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PubMed2001

[Mobbing--significance for private personal insurance].

The social conflict model called mobbing has hitherto almost remained undetected by private personal insurance systems. The mental and functional somatic disturbances caused by mobbing, however, have been well known for a long time and do not differ from those caused by other conflicts. Problems for the personal insurance develop from the fact that more often than not a (feigned) conflict solution will be sought by medical certifications of unfitness to work, referrals to hospitals and striving for acknowledgement of occupational disablement, none of which have a medical justification. A considerable portion of the national economic burden of mobbing will therefore--mostly unknowingly--be shouldered by private insurance companies. There are numerous medical diagnoses which may hide a mobbing conflict and are difficult to comprehend. This article represents instructions for better understanding and handling.

Costs and Cost Analysis↗
PubMed2001

[Interviews with physicians in private practice as a starting point for quality improvement in hospitals].

Subjective criteria gain importance in care research and quality management. Therefore, psychiatrists in private practice and general practitioners working in the catchment area of a psychiatric hospital were surveyed by questionnaire evaluating expectations and satisfaction concerning their collaboration with the hospital. Psychiatrists and general practitioners rated legible interim discharge letters, good in-patient treatment, adequate diagnostics, and direct referral to the hospital as most important. Psychiatrists express dissatisfaction regarding prescription of expensive drugs, lack of involvement in planning new psychiatric institutions, delivery of discharge summaries, referring back the patient after in-patient care, and delay of hospital admission. As conclusion, quality management should pay more attention to ambulatory care physicians' points of view to reduce problems of interaction between clinicians and their colleagues in private practice and to improve the treatment continuity of psychiatric patients.

Aftercare↗
PubMedDate not supplied

[Public and private in times of the pest].

The paper explores how Hannah Arendt's oppositions public-private and intimate-social can be used as an analytical tool to better understand a very concrete, extreme situation: the state of emergency triggered when an epidemiological outbreak hits a city, totally altering its inhabitants lives. Studied observation of what specific individuals (be they imagined or real) feel and think during times of epidemic is an underutilized tool that may prove helpful in studying epidemics themselves. Focusing on Camus' "The pest" and events in the city of Oran, the article looks at how victims of the plague felt about their public or private lives and their intimate and social ties.

Algeria↗
PubMed1992

[Fuzan Fujibayashi's descendents and the membership list of his private school].

The Dutch scholar Fuzan Fujibayashi's descendents are the well-known Mitsugu Fujibayashi (of Tanabe-machi, Tsuzuki-gun, Kyoto) and his family. Recently I have discovered Takayoshi Fujibayashi (of Minamioguni-machi, Aso-gun, Kumamoto) and his family line. Takayoshi Fujibayashi has Fuzan's genealogical tree and a two volume membership list of Fuzan's private school. The first volume was written by 104 students (1807-1825). The second volume was written by 73 students (1814-1821). Takayoshi Fujibayashi says that after 1825, the membership list was lost in the "Kinmon no Hen" incident in 1863. Toou Komori was Fuzan's friend. In comparing the membership list of Fuzan's private school with that of Toou Komori we see that the two lists have a few differences. I think that Fuzan was good at the Dutch language, but Toou was skillful in clinical medicine and anatomy.

History, 19th Century↗
PubMed1995

[Various institutes and the private Tokyo Medical School and Nihon Medical School, following the closing of Saiseigakusha].

The private Saiseigakusha medical school was suddenly ordered closed on August 30, 1903, under pressure from the Ministry of Education and the Tokyo University Akamon faction (Meiiji Ikai). The more than 700 remaining medical students at Saiseigakusha were astonished and despondent to see the road to learning closed to them. However, Shigenori Sonoda, leader of the medical students, and four others sent out a manifesto to the more than 700 former Saiseigakusha students, calling them to assemble at the Hongo Central Hall. There they formed the Doso Igaku Koshukai ("Classmates' Medical Institute"), and resolved to continue their studies. Former Saiseigakusha lecturer Kiyotada Ishikawa and three others helped with this institute ("Tokyo Medical school"), and moved to 59 Sendagi-machi, Hongo. In April of 1910, the Tokyo Igakkou merged with the private Nippon Igakkou ("Japan Medical School"), to become the present Nippon Ika Daigaku ("Nippon Medical College").

History, 20th Century↗
PubMed2002

What do medical students want from their professional and private life?

