Search

The development of health-promoting hospitals is an important part of the Healthy China Initiative, facilitating the transformation of medical institutions from a primary focus on medical and surgical treatments to a patient-centered approach prioritizing public health. To promote the scientific, standardized, and sustainable development of health-promoting hospitals, the Shanghai Municipal Center for Health Promotion, together with Shanghai General Hospital and other institutions, has jointly developed the Standards for the Development of Health⁃promoting Hospitals (Standards) in accordance with the principles of scientific rigor, feasibility, and advancing with the times. The Standards outlines the requirements for the development of health-promoting hospitals across four aspects: organizational and institutional guarantees, creation of a healthy environment, implementation of health education and promotion, and evaluation. It is applicable to all levels and types of public medical institutions in Shanghai, and can also be referred to and implemented by other medical institutions. The introduction of the Standards is of great significance for promoting the formation of a long-term mechanism in health-promoting hospitals. This paper introduces the basis, principles, main content, precautions, and implementation suggestions of the Standards. Taking into account relevant policies and standards, it interprets the technical aspects in the process of developing health-promoting hospitals, which is helpful for medical institutions and their management to better understand and apply the standards in their work.

ObjectiveTo investigate the trends and significant determinants of delayed HIV diagnosis （DHD） among newly reported HIV/AIDS cases in Xuhui District， Shanghai between 2018 and 2022.MethodsIn the newly reported HIV/AIDS cases， patients died within one year without accident， HIV/AIDS cases with CD4 cell count

ObjectiveTo investigate the current situation of health communication carried out by medical institutions in Shanghai through new media platforms such as WeChat， Weibo， Toutiao， Douyin， Kuaishou， Bilibili and WeChat Videos， and to propose targeted measures.MethodsBased on the systematic collection of new media accounts of medical institutions in Shanghai， and through the combination of keyword screening and manual audit， health communication data of medical institutions on new media platforms were determined.ResultsData from 1 117 new media accounts of 162 medical institutions in Shanghai were collected， including 610 WeChat official accounts， 105 WeChat video accounts， 89 Weibo accounts， 18 Bilibili accounts， 198 Douyin accounts， 37 Toutiao accounts， and 60 Kuaishou accounts， totaling 111 853 posts. After keyword sorting and manual screening， a total of 66 761 health science posts were collected， with WeChat Official Accounts， Douyin， and Weibo having the top three highest number of posts. Video-based new media such as Douyin， WeChat Videos， Kuaishou， and Bilibili had a better communication impact than text and image-based new media like WeChat Official Accounts， Weibo， and Toutiao. Among them， Douyin and Toutiao were the best platforms for video and text-image-based new media， respectively.ConclusionMedical institutions in Shanghai recognize the importance of new media in health communication and have made full use of various media platforms to carry out health communication，having a certain impact on health education. In the future， medical institutions should choose appropriate platforms based on target audiences and content characteristics， fully leverage the advantages of various platforms， explore innovative communication strategies， promote the dissemination of health knowledge， and enhance the health literacy of the public.

Abstract Reducing doctor-patient conflict is an important part of coordinating doctor-patient disputes and easing doctor-patient relationship, which is conducive to building a harmonious medical environment and promoting the healthy development of medical undertakings. This paper constructs a multi-decision-maker mixed conflict model based on rough set theory, puts forward the matrix operation expression of the conflict degree theory in the Pawlak model, and gives a more objective and scientific evaluation function. Combined with hot issues of doctor-patient conflict, the proposed multi-decision-maker mixed conflict model is applied to doctor-patient conflict, examines the doctor-patient relationship in the medical institution system from multiple internal perspectives, and calculates feasible solutions in the conflict system. The results show that high medical quality, high standardize medication, high institutional efficiency, high staff efficiency, high hospital benefits, high hospital revenue, medium employee development, medium equipment development, or high medical quality, high standardize medication, high institutional efficiency, medium staff efficiency, medium hospital benefits, high hospital revenue, high employee development, and high equipment development are important conditions for building a harmonious medical environment and reducing doctor-patient conflicts.

Reducing doctor-patient conflict is an important part of coordinating doctor-patient disputes and easing doctor-patient relationship, which is conducive to building a harmonious medical environment and promoting the healthy development of medical undertakings. This paper constructs a multi-decision-maker mixed conflict model based on rough set theory, puts forward the matrix operation expression of the conflict degree theory in the Pawlak model, and gives a more objective and scientific evaluation function. Combined with hot issues of doctor-patient conflict, the proposed multi-decision-maker mixed conflict model is applied to doctor-patient conflict, examines the doctor-patient relationship in the medical institution system from multiple internal perspectives, and calculates feasible solutions in the conflict system. The results show that high medical quality, high standardize medication, high institutional efficiency, high staff efficiency, high hospital benefits, high hospital revenue, medium employee development, medium equipment development, or high medical quality, high standardize medication, high institutional efficiency, medium staff efficiency, medium hospital benefits, high hospital revenue, high employee development, and high equipment development are important conditions for building a harmonious medical environment and reducing doctor-patient conflicts. [ABSTRACT FROM AUTHOR]

