A Model for Continuing Comprehensive Care in A University Hospital General Medical Clinic.

1971 ◽  
Vol 74 (5) ◽  
pp. 836
Author(s):  
Timm A. Zimmerman
Keyword(s):  
Comprehensive Care ◽  
University Hospital ◽  
Medical Clinic ◽  
General Medical Clinic ◽  
Hospital General

Therapeutic itinerary of transsexual people in light of human rights

2020 ◽  
pp. 096973302096886
Author(s):  
Larissa Luise Ferreira Florêncio ◽  
Karla Romana de Souza ◽  
Elizandra Cassia da Silva Oliveira ◽  
Juliana da Rocha Cabral ◽  
Felicialle Pereira da Silva ◽  
...  
Keyword(s):  
Human Rights ◽  
Health Services ◽  
Fundamental Rights ◽  
Comprehensive Care ◽  
University Hospital ◽  
Service Networks ◽  
Health Services Use ◽  
Transgender People ◽  
Individual Interviews ◽  
Human Research Ethics

Background: The therapeutic itinerary is not limited to the identification and availability of health services offered, but relates to the different individual searches and sociocultural and economic possibilities of each patient. In this study, we discuss the therapeutic itinerary of transsexual people seeking healthcare, from the user’s perspective. Objective: The aim of this study was to discuss the therapeutic itinerary of transsexual people seeking healthcare, from the user’s perspective. Design and participants: Individual interviews were performed with 10 transsexuals at the Trans Space of a University Hospital of Pernambuco, using the Universal Declaration of Human Rights as the theoretical reference and the Bardin’s thematic content analysis as the reference methodological framework. Ethical considerations: This study was approved by the Human Research Ethics Committee at the Federal University of Pernambuco under protocol no. 91284218.5.0000.5208. Findings: The comprehensive care for transsexual people was evidenced through four categories analyzed: low demand of transsexuals in health services; use of social name in health services; care permeated by prejudiced and discriminatory attitudes; and health system and professionals who are not able to meet transgender health issues. Discussion: Transsexual people are stigmatized and experience prejudice in their daily health, in a way they do not enjoy fundamental rights, as if they had fewer rights, or infringe the principle of universality of access to health. Thus, for effective and comprehensive care, the health team must keep up to date on the public policies existing in the healthcare of transsexual people and reconstruct what they understand by gender. Conclusion: Knowledge about the therapeutic itinerary of transgender people may support evaluation processes of health service networks to ensure the access to and reorganization of these services. Understanding this dynamic allows fostering discussions about the structure of health services at all care levels for the care of this population.

Depression and physical illness among elderly general medical clinic patients

1986 ◽  
Vol 10 (2) ◽  
pp. 153-162 ◽  
Author(s):  
W.A. Kukull ◽  
T.D. Koepsell ◽  
T.S. Inui ◽  
S. Borson ◽  
J. Okimoto ◽  
...  
Keyword(s):  
Physical Illness ◽  
Medical Clinic ◽  
General Medical Clinic

Screening for Psychiatric Morbidity in a Medical Outpatient Clinic for HIV Infection: The Need for a Psychiatric Presence

1994 ◽  
Vol 24 (2) ◽  
pp. 103-113 ◽  
Author(s):  
Constantine G. Lyketsos ◽  
Anne Hanson ◽  
Marc Fishman ◽  
Paul R. McHugh ◽  
Glenn J. Treisman
Keyword(s):  
Medical Care ◽  
General Health Questionnaire ◽  
Psychiatric Morbidity ◽  
Self Report ◽  
Johns Hopkins Hospital ◽  
Medical Clinic ◽  
Medical Clinics ◽  
High Prevalence ◽  
First Time ◽  
Hospital General

Objective: To ascertain the prevalence and type of psychiatric morbidity present in HIV infected patients presenting for the first time to a specialty HIV medical clinic. Also, to develop a way of screening for psychiatric cases in this setting using established self-report questionnaires. Method: Fifty patients who presented consecutively for medical care at the Johns Hopkins Hospital General HIV Clinic participated in this study. These patients were first screened using the General Health Questionnaire and the Beck Depression Inventory and subsequently underwent a comprehensive neuropsychiatric evaluation. Results: Fifty-four percent were found to suffer from a psychiatric disorder with an additional 22 percent from an active substance use disorder. These rates are one-and-one-half to two times higher than those reported from other medical clinics. The GHQ and BDI used together as screens could identify psychiatric “cases” with a sensitivity of 81 percent and a specificity of 61 percent, an efficacy similar to that found in other clinics. Conclusions: Given the high prevalence of psychiatric disorders in HIV infected patients presenting for medical care, screening, evaluating, and treating for these disorders is crucial and should be pursued systematically. This is best done through the presence of a psychiatric team within HIV medical clinics rather than in affiliation with such clinics.

