We investigated the perceived health service quality provided by public and private hospitals in Wuhan City, China. We focused on Tertiary level hospital institutions to provide a glimpse into the current perceived service quality among public and private hospitals. A cross-sectional random study was conducted at both public and private hospitals in Wuhan City, China between January and June 2018. A sample size collected consisted of 428 outpatient respondents. IBM SPSS Statistics 22.0 software was used to enter and analyzed data. Out of the 428 questionnaires collected, 400 was used for the study. 200 from the public hospitals and 200 from the private hospitals. More than half of our respondents were females when compared to the male counterpart. The gynecology department had the largest patient visits while the nephrology department had the lowest in patient visits. Overall perceived service quality was higher in the public hospitals than the private hospitals. China health service transformation is currently on-going, a greater understanding for further research should be conducted on the perceived service quality between public and private hospitals to better understand the existing health service quality and provide practical strategies to enhance the delivery in health service quality across all hospital types.
Competence Training and Incentives Medical Services Support the Achievement of Nurses’ Performances in General Hospital of Prof. W. Z. Johannes Kupang
Background.Nurse gives professional nursing service to patients according to competence owned. Based on these services in the end of every year, nurses are given incentives for medical services as financial incentive. Purpose. To analyze the impact of competence training and incentives medical services’ distribution upon the achievement of nurse’s performances in General Hospital of Prof.W.Z. Johannes Kupang. Matterial and method. Observational survey research with cross sectional design. Population. Nurses in General Hospital of Prof.W. Z. Johannes Kupang. Technique. Total sampling technique with number of samples 183 respondents. Inclusive criteria of samples are willing to be interviewed, nurse’s status, permanent offices without limitation from particular working unit or poly in hospital. Independent variable: (1) competence training; (2) Incentives for medical services. Dependent variable; Nurse’s performance achievement. Variables are measured by using Lickert scale. Information are recorded through questionnaire. Analyzes using linier regression. Result. There are impacts of competence training (α=.000;ß=.489)and distribution of incentives for medical services(α=.012; ß=.152)upon nurse’s performances achievement in General Hospital of Prof.W. Z. Johannes Kupang. Conclusion.The training of nursing service status that could increase competences among nurse with affair incentives for medical services’ distribution simultaneously end up in the increasing of nurse’s performances achievement in a hospital
Extraordinary Rapid Wound Healing Time in Diabetic Patients Treated with Microburst Insulin Infusion
Importance: Non-healing diabetic ulcerations of the foot lead to amputations and premature mortality. Microburst Insulin Infusion has demonstrated an ability to accelerate healing in otherwise non-healing wounds. Objective: To demonstrate the benefit of adding Microburst Insulin Infusion to conventional diabetic wound care to significantly decrease wound healing time. Methods: A case series of five patients received Microburst Insulin Infusion therapy for significant peripheral diabetic ulcerations after failing conventional wound care. These five cases were treated from 4 independent Microburst Insulin Infusion clinics. Four of the wounds exceeded 6 cm². Patient charts were reviewed and relevant data was collected. All individuals in this manuscript have given written informed consent to publish these case details. Setting: Multicenter referral clinics providing Microburst Insulin Infusion Therapy Exposure: Microburst Insulin Infusion is an adjunctive treatment to conventional diabetic therapy performed in an outpatient clinic setting. A weight based oral glucose dose is administered while pulsatile intravenous insulin is delivered by the Bionica Microdose pump. The treatment is comprised of three 1 hour sessions and occurs up to five times a week, when the patient presents with un-healing wounds. Main Outcomes and Measures: Time to wound healing. A secondary outcome was failure of wound healing. Hypothesis for this study was formulated post treatment. Results: A significant decrease in wound healing time was observed when utilizing Microburst Insulin Infusion. The mean time to complete healing was 84.2 days compared to 133 days in published literature(1). The patient with a foot wound measuring an amazing 228.6 cm² healed in 102 days and amputation was not necessary. There were no treatment failures in this small series. As a result of decreased healing time, there was an absence of infection and no amputations were required for these wounds. Conclusion and Relevance: The addition of Microburst Insulin Infusion therapy resulted in…
Heavy Metals and Trace Elements in Blood, Hair and Urine of Nigerian Children with Autistic Spectrum Disorder
Autism spectrum disorders (ASD) are a group of developmental disorders defined by a range of behavioral problems including social withdrawal, communication deficits, and stereotypic/repetitive behavior. Patient observation and clinical history rather than biomarkers as known in laboratory analysis are the defining factors. Pathophysiological etiologies remain controversial, but genetic and environmental factors have been discussed in recent years. International research has focused on neurotoxic metals such as mercury and lead, suggesting that these and other metals contribute to the development of the disorder. Since the Niger-Delta region of Nigeria is widely known for its petroleum industry and pollution, we aimed to evaluate if Nigerian children diagnosed with ASD carry a greater burden of toxic metals compared to healthy Nigerian children living in the same region. While the ASD group shows a higher metal concentration in blood and hair, combined with low blood zinc levels, we also determined an unusual metal burden in the healthy group but no zinc deficiency.
