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In the face of the challenges of rising demand and increasing economic pressure, medical service innovations and university hospitals are becoming increasingly important as cornerstones for the continuous development of medical care. Simultaneously, increasing technological complexity, scarce funding, and resource-intensive technology development are forcing university hospitals to open up their internal innovation processes. Numerous studies have highlighted the beneficial effects of cross-sectoral collaboration on the innovation performance of industrial entities, while neglecting the perspective of academic institutions. The impact of industry collaborations on the service innovativeness of university hospitals in particular has not been addressed in previous research. Although the potential for nonlinear effects of university-industry collaborations has been discussed in research, adequate evidence, particularly in the healthcare context, has not been provided. Therefore, this study addresses the questions: (1) What is the impact of university-hospital-industry collaboration (UHIC) on the service innovativeness of university hospitals? (2) Can a nonlinear relationship between UHIC and university hospitals' service innovativeness be empirically verified? The hypotheses are tested based on an unbalanced panel data set, which combines three distinct data sources and comprises annual observations from 2011 until 2019 of all German university hospitals. The findings indicate that the UHIC intensity has a positive effect on university hospitals' service innovativeness with a one-year time lag. Furthermore, a negative quadratic UHIC effect was found. In doing so, this study complements existing research and opens the black box by uncovering the downside of cross-sectoral collaboration for a more complete understanding of the underlying dynamics of this growing area of research, with a particular focus on university hospitals. [ABSTRACT FROM AUTHOR]

Abstract Introduction Death certification is a health indicator and a public health surveillance tool. High-quality death certificate ensures reliability of mortality statistics used to direct the arranging of health-related programs and leading assessments of research and proper healthcare outcomes. The World Health Organization (WHO) puts Egypt in the group of ‘low quality’ death registration data. The aim of this study was to evaluate the impact of composite training and audit intervention on accurate completion of death notification forms (DNFs) in Assiut University Children Hospital (AUCH) that has an average monthly mortality of 120 children’s deaths. Methods A Quasi-experimental study design was conducted among residents of AUCH. The intervention consisted of 1- Preparing training material with basic information on how to report causes of death according to WHO criteria and case scenarios extracted from the medical records of children who died at AUCH, 2- One hundred residents of the AUCH were trained in one day workshops in 4 groups, with a pre-post knowledge assessment questionnaire. 3- A weekly audit of a sample of 10–15 DNFs was done for six months with reporting of findings to quality assurance director of the hospital. Results Eighty- nine physicians completed the pre-post knowledge assessment with significant increase in knowledge score after the intervention (15.7 ± 3.2 vs. 11.9 ± 2.8). There was a significant decrease in the errors of reporting on the DNFs. The main improvement was in decrease from 90 to 18% in reporting the mechanism of death, and significant decline in writing cause of death in Arabic language only. Conclusion Accurate reporting of the medical cause of death can be achieved by educational intervention targeting physicians with institutionalizing of audit system for continuous quality improvement.

Abstract Background Evaluating healthcare information systems, such as the Electronic Health Records (EHR), is both challenging and essential, especially in resource-limited countries. This study aims to psychometrically develop and validate an instrument (questionnaire) to assess the factors influencing the successful adoption of the EHR system by healthcare professionals in Moroccan university hospitals. Methods The questionnaire validation process occurred in two main stages. Initially, data collected from a pilot sample of 164 participants underwent analysis using exploratory factor analysis (EFA) to evaluate the validity and reliability of the retained factor structure. Subsequently, the validity of the overall measurement model was confirmed using confirmatory factor analysis (CFA) in a sample of 368 healthcare professionals. Results The structure of the modified HOT-fit model, comprising seven constructs (System Quality, Information Quality, Information technology Service Quality, User Satisfaction, Organization, Environment, and Clinical Performance), was confirmed through confirmatory factor analysis. Absolute, incremental, and parsimonious fit indices all indicated an appropriate level of acceptability, affirming the robustness of the measurement model. Additionally, the instrument demonstrated adequate reliability and convergent validity, with composite reliability values ranging from 0.75 to 0.89 and average variance extracted (AVE) values ranging from 0.51 to 0.63. Furthermore, the square roots of AVE values exceeded the correlations between different pairs of constructs, and the heterotrait-monotrait ratio of correlations (HTMT) was below 0.85, confirming suitable discriminant validity. Conclusions The resulting instrument, due to its rigorous development and validation process, can serve as a reliable and valid tool for assessing the success of information technologies in similar contexts.

Introduction: Death certification is a health indicator and a public health surveillance tool. High-quality death certificate ensures reliability of mortality statistics used to direct the arranging of health-related programs and leading assessments of research and proper healthcare outcomes. The World Health Organization (WHO) puts Egypt in the group of 'low quality' death registration data. The aim of this study was to evaluate the impact of composite training and audit intervention on accurate completion of death notification forms (DNFs) in Assiut University Children Hospital (AUCH) that has an average monthly mortality of 120 children's deaths. Methods: A Quasi-experimental study design was conducted among residents of AUCH. The intervention consisted of 1- Preparing training material with basic information on how to report causes of death according to WHO criteria and case scenarios extracted from the medical records of children who died at AUCH, 2- One hundred residents of the AUCH were trained in one day workshops in 4 groups, with a pre-post knowledge assessment questionnaire. 3- A weekly audit of a sample of 10–15 DNFs was done for six months with reporting of findings to quality assurance director of the hospital. Results: Eighty- nine physicians completed the pre-post knowledge assessment with significant increase in knowledge score after the intervention (15.7 ± 3.2 vs. 11.9 ± 2.8). There was a significant decrease in the errors of reporting on the DNFs. The main improvement was in decrease from 90 to 18% in reporting the mechanism of death, and significant decline in writing cause of death in Arabic language only. Conclusion: Accurate reporting of the medical cause of death can be achieved by educational intervention targeting physicians with institutionalizing of audit system for continuous quality improvement. [ABSTRACT FROM AUTHOR]

Background: In 2021, a survey was conducted among doctors and nurses at Landspítali Iceland University Hospital (LIUH) regarding their views on medical assistance in dying (MAID) and the underlying arguments, the inclusion criteria and modality of implementation. Surveys on identically defined study groups in 1995 and 2010 were used for comparison. Methods: The survey was sent to 357 doctors and 516 nurses working at LIUH. It included seven questions and several subquestions. Participants' answers were compared by profession, age group, and specialisation status. Descriptive and inferential statistics were used. Results: A total of 135 doctors (38% response rate) and 103 nurses (20% response rate) answered the survey, representing 27% of the study group. A total of 145 (61%) participants were positive about MAID, with the most common argument being patient autonomy. The 95% margin of error for this view was ± 6.2%. Compared to 19% in 2010, support for MAID had tripled in 2021 (p < 0.05). Approximately 18% of participants did not support MAID of any kind, mostly due to arguments regarding preserving life or inconsistencies with the role of health care professionals. Finally, 19% of participants were uncertain of their views towards MAID, mostly due to the high level of complexity of the matter. Conclusion: Compared to previous surveys, a large increase in positive attitudes towards MAID was observed among this study population. The results revealed the reasons for participants' attitudes; weighing patients' dignity/autonomy against professionals' duty to "not to kill"/palliate and showing some differences between professions. [ABSTRACT FROM AUTHOR]

