scholarly journals Hospitals and organizational models based on the intensity of treatment: the internist's point of view

2012 ◽  
pp. 63-71 ◽  
Author(s):  
Giuseppe Chesi ◽  
Fabrizio Boni

IntroductionThe type of patients being treated in our hospitals has changed significantly. Today's patients are much older with more complicated, polypathological problems. As a result, hospital organization and management structures must also change, particularly in Internal Medicine. A widely discussed approach, organization according to “intensity of treatment,” could be an appropriate solution from an organizational viewpoint that would also satisfy these new demands.Materials and methodsWith the aid of a questionnaire sent to internists working in the hospitals of Italy's Emilia-Romagna region and the review of the relevant medical literature, we defined structural, organizational, technological, managerial, and staffing characteristics to better determine and classify this model. We analyzed questionnaire responses of 31 internists heading operative units in their hospitals, a relatively homogeneous subgroup with experience in organizing and managing healthcare as well as its clinical aspects.ResultsAnalysis of these questionnaires revealed important points concerning the model: 1) an accurate identification of the medical care on which to base the model; 2) a well-defined strategy for differentiated allocation of staff to structural and technological areas depending on the level of medical care provided in the area; 3) an accurate definition of the types and features of patients targeted by each level of medical care; 4) an early exchange (starting from the patient's arrival in the Emergency Department) of information and medical knowledge among Emergency Department physicians and those present during the initial stages of hospitalization; 5) a precise definition of responsibilities in the different areas, operative and collaborative stages among different physicians and medical staff, the different disciplines involved in the process.ConclusionsAmong the physicians responsible for managing complex areas of Internal Medicine in Emilia-Romagna hospitals, organization of medical care on the basis of treatment intensity is generally considered the model most likely to meet the demands of the patients being treated in our hospitals. However, application of this model requires a well-defined organizational method. Levels of medical care and organizational instruments need to be precisely defined within this method. Simple differentiated organization of nursing care is clearly no substitute for an organizational model of this kind.

2019 ◽  
Vol 30 (2) ◽  
pp. 109-122
Author(s):  
Aleksandar Bulajić ◽  
Miomir Despotović ◽  
Thomas Lachmann

Abstract. The article discusses the emergence of a functional literacy construct and the rediscovery of illiteracy in industrialized countries during the second half of the 20th century. It offers a short explanation of how the construct evolved over time. In addition, it explores how functional (il)literacy is conceived differently by research discourses of cognitive and neural studies, on the one hand, and by prescriptive and normative international policy documents and adult education, on the other hand. Furthermore, it analyses how literacy skills surveys such as the Level One Study (leo.) or the PIAAC may help to bridge the gap between cognitive and more practical and educational approaches to literacy, the goal being to place the functional illiteracy (FI) construct within its existing scale levels. It also sheds more light on the way in which FI can be perceived in terms of different cognitive processes and underlying components of reading. By building on the previous work of other authors and previous definitions, the article brings together different views of FI and offers a perspective for a needed operational definition of the concept, which would be an appropriate reference point for future educational, political, and scientific utilization.


2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Wilson Otto Gomes Batista ◽  
Alexandre Gomes De Carvalho

Contrast-detail (C-D) curves are useful in evaluating the radiographic image quality in a global way. The objective of the present study was to obtain the C-D curves and the inverse image quality figure. Both of these parameters were used as an evaluation tool for abdominal and chest imaging protocols. The C-D curves were obtained with the phantom CDRAD 2.0 in computerized radiography and the direct radiography systems (including portable devices). The protocols were 90 and 102 kV in the range of 2 to 20 mAs for the chest and 80 kV in the range of 10 to 80 mAs for the abdomen. The incident air kerma values were evaluated with a solid state sensor. The analysis of these C-D curves help to identify which technique would allow a lower value of the entrance surface air kerma, Ke, while maintaining the image quality from the point of view of C-D detectability. The results showed that the inverse image quality figure, IQFinv, varied little throughout the range of mAs, while the value of Ke varied linearly directly with the mAs values. Also, the complete analysis of the curves indicated that there was an increase in the definition of the details with increasing mAs. It can be concluded that, in the transition phase for the use of the new receptors, it is necessary to evaluate and adjust the practised protocols to ensure, at a minimum, the same levels of the image quality, taking into account the aspects of the radiation protection of the patient.


