Mahasin Ali Al-Taha, Omran S. Habib, Kareem Al- Imara and Alim AH Yacoub. Consumers' satisfaction with healthcare services in Basrah. The Medical Journal of Basrah University 2003;21:94-98
Abstract— If job satisfaction is there in employees, work done by these employees is usually of better quality in comparison where the employees are not satisfied with their jobe. So this study to assess job satisfaction and influence of demographic variables on job satisfaction, this study was carried out on 105 doctors of teaching hospitals. Questionnaire method of data collection was adopted. Job satisfaction was measured by six domains: Organizational functioning, Interpersonal relationship, Financial incentives, Non-financial incentives, Physical facilities and Working conditions. Study observed that over all, doctors were moderately satisfied with their job. Domains such as Interpersonal relationship and Working conditions, doctors were highly satisfied, whereas rest of the domains: Organizational functioning, Financial incentives, Non-financial incentives, and Physical facilities doctors were moderately satisfied. It is important to note that even though overall satisfaction is moderate, there were few components, where doctors were highly satisfied were - Communication system between patients and doctors, Involvement in decision making in the department, Rules and regulations of the institution, relationship between the department colleagues and other department colleagues, Provision for leave encashment, reward given for research work, workload of clinical aspect and workload of teaching aspect. Age and sex both shown significant association on level of satisfaction where as experience, designation and marital status of the doctors have not shown significant association.
Understanding the Satisfaction, Perceptions, and Expectations of Clients of P...HFG Project
Taking quality health care to the farthest corners of the country is at the heart of the Government of India’s public health policy and programming. The National Health Mission’s reproductive, maternal, newborn, child and adolescent health (RMNCH+A) strategic approach underscores the need to ensure quality health care. A key thrust of the government’s reform focus has, thus, been on plugging service delivery gaps through improved, evidence-based decision making. The USAID-funded Health Finance and Governance (HFG) project supported the country’s Ministry of Health and Family Welfare (MoHFW) to yield preliminary insights into the level of patient satisfaction and utilization of public health services.
Good medical practice covers a very wide range of issues, including matters of clinical competence and standards relating to more personal and interpersonal skills and attributes, like probity, communication and doctor-patient relationships. Today the patient sees himself as a buyer of health services. Once this concept is accepted, then there is a need to recognize that every patient has certain rights, which puts a special emphasis on to the delivery of quality health care. It is therefore essential that it is informed by a clear understanding of what expectations society actually has of doctors. These expectations are unlikely to be fixed and may be influenced by broader social, moral and cultural shifts.
Abstract— If job satisfaction is there in employees, work done by these employees is usually of better quality in comparison where the employees are not satisfied with their jobe. So this study to assess job satisfaction and influence of demographic variables on job satisfaction, this study was carried out on 105 doctors of teaching hospitals. Questionnaire method of data collection was adopted. Job satisfaction was measured by six domains: Organizational functioning, Interpersonal relationship, Financial incentives, Non-financial incentives, Physical facilities and Working conditions. Study observed that over all, doctors were moderately satisfied with their job. Domains such as Interpersonal relationship and Working conditions, doctors were highly satisfied, whereas rest of the domains: Organizational functioning, Financial incentives, Non-financial incentives, and Physical facilities doctors were moderately satisfied. It is important to note that even though overall satisfaction is moderate, there were few components, where doctors were highly satisfied were - Communication system between patients and doctors, Involvement in decision making in the department, Rules and regulations of the institution, relationship between the department colleagues and other department colleagues, Provision for leave encashment, reward given for research work, workload of clinical aspect and workload of teaching aspect. Age and sex both shown significant association on level of satisfaction where as experience, designation and marital status of the doctors have not shown significant association.
