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Journal articles on the topic "Hospital Real de S"
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Williams, Cheyenne, Aditi Rao, Justin B. Ziemba, Jennifer S. Myers, and Neha Patel. "Text Messaging Real-Time COVID-19 Clinical Guidance to Hospital Employees." Applied Clinical Informatics 12, no. 02 (March 2021): 259–65. http://dx.doi.org/10.1055/s-0041-1726117.
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Abstract Background During the initial days of the coronavirus disease 2019 (COVID-19) pandemic, hospital-wide practices rapidly evolved, and hospital employees became a critical population for receiving consistent and timely communication about these changes. Objectives We aimed to rapidly implement enterprise text messaging as a crisis communication intervention to deliver key COVID-related safety and practice information directly to hospital employees. Methods Utilizing a secure text-messaging platform already routinely used in direct patient care, we sent 140-character messages containing targeted pandemic-related updates to on-duty hospital employees three times per week for 13 weeks. This innovation was evaluated through the analysis of aggregate “read” receipts from each message. Effectiveness was assessed by rates of occupational exposures to COVID-19 and by two cross-sectional attitudinal surveys administered to all text-message recipients. Results On average, each enterprise text message was sent to 1,997 on-duty employees. Analysis of “read” receipts revealed that on average, 60% of messages were consistently read within 24 hours of delivery, 34% were read in 2 hours, and 16% were read in 10 minutes. Readership peaked and fell in the first week of messaging but remained consistent throughout the remainder of the intervention. A survey administered after 2 weeks revealed that 163 (79%) users found enterprise texts “valuable,” 152 (73%) users would recommend these texts to their colleagues, and 114 (55%) users preferred texts to email. A second survey at 9 weeks revealed that 109 (80%) users continued to find texts “valuable.” Enterprise messaging, in conjunction with the system's larger communication strategy, was associated with a decrease in median daily occupational exposure events (nine events per day premessaging versus one event per day during messaging). Conclusion Enterprise text messages sent to hospital-employee smartphones are an efficient and effective strategy for urgent communications. Hospitals may wish to leverage this technology during times of routine operations and crisis management.
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Peimann, C. J. "Modeling Hospital Information Systems with Petri Nets." Methods of Information in Medicine 27, no. 01 (January 1988): 17–22. http://dx.doi.org/10.1055/s-0038-1635515.
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SummaryIn the development of hospital information systems it is difficult to describe data and activities simultaneously and equivalently. Most of the methods used so far are only suitable for either data structures or functional modeling. In particular, it is not possible to comprehend the functional interdependence of hospital procedures.In this paper it is shown that Petri Nets are well suited for the development of complex software systems. Their exceptional properties are, on the one hand, the simulative capacities which allow to visualize interlinked and interdependent procedures of the real world. On the other hand, it is pointed out that Petri Nets comply with the demands of software engineering. In order to make these characteristics clear, two models from real developments are used: Firstly the organizational model of a small hospital and secondly the model of the data entry in the follow-up of tumor patients.
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Canfell, Oliver J., Yasaman Meshkat, Zack Kodiyattu, Teyl Engstrom, Wilkin Chan, Jayden Mifsud, Jason D. Pole, Martin Byrne, Ella Van Raders, and Clair Sullivan. "Understanding the Digital Disruption of Health Care: An Ethnographic Study of Real-Time Multidisciplinary Clinical Behavior in a New Digital Hospital." Applied Clinical Informatics 13, no. 05 (October 2022): 1079–91. http://dx.doi.org/10.1055/s-0042-1758482.
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Abstract Background Understanding electronic medical record (EMR) implementation in digital hospitals has focused on retrospective “work as imagined” experiences of multidisciplinary clinicians, rather than “work as done” behaviors. Our research question was “what is the behavior of multidisciplinary clinicians during the transition to a new digital hospital?” Objectives The aim of the study is to: (1) Observe clinical behavior of multidisciplinary clinicians in a new digital hospital using ethnography. (2) Develop a thematic framework of clinical behavior in a new digital hospital. Methods The setting was the go-live of a greenfield 182-bed digital specialist public hospital in Queensland, Australia. Participants were multidisciplinary clinicians (allied health, nursing, medical, and pharmacy). Clinical ethnographic observations were conducted between March and April 2021 (approximately 1 month post-EMR implementation). Observers shadowed clinicians in real-time performing a diverse range of routine clinical activities and recorded any clinical behavior related to interaction with the digital hospital. Data were analyzed in two phases: (1) content analysis using machine learning (Leximancer v4.5); (2) researcher-led interpretation of the text analytics to generate contextual meaning and finalize themes. Results A total of 55 multidisciplinary clinicians (41.8% allied health, 23.6% nursing, 20% medical, 14.6% pharmacy) were observed across 58 hours and 99 individual patient encounters. Five themes were derived: (1) Workflows for clinical documentation; (2) Navigating a digital hospital; (3) Digital efficiencies; (4) Digital challenges; (5) Patient experience. There was no observed harm attributable to the digital transition. Clinicians primarily used blended digital and paper workflows to achieve clinical goals. The EMR was generally used seamlessly. New digital workflows affected clinical productivity and caused frustration. Digitization enabled multitasking, clinical opportunism, and benefits to patient safety; however, clinicians were hesitant to trust digital information. Conclusion This study improves our real-time understanding of the digital disruption of health care and can guide clinicians, managers, and health services toward digital transformation strategies based upon “work as done.”
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Moorman, Liza Prudente. "Principles for Real-World Implementation of Bedside Predictive Analytics Monitoring." Applied Clinical Informatics 12, no. 04 (August 2021): 888–96. http://dx.doi.org/10.1055/s-0041-1735183.
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AbstractA new development in the practice of medicine is Artificial Intelligence-based predictive analytics that forewarn clinicians of future deterioration of their patients. This proactive opportunity, though, is different from the reactive stance that clinicians traditionally take. Implementing these tools requires new ideas about how to educate clinician users to facilitate trust and adoption and to promote sustained use. Our real-world hospital experience implementing a predictive analytics monitoring system that uses electronic health record and continuous monitoring data has taught us principles that we believe to be applicable to the implementation of other such analytics systems within the health care environment. These principles are mentioned below:• To promote trust, the science must be understandable.• To enhance uptake, the workflow should not be impacted greatly.• To maximize buy-in, engagement at all levels is important.• To ensure relevance, the education must be tailored to the clinical role and hospital culture.• To lead to clinical action, the information must integrate into clinical care.• To promote sustainability, there should be periodic support interactions after formal implementation.
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Rajaram, Akshay, Daniel Thomas, Faten Sallam, Amol A. Verma, and Shail Rawal. "Accuracy of the Preferred Language Field in the Electronic Health Records of Two Canadian Hospitals." Applied Clinical Informatics 11, no. 04 (August 2020): 644–49. http://dx.doi.org/10.1055/s-0040-1715896.
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Abstract Background The collection of race, ethnicity, and language (REaL) data from patients is advocated as a first step to identify, monitor, and improve health inequities. As a result, many health care institutions collect patients' preferred languages in their electronic health records (EHRs). These data may be used in clinical care, research, and quality improvement. However, the accuracy of EHR language data are rarely assessed. Objectives This study aimed to audit the accuracy of EHR language data at two academic hospitals in Toronto, Ontario, Canada. Methods The EHR language was compared with a patient's stated preferred language by interview. Language was dichotomized to English or non-English. Agreement between language documented in the EHR and patient-reported preferred language was calculated using sensitivity, specificity, and positive predictive value (PPV). Results A total of 323 patients were interviewed, including 96 with a stated non-English preferred language. The sensitivity of the EHR for English-language preference was high at both hospitals: 100% at hospital A with a PPV of 88%, and 99% at hospital B with a PPV of 85%. However, the sensitivity of the EHR for non-English preference differed greatly between the two hospitals. The sensitivity was 81% with a PPV of 100% at hospital A and the sensitivity was 12% with a PPV of 60% at hospital B. Conclusion The accuracy of the EHR for identifying non-English language preference differed greatly between the hospitals studied. Language data must be accurate for it to be used, and regular quality assurance is required.
