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PubMed1995

[Control of the work environment in Sweden. I. Instances of control].

The authors discuss the system of the working environment control in Sweden. They presented the organizational structure, objectives, range of activities and priorities of the Labour Inspectorate--a state administration organ responsible for a direct supervision of individual establishments. Basic figures on the control and supervising activities of the Inspection for 1994 are given. The system how the National Board of Occupational Safety, Hygiene and Workers' Health--a body superior to the Labour Inspectorate--coordinates and monitors its activities, is also presented.

Environmental Monitoring↗
PubMed1997

An alternative approach for neonatal clinical pathways.

Defining a generic plan of care for neonatal intensive care patients seems like an impossible task. Many institutions have elected to purchase plans already developed by other practitioners. Implementing these plans can be a frustrating and discouraging experience. In our organization, administration supported multidisciplinary development of pathways, enabling us to review current practice and recommend enhancements in care provision that maintained quality while reducing resource utilization. This article describes how the staff in our 45-bed, Level III NICU, staffed with attending neonatologists, approached the challenge of defining care practices for a diverse patient population.

Cost Control↗
PubMedDate not supplied

[Nosocomial infection in a pediatric intensive care unit].

UNLABELLED: Patients in intensive care units (ICU) are 3 to 4 times more prone to nosocomial infection (NI) than patients in general wards owing to the severity of their pathology and the frequent use of invasive procedures. The aim of this study was to establish the incidence of NI in an ICU and the associated risk factors. PATIENTS AND METHODS: During 18 months, all patients with severity scores III and IV (Clinical Classification System) were studied, (n = 575). The admissions were mainly due to accidents (24.7%), neurological (19.1%), surgical (17.2%), respiratory (11.1%) and infectious (7.0%) disease. The mean duration of stay was 2.4 days. The mortality was 5.2%. The evaluation protocol of these patients included determination of the PRISM score, registration of every invasive procedure and daily search for clinical and laboratory signs of infection. NI was defined according to the criteria of the Centers for Disease Control. Both the intrinsic and extrinsic risk factors were analysed and in the statistical analysis the null hypothesis was rejected at the significance level of p < 0.05. RESULTS: The incidence of NI was 7.6%. The infections occurred in the respiratory tract in 20 patients, bloodstream in 8, genito-urinary tract in 2, central nervous system in 2, skin in 2, gastrointestinal tract in 2, eyes in 1 and surgical wound in 1. There were isolates in 60.6%. The mean duration of stay was longer in patients with NI (9.8 versus 1.9). The factors most closely associated with NI were higher PRISM scores, malnutrition, immunodeficiency failure of 2 or more organs, administration of antibiotic since admission or corticosteroids and simultaneous use of 3 or more invasive procedures. The risk of pneumonia was significantly increased in patients with mechanical ventilation and all the patients with bacteremia had central venous catheters. The mortality was higher in the group with NI (18.2%) than in the group without NI (4.4%). CONCLUSIONS: The incidence of NI is acceptable in our ICU. The most frequent location was the respiratory tract (52.6%). The pathogens most frequently isolated in this ICU were Gram negative rods. The risk of NI increased in more debilitated patients with more severe disease who were administered antibiotic or corticosteroids and submitted to more invasive procedures.

Adolescent↗
PubMedDate not supplied

[Development in the National Hospice Care Service in Korea].

The urgent needs to establish hospice care systems in Korea arise from the following reasons: (1) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e.g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accommodate other medical insurance beneficiaries: (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life: (6) medical and nursing care of AIDS patient in terminal stage: (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage, grouped in hospice and non-hospice care patients, reveal what they want visiting nursing care to help their pain control, psychological, social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains, the non-hospice care patients, in addition to their desire for pain control, demanded more psychological, social and spiritual helps as well. The results of this research could be utilized to (1) define the standard of hospice care, (2) provide the guidance for hospice medical care costs, (3) establish the database of hospice care systems, (4) develop softwares, (5) build communication network through Medinet, and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy, nursing care, and social welfare programs.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Apoptosis in murine lymphoid organs following intraperitoneal administration of dimethyl sulfoxide (DMSO).

A significant increase in lymphocyte apoptosis was detected by the TUNEL method in the thymus, spleen, and Peyer's patches (PP) following intraperitoneal (i.p.) administration of dimethyl sulfoxide (DMSO) (treatment, n = 47; control, n = 8). Interestingly, administration of low doses of DMSO caused apoptosis in only the PP, and suggested that i.p. administration of DMSO induced apoptosis for each lymphoid organ in a dose dependent manner. Moreover, in the early stage during the apoptotic change, a characteristic localization of lymphocytes undergoing apoptosis was observed. Briefly, early apoptosis occurred predominantly in the cortical mid-zone of the thymus, white pulp of the spleen, and germinal centers of PP. With increased time following administration, however, lymphocytes throughout lymphoid tissues, independent of characteristic localization during the early stage, seemed to undergo apoptosis, resulting in the severe loss of lymphocytes. In fact, the relative spleen weight significantly decreased at 24 h following DMSO administration (n = 7; P < 0.001 versus 8 control mice). Taken together, these results showed for the first time that the in vivo administration of DMSO to mice caused apoptosis in lymphoid organs, and also demonstrated that the apoptotic behavior varied between different lymphoid organs.

