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Objective:To explore the effect of narrative medicine course on the empathy ability and comprehensive ability training of residents in the standardized residency training in municipal hospitals.Methods:A narrative medicine group was set up in a municipal hospital, and a anarrative medical course of 2 months of narrative theory teaching and 4 months of clinical practice education was carried out among 42 residents. The Chinese version of the Interpersonal Response Index Scale (IRI-C) was used to measure the empathy ability at 4 time points (before intervention, 2 months after theory education, 2 months after practice, and 4 months after practice). The effect of narrative medicine courses was evaluated through the satisfaction questionnaire survey, parallel medical record writing and the first-time pass rate of Medical Practitioner Qualification Examination. SPSS 25.0 was used to analyze the variance of one-way repeated measurement.Results:The empathy ability of 42 residents was significantly improved. The empathy score after 2 months after practice was higher than that before intervention and after the theoretical course ( P < 0.05), while the empathy score after 4 months of practice was higher than that before intervention and after the theoretical course ( P < 0.05). The most popular theoretical teaching forms among residents were interactive theoretical teaching (64.29%, 27/42), video viewing (59.52%, 25/42), and situational simulation (52.38%, 22/42). The comprehensive abilities of parallel medical record writing and podium performance among residents were improved. Passing the Medical Practitioner Qualification Examination is a necessary condition for passing the residency training program. The first-time pass rate of the Qualification Examination for the residents was 72.00% (18/25), which was higher than that of the residents who were not recruited during the same period (64.71%, 11/17). Conclusion:Carrying out narrative medicine education is helpful to improve the empathy ability and comprehensive ability of training residents in municipal hospitals.
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Objective: The study aimed to identify potential components of the collaboration between hospital and community pharmacists from the perspective of pharmacists in municipal hospitals. Methods: Following a preliminary study, an online survey was conducted among pharmacy directors and those on an equivalent managerial level in municipal hospital pharmacies. The survey used a 5-point Likert scale with 32 items about the components of collaboration between hospital and community pharmacists. We performed an exploratory analysis and structural equation modeling of the data. Results: The analysis proposed a five-factor model (“Organizational climate,” “Information sharing system,” “Community support system,” “Interest in healthcare policy,” and “Understanding of healthcare policy”), which consisted of 17 items. Subsequent confirmation with structural equation modeling created a model with good fit (in terms of partial evaluation and overall goodness of fit) with a chi-square of 86.218, P-value of 0.564, goodness of fit index of 0.907, adjusted goodness of fit index of 0.857, and other good model fit indices (comparative fit index of 1.000 and root mean square error of approximation of 0.000). Discussion: This study identified two core universal concepts and three concepts adhering to the current medical context, that seem to guide the behavior of municipal hospital pharmacists─who are major players in community healthcare─in their collaboration with community pharmacists.
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BACKGROUND: As an alternative to acute hospitalisations, all communities in Norway are required to provide inpatient care in municipal acute bed units (MAUs) for patients who can be treated at the primary care level. Patient selection is challenging, and some patients need transfer from MAUs to hospitals. The aim of this study was to examine associations between characteristics of the patient at admission to MAU and further transfer to hospital. METHODS: In a prospective observational study on all admissions to a large MAU, March 2016-August 2017, information was obtained on patient age, gender, comorbidities, drug use, reason for stay and Triage Early Warning Score (TEWS) on admission and at discharge, and length of stay. Comparison between admissions resulting in discharge to hospital, nursing home or own home were performed with chi-square and ANOVA tests. Estimated relative risks (RR) with 95% confidence interval for transfer to hospital versus being retained at primary care level was estimated for age, gender, comorbidity and TEWS in generalized linear models, crude and adjusted. RESULTS: Two thousand seven hundred forty-four admissions were included. Mean age of the patients was 69.5 years (SD 21.9), 65.2% were women. In 646 admissions (23.6%), the patients were transferred to hospital. Male gender and TEWS > 2 were associated with transfer to hospital. Most transfers to hospital occurred within 24 h, and these patients had unchanged or increasing TEWS during their stay at MAU. When transferred to hospital 41.5% of the patients had the same reason for stay as on MAU admission, 14.9% had another reason for stay, 25.2% had a medical condition outside the treatment scope of MAU, and 18.4% needed further diagnostic clarification in hospital. CONCLUSIONS: Likelihood of transfer to hospital increased with male gender and higher TEWS on admission. Main reasons for transfer to hospital were lack of improvement and identification of clinical conditions that needed hospital care. TEWS > 2 at admission should make physicians alert to the need of close monitoring for lack of improvement.