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Kim, Sollip, Soo Jin Yoo, and Jeonghyun Chang. "Importance of Susceptibility Rate of ‘the First’ Isolate: Evidence of Real-World Data." Medicina 56, no. 10 (September 28, 2020): 507. http://dx.doi.org/10.3390/medicina56100507.
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Background and objectives: For proper antimicrobial therapy, cumulative antibiograms should be representative of geographic region and be accurate. Clinical and Laboratory Standards Institute (CLSI) guidelines recommend that only the first isolates (FI) of a species per patient are used when reporting cumulative antibiograms. However, >50% of hospitals in the United States report antibiograms of all isolates. We compared antibiograms from the FI with those from total isolates (TI). Materials and Methods: Antimicrobial data of all isolates identified in the Microbiology unit of Ilsan Paik Hospital in 2019 were retrospectively acquired from the hospital information system. The susceptibility rates to antimicrobials of Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecium, and Enterococcus faecalis were analyzed by FI and TI, respectively. Isolate counts and susceptibility rates of each species for the reported antimicrobials were compared. Results: The numbers of isolates by FI/TI were as follows: 1824/2692 E. coli, 480/1611 A. baumannii, and 662/1306 K. pneumoniae, and 407/953 P. aeruginosa for gram-negative bacteria and 649/1364 S. aureus, 211/313 E. faecium, and 323/394 E. faecalis for gram-positive bacteria. All antimicrobial agents showed higher susceptibility rates when calculated as FI than as TI in gram-negative bacteria except colistin: 3.7% for E. coli, 14.5% for A. baumannii, 8.3% for K. pneumoniae, and 7.9% for P. aeruginosa. In S. aureus, 8/11 antimicrobial agents revealed higher susceptibility rates for FI than for TI. E. faecalis and E. faecium showed lower susceptibility rates for 7/10 antimicrobial agents for FI than for TI. The oxacillin susceptibility rates of S. aureus were 36.6%/30.2% with FI/TI and vancomycin susceptibility rates for E. faecium were 54.1% and 49.5%, respectively. Conclusions: When comparing cumulative antibiograms by FI with TI using real-world data, there is a large gap for critical species requiring hospital infection control. Although FI calculation is difficult, antibiograms must be calculated as FI for proper preemptive antimicrobial therapy because FI provides proper antimicrobial susceptibility data.
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Gladkov, N. V., and O. A. Fokht. "Hospital information system and quality control of treatment." Manager Zdravoochranenia, S (December 1, 2022): 50–62. http://dx.doi.org/10.21045/1811-0185-2022-s-50-62.
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The article presents an approach to quality control of treatment at the present stage. A trend of today – the use of a medical information system for quality control of the medical and diagnostic process (with special attention paid not to reporting to higher authorities, but to the organization of internal control in a medical organization). Possible tools and benefits are considered. P u r p o s e . Determining the capabilities of Hospital Information System for quality control of medical care. M a t e r i a l s a n d m e t h o d s . We analyzed the requirements of regulatory acts for the control of medical care, as well as the real needs of HIS users. An experiment on the formation of a set of tools for quality control of treatment was carried out using the example of Hospital Information System Interin PROMIS Alpha. We considered the prospects taking into account the results of the research of Ailamazyan Program Systems Institute of RAS in the field of working with clinical data banks. R e s u l t s . General requirements for internal quality control include 5 levels of control. The use of HIS is most in demand in the following areas: compliance with medical care standards, internal control tools (analysis of compliance with clinical recommendations, expert assessment of the quality of treatment, quality and safety of medical activities, format and logic control, etc.) and ensuring patient safety. The use cases of the HIS in these areas are illustrated by the example of the Hospital Information System Interin PROMIS Alpha. The prospects of the development of the direction consisting in transferring the main load from a person to an HIS and in attracting AI technologies and neural networks are considered. F i n d i n g s . The main problems of quality control are the need for the participation of highly qualified specialists and the high complexity of the process. These problems can be solved by shifting the control regulations from «after the fact» to «proactive» and «in real time» by using HIS, as well as involving knowledge-intensive technologies in this process with the involvement of artificial intelligence and neural networks
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Sherer, David, Chukwuma Onyeije, Peter Bernstein, Peter Kovacs, and Frank Manning. "Utilization of Real-Time Ultrasound on Labor and Delivery in an Active Academic Teaching Hospital." American Journal of Perinatology 16, no. 06 (1999): 303–7. http://dx.doi.org/10.1055/s-2007-993876.
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Ball, M., C. Boyer, P. L. Elkin, K. Ishikawa, C. Jaffe, A. March, H. Marin, et al. "Hospital and Health Information Systems – Current Perspectives." Yearbook of Medical Informatics 20, no. 01 (August 2011): 73–82. http://dx.doi.org/10.1055/s-0038-1638741.
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SummaryTo celebrate over 30 years of health information systems’ (HIS) evolution by bringing together pioneers in the field, members of the next generation of leaders, and government officials from several developing nations in Africa to discuss the past, present, and future of HISs.Participants gathered in Le Franschhoek, South Africa for a 2 ½ day working conference consisting of scientific presentations followed by several concurrent breakout sessions. A small writing group prepared draft statements representing their positions on various topics of discussion which were circulated and revised by the entire group.Many new tools, techniques and technologies were described and discussed in great detail. Interestingly, all of the key themes identified in the first HIS meeting held over 30 years ago are still of vital importance today: Patient Centered design, Clinical User Support, Real-time Education, Human-computer Factors and Measuring Clinical User Performance, Meaningful use.As we continue to work to develop next-generation HISs, we must remember the lessons of the past as we strive to develop the solutions for tomorrow.
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Dreyfus, Jill, Elizabeth Begier, Holly Yu, Alvaro Quintana, Julie Gayle, and Margaret A. Olsen. "1228. Incidence of Staphylococcus aureus Infection after Elective Surgeries Among Adults in US Hospitals." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S372—S373. http://dx.doi.org/10.1093/ofid/ofy210.1061.
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Abstract Background Staphylococcus aureus is a leading cause of postsurgical infections. National estimates of these infections after elective surgeries based on microbiology data are limited. This study assessed 180-day postsurgical S. aureus incidence in real-world hospital settings. Methods Adults (≥18 years) who underwent elective surgery during a hospital-based outpatient or inpatient encounter from July 1, 2010–June 30, 2015 at one of 181 hospitals reporting microbiology results in the Premier Healthcare Database (PHD). Eighty-seven surgical categories were defined using ICD-9-CM and CPT procedure codes according to National Hospital Surveillance Network groupings plus additional categories. Microbiology results and ICD-9-CM diagnosis codes were used to identify invasive (e.g., deep incisional and organ-space SSI, bloodstream) and overall (i.e., invasive, superficial incisional, urinary tract, respiratory) S. aureus infections. Cumulative 180-day S. aureus infection rates were calculated as number of infections divided by number of discharges with elective surgeries. National infection volumes were calculated by multiplying infection rates by national inpatient elective surgery estimates using surgery counts in the entire PHD (665 hospitals) and weights based on hospital characteristics. Results Following 1,116,994 hospital-based outpatient elective surgeries, 180-day S. aureus incidence was 1.19% overall, with 0.38% complicated by invasive S. aureus infections. Among 884,803 inpatient elective surgeries, overall and invasive 180-day S. aureus infection incidence was 1.35% and 0.53%, respectively. This translated to an estimated 57,200 S. aureus infections (22,400 invasive) among an estimated 4.2 million elective inpatient surgeries annually in the US methicillin-resistance (MRSA) was observed in 45% and 46% of S. aureus infections after inpatient and outpatient surgeries, respectively. Figure 1 shows cumulative S. aureus incidence rates at each time point after outpatient and inpatient elective surgeries. Figure 2 delineates the incidence rates for each type of S. aureus infection. Conclusion Our study indicated similar S. aureus infection rates after inpatient and outpatient elective surgeries. The results highlight the much larger burden of disease of S. aureus infection in the United States beyond inpatient surgeries. Disclosures J. Dreyfus, Premier, Inc.: Employee and Shareholder, Salary. E. Begier, Pfizer, Inc.: Employee and Shareholder, Salary. H. Yu, Pfizer, Inc.: Employee and Shareholder, Salary. A. Quintana, Pfizer, Inc.: Employee and Shareholder, Salary. J. Gayle, Premier, Inc.: Employee, Salary. M. A. Olsen, Pfizer: Consultant, Consulting fee.