Background: Evaluating healthcare information systems, such as the Electronic Health Records (EHR), is both challenging and essential, especially in resource-limited countries. This study aims to psychometrically develop and validate an instrument (questionnaire) to assess the factors influencing the successful adoption of the EHR system by healthcare professionals in Moroccan university hospitals. Methods: The questionnaire validation process occurred in two main stages. Initially, data collected from a pilot sample of 164 participants underwent analysis using exploratory factor analysis (EFA) to evaluate the validity and reliability of the retained factor structure. Subsequently, the validity of the overall measurement model was confirmed using confirmatory factor analysis (CFA) in a sample of 368 healthcare professionals. Results: The structure of the modified HOT-fit model, comprising seven constructs (System Quality, Information Quality, Information technology Service Quality, User Satisfaction, Organization, Environment, and Clinical Performance), was confirmed through confirmatory factor analysis. Absolute, incremental, and parsimonious fit indices all indicated an appropriate level of acceptability, affirming the robustness of the measurement model. Additionally, the instrument demonstrated adequate reliability and convergent validity, with composite reliability values ranging from 0.75 to 0.89 and average variance extracted (AVE) values ranging from 0.51 to 0.63. Furthermore, the square roots of AVE values exceeded the correlations between different pairs of constructs, and the heterotrait-monotrait ratio of correlations (HTMT) was below 0.85, confirming suitable discriminant validity. Conclusions: The resulting instrument, due to its rigorous development and validation process, can serve as a reliable and valid tool for assessing the success of information technologies in similar contexts. [ABSTRACT FROM AUTHOR]

Introduction: Advances in treatment have transformed cancer from a fatal to a chronic illness. This requires healthcare professionals, particularly nurses, to have advanced knowledge and collaborative skills. However, challenges persist in implementing patient-centered care in the context of evolving treatment complexity. Objectives: This study aimed to clarify nurses' support practices in providing cancer pharmacotherapy at a university hospital in Japan and compare these practices based on nurses' years of experience. Methods: A questionnaire survey was conducted from February to April 2023 among 430 nurses involved in provision of cancer pharmacotherapy at a Japanese university hospital. Nurses were asked about the types of support they provided during care for patients undergoing cancer pharmacotherapy. Nurses' cancer pharmacotherapy support practices were extracted using factor analysis, and differences in support scores by years of experience were examined. Results: Responses were received from 184 nurses (42.8% response rate). Three support factors were identified: "Providing patient-centered cancer pharmacotherapy," "Management of continued cancer pharmacotherapy treatment," and "Assessment of and response to physical symptoms." Scores for "Providing patient-centered cancer pharmacotherapy" were significantly lower than those for the other two factors (p <.001). The group with ≥10 years of nursing experience had statistically significantly lower practice scores than those with 4–9 years of experience. Conclusions: Enhancing nursing education and interprofessional collaboration are crucial to overcome barriers to patient-centered cancer care. Continuous learning opportunities are essential to adapt to evolving cancer treatment protocols and ensure delivery of patient-centered care, particularly for experienced nurses. [ABSTRACT FROM AUTHOR]

Changes in the healthcare system directly impact the nursing profession. Nursing is a vital profession, and nurses face many challenges and the need for changes in healthcare. This first-time study aimed to describe the change agent competency of clinical nurses from their perspectives in the Thai healthcare context. The researchers conducted a qualitative descriptive study. In-depth interviews were conducted among 12 clinical registered nurses in a Thailand Quality Award recipient super-tertiary university hospital in southern Thailand using semi-structured interviews, audio-recording, and observation record forms during October to December 2021. Purposive and snowball sampling were used to select participants. Using content analysis, seven themes of change agent competency were revealed: 1) improving quality of care, 2) commitment to achieving change, 3) clinical ability, 4) enhancing engagement in improvement, 5) using information efficiently, 6) knowing how to seek useful resources, and 7) improving after receiving feedback contributing to the conceptual structure of change agent competency. Trustworthiness was assessed using member checking and peer debriefing to ensure the quality of the study. The findings are helpful for nurses and health leaders to better understand the potential of nurses as change agents in reforming practice. The findings of this study also form a foundation for nurse educators to incorporate change agent theory and practices in education and training. However, since this was a first-time study on the topic with clinical nurses in Thailand, much more research is needed, including developing a standard tool to measure and develop change agent competency of Thai clinical nurses, given there is no such instrument in the country [ABSTRACT FROM AUTHOR]

Introduction: Kitasato University Hospital offers a training course for community pharmacists that focus on advanced pharmacy management care in outpatient cancer chemotherapy. The objective of this training program is to facilitate the transition from general to oncology certification for community pharmacists with limited experience in outpatient oncology to support the acquisition of an oncology specialty. Aim: To evaluate the relationship between the changes in awareness, knowledge, and self-assessment that advanced pharmacy management care traineeship in an outpatient oncology unit for community pharmacists brings to trainees and the duration of training. Methods: A quantitative text analysis was conducted of the daily training reports of six community pharmacists who had participated previously in the training course and had received in-service training in oncology for at least 30 days. The pre- and post-training results of the knowledge tests and self-assessments of confidence, understanding, and performance were compared. This study was approved by the Research Ethics Committee of Kitasato Institute Hospital in October 2019 (Study No. 19044). Results: The terms Prescription, Recommendation were extracted from the daily report after the 21st day of oncology in-service training. Furthermore, factors such as knowledge of cancer pharmacotherapy, confidence in patient education regarding the side effects of chemotherapy, and understanding of the work of pharmacists in outpatient cancer chemotherapy significantly increased at the end of the training. Conclusions: Community pharmacists with limited experience in outpatient oncology could improve their knowledge, understanding, and awareness of outpatient oncology patient care through 30 days of in-service oncology training in a hospital setting. The issues that emerged included training pharmacists to send follow-up documents on the patients' side effects and medication status as well as developing the literature search environment in community pharmacies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the occupational radiation exposure of medical workers between general hospitals and university hospitals. Methods: Radiation exposure data from three hospitals in Hiroshima city, including one university hospital and two general hospitals, were collected using personal dosimeters. Monthly radiation doses were analyzed, and the annual sum of radiation exposure dose was calculated for 538 subjects in general hospitals and 1224 subjects in the university hospital. To assess the impact of locality, additional data from Nagasaki University Hospital and Fukushima Medical University Hospital were included for comparative analysis. Professional affiliations, such as doctors, nurses, and radiological technologists, were considered in the evaluation. Results: The study revealed slight but significant differences in radiation doses between general and university hospitals. In general hospitals, except for radiological technologists, a slightly higher radiation dose was observed compared to university hospitals. Despite the annual increase in the use of medical radiation, the majority of hospital workers in both settings adhered to safety guidelines, with occupational radiation exposure remaining below the limit of detection (LOD). Workers who involved in fluoroscopic procedure, whether at university or general hospitals, had higher radiation doses than those who did not. Conclusion: The study's primary conclusion is that workers in general hospitals experience a slight but significantly higher radiation dose and a lower percentage below the LOD compared to university hospitals. The observed difference is attributed to the greater workload at general hospitals than at university hospitals, and also may be due to the different nature of university hospital and general hospital. University hospitals, characterized by greater academic orientation, tend to benefit from comprehensive support systems, specialized expertise, and advanced technology, leading to more structured and regulated radiation control. These findings provide a basis for targeted interventions, improved safety protocols. [ABSTRACT FROM AUTHOR]

