743 resultados para Patient Experiences in ED


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This study provides data which can contribute to improving services and delivering quality health care in government health facilities in the state of Qatar. To measure the satisfaction with current care of selected patients who receive care in Hamad General Hospital and the Khalifa Town Health Center in the city of Doha, a cross-sectional survey and a self-administered questionnaire were used.^ Analysis was performed on data from 444 patients on eight dimensions of patient satisfaction with medical care. These include: general satisfaction, availability of services, convenience of services, facilities, humaneness of doctors, quality of care, continuity of care, and aspects of the last visit. Patient satisfaction parameters were compared for males vs. females, for citizens vs. non-citizens, and for patients seen in the hospital vs. those seen in the health center.^ Results indicate that patients seen in the hospital were more satisfied with care than patients seen in the health center, that non-citizens were more satisfied than citizens, and that males were slightly more satisfied than females with medical services. ^

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Background. End-stage liver disease (ESLD) is an irreversible condition that leads to the imminent complete failure of the liver. Orthotopic liver transplantation (OLT) has been well accepted as the best curative option for patients with ESLD. Despite the progress in liver transplantation, the major limitation nowadays is the discrepancy between donor supply and organ demand. In an effort to alleviate this situation, mismatched donor and recipient gender or race livers are being used. However, the simultaneous impact of donor and recipient gender and race mismatching on patient survival after OLT remains unclear and relatively challenging to surgeons. ^ Objective. To examine the impact of donor and recipient gender and race mismatching on patient survival after OLT using the United Network for Organ Sharing (UNOS) database. ^ Methods. A total of 40,644 recipients who underwent OLT between 2002 and 2011 were included. Kaplan-Meier survival curves and the log-rank tests were used to compare the survival rates among different donor-recipient gender and race combinations. Univariate Cox regression analysis was used to assess the association of donor-recipient gender and race mismatching with patient survival after OLT. Multivariable Cox regression analysis was used to model the simultaneous impact of donor-recipient gender and race mismatching on patient survival after OLT adjusting for a list of other risk factors. Multivariable Cox regression analysis stratifying on recipient hepatitis C virus (HCV) status was also conducted to identify the variables that were differentially associated with patient survival in HCV + and HCV − recipients. ^ Results. In the univariate analysis, compared to male donors to male recipients, female donors to male recipients had a higher risk of patient mortality (HR, 1.122; 95% CI, 1.065–1.183), while in the multivariable analysis, male donors to female recipients experienced an increased mortality rates (adjusted HR, 1.114; 95% CI, 1.048–1.184). Compared to white donors to white recipients, Hispanic donors to black recipients had a higher risk of patient mortality (HR, 1.527; 95% CI, 1.293–1.804) in the univariate analysis, and similar result (adjusted HR, 1.553; 95% CI, 1.314–1.836) was noted in multivariable analysis. After the stratification on recipient HCV status in the multivariable analysis, HCV + mismatched recipients appeared to be at greater risk of mortality than HCV − mismatched recipients. Female donors to female HCV − recipients (adjusted HR, 0.843; 95% CI, 0.769–0.923), and Hispanic HCV + recipients receiving livers from black donors (adjusted HR, 0.758; 95% CI, 0.598–0.960) had a protective effect on patient survival after OLT. ^ Conclusion. Donor-recipient gender and race mismatching adversely affect patient survival after OLT, both independently and after the adjustment for other risk factors. Female recipient HCV status is an important effect modifier in the association between donor-recipient gender combination and patient survival.^

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The focus of this paper is to outline the practical experiences and the lessons learned derived from the assessment of the requirements management process in two industrial case studies. Furthermore this paper explains the main structure of an alternative assessment approach that has been used in the appraisal of the two case studies. The assessment approach helped us to know the current state of the organizational requirement management process. We have to point out that these practical experiences and the lessons learned can be helpful to reduce risks and costs of the on-site assessment process.

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Personalized health (p-health) systems can contribute significantly to the sustainability of healthcare systems, though their feasibility is yet to be proven. One of the problems related to their development is the lack of well-established development tools for this domain. As the p-health paradigm is focused on patient self-management, big challenges arise around the design and implementation of patient systems. This paper presents a reference platform created for the development of these applications, and shows the advantages of its adoption in a complex project dealing with cardio-vascular diseases.

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In this paper, the experience of ETSIT-UPM in hands-on nanosatellite activities is presented. Innovate methodologies based on the active participation of students are presented. Projects with the participation of students have proven to be successful if students are motivated and assume responsibilities. Aspects as international collaboration and students motivation are described.

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Objective: To describe the documentary quality of two records related to patient safety in the operating room and to identify differences between information related to infection and hospitalization. Methods: Comparative study based on two cross sections, conducted with 3,033 patients who had been hospitalized for more than 24 hours in an Orthopedics and Traumatology Center. Sociodemographic and clinical data, as well as information provided in forms were compared. Postoperative infection was identified as an adverse event. Results: There was a significant correlation between hospitalization days and the total number of diagnoses collected (Pearson=0.328; p<0.001). When diagnoses and infections were grouped together, a significant value was found between closed fractures and infection (p=0.001). Conclusion: Differences in the degree of completion were observed between the two records. There were no differences between adverse events.

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Introducing teaching about healthy solutions in buildings and BIM has been a challenge for the University of Alicante. Teaching attached to very tighten study plans conditioned the types of methods that could be used in the past. The worldwide situation of crisis that especially reached Spain and the bursting of the housing bubble generated a lack of employment that reached universities where careers related to construction, Architecture and Architectural Technologist, suffered a huge reduction in the number of students enrolled. In the case of the University of Alicante, students’ enrolment for Architectural Technology reached an 80% reduction. The necessity of a reaction against this situation made the teachers be innovative and use the new Bologna adapted study plans to develop new teaching experiences introducing new concepts: people wellbeing in buildings and BIM. Working with healthy solutions in buildings provided new approaches for building design and construction as an alternative to sustainability. For many years sustainability was the concept that applied to housing gave buildings an added value and the possibility of having viability in a very complex scenario. But after lots of experiences, the approved methodologies for obtaining sustainable housing were ambiguous and at the end, investors, designers, constructors and purchasers cannot find real and validated criteria for obtaining an effective sustainable house. It was the moment to work with new ideas and concepts and start facing buildings from the users’ point of view. At the same time the development of new tools, BIM, has opened a wide range of opportunities, innovative and suggestive, that allows simulation and evaluation of many building factors. This paper describes the research in teaching developed by the University of Alicante to adapt the current study plans, introducing work with healthy solutions in buildings and the use of BIM, with the aim of attracting students by improving their future employability. Pilot experiences have been carried out in different subjects based on the work with projects and case studies under an international frame with the cooperation of different European partner universities. The use of BIM tools, introduced in 2014, solved the problems that appeared in some subjects, mainly building construction, and helped with the evaluation of some healthy concepts that presented difficulties until this moment as knowledge acquired by the students was hard to be evaluated. The introduction of BIM tools: Vasari, FormIt, Revit and Light Control among others, allowed the study of precise healthy concepts and provided the students a real understand of how these different parameters can condition a healthy architectural space. The analysis of the results showed a clear acceptance by the students and gave teachers the possibility of opening new research lines. At the same time, working with BIM tools to obtain healthy solutions in building has been a good option to improve students’ employability as building market in Spain is increasing the number of specialists in BIM with a wider knowledge.

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The purpose of this study was to gain understanding of adolescents’ positive and negative developmental experiences in sport. Twenty-two purposefully sampled adolescent competitive swimmers participated in a semistructured qualitative interview. Content analysis led to the organization of meaning units into themes and categories (Patton, 2002). Athletes suggested their sport involvement facilitated many positive developmental experiences (i.e., related to challenge, meaningful adult and peer relationships, a sense of community, and other life experiences) and some negative developmental experiences (i.e., related to poor coach relationships, negative peer influences, parent pressure, and the challenging psychological environment of competitive sport). Findings underline the important roles of sport programmers, clubs, coaches, and parents in facilitating youths’ positive developmental experiences in sport, while highlighting numerous important directions for future research. Implications for coach training and practice are outlined.

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Tese de doutoramento, Alterações Climáticas e Políticas de Desenvolvimento Sustentável (Sociologia), Universidade de Lisboa, Instituto de Ciências Sociais, 2016