severe motorized sawing machine thoraco-abdominal injuries in a Semi-Urban temporary University Teaching Hospital were successfully managed due to rapid pre-hospital transfer and co-ordinated team effort.

  6. Surfactant replacement therapy: development of criteria for appropriate use. Ohio State University Hospitals.

    PubMed

    Gardner, D K

    1992-08-01

    At The Ohio State University (OSU) Hospitals, DUE criteria were established when colfosceril palmitate, a synthetic surfactant, was added to the formulary in January 1991. The DUE criteria were designed to assure appropriate drug use, educate physicians, and establish an effective way to monitor drug use and patient outcome (ie, response rate and complications). The criteria include a mechanism for evaluation and modification of the guidelines, as necessary. In addition, a review process will be used to determine the therapy's cost effectiveness and to serve as a guideline for making recommendations on other surfactant formulations as they become available.

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

    PubMed Central

    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. PMID:23819004

  8. [Risk factors for a complicated disease course in children with measles admitted to a Philippine university hospital].

    PubMed

    Bronzwaer, S L; de Groot, C J

    1997-12-20

    To analyse the correlation of specific risk factors and measles complications in children admitted to a Philippine university medical centre. Retrospective cross-sectional study. Department of Pediatrics, De La Salle University Medical Center at Dasmarinas, a suburb of Manila, the Philippines. Information was collected on patients under 16 admitted for measles from January 1993 to May 1996, using a data collection form. Of the 180 patients included in this study, 8 (4%) died during the hospital stay, and 172 left the hospital in good condition. 61 Patients (34%) had complicated measles (pneumonia, gastroenteritis, and (or) encephalitis). Age under 2 years and stay in the service ward (as opposed to the private ward) were significantly related to complicated measles. No significant relation was found for the presence of associated illnesses or malnutrition. More severe complications were seen at an early age than in industrialised countries where the frequency appears to increase with age. Malnutrition possibly contributes less to severity of the disease than environmental factors such as hygiene and social class.

  9. Keyhole Surgery of the Kidney at Sultan Qaboos University Hospital, Oman

    PubMed Central

    Al-Marhoon, Mohammed S; Mathew, Josephkunju; Al-Lawati, Hawraa

    2007-01-01

    Objectives: Percutaneous access surgery of the kidneys was introduced in Sultan Qaboos University Hospital (SQUH) in 1998. We are presenting our early experience in the first 31 patients operated on over an eight year period using the percutaneous approach. Methods: A retrospective review of 25 patients, who underwent percutaneous nephrolithotomy (PCNL) for the treatment of large renal stones and 6 patients who underwent endopyelotomy for the treatment of pelviureteric junction (PUJ) obstruction. Results: In the PCNL group complete stone clearance was achieved in 68% (17/25) patients and the complication rate was 28% (7/25). In the endopyelotomy group the success rate of relief of obstruction of PUJ measured by renogram and relief of symptoms was 83% (5/6 patients). Conclusion: Our early results of PCNL are promising and comparable to international results. PMID:21748093

  10. The eye disease of Jefferson Davis (1808-1889).

    PubMed

    Hertle, Richard W; Spellman, Robert

    2007-01-01

    The only Confederate president, Jefferson Davis, led a long and eventful life. He was a Mississippi planter, a husband, a father, West Point graduate, war hero, congressman, senator, secretary of war, and finally President of the Confederate States of America. In many ways he was a study of contrast with his northern counterpart Abraham Lincoln. Davis was personally courageous and a rich, educated, southern aristocrat who did not deeply understand the political process or have the refined personal skills necessary to work well with others. Prior to his Presidency he served with distinction in two wars, but as a result of his confederate activity and pro-slavery philosophy he is one of the least discussed famous Americans. Davis's health was a constant problem and he suffered an almost fatal attack of 'malaria' in 1836. In the winter of 1857-1858, he again was seriously ill and by the end of February 1858, a chronic, relapsing, ocular inflammatory condition began. Using historical evidence from multiple sources, this paper will propose a diagnosis of the Confederate President's ocular condition and consider how this could have influenced his military and political decisions.

  11. The eye disease of Jefferson Davis (1808-1889).

    PubMed

    Hertle, Richard W; Spellman, Robert

    2006-01-01

    The only Confederate president, Jefferson Davis, led a long and eventful life. He was a Mississippi planter, a husband, a father, West Point graduate, war hero, congressman, senator, secretary of war, and finally President of the Confederate States of America. In many ways he was a study of contrast with his northern counterpart, Abraham Lincoln. Davis was personally courageous and a rich, educated, southern aristocrat who did not deeply understand the political process or have the refined personal skills necessary to work well with others. Prior to his Presidency he served with distinction in two wars, but as a result of his confederate activity and pro-slavery philosophy he is one of the least discussed famous Americans. Davis's health was a constant problem and he suffered an almost fatal attack of "malaria" in 1836. In the winter of 1857-1858 he again was seriously ill and by the end of February 1858 a chronic, relapsing, ocular inflammatory condition began. Using historical evidence from multiple sources, this paper will propose a diagnosis of the Confederate President's ocular condition and consider how this could have influenced his military and political decisions.

  12. 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

    PubMed Central

    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.

    2017-01-01

    Introduction 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. Objective 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. Design Retrospective, observational cohort study Participants Non-traumatic, adult (≥18 years) OHCA patients of presumed cardiac etiology treated by EMS providers Setting ROC-PRIMED and ROC-Epistry post ROC-PRIMED databases between 2007 and 2011. Outcomes 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. Results 36,543 treated OHCAs occurred of which 9,467 (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. Conclusion Using absence of ROSC as a sole predictor of futility misses potential survivors. The Universal TOR Guideline remains a strong predictor of survival. PMID:27923115

  13. Routine clinical heart examinations using SQUID magnetocardiography at University of Tsukuba Hospital

    NASA Astrophysics Data System (ADS)

    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.

  14. A Study of the Readiness of Hospitals for Implementation of High Reliability Organizations Model in Tehran University of Medical Sciences.

    PubMed

    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

  15. Physician-Owned Surgical Hospitals Outperform Other Hospitals in Medicare Value-Based Purchasing Program.

    PubMed

    Ramirez, Adriana G; Tracci, Margaret C; Stukenborg, George J; Turrentine, Florence E; Kozower, Benjamin D; Jones, R Scott

    2016-10-01

    The Hospital Value-Based Purchasing Program measures value of care provided by participating Medicare hospitals and creates financial incentives for quality improvement and fosters increased transparency. Limited information is available comparing hospital performance across health care business models. The 2015 Hospital Value-Based Purchasing Program results were used to examine hospital performance by business model. General linear modeling assessed differences in mean total performance score, hospital case mix index, and differences after adjustment for differences in hospital case mix index. Of 3,089 hospitals with total performance scores, categories of representative health care business models included 104 physician-owned surgical hospitals, 111 University HealthSystem Consortium, 14 US News & World Report Honor Roll hospitals, 33 Kaiser Permanente, and 124 Pioneer accountable care organization affiliated hospitals. Estimated mean total performance scores for physician-owned surgical hospitals (64.4; 95% CI, 61.83-66.38) and Kaiser Permanente (60.79; 95% CI, 56.56-65.03) were significantly higher compared with all remaining hospitals, and University HealthSystem Consortium members (36.8; 95% CI, 34.51-39.17) performed below the mean (p < 0.0001). Significant differences in mean hospital case mix index included physician-owned surgical hospitals (mean 2.32; p < 0.0001), US News & World Report honorees (mean 2.24; p = 0.0140), and University HealthSystem Consortium members (mean 1.99; p < 0.0001), and Kaiser Permanente hospitals had lower case mix value (mean 1.54; p < 0.0001). Re-estimation of total performance scores did not change the original results after adjustment for differences in hospital case mix index. The Hospital Value-Based Purchasing Program revealed superior hospital performance associated with business model. Closer inspection of high-value hospitals can guide value improvement and policy-making decisions for all Medicare Value

  16. Approach to Emergencies in Schizophrenia in University Hospital "Vrapče".

    PubMed

    Silić, Ante; Savić, Aleksandar; Čulo, Ilaria; Kos, Suzana; Vukojević, Jakša; Brumen, Daška; Ostojić, DraŽenka

    2018-06-01

    An emergency in psychiatric setting is any disorder in thought process, feelings and/or behavior of the patient that requires urgent therapeutic intervention. In general, we can observe an increase in numbers of psychiatric emergencies throughout the world and in Croatia as well. Agitation and aggression are one of the most common causes of emergency in psychiatry. Agitation is common and frequent in patients suffering from schizophrenia. Patient can be agitated in various levels such as: mild, moderate or severe and can alternate between these levels in the same presentation. Agitated patients often require hospitalization that includes pharmacotherapy and sometimes physical restraining, in order to treat the cause of agitation and prevent auto and/or heterodestructive behavior. In this paper we focus on patients suffering from schizophrenia that were admitted in University Hospital "Vrapče" in 2017, and assess the numbers through the criteria of voluntary vs. involuntary admissions and physical restraint usage. Out of total observations, 130 (35.6%) were patients admitted for the first time and 179 (49%) were patients later diagnosed with schizophrenia spectrum and other psychotic disorders. Court ordered involuntary hospitalization was ordered for 35 (2.8%) patients out of total admitted patients, and 68.6% (N24) of them were diagnosed with schizophrenia spectrum and other psychotic disorders. Physical restraint was used for 122 patients out of total admissions and 28.7% (N35) of restrained patients were diagnosed with schizophrenia spectrum and other psychotic disorders. Emergencies in patient suffering from schizophrenia are extremely delicate and demanding situations in every-day clinical practice of psychiatrist. There is an increased risk involved for the patient but for the staff as well. All interventions should be individualized and patient should carefully monitored throughout the entire process. All professionals involved in care for a patient should

  17. Nursing staff turnover at a Swedish university hospital: an exploratory study.

    PubMed

    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.

  18. Indoor air quality levels in a University Hospital in the Eastern Province of Saudi Arabia

    PubMed Central

    El-Sharkawy, Mahmoud F.; Noweir, Mohamed E. H.

    2014-01-01

    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 (PM10) inside the selected hospital were found at locations that are characterized with m4ore human activity. Conclusions: Levels of particulate matter (both PM10 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. PMID:24696632

  19. A high-finesse Fabry-Perot cavity with a frequency-doubled green laser for precision Compton polarimetry at Jefferson Lab

    DOE PAGES

    Rakhman, A.; Hafez, Mohamed A.; Nanda, Sirish K.; ...