Abstract Background Little is known about patient profile changes in medical facilities in our country, leading to this study to describe and compare patient profiles in 2010 and 2022. Patients and methods This was a cross-sectional study with new outpatients aged 15 years and more seen in the cardiology department of the UH-GT. Measurements included height, weight and body mass index (BMI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Quantitative data are presented as the mean with standard deviation, and categorical one as proportions. Statistical tests were the t test to compare means and chi-test for categorical variables. The level of significance was set to 0.05. Results The sample consisted of 515 new patients (199 in 2010 and 316 in 2022) with 59.1% female in 2010 and 60.1% in 2022 (p = 0.821). We noticed an increase in hypertension (59.1–71.8%, p = 0.003) and a decrease in tobacco smoking (from 13 to 05.4%, p = 0.002) and stroke (from 05.8 to 02.2%, p = 0.033). Height increased significantly from 1.59 m to 1.66 m, p = 0.002. SBP and DBP showed significant decreases in their means from 155.43 to 144.97 mmHg, p =

Objectives: As part of the further development of an existing training program on scientific skills for health services research at the University Hospital Tübingen, the aim of the study is to determine the level of knowledge, utilization and needs for continuing education among staff. Methods: In 2022, a semi standardized anonymous cross-sectional survey was conducted at the University Hospital Tübingen. The content of the questionnaire survey was the level of knowledge and utilization of various research methods, the need for continuing education on these and other healthcare research-related topics and the preferred training concept. The data analysis was carried out descriptively based on absolute and relative frequencies overall and grouped according to the scientific experience of the participants. Results: Participants' self-assessment indicated that a proportion of them had research skills. However, the level of knowledge and utilization varied greatly with regard to different research methods. The 222 participants most frequently expressed a desire for continuing education in the preparation of meta-analyses (56%), questionnaire validation (43%) and -development (42%). There was also great interest in continuing education in the fields of project coordination (57%), third-party funded projects (46%) and science communication (45%). Conclusion: The survey highlights existing research skills and the need for methodological qualification in the field of healthcare research among the staff of the University Hospital Tübingen. The focus appears to be on evidence generation, methods of empirical social research and general research-related skills. The results will be used to design new training courses with a focus on health services research. [ABSTRACT FROM AUTHOR]

Background: Little is known about patient profile changes in medical facilities in our country, leading to this study to describe and compare patient profiles in 2010 and 2022. Patients and methods: This was a cross-sectional study with new outpatients aged 15 years and more seen in the cardiology department of the UH-GT. Measurements included height, weight and body mass index (BMI). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. Quantitative data are presented as the mean with standard deviation, and categorical one as proportions. Statistical tests were the t test to compare means and chi-test for categorical variables. The level of significance was set to 0.05. Results: The sample consisted of 515 new patients (199 in 2010 and 316 in 2022) with 59.1% female in 2010 and 60.1% in 2022 (p = 0.821). We noticed an increase in hypertension (59.1–71.8%, p = 0.003) and a decrease in tobacco smoking (from 13 to 05.4%, p = 0.002) and stroke (from 05.8 to 02.2%, p = 0.033). Height increased significantly from 1.59 m to 1.66 m, p = 0.002. SBP and DBP showed significant decreases in their means from 155.43 to 144.97 mmHg, p = < 0.001 for SBP and from 95.53 to 89.02 mmHg, p = < 0.001 for DBP. Conclusions: Cardiovascular risk factors showed different trends with decreasing tobacco smoking, similar to systolic and diastolic blood pressure, albeit with an increase in hypertension prevalence. Other CVrf values increased. Awareness campaigns must be reinforced and maintained to obtain their decrease. [ABSTRACT FROM AUTHOR]

Background and Aims: Job satisfaction of healthcare workers from conventional and university hospitals (or teaching hospitals) might be different due to several factors, for example medical staff required to carry out multiple clinical and teaching tasks simultaneously. Our study aimed to determine how the job satisfaction among healthcare workers in university hospitals is different from those in conventional hospitals. Methods: A cross‐sectional study was conducted by using the validated and contextualized job satisfaction tool for the Vietnamese context to survey 216 healthcare workers at a university hospital in Vietnam from January to March 2020 with online Google forms. Results: The results indicated low overall job satisfaction (43.1%) in our study university hospital with the score cutoff of 80%. However, healthcare workers still reported high job satisfaction rates in certain aspects, such as personal empathy (70.8%), discipline, and reward (67.6%), co‐worker collaboration (65.3%), training and promotion (63%), workplace environment (57.4%), and salary and allowance (44.9%). Subgroup analysis revealed statistically significant differences in job satisfaction (p < 0.01) related to age (31 to 40‐year‐old), and job position with ORs 3.9, and 8.6 respectively. Conclusion: University hospitals need to improve the healthcare workers' job satisfaction. It is recommended that special human resource strategies should be developed focusing on keeping satisfying older healthcare staff by recognizing their contributions and providing appropriate benefits based on their positions in the hospital. [ABSTRACT FROM AUTHOR]

Aim: To investigate the distribution of paediatric surgery in various hospitals and to study postoperative risk factors of mortality. Methods: Retrospective registry‐based cohort study of children aged 0–14 years undergoing surgery from 2017 to 2021. Data were extracted from the Swedish Perioperative Registry. A mixed logistic regression was applied for the all‐risk mortality analysis. Results: A total of 126 539 cases were identified, 50% in university, 36% in county and 14% in district hospitals. The dominating operations were appendectomy in 6667, orchidopexy in 5287, inguinal hernia repair in 4200 and gastrostomy in 1152 children. Among children under 1 year of age or American Society of Anesthesiologists Physical Status classification (ASA‐PS‐Class) 3–5, the majority underwent surgery in university hospitals. The 30‐day mortality in university hospitals was 0.5% and in county hospitals 0%. The proportion of emergency surgery was similar in university and county hospitals. Independent risk factors of mortality were being under 1 year of age, ASA‐PS‐class 4–5, emergency surgery and surgery at university hospitals. Conclusion: Half of all operations in children were performed in university hospitals, with low postoperative mortality despite effective centralisation of high risk patients <1 year of age or ASA‐PS‐Class 3–5. [ABSTRACT FROM AUTHOR]