Dissertations / Theses on the topic "Hospital Real de S"
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Kroth, Leonardo Viliano. "Avalia??o dos 35 anos de transplante renal no Hospital S?o Lucas da PUCRS." Pontif?cia Universidade Cat?lica do Rio Grande do Sul, 2015. http://tede2.pucrs.br/tede2/handle/tede/6070.
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This is a retrospective study reporting 35 years of kidney transplantation at Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. An historical approach of the origins and development of the Nephrology Unit over the years was performed. Data were separated into different eras, based on the type of immunosuppression, and the patient?s characteristics before, during and after transplantation were assessed. There were significant differences between each era, mainly on the characteristics of the recipients and donors, but also in the rates of complications and technical aspects of surgery. A total of 1231 transplants were performed until 2013, April 30. Of these, 55.8% were male, white (86.9%) and 76.6% from deceased donors. Most recipients aged between 19 and 59 years (77.5%), and 1.9% over 70 years. Significant differences were observed between the characteristics of each era, especially in relation to recipients and donors. Through the eras, an increased number of patients are being transplanted, with grafts from older donors (p<0.001) subjected to longer cold ischemia times (p<0.001) transplanted in an increasing proportion of elderly recipients (p<0.001), maintained in a longer period on the waiting list (p<0.001). Fewer episodes of rejection were observed (p<0.001), lower incidence of some clinical complications such as myocardial infarction (p<0.001), strokes (p=0.02) and post-??transplant diabetes (p<0.001), along of the time. In the present era, survival of patients at 1, 3 and 5 years were 98.3%, 94.6% and 90.5% for living donors and 92.4%, 87.2% and 80.7% for deceased donors, respectively. Survival of grafts were, for living donors, 92.2%, 88.7% and 82.4% and deceased donors 80.4%, 71.1% and 63.7%. Transplants with acute pyelonephritis in the first 30 days after transplantation, had significantly worse graft and patients survivals, compared to patients without pyelonephritis in the first 30 days. In addition, age, use of ureteral stents, thymoglobulin induction and longer hospital stays increased the risk of this infection. Recipients of expanded criteria donors transplants induced with thymoglobulin may be at a 25.75 fold increase in risk for death 24 hours after diagnosis of CRAB septicemia, a severe complication occurring in 10 recipients between January 2000 and April 2013, of 807 transplants patients. In recent years, our study showed a low incidence of cytomegalovirus (CMV) infection, despite the increased use of Thymoglobulin. We found that the use of low thymoglobulin doses reduces the risk of cytomegalovirus and, the use of oral ganciclovir had a protective effect on CMV, in the first year of transplantation. Finally, patients with a positive polyomavirus urinary cytology had worse renal function and graft survival in a seven years follow-??up period, compared with the patients without the presence of decoy cells in urine. The analysis of the 35 years of transplantation at the Renal Unit of Hospital S?o Lucas da PUCRS depicts the evolution and development of a program that is a reference in South Brazil, and the different management and results through the different eras. There were changes in donor and recipient?s characteristics, inclusion selection, compatibility assessment and immunosuppression protocols, among others.
Este trabalho consiste em um estudo retrospectivo que abordou a hist?ria dos 35 anos de transplantes renais no Hospital S?o Lucas da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Foi realizado um levantamento da hist?ria das origens do servi?o de nefrologia e sua evolu??o ao longo dos anos. Os dados foram separados em diferentes eras, com base no tipo de imunossupress?o, sendo avaliadas as caracter?sticas dos pacientes antes, durante e ap?s o transplante. Encontramos diferen?as significativas entre cada era, principalmente nas caracter?sticas dos receptores e doadores, mas tamb?m na ocorr?ncia de complica??es e nos aspectos cir?rgicos. Foram realizados 1231 transplantes at? 30 de abril de 2013, sendo 55,8% do sexo masculino, ra?a branca (86,9%) e com 76,6% de doadores falecidos. A maioria dos receptores com idade entre 19 e 59 anos (77,5%), sendo 1,9% acima de 70 anos. Diferen?as significativas entre as caracter?sticas de cada era, principalmente em rela??o aos receptores e doadores. Estamos transplantando um n?mero progressivamente maior de pacientes, significativamente mais idosos (p<0,001), com maior tempo em lista de espera (p<0,001), com doadores mais idosos (p<0,001) e tempos mais longos de isquemia (p<0,001). Foram verificados menos epis?dios de rejei??o (p<0,001), menor ocorr?ncia de algumas complica??es cl?nicas, tais como infarto de mioc?rdio (p<0,001), AVE (p=0,02) e diabete p?s transplante (p<0,001), ao longo do tempo. Na era atual, sobrevida de pacientes foram em 1, 3 e 5 anos de 98,3%, 94,6% e 90,5% para doadores vivos e de 92,4%, 87,2% e 80,7% para doadores falecidos, respectivamente. Sobrevida de enxertos foram para doadores vivos de 92,2%, 88,7% e 82,4% e doadores falecidos de 80,4%, 71,1% e 63,7%. Foi encontrado que transplantados que apresentaram pielonefrite aguda nos primeiros 30 dias ap?s o transplante, apresentavam significativamente pior sobrevida de enxertos e pacientes, comparado com os que n?o apresentavam pielonefrite nos primeiros 30 dias. Al?m disto, idade, uso de cateteres de duplo J, indu??o com timoglobulina e tempo maior de hospitaliza??o aumentam o risco desta infec??o. Pacientes que receberam rins com doadores com crit?rios expandidos e induzidos com timoglobulina podem apresentar risco maior para morte ap?s 24 horas do diagn?stico de septicemia por Acinetobacter baumannii resistentes a carbapen?micos, complica??o grave que ocorreu em 10 pacientes transplantados, dentre os 807 transplantados entre janeiro de 2000 e abril de 2013. Ocorreu baixa incid?ncia de citomegalov?rus nos ?ltimos anos, apesar do aumento do uso de timoglobulina. Verificamos que o uso de timoglobulina em doses menores diminui o risco de citomegalov?rus e que o uso de ganciclovir oral tem efeito protetor para o desenvolvimento de citomegalov?rus no primeiro ano do transplante. E por fim, verificamos que pacientes que apresentavam presen?a de citologia urin?ria positiva para poliomav?rus apresentaram pior fun??o renal e pior sobrevida de enxerto, em acompanhamento de 7 anos, comparado com grupo de pacientes que n?o tinha presen?a de c?lulas decoy na urina. A an?lise de 35 anos de transplante do Servi?o de Nefrologia da PUCRS, mostra a evolu??o de um programa de refer?ncia no nosso meio e as diferentes condutas e resultados nas diversas ?pocas. Ocorreram mudan?as nas caracter?sticas dos doadores e receptores, crit?rios de sele??o, avalia??o de compatibilidade e protocolos de imunossupress?o, entre outros.
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Higgins, Maddie Joyce. "The Development of a Real-Time Quantitative Polymerase Chain Reaction Method for the Diagnosis of Staphylococcus Aureus in Intravascular Catheter Colonisation." Thesis, Griffith University, 2017. http://hdl.handle.net/10072/367624.