Introduction Population aging is one of the greatest challenges in contemporary public health. Thus, one of the consequences of this dynamic is a greater demand for health services. The aim of the present research consists in explaining the main topics that justify the fact that the increase of population-aging worldwide influences public health strategies applied. Materials and methods To carry out this review article the search strategies included electronic databases, such as PubMed, Cochrane Library and Science Direct, reference lists of articles, and selected textbooks. Articles and textbooks used in this study were mainly reached by using the following keywords: “Public health”; “Population-ageing “; “Global Aging”; “Elderly” and “Health”. Selection criteria included articles published from 1985 to the present year of 2018. At the end of the search, 11 scientific articles were selected. Results and Discussion The physical / biological, psychological and social changes associated with the elderly leads to decrease of health, withdrawal from the labor market and several unfavorable situations, which cannot be controlled. In this context, the elderly seek to find support in the family, neighborhood, friends and institutions that will influence their quality of life. Therefore, the path of Public Health has three essential points: first, health promotion and primary prevention, which requires a lot of health education to develop healthy living habits and improve understanding of the aging process; secondly, appropriate health treatments, including professionals trained in Geriatrics and Gerontology, aiming at early diagnosis and interdisciplinary administration of diseases, seeking to preserve functional capacity; and finally, the rehabilitation of the functions committed, aiming at functional independence and mental autonomy, in any type of incapacity or limitation. Conclusions Aging is a challenge to be integrated by Public Health and the vulnerability inherent in the elderly should never be seen in a unique way. Thus, we believe…
We formulated a deterministic model for simulation of zika virus (ZIKV) infections. This cooperates with WHO serious alert on February 1st, 2016 to contain ZIKV epidemic in the world, Brazil being the most hit. Accordingly, we have taken Brazil records on ZIKV cases as an example to justify the model. According to the model, simulations suggests that by 2020, ZIKV infections is no longer a threat in this country. In our analytic analysis we have included some brief simulations as specific cases. Finally, model simulation is all about Brazil. In this model, besides a disease free equilibrium (DFE) point being globally stable, analysis of local DFE has two sets of eigenvalues, leading two different qualitative behavior. This follows due to variation in some parameters. In each of these two sets, none has backward bifurcation. That is the disease is controllable when R_01 the disease free is unstable. In the analytic analysis of either qualitative behavior, we have associated brief simulation. Only analytic analysis of endemic equilibrium has not been fully developed. We have considered Brazil ZIKV cases from January 2016 onward to verify the model plus having some predictions about ZIKV infections to around 2020. The basic reproduction (R_0) has been estimated as R_0=0.19221.
Introduction: Parkinson’s disease is a neurodegenerative disease characterized clinically by tremor, stiffness, bradykinesia and postural instability. In addition to motor symptoms, some non-motor signals may be observed, such as olfactory dysfunction, sleep disturbance, constipation, depression, irritable bowel syndrome, hearing loss, cataract and others. Some non-motor symptoms may precede the onset of motor symptoms that are characteristic of Parkinson’s disease. Herpes zoster infection as a potential predecessor for the disease was recently reported. Objective: In this study, we do a case report of a patient, attended at the University Hospital of Sergipe (HU), with initial symptoms of herpes zoster infection who developed Parkinson’s disease in a subsequent year. Methodology: A medical record analysis was performed. Information such as age, sex, occupation, residence, previous pathological history and clinical evolution were collected. Results and Discussion: A 70-year-old male patient was admitted to the Neurology outpatient clinic, HU, in 2007. He reported being a former smoker and having cancer in the axillary region in 2003. Physical examination showed bilateral tremor, accentuated in upper left and left cog wheel. The patient was attended until 2015 in the hospital, followed with use of Prolopa, symptomatic treatment and motor physiotherapy. He did not evolve with psychiatric alterations. The symptoms of Parkinson’s disease began approximately one year after herpes zoster infection in the chest region. The following year, patient started a tremor in the fingers of one hand, which evolved throughout the arm, leading the patient to his first medical care in the HU, in 2007. Conclusion: Herpes zoster infection may possibly confer a risk factor for Parkinson’s Disease development.