Background Japan is reviewing how physicians operate and plans to implement a work-style reform for physicians in 2024. This study examined how outsourcing housework cleaning tasks changed the daily lives of university hospital physicians. Methods A total of 18 physicians participated in the study, outsourcing cleaning tasks either once or thrice. Results Fourteen out of 18 respondents reported a decrease in the burden of household chores. Additionally, 10 respondents reported having more time for family contact, and nine respondents reported having more time for their own hobbies and diversions. Meanwhile, only five respondents reported that they had more time to work. Conclusion Outsourcing housework cleaning tasks and using the newly created time for family and self may improve work performance. [ABSTRACT FROM AUTHOR]

In addition to patient care, physiotherapy is increasingly important in research at university hospitals. Genuine physiotherapy research plays a decisive role in this. This position statement describes the opportunities, benefits, framework conditions, challenges, and research priorities of genuine physiotherapy research at German university hospitals.

Abstract Background and Aims Job satisfaction of healthcare workers from conventional and university hospitals (or teaching hospitals) might be different due to several factors, for example medical staff required to carry out multiple clinical and teaching tasks simultaneously. Our study aimed to determine how the job satisfaction among healthcare workers in university hospitals is different from those in conventional hospitals. Methods A cross‐sectional study was conducted by using the validated and contextualized job satisfaction tool for the Vietnamese context to survey 216 healthcare workers at a university hospital in Vietnam from January to March 2020 with online Google forms. Results The results indicated low overall job satisfaction (43.1%) in our study university hospital with the score cutoff of 80%. However, healthcare workers still reported high job satisfaction rates in certain aspects, such as personal empathy (70.8%), discipline, and reward (67.6%), co‐worker collaboration (65.3%), training and promotion (63%), workplace environment (57.4%), and salary and allowance (44.9%). Subgroup analysis revealed statistically significant differences in job satisfaction (p

ObjectivesWorkplace violence (WPV) against healthcare workers (HCWs) has reached significant levels globally, impeding the quality and accessibility of healthcare systems. However, there is limited available knowledge regarding the determinants linked with WPV among HCWs and the discrepancies observed across various levels of hospitals in China. The objective of the present research was to investigate the factors linked to WPV and job satisfaction among HCWs in China.MethodsA self-developed questionnaire based on WeChat was employed to collect data. The questionnaire consisted of demographic information as well as occupational factors. To measure WPV, the Chinese version of the Workplace Violence Scale was utilized. Career satisfaction was assessed through two questions regarding career choices. The collected data was analyzed using descriptive analyses, chi-square tests, and multivariate logistic regressions.ResultsA total of 3,781 valid questionnaires (1,029 doctors and 2,752 nurses) were collected. Among all participants, 2,201 (58.2%) reported experiencing at least one form of WPV in the past year, with emotional abuse being the most frequent occurrence (49.7%), followed by threats (27.9%). The multivariate logistic regression analysis revealed several risk factors associated with WPV, including male gender, shift work, senior professional title, bachelor’s degree education, employment in secondary-level hospitals, and working over 50 h per week (p

This study proposes a critical and reflective analysis of the adhesion of the University Hospital (HU) of the Federal University of Santa Catarina (UFSC) to the Brazilian Hospital Services Company (EBSERH), based on the theory of Organizational Hybridism as a lens of analysis. The methodology used in the research is qualitative, with descriptive and explanatory objectives, carried out through bibliographic and documentary data collection. We argue that Organizational Hybridism has the potential to be adopted as a theory for analyzing phenomena related to the management of university hospitals run by public companies under private law. HU-UFSC/EBSERH is a hybrid organization which, given its organizational specificity and complexity, as well as the multiple institutional logics that make it up, is still in the process of building its organizational identity The integration of the institutional public policies materialized by HU-UFSC with the educational public policies materialized by EBSERH causes inconsistencies and contradictions in the face of contractual, educational and social divergences. The main results show that the work of managers becomes more complex when it comes to giving back to society about the social function that the university hospital performs. Since it combines the characteristics of non-profit organizations with profit-making organizations. HU-UFSC/EBSERH is a dissident hybrid, where the role of organizational governance is crucial to balancing different logical prescriptions. [ABSTRACT FROM AUTHOR]

The incidence of fatal adverse drug reactions (ADRs) in hospitals varies widely, and ADRs are often underreported. The impact of medical safety processes is not easily evaluated, and although medical practice changes constantly, little is known about ADR trends. This study concentrated on the current incidence and properties of fatal ADRs occurring in a university hospital and compared the results with two previous studies performed in the same hospital. We investigated retrospectively all 1236 deaths that occurred during 2019 in the Helsinki University Hospital. All the cases were evaluated by a team of experts, and the causality was assessed using the categories by World Health Organization and Uppsala monitoring centre. Suicides were excluded. Among death cases, we identified 65 certain or probable ADR cases (5.3%), representing 0.011% of all hospital admissions. Cytostatics and antithrombotics remained the largest drug classes, with neutropenia or sepsis and bleedings as the most common fatal ADRs. Compared with our earlier studies, warfarin caused less, and direct oral anticoagulants caused more fatal bleedings, reflecting the drug usage among the population. In contrast to earlier studies, contrast media and insulin did not cause any fatal ADRs, which may reflect an improvement in pharmacovigilance awareness among healthcare workers. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to clarify the prevalence, predictors, and prognosis of frailty and sarcopenia in both cross‐sectional and longitudinal study of the real world. Methods: The JUSTICE‐TOKYO study is a single‐center, prospective observational study of elderly patients. Patients aged ≥65 years who regularly visited our center were enrolled and followed up for 4 years (n = 1042). The diagnosis of sarcopenia and frailty in the enrolled patients was based on the criteria established by the Asian Working Group for Sarcopenia and Japanese version of the Cardiovascular Health Study criteria, respectively. The primary end point is the incidence of all‐cause mortality and hospitalization for treatment. The secondary end points are clinically significant bleeding, cardiovascular events, strokes, malignancies, incidence of falling, fractures, pneumonia, and the onset of new dementia cases. Results: A total of 1042 patients were enrolled in this study. The mean age of the cohort at baseline was 78.2 years, with 56% being women. Among the enrolled patients, 223 (21.4%) diagnosed with sarcopenia, 172 (16.5%) exhibited frailty, and 541 (51.9%) fell into the prefrailty category. Conclusions: The JUSTICE‐TOKYO study provides valuable insights into the prevalence of sarcopenia and frailty among older adult outpatients in a real‐world context and contributes to measures aimed at extending healthy life expectancy. Geriatr Gerontol Int 2024; 24: 168–172. [ABSTRACT FROM AUTHOR]