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Staphylococcus aureus (S. aureus) catheter-related bloodstream infection (CRBSI) remains a leading cause of nosocomial (hospital acquired) infection worldwide. Early detection of S. aureus as a causative organism and appropriate antibiotic therapy is crucial in reducing patient morbidity and mortality rates. Current diagnosis of S. aureus intravascular catheter (IVC) colonisation relies on the use of conventional culture-dependent methods. However, many fastidious bacteria are difficult to be recovered in current laboratory conditions. Furthermore, a definitive diagnosis following a positive culture may take up to seven days and is therefore not useful in directing early antibiotic therapy in patients with CRBSI. A real-time polymerase chain reaction (PCR) assay, using primers specific to the thermonuclease (nuc) gene, targeting the S. aureus genome has the potential to address these limitations.Thesis (Masters)
Master of Science (MSc)
School of Natural Sciences
Science, Environment, Engineering and Technology
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Berdichevski, Eduardo Herz. "Preval?ncia de pielonefrite aguda e incid?ncia de cicatriz renal em crian?as menores de dois anos de idade com infec??o do trato urin?rio avaliadas atrav?s da cintilografia renal com 99mTcDMSA : a experi?ncia de hospital universit?rio." Pontif?cia Universidade Cat?lica do Rio Grande do Sul, 2013. http://tede2.pucrs.br/tede2/handle/tede/1418.
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Previous issue date: 2013-03-04OBJECTIVE: To calculate the frequencies of acute pyelonephritis and renal scarring in youngers than two years old through scintigraphy with 99mTcDMSA with first episode of UTI in a Brazilian university hospital and comparing with international literature. MATERIALS AND METHODS: We reviewed reports scintigraphy of youngers than two years old who underwent scintigraphy with 99mTcDMSA in a university hospital in Rio Grande do Sul, between 2006 and 2009 to search for APN and renal scarring. It was also revised the presence of vesicoureteral reflux, early use of antibiotics, and comorbidities that were recorded in e lectronic records. The sample size calculation was based on a systematic review study and obtained a minimum of 147 patients. We excluded patients with no electronic record. RESULTS: 157 children met the inclusion criteria, where 48 had APN and 8 of these had renal scars. There was no statistical difference in the association of VUR and APN (p=1.0) as well as among all comorbidities (p=0.470). There was no significance relation to early use of antibiotics and APN (p=0.130) and renal scarring (p=0.720). CONCLUSION: The frequency of renal scarring and APN obtained agree with the results of most studies.
OBJETIVO: Calcular as frequ?ncias de pielonefrite aguda (PNA) e cicatriz renal em pacientes menores de dois anos com cintilografia renal com 99mTcDMSA com primeiro quadro de ITU em hospital universit?rio brasileiro comparando com dados da literatura internacional. MATERIAIS E M?TODOS: Foram revisados laudos cintilogr?ficos de crian?as menores de dois anos de idade que realizaram cintilografia renal com 99mTcDMSA em um hospital universit?rio de no Rio Grande do Sul, entre 2006 e 2009 para pesquisa de PNA/cicatriz renal. Revisouse a presen?a de refluxo v?sicoureteral (RVU), uso precoce de antibi?tico, e presen?a de comorbidades que constassem nos prontu?rios eletr?nicos. Calculouse a amostra baseado num estudo de revis?o sistem?tica e obtevese um m?nimo de 147 pacientes. Excluiu-se pacientes sem registro eletr?nico. RESULTADOS: 157 crian?as preencheram crit?rios de inclus?o do estudo, 48 tiveram PNA e 8 destes apresentaram cicatriz renal. Nem a idade e g?nero dos pacientes apresentaram associa??o significativa com PNA (p=0,405; p=0,124 respectivamente). N?o houve diferen?a estat?stica nas associa??es de RVU e PNA (p=1,0) e outras comorbidades (p=0,470); e em rela??o ao uso precoce de antibi?tico com PNA (p=0,130) e cicatriz renal (p=0,720). CONCLUS?O: As frequ?ncias de PNA e cicatriz renal obtidas concordam com os resultados da maioria dos estudos publicados
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Dantas, Etienne Andrade de Medeiros. "A Rela??o entre a sa?de organizacional e a S?ndrome de Burnout." Universidade Federal do Rio Grande do Norte, 2003. http://repositorio.ufrn.br:8080/jspui/handle/123456789/17443.
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Previous issue date: 2003-11-26Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior
We studied about the organizational health and the syndrome of burnout in professionals of the education and health field, with the objective of establishing a connection between those two constructs. This research was realized in three public schools and in three hospitals, two publics and one from the military. We obtained 168 valid questionnaires for investigation about the syndrome of burnout, being 83 in the hospitals and 85 in the schools, among the questionnaires given in those two organizations. Worked with accidental sample, although it was decided the professional proportions, with the objective of reproducing the population characteristics. In the schools the sample was planned with the teachers. In the hospitals the sample was planned with doctors, nurses and nurse assistants, nutritionists, psychologists, dentists and social assistants. To assure the syndrome of burnout, it was used the Maslach Burnout Inventory (MBI), followed with social demographic information. We used semi-structured interviews, based in the indicators, with the organizations key persons, directors, coordinators, and people involved in the human resources department, for research about the organizational health. Only among the hospitals were found significant statistics differences between the scores of factors and the incidence of burnout. Besides that, it was observed as well that it is possible to establish a connection between the organizational health and the syndrome of burnout, this research main objective
Estudamos sobre a sa?de organizacional e a s?ndrome de burnout em profissionais de educa??o e sa?de, objetivando estabelecer uma rela??o entre esses dois construtos te?ricos. A pesquisa foi realizada em tr?s escolas p?blicas de ensino m?dio e em tr?s hospitais, dois p?blicos e um hospital militar. Dos question?rios aplicados nos dois tipos de organiza??es, obtivemos 168 question?rios v?lidos para investiga??o da incid?ncia da s?ndrome de burnout, sendo que 83 nos hospitais e 85 nas escolas. Trabalhamos com amostras acidentais, embora tenha sido planejada a propor??o de profissionais, visando reproduzir as caracter?sticas da popula??o. Nas escolas as amostras foram planejadas com professores. Nos hospitais, com m?dicos, enfermeiros, auxiliares de enfermagem, nutricionistas, psic?logos, odont?logos e assistentes sociais. Para aferi??o da s?ndrome de burnout, utilizamos o Invent?rio de Burnout de Maslach (MBI), acrescido de uma ficha sociodemogr?fica. Para an?lise de sa?de organizacional, utilizamos entrevistas semi-estruturadas com pessoas-chave das organiza??es, diretores, coordenadores pedag?gicos e pessoas envolvidas com o setor de recursos humanos, utilizando um roteiro baseado nos indicadores. Somente entre os hospitais encontramos diferen?as estatisticamente significavas em rela??o aos escores dos fatores e a incid?ncia de burnout. Al?m disso, observamos tamb?m que ? vi?vel estabelecer a rela??o entre a sa?de organizacional e a s?ndrome de burnout, principal objetivo da pesquisa
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Pippal, René. "Rizika spojená s obchodem s nemovitostmi." Master's thesis, Vysoké učení technické v Brně. Ústav soudního inženýrství, 2013. http://www.nusl.cz/ntk/nusl-232724.
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This thesis is focused on the risks arising from the data recorded in the cadastre of real estate and legislation related to the cadastre. Introductory chapters are devoted to the definition of risk for the purposes of this work and of basic terms in response to the changes brought by the new Civil Code. A brief historical overview coupled to the cadastre and description of the basic principles of the cadastre is complemented by context resulting from the integration with information systems of public administration. The merit of the work is dedicated to risks arising from the principles of the cadastre, historical circumstances, the importance and obligatory force of the registered data and their accuracy. Among the major factors influencing the risks associated with trade in real estate can be classified in particular, the evidence of ownership of itself and fulfilling the principle of publicity material, the question of the acreage recorded in cadastre, providing access to the property or existence of the simplified register. The work is enriched by concrete examples from practice that show errors and possible solutions.
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Halamíček, Jan. "Real-time počítačová hra s prvky UI." Master's thesis, Vysoké učení technické v Brně. Fakulta informačních technologií, 2009. http://www.nusl.cz/ntk/nusl-236655.
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This work deals with an artificial intelligence problematics in real-time computer games. Goal of this project is a creation of an intelligent computer opponent in a real-time enviroment of a multiagent systems.
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Messingher, Lang Gabriel. "Relating hospital acoustics to staff outcomes in real and simulated settings." Thesis, Georgia Institute of Technology, 2013. http://hdl.handle.net/1853/52922.