Author(s):  
Olena Karpenko ◽  
Tetiana Stoianova

The article is devoted to the study of personal names from a cognitive point of view. The study is based on the cognitive concept that speech actually exists not in the speech, not in linguistic writings and dictionaries, but in consciousness, in the mental lexicon, in the language of the brain. The conditions for identifying personal names can encompass not only the context, encyclopedias, and reference books, but also the sound form of the word. In the communicative process, during a free associative experiment, which included a name and a recipient’s mental lexicon. The recipient was assigned a task to quickly give some association to the name. The aggregate of a certain number of reactions of different recipients forms the associative field of a proper name. The associative experiment creates the best conditions for identifying the lexeme. The definition of a monosemantic personal name primarily includes the search of what it denotes, while during the process of identifying a polysemantic personal name recipients tend have different reactions. Scientific value is posed by the effect of the choice of letters for the name, sound symbolism, etc. The following belong to the generalized forms of identification: usage of a hyperonym; synonyms and periphrases or simple descriptions; associations denoting the whole (name stimulus) by reference to its part (associatives); cognitive structures such as “stimulus — association” and “whole (stimulus) — part (associative)”; lack of adjacency; mysterious associations. The topicality of the study is determined by its perspective to identify the directions of associative identification of proper names, which is one of the branches of cognitive onomastics. The purpose of the study is to identify, review, and highlight the directions of associative identification of proper names; the object of the research is the names in their entirety and variety; its subject is the existence of names in the mental lexicon, which determines the need for singling out the directions for the associative identification of the personal names.


Author(s):  
Marina Aleksandrovna Kalievskaya

In this article, a model of the mechanism of ensuring public security and orderliness in accordance with the principles and tasks of the relevant institu- tions in public administration, taking into account resources, technologies, mea- sures for the state policy implementation in the spheres of ensuring the protection of human rights and freedoms, the interests of society and the state, combating crime, maintaining public security and order. It was found that ensuring public security and order in Ukraine is a mechanism for the implementation of national goals of state policy in the areas of ensuring the protection of human rights and freedoms, the interests of society and the state, combating crime, maintaining public security and order, by defining tasks according to certain principles. The idea is that if one considers the state policy in the spheres of ensuring the protec- tion of human rights and freedoms, the interests of society and the state, combat- ing crime, maintaining public security and order as a national priority (purpose, task), then the mechanism of ensuring public security and order in Ukraine needs coordination with the state development strategy. From the point of view of the implementation of the state policy in the areas of ensuring the protection of hu- man rights and freedoms, the interests of society and the state, combating crime, maintaining public security and order, the mechanism of ensuring public security and order in Ukraine can be considered as the main system providing intercon- nection such elements as institutions (implementing the specified state policy), resources (human resources, logistical, natural and so on, with the help of which it is possible to implement state policy), technologies (skills, knowledge, means and so on the implementation of state policy), measures (action plans), as well as external (internal) threats.


Author(s):  
Суусар Искендерова

Аннотация: Исследование проблемы фольклоризма является наиболее актуальной в современной науке о фольклоре. На разных этапах развития художественной литературы для формирования индивидуального творчества писателя особенно значимым становятся фольклорные жанры, сюжетные мотивы и художественные средства. В статье рассматривается связь письменной литературы и фольклора, особенно точка зрения проблеме фольклоризма в прошлом и их анализ. Термин «фольклоризм» начал использоваться советскими исследователями учеными как научный термин еще в 1930-х гг. Термин «фольклоризм» используется в различных сферах культуры, а в этой статье мы будем рассматривать в литературе. Несмотря на то, что на протяжении многих лет этот вопрос изучается литературоведами, фольклористами, все -таки нет единого теоретического определения понятия. Ключевые слова: фольклор, фольклоризм, литература, культура, письменная литература, художественная литература, оседлый народ, пословицы и поговорки, фольклорные песни. Аннотация: Көркөм адабияттын өнүгүүсүнүн ар кайсы баскычтарында сүрөткердин жеке чыгармачылыгынын калыптанышы үчүн фольклордук жанрлар, сюжеттер, мотивдер жана көркөм каражаттар айрыкча мааниге ээ. Макалада жазма адабият менен фольклордук карым-катышы, айрыкча фольклоризм маселеси жөнүндө мурдагы көз караштарга кайрылып, аларга талдоо жүргүзүү менен бирге автор өз байкоолорунда келтирет. “Фольклоризм” деген илимий термин 1930-жылы баштап колдонула баштаган. “Фольклоризм” термини маданияттын түрдүү сфераларында кеңири колдо- нулат, бул жерде адабияттагы колдонулушун каралат. Макалада адабий материал менен фольклордук байланышын терең түшүнүү үчүн адабий фольклоризм маселесинин талаштуу жактары каралат. Түйүндүү сөздөр: фольклор, фольклоризм, адабият, маданият, жазма адабият, көркөм адабият, көчмөн калк, макал-лакап, фольклордук ырлар. Annotation: The study of the problem of folklore is the most relevant in the modern science of folklore. At various stages in the development of fiction, folklore genres, plot motifs, and artistic means become especially significant for the formation of the writer's individual creativity. The article examines the relationship between written literature and folklore, especially the point of view of the problem of folklorism in the past and their analysis. The term "folklorism" began to be used by Soviet scholars as a scientific term back in the 1930s. The term "folklorism" is used in various fields of culture, and in this article we will consider in the literature. Despite the fact that for many years this issue has been studied by literary scholars, folklorists, all the same there is no single theoretical definition of the concept. Keywords: folklore, folklorism, literature, culture, written literature, fiction, settled people, proverbs and sayings, folk songs.