Background and Objective: Little information is available on how to assess the impact of research studies conducted in government hospitals in Latin America and specifically in Mexico. We aimed to determine the returns on investment of the research projects that were carried out in the Hospital General "Dr. Manuel Gea Gonzalez" (HGMGG), a general university hospital located in Mexico City, using a categorization model. Methods: We conducted a study including bibliometric analyses of publications associated with all research studies performed during the period 2016-2019 in the HGMGG and investigator interviews, according to the payback framework categorization model. Results: All studies analyzed had a positive impact based on outcomes in 5 "payback categories": (1) knowledge; (2) research targeting, capacity building, and absorption; (3) policy and product development; (4) health benefits; and (5) broader economic benefits. Conclusions: To date, it has not been possible to establish a set of indicators that show the results of the investigations carried out by medical specialists in training, who carry out the bulk of medical care in general hospitals and in the National Institutes of Health in Mexico. We identified, in the 5 categories of the payback framework model, different areas of opportunity to improve the benefits of the hospital's medical services through the development of scientific research projects. [ABSTRACT FROM AUTHOR]

The study aims to learn the relationship between Maladaptive cognitive schemes and functional combustion in a sample of Jeddah University Hospital nurses. The researcher relied on the correlative descriptive curriculum, and the study sample reached (257) Nurse and nurse. With regard to the study tool, the researcher used both the Latvian Cognitive Chart Scale of Maliki Preparation (2021) and the Functional Combustion Measure of Indian Preparation (2020). The study found several findings, the most important of which was a statistically significant correlation (P < .001) between Maladaptive cognitive schemes and functional combustion. One of the study's findings is that there are no statistically significant differences in Maladaptive cognitive schemes in Jeddah University Hospital nurses and nurses according to the variable type and found that there are no statistically significant differences in occupational combustion in the nurses of the Jeddah University Hospital according to the type variable, While there are no differences in the Maladaptive cognitive schemes of Jeddah University Hospital nurses and nurses according to the variable marital status and the results of the study also showed that there were no differences in occupational combustion in the nurses of the Jeddah University Hospital according to the variable marital status, The study recommended several recommendations, most notably the need to promote spatial, psychological and social conditions to raise the level of adaptation among the nurses of the Jeddah University Hospital. [ABSTRACT FROM AUTHOR]

Aim: A quality health service is not independent of patient satisfaction. Patient satisfaction research is one of the primary instruments for better quality service. With this study, we aimed to evaluate the satisfaction levels and expectations of the patients hospitalized in the Department of Gynecology and Obstetrics of the Kafkas University Training and Research Hospital to determine whether the satisfaction level differs according to socio-demographic characteristics and to restructure the light of the positive and negative data obtained. Material and Method: Between May 2021 and September 2022, 655 patients who received inpatient services at the Department of Gynecology and Obstetrics at Kafkas University Training and Research Hospital were surveyed. The questionnaire included a section about socio-demographic characteristics and 14 questions to determine their views on satisfaction. The questions were answered as 'yes', 'a little', and 'no'. Results: In our study, the highest level of satisfaction was for the nurses giving information about the treatment and care to the patient and the doctor's interest in the patient. According to the results of the multivariate linear regression analysis, it was determined that age, education status, and length of stay affected the satisfaction level independently of other variables (p<0.001). It was observed that working status did not affect satisfaction (p=0.434). Conclusion: Our study highlighted that hospital cleanliness significantly impacted the overall satisfaction levels, indicating a need for readjustments by hospital management. [ABSTRACT FROM AUTHOR]

Aim: Patient satisfaction surveys stand as one of the most effective methods for assessing the quality of healthcare services, aimed at gathering feedback from patient opinions and recognizing the service provider's pivotal role. This study aims to measure the satisfaction of the patients receiving outpatient services in a tertiary center with the quality of these services and to prepare an infrastructure that can create policies that can respond to the needs and wishes of the people as a hospital. Material and Method: This study was conducted on 780 outpatients who applied obstetrics and gynecology services at Kafkas University Medical Faculty Training and Research Hospital, a tertiary public hospital, between November 2021 and February 2022." The questionnaire consisted of two parts, asking 15 questions about the service they received from the institution and six questions about their sociodemographic characteristics. Results: The highest Yes rate was 96.4% (752 people) as "The doctor who examined me was interested". The highest No rate was 31.0% (242 people) with the expression "I was informed about the waiting times in the hospital". While the lowest yes rate was 51.5% (402 people), the statement "The hospital was clean in general", the lowest no rate was again the statement "The doctor who examined me was interested". 87.1% of the participants (679 people) stated that the waiting time for registration was long, 52.7% said it was difficult to reach the hospital, and 88.8% (693 people) said they would recommend the hospital to their friends and family. Patients reported that they were generally satisfied with the services provided. Conclusion: Similar to every sector, the pursuit of quality in delivering healthcare services is a prevalent goal in today's healthcare sector. Patient satisfaction surveys are essential in terms of measuring these services. [ABSTRACT FROM AUTHOR]

Introduction: To provide patients with appropriate treatment and foster therapeutic interactions, nurses must possess assertiveness. The study objective was to find out the assertiveness of nurses. Methods: In this cross-sectional study, 272 nurses were recruited using a proportionate stratified random sampling at Tribhuvan University Teaching Hospital (TUTH), Nepal. Assertiveness was measured with a self-administered questionnaire, 30-item Simple Rathus Assertiveness Schedule. Data analysis was done in SPSS version 16. Independent Sample t-test, Pearson Chi-square test, Fisher's Exact test, and odds ratio were used to examine the association. Results: Among nurses, 192 (70.6%) were assertive with a mean assertiveness score of 18.1±14.7. There was a significant association of nurses' assertiveness with their marital status (p = 0.02), nursing degree (p=0.03), professional designation (p=0.04), employment type (p= 0.03), and additional training (p=0.004). Nurses with bachelor-level nursing degrees were 1.8 times more assertive (95% CI = 1.05-3.07) than those nurses with certificate-level nursing degrees. Nursing officers were 2.1 times more assertive (95% CI = 1.02 - 4.2) than staff nurses. Further, permanently employed nurses were 2.63 times more assertive (95% CI = 1.35-5.12), and nurses who received additional training were 2.2 times more assertive (95% CI = 1.29-3.83). Conclusion: More than two-thirds of nurses working in the university hospital were assertive. Nurses with bachelor-level nursing degrees, with professional designation as "nursing officers", with permanent employment, and those who received additional training were more assertive. These things should be taken into consideration by the hospital administration to increase assertiveness among nurses. [ABSTRACT FROM AUTHOR]

