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Contents:All components of organizational intelligence were in the optimum status. Component of Shared fate gained the first rank and component of knowledge Deployment gained the last rank. Ranking of organizational intelligence components is different in hospitals of the province and the county; representing different features and conditions. Considering the importance of organizational intelligence role in the promotion of organization, hospital managers can take active steps to improve organizational intelligence based on done rankings.
Risks predicting prolonged hospital discharge boarding in a regional acute care hospital. Prolonged hospital discharge boarding can impact patient flow resulting in upstream Emergency Department crowding. We aim to determine the risks predicting prolonged hospital discharge boarding and their direct and indirect effects on patient flow. Retrospective review of a single hospital discharge database was conducted. Variables including type of disposition, disposition boarding time, case management consultation, discharge medications prescriptions, severity of illness, and patient homeless status were analyzed in a multivariate logistic regression model.
Hospital charges, potential savings of hospital bed hours, and whether detailed discharge instructions provided adequate explanations to patients were also analyzed. A total of 11, admissions was entered into final analysis. AOR of early case management consultation was 1. Type of disposition, case.
Anemia y deficiencia de hierro en mujeres en edad reproductiva usuarias del Hospital Regional de Villa Hayes, Paraguay. En Paraguay, existen datos limitados sobre la frecuencia de anemia en mujeres en edad reproductiva no gestantes. One of the integral elements of health systems are the hospitals. The purpose of this paper is to review the need for formalized training in hospital management to improve the quality of care.
Literature review and hands on experience of conducting a regional training in hospital management for Eastern Mediterranean Region EMR countries. Majority of patients in EMR bypass Primary Health Care facilities due to inadequate quality of services and prefer seeking specialized care at a tertiary level. There is mounting evidence of mediocre to poor patient satisfaction due to inefficient health care practices in hospitals of EMR.
Strengthening the management capacity of the hospitals through a formal training programme is therefore necessary for improving the performance of health care delivery and the overall health system. Hospital management encompasses hospital planning and operational activities including development and implementation of organizational strategies to ensure adequate numbers and quality of trained human resources and effective financial management, disaster management, health management information system utilization, support services, biomedical engineering, transport and waste management.
Such training will prepare health care professionals with leadership skills to deliver quality hospital services. This is one of the first papers emphasizing the need for a formal structured regional training in hospital management for the countries of EMR. X-ray photoelectron spectroscopy on 1- peso and 2- pesos of the Argentine Republic. Relative concentrations of nickel and copper at the surface of the ring and centre parts of 1- peso and 2- pesos Argentine coins have been studied by means of X-ray photoemission spectroscopy XPS.
It has been observed Ni-enrichment at the surface of the ring silvery part of a 1- peso , minted in , whereas the XPS data reveals lack of nickel at the surface of the centre silvery part of a 2- pesos , minted in This discrepancy is explained by analyzing the XPS peaks of oxygen and carbon, and is suggested to be related to the contamination layer on the surface of the coins.
The possible oxidations states of the metals at the surface of the untreated and treated coins with the artificial human sweat were also identified. Point prevalence of hospital -acquired infections in two teaching hospitals of Amhara region in Ethiopia. Hospital -acquired infection HAI is a major safety issue affecting the quality of care of hundreds of millions of patients every year, in both developed and developing countries, including Ethiopia.
In Ethiopia, there is no comprehensive research that presents the whole picture of HAIs in hospitals. The objective of this study was to examine the nature and extent of HAIs in Ethiopia. A repeated cross-sectional study was conducted in two teaching hospitals. All eligible inpatients admitted for at least 48 hours on the day of the survey were included. The survey was conducted in dry and wet seasons of Ethiopia, that is, in March to April and July Univariate and multivariable logistic regression analyses were used to examine the prevalence of HAIs and relationship between explanatory and outcome variables.
A total of patients were included in this survey, the median age of the patients was 27 years interquartile range: A total of There were patients with HAI, with a mean prevalence of Culture results showed that Klebsiella spp. The association of patient age and hospital type with the occurrence of HAI was. In Bavarian psychiatric hospitals approximately 15, people with mental handicaps and mental illnesses were killed after the so-called Action T4.
The aim of the study was to analyze its role in carrying out " regionalized euthanasia". The learning curve for laparoscopic colectomy in colorectal cancer at a new regional hospital. Laparoscopic colectomy for colorectal cancer in a new regional hospital is feasible and safe.
It does not need additional time for learning. Laparoscopic sigmoidectomy can be considered as the initial surgery for a trainee. Neonatal deaths occur due to asphyxia, preterm delivery, sepsis and tetanus. The study was conducted at the large regional hospital in Worcester,. Evaluation of nutritional support in a regional hospital.
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Disease-related malnutrition DRM is highly prevalent in Spanish hospitals occurring in 1 out of every 4 patients. In Extremadura Spain , the public health system has included nutritional screening as the only mechanism to fight malnutrition. The results of this strategy are evaluated here. An agreement study was conducted in standard clinical practice.
Variables collected included the following rates: Standards to comparison based on the results of the Netherland Program to Fight Malnutrition. Nutritional screening rate at entry was Weight and height were both measured in Significantly lower values were found for all indicators as compared to standards, with kappa values lower than 0. Data analysis showed poorer results when patients referred to the NSU were excluded.