Understanding the Satisfaction, Perceptions, and Expectations of Clients of P...HFG Project
Taking quality health care to the farthest corners of the country is at the heart of the Government of India’s public health policy and programming. The National Health Mission’s reproductive, maternal, newborn, child and adolescent health (RMNCH+A) strategic approach underscores the need to ensure quality health care. A key thrust of the government’s reform focus has, thus, been on plugging service delivery gaps through improved, evidence-based decision making. The USAID-funded Health Finance and Governance (HFG) project supported the country’s Ministry of Health and Family Welfare (MoHFW) to yield preliminary insights into the level of patient satisfaction and utilization of public health services.
Good medical practice covers a very wide range of issues, including matters of clinical competence and standards relating to more personal and interpersonal skills and attributes, like probity, communication and doctor-patient relationships. Today the patient sees himself as a buyer of health services. Once this concept is accepted, then there is a need to recognize that every patient has certain rights, which puts a special emphasis on to the delivery of quality health care. It is therefore essential that it is informed by a clear understanding of what expectations society actually has of doctors. These expectations are unlikely to be fixed and may be influenced by broader social, moral and cultural shifts.
The Choice of Antenatal Care and Delivery Place in Surabaya (Based on Prefere...irjes
- Person's desire to do a pregnancy examination is determined by the service place that suits the tastes
and facilities owned by it. Until now, the utilization of antenatal care by pregnant women is still low (Mardiana,
2014). The purpose of the study is to analyze factors affecting the utilization of antenatal care and delivery place
in Surabaya city based on the preferences and choice theory.
Type of survey research is cross sectional approach, the population is mothers who have children aged 1-
12 months in Surabaya. The large sample of 250 mothers who have children aged 1-12 months in 2013 is taken
by simple random sampling technique. Variables of the research are the preference elements and steps, choice
elements and steps, utilization of antenatal care and delivery place. Data were collected through questionnaires
and secondary data were then analyzed with descriptive statistics in the form of a frequency distribution, shown
by the schematic diagram.
The result showed that the preference elements and steps showed almost half (42.9%) desire to give birth
in a health care because of information got from someone else, while the choice element and step shows the
bulk (57.1%) of the criteria of delivery place chosen is a safe, comfortable and cheap delivery place, the labor
place which is the main choice most (57.1%) is cheap, comfortable, close.
Conclusion of the research based on the preferences and choice theory can be found three (3) new
theories, they are preferences become choice, preferences do not become choice, choice is preceded by
preferences
Dr. William Zubkoff is one of the very few individuals solely involved in active groundwork and practices in order to help people get appropriate healthcare.
Medical Self-care Education for Elders: A Controlled Trial to Evaluate ImpactWilliam Zubkoff
We conducted a trial to evaluate the impact of medical self-care education on 330 elders whose average age was 71. The test group participated in a 13-session educational intervention with
training in clinical medicine, life-style, and use of health services.
The comparison group received a two-hour lecture-demonstration.
Both groups were assessed pre-intervention, post-intervention, and one year after entry.
Dr. William Zubkoff joined the board of Plaza Health Network based in Miami FL, bringing added expertise in real estate and health care administration to the team.
Assessment of Patients Satisfaction in Accredited and Non–Accredited Primary ...Mohammad Shishtawy
Master Thesis in Family Meidicne about Assessment of Patient Satisfaction in Accredited and Non-Accredited Primary Health Care Facilities in Nabaroh Health District
Zagazig University
2015
Standardized Bedside ReportingOne of the goals of h.docxwhitneyleman54422
Standardized Bedside Reporting
One of the goals of healthcare is to ensure that the patients get the best service possible while not compromising on the satisfaction and goodwill of the nurses and other healthcare professionals. A key aspect of ensuring quality healthcare is the consistent handling of patient information from nurse to nurse during shifts; information handled wrongly can jeopardize the patients’ health (Baker, 2010). It is important to implement procedures that ensure consistent and smooth handling of patient information from nurse to nurse to increase patient safety and improve nurse satisfaction. This paper will explore the merits of standardized bedside reporting as opposed to board reporting in ensuring a positive outcome and consistent quality healthcare.