[Background] The Japanese government anticipated refill prescriptions to reduce medical expenditures by 47 billion yen, but the actual reduction was only approximately 7 billion yen. We have previously reported that refill prescriptions accounted for 0.5% of total prescriptions filled at insurance pharmacies in Tokyo. This study expanded our trend analysis of refill prescriptions to the Kanto region, and compared the number and percentage of refill prescriptions issued by large university hospitals and other hospitals/clinics. [Methods] We analyzed refill prescriptions dispensed between April 2022 and June 2023 at Nihon Chouzai pharmacies within the Kanto region. The study variables included patient sex, age, number of refill prescriptions, and hospital type. [Results] In the Kanto region, Chiba had the highest number of refill prescriptions, followed by Tokyo and Kanagawa. As of June 2023, the number (percentage) of refill prescriptions was 5,718 (6.51%) in Chiba, 1,475 (0.45%) in Tokyo, and 312 (0.45%) in Kanagawa. Refill prescriptions were issued by 15 university hospitals during the study period, but were predominantly used by two university hospitals located in Chiba and Tokyo. [Discussion] The use of refill prescriptions in the Kanto region was especially high in Chiba. Refill prescriptions were also used in Tokyo, but were less common in other prefectures. Although a university hospital in Chiba was actively issuing refill prescriptions, many university hospitals hesitated to use. Future implementation and utilization of refill prescriptions may not only reduce medical expenditures, but also demonstrate the active engagement of pharmacies and pharmacists in medical care. [ABSTRACT FROM AUTHOR]

Rapid increase in cost continues to have negative impact on patients’ accessibility to life-changing anticancer medications. Moreover, the rising cost does not equate to similar increase in medication effectiveness. We recognise our responsibility as a university hospital to tackle this imbalance and strive to provide high quality, sustainable, affordable and accessible care. An active approach in cost containment of expensive and innovative cancer drugs was adopted in our organisation to safeguard accessibility and improve quality of life for patients. In this article, we described four inverventions: 1) identify right patient and minimise overtreatment, 2) in-house medicine production for selected indications, 3) minimise medicine spillages and 4) effective procurement strategies. We call on other hospitals to take action and, favourably, to collaborate on a European level. Together, we will safeguard the current and future care of our patients. [ABSTRACT FROM AUTHOR]

The present research was conducted in the city of Londrina-PR, the aim was to analyze the service uses of the University Hospital at the State University of Londrina-UH/UEL - and its geospatial comprehensiveness, as it was defined by the 17th Health zone from 2000 to 2013. We aim to understand how UH users deal with health problems. A qualitative study was conducted with patients who were hospitalized or treated at the emergency room during the year 2013, the nonprobability sampling method for convenience was employed. Interviews conducted with users within the UH premises indicate the following: firstly, they take self-medication and; just secondly, depending on the symptom-they look for the hospital health services to meet their demands. From the simplest needs to the most complex, users seek these services in order to solve their problems and also seek professionals who are technically proficient and creative. [ABSTRACT FROM AUTHOR]

Aim: In this study, it was aimed to evaluate the medication wastage and associated factors in a university hospital and to reveal the economic dimension of medication wastage. Method: The population of this descriptive study consisted of 834 medications that were wasted in a university hospital in Istanbul. Sample selection was not made in the study and the entire population was taken into consideration. The data were collected using Medication Wastage Forms and Medication Wastage Reports recorded by the Pharmacy Department. Descriptive statistics (frequency, percentage) were used in the analysis of the data. The World Health Organization Anatomical Therapeutic Chemical (ATC) Classification System was used to classify wasted medications. Results: The study results showed that medication wastage has been mostly caused by preparation-related reasons, treatment changes, and adverse drug reactions. It was determined that the wastage rate was higher in pediatric hematology, chemotherapy, and adult hematology units. It was determined that the total cost of medication wastage was 98,950.12 ₺ and 66.98% of this cost was preventable. According to the Anatomical, Therapeutic and Chemical (ATC) Classification System, 33.81% of the wasted medication was classified as antineoplastic and immunomodulating agents. Conclusion: In this study, it was determined that the amount and cost of medication wastage in the hospital were at a serious level. It was determined that wastage predominantly occurred in units with high-risk patient groups and that a large part of it was preventable. Hospital management needs to focus on preventable causes of waste in terms of the effective use of resources.

Abstract Background Poisoning is a major health problem especially in developing countries and leads to high morbidity and mortality. Aim To identify the profile of acute poisoning in the Toxicology Unit at Tanta University Hospital, Egypt (2017-2021). Methods A cross-sectional study using data extracted from medical records from beginning of January 2017 to end of December 2021. Data including demographic data, Glasgow coma scale, type of poisons, manner of poisoning, time of admission and discharge and state at discharge. Results This study included 9713 cases. Rodenticides represented the most frequent cause of poisoning among both males (30%) and females (27%). Pharmaceutical drugs, CNS abused pharmaceutical drugs, and chemicals represent the most common categories (24%, 22%, and 21%, respectively) among children (up to 12 years). Rodenticides and pharmaceutical drugs represent the highest categories among other age groups. Evening admissions represented 52% of cases. Glasgow coma scale was 15 among 86.3% of cases. Intentional poisoning was more common than accidental poisoning (58.6% and 34.7%, respectively). One half (52.2%) of the admitted cases were discharged within 24 hours of admission and 44.4% of them were discharged after 48-72 hours. Family request was the main reason of discharge of cases (70.3%), 15.7% were improved, 4% died. Mortality by rodenticide was 12.5%. Conclusion Rodenticides, pharmaceutical and CNS abused pharmaceutical drugs were the most common categories of poisoning. Intentional poisoning was more common than accidental poisoning. Rodenticides were responsible for most deaths.

Abstract Aims To assess toxic leadership and organizational performance among nurses of a University Hospital, and explore the mediating effect of nurses ‘silence. Background Toxic Leadership behaviours are hurtful to feelings, leading to emotive fatigue and nurses silence within the legislative framework. In fact, it is very harmful to all organizations. However, little emphasis has been paid to research on the mediating mechanism and border factors of their connection. Methods A cross-sectional design was applied. Data was collected from 750 nurses over the course of three months. The researchers employed structured equation modeling [SEM] to investigate the role of nurses’ silence in mediating the association between toxic leadership and organizational performance. Results The toxic leadership level and Organisational performance level were both high. In addition to, the nurses’ silence level was moderate. The SEM revealed that toxic Leadership accounted for the prediction of 65% of the variance of nurses’ silence and 87% of the variance of organizational performance. Also, nurses silence as a mediating factor accounted for 73% of the variance of organizational performance. Conclusions This study emphasized on the importance of creating a work environment that encourages and promotes open communication, as well as eliminating toxic leadership behaviours from the organizational culture among nurses as it effects on the organizational performance.