A strategy to fight malnutrition based on nutritional screening alone is highly inefficient in hospitals such as HVP. Despite the lack of efficacy data, robotic-assisted surgery has diffused rapidly into practice. Marketing to physicians, hospitals , and patients has been widespread, but how this marketing has contributed to the diffusion of the technology remains unknown. To examine the effect of regional hospital competition and hospital financial status on the use of robotic-assisted surgery for 5 commonly performed procedures.
The association between hospital competition, hospital financial status, and performance of robotic-assisted surgery was examined. The association between hospital competition was measured with the Herfindahl-Hirschman Index HHI , hospital financial status was estimated as operating margin, and performance of robotic-assisted surgery was examined using multivariate mixed-effects regression models. Robotic-assisted operations were performed for 20 Use of robotic-assisted surgery increased for each procedure from January through December For all 5 operations, increased market competition as measured by the HHI was associated with increased use of robotic-assisted surgery.
Job stress and burnout in hospital employees: Objectives To explore the prevalence and associated factors of burnout among five different medical professions in a regional teaching hospital. Setting Hospital -based survey. These voluntary participants included physicians, 68 physician assistants, nurses, medical technicians and administrative staff.
Primary and secondary outcome measures Demographic data included gender, age, level of education and marital status, and work situations, such as position, work hours and work shifts, were obtained from an electronic questionnaire. Job strain and burnout were measured by two validated questionnaires, the Chinese version of the Job Content Questionnaire and the Copenhagen Burnout Inventory.
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Hierarchical regression analysis indicated that job strain, overcommitment and low social support explained the most variance Conclusions Physician assistant is an emerging high burnout group; its severity is similar to that of nurses and far more than that of physicians, administrative staff and medical technicians. These findings may contribute to the development of feasible strategies to reduce the stress which results in the burnout currently plaguing most hospitals in Taiwan.
Lower limb fracture presentations at a regional hospital. We found that lower limb fractures, which were largely the result of minimal trauma, had high levels of hospitalisation, length of stay and surgery. It is therefore important to prevent fractures at all sites to avoid the associated morbidity and mortality. Hip fractures are a major cause of morbidity and mortality, particularly in older women. In comparison, less is known about the epidemiology and burden of other lower limb fractures.
The study aimed to investigate the epidemiology and burden of these fractures. Age, cause of fracture, post-fracture hospitalisation, surgery, length of stay and discharge location were ascertained from medical records. Fractures were largely a result of minimal trauma. Most women with hip or femur fractures were hospitalised; fewer were hospitalised for fractures at other sites.
Surgery for fracture followed the same pattern as hospitalisations. Length of stay was the highest for hip and femur fractures and the lowest for foot fractures. Women with hip or femur fractures were discharged to rehabilitation more often than home. Fractures at other sites were most commonly discharged home. Fractures of the lower limb occurred frequently in older women.
Hospitalisation and subsequent surgery were common in cases of hip and femur fractures. It is important for prevention strategies to target fractures at a range of skeletal sites to reduce costs, hospitalisations, loss of independence and reduced quality of life. The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.
An effect of different demographic trends? Population aging and population decline in many regions of the Federal Republic of Germany are key elements of demographic change. So far, the consequences of regional shrinkage and growth for inpatient care don't seem to have been analysed very well. One result of the analysis is that there are major differences between the Federal States. The analysis shows, for example, an increase of hospitalizations in Berlin while in Saxony-Anhalt the number of hospitalizations declines. Population aging and non-demographic factors were not able to compensate this trend.
Overall, the effect of demographic factors on the number of hospitalizations remains constant over time. Short-term changes of hospitalizations are due to non-demographic factors, such as epidemiological trends, for example trends of incidence or prevalence , or structural changes of health care service for example patients shifting between different sectors of health care or the introduction of new reimbursement systems. This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province.
Research conceptual constructs are based on input and output performance in institutional performance processes. This research approach uses positivist pattern and is derived by quantitative method. This is to explain the efficiency pattern of the installation of hospital and private hospital surgery rooms.
The quantitative method chosen is the concept of Dat Rev Med Hered ; Factores asociados al bajo peso al nacer. Dentro de los factores de riesgo del BPN se han encontrado con mayor frecuencia en estudios realizados por diferentes autores, los siguientes: A lot of research works have been carried out about its causes and consequences. The importance of LBW not only lies in its meaning for infant mortality and morbidity but also in the many problems that low birth weight children regularly face in the future.
Among the low birth weight risk factors, a number of studies by various authors have frequently found the following; pregnancy at adolescence; undernourishment in mothers, smoking, blood hypertension during pregnancy, cervix-vaginal sepsis; anemia, twin. To explore the modern hospital and regional medical consumable reagents logistics system management. The characteristics of regional logistics, through cooperation between medical institutions within the region , and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics.
To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down. Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution.
Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs. Estudo quantitativo, descritivo e correlacional. Estudio cuantitativo, descriptivo y correlacional. El sexo predominante fue el masculino Extracorporeal cardiopulmonary resuscitation after out-of- hospital cardiac arrest in a Danish health region.
Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre- hospital emergency service organisation. OHCA was managed with pre- hospital advanced airway management and mechanical chest compression during transport. Relevant pre- hospital and in- hospital data were collected with special focus on low-flow time and ECPR duration.
Survival to hospital discharge with Cerebral Performance Category CPC of 1 and 2 at hospital discharge was the primary endpoint. Twenty-one patients were included. Median pre- hospital low-flow time was 54 min [range ] and median total low-flow time was min [range ]. Survivors had a CPC score of 1 or 2 at hospital discharge. Five survivors had a shockable initial rhythm.
In all survivors coronary occlusion was the presumed cause of cardiac arrest. Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration.
Diabetic patients served at a regional level hospital: We describe the demographics, diabetic characteristics, diabetic control and complications in the diabetes service in Edendale Regional Hospital , Pietermaritzburg, in this study. Diabetes mellitus, together with its complications, is increasing at an alarming rate worldwide. Good glycaemic control translates into Three cases of Capnocytophaga canimorsus meningitis seen at a regional hospital in one year.
Three cases of meningitis caused by the fastidious Gram-negative rod Capnocytophaga canimorsus have been observed at a regional hospital in 1 y. The difficulties connected with the correct diagnosis by classical culturing methods in contrast to molecular methods, as well as possible reasons Full Text Available This study aims to investigate the efficiency level of hospital surgery hospital installation in Special Region of Yogyakarta Province.
The results showed that 1 the installation of a private hospital surgery room tends to be more efficient than government property; 2 the installation of a special hospital surgical hospital is not absolutely more efficient than a public hospital. As a recommendation, this research provides scenario for setting input usage for efficient performance. Survey of safety practices among hospital laboratories in Oromia Regional State, Ethiopia.
Unsafe working practices, working environments, disposable waste products, and chemicals in clinical laboratories contribute to infectious and non-infectious hazards. Staffs, the community, and patients are less safe. Furthermore, such practices compromise the quality of laboratory services. We conducted a study to describe safety practices in public hospital laboratories of Oromia Regional State, Ethiopia. Randomly selected ten public hospital laboratories in Oromia Regional State were studied from Oct Feb Self-administered structured questionnaire and observation checklists were used for data collection.
The respondents were heads of the laboratories, senior technicians, and safety officers. The data was analyzed using descriptive analysis with SPSS version16 statistical software. All of the respondents reported none of the hospital laboratories were labeled with the appropriate safety label and safety symbols. These respondents also reported they may contain organisms grouped under risk group IV in the absence of microbiological safety cabinets. Overall, the respondents reported that there were poor safety regulations or standards in their laboratories. Laboratory safety in public hospitals of Oromia Regional State is below the standard.
The laboratory workers are at high risk of combined physical, chemical and microbial hazards. Prompt recognition of the problem and immediate action is mandatory to ensure safe working environment in health laboratories. Factors associated with induced abortion at selected hospitals in the Volta Region , Ghana. Induced abortion rates remained persistently high in the Volta Region of Ghana in the 5 years from to Some hospitals , both rural and urban, report induced abortion-related complications as one of the top ten conditions in hospital admissions.
This study explored demographic and other factors associated with induced abortion, and also assessed awareness of abortion-related complications among women of reproductive age in the Volta Region. A quantitative, hospital -based, unmatched case-control study was performed. The Volta Region was stratified into two health administration zones, ie, north and south.
For each zone, hospitals were stratified into government and private hospitals. Employing simple random sampling, one private and three government hospitals were selected from each zone. This study is therefore based on eight hospitals , ie, six government hospitals and two private hospitals. Marital status, employment status, number of total pregnancies, and knowledge about contraception were found to be associated with induced abortion.
Unemployed women of reproductive age were found to be 0. It was also observed that women with their second pregnancies were 3. Women with no knowledge of contraceptive methods were 4. Compared with women who had not had induced abortion, women with a high number of pregnancies and no contraceptive knowledge were more likely to have induced abortion. It was found that lack. Full Text Available This study applies the game theory to the discussion and analysis of trans- regional Telemedicine System, builds the game model of the selection strategies of trans- regional hospitals and patients and analyzes evolving paths, equilibrium states and influencing factors of the three parties.
It is derived that medical insurance reimbursement proportion of specialized hospitals , government support for general hospitals and medical expenses in specialized hospitals , operating costs of general hospitals are the influential factors in the Telemedicine System. This research is quantitative which placed latent variables General Audit Engagements as intervening variables. Partial Least Square PLS is used to confirm the model created in order to explain the relationship between variables. The results show that the perception of BLUD hospital management on the role of independent auditors and their understanding of good governance to give effect to the implementation of the audit engagement and the implications for the prevention of fraud in BLUDs hospital.
This is consistent with the theory of auditing and fraud prevention concepts. The southern region renal transplant program at armed forces hospital , khamis mushayt. The Southern Region renal transplant program was established in February The appointment of a transplant co-ordinator and creation of a waiting list for the Southern Region as well as tissue typing of all patients in the region were important early steps. Of them, 52 were cadaveric donor transplants and the remaining were from living related donors.