Change model overview
A key aspect in determining whether bedside shift reporting has any merits over board reporting is the John Hopkins Nursing Evidence-Based Practice Process (JHNEBP). The John Hopkins Nursing Evidence-Based Practice Process is a framework for guiding the translation and synthesis of evidence into valid healthcare practice. JHNEBP has three cornerstones that include research, education, and practice; the framework ensures that research evidence is the basis of clinical decision-making. (Dearholt & Dang, 2012) The implementation of the John Hopkins Nursing Evidence-Based Practice Process has three key phases, the first phase is the identification of an important question, the second phase involves the systematic review of research evidence, and the third phase is translating the results into action. Nurses should use the JHNEBP process because it provides a clear way for healthcare professionals to translate research results into healthcare practice.
Practice Question
The team includes several key stakeholders who will benefit greatly from my research. Among the team members include myself as ER nurse, charge nurse, ERT ( Emergency room tech), nurse case manager, nurse supervisor, physician and hospital manager.
The evidence-based practice question that the team members will explore is "Does the use of a standardized bedside report versus board reporting help increase patient safety, nurse satisfaction, and positive outcome?" The evidence-based practice question assesses the ability of bedside shift reporting to improve healthcare provision. The practice area of the question is clinical. The practice issue came about because of assessing risk management concerns in ensuring good health practices. To answer the question, the team members gathered evidence from patient preferences, peer-reviewed journals, and clinical guidelines. The team members searched peer-reviewed journal databases to gather relevant information from previous research that could affect the results.
Understanding the merits of bedside shift reporting as opposed to board reporting is important as most healthcare organization use either strategy in collecting and passin.
The Choice of Antenatal Care and Delivery Place in Surabaya (Based on Prefere...irjes
- Person's desire to do a pregnancy examination is determined by the service place that suits the tastes
and facilities owned by it. Until now, the utilization of antenatal care by pregnant women is still low (Mardiana,
2014). The purpose of the study is to analyze factors affecting the utilization of antenatal care and delivery place
in Surabaya city based on the preferences and choice theory.
Type of survey research is cross sectional approach, the population is mothers who have children aged 1-
12 months in Surabaya. The large sample of 250 mothers who have children aged 1-12 months in 2013 is taken
by simple random sampling technique. Variables of the research are the preference elements and steps, choice
elements and steps, utilization of antenatal care and delivery place. Data were collected through questionnaires
and secondary data were then analyzed with descriptive statistics in the form of a frequency distribution, shown
by the schematic diagram.
The result showed that the preference elements and steps showed almost half (42.9%) desire to give birth
in a health care because of information got from someone else, while the choice element and step shows the
bulk (57.1%) of the criteria of delivery place chosen is a safe, comfortable and cheap delivery place, the labor
place which is the main choice most (57.1%) is cheap, comfortable, close.
Conclusion of the research based on the preferences and choice theory can be found three (3) new
theories, they are preferences become choice, preferences do not become choice, choice is preceded by
preferences
Dr. William Zubkoff is one of the very few individuals solely involved in active groundwork and practices in order to help people get appropriate healthcare.
Medical Self-care Education for Elders: A Controlled Trial to Evaluate ImpactWilliam Zubkoff
We conducted a trial to evaluate the impact of medical self-care education on 330 elders whose average age was 71. The test group participated in a 13-session educational intervention with
training in clinical medicine, life-style, and use of health services.
The comparison group received a two-hour lecture-demonstration.
Both groups were assessed pre-intervention, post-intervention, and one year after entry.
Dr. William Zubkoff joined the board of Plaza Health Network based in Miami FL, bringing added expertise in real estate and health care administration to the team.
