Base de dados : MEDLINE
Pesquisa : N02.278.421.510.100 [Categoria DeCS]
Referências encontradas : 1107 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 111 ir para página                         

  1 / 1107 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29391113
[Au] Autor:Losh JM; Gough A; Rutherford R; Romero J; Diaz G; Schweitzer J
[Ad] Endereço:Ventura County Medical Center, Ventura, California, USA.
[Ti] Título:Surgical Site Infection Reduction Bundle: Implementation and Challenges at Ventura County Medical Center.
[So] Source:Am Surg;83(10):1147-1151, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Surgical Site Infections (SSIs) are a significant cause of morbidity and increased cost in the postoperative patient occurring in 2-5 per cent of those undergoing inpatient surgery. Ventura County Medical Center (VCMC) initiated an SSI reduction bundle in 2013, to try to reduce the incidence of SSI. The bundle is a series of best practices including preoperative, perioperative, intraoperative, and postoperative components, as well as items focused on the staff and electronic medical record. VCMC started with a 6.1 per cent SSI rate in 2013. A consistent reduction in SSI rate followed each quarter after that for a rate of less than 2.0 per cent in early 2016. The most critical aspect of this process was the necessary collaboration between disparate departments and the ongoing investment of the staff to this challenging process; the people at the heart of the collaborative process were the key to its success.
[Mh] Termos MeSH primário: Pacotes de Assistência ao Paciente
Assistência Perioperatória/métodos
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: California
Seguimentos
Hospitais de Condado
Seres Humanos
Assistência Perioperatória/normas
Guias de Prática Clínica como Assunto
Infecção da Ferida Cirúrgica/epidemiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


  2 / 1107 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29391102
[Au] Autor:Pillado E; Korn A; de Virgilio C; Bowens N
[Ad] Endereço:David Geffen School of Medicine at UCLA Dean's Leadership in Health and Science Scholarship, Torrance, California, USA.
[Ti] Título:The Burden of Tunneled Central Venous Catheters for Hemodialysis in a County Hospital.
[So] Source:Am Surg;83(10):1095-1098, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Prolonged use of central venous catheters (CVCs) for hemodialysis (HD) is associated with greater morbidity and mortality when compared with autogenous arteriovenous fistulas (AVF). The objective was to assess compliance with CVC guidelines in adults referred for hemoaccess at a county teaching hospital. Out of 256 patients, 172 (67.2%) were male, with a mean age of 50.0 ± 12.4 years. Overall 62.5 per cent initiated dialysis via CVC. Patients were divided into two groups (those with CVC (62.5%) and those without (37.5%)). Male gender was associated with initiation of dialysis via CVC versus no CVC (72.5 vs 58.3%, P = 0.02), as was a history of prior vascular access (P < 0.01). There were no significant differences between the groups regarding age, diabetes, smoking, ambulatory status, or insurance status. There were no differences in gender, age, insurance status, or prior vascular access between prolonged CVC use (≥90 days) and short-term CVC use (<90 days). We conclude that most patients initiated HD with CVC and exceed the recommended CVC duration. Men are more likely to initiate HD via CVC. Insurance status was not associated with CVC use. Multidisciplinary action may address barriers to reducing CVC duration.
[Mh] Termos MeSH primário: Cateteres Venosos Centrais/utilização
Fidelidade a Diretrizes/estatística & dados numéricos
Hospitais de Condado/estatística & dados numéricos
Diálise Renal/instrumentação
[Mh] Termos MeSH secundário: Adulto
Idoso
California
Cateteres Venosos Centrais/efeitos adversos
Cateteres Venosos Centrais/normas
Cateteres Venosos Centrais/estatística & dados numéricos
Feminino
Seguimentos
Hospitais de Condado/normas
Seres Humanos
Masculino
Meia-Idade
Guias de Prática Clínica como Assunto
Diálise Renal/normas
Diálise Renal/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