This study examines the institutional changes and topographical landmarks within which the incident of death took place in the Moroccan context by focusing on the topic of in-hospital death during the COVID-19 pandemic. The complicated aspects surrounding the death arise from the process of medicalization, burial, and mourning among the relatives of the deceased. Methodologically, the research is based on a grounded phenomenological analysis of the experiences of relatives (50 participants) who lost their deaths in the first wave of the pandemic in four Moroccan cities: Rabat, Kenitra, Fez, and Missour. The study concludes that the negative attitude of Moroccans towards in-hospital death does not stem from the fragility of health services or the characteristics of loneliness and isolation, as revealed by Norbert Elias’s sociology. However, it closely links to the anthropological factors that construct the personal concept in the Moroccan context as a knot of relationships and looks at the body in its social, cultural and cosmological extensions. [Penelitian ini mengkaji perubahan institusional dan landmark topografis tempat terjadinya kematian dalam konteks masyarakat Maroko dengan fokus kematian di rumah sakit selama pandemi COVID-19. Aspek rumit kematian muncul selama proses penanganan medis, penguburan, dan perkabungan di antara kerabat almarhum. Secara metodologis, penelitian ini didasarkan pada analisis fenomenologis terhadap pengalaman 50 orang dari keluarga orang yang meninggal pada gelombang pertama pandemi COVID-19 di empat kota di Maroko: Rabat, Kenitra, Fez, dan Missour. Tulisan ini menyimpulkan bahwa sikap negatif masyarakat Maroko terhadap kematian di rumah sakit tidak berasal dari buruknya layanan kesehatan atau pun dari dampak isolasi dan rasa kesepian yang khas, seperti yang diungkapkan sosiologi Norbert Elias. Namun, sikap negatif tersebut erat terkait dengan faktor antropologis yang mengkonstruksi konsep personal dalam konteks masyarakat Maroko yang menjadi simpul hubungan sosial dan pandangan terhadap jasad dalam konteks sosial, budaya, dan kosmologi.]

Abstract Objective Antimicrobial resistance (AMR) has emerged as a serious global public health crisis. In response, 2016, 14 ministries in China, under the leadership of the National Health Commission, collaboratively issued the National Action Plan (NAP) to Contain Antibacterial Resistance (2016–2020). The NAP outlines strategies for medical institutions to adopt stewardship and implement AMR control. The purpose of this study was to comprehend stakeholders’ perceptions of the NAP and explore the factors that influence its implementation in medical institutions. Methods Semi-structured interviews were conducted with practitioners from medical institution in March and April 2021. Interviews were audio-recorded, transcribed and analyzed using thematic analysis via the framework approach. Results Twenty practitioners, representing diverse roles (4 administrators, 7 clinicians, 3 microbiologists, 3 pharmacists, 3 nosocomial infection management personnel) from seven institutions, participated in the study. Substantial efforts have been undertaken to regulate the rational use of antibiotics and enhance the management of hospital infections. Participants demonstrated awareness and concern regarding antimicrobial resistance, with widespread support expressed for the NAP. Among all professions, there were varying opinions on whether they felt restricted in their daily work. The tertiary hospitals have established multidisciplinary cooperation mechanisms. Six main themes were identified as both barriers and facilitators to the implementation of the NAP in the medical institutions: individual factors, leadership, multidisciplinary collaboration, patient factors, training and culture. The capacity for administrative attention is constrained or limited, poor enforcement of guidelines, insufficient specialist staff and the liability pressure on clinicians were perceived barriers. To containing AMR in medical institutions, management of hospital infections, the public’s knowledge of antibiotics’ usage, routine education and multidisciplinary support would be facilitators. Conclusions Practitioners from medical institutions were highly supportive for the NAP. Consideration of practitioners’ perceived barriers and facilitators might enhance implementation of the NAP to contain antimicrobial resistance.

Objective: Antimicrobial resistance (AMR) has emerged as a serious global public health crisis. In response, 2016, 14 ministries in China, under the leadership of the National Health Commission, collaboratively issued the National Action Plan (NAP) to Contain Antibacterial Resistance (2016–2020). The NAP outlines strategies for medical institutions to adopt stewardship and implement AMR control. The purpose of this study was to comprehend stakeholders' perceptions of the NAP and explore the factors that influence its implementation in medical institutions. Methods: Semi-structured interviews were conducted with practitioners from medical institution in March and April 2021. Interviews were audio-recorded, transcribed and analyzed using thematic analysis via the framework approach. Results: Twenty practitioners, representing diverse roles (4 administrators, 7 clinicians, 3 microbiologists, 3 pharmacists, 3 nosocomial infection management personnel) from seven institutions, participated in the study. Substantial efforts have been undertaken to regulate the rational use of antibiotics and enhance the management of hospital infections. Participants demonstrated awareness and concern regarding antimicrobial resistance, with widespread support expressed for the NAP. Among all professions, there were varying opinions on whether they felt restricted in their daily work. The tertiary hospitals have established multidisciplinary cooperation mechanisms. Six main themes were identified as both barriers and facilitators to the implementation of the NAP in the medical institutions: individual factors, leadership, multidisciplinary collaboration, patient factors, training and culture. The capacity for administrative attention is constrained or limited, poor enforcement of guidelines, insufficient specialist staff and the liability pressure on clinicians were perceived barriers. To containing AMR in medical institutions, management of hospital infections, the public's knowledge of antibiotics' usage, routine education and multidisciplinary support would be facilitators. Conclusions: Practitioners from medical institutions were highly supportive for the NAP. Consideration of practitioners' perceived barriers and facilitators might enhance implementation of the NAP to contain antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Background: Inguinal hernias are frequently encountered in surgical practice. Early analysis and elective repair is a safe and effective approach for patients of all ages that keep away from incarceration, strangulation, and complications and reduces morbidity and mortality. Aim and Objective: To study inguinal hernias and their management at a tertiary care hospital at NCMCH. Material and Methods: 60 cases of inguinal hernia admitted in NC Medical College and Hospitals were selected by purposive sampling method. All the cases were clinically suspected and diagnosed with inguinal hernia, above 12 years of age. All subjects underwent detailed clinical and radiologist examination and data was recorded. Post-operative follow-up was done to assess the complications. Result: Our study showed that indirect inguinal hernia (80%) was the more common than direct inguinal hernia (20%). 96.67% was reported unilateral hernia (Right 56.67% and Left 33.33%) and bilateral hernia in 6.67% of the cases. In 58.33% of cases, the bowel was the hernial content and in 41.67% of cases, omentum was the hernial content. It was observed that postoperative complications were very minimal i.e. wound infections (5%), groin pain (3.33%), hematoma (3.33%), scrotal swelling (1.67%), and recurrence (1.67%). Conclusion: The prevalence of inguinal hernia is increasing nowadays. The study concluded that hernioplasty (51.67%) is a better surgical choice for controlling hernia. For the better management of hernia, there is a need for awareness in the population that might also help detect it at an advanced stage and reduce the disorder's morbidity. [ABSTRACT FROM AUTHOR]