    2016-03-31

    Here, a high-finesse Fabry-Perot cavity with a frequency-doubled continuous wave green laser (532 nm) has been built and installed in Hall A of Jefferson Lab for high precision Compton polarimetry. The infrared (1064 nm) beam from a ytterbium-doped fiber amplifier seeded by a Nd:YAG nonplanar ring oscillator laser is frequency doubled in a single-pass periodically poled MgO:LiNbO 3 crystal. The maximum achieved green power at 5 W infrared pump power is 1.74 W with a total conversion efficiency of 34.8%. The green beam is injected into the optical resonant cavity and enhanced up to 3.7 kW with a corresponding enhancementmore » of 3800. The polarization transfer function has been measured in order to determine the intra-cavity circular laser polarization within a measurement uncertainty of 0.7%. The PREx experiment at Jefferson Lab used this system for the first time and achieved 1.0% precision in polarization measurements of an electron beam with energy and current of 1.0 GeV and 50 μA.« less

  20. From customer satisfaction survey to corrective actions in laboratory services in a university hospital.

    PubMed

    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.

  1. Increasing access to legal termination of pregnancy and postabortion contraception at the University Teaching Hospital, Lusaka, Zambia.

    PubMed

    Macha, Swebby; Muyuni, Mutinta; Nkonde, Scholastica; Faúndes, Anibal

    2014-07-01

    The Zambian Association of Gynecology and Obstetrics is one of the International Federation of Gynecology and Obstetrics (FIGO) member societies participating in the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences from the East, Central, and Southern Africa region. The activities included in this country's plan of action were to provide access to safe abortion within the full extent of the law to women receiving care at the University Teaching Hospital in Lusaka, and to increase the proportion of women leaving the hospital with a contraceptive method. Zambian law regarding abortion is liberal, but in general it was not applied until very recently. The proportion of legal terminations of pregnancy among patients receiving abortion care at the hospital increased from 3.2% in 2009 to 7.7% in 2011, while the percentage of women leaving the hospital with a contraceptive method increased from 25.3% to 69.4% over the same period. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  2. [Medico-economic analysis of a neurosurgery department at a university hospital].

    PubMed

    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.

  3. Report of Block Field Experience at Jefferson County Department of Health Bureau of Nutrition, Birmingham, Alabama.

    DTIC Science & Technology

    1985-01-01

    Despite the recent economic growth of Jefferson County, poverty * still abounds. In 1980, 12% of the families lived below the poverty level and some...residents with the charge for services being based on a sliding fee scale. Those at or below 150% of poverty level are charged only a minimum fee. F...be at risk? 1. Poor dietary calcium intake - average intake for American women is less than 500 grams per day. 2. Smoking - nicotine hurries the

  4. Decreased Hospital Costs and Surgical Site Infection Incidence With a Universal Decolonization Protocol in Primary Total Joint Arthroplasty.

    PubMed

    Stambough, Jeffrey B; Nam, Denis; Warren, David K; Keeney, James A; Clohisy, John C; Barrack, Robert L; Nunley, Ryan M

    2017-03-01

    Staphylococcus aureus colonization has been identified as a key modifiable risk factor in the reduction of surgical site infections (SSI) related to elective total joint arthroplasty (TJA). We investigated the incidence of SSIs and cost-effectiveness of a universal decolonization protocol without screening consisting of nasal mupirocin and chlorhexidine before elective TJA compared to a program in which all subjects were screened for S aureus and selectively treated if positive. We reviewed 4186 primary TJAs from March 2011 through July 2015. Patients were divided into 2 cohorts based on the decolonization regimen used. Before May 2013, 1981 TJA patients were treated under a "screen and treat" program while the subsequent 2205 patients were treated under the universal protocol. We excluded the 3 months around the transition to control for treatment bias. Outcomes of interest included SSI and total hospital costs. With a universal decolonization protocol, there was a significant decrease in both the overall SSI rate (5 vs 15 cases; 0.2% vs 0.8%; P = .013) and SSIs caused by S aureus organisms (2 vs 10; 0.09% vs 0.5%; P = .01). A cost analysis accounting for the cost to administer the universal regimen demonstrated an actual savings of $717,205.59. TJA complicated by SSI costs 4.6× more to treat than that of an uncomplicated primary TJA. Our universal decolonization paradigm for elective TJA is effective in reducing the overall rate of SSIs and promoting economic gains for the health system related to the downstream savings accrued from limiting future reoperations and hospitalizations. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    PubMed

    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

  6. The Howard University Hospital Transplant and Dialysis Support Group: twenty years and going strong.

    PubMed

    Stewart, A M; Kelly, B; Robinson, J D; Callender, C O

    1995-10-01

    This article discusses group therapy as part of a multidisciplinary approach to the management of the various psychological and physical rehabilitation concerns posed by kidney and liver transplant candidates and recipients at Howard University Hospital in Washington, DC. The group's history, format, intervention foci, and roles of clinicians and patients attending the group are described and evaluated. Given the relative paucity of research literature in this area, the authors offer recommendations for empirical evaluation of the benefits of multidisciplinary group psychotherapy in ameliorating physical and emotional suffering and prolonging life among transplant patients.

  7. National Dam Safety Program. Cedar Hill Lake Number 2 and Number 3 Dams (MO 30005) and (MO 31020), Mississippi - Kaskaskia - St. Louis Basin, Jefferson County, Missouri. Phase I Inspection Report.

    DTIC Science & Technology

    1979-01-01

    ST. LOUIS I3ASIN ’ADA l1047 82 -3 CEDAR HILL LAKE NO. 2 AND NO. 5 DAMS 5JEFFERSON COUNTY, MISSOURI SMO 30005 AND MO 31020% SPHASE I INSPECTION REPORT...and Number 3 17. DISTRIBUTION STATEMENT (of the abstraect Un ((NO 30005 and MO 31020),, Mississippi - Kaskaskia - St. Louis i ,-_Basin, Jefferson County...results of field inspection and evaluation of Cedar Hill No. 2 and No. 3 Dams (Mo. 30005 and 31020). It was prepared under the National Program of

  8. Analysis of complications from abdominoplasty: a review of 206 cases at a university hospital.

    PubMed

    Neaman, Keith C; Hansen, Juliana E

    2007-03-01

    The number of abdominoplasties performed in the United States has been steadily increasing over the past decade. A large proportion of these patients are bariatric patients who remain obese despite prior weight-reduction surgery. This study was done to review the experience of patients undergoing abdominoplasty at a university hospital. A retrospective chart review of 206 consecutive patients was performed. The overall complication rate was 37.4%. Major complications [hematoma requiring surgical intervention, seroma requiring aspiration or surgical drainage, cellulitis or abscess requiring hospitalization and intravenous (IV) antibiotics, deep vein thrombosis (DVT), and pulmonary embolism (PE)] occurred in 16% of patients. The rate of minor complications (hematoma or seroma requiring no intervention, epidermolysis, small-wound dehiscence, neuropathic pain, and minor cellulitis) was 26.7%. Obese patients had a significantly increased risk of developing major complications as compared with nonobese patients (53.4% versus 28.8%, P = 0.001). An in-depth analysis of all complications and risk factors was done.

  9. Evolution of the Generic Lock System at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brian Bevins; Yves Roblin

    2003-10-13

    The Generic Lock system is a software framework that allows highly flexible feedback control of large distributed systems. It allows system operators to implement new feedback loops between arbitrary process variables quickly and with no disturbance to the underlying control system. Several different types of feedback loops are provided and more are being added. This paper describes the further evolution of the system since it was first presented at ICALEPCS 2001 and reports on two years of successful use in accelerator operations. The framework has been enhanced in several key ways. Multiple-input, multiple-output (MIMO) lock types have been added formore » accelerator orbit and energy stabilization. The general purpose Proportional-Integral-Derivative (PID) locks can now be tuned automatically. The generic lock server now makes use of the Proxy IOC (PIOC) developed at Jefferson Lab to allow the locks to be monitored from any EPICS Channel Access aware client. (Previously clients had to be Cdev aware.) The dependency on the Qt XML parser has been replaced with the freely available Xerces DOM parser from the Apache project.« less

  10. [Proposal for graduate school education in the future: from the viewpoint of the Department of clinical Laboratory in a university hospital].

    PubMed

    Ishii, Junichi

    2009-08-01

    Fujita Health University Hospital, located in Toyoake, is a large teaching hospital with 1,505 beds. The Department of Clinical Laboratory in our hospital, in which 136 medical technologists work, is one of the largest clinical laboratories in Japan. Medical technologists in our hospital are required not only to perform accurate laboratory examinations, but also to contribute to the medical care team. In addition, they must educate students and trainee medical technologists. Furthermore, they conduct research to develop and evaluate new laboratory methods. Thus, we hope that education in graduate schools of medical technology (Master's course), along with promoting the specialty of laboratory techniques, will develop students' clinical skills to examine patients and research skills to conduct studies.

  11. Prevalence and factors associated with pregnancy loss among physicians in King Abdul-Aziz University Hospital, Saudi Arabia.

    PubMed

    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.

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

    PubMed Central

    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: 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. PMID:27384969

  13. TEMPOROMANDIBULAR PAIN DYSFUNCTION SYNDROME IN PATIENTS ATTENDING LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA.

    PubMed

    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.

  14. Initial experience of Da Vinci robotic thoracic surgery at the First Affiliated Hospital of Zhejiang University

    PubMed Central

    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

  15. Clinico-laboratory profile of breath-holding spells in children in Sohag University Hospital, Upper Egypt

    PubMed Central

    Sadek, Abdelrahim Abdrabou; Mohamed, Montaser Mohamed; Sharaf, El-Zahraa El-Said Ahmed; Magdy, Rofaida Mohamed; Allam, Ahmed Ahmed

    2016-01-01

    Introduction Breath-holding spells (BHSs) are involuntary pauses of breathing, sometimes accompanied by loss of consciousness. They usually occur in response to an upsetting or surprising situation. Breath-holding spells are usually caused by either a change in the usual breathing pattern or a slowing of the heart rate. In some children, BHSs may be related to iron deficiency anemia. The aim of the work was to study the clinical and laboratory profile of BPHs in children presented to the Neuropediatric Clinic at Sohag University Hospital. Methods An observational prospective study was done at Sohag University Hospital over a period of one year on children diagnosed as having BHSs by clinical history and laboratory evaluation, including complete blood count (CBC), serum iron, serum ferritin, total iron binding capacity, and Electroencephalography (EEG). Results During the period of study (one year), we reviewed data of 32 children who had been diagnosed as having BHSs. We found that cyanotic spells (71.88%) predominated over pallid spells. There were positive family histories (31.25%) and consanguinity (53.135) in the studied patients. We found a high incidence of iron deficiency anemia (62.5%) in association with BHS. Abnormal EEGs were found in (65.63%) of studied children. Conclusion BHS is a common, important problem associated with iron deficiency anemia, which is, in turn, a common nutritional problem in our country. PMID:27279996

