An evidence-based definition of anemia for singleton, uncomplicated pregnancies

Background The definition for anemia in pregnancy is outdated, derived from Scandinavian studies in the 1970’s to 1980’s. To identity women at risk of blood transfusion, a common cause of Severe Maternal Morbidity, a standard definition of anemia in pregnancy in a modern, healthy United States cohort is needed. Objective To define anemia in pregnancy in a United States population including a large county vs. private hospital population using uncomplicated patients. Materials and methods Inclusion criteria were healthy women with the first prenatal visit before 20 weeks. Exclusion criteria included preterm birth, preeclampsia, hypertension, diabetes, short interval pregnancy (<18 months), multiple gestation, abruption, and fetal demise. All women had iron fortification (Ferrous sulfate 325 mg daily) recommended. The presentation to care and pre-delivery hematocrits were obtained, and the percentiles determined. A total of 2000 patients were included, 1000 from the public county hospital and 1000 from the private hospital. Each cohort had 250 patients in each 2011, 2013, 2015, and 2018. The cohorts were compared for differences in the fifth percentile for each antepartum epoch. Student’s t-test and chi-squared statistical tests were used for analysis, p-value of ≤0.05 was considered significant. Results In the public and private populations, 777 and 785 women presented in the first trimester while 223 and 215 presented in the second. The women at the private hospital were more likely to be older, Caucasian race, nulliparous, and present earlier to care. The fifth percentile was compared between the women in the private and public hospitals and were clinically indistinguishable. When combining the cohorts, the fifth percentile for hemoglobin/hematocrit was 11 g/dL/32.8% in the first trimester, 10.3 g/dL/30.6% in the second trimester, and 10.0 g/dL/30.2% pre-delivery. Conclusions Fifth percentile determinations were made from a combined cohort of normal, uncomplicated pregnancies to define anemia in pregnancy. Comparison of two different cohorts confirms that the same definition for anemia is appropriate regardless of demographics or patient mix.

Experiencing pregnancy at an advanced maternal age in a private hospital

Objective: to describe the experiences of pregnant women at advanced maternal age assisted in a private hospital. Methods: a qualitative study, carried out with 17 women, by means of semi-structured interviews via telephone. The data was submitted to Thematic Content Analysis. Results: the participants were between 35 and 40 years old. Two categories emerged: Experiencing pregnancy as a couple and family: the preparation of the couple for pregnancy and childbirth (Pregnancy after 35 years old as an element of potentiality; Change in the family routine for the baby’s arrival) and Experiencing pregnancy and its changes: perceiving pregnancy as a healthy and calm experience (Change in emotional patterns related to the pregnancy process). Conclusion: experiencing pregnancy late in life was not a concern for women. Maturity and favorable socioeconomic conditions may have a protective influence on the course of healthy pregnancies in women attending the private health service.

Employee Performance Analysis Based on Human Resources Management Practices in Private Hospital in Surakarta

<p>Human resource management (HRM) is the foundation to face business competition. Organizational strategies related to HRM create satisfaction among employees so that employees perform well and can create a competitive advantage for their organization. The need for human resources in the hospital industry has developed along with the availability of hospitals reaching 2813 hospitals in Indonesia. This of course requires superior human resources performance. HRM practices are expected to drive human resources performance and achieve a competitive advantage in the hospital industry. This study will examine the effect of HRM practices, namely training, performance appraisal, and compensation systems on employee performance. Furthermore, this study will also examine the role of job satisfaction to mediate HRM practices on employee performance. The study was conducted in a private hospital in the Surakarta area with a sample of 120 respondents. Convenience sampling technique as a sampling method used to collect samples using a questionnaire. SmartPLS is used to analyze research data. The results showed that there was a significant positive effect on HRM Practices (training, performance appraisal, compensation system) on employee performance. However, job satisfaction only mediates the effect of performance appraisal and compensation system on employee performance, while job satisfaction does not play a role in mediating the effect of training on employee performance..</p>

Antecedents and Consequences of Patient Satisfaction in the Context of Private Hospitalization Services