Introduction: It is important to chart the profile of service users so that actions and resources are planned to ensure effectiveness, and proportionality. The funds will be procured in accordance with hospital demand, with the best of them and loss prevention. And the shares will be effected in a targeted manner to the real needs of users. Objective: To describe the situational diagnosis of a Regional Hospital of Pernambuco. Methodology: Descriptive sectional research, with a quantitative approach performed in the period from january to december, 2016 at the Belarmino Correa Hospital, located in the city of Goiana, Pernambuco. Secondary data were analyzed in the Excel® 2017 program. Results and Discussion: Female users predominated (56%). Prevalent age range of 15 to 59 years (55%). The main place of residence was the home (93%), highlighting the demand of users for the emergency medical clinic (43%). In view of the findings, it can be inferred that the female sex is the majority in the total number of visits, with emphasis on the adult and economically active population, standing out health problems related to clinical demands. It is noteworthy that the users’ preferential entrance door is still the hospital first to the detriment of the family health units, since this is responsible for 80% of the resolution of community health problems it covers. Conclusion: With the study it was possible to identify the difficulties that the institution presents in solving the health problems of the population, evidencing the increase in the demand in the entrance doors mainly of clinical nature and that could be being solved in Primary Care.
Introduction: Epidemiology is the study of factors that determine the frequency and distribution of diseases in human collectivities. Neurodegenerative diseases compose a very heterogeneous group of diseases, caused by distinct mechanisms and characterized by the neuronal degeneration in different regions of the Nervous System. Objective: The objective of this study was to perform a survey on the number of cases of neurodegenerative diseases in the Sergipe University Hospital (HU). Methodology: In this study, an analytic epidemiology study, with a cross-sectional design, we analyzed the epidemiological profile of patients’s medical appointments at HU Neurology Clinic, from January 2003 to January 2016. The research was based on the analysis of patient medical records. These were selected in fixed percentages, per year, at random sampling. Descriptive statistics were performed and the percentage values of the analyzed data were reported. Results and Discussion: A total of 819 medical records were analyzed, of which 166 were cases of neurodegenerative diseases, representing an incidence of 20.2% in the studied episodes. In these cases, 1.2% was patients with Wilson’s Disease, 7.8% with Amyotrophic Lateral Sclerosis, 9% with Alzheimer’s Disease and 82% with Parkinson’s Disease (PD). In this study, it was possible to observe that there is a high percentage of people in the HU with neurodegenerative diseases, mainly PD. In the national literature, no articles were found that presented results of epidemiological studies in PD. It is estimated that this disease affects about 1% of the world’s population over 65 years old, representing up to 2/3 of patients attending major movement disorders centers around the world. Conclusion: The results of this work contribute to the determination of the profile of care in HU, providing greater clarity for the planning and replanning of actions at all levels of health care.
Introduction: South Korean international students are the fourth largest number of international students in Japan. Japan and Korea have similar sexuality-related issues, such as declining birthrates, increasing ages of marriage and childbirth. The purpose of this study is to clarify the feelings of Korean international student couples living in Japan about topics such as marriage, family planning, work-life balance, and sexual concerns in Japan and South Korea. Based on our study, we consider future supports for these students’ sexuality. Materials and Methods: The study targeted four unmarried South Korean couples (eight people) aged 20–35 and conducted a qualitative descriptive study using semi-structured interviews. Results: Participants’ average age was 23.5 years for women and 25.5 years for men. The participants thought about when they want to get married; reasons why they want to get married; anxiety about marriage; hopes to be mother or father, timing of having children; thoughts on child-rearing; and hopes about having children. They considered feelings toward work-life balance and sexual concerns; hopes to continue working after marriage and childbirth; the need for coordination between ideal scenarios and reality; reasons for the declining birth rate and increasing age of marriage; good quality of life; feelings of double-standard about pregnancy as a reason for early marriage; and reasons for their negative feelings. Discussion: This study demonstrated that South Korean international student couples in Japan have hopes for marriage and family planning. However, economic uncertainty is a large obstacle, so they think that it was important to build an economic foundation first. Two-income family is common in South Korea. Participants thought [Hope to continue working], but they consider the [Possibility to stop working for a period after marriage and childbirth]. It was clear that there was a [Feeling of a double-standard about working]. For that reason, role sharing and work-life…