  16. Methicillin-resistant Staphylococcus aureus nosocomial infection trends in Hospital Universiti Sains Malaysia during 2002-2007

    PubMed Central

    Al-Talib, Hassanain I.; Yean, Chan Y.; Al-Jashamy, Karim; Hasan, Habsah

    2010-01-01

    BACKGROUND AND OBJECTIVES: 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. METHODS: This was a retrospective analysis of a database of all S aureus that were cultured from patients admitted to the different wards of Hospital Universiti Sains Malaysia (HUSM) over a period of 6 years. RESULTS: 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 patient-days. Duration of hospitalization, previous antibiotic use, and bedside invasive procedures were significantly higher among MRSA than methicillin-sensitive S aureus patients (P>.05). The highest number of MRSA infections were found in orthopedic wards (25.3%), followed by surgical wards (18.2%) and intensive care units (ICUs) (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. CONCLUSION: The rate of nosocomial MRSA infection per 1000 admissions was higher than that in other studies. The three factors associated most significantly 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. PMID:20697171

  17. Edward Gantt (1742-1837): US senate chaplain and first White House physician to Thomas Jefferson.

    PubMed

    Cavanagh, Harrison Dwight

    2017-08-01

    In his long and eventful life, Edward Gantt (1742-1837) made important contributions to the newly independent American Republic, as well as to the development of scientific evidence-based American medicine. Unfortunately, his achievements have gone unrecognized and unreported in mainstream historical publications. Specifically, his service as the first designated White House doctor, and personal physician to President Thomas Jefferson from 1801 to 1809 has not been reported. The purpose of this paper is to document the biographical and scientific details of his extraordinary life and notable contributions.

  18. Precision Compton polarimetry for the QWeak experiment at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wouter Deconinck

    2011-10-01

    The Q Weak experiment, scheduled to run in 2010-2012 in Hall C at Jefferson Lab, will measure the parity-violating asymmetry in elastic electron-proton scattering at 1.1 GeV to determine the weak charge of the proton, Q{sub Weak}{sup p} = 1 - 4 sin{sup 2} {theta}{sub W}. The dominant experimental systematic uncertainty will be the knowledge of the electron beam polarization. With a new Compton polarimeter we aim to measure the beam polarization with a statistical precision of 1% in one hour and a systematic uncertainty of 1%. A low-gain Fabry-Perot cavity laser system provides the circularly polarized photons. The scatteredmore » electrons are detected in radiation-hard diamond strip detectors, and form the basis for a coincidence trigger using distributed logic boards. The photon detector uses a fast, undoped CsI crystal with simultaneous sampling and integrating read-out. Coincident events are used to cross-calibrate the photon and electron detectors.« less

  19. Low momentum recoil detectors in CLAS12 at Jefferson Lab

    NASA Astrophysics Data System (ADS)

    Charles, Gabriel; CLAS Collaboration Collaboration

    2017-01-01

    Part of the experimental program in Hall B of the Jefferson Lab is dedicated to studying nucleon structure using DIS on nuclei and detecting low-momentum recoil particles in coincidence with the scattered electron. For this purpose, specially designed central detectors are required in place of the inner tracker of CLAS12 to detect particles with momenta below 100 MeV/c. We will present the status of the BONuS12 RTPC detector that will take data within the next 2 years. We will detail the main improvements made from the previous BONuS RTPC. In a second part, we will discuss another recoil experiment, called ALERT, that has been proposed to run in Hall B. The constraints being different, the recoil detector is based on a drift chamber and an array of scintillators. We will present the main differences between the two detectors and summarize the R&D performed to develop the ALERT detector.

  20. Pediatric chronic patients at outpatient clinics: a study in a Latin American University Hospital.

    PubMed

    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.

  1. Antibiotic treatment in childhood community-acquired pneumonia - clinical practice versus guidelines: results from two university hospitals.

    PubMed

    Man, Sorin Claudiu; Sas, Valentina; Schnell, Cristina; Florea, Camelia; Ţuţu, Adelina; Szilágyi, Ariana; Belenes, Sergiu; Hebriştean, Amalia; Bonaţ, Anca; Cladovan, Claudia; Aldea, Cornel

    2018-01-01

    Community-acquired pneumonia (CAP) is a both common and serious childhood infection. Antibiotic treatment guidelines help to reduce inadequate antibiotics prescriptions. We conducted a retrospective study at the Clinical Emergency Hospital for Children, 3rd Pediatric Clinic, Cluj-Napoca and Dr. Gavril Curteanu Clinical City Hospital, in Oradea. All patients discharged with a diagnosis of CAP between December 1, 2014 and February 28, 2015, were included in the study. There were 146 cases discharged with pneumonia in Cluj-Napoca center (mean age 4 years; range: 1 month - 16 years), and 212 cases in Oradea center (mean age 0.9 years; range: 2 weeks - 8 years). All cases were analyzed. The analysis made in Clinical Emergency Hospital for Children, 3rd Pediatric Clinic, Cluj-Napoca, showed that the antibiotics used in children hospitalized with community-acquired CAP are cefuroxime (43%), ceftriaxone (23%), macrolides (16%), ampicillin in association with an aminoglycoside (6%) and other antibiotics. The same antibiotics were used in Dr. Gavril Curteanu Clinical City Hospital of Oradea, where ampicillin in association with aminoglycoside was utilized in younger children (mean age 1.3 years), while ceftriaxone in older children (5.7 years) and children with high inflammation markers (ESR, CRP). From 11 pleurisy cases, 9 received cefuroxime or ceftriaxone. There was a wide variability in CAP antibiotic treatment across university hospitals, regarding antibiotic choice and dosing. Antibiotic selection was not always related to the clinical and laboratory characteristics of the patient. The national guideline was not followed, especially in children aged one to three months.

  2. Corneal graft rejection in African Americans at Howard University Hospital

    PubMed Central

    Ferdinand, Larry; Ngakeng, Vanessa; Copeland, Robert A.

    2011-01-01

    Purpose There is scarcity of data in the literature on cornel graft rejection rate in patients exclusively of African ancestry. The purpose of this study was to evaluate the rejection rate of corneal transplant surgery performed at Howard University Hospital on such patients over a 15 year period. Design A retrospective evaluation was performed of the cornea graft rejection and corneal graft failure rate in 125 penetrating keratoplasties (PKPs) done by one corneal specialist at Howard University Hospital from January 1, 1990 to August 31, 2005. Methods Of the 125 patients, 62 were eliminated from the study because of re-grafted eyes, non-African descent, primary graft failures, follow-up less than 1 month and lack of availability of charts. This study, therefore, studied and recorded data from 63 penetrating keratoplasties of 63 eyes from 60 patients. Results Episodes of graft rejection were documented in 23 eyes (36.5% of cases). Nine out of the 23 graft rejections manifested to secondary graft failure (39%). Overall, there were nine out of the 63 PKPs (14.3%) that resulted in secondary graft failure over the past 15 years. The major diagnostic categories were bullous keratopathy 24 (38%), keratoconus 10 (15.8%), Fuch’s dystrophy 4 (6.3%), other 20 (31.7%). Of the cases with episodes of rejection and failure, 4.3% and none were attributable to keratoconus, 30.4% and 22.2% for bullous keratopathy, and 8.7% and 22.2% for Fuch’s dystrophy, respectively. Also, best visual acuity was looked at in patients with rejection episodes. None of the patients had a pre-op visual acuity 20/40 or better; however, post-op PKP 2 (8.7%) of patients achieved 20/40 or better. Also, 4 (17.4%) of patients had a pre-op visual acuity between 20/50 and 20/150, but post-op PKP best visual acuity between 20/50 and 20/150 was increased to 9 (39.1%). Conclusion At 36% the prevalence of corneal graft rejection was one of the highest in the reported literature. But only 14% of those

  3. Corneal graft rejection in African Americans at Howard University Hospital.

    PubMed

    Ferdinand, Larry; Ngakeng, Vanessa; Copeland, Robert A

    2011-07-01

    There is scarcity of data in the literature on cornel graft rejection rate in patients exclusively of African ancestry. The purpose of this study was to evaluate the rejection rate of corneal transplant surgery performed at Howard University Hospital on such patients over a 15 year period. A retrospective evaluation was performed of the cornea graft rejection and corneal graft failure rate in 125 penetrating keratoplasties (PKPs) done by one corneal specialist at Howard University Hospital from January 1, 1990 to August 31, 2005. Of the 125 patients, 62 were eliminated from the study because of re-grafted eyes, non-African descent, primary graft failures, follow-up less than 1 month and lack of availability of charts. This study, therefore, studied and recorded data from 63 penetrating keratoplasties of 63 eyes from 60 patients. Episodes of graft rejection were documented in 23 eyes (36.5% of cases). Nine out of the 23 graft rejections manifested to secondary graft failure (39%). Overall, there were nine out of the 63 PKPs (14.3%) that resulted in secondary graft failure over the past 15 years. The major diagnostic categories were bullous keratopathy 24 (38%), keratoconus 10 (15.8%), Fuch's dystrophy 4 (6.3%), other 20 (31.7%). Of the cases with episodes of rejection and failure, 4.3% and none were attributable to keratoconus, 30.4% and 22.2% for bullous keratopathy, and 8.7% and 22.2% for Fuch's dystrophy, respectively. Also, best visual acuity was looked at in patients with rejection episodes. None of the patients had a pre-op visual acuity 20/40 or better; however, post-op PKP 2 (8.7%) of patients achieved 20/40 or better. Also, 4 (17.4%) of patients had a pre-op visual acuity between 20/50 and 20/150, but post-op PKP best visual acuity between 20/50 and 20/150 was increased to 9 (39.1%). At 36% the prevalence of corneal graft rejection was one of the highest in the reported literature. But only 14% of those episodes resulted in graft failure which is one of

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

    PubMed

    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 (p<0.05). Midwives and nurses differed significantly with respect to age (p=0.002). Midwives were younger and had spent fewer years working in their current workplace compared with paediatric nurses (p<0.001). Also, midwives had a lower level of education than paediatric nurses (p=0.044). The mean WAI score for midwives was 40.0 [95% confidence

  5. Evaluation of the efficiency of hospital antibiotic policy applied Dr Jan Biziel University Hospital No 2 in Bydgoszcz in 2009-2013.