This study aims to investigate the impacts of perceived quality and perceived value on patient satisfaction as well as the influence of patient satisfaction on hospital’s brand image, patient loyalty and word-of-mouth intention in the context of private hospitalization services. With regards to the conceptualization of perceived quality, this study also attempts to uncover the underlying dimensions of hospitalization quality in the specific context of private hospital. This study surveyed 254 patients who were admitted for at least three days at private hospital in Malaysia, revealing that patient satisfaction with hospitalization services could be explained directly or indirectly by five hospitalization quality domains namely outcome quality, rights and privacy, medical quality, service quality, and servicescape. The findings of this study also show that patient satisfaction has significant impacts on all the three consequences variables – brand image, patient loyalty and WoM intention. The two major contributions of this study include the conceptualization of hospitalization quality domains and the newly developed measurement of perceived value in the context of profit-oriented healthcare institutions.

Awareness and use of PPE among radiographic workers working in some selected Government and Private Hospital in Dhaka City

Aim: This was a descriptive cross sectional study with an aim to find out the occurrences of awareness and use of PPE among the radiographic workers. Methods: The study was conducted among 80 radiographic workers working in 30 different X-ray installations in Dhaka city. Data were collected by direct interviewing of the respondents by using structured questionnaires. Result: Out of all respondents, 93.8%were male and 6.2% were female. Fifty two percent were within the age group 31-40 years. Forty-five percent of all the respondents had higher academic qualification on radiography and eighty-six percent of them were trained in radiography. Ninetynine percent of the workers were aware about using personal protective equipments and Ninetyseven percent were aware about using monitoring devices. However PPE was used by ninety-two percent and radiation monitoring devices by only thirty-six percent. Conclusion: Appropriate protective devices and monitoring devices were not available in most the installations. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 114-119

Modeling of a solar water heating system for a private hospital in Sana’a, Yemen using TRNSYS: دراسة استخدام الطاقة الشمسية لإنتاج المياه الساخنة لمستشفى خاص في صنعاء باستخدام برنامج المحاكاة TRNSYS

The objective of the present work is to simulate and analysis the performance of a proposed solar water heating system for a 160-bed capacity private hospital in Sana’a City-Yemen. The systems consist of solar collectors, hot water circulation pump, a storage tank with an electrical heater, and identical auxiliary components. The simulation and the thermal performance analysis have been done using TRNSYS software. In addition, a comparison between the performance of evacuated tubes collectors and flat plate collectors was done to justify the selection of ETC for the designed. The thermal performance analysis shows that the evacuated tubes collectors have an annual contribution of 87.73 MWh with an annual average solar fraction of 63 percent and annual average installation efficiency of 68 percent.

The use of anti-hyperlipidemia in a private hospital in Yogyakarta during 2013-2019

Background: Lipid modifying agents have an important role in the primary and secondary prevention of cardiovascular diseases such as coronary heart disease and stroke. The use of lipid-modifying agents tends to increase along with the increasing prevalence of these diseases. Objectives: To determine the utilization of lipid modifying agents for hospitalized patients in a private hospital in Yogyakarta during the period of 2013 - 2019 in regard to the agents used and their quantity. Methods: The main data for this study were aggregate data on the use of lipid modifying agents for hospitalized patients during 2013-2019 obtained from the hospital pharmacy department. After identification of the names of lipid modifying agents, the quantities of these drugs were then calculated in units of defined daily dose (DDD) and the final quantity was expressed in DDD/100 bed days (BD). The R2 value from linear regression was used to determine the trend of use of individual agents over the period. Results: There were two pharmacological subgroups of lipid modifying agents used during the period of 2013 – 2019 with an average of total quantity of 14.81 DDD/100 BD. Utilization of statins was approximately 90% of the total use, and utilization of fibrates tended to decrease over the period. Individually, simvastatin use decreased significantly over the period (R2 = 0.885), but atorvastatin use continued to increase (R2 = 0.908) with 10-fold increase from 2013 to 2019. Conclusion: The lipid modifying agents used during the period 2013 - 2019 were predominantly statins, and the utilization of atorvastatin increased significantly during this period. Keywords: lipid modifying agents, ATC/DDD, fibrates, statins