Of the patients who were transplanted, 79 patients were from other hospitals in the region and 73 were from AFHSR. Maintenance immunosuppression consisted of cyclosporin, azathioprine and prednisolone. Use of the spouse as a donor was an early feature of this program. Our results compare favorably with results published from other centers. To cope with the increasing demand of transplantation in the Southern Region , we have to look into ways of increasing our transplant numbers to match the needs.
The dataset only includes hospital facilities and Full Text Available Introduction. Globally, depression is one of the three leading causes of disease and it will be the second leading cause of world disability by In Ethiopia, depression was found to be the seventh leading cause of disease burden and its prevalence has been increased in hospital compared to community setting because hospital environment itself is stressful. Yet, no study was done in Eastern Ethiopia, where substance use like Khat is very rampant.
To assess depression and associated factors among adult inpatients at public hospitals of Harari Regional State, Eastern Ethiopia, from February 01 to 28, Hospital based cross-sectional study design was employed on admitted adult patients in Harari region hospitals. Consecutive sampling method was used to include study population.
The data were collected by interviewee and analyzed by SPSS version Bivariate and multivariate logistic regression analyses were employed. A total of patients were interviewed with response rate of Prevalence of depression among admitted inpatients was high. Therefore, increasing the awareness of benefits of early diagnosis of patients to prevent major form of depression and strengthening the clinical set-up and establishing good referral linkage with mental health institutions was considered to be cost-effective method to reduce its prevalence.
Safe injections and waste management among healthcare workers at a regional hospital in northern Tanzania. Unsafe injections and substandard waste management are public health issues exposing healthcare workers and the community to the risk of infections. The objective of this study was to assess the knowledge and practice of safe injections and health care waste management among healthcare workers at a regional hospital in northern Tanzania.
This cross sectional descriptive study was conducted in a regional hospital in northern Tanzania. Data was collected through a self-administered questionnaire with additional observations of the incinerator, injections, waste practices, and the availability of medical supplies. Data was analysed in SPSS descriptive statistics and chi-square tests were performed.
The majority of healthcare workers had adequate knowledge and practice of safe injections, but inadequate knowledge about waste management. The majority of the staff reported knowledge of HIV as a risk factor, however, had less knowledge about other blood-borne infections. Guidelines and posters on post exposure prophylaxes and waste management -were present at the hospital , however, the incinerator had no fence or temperature gauge. In conclusion, healthcare workers reported good knowledge and practice of injections, and high knowledge of HIV transmission routes.
However, the hospital is in need of a well functioning incinerator and healthcare workers require sufficient medical supplies. There was a need for continual training about health care waste management and avoidance of blood-borne pathogens that may be transmitted through unsafe injections or poor health care waste management.
Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement. To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies. In , Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed.
Key areas for improvement were grouped into "bundles" based on personnel, systems management, and service quality. Primary outcomes included maternal and perinatal mortality, and case fatality rates for hemorrhage and hypertensive disorders. Implementation and outcomes were evaluated tri-annually between and Case fatality rates for pre-eclampsia and hemorrhage decreased from 3.
Published by Elsevier Ireland Ltd. Systemic Review of Insights from Simulation Models. Optimal solutions for reducing diversion without worsening emergency department ED crowding are unclear. We performed a systematic review of published simulation studies to identify: Additional studies identified through bibliography review, Google Scholar, and scientific conference proceedings.
Only simulations modeling ambulance diversion as a result of ED crowding or inpatient capacity problems were included. Independent extraction by two authors using predefined data fields. We identified 5, potentially relevant records; 10 studies met inclusion criteria. In models that quantified the relationship between ED throughput times and diversion, diversion was found to only minimally improve ED waiting room times. Adding holding units for inpatient boarders and ED-based fast tracks, improving lab turnaround times, and smoothing elective surgery caseloads were found to reduce diversion considerably.
While two models found a cooperative agreement between hospitals is necessary to prevent defensive diversion behavior by a hospital when a nearby hospital goes on diversion, one model found there may be more optimal solutions for reducing region wide wait times than a regional ban on diversion. Smoothing elective surgery caseloads, adding ED fast tracks as well as holding units for inpatient boarders, improving ED lab turnaround times, and implementing regional cooperative agreements among hospitals.
Full Text Available Reviews the legal and regulatory basis in the sphere of the guardianship treatment centres in the Russian Empire in the middle of the XIXth century, alleging the establishment of the public supervision over the activities of city, County and provincial hospitals. Contents of the powers of the Trustees, their objectives and main activities. Specific examples in the Danube region proved the thesis that among the Trustees were dominated by representatives of the nobility.
Benefits of an ISO certification--the case of a Swiss regional hospital. This paper reports the experience of a quality management project leading to an ISO certification in a Swiss regional hospital. It describes the motivations for the project, the process that was followed and the benefits of the approach.
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It also shows its limitations, problems encountered as well as costs and resources involved. The emphasis is on practical issues. Choices that were made are discussed and lessons are drawn. Objective To determine whether surgical quality measures that Medicare publicly reports provide a basis for patients to choose a hospital from within their geographic region. We defined regions within which patients were likely to compare hospitals using the hospital referral regions HRRs from the Dartmouth Atlas of Health Care Project.