AIM: To analyze medical students wishes regarding their professional and private life and whether their wishes change over the years of medical studies. METHODS: We surveyed 886 of 1,686 students at the Zagreb University School of Medicine during the academic year 2000/2001. The students were asked to complete an anonymous questionnaire with two groups of 5 wishes, one group pertaining to professional and the other to personal life. Students were offered to choose a single, most appealing goal they wanted to achieve in private and professional life. RESULTS: The predominant categories of professional wishes were for humanism and achievement (36%), knowledge (31%), and altruism (22%). Among personal wishes, 42% of the students wished for intimacy and love and 38% for self-confidence. The frequency of altruistic wishes did not significantly vary over the years of study. Women wished more for self-confidence and made more altruistic wishes, whereas men preferred influence, friendship, and money. Factors, such as the year of studies, average grade, rank at admission test, and residence in a large city did not influence the students choices. CONCLUSION: The wishes of medical students over the six years of studies proved to be remarkably stable and related to personal achievement, knowledge, and altruism.

Croatia↗
PubMed1998

Fine needle aspiration of breast masses: an analysis of 1533 cases in private practice.

The diagnostic efficacy of fine needle aspiration cytology of breast masses and the causes for unsatisfactory specimens in private practices were investigated in Hong Kong. All specimens that were submitted to the histopathology unit at the Canossa Hospital between 1 January 1996 and 30 April 1997 formed the basis of this report. A total of 1533 specimens were received from 1447 patients; 274 (17.8%) cases were unsatisfactory for assessment, 1080 (70.4%) were benign, 51 (3.3%) atypical, 19 (1.2%) suspicious, and 67 (4.4%) malignant. The specimens were submitted by 105 doctors, who each performed between 1 and 561 smears. The proportion of unsatisfactory samples was high for doctors who performed an occasional fine needle aspiration (48%; overall mean, 25%). Histological correlation was available in 165 cases. The overall sensitivity was 79%, specificity 98%, positive predictive value (including the 'suspicious' category) 92%, and negative predictive value 94%. Two false positive cases that were reported as suspicious were found to be fibroadenomata following subsequent excision biopsy. No adverse clinical outcomes were recorded for the false positive cases. There were six false negative cases (reported as a cyst in one case, benign in two cases, and atypical in three cases). The results compared favourably with published data and affirmed the effectiveness of the test in private practice.

Journal Article↗
PubMed2002

[Variation in indoor air pollutant concentrations with time in a newly constructed private house].

An indoor air quality research project was conducted in a new private house built in January 1997 to investigate time course changes in formaldehyde concentrations during an 11-month period from April 1997 to February 1998. Indoor and outdoor concentrations of volatile organic compounds (VOCs) and nitrogen dioxide were also measured in August 1997 and February 1998. Indoor formaldehyde concentrations were measured 14 times (48 hrs sampling for each measurement) for 28 days in the living room, a bedroom and the kitchen in April '97. The concentrations exceeded the Japanese Government's guideline value of 0.08 ppm in 34 of the 42 (81.0%). Day to day variation in the formaldehyde concentration was found to be substantial, the range being between 0.073 and 0.232 ppm for the bedroom, for example. In June and August '97, values for 20 of 21 measurements exceeded the guideline, the results suggesting that indoor formaldehyde concentrations remain high until 7 months after the completion of construction. There were positive correlations between the formaldehyde concentrations in the living room and the kitchen and personal exposure levels to formaldehyde, the result indicating a direct influence of the home environment. The formaldehyde concentration in the living room also exhibited a positive correlation with the room temperature. Natural ventilation by opening windows was found to be effective for decreasing the concentration of formaldehyde in the indoor air. Indoor VOC concentrations decreased rapidly after the completion of construction except for that of toluene, which was higher than the outdoor concentration even after 7 months. Indoor concentrations of all of the VOCs were, however, found to be almost the same as those outdoor at the 13 month time point. Indoor nitrogen dioxide concentrations measured in the bedroom in winter (February '98) exceeded the Environmental Air Quality Standard in Japan, this result being considered due to use of an oil fan heater. These data suggest that personal exposure levels to formaldehyde and nitrogen dioxide are high in newly constructed private homes in Japan. In order to avoid prolonged exposure to high concentrations of indoor air pollutants, it is considered very important to take measures such as of use building materials with low formaldehyde emissions and to discontinue the use of oil fan heaters.

Air Pollution, Indoor↗
PubMed2002

Prenatal HIV testing in private OB-Gyn practices in Texas.