scholarly journals Use of monitoring indicators in hospital management of antimicrobials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ravena Melo Ribeiro da Silva ◽  
Simonize Cunha B. de Mendonça ◽  
Ingrid Novaes Leão ◽  
Quesia Nery dos Santos ◽  
Alessandra Macedo Batista ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Analytical Study ◽  
University Hospital ◽  
Medical Clinic ◽  
Carbapenem Resistant ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Length Of Therapy ◽  
Surgical Clinic ◽  
Gathering Data

Abstract Background According to the literature, 25% to 50% of antimicrobials prescribed in hospitals are unnecessary or inappropriate, directly impacting antimicrobial resistance. Thus, the present study aimed to evaluate the use of antimicrobials in a university hospital in Northeast Brazil, using days of therapy (DOT) and length of therapy (LOT) indicators in accordance with the latest national and international recommendations for monitoring the use of antimicrobials. Methods This is an observational, prospective analytical study conducted in a teaching hospital, with 94 active beds, distributed between the intensive care unit (ICU), the surgical clinic (SUR), the medical clinic (MED), the pneumology/infectology department (PNE/INF) and pediatrics (PED). The duration of the study was from the beginning of January to the end of December 2018. Results During the study period, a total of 11,634 patient-days were followed up and 50.4% of the patients were found to have received some antimicrobial, with a significant reduction in use of 1% per month throughout the year. Patients were receiving antimicrobial therapy for 376 days in every 1000 days of hospitalization (LOT = 376/1000pd). Overall, the 1st-generation cephalosporins and fluoroquinolones were the most used in respect of the number of prescriptions and the duration of therapy. The calculated global DOT/LOT ratio showed that each patient received an average of 1.5 antimicrobials during the hospital stay. The incidence of antimicrobial resistance, globally, for both methicillin-resistant Staphylococcus aureus (methicillin R), Carbapenem-resistant Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii (Carbapenem R), was 1 per 1000 patient-days. Conclusions The results obtained from the analyses revealed that half of the patients admitted to the hospital who took part in the study were exposed to the use of antimicrobials at some point during their stay. Although moderate, it is noteworthy that there was a decline in the use of antimicrobials throughout the year. The indicators used in this study were found to be very effective for gathering data on the use of antimicrobials, and assessing the results of the initiatives taken as part of the Stewardship program.

scholarly journals Effect of COVİD-19 Pandemic on General Surgery Practice and Resident Education

2021 ◽  
Author(s):  
Timuçin Erol ◽  
Kamran Mahmudzada ◽  
Busenur Kırımtay ◽  
Doğukan Doğu ◽  
Mustafa Oruç ◽  
...  
Keyword(s):  
General Surgery ◽  
Sudden Change ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Case Volume ◽  
Cross Sectional ◽  
Residency Programs ◽  
Surgical Residency ◽  
Surgery Department ◽  
Hospital General

Abstract Background Sudden change in general surgery practice during pandemic caused a detrimental effect on residency training. The main objective of this study is to reveal the effect of Covid-19 pandemic on general surgery practice and surgical residency education. Methods This retrospective cross sectional study included all patients operated at a tertiary university hospital, general surgery department between 11-March 2019/ 11- January-2019 (Pre-Covid 19 Period) and 11-march 2020- 11- January − 2020 (Covid 19 period). Two period compared in terms of case volume, complexity difference and effect of this difference on residents training. Results Overall 2740 cases included to study. Elective case volume significantly decreased during pandemic (p = 0.001). This decrease is much more obvious for B-C category operations. Intermediate seniority resident’s case volumes and complexity of the cases they performed decreased during pandemic. Conclusion Surgical residency programs must be revised urgently in order to provide adequte training which altered due to Covid-19 pandemic.

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