  3 / 1107 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29391088
[Au] Autor:Spence LH; Schwartz S; Kaji AH; Plurad D; Kim D
[Ad] Endereço:Department of Surgery, Harbor UCLA Medical Center, Torrance, California, USA.
[Ti] Título:Concurrent Biliary Disease Increases the Risk for Conversion and Bile Duct Injury in Laparoscopic Cholecystectomy: A Retrospective Analysis at a County Teaching Hospital.
[So] Source:Am Surg;83(10):1024-1028, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Biliary tract disease remains a common indication for operative intervention. The incidence of concurrent biliary tract disease (>2 biliary tract disease processes) is unknown and the impact of more than one biliary tract diagnosis on outcomes remains to be defined. The objective of this study was to determine the effect of concurrent biliary tract disease on conversion rate and outcomes after laparoscopic cholecystectomy. A 5-year retrospective analysis of all patients who underwent a laparoscopic cholecystectomy was performed comparing those with a single biliary diagnosis to patients with concurrent biliary tract disease. Variables analyzed were conversion to open cholecystectomy, incidence of bile duct injury, use of endoscopic retrograde cholangiopancreatography and/or intraoperative cholangiogram, length of surgery, and duration of hospitalization. The incidence of concurrent biliary tract disease was 9 per cent and a conversion to open cholecystectomy was performed in 16 per cent of patients. After adjusting for confounding factors, concurrent biliary tract disease was predictive of conversion (odds ratio 1.6, 95% confidence interval 1.1-2.3, P = 0.03) and bile duct injury (odds ratio 2.5, 95% confidence interval 0.8-5, P = 0.01). Concurrent biliary tract disease patients were more likely to undergo intraoperative cholangiogram or endoscopic retrograde cholangiopancreatography, as well as longer operation and length of stay.
[Mh] Termos MeSH primário: Ductos Biliares/lesões
Doenças Biliares/cirurgia
Colecistectomia Laparoscópica/efeitos adversos
Conversão para Cirurgia Aberta/estatística & dados numéricos
Complicações Intraoperatórias/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Ductos Biliares/cirurgia
Feminino
Hospitais de Condado
Hospitais de Ensino
Seres Humanos
Incidência
Complicações Intraoperatórias/epidemiologia
Modelos Logísticos
Masculino
Meia-Idade
Razão de Chances
Estudos Retrospectivos
Fatores de Risco
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


  4 / 1107 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29190816
[Au] Autor:Yao D; Xi X; Huang Y; Hu H; Hu Y; Wang Y; Yao W
[Ad] Endereço:State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China.
[Ti] Título:A national survey of clinical pharmacy services in county hospitals in China.
[So] Source:PLoS One;12(11):e0188354, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Clinical pharmacy is not only a medical science but also an elaborate public health care system firmly related to its subsystems of education, training, qualification authentication, scientific research, management, and human resources. China is a developing country with a tremendous need for improvements in the public health system, including the clinical pharmacy service system. OBJECTIVES: The aim of this research was to evaluate the infrastructure and personnel qualities of clinical pharmacy services in China. SETTING: Public county hospitals in China. MATERIALS AND METHOD: A national survey of clinical pharmacists in county hospitals was conducted. It was sampled through a stratified sampling strategy. Responses were analyzed using descriptive and inferential statistics. The main outcome measures include the coverage of clinical pharmacy services, the overall staffing of clinical pharmacists, the software and hardware of clinical pharmacy services, the charge mode of clinical pharmacy services, and the educational background, professional training acquisition, practical experience, and entry path of clinical pharmacists. RESULTS: The overall coverage of clinical pharmacy services on both the department scale (median = 18.25%) and the patient scale (median = 15.38%) does not meet the 100% coverage that is required by the government. In 57.73% of the sample hospitals, the staffing does not meet the requirement, and the size of the clinical pharmacist group is smaller in larger hospitals. In addition, 23.4% of the sample hospitals do not have management rules for the clinical pharmacists, and 43.1% do not have rational drug use software, both of which are required by the government. In terms of fees, 89.9% of the sample hospitals do not charge for the services. With regard to education, 8.5% of respondents are with unqualified degree, and among respondents with qualified degree, 37.31% are unqualified in the major; 43% of respondents lack the clinical pharmacist training required by the government. Most respondents (93.5%) have a primary or medium professional title. The median age and work seniority of respondents are 31 and four years, respectively. Only 18.5% of respondents chose this occupation by personal consideration or willingness. CONCLUSIONS: The main findings in this research include the overall low coverage of clinical pharmacy services, the low rate of clinical pharmacy service software, hardware, and personnel as well as a wide variance in educational training of pharmacists at county hospitals.
[Mh] Termos MeSH primário: Hospitais de Condado/organização & administração
Serviço de Farmácia Hospitalar/organização & administração
[Mh] Termos MeSH secundário: China
Hospitais de Condado/estatística & dados numéricos
Admissão e Escalonamento de Pessoal
Serviço de Farmácia Hospitalar/estatística & dados numéricos
Software
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188354