Aims: Traditionally, Kampo practitioners have relied on the five senses to carry our quality evaluation of cut crude drugs. In a previous paper, we reported on an investigation into eight cut crude drugs (Ephedra Herb, Coptis Rhizome, Rhubarb, Scutellaria Root, Peony Root, Magnolia Bark, Phellodendron Bark, Moutan Bark) purchased by the Kitasato University Oriental Medicine Research Center (OMRC). In that investigation, we used the test data provided by the supplier for the relevant lots to compare marker ingredient amounts with those stipulated in The Japanese Pharmacopoeia (JP) and to ascertain fluctuations in the ingredient amounts between lots for each of the drugs, which we expressed in terms of a fluctuation index (CV). We developed a checksheet to help practitioners conduct a more thorough evaluation of cut crude drugs than is possible through use of the five senses alone, where a CV of greater than 10% is considered to be a significant change in the profile of the cut crude drugs. In the present prospective study, we attempt to determine the feasibility of the method and develop recommendations for JP. Methods: The present investigation was conducted with the same eight cut crude drugs, including all the lots used at the OMRC from the year 2007 to the year 2011. Using the test data provided by the supplier, we checked the ingredient amount for marker ingredients Total Alkaloids, Berberine, Sennoside A, Baicalin, Paeoniflorin, Magnolol, Berberine, and Paenol. We also considered the utility of the checksheet and its prospects for use in future practice. Results: Using the checksheet, we were able to show changes over time in ingredient amounts for the eight cut crude drugs in question. Although results differed depending on the drug, fluctuations were generally within the acceptable limits. Conclusion: For most of the drugs listed in The Japanese Pharmacopeia, only lower limits are specified for the quantities of marker ingredients. This is inadequate from the point of view of ensuring consistent treatment. We developed a checksheet designed to aid Kampo practitioners and demonstrated its usefulness. We hope for a revision of JP that takes greater account of the realities of clinical use. [ABSTRACT FROM AUTHOR]

The quality of Fludeoxyglucose ［18F］ injection prepared by medical institutions from 2016 to 2021 was reviewed, in order to provide reference for improving the quality control level and operation standard of Fludeoxyglucose ［18F］ injection prepared by medical institutions. According to the results analyzed by the Chinese Pharmacopoeia from 123 batches of Fludeoxyglucose ［18F］ injection prepared by 38 medical institutions, the unqualified rate of the products was 14.6%, and the unqualified items were mainly due to pH value and residual solvents. By analyzing the causes, preparation and quality control process of the samples, it is considered that the main reason is the lack of quality control awareness of the production unit, and also there are problems such as incomplete quality control inspection items and nonstandard inspection operations of the production unit. It is suggested that medical institutions should strengthen the capability building of preparation and quality control process.

Introduction: Mental health at the workplace (WMH) is an important indicator for the optimum functioning of a medical institute. To establish an effective WMH, it is essential to understand the level of awareness, perceptions, and felt needs of students and staff of a medical institute regarding mental health services within the campus. Material and Methods: A cross-sectional web-based survey was conducted in an institution of national importance in Central India using a semistructured questionnaire based on Kobo Toolbox. Felt need for periodic mental health screening within the institutional campus (FN-S) and felt need of having a separate cell for mental healthcare of students and employees (FN-C) were analyzed using univariable and multivariable logistic regression. Results: A total of 526 out of 2190 eligible students and staff completed the survey (response rate 24.1%). About half of the participants were not aware, of whom to contact on campus in case of mental health concerns (MHCs), more than three-fourths were not aware of the rights for seeking treatment, and three-fourths thought that getting diagnosed with an MHC would negatively impact their academic course or work. There was a high felt need for mental health screening services (91.1%), and almost two-thirds felt the need for a separate mental health cell. The FN-S was higher among those from rural areas, those not using social media, those without a preexisting MHC, and those without FN-C. FN-C was higher in those not using social media, those having sleep disturbances, those with unawareness of the rights of a mentally ill person, those without any MHC, and those not having FN-S. Conclusion: Active efforts are needed to roll out a mental health screening policy and separate mental health cells within the medical institute. Future research should focus on a qualitative inquiry into the details of the above findings. [ABSTRACT FROM AUTHOR]

Introduction: Mental health at the workplace (WMH) is an important indicator for the optimum functioning of a medical institute. To establish an effective WMH, it is essential to understand the level of awareness, perceptions, and felt needs of students and staff of a medical institute regarding mental health services within the campus. Material and Methods: A cross-sectional web-based survey was conducted in an institution of national importance in Central India using a semistructured questionnaire based on Kobo Toolbox. Felt need for periodic mental health screening within the institutional campus (FN-S) and felt need of having a separate cell for mental healthcare of students and employees (FN-C) were analyzed using univariable and multivariable logistic regression. Results: A total of 526 out of 2190 eligible students and staff completed the survey (response rate 24.1%). About half of the participants were not aware, of whom to contact on campus in case of mental health concerns (MHCs), more than three-fourths were not aware of the rights for seeking treatment, and three-fourths thought that getting diagnosed with an MHC would negatively impact their academic course or work. There was a high felt need for mental health screening services (91.1%), and almost two-thirds felt the need for a separate mental health cell. The FN-S was higher among those from rural areas, those not using social media, those without a preexisting MHC, and those without FN-C. FN-C was higher in those not using social media, those having sleep disturbances, those with unawareness of the rights of a mentally ill person, those without any MHC, and those not having FN-S. Conclusion: Active efforts are needed to roll out a mental health screening policy and separate mental health cells within the medical institute. Future research should focus on a qualitative inquiry into the details of the above findings.