In 62 percent of HRRs, hospitals were skewed toward the higher rates negative skewness. Seven percent of HRRs demonstrated positive skewness. Only 1 percent had a positive outlier. Conclusions Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider.
More studies are needed to improve public reporting's ability to positively impact patient decision making. Full Text Available Rationale: According to prognosis made by World Health Organization experts, by midst century gastrointestinal disorders will be among the leaders, partially due to lifestyle of a modern man stress, unhealthy diet, lack of physical exercise, unhealthy habits, environmental pollution, genetically modified and low quality foods.
To provide informational support of activities aimed at improvement of organization of medical care to patients with gastrointestinal disorders and at further development of specialized gastroenterological care to the population of the Moscow Region , its better availability and higher efficacy and quality. We calculated and analyzed gastrointestinal morbidity in according to referrals among the main age categories children, adolescents, adults of the population of the Moscow Region , as well as hospitalization rates and in- hospital mortality.
The information was taken from the Federal Statistical Surveillance report forms 12 and In , the highest prevalence of gastrointestinal disorders was registered in adolescents, being by The leading causes of referrals in all age categories were gastritis and duodenitis, as well as gall bladder and bile tract disorders. The structure of morbidity was characterized by a high proportion of pancreatic disorders, stomach and duodenal ulcers in adults. The rate of hospitalizations due to gastrointestinal disorders was The main reasons for hospitalization in adults were diseases of pancreas In children and adolescents, the main reasons for hospitalizations were intestinal disorders In- hospital mortality from.
Air pollution exposure, cause-specific deaths and hospitalizations in a highly polluted Italian region. The Lombardy region in northern Italy ranks among the most air polluted areas of Europe. Previous studies showed air pollution short-term effects on all-cause mortality.
We considered air pollution, mortality and hospitalization data for a non-opportunistic sample of 18 highly polluted and most densely populated areas of the region in the years We obtained area-specific effect estimates for PM10 and NO2 from a Poisson regression model on the daily number of total deaths or cause-specific hospitalizations and then combined them in a Bayesian random-effects meta-analysis. For cause-specific mortality, we applied a case-crossover analysis. Age- and season-specific analyses were also performed.
Natural mortality was positively associated with both pollutants 0. Cardiovascular deaths showed a higher percent variation in association with NO2 1. The effect of both pollutants was more evident in the summer season. Air pollution was also associated to hospitalizations , the highest variations being 0.
The effect of PM10 on respiratory hospital admissions appeared to increase with age.
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For both pollutants, effects on cerebrovascular hospitalizations were more evident in subjects aged less than. Evaluation of hospital -learning environment for pediatric residency in eastern region of Saudi Arabia. Full Text Available Purpose: It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. The number of respondents was There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents.
There was a difference among the participant teaching hospitals p Institutional traps in the hospitality industry financing by the example of Krasnodar region. Full Text Available Objective to determine and classify the institutional traps in financing the hospitality industry in Russia. Methods abstractlogical generalization and observation. Results basing on the analysis of statistics and regional program of tourism development in Krasnodar region the challenges and obstacles were identified to the development and improvement of tourist services quality.
The research result is the identification and systematization of institutional traps in the financing of tourism expressed in the increased public support of the sector. In particular a significant proportion of touristrecreational sector funding is still taken from the budget though the specific weight of profitable health resort organizations amounted to 60 over the past three years.
In the process of research the author formulated a general concept of the institutional structure of the hospitality industry in Russia and the model of the sector financing through a system of incentives and benefits for vacationers forming the tourist clusters and forming a mechanism of dialogue between the authorities and representatives of tourist business.
Scientific novelty the institutional traps are defined and systematized which are formed in the system of tourism financing measures to overcome them are proposed. Practical significance the proposed recommendations can be used by the entities of the hospitality industry to enhance business activities and by authorities to implement tasks outlined in the state programs. Dementia in older people admitted to hospital: However, there is a lack of published data from any European country on the prevalence of dementia across hospitals and between patient groups.
Prevalence varied between hospitals P dementia had a previous diagnosis. Most dementia is not previously diagnosed, emphasising the necessity for cognitive assessment in older people on presentation to hospital. Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay.
The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country's 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms ECGs of patients who needed a diagnosis by a specialized physician were entered into the system.
This information was sent to specialists in diagnostic imaging and in cardiology for remote diagnosis and the report was then forwarded to the hospitals connected to the system. The cost-benefit and impact of the remote diagnosis tool was analyzed from the perspective of the National Health System. Between January and May , a total of 34 remote diagnoses were made in 25 hospitals in the Ministry of Health's telemedicine system. As a result of remote diagnosis, unit costs were 4. Paraguay has a remote diagnosis system for electrocardiography, tomography, and sonography, using low-cost information and communications technologies ICTs based on free software that is scalable to other types of remote diagnostic studies of interest for public health.
Implementation of remote diagnosis helped to strengthen the integrated network of health services and programs, enabling professionals to optimize their time and productivity, while improving quality, increasing access and equity, and reducing costs. Occupational stressors, burnout and coping strategies between hospital and community psychiatric nurses in a Dublin region. Burnout negatively impacts the delivery of mental health services.
Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February , investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region.
The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively.
Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups.
It is recommended that interventions. Hospital emergencies HE arising from nursing homes NH are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region , as well as resulting hospital admissions.
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Sample to evaluate appropriateness: Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector. Although the total number of stillbirths worldwide was estimated at 2. The findings add to a global initiative advanced by the Lancet series on stillbirths, aimed at raising awareness of stillbirth statistics in low- and middle-income countries. A retrospective audit of the HUMMET forms was conducted and the cases were further summarised in a Microsoft Excel spreadsheet that allowed for a univariate analysis of the variables.
The stillbirth rate at LUWMRH is much higher than that at other regional hospitals owing to the number of at-risk referrals and emergency cases from surrounding clinics and district hospitals. Avoidable factors were predominantly a late patient response to reduced fetal movements and delays in transfer to hospital. Twenty percent of stillbirths were associated with inappropriate monitoring or management of the obstetric condition at the district hospital.
This study aimed to determine the prevalence of diabetic foot ulcer and high risk for ulceration, describe the clinical presentation, and identify factors associated with diabetic foot ulcer in the Southwest regional hospitals of Cameroon. In this cross-sectional study, data were collected using a structured questionnaire administered to consecutive patients with diabetes. Findings from detailed foot examination were recorded. Data were analyzed with Stata IC version Of the participants included, Age ranged from 26 to 96 years.
The median duration of diabetes was 4. The prevalence of diabetic foot ulcer was The prevalence of high risk for ulceration was Diabetic foot ulcer is a common complication among patients with diabetes attending these regional hospitals. Loss of protective sensation, and peripheral arterial disease increase the odds of having diabetic foot ulcer, and we suggest them as the main target of interest for prevention.
Results of a survey among medical directors of Bavarian district hospitals ]. In this study, the medical directors of all Bavarian district psychiatric hospitals evaluated certain aspects of the integration of their hospitals into the development of regional community psychiatry networks "Gemeindepsychiatrische Verbunde" - GPVs. They were asked to rate the actual quantity of cooperation between their hospitals and diverse community based services and to express their requests concerning the quality of cooperation.
An estimation of possible advantages of the hospitals ' integration in GPVs and expectations to future perspectives of GPV development were also investigated. The data were collected by a written questionnaire. The results of the survey indicate that a high relevance is attached to GPV: Full Text Available Aim. To evaluate the real practice of thrombolytic therapy of patients with ST-elevation myocardial infarction STEMI at cardiological departments of Saratov and Saratov region hospitals. Retrospective pharmacoepidemiologic study was carried out.
Case histories of STEMI patients discharged from cardiologic departments of several central district hospitals CDH of Saratov region , cardiologic department of one of Saratov general municipal hospitals MH and urgent cardiology department of Saratov clinical hospital CH in were analyzed.
In CH all patients received thrombolytic therapy given they did not have contraindications and were admitted to the hospital timely. Cephalic region war injuries in children: Medical assistance to civilians was an additional mission which included support for children who were war injured. The objective of this study was to analyze characteristics of cephalic injuries in children victims of war trauma.
A retrospective study was conducted and commenced with the hospital opening July to March on all children regions. We analyzed mechanism, region , severity score, surgeries and resuscitation efforts. Mortality rate was 5. Ophthalmic injuries were the most common of cephalic injuries; 19 children of which 7 had a bilateral injury 26 eyes.
In cerebral lesion group, the lesions were linked to a bullet or a shrapnel in 9 of 13 children. This mechanism systematically caused a crania-cerebral wound. Explosion fragmentary and shrapnel was the most important in the neck lesions 7 children of The cephalic lesions were the second most common region in children during our experience in Afghanistan. Lack of protection helmet in children may explain the frequency of cephalic wounds. Making regional facility location decisions: Full Text Available This paper seeks to contribute to the debate on the decision-making process for the location of large public facilities, responding to the growing demand for greater rationality in public investment whilst still offering services of quality and addressing the problem of spatial friction.
The specific problem analysed in this paper is the need to define the best location for a public hospital in a particular region of Portugal. The singularity of the approach adopted lies above all in the seg- mentation into macro-location and micro-location. Prevention of hospital -onset Clostridium difficile infection in the New York metropolitan region using a collaborative intervention model.
The incidence, severity, and associated costs of Clostridium difficile C. This article describes a multifaceted collaborative approach to reduce hospital -onset CDI rates in 35 acute care hospitals in the New York metropolitan region. Hospitals participated in a comprehensive CDI reduction intervention and formed interdisciplinary teams to coordinate their efforts. Standardized clinical infection prevention and environmental cleaning protocols were implemented and monitored using checklists.
Monthly data reports were provided to hospitals for facility-specific performance evaluation and comparison to aggregate data from all participants. Hospitals also participated in monthly teleconferences to review data and highlight successes, challenges, and strategies to reduce CDI. Incidence of hospital -onset CDI per 10, patient days was the primary outcome measure. Additionally, the incidence of nonhospital-associated, community-onset, hospital -associated, and recurrent CDIs were measured. The use of a collaborative model to implement a multifaceted infection prevention strategy was temporally associated with a significant reduction in hospital -onset CDI rates in participating New York metropolitan regional hospitals.