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Hospitals, Municipal/statistics & numerical data , Patient Admission/statistics & numerical data , Patient Transfer/statistics & numerical data , Patients/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Early Warning Score , Female , Humans , Male , Middle Aged , Norway , Prospective Studies , Sex Factors , Triage , Young AdultABSTRACT
OBJECTIVES: The aim of this pilot study was to confirm the safety and feasibility of the induction of robotic-assisted laparoscopic rectal surgery (RRS) at a local municipal hospital. A municipal hospital does not indicate a small hospital. The most significant difference between a municipal hospital and a center or university hospital is that most surgeons in a municipal hospital are general surgeons. METHODS: The first 30 patients who underwent RRS at the municipal hospital were enrolled between April 2015 and June 2016. All surgeries were performed by a single trained surgeon using the da Vinciâ Si surgical system. The primary endpoint was the incidence of postoperative major complications. RESULTS: Of the study patients, 29 had adenocarcinoma and 1 had ulcerative colitis. The surgical procedures included anterior resection (n = 22), intersphincteric resection (n = 2), abdominoperineal resection (n = 4), Hartmann's procedure (n = 1), and total coloproctectomy (n = 1). There were no intraoperative complications and conversion cases. The median operative time and blood loss were 283.5 min and 9 ml, respectively. The incidence rate of postoperative major complications was 10%, which included anastomotic leakage in 2 patients and ileus in 1 patient. Postoperative urinary dysfunction did not occur in any patient. Complete resection was achieved for all patients. CONCLUSIONS: We demonstrated that the induction of RRS was safe and feasible, even at a local municipal hospital, given that the surgeons had the sufficient skills and experience in both laparoscopic and colorectal surgery. *The study protocol was registered at the University Hospital Medical Information Network (UMIN000017022).
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BACKGROUND: Anaemia among pregnant women and post-partum mothers is a public health challenge in Ghana, especially in the Volta Region. While literature abounds on anaemia among pregnant women, the same cannot be said for anaemia among post-partum mothers in the region. This study, therefore, examined the prevalence and associated risk factors of anaemia among women attending antenatal care and post-natal care. METHODS: This descriptive cross-sectional survey recruited 409 pregnant women and 194 post-natal mothers attending antenatal and post-natal care, at the Hohoe Municipal Hospital. Background characteristics were collected using a semi-structured questionnaire, blood samples were analysed for the presence of anaemia and malaria parasitaemia and folders were reviewed for estimated blood loss. RESULTS: We found the prevalence of anaemia among pregnant women and post-partum mothers to be 33 and 16% respectively. Higher malaria parasitaemia (2%) was found in pregnant women compared with postpartum mothers (1%). We found that 4% of post-partum mothers had abnormal blood loss (301mls-500mls) whereas 5% of them had postpartum haemorrhage (>500mls) during child birth. A univariate logistics regression of anaemia status on some risk factors in pregnant women showed no significant association between anaemia and any of the risk factors. Among post-partum mothers, only mothers' age was statistically significant in the univariate analysis [COR = 0.27 (95% CI:0.103, 0.72);0.008]. Mothers aged 20-29 were 73% less likely to be anaemic. CONCLUSION: The prevalence of anaemia among pregnant women found in this study points to a situation of moderate public health problem according to WHO cut-off values for the public health significance of anaemia. Strategies should therefore be put in place to encourage thorough health education and promotion programmes among both pregnant and post-partum women.
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The Department of Urology, Municipal Hospital, Thalkirchnerstr. 48, Munich (1938-1984) is justly reputed as one of the germ-cells of German Urology, not only by Prof. May's protagonism for an independent urology, but also by the multiple, especially technical innovations under the successors, which are fundamentals for the modern urology.