The study focuses on a detailed analysis of a civil case based on court orders (merits and appeals) in order to assess the quality of the act performed. The aim is to argue that the quality of the act of justice depends on the manner in which the admission or rejection of the action by the judge is carried out and argued, the correct identification of the law and its effective application in resolving the dispute, while respecting the law and the right to a fair trial of litigants, the manner of conducting judicial review and the correction of judicial errors.

Aims: In clinical practice, an important goal of ours is to have an objective and easy way of assessing the quality of cut drugs, and we have been carrying out investigations with that aim in mind. In a previous investigation, we found that the Moutan Bark and Phellodendron Bark used at Kitasato University Oriental Medicine Research Center differed greatly between lots for index ingredient amount, underlining the necessity for such a method. In the present study, we extend our investigations to other cut drugs and discuss the possibilities for easy and practical quality assessment. Methods: In order to quantify the degree of variation in quality of cut crude drugs, we referred to the test tables provided with each lot by the suppliers of cut crude drugs and generated a fluctuation index for the index ingredient of each crude drug based on average value and standard deviation. Results: The fluctuation indices were as follows: Total Alkaloid content of Ephedra Herb, 0.03; Berberine content of Coptis Rhizome, 0.05; Sennosides A content of Rhubarb, 0.05; Baicalin content of Scutellaria Root, 0.06; Paeoniflorin content of Peony Root, 0.07; Magnolol content of Magnolia Bark, 0.11. Somewhat reassuringly, these values were lower than those for the Paeonol content of Moutan Bark and the Berberine content of Phellodendron Bark in our earlier study. However, the actual values were between 1.5 and 3.8 times those cited in the 14th edition of The Japanese Pharmacopoeia, with the values for Rhubarb and for Magnolia Bark being of particular concern. Conclusion: The index ingredient amounts for crude cut drugs vary to greater or lesser degrees depending on the properties of each crude drug. We suggest that setting an institution-specific reference interval for each drug stipulating acceptable limits for index ingredient content can reduce the subjectivity and reliance on experience of drug quality assessment. [ABSTRACT FROM AUTHOR]

The essence of the provision of emergency medical care consists of: prevention of diseases and accidents, readiness to act in the event of an accident or illness, rapid response and treatment. The essence of the provision of all emergency medical care is to reduce the number of deaths and disabilities. The conducted study showed that only a small percentage of students of the faculty of the health sciences can adequately provide emergency medical care in case of the choking. However, students know what to do during partial or complete choking, and also know the main ways to help in case of the choking. The students also identified the consequences of choking caused by the wrong provision of the emergency care. [ABSTRACT FROM AUTHOR]

Stress is a state of worry or mental tension caused by a difficult situation. Stress is a natural human response that prompts to address challenges and threats. Prolonged stress is harmful to all patients, and especially in the elderly, as it interferes with the faster recovery of patients, debilitates the person's immune system, and as a result, various undesirable symptoms appear. The vast majority of all patients experience anxiety and stress before visits to doctors, various medical procedures and of course operations. Being in a medical institution, seeing various medical equipment and instruments, feelings of uncertainty, fear of death, fear of instability and changes in health status are the main aspects that cause negative psychological reactions in patients. The study was conducted using a quantitative research method. In this study participated 138 elderly people which age was from 55 years. After summarizing and reviewing all answers of the respondents, the fact is noticed that stress is a comulative phenomenon in our body, and it becomes more and more difficult to survive it with time. It is also possible to see how much influence changes in medical institutions have on the emotional state of patients. [ABSTRACT FROM AUTHOR]

Medical students experience significant stress and impacts on mood due to multiple factors. Unmitigated stress impacts both physical and mental health while increasing the risk of unethical behavior. It is important for medical institutions to identify strategies that effectively reduce perceived stress and improve the well-being of their students. The authors undertook a scoping review of the literature to identify strategies implemented by medical educational programs to improve the well-being of medical students. Of 1068 articles identified, 19 studies met the inclusion criteria. Interventions were categorized as mindfulness-based programs, reflection groups, curriculum changes, and 'miscellaneous.' All studies assessed outcomes of student stress/resilience, as well as additional domains including academic performance, mental health, and interpersonal skills. Some also assessed the acceptability of the intervention to students. Despite the heterogeneity of interventions and outcome measures, a clear theme emerged that institutionally-provided strategies to promote student well-being tend to be effective when students opt into the program. It was noted that adding mandatory content or activities to a medical program without creating adequate space or support for it can have the opposite effect. Further high quality intervention studies involving randomization, blinding and rigorous controls are warranted. [ABSTRACT FROM AUTHOR]

Malone Dies (1956) by Samuel Beckett and Chambre simple (2018) by Jérôme Lambert present the narratives of precarity in the clinical setting, wherein the clinical caregivers view the suffering of the patients as a spectacle and chart out pre(script)ions and pro(script)ions for them. Both novels open on a note of uncertainty. This paper examines the narratives of fear and anxiety of the institutionalized patients (probably) in the mental asylum in Malone Dies and the public hospital in Chambre simple. The caregivers in both novels represent the voice of medical authority who focus on cure rather than care, providing their patients food and medications or conducting tests. Hence, Malone and le Patient are compelled to develop artistic coping mechanisms of self-care, reclaiming the ownership of the self. In Malone Dies, the abatement of in-person care and the fear of spending time in isolation before death motivates Malone to devise the narratives. Malone is the sole performer and spectator of his performance of patienthood. Similarly, le Patient chooses the position of the spectator, thus turning upside down the "spectacle" of the epilepsy script, where the patient is viewed as the performer of catharsis by the clinical audience. Here, the lens of performance studies helps us understand clinical caregivers' emphasis on preparing an illness script that governs Malone and le Patient's script of narrative self-care. We argue that caregivers' expectations pressurize patients with chronic conditions to implement forms of artistic self-care in clinical settings. [ABSTRACT FROM AUTHOR]

Introduction Medical students experience significant stress and impacts on mood due to multiple factors. Unmitigated stress impacts both physical and mental health while increasing the risk of unethical behavior. It is important for medical institutions to identify strategies that effectively reduce perceived stress and improve the well-being of their students.Methods The authors undertook a scoping review of the literature to identify strategies implemented by medical educational programs to improve the well-being of medical students.Results Of 1068 articles identified, 19 studies met the inclusion criteria. Interventions were categorized as mindfulness-based programs, reflection groups, curriculum changes, and ‘miscellaneous.’ All studies assessed outcomes of student stress/resilience, as well as additional domains including academic performance, mental health, and interpersonal skills. Some also assessed the acceptability of the intervention to students.Conclusions Despite the heterogeneity of interventions and outcome measures, a clear theme emerged that institutionally-provided strategies to promote student well-being tend to be effective when students opt into the program. It was noted that adding mandatory content or activities to a medical program without creating adequate space or support for it can have the opposite effect. Further high quality intervention studies involving randomization, blinding and rigorous controls are warranted.