The government of Ghana and key stakeholders have put into place several interventions aimed at reducing maternal deaths. At the institutional level, the conduct of maternal deaths audit has been instituted. This also contributes to reducing maternal deaths as shortcomings that may have contributed to such deaths could be identified to inform best practice and forestall such occurrences in the future.
The objective of this study was to review the quality of maternal care in a regional hospital. Poor documentation, non-involvement of senior clinicians in the management of cases, laboratory related issues particularly in relation to blood and blood products as well as promptness of care and adequacy of intensive care facilities and specialists in the hospital were contributory factors to maternal deaths.
These are common themes contributing to maternal deaths in developing countries which need to be urgently tackled. Maternal death review with emphasis on quality of care, coupled with facility gap assessment, is a useful tool to address the adequacy of emergency obstetric care services to prevent further maternal deaths. In , nurses of a Lazio Region Hospital were assessed to verify whether certain Human Resources decisions, such as outsourcing, can negatively influence their working motivation and sense of belonging to a health organization and whether any dissatisfaction can be attributed to poor ethical information within the health service.
The research method had a descriptive basis and for data collection a questionnaire with 35 questions was issued. Results showed that nurses felt strongly involved in the study and interesting aspects for management of human resources emerged, depicting an organization lacking in motivation: The strong points of the study were: The limits of the study were: Determinants of regional labour productivity growth: A study for the hospitality sector in Spain.
Full Text Available The aim of this paper is to analyze the determinants of labour productivity growth in the hospitality industry in Spain using regional data over the period The results obtained suggest that the increase in the number of 3-star hotels and the reduction process in the stock of physical capital per worker are factors which may have contributed to the fall in productivity growth. However, increased regional tourism intensity has a positive impact on the growth of labour productivity.
Nonetheless, changes in demand-related factors, such as average length of stay and the seasonality of demand, have not had a significant aggregate impact on labour productivity growth during this period. The challenge could be briefly seen in these terms: In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them.
Contemporary methods and advances This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning The German Social Act V section sign 12 is aimed towards competition, efficiency and quality in healthcare. Because surgical departments are billing standard diagnosis-related group DRG case costs to health insurance companies, they claim best value for money for internal services. Thus, anaesthesia concepts are being closely scrutinized.
The present analysis was performed to gain economic arguments for the strategic positioning of regional anaesthesia procedures into clinical pathways. Surgical procedures, which in had a relevant caseload in Germany, were chosen in which regional anaesthesia procedures alone or in combination with general anaesthesia could routinely be used. The structure of costs and earnings for hospital services, split by types and centres of cost, as well as by underlying procedures are contained in the annually updated public accessible dataset DRG browser of the German Hospital Reimbursement Institute InEK.
This curve intersects by the cost curve at the point of national mean length of stay. The cost curve was calculated by process-oriented distribution of cost centres over the length of stay and allows benchmarking within the national competitive environment. For comparison of process times data from our local database were used. While the InEK browser lacks process times, the cost positions 5. Within the portfolio diagram of lengths of stay for each DRG and process times most procedures are located in the economic lower left, in particular those with high case mix length of stay and.
ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented.
Conclusions NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. As China approaches the elimination of measles, outbreaks of measles continue to occur.
Healthcare workers HCWs are known to be at high risk of infection and transmission of measles virus. We report an investigation of this outbreak and its implications for measles elimination and outbreak preparedness. We conducted a retrospective search for measles cases using hospital records. Information on cases was collected by interview, and was used to determine epidemiological linkages. We surveyed HCWs to determine their demographic characteristics, disease history and vaccination status, and knowledge about measles.
The primary case was a year-old neurology department nurse who developed a rash on 22 December that was reported on 11 January She continued working and living with her workmates in a dormitory during her measles transmission period. Among the 19 infected HCWs, 2 had received a dose of measles-containing vaccine MCV before the outbreak, and 16 had unknown vaccination status. Low MCV coverage, low measles knowledge among HCWs, delayed reporting of measles cases, and absence of proper case management were associated with this outbreak.
I need 2 units. Please get in touch with me as soon as possible. Owned and operated the original sk-5 since release in the late 80's. Will not circuit bend my original. Great board, simple sampling and effects. I have a Very good condition SK-5, clean and works perfect. I like deeese, stop talkin' shit. Tengo un piano casio sk60 como uevo en su caja listo para la venta,buen precio llamame al o escribeme.
This may be of interest; I play in an improvised music group that makes all of it's music on four formerly three Casio SK5 keyboards run through a bunch of guitar pedals. We've made an album, that will hopefully get some kind of limited release soon, and we've also made a short, crude technically speaking! Check out the link!
Further to the above post, a couple of tracks are available for free download upon following the link below. Never take your best friends sister out. We do the occasional improvised gig in and around Bournemouth, Dorset, but wouldn't it be great to team up with everybody else of a like mind for an SK5-Fest somewhere!? Preferably somewhere abroad and hot actually, but I'm not fussy And, at the risk of repeating ourselves, you can download some stuff at: I have a great SK-5 listed, with more to come.