This study evaluates the prenatal human immunodeficiency virus (HIV) testing behaviors of private obstetrics and gynecology practitioners in Texas. A statewide telephone survey of 614 providers of prenatal care determined the level of HIV testing, how testing is offered, and patient acceptance of the test. Ninety-nine percent of the practices offered HIV testing to all their pregnant patients, and 96% of the practices included HIV testing in the routine panel of tests for pregnant patients. More than 95% of the practices reported that 10% or less of the women refused the test when offered it; 73% of the practices reported no refusals. Less than half of the practices, however, discussed HIV prevention topics, and only 29% of the practices referred high-risk pregnant patients for prevention counseling. Although private practices of obstetrics and gynecology report testing almost all their prenatal patients, survey results suggest that providers could improve their prevention and patient education practices.

AIDS Serodiagnosis↗
PubMed2002

[Manpower at private university hospitals in Japan].

We studied the numbers of teaching staff in anesthesiology departments and of patients operated on and managed by anesthesiologists at private university hospitals in 1999, in Japan. Questionnaires were sent to 49 institutions, and 36 responded (response rate, 73%). The mean number of patients managed by anesthesiologists in an institution was 3899 (range, 942-8135). The mean number of patients who were managed by a staff anesthesiologist was 428 cases (range, 118-980). The data indicate that a prompt increase in manpower at the private university hospitals is necessary to improve patient care, education, and research work.

Anesthesiology↗
PubMed1994

[Demographic aging in Germany and the need for care in private households: a regional perspective].

"In the Federal Republic of Germany there are regional differences in the ageing process. As a result the increase of people needing care and attention differs regionally, too. The authors deal with the following questions: Which particular regions will be most affected by the ageing process and to which extent? How is the proportion of people needing care and those providing it in private households affected by this? To which extent can private households cope with the demands of nursing elderly people at home?" The focus is on the period 1992 to 2010. (SUMMARY IN ENG)

Demography↗
PubMed2002

Hearing loss among private farmers in the light of current criteria for diminished sense of hearing.

The study covered a group of 128 private farmers aged 28-65 (mean age 47.2) who had a period of occupational activity of 11-40 years (23.9 years average). The evaluation of hearing capability was based on 2 calculated values: PTA (mean from frequency: 0.5; 1; 2 and 3 kHz) and HFA (mean from 3; 4; and 6 kHz). Statistically significant differences in mean hearing loss were observed between the 2 groups in the study: farmers-control group (p < 0.001). The value of 20 dB was adopted as a criterion of the deterioration of hearing. This criterion was exceeded in 78% of farmers examined--within the range of high frequencies (HFA), and in 45 % of farmers within the range of medium frequencies (PTA). In the control group, abnormal hearing loss was noted in 17% of people only for mean HFA value. In the group of farmers a significant correlation was noted between hearing loss (PTA and HFA) and age, as well as period of occupational activity. It was statistically confirmed that the most significant decrease in hearing occurred during the age interval up to the age of 50 and during the period of occupational activity of up to 30 years. The results of the study confirmed that noise present in the agricultural environment is the primary cause of the decrease in hearing among private farmers.

Adult↗
PubMed2003

Costs of poor birth outcomes among privately insured.

Despite expansions in the public insurance coverage of pregnant women, concerns over poor birth outcomes remain. Poor birth outcomes occur among publicly and privately insured women, however, thereby imposing excess costs on employers and their insurers. Data from a large sample of privately insured for 1996 are used to examine these outcomes and costs. Almost one-fourth (24.3 percent) of the infants in our matched sample of 12,020 deliveries was premature or had other problems at birth. Costs for these infants accounted for 82 percent of the total $56 million spent on sample infants. The incremental cost of infants with poor birth outcomes versus those with normal, full-terms was approximately $14,600. We found that these relative costs had increased over time due perhaps to the increased technology and intensity of services used to save infant lives. We also found that factors other than maternal and infant complications affected cost variations. For example, employers located in the Northeast, hiring older mothers, and in unionized sectors have higher prenatal, delivery, and infant costs.

Adult↗
PubMed2003

A comparison of the antimicrobial resistance patterns of gram-positive cocci isolated from community-private and university-affiliated hospitals from Puerto Rico.