Digital marketing has given new life to healthcare services by enhancing their visibility in the online space. People choose online healthcare services because they can receive instant answers and communicate with specialists in their comfortable environment at the right time. The purpose of this study was to understand the impact of virtual communities on the intention to use telemedicine. The model is based on a combination of consumer desire (psychological objective) and loyalty through promotional formats (economic objective), as well as data collected from 442 respondents analyzed using structural equation modeling. The research results show that by analyzing target groups in social networks, content can be individualized, and an accurate measurement of e-patient satisfaction must be conducted in order to improve the experience of future consumers of telemedicine services. The results of this study explain what makes people want to use digital healthcare services and can serve as a guide for people who run virtual communities and help digital healthcare service providers figure out how to market their services. [ABSTRACT FROM AUTHOR]

PurposeThis paper is an exploratory study to investigate possible remedial measures accounting for a relatively favorable prognosis of health sector workers who have experienced physical WPV in Zhejiang province, China.MethodsFollowing a proportionate stratified sampling strategy, five tertiary hospitals (in the developed capital city of Hangzhou and other prefecture-level cities), eight secondary hospitals (in counties), and thirty-two primary care facilities (16 urban community health centers and 16 rural township health centers) were conveniently selected. Among 4,862 valid respondents out of 6,089 self-conducted questionnaires, 224 health sector workers who have been directly exposed to physical WPV in the past year were included in the present study.ResultsThe present study has three major findings: (1) Victims’ satisfaction with the resolution of the physical WPV conflict was directly associated with the favorable prognosis. (2) Taking days off from work after the violence can promote victims’ satisfaction with the resolution of the physical WPV conflict. (3) Knowing that relevant departments investigated the case can promote victims’ satisfaction with the resolution of the physical WPV conflict.ConclusionWe propose a combined gesture of “offering adequate days off work after physical WPV” and “every physical violence must be investigated” that should be taken by all medical institutions in China. Health sector workers who get involved in physical WPV incidents should prioritize their safety and avoid any behavior that may intensify the conflicts.

Aim of investigation. The article summarizes the scientific idea of the epoch-making path of the detrimental effect of patient safety – medical error, in the practical activity of doctors around the world and substantiation of its place in the conditions of transformation of the system of medical care to the population of Ukraine to the European standards. The historical, bibliographic, abstract, historical and comparative, logical and analytical research methodologies are used, as well as deductive awareness, analogy, synchronization, structural and logical analysis taking into account the principles of systematization the current, passive, retrospective, continuous research is performed, where the scientific material is available domestic and foreign scientific medical information sources of various genesis, collected for processing using the electronic search engine Google in accordance with package of Microsoft Office 2016. Scientific novelty. For the first time the epochal way of formation of a detrimental consequence of patient safety – a medical error is systematically and scientifically substantiated, in the practical activity of doctors of the world and its place in the conditions of transformation of the system of medical care to the population of Ukraine to the European standards is substantiated. This allows the practitioner and the head of the body or institution of medical care convincingly and fully realize the importance of such a component of evidence-based medicine as patient safety, in the context of efficiency and cost-effectiveness of medical service; the patient – to understand the content of safety in the treatment process and the ability of the health care system to minimize risks in diagnostic, treatment, preventive and rehabilitation processes, and to the scientist from medicine to comprehend corresponding quality and efficiency in scientific researches. Conclusions. Based on world experience in the observance of patients' rights in the context of medical service safety, to create a patient safety system in Ukrainian medicine that will raise the medical practice of doctors to the European level in accordance with the principles of evidence-based medicine and minimize medical error according to its legal, psychological, deontological, spiritual, bioethical, social, economic and medical aspects.

The need for innovative development of healthcare institutions is determined by the necessity to increase the efficiency of organizational processes based on the formation of new models of cooperation, which will make it possible to get access to new technologies and knowledge. The goal of the study is to determine the parameters of the impact of innovative open cooperation strategy and the strategy of innovative closed cooperation of healthcare institutions on the effectiveness of their organizational structure in the context of dissemination and the use of knowledge. Simulation modeling was applied to generate the most effective organizational management structure in the context of innovative cooperation and knowledge exchange within the organizational processes “Inside-out” and “Inside-in”. It is substantiated that the strategies of innovative cooperation “Open Innovation/Closed Innovation” have a significant impact on the organizational structure of management of healthcare institutions in terms of the “degree of centralization” (Dci), “degree of mediation” (Dii), and “degree of centralization of powers” (Dpi). The values of the selected criteria range from 25,52% to 61,50% in the case of Dii, and from 34,53% to 52,63% in the case of Dci, which indicates a higher efficiency of organizational knowledge exchange processes in healthcare institutions, which adhere to the Open Innovation strategy of innovative cooperation. Therefore, there are significant differences in the effectiveness of the management’s organizational structure depending on the degree of openness of innovative cooperation of healthcare institutions. The strategy of innovative openness allows increasing the number and quality of connections in the context of knowledge exchange between the subjects (actors, agents) of the organizational structure (in a broad sense, considering internal and external levels of externality) of healthcare institutions, regardless of the distance between them and the level of similarity.