Abstract Introduction: The participation of students in clinical consultations is essential for their medical education. This experience allows for the acquisition of technical skills and the transmission of ethical and professional values. Objective: To evaluate how differences in outpatient conditions (gynecological or prenatal care), appraisal of previous experience, and sociodemographic profiles influence women’s willingness to accept student participation in their consultations. Methods: We selected 743 cases (45.1% prenatal) with previous experience in student participation of 893 women attending outpatient gynecological (52.6%) or prenatal (47.4%) clinics at Brasilia University Hospital from 2016 to 2019. Scales were adopted for women’s appraisal of student interpersonal communication, willingness to accept, and unwillingness to accept student participation. We used t tests to assess differences, chi-square statistics to compare proportions between outpatient groups, correlations between key variables, and linear regression to estimate variables predicting the willingness outcome. Results: Odds ratios over 1 (p< 0.01) emerged for age older than 35 years, not married, less than higher education, multiparity, discomfort with students, and lower acceptance of gender equality in relation to the Ob-Gyn gender for the gynecological group. Women in the gynecological group offered a better appraisal (from one to five) of interpersonal communication (4.75 vs. 4.43, effect size g= 0.605), showed more willingness (4.58 vs. 4.26, g= 0.625), and conveyed less unwillingness to accept student participation (2.35 vs. 2.47, g= 0.143) than women in the prenatal group. In the linear regression analysis (N= 743), a higher willingness to accept student participation was significantly related (in decreasing impact) to better appraisal of student interpersonal communication (p< 0.001), lower unwillingness (p< 0.001), gynecological group (p< 0.001), tolerance to pelvic examination by a student (p= 0.017), and age older than 35 years (p= 0.016). Conclusions: The experience of supportive interpersonal communication, especially regarding the gynecological group, had a predominant impact on the patient’s willingness to accept the participation of students in consultations. Overall, the willingness to accept this participation differs depending on the patient’s (reason for consultation, lower unwillingness, age) and student’s (communication, gender) factors. Hopefully, the findings can contribute to fostering student-patient partnerships from the perspective of the articulation between service and teaching in medicine.

Copyright of Gümüshane Üniversitesi Saglik Bilimleri Dergisi is the property of Gumushane University, Faculty of Health Sciences 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.)

Purpose: The goal of this study is to examine the chronological development of hospitalized oncology and COVID-19 patients, and compare effects on oncology sub-disciplines for pre-pandemic (2017–19) and pandemic (2020–21) years in the setting of a German university maximum care provider. Methods: Data were retrospectively retrieved from the hospital performance controlling system for patient collectives with oncological main (nOnco) and COVID-19 secondary diagnosis (nCOVID-19). Data analysis is based on descriptive statistical assessment. Results: The oncology patient collective (nOnco = 27,919) shows a decrease of hospitalized patients for the whole pandemic (− 4% for 2020 and − 2,5% for 2021 to 2019). The number of hospitalized COVID-19 patients increases from first to second pandemic year by + 106.71% (nCOVID-19 = 868). Maximum decline in monthly hospitalized oncology patients amounts to − 19% (May 2020) during the first and − 21% (December 2020) during the second lockdown. Relative monthly hospitalization levels of oncology patients reverted to pre-pandemic levels from February 2021 onwards. Conclusion: The results confirm a decline in hospitalized oncology patients for the entire pandemic in the setting of a maximum care provider. Imposed lockdown and contact restrictions, rising COVID-19 case numbers, as well as discovery of new virus variants have a negative impact on hospitalized treated oncological patients. [ABSTRACT FROM AUTHOR]

Shun Yamashita,1 Masaki Tago,1 Midori Tokushima,2 Sei Emura,2 Shu-Ichi Yamashita1 1Department of General Medicine, Saga University Hospital, Saga, Japan; 2Saga Medical Career Support Center, Saga University Hospital, Saga, JapanCorrespondence: Shun Yamashita, Department of General Medicine, Saga University Hospital, 5-1-1 Nabeshima, Saga, 849-8501, Japan, Tel +81952343238, Fax +81952342029, Email sy.hospitalist.japan@gmail.comPurpose: Many countries will be aged societies by 2060. As a super-aged society, Japan may offer a valuable reference point. The number of medical residents and doctors working at university hospitals in Japan has halved since 2004, resulting in serious shortages of doctors in rural areas. This study clarified factors influencing medical students to choose university hospitals as facilities for their initial training or to only choose community hospitals.Methods: This single-center cross-sectional study was conducted in a typical rural city in Japan from February to March 2021. Data were collected using a questionnaire developed from a narrative review and discussion among four researchers. The participants were divided into those who chose university hospitals and those chose only community hospitals for logistic regression analysis.Results: Of the 300 students who answered the questionnaire (46.4% response rate), 291 agreed to participate in the study. At the time, 93 students had not decided where to undertake initial training, and were excluded. Of the 198 analyzed students, 113 (57.1%) had chosen university hospitals. Significant factors affecting students’ choices were “good salary or fringe benefits” (odds ratio [OR] 2.6, 95% confidence interval [CI]: 1.3– 5.2) in the community hospital group, and “desire to have contact with doctors practicing in a medical setting before starting hospital training in the fifth and sixth grade” (OR 0.4, 95% CI: 0.2– 0.8) and “prefer Saga Prefecture for initial training” (OR 0.2, 95% CI: 0.1– 0.4) among the university hospital group.Conclusion: University hospitals could offer a good salary or fringe benefits to secure residents. Other useful measures include preferential admission of students who pledge to work in the prefecture of their medical school after graduation and facilitating contact between motivated students and senior doctors before starting hospital training.Keywords: medical student, initial clinical training, university hospital, community hospital, questionnaire, cross-sectional study

Rapid increase in cost continues to have negative impact on patients’ accessibility to life-changing anticancer medications. Moreover, the rising cost does not equate to similar increase in medication effectiveness. We recognise our responsibility as a university hospital to tackle this imbalance and strive to provide high quality, sustainable, affordable and accessible care. An active approach in cost containment of expensive and innovative cancer drugs was adopted in our organisation to safeguard accessibility and improve quality of life for patients. In this article, we described four inverventions: 1) identify right patient and minimise overtreatment, 2) in-house medicine production for selected indications, 3) minimise medicine spillages and 4) effective procurement strategies. We call on other hospitals to take action and, favourably, to collaborate on a European level. Together, we will safeguard the current and future care of our patients.

Copyright of Journal of Health & Nursing Management / Sağlık ve Hemşirelik Yönetimi Dergisi is the property of Logos Medical Publishing 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.)

Copyright of Notfall & Rettungsmedizin is the property of Springer Nature 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.)