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Anniversaries and Special Events , Urology Department, Hospital/history , Urology/history , History, 20th Century , History, 21st CenturyABSTRACT
In 1913, after the Russian Prostitutes Sanatorium of Harbin Eastern Railway was received by the board of directors, they established the "Harbin City Board Hospital" and funded its expansion. In March 1926, the provisional Committee of the Harbin autonomous renamed the "City Board of First Hospital" to "The Public Hospital" . In November 1926, "The Public Hospital" was renamed as "Harbin Special Municipal Hospital" by the Harbin City Council and further funds were invested in its construction. In 1931, the Japanese invaded Northeast China, and controlled the "City Hospital" . In 1946, when Harbin was liberated, after the Communist's take-over of the Hospital, it developed sustainedly since then. From 1946-1949, The First Hospital of Harbin City dispatched manpower, material resources, and financial resources to support the people's Liberation Army, establishedthe medical service team, received and treated the wounded. From the 1930s, the Hospital was involved in the treatment of cholera, plague, scarlet fever, typhus and other infectious diseases, and participated in the medical rescue in Wenchuan of Sichuan and Xinjiang Aletai area. From 1928, the Hospital took over from Binjiang Hospital as the Teaching Hospital of Harbin Medical School, and later became the Harbin Medical University Teaching Hospital. It made contribution to the training of medical students.
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Hospitals, Urban/history , China , History, 20th Century , Hospitals, Teaching/historyABSTRACT
@#Objective To explore the safety, feasibility and learning curve of video-assisted thoracoscopic surgery(VATS) in treatment of thoracic diseases. Method We retrospectively analyzed the clinical data of 591 patients of thoracic surgery in our hospital between September 2009 and September 2016. There were 378 males and 213 females at age of 14–82 years. Result All patients were successfully completed surgery. Twelve patients converted to open chest with conversion rate of 2.0%. Postoperative complications occurred in 24 patients (4.1%). Four patients died during the perioperative period, and mortality rate was 0.7%. The learning curve of VATS for lung cancer was about 25 patients. And the learning curve of video-assisted laparoscopy for resection of esophageal cancer was about 15 patients. Conclusion VATS is safety and feasible for the chest disease patients in municipal hospital, and is worthy to popularize.
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ObjectiveBy reviewing TCM research projects in Nanjing municipal hospitals from 2006 to 2010 (eleventh five-year plan), this study aimed to recognize the existing problems, put forward corresponding solutions, and help Nanjing municipal hospitals improve scientific research level.Methods Through field investigations and interviews with experts, this study set 139 research projects from 2006 to 2010 in 10 municipal hospitals in Nanjing as study samples. ResultsDuring 2006-2010, current situations in TCM research projects of Nanjing municipal hospitals were as follows:the number of TCM research projects was small, the research level was low, and the fund was little. TCM research resources were unevenly distributed;the overall quality of TCM human resources were not high;talent structure was unreasonable;great differences existed among different types of hospitals.ConclusionsDuring the eleventh five-year plan period, there were significant differences between TCM research projects and WM research projects in Nanjing municipal hospitals, such as the differences in number, level, fund and project channel. The study proposed that TCM research materials should be rationally allocated, related mechanisms should be perfected, the industrial structure should be optimized, and the pace of training and introducing TCM research human resources should be quickened, with a purpose of making contributions to TCM development in Nanjing.
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Objective To evaluate the efficacy of stroke rehabilitation unit in municipal hospitals during the acute phase of cerebral infarction.Methods 77 acute cerebral infarction patients were randomly assigned to stroke rehabilitation unit group and 73 to ordinary group.The NIH stroke scale(NIHSS),activities of daily living(ADL)Barthel index and average hospitalized time were compared in two groups before and after the treatment.Results The average NIHSS in two groups before treatment were 9.26 and 9.12 respectively(P＞0.05)but became 2.62 and 7.64 after treatment(P＜0.01).The average ADL Barthel index in two groups before the treatment were 52.04 and 53.16(P＞0.05)but 87.26 and 64.20 after the treatment(P＜0.01).The average hospitalized time in the two groups were 22.25 and 26.67 days(P＜0.05).Conclusion When stroke rehabilitation unit being applied in the acute phase of cerebral infarction,it showed positive results in the following aspects as:improving the neurological function,capabilities of managing daily life,and also shortening the days of hospitalization.
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KIE: Expanding on a program of neonatal ethics rounds, four hospitals in New York City developed committees in an infant bioethical review program. A core group of experts from each hospital serve on the interlocking committee, while each hospital maintains its own ethics committee with additional members. Two types of cases require mandatory review: those in which it is proposed to withdraw or withhold life-sustaining treatment from a patient who is not imminently dying, and those in which there is disagreement between health care providers and the family concerning treatment. In its first 26 months, the joint committee was consulted in 24 cases. In one case in which parents and physicians agreed to withhold treatment, they changed their minds subsequent to committee involvement. In a second case, Child Protective Services were asked to override parental refusal of treatment. A third case involved a child whose parents insisted on treatment thought to be inappropriate.^ieng