Background. This study is devoted to solving one of the important health problems in the field of providing medical care to the population – supporting management decisions in organizing the work of medical institutions. The purpose of this study was to develop a modeling system to support managerial decision-making in the field of managing medical institutions and assess the possibility of its application. Materials and methods. As a test example, a system of three medical institutions with a staff of general practitioners and cardiologists was used. The data of the work schedule and workload of doctors were analyzed. The AnyLogic environment was used as a simulation modeling tool. Results. A scheme of interaction between systems and users, as well as a functional model of the system, has been developed. Based on the initial data, using the AnyLogic modeling tool, a simulation model of the patient service process in a network of medical institutions was built. The results of experiments to increase the workload and reduce the number of specialists are presented. Conclusions. The results show that the chosen approach is workable and the developed system can be used to support managerial decision making. Further development of the system may be related to providing remote access to simulation data for officials.

Aim: Quality evaluation of crude drugs in clinical practice has traditionally been dependent on practical experience. In recent years, though, scientific and technological advances have enabled the development of various analytical equipment that are now used for quality evaluation. However, for medical institution, incorporating quality evaluation of cut crude drugs using advanced equipment into daily practice can still be a challenge. In this paper, with the aim of enabling the easy and objective quality evaluation of crude drugs we conducted a fact-finding survey. Methods: Using the test data provided by the supplier with the cut crude drugs, we investigated the ingredient amounts in Moutan Bark and Phellodendron Bark used in clinical practice. Results: We found that both Moutan Bark and Phellodendron Bark had products with extremely high amounts of active ingredients in the product lot numbers used. Possible reasons for the findings are differences in the parts used or in the geographical locations where the plants were grown. Conclusion: Kampo treatment with crude drugs has advantages that other formulations do not have. On the other hand, there is concern about the complexity of quality evaluation and management of crude drugs. We suggest the possibility of establishing the easy and objective quality evaluation method in clinical practice by conducting a fact-finding survey on the management status of crude drugs. [ABSTRACT FROM AUTHOR]

Aim. To assess the importance, role, methods and conditions for creating and sustaining positive motivation of medical personnel in deploying a modern management system based on lean production to optimise the production flow in medical institutions, improve quality, availability and efficiency of public medical care.Materials and methods. The authors employed historical, bibliometric and statistical methods to analyse domestic and foreign scientific archives on lean production, motivation and motivational risks as key factors in implementing lean technologies in medical institutions.Results. Implementation of lean production (LP) as a manufacturing management system is among key conditions for creating a new model of the medical institution. Principles of LP are applied at three interfaces: with patients, personnel and resources. Positive motivation of employees is prerequisite for accomplishing a project, which requires supervisors to know and leverage the basics of motivational management. Creation of a motivating environment for various categories of employees in developing a LP system requires taking into account the type and management culture level of a medical institution.Conclusion. In order to create and sustain motivation for realising creative potential of the team, it is necessary to account for the motivation risks, develop and implement a motivation system differentially by employee categories and project stages. Effective motivational measures are necessarily based on a system of material and non-material incentives with clear and achievable criteria, amounts and forms valued by employees and rooted in medical and economic feedback of implementing the LP principles.

Abstract Background This study compares perspectives on specialized ophthalmic medical institutions, identifies the gaps in property and geographic offerings, and explores the ways that ophthalmic medical institutions can better allocate resources. The results of this research will increase patient’s access to equitable and high-quality ophthalmic care in China. Methods The data for this research was gathered from the Survey of China National Eye Care Capacity and Resource for the year 2015. The paper specified the number, professional level of expertise, and educational background of ophthalmic health personnel. The authors of the paper analyzed and compared the differences in ophthalmic care in public vs. private and urban vs. rural regions in China. Descriptive statistics were used. Results Of the 395 specialized ophthalmic hospitals surveyed, 332 were private medical institutions (84%), and 63 were public (16%). Of the 26 607 ophthalmic personnel surveyed, working in specialized ophthalmic hospitals, 17 561 were in private hospitals (66%) and 9 046 were in public ones (34%). Furthermore, 22 578 of those personnel worked in urban ophthalmic institutions (85%) and 4 029 worked in rural ones (15%). As for regional differences, 14 090 personnel were located in eastern China (53%), 8 828 in central regions (33%), and 3 689 in the western regions (14%). Conclusions Public ophthalmic medical institutions still face challenges in providing equitable and widespread care. The availability of well-staffed health centers varies significantly by region. These variations impact resource allocation and directly lead to inequalities and inaccessibility of health services in certain regions of China.

The existence of international agreements of social security rights regulate the transfer, from one state to another contracting state, of health and social security rights. Although they have existed for many years, the application of the so called, the convention on social security, and the rights derived therefrom, have not yet sufficiently taken root in the work of medical institutions, they represent ignorant and ignore their application. Some medical institutions have greater experience in obtaining benefits from service provision by contracts, but they also have reserves and unused potentials. The provision of services to foreign insurance consumer can be equated with the export of health services, which is given in a domestic institution. The benefits of providing services under international agreements also have a foreign insured person in need of the service, a health institution that receives a new consumer, and health insurance, which can indirectly and sometimes even cheaper, cover the insured event. The aim of this paper is to point out the need for an active approach to the provision of services to foreign policyholders, as well as to implement the contract in the most efficient way possible, and to achieve benefits for the institution and for the service user.

The article reviews international experiences in the designing of in-patient medical institutions: hospitals, medical centers, health centers, social welfare centers, psychiatric rehabilitation centers, centers for people with disabilities, mental health centers. Current trends in the design of these typologies in the form of spatial and functional models are identified. A concept of mental health center is introduced.