  5 / 1107 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28771558
[Au] Autor:Barasa EW; Manyara AM; Molyneux S; Tsofa B
[Ad] Endereço:KEMRI Centre for Geographic Medicine Research-Coast, and Wellcome Trust Research Programme, Nairobi, Kenya.
[Ti] Título:Recentralization within decentralization: County hospital autonomy under devolution in Kenya.
[So] Source:PLoS One;12(8):e0182440, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. METHODS: We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. FINDINGS: Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. CONCLUSION: Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions.
[Mh] Termos MeSH primário: Assistência à Saúde/organização & administração
Hospitais de Condado/organização & administração
Política
Administração da Prática Médica
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Administração Hospitalar
Seres Humanos
Lactente
Quênia
Governo Local
Masculino
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182440


  6 / 1107 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28665490
[Au] Autor:Wei X; Yin J; Walley JD; Zhang Z; Hicks JP; Zhou Y; Sun Q; Zeng J; Lin M
[Ad] Endereço:Division of Clinical Public Health, and Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
[Ti] Título:Impact of China's essential medicines scheme and zero-mark-up policy on antibiotic prescriptions in county hospitals: a mixed methods study.
[So] Source:Trop Med Int Health;22(9):1166-1174, 2017 Sep.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the impact of the national essential medicines scheme and zero-mark-up policy on antibiotic prescribing behaviour. METHODS: In rural Guangxi, a natural experiment compared one county hospital which implemented the policy with a comparison hospital which did not. All outpatient and inpatient records in 2011 and 2014 were extracted from the two hospitals. Primary outcome indicator was antibiotic prescribing rate (APR) among children aged 2-14 presenting in outpatients with a primary diagnosis of upper respiratory tract infection (URTI). We organised independent physician reviews to determine inappropriate prescribing for inpatients. Difference-in-difference analyses based on multivariate regressions were used to compare APR over time after adjusting potential confounders. We conducted 12 in-depth interviews with paediatricians, hospital directors and health officials. RESULTS: A total of 8219 and 4142 outpatient prescriptions of childhood URTIs were included in the intervention and comparison hospitals, respectively. In 2011, APR was 30% in the intervention and 88% in the comparison hospital. In 2014, the intervention hospital significantly reduced outpatient APR by 21% (95% CI:-23%, -18%), intravenous infusion by 58% (95% CI: -64%, -52%) and prescription cost by 31 USD (95% CI: -35, -28), compared with the controls. We collected 251 inpatient records, but did not find reductions in inappropriate antibiotic use. Interviews revealed that the intervention hospital implemented a thorough antibiotics stewardship programme containing training, peer review of prescriptions and restrictions for overprescribing. CONCLUSION: The national essential medicines scheme and zero-mark-up policy, when implemented with an antimicrobial stewardship programme, may be associated with reductions in outpatient antibiotic prescribing and intravenous infusions.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Prescrições de Medicamentos/economia
Medicamentos Essenciais/uso terapêutico
Custos de Cuidados de Saúde
Prescrição Inadequada/economia
Políticas
Infecções Respiratórias/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Antibacterianos/economia
Criança
Pré-Escolar
China
Medicamentos Essenciais/economia
Feminino
Pessoal de Saúde
Hospitais de Condado
Seres Humanos
Masculino
Pediatria
Infecções Respiratórias/economia
População Rural
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Drugs, Essential)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12922


  7 / 1107 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28362869
[Au] Autor:Masha SC; Wahome E; Vaneechoutte M; Cools P; Crucitti T; Sanders EJ
[Ad] Endereço:Centre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya.
[Ti] Título:High prevalence of curable sexually transmitted infections among pregnant women in a rural county hospital in Kilifi, Kenya.
[So] Source:PLoS One;12(3):e0175166, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Women attending antenatal care (ANC) in resource-limited countries are frequently screened for syphilis and HIV, but rarely for other sexually transmitted infections (STIs). We assessed the prevalence of curable STIs, defined as infection with either Chlamydia trachomatis or Neisseria gonorrhoeae or Trichomonas vaginalis, from July to September 2015. METHODS: In a cross-sectional study, women attending ANC at the Kilifi County Hospital, Kenya, had a urine sample tested for C. trachomatis/N. gonorrhoeae by GeneXpert® and a vaginal swab for T. vaginalis by culture. Bacterial vaginosis (BV) was defined as a Nugent score of 7-10 of the Gram stain of a vaginal smear in combination with self-reported vaginal discharge. Genital ulcers were observed during collection of vaginal swabs. All women responded to questions on socio-demographics and sexual health and clinical symptoms of STIs. Predictors for curable STIs were assessed in multivariable logistic regression. RESULTS: A total of 42/202 (20.8%, 95% confidence interval (CI):15.4-27.0) women had a curable STI. The prevalence was 14.9% for C. trachomatis (95% CI:10.2-20.5), 1.0% for N. gonorrhoeae (95% CI: 0.1-3.5), 7.4% for T. vaginalis (95% CI:4.2-12.0), 19.3% for BV (95% CI: 14.1-25.4) and 2.5% for genital ulcers (95% CI: 0.8-5.7). Predictors for infection with curable STIs included women with a genital ulcer (adjusted odds ratio (AOR) = 35.0, 95% CI: 2.7-461.6) compared to women without a genital ulcer, women who used water for cleaning after visiting the toilet compared to those who used toilet paper or other solid means (AOR = 4.1, 95% CI:1.5-11.3), women who reported having sexual debut ≤ 17 years compared to women having sexual debut ≥18 years (AOR = 2.7, 95% CI:1.1-6.6), and BV-positive women (AOR = 2.7, 95% CI:1.1-6.6) compared to BV-negative women. CONCLUSION: One in five women attending ANC had a curable STI. These infections were associated with genital ulcers, hygiene practices, early sexual debut and bacterial vaginosis.
[Mh] Termos MeSH primário: Doenças Sexualmente Transmissíveis/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Infecções por Chlamydia/epidemiologia
Estudos Transversais
Feminino
Gonorreia/epidemiologia
Hospitais de Condado/estatística & dados numéricos
Seres Humanos
Quênia/epidemiologia
Meia-Idade
Gravidez
Prevalência
Tricomoníase/epidemiologia
Vaginose Bacteriana/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170401
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175166