Animals↗
PubMed1975

Norepinephrine content of various rat organs after chronic administration of desmethylimipramine.

The effect of chronic oral administration of desmethylimipramine (DMI) on the norepinephrine (NE) content of various organs was examined in rats. The present results show that in contrast to its effect on the brain, where it lowered the NE concentration, chronically administered DMI either did not change (vas deferens) or tended to increase (heart and spleen) the NE concentrations in the examined peripheral organs. The effect of chronic DMI administration on the brain seems to be specific since this was the only studied organ in which a decreased NE concentration was observed.

Animals↗
PubMed2002

Prevention of scours in neonatal kids after oral administration of an organic acid solution.

The purpose of this study was to evaluate under field conditions, the efficacy of mild organic acid solutions in the prevention of neonatal kid diarrhoea. At a goat farm, two experimental groups of approximately 120 kids each were formed. The kids of the first group were not submitted to any treatment and served as negative controls, whereas the kids of the second group received a solution of organic acids (Euroacid 50-L; Eurotec, Waterloo, Belgium) which was administered orally on the first and second day of life. Groups were compared with regard to the incidence of diarrhoea, its duration, and the mortality of the kids. The results showed that, in comparison with the control group, the morbidity, the mortality and the case fatality of the treated kids was significantly reduced (P < 0.05). Furthermore, the duration of diarrhoea per sick kid was markedly reduced in the acidifier-treated group in comparison with the control animals (P < 0.05). Cultures of the diarrhoeic faeces from kids indicated that enterotoxigenic strains of Escherichia coli, and more specifically strains that were positive for K88 and K99 antigens, were present in the particular farm. It was concluded that the administration of organic acids can be a helpful means in controlling scours in neonatal kids.

Administration, Oral↗
PubMed1964

THE FORUM MEETING.

Explore the source record for details and available documents.

Organization and Administration↗
PubMedDate not supplied

Administrative competencies for physician organizations with capitation.

In California, it is common for HMOs to capitate physician organizations (e.g., independent practice organizations and multispecialty medical groups) for all professional and outpatient ancillary services (and to share risk for inpatient care) under professional risk capitation contracts. This arrangement exports most of the financial risk from the HMO to the physician organization. When HMOs and physician organizations contract under these arrangements, HMOs delegate many of their administrative functions to physician organizations--giving the physician organization authority to make the decisions needed to manage capitated risk. As a result, administrators of physician organizations must be competent in such areas as provider network development, financial forecasting, utilization and quality management, contract negotiation, and establishing systems for claims, reporting, authorizations, and the like. In this study four HMO and 22 physician organization administrators were interviewed concerning key administrative competencies for managing capitation contracts. The competencies were assessed as key administrative work activities that required specific knowledge, skill, or ability to perform. Identifying these competencies is important for physician organizations preparing for capitated risk and will be essential for organizations preparing for HMO or Medicare capitation.

Administrative Personnel↗
PubMed1989

Pharmacokinetics of falintolol II. Absorption, distribution and elimination from tissues and organs following ocular administration and intravenous injection of falintolol in albino rabbits.

The absorption, distribution and elimination of falintolol maleate was studied in various ocular and extraocular tissues and organs following ocular instillation, intravenous injection of a 0.5% 14C-falintolol ophthalmic solution and repeated ocular instillations of a 1% non-labeled falintolol ophthalmic solution into albino New Zealand rabbits. Falintolol was distributed in all studied tissues and organs after both routes of administration. After ocular instillation, levels of total radioactivity were distinctly higher in ocular tissues than after intravenous injection. Thus, the level was 475 times more important in cornea, 72 times in aqueous humor and 36 times in iris and ciliary body after ocular instillation. On the other hand, levels of total radioactivity in extraocular tissues and organs were 30-50% higher after intravenous injection compared to ocular instillation of the same dose. Peak levels of total radioactivity were generally achieved between 30 min and 1 h after ocular instillation, while 1.5 h after intravenous injection an increase in the declining part of the curve occurred. This increase, characteristic of an enterohepatic reabsorption, was also observed in blood and plasma 1 h after intravenous injection. Urinary elimination was the major means of excretion since 79.6% of total radioactivity was found in urine 6 h after intravenous injection and 74.5% 12 h after ocular instillation. But after ocular instillation, only 5% was excreted as unchanged falintolol. Whatever the route of administration, after single or repeated application, no drug accumulation was evident.

Administration, Topical↗
PubMed1984

Blending administrative and community organization practice: the case of community residential facilities.

The authors discuss the management of community programs serving deinstitutionalized populations. They make a case for the concept of "community integration" (re-entry into society), arguing that translating the concept into meaningful practice requires clearer specification of the relevant client communities and calls for a blending of traditional administrative and community organizations skills, with resultant implications for social work education. Illustrations are drawn from the field of mental health and the needs of the chronically mentally ill.

Community Mental Health Services↗