Malone Dies (1956) by Samuel Beckett and Chambre simple (2018) by Jérôme Lambert present the narratives of precarity in the clinical setting, wherein the clinical caregivers view the suffering of the patients as a spectacle and chart out pre(script)ions and pro(script)ions for them. Both novels open on a note of uncertainty. This paper examines the narratives of fear and anxiety of the institutionalized patients (probably) in the mental asylum in Malone Dies and the public hospital in Chambre simple. The caregivers in both novels represent the voice of medical authority who focus on cure rather than care, providing their patients food and medications or conducting tests. Hence, Malone and le Patient are compelled to develop artistic coping mechanisms of self-care, reclaiming the ownership of the self. In Malone Dies, the abatement of in-person care and the fear of spending time in isolation before death motivates Malone to devise the narratives. Malone is the sole performer and spectator of his performance of patienthood. Similarly, le Patient chooses the position of the spectator, thus turning upside down the “spectacle” of the epilepsy script, where the patient is viewed as the performer of catharsis by the clinical audience. Here, the lens of performance studies helps us understand clinical caregivers’ emphasis on preparing an illness script that governs Malone and le Patient’s script of narrative self-care. We argue that caregivers’ expectations pressurize patients with chronic conditions to implement forms of artistic self-care in clinical settings.

Digital marketing has given new life to healthcare services by enhancing their visibility in the online space. People choose online healthcare services because they can receive instant answers and communicate with specialists in their comfortable environment at the right time. The purpose of this study was to understand the impact of virtual communities on the intention to use telemedicine. The model is based on a combination of consumer desire (psychological objective) and loyalty through promotional formats (economic objective), as well as data collected from 442 respondents analyzed using structural equation modeling. The research results show that by analyzing target groups in social networks, content can be individualized, and an accurate measurement of e-patient satisfaction must be conducted in order to improve the experience of future consumers of telemedicine services. The results of this study explain what makes people want to use digital healthcare services and can serve as a guide for people who run virtual communities and help digital healthcare service providers figure out how to market their services.

The aim of the study is to analyze medical aid given to the workers of ferrous metallurgy enterprises in the first half of the 1950s. Primary medical unit provided medical aid for workers of the ferrous metallurgical enterprises. Because of the lack of medical unit at the metallurgical plant or because there was no medical institutions in the organizational structure of the medical unit, local medical institutions provided the workers with medical care. During the first half of the 1950s, was the problem of the lack of medical staff in the medical institutions caused by insufficient material and household support. It did not allow implementing the shop principle of medical service of metallurgists. At the enterprises, individual shops did not have a factory’s sectorial doctor, or the number of workers assigned to a factory’s sectorial doctor exceeded the norm. Because the local hospitals, which controlled the health post at the ferrous metallurgy enterprises of the Zaporizhzhya region, were placed at a considerable distance, ‘the shop principle’ was not implemented there at all. The personnel problem also affected the formation of queues, which were a characteristic feature of the medical care provided to the workers. Work overload of physicians led to a quick examination of the patients, resulting in mistakes in the diagnosis. Contrary to accepted laws aimed at improving the quality of diagnosis, the periodic medical examinations of workers were not always carried out qualitatively, and the medical examination was carried out in a number of plants partly. In the first half of the 1950s the enterprises of the ferrous metallurgy of Zaporizhzhya region had a problem that the medical institutions were on a far distance and the percentage of patients needed medical help reduced. Lack of hospital beds had caused the untimely hospitalization of patients that prevented recovery of their. Many of the medical institutions were located in the old or non-specialized buildings with limited space, stove heating and primitive food units, without household premises and sewage. Characteristic of the medical services of metallurgists were depreciation of the material fund of medical institutions, lack of medicines, medical equipment. Not all medical institutions were provided with ambulances. There were cases of refusal to leave for a challenge or untimely provision of emergency care. It was concluded that the level of medical services given to the metallurgists in the first half of the 1950s was insufficient, despite the fact that they were workers of one of the leading branches of the Soviet economy.

Abstract Background To identify the prevention situation, the main factors influencing prevention effects and to develop control measures over retinopathy of prematurity in China. Methods Using stratified random sampling method, we randomly selected 23 provincial and ministerial hospitals (8 in Guangdong province, 5 in Hunan province and 10 in Shaanxi province), 81 municipal hospitals (38 in Guangdong province, 19 in Hunan province and 24 in Shaanxi province), 180 district and county hospitals (76 in Guangdong province, 57 in Hunan province and 47 in Shaanxi province) in China. A total of 284 hospitals were enrolled in the study, with questionnaires distributed investigating the status and constrain factors of ROP presentation. Significant outcomes were analyzed thereafter by SPSS 19.0. Results The screening rate of ROP in medical institutions from eastern, central and western China were 84.6%, 35.0% and 56.7%, respectively. The screening rate of tertiary and secondary medical institutions were 84.6% and 25.7% in the eastern, 35.0% and 4.9% in the central, 56.7% and 5.9% in the western region. Screening was carried out better in the tertiary than that in the secondary and primary institutions. Treatment for ROP was available in 15.7% of all the tertiary hospitals surveyed. Lack of professionals, equipments and technologies were considered to be major restrain factors for screening. Conclusions The ROP screening and treatment status have demonstrated significant regional diversity due to uneven distribution of medical resources in China. Developed areas had established intraregional cooperation models, whereas less-developed areas should consider set up a large-scale, three-level ROP prevention network. It is of paramount importance that education and training towards ophthalmologists should be vigorously strengthened. It is strongly recommended that implement ROP telemedicine and integrated ROP prevention and management platforms through the Internet should be established.

Background: This study compares perspectives on specialized ophthalmic medical institutions, identifies the gaps in property and geographic offerings, and explores the ways that ophthalmic medical institutions can better allocate resources. The results of this research will increase patient's access to equitable and high-quality ophthalmic care in China.Methods: The data for this research was gathered from the Survey of China National Eye Care Capacity and Resource for the year 2015. The paper specified the number, professional level of expertise, and educational background of ophthalmic health personnel. The authors of the paper analyzed and compared the differences in ophthalmic care in public vs. private and urban vs. rural regions in China. Descriptive statistics were used.Results: Of the 395 specialized ophthalmic hospitals surveyed, 332 were private medical institutions (84%), and 63 were public (16%). Of the 26 607 ophthalmic personnel surveyed, working in specialized ophthalmic hospitals, 17 561 were in private hospitals (66%) and 9 046 were in public ones (34%). Furthermore, 22 578 of those personnel worked in urban ophthalmic institutions (85%) and 4 029 worked in rural ones (15%). As for regional differences, 14 090 personnel were located in eastern China (53%), 8 828 in central regions (33%), and 3 689 in the western regions (14%).Conclusions: Public ophthalmic medical institutions still face challenges in providing equitable and widespread care. The availability of well-staffed health centers varies significantly by region. These variations impact resource allocation and directly lead to inequalities and inaccessibility of health services in certain regions of China. [ABSTRACT FROM AUTHOR]

Objective: to analyze organizational aspects in the work of ultrasound diagnostic services of Kursk city and Kursk region in terms of cancer patients’ primary examination, specialized treatment, follow-up and seeking medical care in private clinics by these patients.Materials and methods. The study included 245 patients followed-up in the Kursk Regional Clinical Oncology Dispensary during 2012–2015. We analyzed the reports of ultrasound examination (USE) performed by various healthcare institutions at different stages of diagnostics, treatment and follow-up. We also assessed the quality and completeness of USE as well as the frequency of seeking medical assistance at private clinics.Results and conclusions. We revealed substantial organizational problems in USE of gynecological cancer patients in Kursk region.

The aim of the article is to identify the criteria and methods for the evaluation of medical institutions. The article uses economic analysis, comparative analysis, and methods of descriptive statistics. The analysis of existing regulations, source materials, and the specific business character of health care entities indicates the need to evaluate these units with particular regard to the criteria such as costs, quality of assets (level of consumption, i.e., wear and tear and modernness), employment, financial liquidity or the level of debt. The results of the study are the basis for the evaluation of the healthcare sector. The value of the article is in showing the direction taken by the evaluation of the financial standing of entities. The ability to use specific criteria and methods of evaluation for health care entities in business practice.

Background: Clinical research is a specific phase of the production process in the pharmaceutical industry in which companies test candidate drugs on patients in order to collect clinical evidence about safety and effectiveness.Objective: This paper is an operational research which aimed to support the hypothesis that pharmaceutical clinical research is like any other production process which could be localized where the cost is most competitive. In other words, this work aimed to demonstrate that the localization process of this specific phase of the pharmaceutical industry’s R&D is based on the price of clinical evidence.Methods: Considering Europe and taking panel data into account, an efficiency frontier through data envelopment analysis (DEA) was estimated. The efficiency of countries in maximizing the number of innovative medical treatments, given their available resources was estimated. Afterwards, focusing on European macro-regions, authors analyzed whether a significant concentration of clinical research exists.Results: Results suggest that, taking the expected principal investigators’ fee into account, Southeastern Europe and Central Eastern Europe are the most attractive macro-regions for the pharmaceutical industry’s foreign direct investments in clinical research.Conclusion: The results of the proposed operational research cannot reject the suggested evolution of the pharmaceutical industry’s clinical research. In other words, results confirm the localization process of the testing phase in East Europe, where the expected principal investigators’ fee is more competitive.

Background: Mobile apps can aid with the management of gestational diabetes mellitus (GDM) by providing patient education, reinforcing regular blood glucose monitoring and diet/lifestyle modification, and facilitating clinical and social support., Objective: This study aimed to describe our process of designing and developing a culturally tailored app, Garbhakalin Diabetes athawa Madhumeha-Dhulikhel Hospital (GDM-DH), to support GDM management among Nepalese patients by applying a user-centered design approach., Methods: A multidisciplinary team of experts, as well as health care providers and patients in Dhulikhel Hospital (Dhulikhel, Nepal), contributed to the development of the GDM-DH app. After finalizing the app's content and features, we created the app's wireframe, which illustrated the app's proposed interface, navigation sequences, and features and function. Feedback was solicited on the wireframe via key informant interviews with health care providers (n=5) and a focus group and in-depth interviews with patients with GDM (n=12). Incorporating their input, we built a minimum viable product, which was then user-tested with 18 patients with GDM and further refined to obtain the final version of the GDM-DH app., Results: Participants in the focus group and interviews unanimously concurred on the utility and relevance of the proposed mobile app for patients with GDM, offering additional insight into essential modifications and additions to the app's features and content (eg, inclusion of example meal plans and exercise videos).The mean age of patients in the usability testing (n=18) was 28.8 (SD 3.3) years, with a mean gestational age of 27.2 (SD 3.0) weeks. The mean usability score across the 10 tasks was 3.50 (SD 0.55; maximum score=5 for "very easy"); task completion rates ranged from 55.6% (n=10) to 94.4% (n=17). Findings from the usability testing were reviewed to further optimize the GDM-DH app (eg, improving data visualization). Consistent with social cognitive theory, the final version of the GDM-DH app supports GDM self-management by providing health education and allowing patients to record and self-monitor blood glucose, blood pressure, carbohydrate intake, physical activity, and gestational weight gain. The app uses innovative features to minimize the self-monitoring burden, as well as automatic feedback and data visualization. The app also includes a social network "follow" feature to add friends and family and give them permission to view logged data and a progress summary. Health care providers can use the web-based admin portal of the GDM-DH app to enter/review glucose levels and other clinical measures, track patient progress, and guide treatment and counseling accordingly., Conclusions: To the best of our knowledge, this is the first mobile health platform for GDM developed for a low-income country and the first one containing a social support feature. A pilot clinical trial is currently underway to explore the clinical utility of the GDM-DH app., (©Aarthi Shanmugavel, Prabin Raj Shakya, Archana Shrestha, Jyoti Nepal, Abha Shrestha, Jean-Francois Daneault, Shristi Rawal. Originally published in JMIR Formative Research (https://formative.jmir.org), 17.01.2024.)

Copyright of Collected Papers of the Law Faculty of the University of Rijeka / Zbornik Pravnog Fakulteta Sveučilišta u Rijeci is the property of Pravni fakultet Sveucilista u Rijeci and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)