We've recently taken to performing from inside a tent onstage, there's a couple of pictures of that on the "images" page. Follow the link for more Dominic Cinimo - many thanks for checking out the site, glad you liked the noises! All our sounds are generated by SK5s and processed using mostly guitar stomp-boxes.
We have a Roland SP Dr Sample, but we only use the effects on that, it doesn't get used for sampling. None of the SK5s are circuit-bent yet! We've recently discovered MySpace and put a couple of tunes up on our page there, more will follow shortly. Hi all, I've recently got hold of an SK-5 and was wondering if anyone knows how to feed the SK-5 output into my guitar effects rig i. Guess it's just a matter of using the right lead Jazz - have a look in the user manual zip file at the top of this page, I think it names the preset demonstration tunes there.
Just put one on eBay if anyone is interested.. Its pretty good, my favourite sound is the 'pipe organ'. You can't play more than 4 or 5 notes at one time though. Its so cool to record sounds and then manipulate them, I love casio I want to get my hands on the SK-1 particularly the white one I don't give a shit if its for girls I want it now.
If any body wants to buy it email me with an offer. I'm selling my un-bent SK-5 on ebay http: Acabo de empezar con el piano y estoy interesada en comprar uno a un precio asequible de 51 teclas y con opcion de auriculares. Well, do anyone know where i can get hands on one of theese? Denmark doesn't really have the biggest buying posibillities for such vintage stuff. I have one of these, and I never did figure out what the melody, obligato and accomp buttons were supposed to do.
The grey part of the switch is missing, but there's still a nub. I can still move the switch, but it does nothing. Anybody know what the deal is? Necesito un Casio SK 5, para comprarlo de forma inmediata. I can't figure it out! I think they mess with the demo mode. I was hoping it was accosomething like the "chord mode" setting on the sk1. Anybody have more info??? I invite You to our site http: I'd like to hear your opinions. Chose SK-5, as it's better. Although SK-1 is more famous and arounded by kinda cult.
What a wonderful website, suddenly I need to go find my old SK5 in the attic and start playing with it again. Does the machine have limitations stopping this mod? Please could somebody tell me how to save samples and make loops on the casio sk5? I just bought one off ebay - it's really really cool, i love the way you can record samples and play it back in different pitches! Mi correo es ederabc hotmail. I'm looking for one too! Drop me a line!
I have an sk-5 with midi!! Hi, if someone has an sk-5 for sale in the UK please email me. Hello, I bought an SK-5 back in when I was 16 and into all things musical. I would have loved a full sized version but me and my mates had great fun sampling our voices and sending them down the CB radio at the time.
Very annoying to everyone else probably but we had such great fun. Might buy another just for nostalgia. Great work with the site by the way. I have a Casio SK 5 in excellent working condition - no box or manual though. How much is it worth? I might be looking at selling it.
I've got a casio PK-1, it's a very mini-keyboard. It's white in color and tiny at about 20 keys across. It says Pulse Code Modulation on it with 16 pre-sets for tone. Can someone give me some background on this? Ok mira elkin me llamo carlos mira ya yo te agregue a mi correo, necesito hablar contigo, sobre el piano sk-5, soy de la miniteca, Dimension Dispclay, yo pertenesia a la miniteca soll treen, ahora necesito comprar un piano sk-5 si eres amable llamame a este numero o enviame un msj, , para hablar de negocio esperare que me des la respuesta Ive got an Sk-5 for sale.
Email me with info thanks: I want a casio sk.. Hi, looking for a SK Let me know if you have one for sale.
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I want to buy an sk-5, please help! I like it a lot! Nice site, I will bookmark! Vendo piano Sk-5 en buen estado. Lo vendo en pesos. We've put some tunes from the Archive up on our site - help yrselves! I got an sk-5 a few months back. I was just sitting there thinking, what the fuck does the tuning control do and how do you use it If it's meant to be like that, anyone care to tell me how the fuck you use it? Estoy interesado en un Piano Casio SK5. I'm guessing this is a common question, but is there a way to remove the snare sound the indicates a sample is loaded? I am interested in buying a casio sk I just found this while I was looking for classic drum sounds, you'll love this!
It's an incredible sounding assortment of clasic casio sounds. Preset sounds kinda suck - SK-1's are better. Had to pick it up. Already have one but the sound output of the speaker and the line out are both very quiet. Can't wait to have this! It comes with mint-condition manual and box slightly worn corners and handful of scratches plus original battery cover.
I'd really like to know if the SK-5 can be modified to output midi data or to convert key triggering into midi notes? So, can you bend an SK-5 so that it can control midi much like a modern midi controller keyboard can? The SK-5 is full of gimmicky features whereas the SK-8 is straightforward and focuses only on professional-like features. IMHO those 4 extra pads are a useful idea but a complete waste of a feature simply because you cannot use them to trigger a basic set of drums.
If the preset sample pads were programmed to trigger off a bass-drum, snare-drum, hi-hat and crash-cymbal Also, if the lion, laser, dog and surf sounds were replaced with some decent instruments, such as those on the SK-1, then I wouldn't consider the SK-5 to be so gimmicky.