  8 / 1107 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28336675
[Au] Autor:Jin H; Parker WT; Law NW; Clarke CL; Gisseman JD; Pflugfelder SC; Wang L; Al-Mohtaseb ZN
[Ad] Endereço:Department of Ophthalmology, School of Medicine, Baylor College of Medicine, Houston, Texas, USA.
[Ti] Título:Evolving risk factors and antibiotic sensitivity patterns for microbial keratitis at a large county hospital.
[So] Source:Br J Ophthalmol;101(11):1483-1487, 2017 Nov.
[Is] ISSN:1468-2079
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:To identify the risk factors, causative organisms, antimicrobial susceptibility and outcomes of microbial keratitis in a large county hospital in Houston, Texas. Case series. METHODS: Setting: A large county hospital in Houston, Texas. STUDY POPULATION: Patients with known diagnosis of microbial keratitis from January 2011 to May 2015. OBSERVATION PROCEDURE: Retrospective chart review. MAIN OUTCOMES: Epidemiology, risk factors, outcomes and antibiotic susceptibility of microbial keratitis. RESULTS: The most commonly identified risk factors were contact lens use (34.4%), ocular trauma (26.3%), diabetes mellitus (16.7%), ocular surgery (13.5%), ocular surface diseases (11.5%), previous keratitis (10.4%), glaucoma (6.3%), cocaine use (5.2%) and HIV-positive status (4.2%). Eyes with positive cultures (61.5%) were associated with worse visual outcomes (p=0.019) and a higher number of follow-up visits (p=0.007) than eyes with negative cultures (38.5%). Corneal perforation was the most common complication (11.5%). Gram-negative organisms (21.9%) were all susceptible to ceftazidime, tobramycin and fluoroquinolones. Gram-positive organisms (33.3%) had worse outcomes than Gram-negative organisms (21.9%) and exhibited a wide spectrum of antibiotic resistance, but all were susceptible to vancomycin. Twenty-seven per cent of the coagulase-negative were resistant to fluoroquinolones. CONCLUSION: This study identified a recent shift in risk factors and antibiotic resistance patterns in microbial keratitis at a County Hospital in Houston, Texas. In our patient population, fluoroquinolone monotherapy is not recommended for severe corneal ulcers. On the basis of these results, vancomycin and tobramycin should be used for empirical therapy until microbial identity and sensitivity results are available.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Farmacorresistência Bacteriana
Infecções Oculares Bacterianas/tratamento farmacológico
Hospitais de Condado/estatística & dados numéricos
Hospitais com Alto Volume de Atendimentos
Ceratite/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Infecções Oculares Bacterianas/epidemiologia
Infecções Oculares Bacterianas/microbiologia
Feminino
Seguimentos
Seres Humanos
Incidência
Ceratite/epidemiologia
Ceratite/microbiologia
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Prognóstico
Estudos Retrospectivos
Fatores de Risco
Texas/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1136/bjophthalmol-2016-310026