Aim:Chronic Obstructive Pulmonary Disease(COPD) is an important mortality and morbidity reason and brings serious burdens to the economies of countries.We analyzed differences in examination,treatment and approach that may affect the economic burden of COPD in hospitalized patients with a diagnosis of COPD exacerbation in state and university hospitals Material and Methods:104 patients who were being treated in university hospital(UH) and 102 patients in State Hospital(SH) because of COPD were included.The difference in approach of physicians and cost analysis between two hospitals were compared Results and Conslusion:The average age was higher in SH(p=0,01).Comorbities were higher in UH(p lt;0.001).The number of patients who received nebulizer treatment(p=0,02) in UH and total number of nebulizer medication used was higher in SH(p lt;0,001).The number of patients for whom intravenous(IV) medication was used and the number of total IV medication used was higher in SH(p lt;0,001).The total number of IM medication used was higher in UH(p lt;0,001).The number oral antibiotics used was higher in UH(p lt;0,001).The penicillins,macrolids,penicillin-macrolids were used more in patients in UH.The cephalosporins and quinolons were used more in SH(p lt;0,001).Inhaler corticosteroid(ICS)(p lt;0,001),salbutamol+ipratropiumbromur combination in nebulizer form(p lt;0,001) and IV teophilin was used in more patients in SH(p=0,01).The use of salbutamol in nebulizer form was more in UH(p lt;0,001).Spirometry,arterial blood gas analysis(respectively p lt;0,001,p lt;0,001),chest radiography was applied more in UH(p=0,02).Total cost(p lt;0,001),total and daily medication costs was more in SH(p lt;0,001).Costs other than medication was more in UH(p=0,02).We believe that adherence to the guidelines has a very important effect on cost in patients hospitalized with COPD exacerbation

Walaiporn Wangchinda, Kanokwan Laohasakprasit, Kanokorn Lerdlamyong, Visanu Thamlikitkul Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Visanu Thamlikitkul, Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand, Tel +66 81-820-6271, Fax +66 2-412-5994, Email visanu.tha@mahidol.ac.thPurpose: To investigate the epidemiology of carbapenem-resistant Enterobacterales (CRE) colonization or CRE infection relative to the natural history and clinical course of CRE colonization or CRE infection in hospitalized patients during admission and after discharge.Material and Methods: Two adult cohorts were enrolled. Cohort I comprised hospitalized patients who had CRE isolated from their clinical specimens during 2018– 2020. CRE colonization or CRE infection was based on the absence/presence of clinical features of infection. Information regarding the natural history and clinical course of these patients was collected during hospitalization. Stool samples were evaluated for CRE once a week during hospitalization, and then once every few months after discharge until negative for CRE. Cohort II comprised patients who had CRE isolated from clinical specimens during hospitalization and who were discharged during 2015– 2018. CRE in stool samples collected from these patients every few months was assessed to determine duration of CRE in stool.Results: CRE in stool was detected in 69.7% of 353 patients in cohort I. K. pneumoniae was the predominant CRE isolated from clinical samples (76.8%) and stool samples (65.7%). Among the 225 CRE-colonized patients, 20.4% developed subsequent CRE infections with a median duration from CRE colonization to CRE infection of 14 days. Among 174 CRE-infected patients, the most common infection was pneumonia with mortality at discharge of 47.7%. Duration of CRE colonization in stool was < 1 year in 50.0% of cohort I patients, and < 2 years in 91.4% of patients in cohort II.Conclusion: CRE isolated from clinical specimens in hospitalized patients are more likely to cause colonization than infection. Patients with CRE colonization are at risk of subsequent CRE infection with high mortality. Stool culture for CRE is needed to verify if contact precautions can be discontinued because the duration of CRE colonization in stool varied from days to years.Keywords: epidemiology, carbapenem-resistant Enterobacterales, infection, colonization, patients, university hospital, Thailand

Background : Poisoning is a major health problem especially in developing countries and leads to high morbidity and mortality. Aim: To identify the profile of acute poisoning in the Toxicology Unit at Tanta University Hospital, Egypt (2017-2021). Methods: A cross-sectional study using data extracted from medical records from beginning of January 2017 to end of December 2021. Data including demographic data, Glasgow coma scale, type of poisons, manner of poisoning, time of admission and discharge and state at discharge. Results: This study included 9713 cases. Rodenticides represented the most frequent cause of poisoning among both males (30%) and females (27%). Pharmaceutical drugs, CNS abused pharmaceutical drugs, and chemicals represent the most common categories (24%, 22%, and 21%, respectively) among children (up to 12 years). Rodenticides and pharmaceutical drugs represent the highest categories among other age groups. Evening admissions represented 52% of cases. Glasgow coma scale was 15 among 86.3% of cases. Intentional poisoning was more common than accidental poisoning (58.6% and 34.7%, respectively). One half (52.2%) of the admitted cases were discharged within 24 hours of admission and 44.4% of them were discharged after 48-72 hours. Family request was the main reason of discharge of cases (70.3%), 15.7% were improved, 4% died. Mortality by rodenticide was 12.5%. Conclusion: Rodenticides, pharmaceutical and CNS abused pharmaceutical drugs were the most common categories of poisoning. Intentional poisoning was more common than accidental poisoning. Rodenticides were responsible for most deaths. [ABSTRACT FROM AUTHOR]

Introduction: Candida auris is an emerging pathogen in health care‐associated infections. In contrast to many other countries with rising numbers of C. auris, only seven cases have been reported in Germany from 2015 to 2017, mostly from patients who received prior medical treatment abroad. We therefore established a mandatory screening for C. auris colonisation at our tertiary care centre for all patients who were admitted as international patients or previously hospitalised in a foreign country within the past 6 months. Methods: Colonisation of patients was assessed using a previously established screening protocol for multidrug resistant bacteria. Since 2017, all screening samples were additionally analysed for C. auris using CHROMagar Candida (CHROMagar, Paris, France). Yeast isolates were identified using matrix‐assisted laser ionisation time‐of‐flight (MALDI TOF), except for C. albicans (identified by the typical green colour on chromogenic agar). Data were analysed retrospectively. Results: Our study cohort included 655 patients and an overall number of 1399 samples. Fifty‐three patients were colonised with Candida species (C. albicans, n = 37; C. glabrata, n = 14; others n = 9). No case of C. auris was detected. Candida spp. were mainly detected from respiratory samples (5.4% positive) and gastrointestinal specimen (5.2%). Laboratory costs were 14,689 € and analyses resulted in 98.7 h of additional technician's work. Conclusion: No colonisation with C. auris was detected among patients with previous hospitalisation abroad. Universal C. auris screening of patients with any contact to foreign health care does not seem to be cost‐effective in our setting and more targeted screening strategies have to be developed. [ABSTRACT FROM AUTHOR]