2020 ◽  
Vol 10 ◽  
pp. 62-69
Author(s):  
К. А. Pisenkо ◽  

The article is devoted to defining the main approaches to classifying acts as violations of аntimonopoly legislation. On administrative and judicial practice discusses current issues and problems of definition of illegal acts, both from the point of view of antimonopoly regulation, and the delineation of antimonopoly violations and violations of other mandatory requirements established by the legislation of the Russian Federation.


Author(s):  
Anatoly S. Kuprin ◽  
Galina I. Danilina

The purpose of this study is the analysis of limit situation in the narrative of war. The material of the study is the novel of Daniil Granin “My Lieutenant” and related texts. In the first part of the paper, the authors explore existing approaches to the term “limit situation” and similar concepts into scientific and philosophical traditions; limits of its applicability in literary studies and its relation to the categories of “narrative instances” and “event”. Proposed a literary-theoretical definition of the limit situation, which can be used in the analysis of fiction texts. Existing approaches to the examination of the situation of war are analyzed: philosophical-existential, psychoanalytic, sociological, literary. In the second part of the paper, the authors propose their method for analyzing limit situations in texts about war, which basis on existing approaches and preserves the text-centric principle of studying the structure of the story. Two interrelated areas of research have been identified: the study of war as a continuous limit situation in the intertextual aspect (the discourse of war); the study of limit situations (death, suffering, guilt, accident) in the narrative of war as part of a specific text. In the third part of the scientific work,the analysis of war as a continuous limit situation results in the study of the concept of “limit” (border) in a fiction text. The role of “limit” (border) concept in the texts about the war is studied, the possible types of limits in the discourse of war are examined. Limit situations in the narrative of war are analyzed on the basis of the novel “My Lieutenant” by Daniil Granin. A review of journalistic and scientific works about the novel revealed both the continuity and the differences between the novel and the “lieutenant” prose of the 20th century. An analysis of the limit situations in the novel revealed their key position in the narrative. These situations are independent of the fiction time, of the fluctuation of the point of view’; the function of the abstract author is to build the narrative as a “directive” immersion of the hero and narrator in these situations.


2015 ◽  
Vol 5 (2) ◽  
pp. 148-171
Author(s):  
Denisa Gunišová ◽  
Jana Duchovičová

Authors in this contribution focus on issue of subject matter structure creation by the teacher as an important psycho-didactic domain of education process and how does a student perceive this structure. The aim of the teacher is not only to impart the knowledge to students but also to show them and teach them possible ways of how to understand the subject matter better and how to get to the fundamentals of it. Based on the structure of subject matter created by the teacher a student creates cognitive frames which become basis for his further learning. We pay attention to definition of epistemology of subject matter structure, questions of psycho-didactic approach to teaching, creating structure of subject matter and how does the teacher work with the text. Empirical part of the contribution investigates teachers' preferences of subject matter structure and statistically describes subjective perception of level of understanding of the subject matter by a student influenced by the particular subject matter structure realized by the teacher.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040699
Author(s):  
Fares Alahdab ◽  
Andrew J Halvorsen ◽  
Jayawant N Mandrekar ◽  
Brianna E Vaa ◽  
Victor M Montori ◽  
...  

BackgroundThere has been limited research on the positive aspects of physician wellness and to our knowledge there have been no validity studies on measures of resilience and grit among internal medicine (IM) residents.ObjectivesTo investigate the validity of resilience (10 items Connor-Davidson Resilience Scale (CD-RISC 10)) and grit (Short Grit Scale (GRIT-S)) scores among IM residents at a large academic centre, and assess potential associations with previously validated measures of medical knowledge, clinical performance and professionalism.MethodsWe evaluated CD-RISC 10 and GRIT-S instrument scores among IM residents at the Mayo Clinic Rochester, Minnesota between July 2017 and June 2019. We analysed dimensionality, internal consistency reliability and criterion validity in terms of relationships between resilience and grit, with standardised measures of residents’ medical knowledge (in-training examination (ITE)), clinical performance (faculty and peer evaluations and Mini-Clinical Evaluation Examination (mini-CEX)) and professionalism/dutifulness (conference attendance and evaluation completion).ResultsA total of 213 out of 253 (84.2%) survey-eligible IM residents provided both CD-RISC 10 and GRIT-S survey responses. Internal consistency reliability (Cronbach alpha) was excellent for CD-RISC 10 (0.93) and GRIT-S (0.82) overall, and for the GRIT subscales of consistency of interest (0.84) and perseverance of effort (0.71). CD-RISC 10 scores were negatively associated with ITE percentile (β=−3.4, 95% CI −6.2 to −0.5, p=0.02) and mini-CEX (β=−0.2, 95% CI −0.5 to −0.02, p=0.03). GRIT-S scores were positively associated with evaluation completion percentage (β=2.51, 95% CI 0.35 to 4.67, p=0.02) and conference attendance (β=2.70, 95% CI 0.11 to 5.29, p=0.04).ConclusionsThis study revealed favourable validity evidence for CD-RISC 10 and GRIT-S among IM residents. Residents demonstrated resilience within a competitive training environment despite less favourable test performance and grittiness that was manifested by completing tasks. This initial validity study provides a foundation for further research on resilience and grit among physicians in training.


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