The antimicrobial resistance patterns of 2,462 selected Gram-positive cocci obtained from three Community-Private Hospitals (CPH) and three University-Affiliated Hospitals (UAH) were evaluated utilizing the institutions' antimicrobial susceptibility reports for the year 2000. The objectives of this study were: 1) to evaluate the in vitro resistance to selected standard antibiotics of Staphylococcus aureus, Enterococcus faecalis, Enterococcus faecium and Streptococcus pneumoniae clinical isolates, and 2) to compare the antimicrobial resistance patterns between community-private (CPH) and university-affiliated hospitals (UAH). Staphylococcus aureus was the most common Gram-positive isolated organism in CPH (63.3%) followed by E. faecalis (31.0%). In UAH, the most prevalent cocci were E. faecalis (51.7%) followed by S. aureus (43.9%). Enterococcus faecium represented 2.3% and 4.4% of CPH and UAH isolates, respectively. Streptococcus pneumoniae represented 3.4% of the total Gram-positive isolates from CPH, no S. pneumoniae was reported in UAH. The antimicrobial susceptibility results showed that for Staphylococcus aureus there was a statistically significant higher resistance to methicillin and thrimethoprim sulfamethoxazole in UAH, while resistance to erythromycin was significantly higher in CPH. There was no difference in the resistance of S. aureus to other antimicrobial agents between hospitals groups. A statistically significant resistant to vancomycin was found between enterococcal isolates from UAH (43%) and CPH (12.7%). High-level aminoglycoside resistance (HLAR) was observed among UAH enterococcal isolates with E. faecium showing a higher resistance than E. faecalis, no data for HLAR in CPH could be obtained. For pneumococci 46% of CPH isolates were resistant to penicillin. In summary, there are important differences in the prevalence and antimicrobial resistance between the Gram-positive bacteria isolated from community and teaching hospitals.

Anti-Bacterial Agents↗
PubMed1992

[Psychiatric hospitalization in public wards and in private clinics. A comparative study on a population of a district of Turin from 1981 to 1988].

After the 1978 psychiatric reform law, public inpatient facilities (SPDC) and private clinics, with a higher number of available beds, coexist in the metropolitan area of Turin. Presented data, concerning the population of a specific catchment area, allow a comparison between the admissions in the two kinds of facilities. Patients hospitalized in 1981 were followed up to 1989, evaluating their contacts with the Community Mental Health Centre (SSM). A higher number of admissions in private clinics emerges, but there is no progressive increase during the considered period. The SPDC has evolved towards a sort of 'specialization' in psychotic syndromes; lengths of stay, moreover, were shorter. Public services (SPDC and SSM) seem to play a limited role in meeting the demand for psychiatric care expressed by the considered population.

Female↗
PubMedDate not supplied

Posterolateral lumbar spine fusions: private v. NHS. Comparative, preliminary study.

In the present study comparative evaluation has been carried out between the groups of patients (31 in each group, private and National Health Service) treated by posterolateral lumbar spine fusion for mechanical lower back pain. The same surgical team was involved in the treatment. The patients were evaluated independently at an average follow-up of more than three years in each group. The acceptable clinical results (good and fair) showed a remarkable difference between the two groups, with the private group enjoying the better outcome. The difference of final outcome was analyzed by looking at the waiting time for surgery, the social classification of the patients and the provision of state benefit for disability.

Adult↗
PubMed1992

The process and outcome of hospital care for Medicaid versus privately insured hospital patients.

Some have argued that low Medicaid payment rates compromise the accessibility and quality of medical care for Medicaid beneficiaries. In this study we compare the process and outcome of hospital care for Medicaid versus privately insured hospital patients. We studied 4,033 emergency patients admitted with a principal diagnosis of acute myocardial infarction, to Massachusetts hospitals in 1987. After we statistically adjusted for differences among patients relating to clinical and demographic characteristics and the type of hospital where treatment occurred, we found that the Medicaid patients had longer hospital stays but were less likely to receive three selected coronary procedures. Moreover, after controlling for confounding variables, we found the risk of death for Medicaid patients to be almost twice as high as for privately insured patients.

Angiography↗
PubMed1992

Private pensions. A less taxing alternative.

The results of the Joneses' coordinated retirement income and estate planning strategies are as follows: 1. The Joneses maximized their estate assets by converting an inefficient estate asset (the qualified retirement plan) into an efficient estate asset (the income-tax-free death benefit) without jeopardizing their current or future standard of living or the value passed on to their heirs. This allows them to satisfy their conflicting objectives. 2. They added flexibility to their future family gifting plans by providing themselves a secure income for the rest of their lives. 3. They fulfilled their desire to protect their family against government confiscation of retirement plan assets in the event they both die before using all their qualified retirement assets. This private pension plan strategy is obviously not available to everyone, nor is it appropriate for everyone. This solution worked well for this client, but everyone's situation is unique. Before creating such a plan, it is important to review all the factors in an individual's financial picture, including financial and retirement objectives and investment risk tolerance. Although this is an innovative idea that may solve a pension dilemma, it should not be used in place of qualified retirement plans but, rather, used in conjunction with such a plan. The private pension plan does not work with all insurance products or all insurance companies. Choosing the right company and product for each client requires care and expertise.

Financing, Personal↗