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The sound environment in hospitals is complex. While there have been several studies that address the acoustic environment in hospitals, there is a limited amount of research done concerning the effect that noise has on staff. This thesis describes two related studies: 1) analysis of the relationships between acoustics and perceptual staff outcomes using an existing data set collected in real hospitals; 2) development of methodologies to test the relationships between acoustics and hospital staff task performance in a simulated laboratory setting.
In the first study it was found that mental health and perception of noisiness were occupational factors that were related to the sound environment using a variety of acoustic metrics. Only a few acoustic metrics were shown to be statistically significant related to dependent variables in a direct correlation (e.g., as the acoustic conditions worsened the dependent variable also decreased). However, almost all acoustic metrics tested had a statistically significant relationship with mental health once subjective job strain was considered as a moderating factor. This means that while the direct impact of sound may not be immediately observable, sound may play a more significant role once subjective job strain is taken into account.
In the second study, a new methodology was developed to directly relate staff task performance to noise and beta-tested on a single group of subjects. The methodology development included synthesizing a signal that was acoustically comparable to those heard in real hospitals in order to simulate a realistic noise exposure in a controlled environment. Additionally, objective methods of measuring performance and perception were devised by utilizing task performance scripts already validated in other studies and developing new surveys that could be administered to subjects to garner their perceived task performance and perceptions of the simulation room environment, including noise.
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Coronas, Tejada Luis. "El Hospital real de Nuestra Señora de la Misericordia de Loja /." Granada : Universidad de Granada, 1990. http://catalogue.bnf.fr/ark:/12148/cb355354345.
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Křenek, Tomáš. "Audio a video vysílání s využitím real-time protokolu." Master's thesis, Vysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií, 2009. http://www.nusl.cz/ntk/nusl-218188.
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This diploma thesis focus on transmiting multimedia over computer network. There are detailed informations about protocols RTP and RTPC in a first part because a transmition over a network is realized by using these protocols. Some basic multimedia terms, FFmpeg codecs and SDL library are described in next chapters. A multimedia player using FFmpeg and SDL is implemented in a second part of thesis. The player is console application and it has basic user interface. The player reproduces video and audio from a given file. RTP communication is described in next chapters of the second part. RTP server and client are implemented there too. They are console aplications and they use data coded by Theora or Vorbis. There are summarized results in a conclusion.
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Oliveira, Maria Helena da Rocha. "A Confraria de S. Crispim e S. Crispiniano e o seu Hospital na Idade Média." Master's thesis, Porto : [Edição do Autor], 2001. http://hdl.handle.net/10216/13041.
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A presente dissertação pretende contribuir para o conhecimento da história da vida corporativa e assistencial na cidade do Porto através da Confraria dos Sapateiros nos sécs. XIV e XV. Limita-se a uma abordagem sobre as origens das confrarias e como se desenvolveram em Portuga. A Confraria dos Sapateiros aparece-nos com uma relevante vertente assistencial através do seu hospital aos peregrinos de S. Tiago. Na assistência prestada transparece toda a esfera religiosa que envolvia o homem medieval e o medo perante a morte, o que leva a praticar todo o bem que lhe possa sufragar a alma. De salientar a organização, o brio e o bom desempenho na administração do Hospital pelos confrades sapateiros, cativando a simpatia real, levando ao embargue da ordem régia da anexação à Misericórdia.
Books on the topic "Hospital Real de S"
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Lubelza, Concepción Félez. El Hospital Real. Granada: Universidad de Granada, 1990.
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Garzon, Juan María Garzon. El Real Hospital de Madrigal. Avila]: Institución "Gran Duque de Alba" de la Excma. Diputación Provincial de Avila, 1985.
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Rosa, Sánchez Dehesa-García Ma. El Hospital Real de Santa Fé. [Granada]: Diputación Provincial de Granada, 1985.
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United States. Dept. of Veterans Affairs, ed. William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin. [Washington, D.C.?]: Dept. of Veterans Affairs, 1989.
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A, Goremykin V. Sdelki s nedvizhimostʹi︠u︡: Prakticheskoe posobie. 2nd ed. Moskva: Filin, 2007.
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1948-, Tolkachev Oleg Mikhaĭlovich, and Damurchiev V. N, eds. Tekhnologii͡a︡ raboty s nedvizhimostʹi͡u︡. Moskva: Gorodskai͡a︡ sobstvennostʹ, 1999.
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Gubin, Dmitriĭ. Realʹnyĭ Peterburg: O gorode s tochki zrenii͡a︡ nedvizhimosti i o nedvizhimosti s tochki zrenii͡a︡ istorii. Sankt-Peterburg: Limbus Press, 1999.
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United States. Army. Corps of Engineers, ed. Real estate: Challenges for the 90's. [Fort Belvoir, Va.?]: US Army Corps of Engineers, 1990.
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Balabanov, I. T. Operat͡s︡ii s nedvizhimostʹi͡u︡ v Rossii. Moskva: "Finansy i statistika", 1996.
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Crouch, Holmes Forester. Selling your home(s). 3rd ed. Saratoga, CA: Allyear Tax Guides, 2004.
Find full textBook chapters on the topic "Hospital Real de S"
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Washington, Mary Ford. "Wildwood Animal Hospital." In Real Life Math Mysteries, 6. New York: Routledge, 2021. http://dx.doi.org/10.4324/9781003237631-4.
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Bradley, Robert E., and C. Edward Sandifer. "On real functions." In Cauchy¿s Cours d¿analyse, 17–20. New York, NY: Springer New York, 2009. http://dx.doi.org/10.1007/978-1-4419-0549-9_1.
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Staiger, Roger. "Accounting statement(s)." In Foundations of Real Estate Financial Modelling, 391–431. Second Edition. | New York : Routledge, 2018. | Revised edition of the author’s Foundations of real estate financial modelling, 2015.: Routledge, 2018. http://dx.doi.org/10.1201/9781315171524-12.
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Staiger, Roger. "Accounting Statement(s)." In Foundations of Real Estate Financial Modelling, 429–60. 3rd ed. New York: Routledge, 2023. http://dx.doi.org/10.1201/9781003378808-16.
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Jason, Christopher, and Himati P. Patel. "Common Career Pitfalls: Real-World Guidance of Common Mistakes to Avoid that May Impact a Hospitalist’s Ability to Be Successful." In Hospital Medicine, 35–44. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-49092-2_4.
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Tsumoto, Yuko, and Shusaku Tsumoto. "Mining Hospital Management Data using R." In Chance Discoveries in Real World Decision Making, 393–404. Berlin, Heidelberg: Springer Berlin Heidelberg, 2006. http://dx.doi.org/10.1007/978-3-540-34353-0_23.
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Ma, Huei-Ning Natasha, Martha Evens, David A. Trace, and Frank Naeymi-Rad. "An interactive system for generating hospital progress notes." In Computing in the 90's, 378–84. New York, NY: Springer New York, 1991. http://dx.doi.org/10.1007/bfb0038518.
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Albert, Tim. "So what′s your real problem?" In Write effectively, 7–12. London: CRC Press, 2021. http://dx.doi.org/10.1201/9780429183874-3.
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Kerner, Boris S. "Understanding Empirical Nuclei for Traffic Breakdown (F$$\rightarrow $$S Transition) at Bottleneck." In Understanding Real Traffic, 119–33. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-79602-0_9.
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Maria, Koutraki, Efthymiou Vasilis, and Antoniou Grigoris. "S-CRETA: Smart Classroom Real-Time Assistance." In Ambient Intelligence - Software and Applications, 67–74. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-28783-1_9.
Full textConference papers on the topic "Hospital Real de S"
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Nitika, Mittal, Kumar Ajit, Kothari G. Harit, Babu Pydikilli Kiran, and Das Kunal. "Real-World Incidence of Post-ERCP Pancreatitis (PEP) from a North Indian Tertiary Care Hospital." In ENDOCON 2024. Thieme Medical and Scientific Publishers Pvt. Ltd., 2024. http://dx.doi.org/10.1055/s-0044-1786329.