  9 / 1107 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27679522
[Au] Autor:Barasa EW; Cleary S; Molyneux S; English M
[Ad] Endereço:KEMRI Centre for Geographic Medicine Research - Coast, and Wellcome Trust Research Programme, Nairobi, Kenya.
[Ti] Título:Setting healthcare priorities: a description and evaluation of the budgeting and planning process in county hospitals in Kenya.
[So] Source:Health Policy Plan;32(3):329-337, 2017 Apr 01.
[Is] ISSN:1460-2237
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes. The budgeting and planning process in the case study hospitals was characterized by lack of alignment, inadequate role clarity and the use of informal priority-setting criteria. With regard to consequentialist conditions, the hospitals incorporated economic criteria by considering the affordability of alternatives, but rarely considered the equity of allocative decisions. In the first hospital, stakeholders were aware of - and somewhat satisfied with - the budgeting and planning process, while in the second hospital they were not. Decision making in both hospitals did not result in reallocation of resources. With regard to proceduralist conditions, the budgeting and planning process in the first hospital was more inclusive and transparent, with the stakeholders more empowered compared to the second hospital. In both hospitals, decisions were not based on evidence, implementation of decisions was poor and the community was not included. There were no mechanisms for appeals or to ensure that the proceduralist conditions were met in both hospitals. Public hospitals in Kenya could improve their budgeting and planning processes by harmonizing these processes, improving role clarity, using explicit priority-setting criteria, and by incorporating both consequentialist (efficiency, equity, stakeholder satisfaction and understanding, shifted priorities, implementation of decisions), and proceduralist (stakeholder engagement and empowerment, transparency, use of evidence, revisions, enforcement, and incorporating community values) conditions.
[Mh] Termos MeSH primário: Orçamentos
Tomada de Decisões Gerenciais
Organizações de Planejamento em Saúde
Prioridades em Saúde
Hospitais de Condado
[Mh] Termos MeSH secundário: Hospitais Públicos
Seres Humanos
Entrevistas como Assunto
Quênia
Estudos de Casos Organizacionais/métodos
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:160929
[St] Status:MEDLINE
[do] DOI:10.1093/heapol/czw132


  10 / 1107 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27648929
[Au] Autor:Wandera EA; Mohammad S; Komoto S; Maeno Y; Nyangao J; Ide T; Kathiiko C; Odoyo E; Tsuji T; Taniguchi K; Ichinose Y
[Ad] Endereço:Institute of Tropical Medicine, Center for Microbiology Research, KEMRI, KEMRI-Nagasaki University, Nairobi, Kenya.
[Ti] Título:Molecular epidemiology of rotavirus gastroenteritis in Central Kenya before vaccine introduction, 2009-2014.
[So] Source:J Med Virol;89(5):809-817, 2017 May.
[Is] ISSN:1096-9071
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Between July 2009 and June 2014, a total of 1,546 fecal specimens were collected from children <5 years of age with acute gastroenteritis admitted to Kiambu County Hospital, Central Kenya. The specimens were screened for group A rotavirus (RVA) using ELISA, and RVA-positive specimens were subjected to semi-nested RT-PCR to determine the G and P genotypes. RVA was detected in 429/1,546 (27.5%) fecal specimens. RVA infections occurred in all age groups <59 months, with an early peak at 6-17 months. The infections persisted year-round with distinct seasonal peaks depending on the year. G1P[8] (28%) was the most predominant genotype, followed by G9P[8] (12%), G8P[4] (7%), G1P[4] (5%), G9P[4] (4%), and G12P[6] (3%). In the yearly change of G and P genotypes, a major shift from G9P[8] to G1P[8] was found in 2012. Phylogenetic analysis of the nucleotide sequences of the VP7 and VP4 genes of seven strains with unusual G8 or P[6] showed that the VP7 nucleotide sequences of G8 were clustered in lineage 6 in which African strains are included, and that there are at least two distinct VP4 nucleotide sequences of P[6] strains. These results represent basic data on RVA strains circulating in this region before vaccine introduction. J. Med. Virol. 89:809-817, 2017. © 2016 Wiley Periodicals, Inc.
[Mh] Termos MeSH primário: Gastroenterite/epidemiologia
Gastroenterite/virologia
Genótipo
Infecções por Rotavirus/epidemiologia
Infecções por Rotavirus/virologia
Rotavirus/classificação
Rotavirus/genética
[Mh] Termos MeSH secundário: Pré-Escolar
Ensaio de Imunoadsorção Enzimática
Fezes/virologia
Feminino
Hospitais de Condado
Seres Humanos
Lactente
Recém-Nascido
Quênia/epidemiologia
Masculino
Epidemiologia Molecular
Reação em Cadeia da Polimerase
Prevalência
Reação em Cadeia da Polimerase Via Transcriptase Reversa
Rotavirus/isolamento & purificação
Estações do Ano
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160921
[St] Status:MEDLINE
[do] DOI:10.1002/jmv.24691



página 1 de 111 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde