Social work in a hospital emergency department

This paper describes how a Hospital Social Work Department's Emergency Team has attempted to provide a crisis and out-of-hours service to its Emergency Department. Through a staffing commitment to extensive evening and weekend cover, the Emergency Team's social worker is able to provide an immediate intervention and assessment service to problems. This has resulted in early detection and treatment of the non-medical aspects of a patient's problem and appropriate referral to other agencies for longer-term follow-up.

Hospital social work in Australia: Emerging trends or more of the same?

Social work in health care has been established for more than 100 years and is one of the largest areas of practice for social workers. Over time, demographic changes and growth in the aging population, increased longevity rates, an explosion in rates of chronic illness together with rapidly increasing cost of health care have created serious challenges for acute hospitals and health social workers. This article reviews the Australian health care system and policies with particular emphasis on the public hospital system. It then examines current hospital social work roles, including the continued role in discharge planning and expanding responsibility for emerging client problems, such as patient complexity, legal, and carer issues. The article concludes with a discussion of evolving issues and challenges facing health social work to ensure that social work remain relevant within this practice context.

Pain measurement and management in elderly patients : Clinical studies in long term hospital care and after cardiac surgery

The proportion of patients over 75 years of age, receiving all different types of healthcare, is constantly increasing. The elderly undergo surgery and anaesthetic procedures more often than middle-aged patients. Poor pain management in the elderly is still an issue. Although the elderly consumes the greatest proportion of prescribed medicines in Western Europe, most clinical pharmacological studies have been performed in healthy volunteers or middle-aged patients. The aim of this study was to investigate pain measurement and management in cognitively impaired patients in long term hospital care and in cognitively normal elderly patients after cardiac surgery. This thesis incorporated 366 patients, including 86 home-dwelling or hospitalized elderly with chronic pain and 280 patients undergoing cardiac surgery with acute pain. The mean age of patients was 77 (SD ± 8) years and approximately 8400 pain measurements were performed with four pain scales: Verbal Rating Scale (VRS), the Visual Analogue Scale (VAS), the Red Wedge Scale (RWS), and the Facial Pain Scale (FPS). Cognitive function, depression, functional ability in daily life, postoperative sedation and postoperative confusion were assessed with MMSE, GDS, Barthel Index, RASS, and CAM-ICU, respectively. The effects and plasma concentrations of fentanyl and oxycodone were measured in elderly (≥ 75 years) and middle-aged patients (≤ 60 years) and the opioid-sparing effect of pregabalin was studied after cardiac surgery. The VRS pain scores after movement correlated with the Barthel Index. The VRS was most successful in the groups of demented patients (MMSE 17-23, 11-16 and ≤ 10) and in elderly patients on the first day after cardiac surgery. The elderly had a higher plasma concentration of fentanyl at the end of surgery than younger patients. The plasma concentrations of oxycodone were comparable between the groups. Pain intensity on the VRS was lower and the sedation scores were higher in the elderly. Total oxycodone consumption during five postoperative days was reduced by 48% and the CAM-ICU scores were higher on the first postoperative day in the pregabalin group. The incidence of postoperative pain during movement was lower in the pregabalin group three months after surgery. This investigation demonstrates that chronic pain did not seem to impair daily activities in home-dwelling Finnish elderly. The VRS appeared to be applicable for elderly patients with clear cognitive dysfunction (MMSE ≤17) and it was the most feasible pain scale for the early postoperative period after cardiac surgery. After cardiac surgery, plasma concentrations of fentanyl in elderly were elevated, although oxycodone concentrations were at similar level compared to middle-aged patients. The elderly had less pain and were more sedated after doses of oxycodone. Therefore, particular attention must be given to individual dosing of the opioids in elderly surgical patients, who often need a smaller amount for adequate analgesia than middle-aged patients. The administration of pregabalin reduced postoperative oxycodone consumption after cardiac surgery. Pregabalin-treated patients had less confusion, and additionally to less postoperative pain on the first postoperative day and during movement at three months post-surgery. Pregabalin might be a new alternative as analgesic for acute postoperative and chronic pain management in the elderly. Its clinical role and safety remains to be verified in large-scale randomized and controlled studies. In the future, many clinical trials in the older category of patients will be needed to facilitate improvements in health care methods.

Standardizing Patent Data Cleaning in a University Technology Transfer Office

There are multiple goals of a technology transfer office (TTO) based in a university system. Whilst commercialization is a critical goal, maintenance and cleaning of the TTO's database needs detailing. Literature in the area is scarce and only some researchers make reference to TTO data cleaning. During an attempt to understand the commercial strategy of a university TTO in Bangalore the challenge of data cleaning was encountered. This paper describes a case study of data cleaning at an Indian university based TTO. 382 patent records were analyzed in the study. The case study first describes the back ground of the university system. Second, the method to clean the data and the experiences encountered are highlighted. Insights drawn indicate that patent data cleaning in a TTO is a specialized area which needs attention. Overlooking this activity can have legal implications and may result in an inability to commercialize the patent. Two levels of patent data cleaning are discussed in this case study. Best practices of data cleaning in academic TTOs are discussed.

Discharge Plasma Combined With Bauxite Residue for Biodiesel Exhaust Cleaning: A Case Study on NOx Removal

Experiments were conducted at laboratory level to treat the oxides of nitrogen (NOx) present in raw and dry biodiesel exhaust utilizing a combination of electric discharge plasma and bauxite residue, i. e., red mud, an industrial waste byproduct from the aluminum industry. In this paper, the adsorption and a possible catalytic property of bauxite residue are discussed. Nonthermal plasma was generated using dielectric barrier discharges initiated by ac/repetitive pulse energization. The effect of corona electrodes on the plasma generation was qualitatively studied through NOx cleaning. The plasma reactor and adsorbent reactors were connected in cascade while treating the exhaust. The diesel generator, running on biodiesel fuel, was electrically loaded to study the effectiveness of the cascade system in cleaning the exhaust. Interestingly, under the laboratory conditions studied, plasma-bauxite residue combination has shown good synergistic properties and enhanced the NOx removal up to about 90%. With proper scaling up, the suggested cascade system may become an economically feasible option to treat the exhaust in larger installations. The results were discussed emphasizing the role of bauxite residue as an adsorbent and as a room temperature catalyst.

Estimation of Power Input to Complex Dielectric Barrier Discharge Reactor Geometries used in NOx Cleaning

Studies were carried out to estimate the power input to Dielectric Barrier Discharge (DBD) reactors powered by AC high voltage in the context of their application in non-thermal plasma cleaning of exhaust gases. Power input to the reactors was determined both theoretically and experimentally. Four different reactor geometries energized with 50 Hz and 1.5 kHz AC excitation were considered for the study. The theoretically estimated power using Manley's equation was found to agree with the experimental results. Results show that the analytically computed capacitance, without including the electrode edge effects, gives sufficiently good results that are matching with the measured values. For complex geometries where analytical calculation of capacitance is often difficult, a novel method of estimating the reactor capacitance, and hence the power input to the reactor, was introduced in this paper. The predicted results were validated with experiments.

Determinacion de frecuencia de politraumatismo oseo (ptos) en mascotas caninas en el hospital animal El Dorado

Ante la falta de información acerca de la frecuencia, diagnóstico, tratamiento y primeros auxilios de la mascota canina politraumatizada en nuestro país, y la falta de medios para la praxis ortopédica, se propuso este estudio de tesis; cuyo titulo es: Determinación de frecuencia de politraumatismo óseo con diagnostico radiológico en mascotas caninas en el Hospital Animal El Dorado. Para lo cual se procedió a establecer los siguientes objetivos: la evaluación de la frecuencia de politraumatismos óseos (PTO) atendidos en la clínica veterinaria El Dorado con diagnostico radiológico, para esto se realizó dicho estudio en un periodo de 3 meses, en el cual se estudiaron expedientes y recopilación de datos, con este estudio de tesis se logró comprobar que la mayor afectación por fracturas la sufren los canes de raza criolla, seguidos por los Pastores Alemanes, así mismo se determinó que el manejo de las mascotas es determinante y predisponente a que una mascota sufra una fractura. Se identificó que los animales menores de 2 años sufren mayormente fracturas. Se concluyó que debido a los altos costos de la praxis, muchos veterinarios no atienden a sus pacientes y también debido a la misma razón muchos dueños de mascotas optan por la eutanasia o simplemente dejan que el tiempo repare las fracturas. Este estudio pretende ser una herramienta que permita al estudiante de Medicina Veterinaria tener un mayor entendimiento acerca de los politraumatismos. Para el profesional una referencia. Se concluyó que la raza y edad de las mascotas, así mismo, como la época del año (invierno) son factores determinantes en el surgimiento de Politraumatismo óseo, los cuales se localizan con mayor frecuencia en mascotas a nivel cubito/radio, fémur, tibia y peroné, la terapia mayormente utilizada fue la conservadora mediante el uso de férulas seguida de la quirúrgica con el uso de cerclaje.

La Facultad de Teología en una Iglesia llamada a ser “hospital de campaña”

En el mes de octubre del año pasado se realizó en la Facultad una Reunión de Claustro en la que participamos unos cuarenta profesores, reunidos para conversar e intercambiar ideas acerca de la entrevista que el P. Antonio Spadaro S.J. le hiciera al papa Francisco. Como los temas abordados allí fueron muchos, nos pareció oportuno señalar los que podían interesar de manera más directa a nuestra Facultad. En el diálogo tuvimos presente esa perspectiva, la de la posible recepción o incidencia entre nosotros de algunas de las afirmaciones hechas en esa entrevista. La conversación giró en torno a cuatro grandes campos temáticos: Eclesiológico; Pastoral-Moral; Espiritualidad; Diálogo fe-cultura. Haciéndome eco de esa rica experiencia, que seguramente se prolongará en el presente año académico, quisiera retener un párrafo de dicha entrevista, a partir del cual intentaré reflexionar manteniendo la misma perspectiva, a saber, la de su posible incidencia en la vida de nuestra Facultad...

Un modelo de programación por metas para la elaboración del contrato-programa de un hospital público

[ES] Proponemos un modelo de programación por metas para la estimación del plan de producción (case-mix) que debe reflejarse en el Contrato–Programa que suscriben anualmente los Hospitales Públicos y la Administración. Las variables de decisión son los volúmenes de actividad de cada servicio médico del hospital y los atributos son los indicadores básicos que se manejan al elaborar el Contrato-Programa: fi nanciación, número de altas, estancia media y peso de complejidad. Para resolver nuestro modelo empleamos la herramienta SOLVER de la hoja de cálculo EXCEL. La utilización de esta herramienta permite simular varios escenarios de una manera ágil, lo que es de gran ayuda para el estudio y discusión de las cantidades a contratar entre el Hospital y la Administración. El artículo finaliza con una breve presentación de los resultados obtenidos al aplicar nuestro modelo a un hospital de tamaño medio (118 camas) del Servicio Vasco de Salud.

Las aportaciones del Condado de Treviño a las instituciones de Vitoria en la Edad Moderna: La Colegial de Santa María y el Hospital de Santiago

Ponencia presentada en I Congreso de Estudios Históricos del Condado de Treviño: 850 aniversario de la fundación de la Villa de Treviño, celebrado los días 1,2 y 3 de junio de 2011 en Treviño (Condado de Treviño)