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Nakka, Thejeswar, Prasanth Ganesan, Luxitaa Goenka, Biswajit Dubashi, Smita Kayal, Latha Chaturvedula, Dasari Papa, Prasanth Penumadu, Narendran Krishnamoorthy, and Divya B. Thumaty. "Epithelial Ovarian Cancer: Real-World Outcomes." In Annual Conference of Indian Society of Medical and Paediatric Oncology (ISMPO). Thieme Medical and Scientific Publishers Pvt. Ltd., 2021. http://dx.doi.org/10.1055/s-0041-1735369.
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Abstract Introduction Ovarian cancer is the third most common cancer and the second most common cause of death among gynecological cancers in Indian women. Ovarian cancer is heterogeneous, among them, epithelial ovarian cancer (EOC) is the most common. Primary cytoreductive surgery along with six to eight cycles of a combination of platinum and taxanes chemotherapy is the cornerstone of first-line treatment in EOC. This study was done to find clinicopathological factors affecting survival outcomes with first-line therapy in EOC in a real-world setting. Objectives This study was aimed to find factors affecting progression-free survival (PFS) and overall survival (OS) with first-line treatment in EOC. Materials and Methods We conducted a single-center retrospective study. We screened all the patients diagnosed with ovarian cancer from January 2015 till December 2019. We locked data in August 2019. Eligible patients were histologically confirmed EOC who underwent primary cytoreduction or received more than or equal to two cycles of chemotherapy or both. Patients who had received first-line treatment at another hospital were excluded. Results Patients demographics and clinical characteristics: between January 5, 2015 to August 31, 2019, 435 patients with a diagnosis of ovarian malignancy were registered at our center. Among them, 406 (82%) had EOC, 290 (64%) newly diagnosed, and fulfilling eligibility criteria were included in the final analysis. The median age of the cohort was 53 years (range: 21–89 years) and 157 patients (54%) were >50 years of age (the Eastern Oncology Cooperative Group Performance status was ≥ 2 in 124 patients [43%]; median duration of symptoms was 3 months; and stage III/IV: 240 [83%]). Grading of the tumor was available in 240 patients of which 219 (91%) were of high grade. Subtyping was available in 272 patients (94%) of which the serous subtype was the most common constituting 228 patients (79%).Treatment Most patients received chemotherapy (n = 283 [98%]) as the first modality of treatment (neoadjuvant/adjuvant and palliative). As neoadjuvant (NACT) in 130 patients (45%) and as adjuvant following surgery in 81 patients (29%). The most common chemotherapy regimen was a combination of carboplatin and paclitaxel in 256 patients (88%). Among 290 patients 218 (75%) underwent cytoreductive surgery. Among them, optimal cytoreduction was achieved in 108 patients (52%). Optimal cytoreduction rate (OCR) with upfront surgery and after NACT was 44 and 53%, respectively (Chi-square test: 0.86; p = 0.35).Survival The median follow-up of the study was 17 months (range: 10–28 months) and it was 20 months (range: 12–35 months) for patients who were alive. At last, follow-up, 149 patients (51%) had progressed and 109 (38%) died. The estimated median PFS and OS were 19 months (95% CI: 16.1–21.0) and 39 months (95% CI: 29.0–48.8), respectively. On multivariate analysis, primary surgery (HR: 0.1, 95% CI: 0.06–0.21; p-value: <0.001) and early-stage disease (HR: 0.2, 95% CI: 0.1–0.6; p-value 0.04) were associated with superior PFS and primary surgery (HR: 0.1, 95% CI: 0.09–0.2; p-value: <0.001) was associated with superior OS. Conclusion Primary surgery (upfront or interval) was associated with improved survival. Newer agents like bevacizumab, poly-ADP (adenosine diphosphate)-ribose polymerase inhibitors and HIPEC should be incorporated precisely into first line of therapy to improve outcomes.
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Busch, F., D. Quast, C. Torres Reyes, C. Zeidler, P. Ewald, W. Schmidt, and O. Cahyadi. "Underwater Endoscopic Mucosal Resection (UEMR) is effective and safe in real-life day-to-day clinical practice in a large German university hospital." In ESGE Days 2024. Georg Thieme Verlag KG, 2024. http://dx.doi.org/10.1055/s-0044-1783912.
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Stoicescu, Ramona, Razvan-Alexandru Stoicescu, Codrin Gheorghe, Adina Honcea, and Iulian Bratu. "CONSIDERATIONS ON SARS-COV-2 DIAGNOSIS IN THE LABORATORY OF UNIVERSITY EMERGENCY CLINICAL HOSPITAL OF CONSTANTA." In GEOLINKS Conference Proceedings. Saima Consult Ltd, 2021. http://dx.doi.org/10.32008/geolinks2021/b1/v3/07.
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Coronaviruses are members of the Coronaviridae family. They are enveloped, non-segmented, positive-sense, single-stranded RNA viruses. Their genome size is about 30 kilobases (kb) which consist, at the 5’ end, of non-structural open reading frames (ORFs: ORF1a, ORF 1b) which code for 16 non structural proteins, and at the 3’ end the genes which code for four structural proteins including membrane (M), envelope (E), spike (S), and nucleocapsid (N) proteins. Due to the rapid spread of COVID-19, a reliable detection method is needed for patient diagnosis especially in the early stages of the disease. WHO has recommended nucleic acid amplification tests such as real-time reverse transcription-polymerase chain reaction (RT-PCR). The assay detects three SARS-CoV-2 RNA targets: the envelope (E) gene, the nucleocapsid (N) gene and a region of the open reading frame (ORF1) of the RNA-dependent RNA polymerase (RdRp) gene from SARS-CoV-2 virus isolate Wuhan-Hu-1. Our study was made in the first 3 months of the year 2021 using the real-time RT PCR results obtained in the Cellular Biology ward of the University Emergency Clinical Hospital. In our lab we are testing the inpatients from the hospital wards (Neurology, Pediatrics, Surgery, Internal medicine, ICU, Cardiology, etc.); we are also testing the outpatients from Dialysis and Oncology, 2 days prior to their therapy; we also test the health care personnel. The number of tests we performed was: in January 1456, with 399 positive results (27.4%), 33 deaths; in February 1273 tests, 221 positive (17.36%), 16 deaths; in March 1471 tests, 373 positive (25.36%), 37 deceased.
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Fumai, N., C. Collet, M. Petroni, K. Roger, E. Saab, A. S. Malowany, F. A. Carnevale, and R. D. Gottesman. "Database Considerations for an ICU Patient Data Management System." In ASME 1991 International Computers in Engineering Conference and Exposition. American Society of Mechanical Engineers, 1991. http://dx.doi.org/10.1115/cie1991-0174.
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Abstract A Patient Data Management System (PDMS) is being developed for use in the Intensive Care Unit (ICU) of the Montreal Children’s Hospital. The PDMS acquires real-time patient data from a network of physiological bedside monitors and facilitates the review and interpretation of this data by presenting it as graphical trends, charts and plots on a color video display. Due to the large amounts of data involved, the data storage and data management processes are an important task of the PDMS. The data management structure must integrate varied data types and provide database support for different applications, while preserving the real-time acquisition of network data. This paper outlines a new data management structure which is based primarily on OS/2’s Extended Edition relational database. The relational database design is expected to solve the query shortcomings of the previous data management structure, as well as offer support for security and concurrency. The discussion will also highlight future advantages available from a network implementation.
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Monreal, M., E. Lafoz, M. Foz, and J. Monasterio. "ASPIRIN AND THE KIDNEY IN PATIENTS WITH CEREBRAL ISCHEMIA." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644827.
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The acceptance of aspirin therapy for prevention of cerebral ischemia is based onpositive results of several large clinicaltrials, and the usual dose is 1000-1500 mg/day. Several recent reports emphasize the adverse effects of aspirin and other nonsteroidal anti-inflamatory agents on renal function. We examined wether two extreme doses of aspirin (60 mg vs 1200 mg/day) could alter renal function in patients recently admitted to hospital with cerebral ischemia. We studied 33 patients with cerebralischemia and no history of ingestion of aspirin nor other drugs two weeks prior to admission. During the first 5 days all patients received a 50 mEq sodium diet and no drugs, while during the second 5 days (trial) the patients were randomly assigned (double blind) to placebo, aspirin 20 mg or aspirin 400 mg, 3 times daily, with meals.Overall, body weight increased by 650 gin patients taking 1400 mg/day of aspirin (p≺0,01), but not in patients taking 60 mg/day. Also increases in systolic and diastolic blood pressure did not reach significant differences. While waiting morereports, aspirin at doses near 1000 mg should be administered cautiously in sodium restricted patients with cerebral ischemia.Acute water retention may be specially troublesome.
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Townsend, Dedra, and AmirHossein MajidiRad. "Trust in Human-Robot Interaction Within Healthcare Services: A Review Study." In ASME 2022 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2022. http://dx.doi.org/10.1115/detc2022-89607.
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Abstract There has always been a dilemma of the extent to which human can rely on machines in different activities of daily living. Ranging from riding on a self-driving car to having an iRobot vacuum clean the living room. However, when it comes to healthcare settings where robots are intended to work next to human, making decision gets difficult because repercussions may jeopardize people’s life. That has led scientists and engineers to take one step back and think out of the box. Having concept of trust under scrutiny, this study helps deciphering complex human-robot interaction (HRI) attributes. Screening essential constituents of what shapes the trust in human mind as s/he is working with a robot will provide a more in-depth insight through how to build and consolidate the trust. In physiotherapeutic realm, this feeds into improving safety protocols and level of comfort; as well as increasing the efficacy of robot-assisted physical therapy and rehabilitation. This paper provides a comprehensive framework for measuring trust through introducing several scenarios that are prevalent in rehabilitation environment. This proposed framework highlights importance of clear communication between physicians and how they expect robot to intervene in a human centered task. In addition, it reflects on patients’ perception of robot assistance. Ultimately, recommendations are made in order to maximize trust earned from the patients which then feeds into enhancing efficacy of the therapy. This is an ongoing study; authors are working with a local hospital to implement the know in a real-world application.
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Giri, Shveta, Swati Shah, Rupinder Sekhon, and Sudhir Rawal. "Clinical outcomes of cytoreductive surgery and HIPEC in advanced and recurrent epithelial ovarian cancers with peritoneal carcinomatosis." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685311.
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Introduction: The role of surgery for Peritoneal carcinomatosis (PC) has slowly evolved from palliation to potential curative intent. Attempting to remove all visible tumor deposits, “surgical cytoreduction” (CRS) was reported in 1930s for ovarian cancer and eventually became an accepted therapy with proven survival benefit. The new approach of combining CRS and Hyperthermic intraperitoneal chemotherapy (HIPEC) to treat peritoneal metastasis offer hope for long term survival in this group of patients. The risk and benefit of this approach continued to be debated. A prospective study was conducted to understand the perioperative outcomes of CRS & HIPEC. Aim: To evaluate the perioperative outcomes associated with CRS & HIPEC in Advanced and Recurrent Epithelial Ovarian Cancer with PC. Methods: Prospective analysis of patients undergoing CRS & HIPEC from November 2014 to July 2015 was done. Inclusion criteria included localized disease in peritoneal cavity, no distant metastasis and PS <2. Grade 3/4 complications from day of surgery until 30 days postoperatively were recorded. Results: We performed CRS & HIPEC in 20 patients from Nov 2014 to June 2015. HIPEC Plus regimens included Cisplatin (50 mg/m2) and Lipodox (15 mg/m2) intraperitoneally and Ifosphamide (1300 mg/m2) & Mesna (260 mg/m2) Infusion time was 90 minutes with a temperature range of 41-43 °C. Out of 20 patients 6 (30%) underwent primary debulking surgery and 14(70%) underwent secondary debulking surgery. PCI score ranged from 2-26 (mean 13.65). Mean operating time was 6.42 hrs and average blood loss was 1046 ml. Average hospital stay was 8 days and SICU stay was 4.9 days (range 3-14 days). Total 26 adverse events were observed of which grade 1 were 11 (42%), grade 2 were 8 (30%), grade were 3 (11.5%) and grade4 were 2 (8%). Most common complication was hematological (8) followed by respiratory (6), sepsis (4) renal (2), GI (2). 4 patients (5 events) developed grade3 or 4 complications in the form of septicaemia, pulmonary embolism, GI fistula of which 2 patients expited and remaining recovered although required prolonged hospitalization. Increased morbidity were observed in cases with symptomatic relapse, higher PCI score and CA 125 level higher than 250 U/ml. Most of the adverse events were grade 1 and 2 and were managed by observation only or GCSF support, transfusions and other minor interventions. The combined grade 3-4 morbidity was 20% (4out of 20) which consisted of neutropenia, infection and respiratory complications. One patient required relaparotomy and two patients expired attributed to pulmonary embolism and septicaemia respectively. Conclusion: Enthusiasm associated with improvement in survival is often dampened by increased perioperative mortality and morbidity figures and therefore CRS & HIPEC has not yet been considered standard of care by many centres. HIPEC after extensive cytoreductive surgery for ovarian cancer is a procedure whth acceptable morbidity that patients can tolerate. More follow up is needed to determinr the effect of HIPEC on survival. Till such time more data are obtained by way of larger randomised trials, this approach remains investigational.
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Giri, Shveta, Swati Shah, Rupinder Sekhon, and Sudhir Rawal. "Clinical outcomes of cytoreductive surgery and HIPEC in advanced and recurrent epithelial ovarian cancers with peritoneal carcinomatosis." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685300.
Full textAbstract:
Introduction: The role of surgery for peritoneal carcinomatosis (PC) has slowly evolved from palliation to potential curative intent. Attempting to remove all visible tumor deposits, “surgical cytoreduction” (CRS) was reported in 1930s for ovarian cancer and eventually became an accepted therapy with proven survival benefit. The new approach of combining CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) to treat peritoneal metastasis offer hope for long term survival in this group of patients. The risk and benefit of this approach continued to be debated. A prospective study was conducted to understand the perioperative outcomes of CRS and HIPEC. Aim: To evaluate the perioperative outcomes associated with CRS and HIPEC in Advanced and Recurrent Epithelial Ovarian Cancer with PC. Method: Prospective analysis of patients undergoing CRS and HIPEC from November 2014 to July 2015 was done. Inclusion criteria included localized disease in peritoneal cavity, no distant metastasis and PS <2. Grade 3/4 complications from day of surgery until 30 days postoperatively were recorded. Results: We performed CRS and HIPEC in 20 patients from November 2014 to June 2015. HIPEC Plus regimens included Cisplatin (50 mg/m2) and Lipodox (15 mg/m2) intraperitoneally and Ifosphamide (1300 mg/m2) and Mesna (260 mg/m2). Infusion time was 90 minutes with a temperature range of 41-43°C. Out of 20 patients 6 (30%) underwent primary debulking surgery and 14 (70%) underwent secondary debulking surgery. PCI score ranged from 2-26 (mean 13.65). Mean operating time was 6.42 hrs and average blood loss was 1046 ml. Average hospital stay was 8 days and SICU stay was 4.9 days (range 3-14 days). Total 26 adverse events were observed of which grade 1 were 11 (42%), grade 2 were 8 (30%), grade were 3 (11.5%) and grade 4 were 2 (8%). Most common complication was hematological (8) followed by respiratory (6), sepsis (4) renal (2), GI (2). 4 patients (5 events) developed grade 3 or 4 complications in the form of septicaemia, pulmonary embolism, GI fistula of which 2 patients expited and remaining recovered although required prolonged hospitalization. Increased morbidity were observed in cases with symptomatic relapse, higher PCI score and CA 125 level higher than 250 U/ml. Most of the adverse events were grade 1 and 2 and were managed by observation only or GCSF support, transfusions and other minor interventions. The combined grade 3-4 morbidity was 20% (4 out of 20) which consisted of neutropenia, infection and respiratory complications. One patient required relaparotomy and two patients expired attributed to pulmonary embolism and septicaemia respectively. Conclusion: Enthusiasm associated with improvement in survival is often dampened by increased perioperative mortality and morbidity figures and therefore CRS and HIPEC has not yet been considered standard of care by many centres. HIPEC after extensive cytoreductive surgery for ovarian cancer is a procedure whth acceptable morbidity that patients can tolerate. More follow up is needed to determinr the effect of HIPEC on survival. Till such time more data are obtained by way of larger randomised trials, this approach remains investigational.
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Stout, W. A., and B. Tawney. "An Excel forecasting model to aid in decision making that affects hospital resource/bed utilization - hospital capability to admit emergency room patients." In s and Information Engineering Design Symposium. IEEE, 2005. http://dx.doi.org/10.1109/sieds.2005.193261.
Full textReports on the topic "Hospital Real de S"
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Secrest, T. J., R. F. Szydlowski, and D. Wade. Polish-American Children`s Hospital in Krakow, Poland. Project status report. Office of Scientific and Technical Information (OSTI), March 1993. http://dx.doi.org/10.2172/10137171.
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Rodrigues do Nascimento Junior, Edmilson. Interoperability between public blockchains and the digital real (Brazil´s CBDC). ResearchHub Technologies, Inc., June 2023. http://dx.doi.org/10.55277/researchhub.tvhs7h13.
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Allegretto, Sylvia A., and Dave Graham-Squire. Monopsony in Professional Labor Markets: Hospital System Concentration and Nurse Wages. Institute for New Economic Thinking Working Paper Series, January 2023. http://dx.doi.org/10.36687/inetwp197.
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Rolling waves of consolidation have significantly decreased the number of hospital systems in the U.S. potentially affecting industry quality, prices, efficiency, wages and more. This research concerns the growth in hospital system consolidation in local labor markets and its effect on registered nurse wages. We first use a nonparametric preprocessing data step via matching methods to define MSA-specific samples of workers analogous to nurses outside of the hospital sector. This step enables an accounting of heterogeneous MSA-specific baseline wage growth, and yields a standardized measure of nurse wage growth across MSAs used to set up a multi-site quasi-experiment. We then run a parsimonious linear model; market size matters, for every 0.1 increase in consolidation in smaller-MSAs, real hourly nurse wage growth decreased by $0.70 (p-value of 0.038). Though not the primary aim of this study, a secondary finding is that real hourly wages for nurses grew less than that of comparable workers by $4.08.
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Anastasiou, C. Real radiation at NNLO: e+e- --> 2 jets Through O(a{sub s}{sup 2}). Office of Scientific and Technical Information (OSTI), February 2004. http://dx.doi.org/10.2172/826788.
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Fu, Yuqi, Shuo Liu, Weijie Chen, Guohui Ruan, and Li Liu. Assessing the impact of ventilation on the potential airborne infection risk in hospital lung function room. Department of the Built Environment, 2023. http://dx.doi.org/10.54337/aau541663876.
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Controlling the spread of respiratory infectious diseases in healthcare settings is important to avoid nosocomial infection. We utilized computational fluid dynamics (CFD) simulation, real-time carbon dioxide (CO2) monitoring, microorganism culturing, and microorganism sequencing to quantitatively assess the exposure risk of healthcare workers to infectious respiratory particles (IRPs) in one lung function room under two ventilation configurations. The original ventilation system supplied 2 air changes per hour (ACH) for fresh air and 2 ACH for recirculated air, while the retrofitted ventilation system supplied 6 ACH of fresh air. Indoor CO2 concentration and microorganism concentration decreased after the retrofit. The ventilation modification significantly improved the discharge efficiency for 5 μm IRPs and 50 μm IRPs. The intake fraction of 5 μm aerosols and 50 μm aerosols for HCW decreased by 0.005% and 0.006%, respectively. This study also reviewed the effectiveness of the above methods when evaluating building retrofit.
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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, July 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.
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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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Sweet, William, Michael Gagliardi, Mark Klein, Reed Little, and Roger V. Scoy. Recommendations from the AIA/SEI Workshop on Research Advances Required for Real-Time Software Systems in the 1990's held at Pittsburgh, Pennsylvania on 13-14 September 1989. Fort Belvoir, VA: Defense Technical Information Center, December 1989. http://dx.doi.org/10.21236/ada275239.
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Chang, S., C. Coriano, and J. K. Elwood. Transverse spin dependent Drell Yan in QCD to O({alpha}{sub s}{sup 2}) at large p{sub {Tau}}. 1: Virtual corrections and methods for the real emissions. Office of Scientific and Technical Information (OSTI), October 1997. http://dx.doi.org/10.2172/541934.
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Rosen, Michael, C. Matthew Stewart, Hadi Kharrazi, Ritu Sharma, Montrell Vass, Allen Zhang, and Eric B. Bass. Potential Harms Resulting From Patient-Clinician Real-Time Clinical Encounters Using Video-based Telehealth: A Rapid Evidence Review. Agency for Healthcare Research and Quality (AHRQ), September 2023. http://dx.doi.org/10.23970/ahrqepc_mhs4telehealth.
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Objectives. To review the evidence on harms associated with patient-clinician real time encounters using video-based telehealth and determine the effectiveness of any related patient safety practices (PSPs). PSPs are interventions, strategies, or approaches intended to prevent or mitigate unintended consequences of healthcare delivery and improve patient safety. This review provides information that clinicians and health system leaders need to determine how to minimize harms from increasing real-time use of telehealth. Methods. We followed rapid review processes of the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. We searched PubMed, EMBASE, and Cochrane to identify eligible studies published from 2012 to 2022, supplemented by a search for unpublished evaluations and white papers. Outcomes of interest included: adverse events (any harm to patients due to medical care), other specified harms (i.e., preventable hospitalizations, inappropriate treatment, missed or delayed diagnoses, duplication of services, privacy breaches), and implementation factors for any PSPs. Findings. Our search retrieved 7,155 citations, of which 23 studies (including 6 randomized controlled trials [RCTs]) were eligible for review. Fourteen studies reported on adverse events or unintended effects of telehealth; these studies were conducted in diverse settings, with four studies in behavioral health, two each in rehabilitation, transplant, and Parkinson’s care, and one each in postoperative, termination of pregnancy, community health, and hospital-at-home settings. Adverse events such as death, reoperation, infection, or major complications were infrequent in both telehealth and usual care groups, making it difficult to find statistically significant differences. One RCT found telehealth resulted in fewer medication errors than standard care. Thirteen studies examined preventable hospitalizations or emergency department (ED) visits and reported mixed findings; six of these studies were in postoperative care and two were in urological care. Of the 6 RCTs, 3 showed no difference in risk of hospitalization or ED visits for telehealth compared to usual care, and 3 showed reduced risk for patients receiving telehealth. We found no studies on the effectiveness of PSPs in reducing harms associated with real-time telehealth. Conclusions. Studies have evaluated the frequency and severity of harms associated with real-time video-based telehealth encounters between clinicians and patients, examining a variety of patient safety measures. Telehealth was not inferior to usual care in terms of hospitalizations or ED visits. No studies evaluated a specific PSP. More research is needed to improve understanding of harms associated with real-time use of telehealth and how to prevent or mitigate those harms.
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Pajo, Bianka, Peter J. Becker, Philippe L. Bourdeau, and Marika Santagata. Data Interpretation of Automated Plate Load Test (APLT) for Real-Time In Situ Determination of Unbound Layer Resilient Modulus. Purdue University, 2023. http://dx.doi.org/10.5703/1288284317653.
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This project examined the results of an extensive program of (1) cyclic plate loading tests carried out at Purdue University’s S-BRITE site on two testing strips comprised of a coarse aggregate (Indiana #53) subbase layer compacted over either untreated or cement-stabilized subgrade, and (2) static loading tests conducted on #53 aggregate compacted in a 3.6-foot-deep testing pit. The testing program on the two strips included multistage resilient modulus (MR) tests and extended cyclic performance tests with random distributed loading (RDL) on both the subbase and the underlying subgrade. Two of the RDL tests were performed at locations where a nonwoven geotextile had been placed between subgrade and subbase. The work was aimed at improving the understanding of the behavior of subbase and subgrade materials under cyclic loading, mitigating ambiguities regarding the performance of subbase and subgrade materials, and exploring the use of automated plate load tests for determining such properties, ultimately advancing the state of pavement design practice at INDOT.