    PubMed

    Kuziemski, Arkadiusz; Frankowska, Krystyna; Gonia, Ewa; Czerniak, Beata; Bakhurynska, Olena; Sobociński, Zbigniew

    2015-01-01

    The Hospital Infection Control Team (HICT) of Dr Jan Biziel University Hospital No 2 in Bydgoszcz developed and implemented the principles of a rational antibiotic therapy in 2008. A behavior algorithm has worked since 01.10.2008. Implementation of the principles of a rational antibiotic therapy was part of the hospital antibiotic policy. is to evaluate either introductory principles of the rational antibiotic therapy, after five-year experience lived up to expectations in the range specified by the authors. Hospital microbiological maps, comparisons of antibiotic cost, specification of microbiological tests made before and after introduction of the principles of a rational antibiotic therapy have been analyzed. Annual antibiotic consumption has been counted according to the defined daily dose (DDD) index created by the WHO. After 6 years of implementation of the rational antibiotic therapy principles, the decrease in number of isolated strains which are resistant to Klebsiella pneumoniae ESBL and Acinetobacter baumanii (resistant to carbapenems) has been indicated. The number of the Pseudomonas aeruginosa isolates has increased approximately three times, and the number of resistant isolates to carbapenem has grown six times. The cost of antibiotics has been gradually decreased in 2012 in order to represent 9,66% of all drug budget (without drug programs). Detailed analysis of antibiotic consumption has showed that after the implementation of rational antibiotic therapy principles the consumption of meropenem has increased twice in comparison to the all drugs. The number of microbiological tests grew from 0,20 to 0,29 per one patient, which means material to microbiological tests has been taken from every third patient. Annual DDD index calculated on 100 person-days has been reduced from 59,552 in 2007 to 39,90 in 2009, and it is 47,88 in 2013. The principles of rational antibiotic therapy in comparison with the other elements of antibiotic policy in hospital have

  6. Predictors of preoperative anxiety among surgical patients in Jimma University Specialized Teaching Hospital, South Western Ethiopia

    PubMed Central

    2014-01-01

    Background Hospitalization and surgery are critical negative life events that lead to the experience of considerable anxiety in patients. Patients may perceive the day of surgery as the biggest and the most threatening day in their lives. There is paucity of information on predictors of anxiety in the current study area. The main objective of this study is to assess predictors of preoperative anxiety among patients scheduled for surgery in Jimma University Specialized Teaching Hospital. Methods A facility based cross-sectional study was conducted using quantitative data collection technique in Jimma University Specialized Teaching Hospital from February 13 to April 13, 2012 on 239 patients scheduled for surgery. The data were collected by five trained diploma nurses using structured interviewer administered questionnaires that were prepared based on state trait anxiety inventory measurement scale. The quantitative data were entered into SPSS for windows version 16. 0 and descriptive, simple and multiple linear regression analyses were performed. Results A total of 239 patients were enrolled in the study with a response rate of 93.0%. Their mean age was 42.7 ± 1.8 years (range 16 to 85 years). Nearly over half 53.6% were females, while 48.1% illiterate, 72.4% Oromo and 56.5% were Muslim followers. Significant preoperative anxiety was seen in 70.3% patients. The most common factors that lead to anxiety were fear of death 38.1% and fear of unknown origin 24.3% and the most common strategy mentioned by patient in reducing anxiety were talking to other patient 79.8% and religious belief. Conclusions In the present study, two third 70.3% of preoperative patients had anxiety. Factors which were positively correlated with anxiety were trait anxiety, single and divorced, time of operation and income. Factors which were shown to reduce anxiety were preoperative anxiety related information provision and afternoon operation. Health professionals working in the hospital

  7. [Evolution and viability of an outpatient surgery center for cataract surgery on a large scale in a university hospital].

    PubMed

    Kara-Junior, Newton; Espíndola, Rodrigo França de

    2010-01-01

    To analyze the number of surgeries performed in outpatient surgical center at a university hospital and to assess its financial viability during and after the interruption of the Cataract National Campaign in 2006. Retrospective analytical study between 2005 and 2009 at the Clinical Hospital of the University of São Paulo (HC-FMUSP) which evaluated the economic viability of the outpatient surgical center, the number of cataract surgeries performed and the number of surgeons present daily in that unit. It would be necessary to perform at least 400 procedures monthly to ensure the financial viability of the outpatient surgical center. This number was lower than the expected in the years of 2008 and 2009 (average of 370.6 and 390.1 surgeries respectively). The number of cataract fellows decreased from 13 in 2005 to 3 in 2009. The main factor for the reduction in the number of cataract surgeries performed in the outpatient surgical center after 2006 was the difficulty of access of the population to the hospital due to restrictions on the development of screening projects. The increased use of the operating rooms by other clinics and the decrease in the admission of new surgeons, made the outpatient surgical center appropriate and viable for the new political-economic reality.

  8. Pattern of childhood leukaemia in University College Hospital, Ibadan.

    PubMed

    Babatunde, T O; Ogun, G O; Brown, B J; Akang, E E; Aken'Ova, Y A

    2014-06-01

    Leukaemias are haematological malignancies characterized by unregulated clonal proliferation of haematopoietic cells. To determine the pattern of childhood leukaemia in Ibadan. This was a retrospective study of leukaemia cases diagnosed at the University College Hospital (UCH), Ibadan between January 1991 and December 2010 in children less than 15 years of age. Data obtained was subjected to statistical analysis using the Statistical Package for Social Sciences version 20. There were 64 cases of childhood leukaemia, accounting for 10.2% of childhood cancers seen during this study period. The male to female ratio was 2:1 and modal age group was between 10 and 14 years. Thirty (46.9%) cases were acute lymphoblastic leukaemia (ALL), 22 (34.4%) were acute myelogenous leukaemia (AML) and 12 (18.8%) were unspecified acute leukaemias. There was no case of chronic myeloid or lymphocytic leukaemia. There has been a relative increase in the frequency of leukaemia cases at UCH, Ibadan, which may be largely explained by increased awareness and referrals. There is a need for further collaborative multicentre studies of childhood leukaemias in Nigeria and other developing countries and focused research on childhood leukaemias in order to unravel the aetiology.

  9. Equity in health personnel financing after Universal Coverage: evidence from Thai Ministry of Public Health's hospitals from 2008-2012.

    PubMed

    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

  10. Ambulance Services at Hospital Universiti Sains Malaysia and Hospital Kota Bharu: A Retrospective Study of Calls

    PubMed Central

    Shah Che Hamzah, Mohd Shaharudin; Ahmad, Rashidi; Nik Abdul Rahman, Nik Hisamuddin; Pardi, Kasmah Wati; Jaafar, Naimah; Wan Adnan, Wan Aasim; Jaalam, Kamaruddin; Sahil Jamalullail, Syed Mohsin

    2005-01-01

    This retrospective study attempted to identify the pattern of ambulance calls for the past two years at the Hospital Universiti Sains Malaysia (HUSM) and Hospital Kota Bharu (HKB). This study will provide a simple method of acquiring information related to ambulance response time (ART) and to test whether it met the international standards and needs of the client. Additionally, this paper takes into account the management of emergency calls. This included ambulance response time, which was part of Emergency Medical Services (EMS) episode: onset of ART, which started when details like phone number of the caller, exact location of the incident and the nature of the main complaint had been noted. ART ended when the emergency team arrived at the scene of incident. Information regarding ambulance calls from the record offices of HUSM and HKB was recorded for the year 2001 and 2002, tabulated and analyzed. There was a significant difference in the total number of calls managed by HUSM and HKB in the year 2001. It was noted that 645 calls were managed by HUSM while 1069 calls were recorded at HKB. In the year 2002, however, HUSM led with 613 extra numbers of calls as compare to HKB with 1193 numbers of calls. The pattern of ambulance calls observed is thought to possibly be influenced by social activities like local festivities, school holidays and the seasons. Further, it is observed that no studies were previously undertaken to compare the ART at both the HUSM and HKB to that of the international standards. In fact, a literature review undertaken so far showed no similar studies have been done for the whole Malaysia. PMID:22605956

  11. The Heart and Mind Coming Together: A Case Study of the Implementation of a University-Children's Hospital Partnership

    ERIC Educational Resources Information Center

    O'Connor, C. Richele

    2008-01-01

    The purpose of this qualitative study was to investigate the perceptions of university students serving as volunteers in an oncology ward at a local children's hospital. The implementation of this project was guided by the body of literature regarding service learning. Data were collected from the five students using a structured interview and was…

  12. Hotel-based ambulatory care for complex cancer patients: a review of the University College London Hospital experience.

    PubMed

    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.

  13. [Warning about risk of invasive infections in splenectomized patients. Experiences from University Hospital Brno, Czech Republic, in 2011].

    PubMed

    Polák, P; Freibergerová, M; Husa, P; Slesinger, P; Svoboda, R; Sťásek, J; Frola, L; Macháček, C

    2012-09-01

    Syndrome of fulminant sepsis in splenectomized (overwhelming postsplenectomy infection - OPSI) is feared and often fatal infectious complication in patients after splenectomy. The risk of syndrome of fulminant sepsis in splenectomized in these persons persists lifelong and doesn't diminish during the time. Etiologically, encapsulated bacterias like Streptococcus pneumoniae, Haemophilus influenzae group b and Neisseria meningitidis are involved. As the mortality of syndrome of fulminant sepsis in splenectomized is very high, it is indispensable to educate and vaccinate persons in risk. The authors present case reports of three splenectomized patients who were hospitalized for invasive pneumococcal infection in the University Hospital Brno, Czech Republic, in 2011.

  14. University hospital doctors: what are their beliefs about organ donation?

    PubMed

    Bassit, N H; Habiblah, M; Fadili, W; Laouad, I

    2013-01-01

    Organ and human tissue donation is not well developed in Morocco. This is due in part to the refusal of families, but also to a lack of awareness. We conducted a survey of a representative sample of doctors more exposed to the donation process to assess their knowledge and attitudes toward organ donation and their training needs. This is a cross-sectional study of physicians in Marrakech University Hospital. An anonymous questionnaire adapted to Moroccan context, assessing the knowledge, opinions, attitudes, and needs regarding organ donation was given to doctors. Among 130 distributed questionnaires, we collected 115 completely answered surveys. Respondees were as follows: 60.8% were females, 87 were residents and 28 interns, 80% were aged from 25 to 34 years, and 60% had practiced their profession for 1 to 5 years. Results showed that 28% don't know that tissue and organ donation from a cadaver is authorized in Morocco, 6% are aware of the organs and tissues that can be taken, 76% know the definition of brain death, 35% don't believe in this concept, 88% were favorable for the removal of organs and tissue of deceased persons, 10% ignore that Islam allows organ donation, 62% will give their organs and tissues after death, 25% refuse organ donation of a parent, and 30% refuse it of their children after death. Our findings show that there is discordance between knowledge and attitudes of doctors in our hospital toward organ donation. The promotion of organ donation requires good training of our teams to sensitize the population. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Bacterial contamination, bacterial profile and antimicrobial susceptibility pattern of isolates from stethoscopes at Jimma University Specialized Hospital

    PubMed Central

    2013-01-01

    Introduction Hospital acquired infections are recognized as critical public health problems. Infections are frequently caused by organisms residing in healthcare environment, including contaminated medical equipment like Stethoscopes. Objective To determine bacterial contamination, bacterial profile and anti-microbial susceptibility pattern of the isolates from stethoscopes at Jimma University Specialized Hospital. Methodology Cross-sectional study conducted from May to September 2011 at Jimma University Specialized Hospital. One hundred seventy-six stethoscopes owned by Health Care Workers (HCWs) and Medical students were randomly selected and studied. Self-administered structured questionnaire was used to collect socio-demographic data. Specimen was collected using moisten sterile cotton swab and 1 ml normal saline was used to transport the specimen, all laboratory investigations were done following standard microbiological techniques, at Microbiology Laboratory, Jimma University. SPSS windows version 16 used for data analysis and P <0.05 was considered statistically significant. Result: A total, of 151 (85.8%) stethoscopes were contaminated. A total of 256 bacterial strains and a mean of 1.44×104 CFUs/diaphragm of stethoscopes was isolated. Of the 256 isolates, 133 (52%) were potential pathogens like S. aureus, Klebsiella spp., Citrobacter spp., Salmonella spp., Proteus spp., Enterobacter spp., P. aeruginosa and E. coli. All strains were resistant to multiple classes of antibiotics (two to eight classes of antibiotics). Disinfection practice was poor. Disinfection practice was found to be associated with bacterial contamination of stethoscopes (P < 0.05). High contamination rate 100 (90.9%) was observed among stethoscopes that had never been disinfected; while the least contamination 29 (72.2%) was found on those disinfected a week or less before the survey. Conclusion Bacterial contamination of the stethoscope was significant. The isolates were potential

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

    PubMed Central

    Birhanu, Anteneh Messele; Alemu, Fekadu Mazengia; Ashenafie, Tesfaye Demeke; Balcha, Shitaye Alemu; Dachew, Berihun Assefa

    2016-01-01

    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 similar studies elsewhere. Disease (diabetes) duration of 10 years and above and being a Muslim religion follower (as compared to Christian) were the factors significantly associated with depression. Early screening of depression and treating depression as a routine component of diabetes care are recommended. Further research with a large sample size, wider geographical coverage, and segregation of type of diabetes mellitus is recommended. PMID:27274296

  17. Does medicine still show an unresolved discrimination against women? Experience in two European university hospitals.

    PubMed

    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.

  18. Progress of ILC High Gradient SRF Cavity R&D at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    R.L. Geng, J. Dai, G.V. Eremeev, A.D. Palczewski

    2011-09-01

    Latest progress of ILC high gradient SRF cavity R&D at Jefferson Lab will be presented. 9 out of 10 real 9-cell cavities reached an accelerating gradient of more than 38 MV/m at a unloaded quality factor of more than 8 {center_dot} 109. New understandings of quench limitation in 9-cell cavities are obtained through instrumented studies of cavities at cryogenic temperatures. Our data have shown that present limit reached in 9-cell cavities is predominantly due to localized defects, suggesting that the fundamental material limit of niobium is not yet reached in 9-cell cavities and further gradient improvement is still possible. Somemore » examples of quench-causing defects will be given. Possible solutions to pushing toward the fundamental limit will be described.« less

  19. [Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

    PubMed

    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

  20. Assessment of Service Quality in Teaching Hospitals of Yazd University of Medical Sciences: Using Multi-criteria Decision Making Techniques.

    PubMed

    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.

  1. [Part-time concepts in anaesthesia -example of a department of anaesthesiology at a university hospital in Germany].

    PubMed

    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.

  2. Involvement and emancipation of the worker. Action research in a university hospital.

    PubMed

    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.

  3. Impact of Hurricane Sandy on the Staten Island University Hospital Emergency Department.

    PubMed

    Greenstein, Josh; Chacko, Jerel; Ardolic, Brahim; Berwald, Nicole

    2016-06-01

    Introduction On October 29, 2012, Hurricane Sandy touched down in New York City (NYC; New York USA) causing massive destruction, paralyzing the city, and destroying lives. Research has shown that considerable damage and loss of life can be averted in at-risk areas from advanced preparation in communication procedures, evacuation planning, and resource allocation. However, research is limited in describing how natural disasters of this magnitude affect emergency departments (EDs). Hypothesis/Problem The aim of this study was to identify and describe trends in patient volume and demographics, and types of conditions treated, as a result of Hurricane Sandy at Staten Island University Hospital North (SIUH-N; Staten Island, New York USA) site ED. A retrospective chart review of patients presenting to SIUH-N in the days surrounding the storm, October 26, 2012 through November 2, 2012, was completed. Data were compared to the same week of the year prior, October 28, 2011 through November 4, 2011. Daily census, patient age, gender, admission rates, mode of arrival, and diagnoses in the days surrounding the storm were observed. A significant decline in patient volume was found in all age ranges on the day of landfall (Day 0) with a census of 114; -55% compared to 2011. The daily volume exhibited a precipitous drop on the days preceding the storm followed by a return to usual volumes shortly after. A notably larger percentage of patients were seen for medication refills in 2012; 5.8% versus 0.4% (P<.05). Lacerations and cold exposure also were increased substantially in 2012 at 7.6% versus 2.8% (P<.05) and 3.8% versus 0.0% (P<.05) of patient visits, respectively. A large decline in admissions was observed in the days prior to the storm, with a nadir on Day +1 at five percent (-22%). Review of admitted patients revealed atypical admissions for home care service such as need for supplemental oxygen or ventilator. In addition, a drop in Emergency Medical Services (EMS

  4. Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

    PubMed

    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.

  5. Physical hazard safety awareness among healthcare workers in Tanta university hospitals, Egypt.

    PubMed

    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.

  6. [Effects of restrictions on use of vancomycin in a German university hospital].

    PubMed

    Glück, T; Linde, H J; Wiegrebe, E; Lehn, N; Reng, M; Schölmerich, J

    2000-02-15

    Recently, increasing antibiotic resistance has been observed among gram-positive bacteria. However, only few isolates were found to be resistant against glycopeptides. Therefore, internationally accepted guidelines recommend a restricted use of vancomycin and other glycopeptide antibiotics in order to prevent the development of resistance against these clinically important antibiotics. In many countries, the hospital pharmacies play a key role in control and reinforcement of antibiotic formulary restrictions. In Germany, however, the hospital pharmacies usually do not take over such control functions, and most wards keep a stock of regularly used drugs including antibiotics, which makes reinforcement of restrictions difficult. In an attempt to achieve a restriction of vancomycin use, the pharmacy of our university hospital was advised to deliver vancomycin to the wards only on request with a special order form signed by an attending, individually for every patient who should receive vancomycin. The efficacy of this restriction measure was evaluated in 3-month periods before and after the restriction became effective. Hospitalwide, this led to a 20.1% reduction of i.v. vancomycin and an 85.7% reduction of oral vancomycin use per 1000 patient days. If the hematology/oncology units were not considered, the reduction of i.v. vancomycin use was 41.8%, and the total use after the restriction 24.2 g per 1000 patient days. Microbiology results which justified the use of vancomycin decreased by 8.3% (10.9% hematology/oncology units not considered) between the 2 observation periods. Assuming a 7-day mean course of i.v. vancomycin therapy, the empirical use of i.v. vancomycin decreased from 39.9% to 8% after the restriction had been instituted. Allowing only experienced physicians (attendings) to decide on the use of vancomycin therapy, proved in our experience to be an effective measure to reduce unnecessary vancomycin use.

  7. [Assessing research productivity in Department of Internal Medicine, University of Zagreb, School of Medicine and University Hospital Centre Zagreb].

    PubMed

    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.

  8. Reasons and outcomes of admissions to the medical wards of jimma university specialized hospital, southwest ethiopia.

    PubMed

    Ali, Elias; Woldie, Mirkuzie

    2010-07-01

    Non-communicable diseases are the main reasons for admission to the medical wards in high-income countries. While in low and middle income countries communicable diseases are the main reasons for admission to the medical wards. However, in some low and middle income countries the reasons for admission are changing from communicable diseases to non-communicable diseases. But, data on reasons for admission to the medical wards of low income countries is scarce. Therefore, this study takes one year data from a low income country referral hospital aiming at describing the recent reasons and outcomes of medical admissions to see whether there is a change in reasons for admission and the outcome. A retrospective study examined patient case notes and ward registration books of medical admissions at Jimma University Specialized Hospital from January 1, 2008 to December 31, 2008. Socio-demographic variables, reasons and outcomes of admission were some of the variables recorded during the data collection. The International Statistical Classification of Disease was used for sorting and categorizing the diagnosis. The data was then analyzed using SPSS windows version 13.0. A total of 610 patient case notes were reviewed. The mean age of the patients was 36 years (SD ± 15.75). The highest number of admissions 218 (35.7%) was among the age groups 21 to 30 years. Communicable diseases; namely severe community acquired pneumonia 139(22.8%), all infectious and parasitic diseases category 100 (16.4%), and pyogenic as well as chronic meningitis 80(13.1%) were the most common reasons for admission. The death rate among patients admitted to the medical wards was 12.6%. Communicable diseases were still the common reasons for medical admissions at Jimma University Specialized Hospital. The outcome of medical admissions has not changed over sixteen years.

  9. Debris flows from failures Neoglacial-age moraine dams in the Three Sisters and Mount Jefferson wilderness areas, Oregon

    USGS Publications Warehouse

    O'Connor, J. E.; Hardison, J.H.; Costa, J.E.

    2001-01-01

    The highest concentration of lakes dammed by Neoglacial moraines in the conterminous United States is in the Mount Jefferson and Three Sisters Wilderness Areas in central Oregon. Between 1930 and 1980, breakouts of these lakes have resulted in 11 debris flows. The settings and sequences of events leading to breaching and the downstream flow behavior of the resulting debris flows provide guidance on the likelihood and magnitude of future lake breakouts and debris flows.

  10. [Evaluation of the activity of a urological emergency unit in university hospital].

    PubMed

    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.

  11. Integrated Specialized Early-Course Psychosis Treatment Services - University Psychiatric Hospital Vrapce Model.

    PubMed

    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.

  12. [Communication, participation and leadership in the perception of the emotional climate in a university hospital in Andalusia, Spain].

    PubMed

    Danet, Alina; March, Joan Carles; Romera, Inmaculada García

    2014-03-01

    The aim of this study was to identify and analyze perceptions and opinions among health professionals in a university hospital in Andalusia, Spain, regarding the emotional climate, leadership style, quality of information, and internal communication. The study also aimed to collect health professionals' suggestions for improving these workplace characteristics. The study included 730 participants and used a quantitative and qualitative methodology. The results reflect a medium-to-low level of emotional climate, correlated with the leadership style and information and internal communication. Statistically significant differences appeared when comparing professional categories and hospital units. The health professionals provided a positive assessment of the administrators' work, although requiring more task-oriented, participative, and affiliative leadership skills.

  13. Design and Implementation of PACS at Georgetown University Hospital

    NASA Astrophysics Data System (ADS)

    Mun, S. K.; Benson, H.. R.; Choyke, P.; Fahey, F. H.; Wang, P. C.; Zeman, R. K...; Elliott, L. P.

    1985-09-01

    During the preparation and planning phase of the PACS project at Georgetown University Hospital it was realized that PACS requires truly the state of the art technology in data communication, image processing and man machine interfacing. It was also realized that un-like many other technology intensive devices used in radiology, PACS cannot be seen as an independent system that will provide well defined services. PACS will be the backbone of the department operation in clinical, educational and managerial functions. It will indeed be the nerve center of the radiologic services affecting every aspect of the department. PACS will have to be designed to perform in a cost-effective manner to widely varying needs within the radiology departments. The integration of ever changing complex technology that will impact every aspect of a radiology service is not a trivial matter. This transition period going from current manual film based PACS to Digital PACS can be long, expansive and disruptive unless careful planning preceeds the implementation. PACS is still an emerging technology at its infancy. Performance monitoring and evaluation of diversified functions have to be also established so that improvement to the system can be efficiently implemented. Thus the evaluation criteria should be also established as early as possible.

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

    PubMed

    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 p<0.05. Pelvic organ prolapse accounted for 40.7% of major gynecologic operations. Mean age of patients was 42.43 ± 10.4 years and there was a significant association between prolapse and age of patients (p <0.05). Mean parity of patients was 6.5± 2.64 with a significant association between prolapse and parity (p < 0.05). Majority of them (80.6%) lived in rural area and there was a significant association between prolapse and residence area. Farmers accounted for 68.2% of the patients and there was a significant association between prolapse and occupation (p < 0.05). Risk factors identified were chronic cough (20.9%), constipation (30.2%) with some having more than one risk factor while none was identified in 59.7%. Prolapse is common among rural, farmer, parous and older women where most of them delivered at home with prolonged labor. Age, parity and occupation were associated with the stage of prolapse. Awareness 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.

  15. Inpatient Management of Diabetes Mellitus among Noncritically Ill Patients at University Hospital of Puerto Rico.

    PubMed

    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 <70 mg/dL) were 56.7 and 2.8%, respectively. Nearly 60% of patients were hyperglycemic during the first 24 hours of hospitalization (mean random blood glucose, 226.5 mg/dL), and 54.2% were hyperglycemic during the last 24 hours of hospitalization (mean random blood glucose, 196.51 mg/dL). The mean random last glucose value before discharge was 189.6 mg/dL. Most patients were treated with subcutaneous insulin, with basal insulin alone (60%) used as the most common regimen. The proportion of patients classified as uncontrolled receiving basal-bolus therapy increased from 54.3% on day 1 to 60% on day 5, with 40% continuing to receive only basal insulin. Most of the uncontrolled patients had their insulin dose increased (70.1%); however, a substantial proportion had no change (23.7%) or even a decrease (6.2%) in their insulin dose. The management of hospitalized 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.

  16. A Complete Image Management and Communications Network for the Neuroradiology Service at Georgetown University Hospital

    NASA Astrophysics Data System (ADS)

    Horii, Steven C.; Muraki, Alan; Mallon-Ingeholm, Mary L.; Mun, Seong K.; Clark, Letitia; Schellinger, Dieter

    1989-05-01

    A complete image management and communications system has been installed at Georgetown University Hospital (GUH). The network is based on the A T & T CommView System. In the Neuroradiology Division, this comprehensive 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 remote site has a subsystem capable of acquiring images and transmitting them over a high speed T1 data circuit. The GUH neuroradiologist can view these images on the neuro workstation or any of the workstations available in the Hospital. Fast and easy access to the images allows a radiologist to monitor multiple examinations as well as to utilize the workstation for diagnosis. To provide the neuroradiologist quick access to images at all times, a PC-based Results Viewing Station (RVS) has been placed in a doctor's home. Images may be sent to the RVS, or the user may request images from the central database at the hospital. Images can be viewed at home either as they are transmitted, or following transfer of a whole study. The efficiency and effectiveness of the system's capabilities with special regard to remote and teleradiology (RVS) operations have been studied for the neuroradiology service. This paper will discuss the current clinical acceptance and use, problems in implementation, and ways these difficulties are being surmounted.

  17. Prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Teaching Hospital in 2014, northwest Ethiopia.

    PubMed

    Asrie, Fikir; Enawgaw, Bamlaku; Getaneh, Zegeye

    2017-01-01

    Thrombocytopenia is a common hematologic abnormality during pregnancy. Pregnant women with thrombocytopenia have a higher risk of bleeding excessively during or after childbirth, particularly if they need to have a cesarean section or other surgical intervention during pregnancy, labor or in the puerperium. The main aim of this study was to determine the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital, northwest Ethiopia. A cross-sectional study was used to assess the prevalence of thrombocytopenia among pregnant women attending antenatal care service at Gondar University Hospital from January to April 2015. A total of 217 pregnant women were included in the study and a structured pretested questionnaire was used to obtain sociodemographic information, nutritional factors, obstetrics and gynecological factors, history and clinical condition. Blood samples were collected for platelet count and other platelet parameters, which were determined by using SysmexKX 21 automation. The data were entered to Epi info version 6 software and analyzed using SPSS version 20 software. Bivariable and multivariable statistical analyses were used to evaluate the effect of independent variable over the dependent variable. A p -value of <0.05 was considered as statistically significant. A total of 217 women receiving antenatal care service at Gondar University Hospital participated in the study. Thrombocytopenia among 19 pregnant women showed a prevalence of 8.8%. The mean ± standard deviation platelet count was 238.85×10 9 /L (±74.57). Thrombocytopenia was significantly associated with patients who lived rurally (crude odds ratio =4.3, 95% confidence interval 1.48-12.76). The prevalence of thrombocytopenia was 8.8% predominantly with mild type of thrombocytopenia. Thrombocytopenia was higher among pregnant women who lived rurally. Therefore, health care providers should screen routinely for thrombocytopenia to avoid

  18. [Neonatal and child tetanus morbidity and mortality in the University hospitals of Abidjan, Côte d'Ivoire (2001-2010)].

    PubMed

    Aba, Y T; Cissé, L; Abalé, A K; Diakité, I; Koné, D; Kadiané, J; Diallo, Z; Kra, O; Oulaï, S; Bissagnéné, E

    2016-08-01

    The lack of data on neonatal tetanus and children in university hospitals (UH) in Abidjan for over a decade has motivated the realization of this study. The objective of this study is to evaluate the morbidity and mortality related to neonatal tetanus (NT) and child tetanus (CT) in Abidjan University Hospital from 2001 to 2010. It is a retrospective study, multicenter analysis with records of newborns and children suffering from tetanus in the three UH of Abidjan. The collection and analysis of data were made by the SPHINX 4.5 and EPI.INFO 6.0 software. In ten years, 242 cases of tetanus (53 NT cases and 189 CT cases) were collected with a predominance of cases after the fifth year of life (59.5%). The incidence rate of NT was less than 1 case per 1,000 live births. All mothers of the newborns were inhabiting the city of Abidjan. Their median age was 19 years [16-32] and 64% were teenagers. Gateways were dominated by umbilical wounds (77.3%) in the NTand skin wounds (59%) in CT. The cure rate was 30.2% in the NT and 60% in the CT. Lethality was 60% for NT and 22% for CT with a positive correlation with young age (neonates: p = 4.10-7, age <5 years: p = 0.01), lack of intraspinal injection of tetanus serum (p = 8.10-6), the absence of conventional antibiotic therapy (p = 0.023), the existence of metabolic complications (p = 2.10-5), the score of ≥ 4 Dakar (p = 0.005). Tetanus remains a real morbidly cause among children in Abidjan University Hospital with high lethality. However, the incidence of NT seems consistent with the incidence threshold desired by WHO.

  19. Lead poisoning in dogs at the University of Pennsylvania Veterinary Hospital

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kowalczyk, D.F.

    1976-03-01

    Twenty-seven dogs with lead poisoning were admitted to the University of Pennsylvania Veterinary Hospital from July, 1963, to April, 1975. The major source of the lead was paint. A common history was ingestion of plaster or paint scrapings during room renovation. Most of the dogs were less than 1 year old and had clinical signs referable to the gastrointestinal or the nervous system, or both. The gastrointestinal signs, in order of frequency, were vomiting, anorexia, tender abdomen, diarrhea, and constipation. The neurologic signs, in order of frequency, were hysteria, convulsions, ataxia, blindness, and mydriasis. The finding of many nucleated erythrocytesmore » without severe anemia was nearly pathognomonic for lead poisoning. Of 14 affected dogs subjected to abdominal radiography, 9 had evidence of ingested radiopaque material. A mean blood lead concentration of 18.8 ..mu..g/100 ml, with a range of 0 to 50 ..mu..g/100 ml, was found for 26 dogs that were hospitalized for problems unrelated to lead poisoning. Of the 27 dogs with lead poisoning, 22 had their blood analyzed for lead. This group had blood lead values ranging from 40 to 530 ..mu..g/100 ml. Seven of the affected dogs were monitored throughout their period of treatment with calcium ethylene-diaminetetraacetate. The concentration of lead in the blood decreased quickly after the initiation and treatment but leveled off after 2 or 3 days. The initial rapid phase probably corresponded to the removal of weakly bound or extracellular lead, whereas the slow phase probably corresponded to strongly bound or intracellular lead. 22 references.« less

  20. High-gradient SRF R&D for ILC at Jefferson Lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Geng, Rongli; Crawford, Anthony; Ciovati, Gianluigi

    2008-10-01

    Jefferson Lab plays an active role in high-gradient SRF R&D in the frame work of the internationally coordinated ILC S0 program. The S0 aim is to push the yield at 35 MV/m in 9-cell cavities. So far, twelve cavities have been electropolishing (EP) processed and RF tested by using the state-of-the-art recipes at JLab, in close collaboration with FNAL and KEK. Seven of them reached a best gradient of over 31.5 MV/m. Understanding gradient limiting mechanisms in real 9-cell cavities is an important component of our studies. Thermometry and high-resolution optical inspection are used to locate and understand the sourcemore » of gradient limits. Experimenting with selective cavities is still a necessary method for process optimization. One example is the first demonstration of 35 MV/m without detectable Bremsstrahlung X-ray after a light EP is applied to a previously heavy BCP etched 7-cell cavity. Some new understanding has been gained with regard to quench behaviors, field emission behaviors as« less

  1. The Impact of Court-Ordered Desegregation on Student Enrollment and Residential Patterns in the Jefferson County Kentucky Public School District, Final Report.

    ERIC Educational Resources Information Center

    Cunningham, George K.; Husk, William L.

    After reviewing the literature on school desegregation and the background of the comprehensive metropolitan school desegregation plan implemented in Louisville and Jefferson County in 1975, this report analyzes school enrollment and residential changes in the years after the plan was implemented. Data are presented for public and non-public school…

  2. Career support in medicine - experiences with a mentoring program for junior physicians at a university hospital.

    PubMed

    Buddeberg-Fischer, Barbara; Vetsch, Esther; Mattanza, Guido

    2004-07-01

    Until now, mentoring has hardly been used by the medical profession in German-speaking countries as a means of supporting junior physicians in their careers. The aim of the mentoring project described here was to obtain information for promoting and developing future mentoring programs at a university hospital. A new integrated mentoring model was developed and implemented over a 12-month period. Peer groups were advised on the mentoring process by mentors and program managers. A total of eight mentoring groups (40 peers) from four departments of a university hospital took part in the project: four voluntarily, and four on a compulsory basis. The evaluation was carried out using qualitative methods for analysis of the group protocols and the focus group interviews with the participants. Group discussions revealed that individual mentees, young female physicians in particular, developed concrete career plans and initiated further career-relevant steps. Some mentees - again more women than men - were promoted to senior physician posts. Further measurable career steps were increased research and publishing activity, and research fellowships abroad. The group process developed in five typical phases (forming, storming, norming, performing, and finalizing), which differed according to whether the groups had been formed on a voluntary or compulsory basis. In the evaluation interviews, mentees emphasized the following as effective mentoring factors: Concrete definition of own career goals; exchange of experiences within the peer groups; support and motivation from the mentors; and fostering of the group process by the program managers. Participation in mentoring programs has to be voluntary. Mentees are motivated, autonomous, goal-oriented and prepared to take action. Mentors serve as examples and advisers. They derive satisfaction from being held in high esteem, as well as from the advancement of their own careers. Program managers have experience in systems theory and

  3. A new THz/Far-IR beamline at the Jefferson Lab ERL

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Neil, George; Williams, Gwyn

    2003-08-01

    Multiparticle coherent synchrotron emitted by sub-picosecond bunches of electrons in an energy recovering linac, (ERL), at 75 MHz, yield average powers of ~ 100 watts, even for beam currents of 10 mA.This is 10,000 times higher than typical table-top systems.We describe a new ERL facility under construction at Jefferson Lab, and a new THz extraction system and beamline.We also present theoretical calculations.Potential applications of this exciting new source include driving new non-linear phenomena, performing pump-probe studies of dynamical properties of novel materials, and studying molecular vibrations and rotations, low frequency protein motions, phonons, superconductor bandgaps, electronic scattering, collective electronic excitationsmore » (e.g., charge density waves), and spintronics.This work was supported by the US Department of Energy, the Office of Naval Research and the Commonwealth of Virginia.G.L. Carr, M.C. Martin, W.R. McKinney, K. Jordan, G.R. Neil and G.P. Wi« less

  4. Survival of cutaneous malignant melanoma patients at University of Iowa Hospitals: 1950--1974.

    PubMed

    Griffel, M

    1981-01-01

    Survival of 387 patients treated for cutaneous malignant melanoma at University of Iowa Hospitals during the period 1950--1974 was analyzed. For the entire period, the observed five-year survivals were 57% for women and 33% for men; the corresponding ten-year survivals were 43 and 23%. For both men and women, there was an impressive improvement in outcome between the earliest and the latest periods, so that for 1970--1974, the five-year observed survival was 68% for women and 49% for men. Data are presented on mean age at diagnosis, distribution by stage, site, and sex, and survival by site and sex. The question is raised whether the biologic nature of malignant melanoma is variable, so that increased incidence is associated with better prognosis.

  5. Gender Comparisons of Young Physicians' Perceptions of Their Medical Education, Professional Life, and Practice: A Follow-Up Study of Jefferson Medical College Graduates.

    ERIC Educational Resources Information Center

    Hojat, Mohammadreza; And Others

    1995-01-01

    A survey of 530 male and 137 female graduates of Jefferson Medical College (Pennsylvania) found numerous gender differences in their assessments of selected areas of the medical school curriculum, issues of medical practice and professional life, and specialty choices, professional activities, and research productivity. (Author/MSE)

  6. FMEA on the superconducting torus for the Jefferson Lab 12 GeV accelerator upgrade

    DOE PAGES

    Ghoshal, Probir K.; Biallas, George H.; Fair, Ruben J.; ...

    2015-01-16

    As part of the Jefferson Lab 12GeV accelerator upgrade project, Hall B requires two conduction cooled superconducting magnets. One is a magnet system consisting of six superconducting trapezoidal racetrack-type coils assembled in a toroidal configuration and the second is an actively shielded solenoidal magnet system consisting of 5 coils. Both magnets are to be wound with Superconducting Super Collider-36 NbTi strand Rutherford cable soldered into a copper channel. This paper describes the various failure modes in torus magnet along with the failure modes that could be experienced by the torus and its interaction with the solenoid which is located inmore » close proximity.« less

  7. Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital

    PubMed Central

    Yang, Dong

    2016-01-01

    Background Universal Zero-Markup Drug Policy (UZMDP) mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China’s National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST). Methods This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT) 2009–2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively. Results In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH) in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively) and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively), while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4%) and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%). Conclusion Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital. PMID:27627811

  8. Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital.

    PubMed

    Tian, Wei; Yuan, Jiangfan; Yang, Dong; Zhang, Lanjing

    2016-01-01

    Universal Zero-Markup Drug Policy (UZMDP) mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China's National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST). This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT) 2009-2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively. In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH) in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively) and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively), while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4%) and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%). Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital.

  9. Hospital costs fell as numbers of LVADs were increasing: experiences from Oslo University Hospital

    PubMed Central

    2012-01-01

    Background The current study was undertaken to examine total hospital costs per patient of a consecutive implantation series of two 3rd generation Left Ventricle Assist Devices (LVAD). Further we analyzed if increased clinical experience would reduce total hospital costs and the gap between costs and the diagnosis related grouped (DRG)-reimbursement. Method Cost data of 20 LVAD implantations (VentrAssist™) from 2005-2009 (period 1) were analyzed together with costs from nine patients using another LVAD (HeartWare™) from 2009-June 2011 (period 2). For each patient, total costs were calculated for three phases - the pre-LVAD implantation phase, the LVAD implantation phase and the post LVAD implant phase. Patient specific costs were obtained prospectively from patient records and included personnel resources, medication, blood products, blood chemistry and microbiology, imaging and procedure costs including operating room costs. Overhead costs were registered retrospectively and allocated to the specific patient by predefined allocation keys. Finally, patient specific costs and overhead costs were aggregated into total hospital costs for each patient. All costs were calculated in 2011-prices. We used regression analyses to analyze cost variations over time and between the different devices. Results The average total hospital cost per patient for the pre-LVAD, LVAD and post-LVAD for period 1 was $ 585, 513 (range 132, 640- 1 247, 299), and the corresponding DRG- reimbursement (2009) was $ 143, 192 . The mean LOS was 54 days (range 12- 127). For period 2 the total hospital cost per patient was $ 413, 185 (range 314, 540- 622, 664) and the corresponding DRG- reimbursement (2010) was $ 136, 963. The mean LOS was 49 days (range 31- 93). The estimates from the regression analysis showed that the total hospital costs, excluding device costs, per patient were falling as the number of treated patients increased. The estimate from the trend variable was -14, 096 US$ (CI -3

  10. Descriptive analysis of breast cancer in African-American women at Howard University Hospital, 1960-1987.

    PubMed

    Williams, R; Laing, A E; Demenais, F; Kissling, G; Gause, B L; Chen, V; Bonney, G

    1993-11-01

    This article describes breast cancer cases seen at the Howard University Hospital from 1960 through 1987 using information from the database of the Tumor Registry, established in 1960. Clinical information at presentation is presented as well as a description of reproductive and demographic characteristics. Pre- and postmenopausal women are compared, revealing differences in reproductive experience. This may contribute to the increasing incidence of breast cancer seen among younger women in recent years. This is of particular interest because the classic excess of nulliparous women among breast cancer cases is not seen among the population described here.

  11. Descriptive analysis of breast cancer in African-American women at Howard University Hospital, 1960-1987.

    PubMed Central

    Williams, R.; Laing, A. E.; Demenais, F.; Kissling, G.; Gause, B. L.; Chen, V.; Bonney, G.

    1993-01-01

    This article describes breast cancer cases seen at the Howard University Hospital from 1960 through 1987 using information from the database of the Tumor Registry, established in 1960. Clinical information at presentation is presented as well as a description of reproductive and demographic characteristics. Pre- and postmenopausal women are compared, revealing differences in reproductive experience. This may contribute to the increasing incidence of breast cancer seen among younger women in recent years. This is of particular interest because the classic excess of nulliparous women among breast cancer cases is not seen among the population described here. PMID:8107157

  12. Modelling the Costs and Effects of Selective and Universal Hospital Admission Screening for Methicillin-Resistant Staphylococcus aureus

    PubMed Central

    Hubben, Gijs; Bootsma, Martin; Luteijn, Michiel; Glynn, Diarmuid; Bishai, David

    2011-01-01

    Background Screening at hospital admission for carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been proposed as a strategy to reduce nosocomial infections. The objective of this study was to determine the long-term costs and health benefits of selective and universal screening for MRSA at hospital admission, using both PCR-based and chromogenic media-based tests in various settings. Methodology/Principal Findings A simulation model of MRSA transmission was used to determine costs and effects over 15 years from a US healthcare perspective. We compared admission screening together with isolation of identified carriers against a baseline policy without screening or isolation. Strategies included selective screening of high risk patients or universal admission screening, with PCR-based or chromogenic media-based tests, in medium (5%) or high nosocomial prevalence (15%) settings. The costs of screening and isolation per averted MRSA infection were lowest using selective chromogenic-based screening in high and medium prevalence settings, at $4,100 and $10,300, respectively. Replacing the chromogenic-based test with a PCR-based test costs $13,000 and $36,200 per additional infection averted, and subsequent extension to universal screening with PCR would cost $131,000 and $232,700 per additional infection averted, in high and medium prevalence settings respectively. Assuming $17,645 benefit per infection averted, the most cost-saving strategies in high and medium prevalence settings were selective screening with PCR and selective screening with chromogenic, respectively. Conclusions/Significance Admission screening costs $4,100–$21,200 per infection averted, depending on strategy and setting. Including financial benefits from averted infections, screening could well be cost saving. PMID:21483492

  13. Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university.

    PubMed

    Barati, Omid; Dorosti, Hesam; Talebzadeh, Alireza; Bastani, Peivand

    2016-01-01

    Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014-2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively). Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran.

  14. Residency hospital type and career paths in Japan: an analysis of physician registration cohorts.

    PubMed

    Koike, Soichi; Kodama, Tomoko; Matsumoto, Shinya; Ide, Hiroo; Yasunaga, Hideo; Imamura, Tomoaki

    2010-01-01

    In 2004, a new postgraduate medical training system was introduced in Japan and a shift of new graduates from university hospitals to other postgraduate education hospitals happened. The aim of this study is to analyse the past trends on postgraduate medical education choices and subsequent career options to discuss possible outcomes of the current shift and policy implications. Data from the national physician survey from 1976 to 2006 were analysed. The proportion change of physicians started their career in university hospitals was calculated. The career paths for physicians by different residency type were presented. More than 90% of physicians experienced university hospital work at least once in their 20-year careers. In their first 10 years of their career, physicians who started their residency in a university hospital tended to spend more years working in university hospitals, and those who started in other post-graduate training hospitals tended to spend less in university hospitals. Then, these groups presented quite similar patterns in their career choices. University hospitals need to strengthen their function as continuing education and career development centres and to adopt a less paternalistic approach, as fewer residents start their career in university hospitals.

  15. Proposed measurement of tagged deep inelastic scattering in Hall A of Jefferson lab

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Montgomery, Rachel; Annand, John; Dutta, Dipangkar

    2017-03-01

    A tagged deep inelastic scattering (TDIS) experiment is planned for Hall A of Jefferson Lab, which will probe the mesonic content of the nucleon directly. Low momentum recoiling (and spectator) protons will be measured in coincidence with electrons scattered in a deep inelastic regime from hydrogen (and deuterium) targets, covering kinematics of 8 < W2 < 18 GeV2, 1 < Q2 < 3 (GeV/c)2 and 0:05 < x < 0:2. The tagging technique will help identify scattering from partons in the meson cloud and provide access to the pion structure function via the Sullivan process. The experiment will yield themore » first TDIS results in the valence regime, for both proton and neutron targets. We present here an overview of the experiment.« less

  16. Scaling behavior in exclusive meson photoproduction from Jefferson Lab at large momentum transfers

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Dey, Biplab

    2014-07-01

    With the availability of new high-statistics and wide-angle measurements for several exclusive non-πN meson photoproduction channels from Jefferson Lab, we examine the fundamental scaling law of 90° scattering in QCD that was originally derived in the high-energy perturbative limit. The data show scaling to be prominently visible even in the medium-energy domain of 2.5 GeV ≲√s≲2.84 GeV, where √s is the center-of-mass energy. While constituent quark exchange suffices for pseudoscalar mesons, additional gluon exchanges from higher Fock states of the hadronic wave functions appear be needed for vector-meson production. Finally, the case of the Φ(1020), where two-gluon exchanges are knownmore » to dominate, is especially illuminating.« less

  17. Nurse awareness of clinical research: a survey in a Japanese University Hospital

    PubMed Central

    2014-01-01

    Background Clinical research plays an important role in establishing new treatments and improving the quality of medical practice. Since the introduction of the concept of clinical research coordinators (CRC) in Japan, investigators and CRC work as a clinical research team that coordinates with other professionals in clinical trials leading to drug approval (registration trials). Although clinical nurses collaborate with clinical research teams, extended clinical research teams that include clinical nurses may contribute to the ethical and scientific pursuit of clinical research. Methods As knowledge of clinical research is essential for establishing an extended clinical research team, we used questionnaires to survey the knowledge of clinical nurses at Tokushima University Hospital. Five-point and two-point scales were used. Questions as for various experiences were also included and the relationship between awareness and experiences were analyzed. Results Among the 597 nurses at Tokushima University Hospital, 453 (75.9%) responded to the questionnaires. In Japan, registration trials are regulated by pharmaceutical affairs laws, whereas other types of investigator-initiated research (clinical research) are conducted based on ethical guidelines outlined by the ministries of Japan. Approximately 90% of respondents were aware of registration trials and clinical research, but less than 40% of the nurses were aware of their difference. In clinical research terminology, most respondents were aware of informed consent and related issues, but ≤50% were aware of other things, such as the Declaration of Helsinki, ethical guidelines, Good Clinical Practice, institutional review boards, and ethics committees. We found no specific tendency in the relationship between awareness and past experiences, such as nursing patients who were participating in registration trials and/or clinical research or taking a part in research involving patients as a nursing student or a nurse

  18. Measurement of parity-violating asymmetry in deep inelastic scattering at Jefferson Lab

    NASA Astrophysics Data System (ADS)

    Zheng, Xiaochao

    2015-04-01

    Symmetry permeates nature and is fundamental to all laws of physics. One example is mirror symmetry, also called ``parity symmetry''. It implies that flipping left and right does not change the laws of physics. Laws for electromagnetism, gravity and the subatomic strong force respect parity symmetry, but the subatomic weak force does not. Historically, parity violation in electron scattering played a key role in establishing, and now testing, the Standard Model of particle physics. One particular set of the quantities accessible through measurements of parity-violating electron scattering are the vector-electron axial-vector-quark weak couplings, called C2 q's, measured directly only once in the past 40 years. We report here on a new measurement of the parity-violating asymmetry in electron-quark scattering, that has yielded a specific combination 2C2 u -C2 d five times more precise than the earlier result. (Here u and d stand respectively for the up and the down quarks.) These results are the first evidence, at more than the 95% confidence level, that the C2 q's are non-zero as predicted by the electroweak theory. They lead to constraints on new interactions beyond the Standard Model, particularly on those whose laws change when the quark chirality is flipped between left and right. In today's particle physics research that is focused on colliders such as the LHC, our results provide specific chirality information on electroweak theory that is difficult to obtain at high energies. In addition to deep inelastic scattering, we will report on measurement of the asymmetry in the nucleon resonance region. These data exhibit for the first time that the quark-hadron duality may work for electroweak observables at the (10--15)% level throughout the whole resonance region. At the end I will give a brief outlook on the future PVDIS program using the Jefferson Lab 12 GeV beam, which will not only provide more precise measurement of C2 q, but also for sin2 θW and for

  19. Prevalence and associated factors of job-related depression in laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Ministry of Health Malaysia (MOH) Hospitals in Kelantan.

    PubMed

    Aziah, B D; Rusli, B N; Winn, T; Naing, L; Tengku, M A

    2004-06-01

    Karasek's job strain model postulates that workers chronically exposed to adverse psychosocial work environment (high strain job)--high psychological job demands and low job control, including poor social support, increased physical demand and hazardous work condition--will eventually develop both physical illnesses such as cardiovascular diseases and psychological disorders such as depression. In order to determine the prevalence and associated factors of job-related depression, a cross-sectional study was conducted among laboratory technicians in Hospital Universiti Sains Malaysia (HUSM) and Kementerian Kesihatan Malaysia (KKM) Hospitals in Kelantan between September 2001 and February 2002. One hundred and two laboratory technicians in HUSM and 79 laboratory technicians in 7 KKM Hospitals were selected; 84/102 (82.4%) in HUSM and 71/79 (89.9%) in KKM Hospitals responded. Data was collected using self-administered questionnaires of the validated Malay version of the Job Content Questionnaire (JCQ) originally developed by Robert Karasek. Results indicated that the prevalence of high job strain in laboratory technicians in HUSM and KKM hospitals was 33.3% (28/84) and 26.8% (19/71), respectively (p>0.05). Significantly higher proportion (59.5%) (50/84) of laboratory technicians in HUSM compared to those in KKM Hospitals (39.4%) (28/71) (p = 0.016) experienced job-related depression. Significant associated factors of job-related depression were low social support (HUSM: adjusted OR 4.7, 95% CI 1.2-18.8; KKM: adjusted OR 14.8, 95%CI 2.4-89.3), high psychological demand (HUSM: adjusted OR 3.0, 95%CI 1.0-8.8), and low decision authority (KKM: adjusted OR 9.7, 95%CI 1.0-91.1). We conclude that strengthening the social support network (supervisors' and coworkers' support), reducing psychological job demand, and increasing decision-making authority of laboratory technicians may go a long way towards reducing job-related depression.

  20. Urinary tract infection among obstetric fistula patients at Gondar University Hospital, northwest Ethiopia.

    PubMed

    Wondimeneh, Yitayih; Muluye, Dagnachew; Alemu, Abebe; Atinafu, Asmamaw; Yitayew, Gashaw; Gebrecherkos, Teklay; Alemu, Agersew; Damtie, Demekech; Ferede, Getachew

    2014-01-17

    Many women die from complications related to pregnancy and childbirth. In developing countries particularly in sub-Saharan Africa and Asia, where access to emergency obstetrical care is often limited, obstetric fistula usually occurs as a result of prolonged obstructed labour. Obstetric fistula patients have many social and health related problems like urinary tract infections (UTIs). Despite this reality there was limited data on prevalence UTIs on those patients in Ethiopia. Therefore, the aim of this study was to determine the prevalence, drug susceptibility pattern and associated risk factors of UTI among obstetric fistula patients at Gondar University Hospital, Northwest Ethiopia. A cross sectional study was conducted from January to May, 2013 at Gondar University Hospital. From each post repair obstetric fistula patients, socio-demographic and UTIs associated risk factors were collected by using a structured questionnaire. After the removal of their catheters, the mid-stream urine was collected and cultured on CLED. After overnight incubation, significant bacteriuria was sub-cultured on Blood Agar Plate (BAP) and MacConkey (MAC). The bacterial species were identified by series of biochemical tests. Antibiotic susceptibility test was done by disc diffusion method. Data was entered and analyzed by using SPSS version 20. A total of 53 post repair obstetric fistula patients were included for the determination of bacterial isolate and 28 (52.8%) of them had significant bacteriuria. Majority of the bacterial isolates, 26 (92.9%), were gram negative bacteria and the predominant ones were Citrobacter 13 (24.5%) and E. coli 6 (11.3%). Enterobacter, E.coli and Proteus mirabilis were 100% resistant to tetracycline. Enterobacter, Proteus mirabilis, Klebsella pneumonia, Klebsella ozenae and Staphylococcus aureus were also 100% resistant to ceftriaxone. The prevalence of bacterial isolates in obstetric fistula patients was high and majority of the isolates were gram