Assessment of Patients Satisfaction in Accredited and Non–Accredited Primary ...Mohammad Shishtawy
Master Thesis in Family Meidicne about Assessment of Patient Satisfaction in Accredited and Non-Accredited Primary Health Care Facilities in Nabaroh Health District
Zagazig University
2015
Standardized Bedside ReportingOne of the goals of h.docxwhitneyleman54422
Standardized Bedside Reporting
One of the goals of healthcare is to ensure that the patients get the best service possible while not compromising on the satisfaction and goodwill of the nurses and other healthcare professionals. A key aspect of ensuring quality healthcare is the consistent handling of patient information from nurse to nurse during shifts; information handled wrongly can jeopardize the patients’ health (Baker, 2010). It is important to implement procedures that ensure consistent and smooth handling of patient information from nurse to nurse to increase patient safety and improve nurse satisfaction. This paper will explore the merits of standardized bedside reporting as opposed to board reporting in ensuring a positive outcome and consistent quality healthcare.
Change model overview
A key aspect in determining whether bedside shift reporting has any merits over board reporting is the John Hopkins Nursing Evidence-Based Practice Process (JHNEBP). The John Hopkins Nursing Evidence-Based Practice Process is a framework for guiding the translation and synthesis of evidence into valid healthcare practice. JHNEBP has three cornerstones that include research, education, and practice; the framework ensures that research evidence is the basis of clinical decision-making. (Dearholt & Dang, 2012) The implementation of the John Hopkins Nursing Evidence-Based Practice Process has three key phases, the first phase is the identification of an important question, the second phase involves the systematic review of research evidence, and the third phase is translating the results into action. Nurses should use the JHNEBP process because it provides a clear way for healthcare professionals to translate research results into healthcare practice.
Practice Question
The team includes several key stakeholders who will benefit greatly from my research. Among the team members include myself as ER nurse, charge nurse, ERT ( Emergency room tech), nurse case manager, nurse supervisor, physician and hospital manager.
The evidence-based practice question that the team members will explore is "Does the use of a standardized bedside report versus board reporting help increase patient safety, nurse satisfaction, and positive outcome?" The evidence-based practice question assesses the ability of bedside shift reporting to improve healthcare provision. The practice area of the question is clinical. The practice issue came about because of assessing risk management concerns in ensuring good health practices. To answer the question, the team members gathered evidence from patient preferences, peer-reviewed journals, and clinical guidelines. The team members searched peer-reviewed journal databases to gather relevant information from previous research that could affect the results.
Understanding the merits of bedside shift reporting as opposed to board reporting is important as most healthcare organization use either strategy in collecting and passin.
Similar to Consumers satisfaction with health care services in Basra 2003.pdf (20)
Faecal Excretion of Salmonella Typhi During The Bacteraemic Phase of Typhoid ...Alim A-H Yacoub Lovers
Yacoub AA, Hassan J. Hasony. Faecal Excretion of Salmonella Typhi During the Bacteraemic Phase of Typhoid Fever: An Epidemiological Perspective. MJBU 1989;8(1&2):77-86.
A MEASURE OF COMMUNITY HEALTH NEEDS AND ACTIONS IN A RURAL AREA OF IRAQ THE A...Alim A-H Yacoub Lovers
Joseph G, Sugathan N, Kutty R, Al-Khafajie AMB, Antony R, George A, Habib OS, Yacoub AAH, Mahmood DA, Ajeel NAH. A measure of community health needs and actions in a rural area of Iraq-The Abul-Khasib, experience. Tropical and Geographical Medicine 1982; 34: 279-286
Accidental poisoning among children in Basrah an epidemiological perspective ...Alim A-H Yacoub Lovers
Imad Al-Sadoon, Yacoub AA, Najwa Abdull-Karim. Accidental poisoning among children in Basrah: an epidemiological perspective. J Fac Med (Baghdad) 1988;30(1):105-112.
تقييم خدمات الصحة المدرسية لطلبة المدارس الأبتدائیة في محافظة البصرة original...Alim A-H Yacoub Lovers
عماد عودة السعدون، عالم عبدالحميد يعقوب، ميعاد كاظم حسن. تقييم خدمات الصحة المدرسية لطلبة المدارس الابتدائية في محافظة البصرة (دراسة حالة). المجلة الطبية لجامعة البصرة 1997:(15): 135-125
Health & Social Aspects of Elderly at Home in Basra, Southern Iraq..pdfAlim A-H Yacoub Lovers
Yacoub AA, Ajeel NA, Abdullah AY. Health & social aspects of elderly at home in Basra, southern Iraq. The medical Journal Basra university 1994;12(1&2): 145-166.
Dynamic Aspects of Schistosoma Haematobium Infection as Experimental Model.pdfAlim A-H Yacoub Lovers
Abdul-Hussein H Awad, Alim A-H Yacoub, Sabeeh H Al-Mayah. Dynamic Aspects of Schistosoma Haematobium Infection as Experimental Model. Medical Journal of Basra University 1995;13(1&2):21-30
The effect of chemotherapy on the serological respons of patients with schist...Alim A-H Yacoub Lovers
Yacoub AA, Lillywhite J. The effect of chemotherapy on the serological response of patients with schistosoma haematobium infection using the Enzyme linked immunosorbent assay. Journal of Faculty of Medicine-Baghdad 1985;27(3):19-29.
Public Health Medicine in Basrah Southern Iraq A Report of an Initiative in A...Alim A-H Yacoub Lovers
Yacoub AA. Public health medicine in Basra, Southern Iraq: A report of an initiative in audit. The medical Journal of Basra University 2000; 18 (2): 1-2.
Yacoub AA, Salman DD, Ajeel NAH, Yunis G. Comparison of medical education in two medical colleges: student's perspective. Journal of Faculty of medicine Baghdad 2002;44(2):306-310
قد اعددت هذه السيرة الذاتية للاستاذ المرحوم د عالم عبدالحميد يعقوب بتوفيق من الله و بالاعتماد على معلومات زودني بها بعض الاساتذة و الزملاء الكرام اضافة الى بحثي في الانترنت و انا فخور بما قال عنها الاستاذ الكبير د غانم يونس الشيخ:
”بارك الله بك أخي دكتور عبد السلام على هذا الانجاز الكبير في معانيه والغزير في درجة العناية والقريب من الكمال بإخراجه على هذا الشكل رغم غياب صاحبه منذ عقدين فهكذا أمر يكون من الصعوبة بدرجة لا تقاس. وفقكم الباري وأدام عزّكم وأنجح أعمالكم الإنسانية لمرضاكم وزملائكم وطلبتكم“.
”لقد وجدت هذه السيرة الذاتية متقنة لدرجة سيشعر من يطلع عليها أنها أعدت من قبل الدكتور عالم نفسه. رحم الله عالم كم كان هادئاً ولا يتكلم الا بما يفيد وينفع. وبارك الله بك ووفقك. لقد عرفت الدكتور عالم في بدايات دراسته الطب عندما كا طالباً في الصف الثاني ودرّسته التشريح عام 1972-1973 ومعه عمران سكر ونبيل عبد الجليل ونرجس عجيل وآخرون لا أزال أتواصل معهم وعرفته كذلك في التسعينات عندما كنا نحضر اجتماعات الهيئة القطاعية لعمداء الطب وعرفته في أواخر أيامه رحمه الله في القاهرة كما أخبرتك سابقا. رحمه الله وأسكنه فسيح جناته“.
The epidemiology of schistosomiasis the Basrah study 2 serological profile.pdfAlim A-H Yacoub Lovers
Yacoub AA, Southgate BA, Lillywhite JE. The epidemiology of schistosomiasis in the later stages of a control program based on chemotherapy: the Basra study. 2. The serological profile and the validity of the ELISA in seroepidemiological studies. Transactions of the Royal Society of Tropical Medicine and Hygiene 1987 May;81(3):460-7.
Alim Abdul-Hameed Yacoub Master of Science (MSc) Degree in community health in developing countries with a mark of distinction from the University of London on 3 November 1982
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Consumers satisfaction with health care services in Basra 2003.pdf
1. Consumers' satisfaction with health care
services in Basrah*
Mahasin Ali Al-Taha, Omran S. Habib, Kareem Al- Imara and Alim AH Yacoub
Introduction
Patient satisfaction has been recognized as an essential component of several
measures by which the quality of care is assessed. Many investigators and
policymakers feel that its role in the assessment of quality of care is crucial(1,2)
.
Donabedian has stated that "achieving and producing health and satisfaction is the
ultimate validator of the quality of care" (2)
. The study of patient's satisfaction, aims in
general, at determining the effect of satisfaction on patient behaviour in care seeking
process, compliance with prescribed care and maintenance of relationship with care
providers. In addition, satisfaction can be used as an indicator of perceived quality of
care and can help the providers to understand patient point of view within the context
of doctor-patient encounter (2)
There are numerous typologies of patient satisfaction, but the available measures
assess only a limited number of dimensions of care. Those most frequently used
measures are relating patient satisfaction to the personal aspect of care, the technical
quality of care, accessibility and availability of care, continuity of care, patient
convenience, physical setting, financial consideration and efficacy (1)
.
Factors related to patient satisfaction (1)
Personal factors
A-Sociodemographic characteristics: such as: age, sex, social class. Older patients
tend to report higher levels of satisfaction than do younger patients and that women
tend to be more satisfied than men. In addition, patients with higher incomes and
more education tend to be less satisfied with clinics probably because of their higher
expectation.
B-Physical and psychological health: prior to receiving care, may cause patients to be
more or less satisfied.
C-Attitudes and expectations: patients also tend to be more satisfied if their provider's
behaviour conformed to their expectations. Expectations, however, differ greatly
among patients and may be a function of personality, social and cultural values and
the context in which care is received.
Factors related to health care provision
A- Related to structure: The organization of care accessibility, availability
,convenience of care ,and continuity of care, are found to be positively related to
satisfaction (1)
.Waiting time is also found to be an important factor, the shorter the
waiting time, the more will be the satisfaction with care provided (3)
.
B- Related to process: Technical competence of the providers and the interpersonal
aspect of care are also related to patient satisfaction .Many researchers have found
that patients tend to be more satisfied if they perceive their physicians to be caring
and sensitive to their needs.
*Aversion was published as: Al-Taha MA, Habib OS. Women satisfaction about antenatal
care. The Medical Journal of Basrah University 2003; 21: 94-98.
2. C- Related to outcome: Some studies found that perceived improvement in health was
a predictor of patient satisfaction (1)
.
Different methods have been used to assess patient satisfaction, including questions
and patient interviews, scaling for patient satisfaction, tape recording for patient-
doctor interaction, and others. However, the most commonly used methods, are
questionnaires and opinions of consumers regarding factors they like or dislike, their
knowledge, expectation and anticipated use. These are being obtained by patient
interviews (4-6)
.
To quantify consumer s satisfaction with different aspects of health care provided in
Basrah, a number of studies were carried out in this context and some of the
approaches and results of few of these studies are presented in this chapter.
The aim of these studies was to assess the perceived quality of care provided from
consumers
Study one: Women satisfaction with prenatal care
A systemic random sample of currently pregnant and lactating women attending for
maternal care was studied. The sample included one third of attending women, the
starting point being randomly selected. A total of 266 was obtained. Clinic exit
interview was the method adopted and used to assess satisfaction. Women were
interviewed on two days per week for a period of 6 months (January to June 1999).
Women were interviewed immediately following consultation in the reception area
and just before leaving the centre.
A structured questionnaire was used and included questions on sociodemographic
variables such as age of the women, occupation and education, and on their
satisfaction with different aspects of care, including:
-Satisfaction with accessibility of services.
-Satisfaction with continuity of care. -
Satisfaction with humanity of doctors and other staff:
-Satisfaction with comprehensiveness of services.
-Satisfaction with provision of health education.
-Satisfaction with some services provided.
-Satisfaction with the time spent.
-Overall satisfaction with health services.
The measurement scale of satisfaction for all those items was based on a three point
Likert Scale (1= satisfied, 2= fairly satisfied and 3= not satisfied) (3,4)
.
Sample characteristics
The age of the women sampled ranged from 14-45 years with a mean of 25.96.1
years. Most of them (59.0%) were in the age group (20-29) years. Regarding their
educational level, 5.6% of them were illiterate, 43.3% had an education below
intermediate level, 26.7% had an intermediate level and 24.4% had a high level
(secondary and higher education). Occupation wise, being a housewife, constituted
88.7%, governmental employees (4.9%) and professionals including teachers (6.4%.)
Satisfaction with different aspects of care: (Table 1)
Satisfaction with accessibility
3. Nearly 85% of women were either satisfied or fairly satisfied with accessibility to the
health centre, while only 15% thought that it was far from their houses.
Satisfaction with continuity of care
More than half of the women (58.3%) were satisfied with continuos presence of the
same doctor during consultation, while 36.5% revealed that doctor was not always
available and only 5.3% did not find a doctor at the time of their visits. On the other
hand, 91.4% of women were satisfied with the continuous presence of nurses and
other health staff in the centre. It was also found that all women attending for
antenatal care (100%) were given monthly appointments, but only 91.0% were
satisfied with being seen in the same dates, and 4.0% of the women thought that the
use of appointment systems was inappropriate.
Satisfaction with humanity of health care providers
The majority of women (99.3%) and (93.3%) were satisfied with the human attitude
of doctors and other health staff respectively.
Satisfaction with comprehensiveness of services
About 66.9% of the women reported that antenatal care provided was comprehensive
and sufficient, that they would not need to seek care from other sources like private
clinics or hospitals.
Satisfaction with health education provision
Only 36% of women were satisfied with the health education provided by the staff,
41.4% were fairly satisfied, while (22.6%) reported that they received no health
education of any type during their visits .About (50%) of those satisfied and fairly
satisfied in this aspect, thought that their health knowledge has increased.
Satisfaction with services provided
Nearly 79% of the women expressed satisfaction with some of the provided services
.All of them (100%) were satisfied with the vaccination provided, 85.3% were
satisfied with doctor's care, while 58.6% reported satisfaction with investigation and
only 51.1% were satisfied with the offered treatment.
Satisfaction with time spent
The study demonstrated a low level of satisfaction with time spent in the centre. Only
11.3% of the women were satisfied with the overall time spent, 59.4% were fairly
satisfied, while 29.3% perceived it as long waiting time. Only 8.3% were satisfied
with waiting time for being registered and handed the antenatal records by the
registration staff, while 7.1% were satisfied with waiting time for being seen and
consulted by the doctor, while 65.4% and 63.9% were fairly satisfied with waiting
time for registration and consultation respectively.
Overall satisfaction with services
About three quarters of women (74.1%) expressed positive views and general
satisfaction about obtaining antenatal care in Abulkhasib health centres, 21.4% were
fairly satisfied while only 4.5% were not satisfied.
The areas of deficiency recognized by women are summarized in Table –2- and were
mostly related to insufficient drugs (85.2%), deficient medical examination (46.6%)
insufficient investigations (43.2%), lack of sufficient medical staff (39.8%),
4. overcrowding (28.4%) and inappropriate appointments or postponements (27.3%).
Other reasons for dissatisfaction in this aspect, represented structural deficiencies.
Table 3 demonstrates stepwise multiple regression analysis to predict variables
associated with overall satisfaction. It shows that overall satisfaction was significantly
and positively associated with the satisfaction with the following: comprehensiveness
of services, doctor's care, health education, waiting time for consultation, services
provided, availability of a doctor, treatment offered and availability of a nurse. The
total R2
was 0.747
Table 1: Distribution of women according to their satisfaction with different aspects
of antenatal care (n=266)
Aspects of care
Women who were
Not satisfied Fairly satisfied Satisfied
No. % No. % No. %
Immunization
Humanity of doctors
Humanity of staff
Availability of a nurse
Monthly appointments
Doctor's care
Services provided
Overall satisfaction
Comprehensivenessof services
Availability of doctors
Investigations
Treatment
Health education
Accessibility
Overall time spent
Registration time
Consultation time
0
0
3
2
11
14
3
12
14
14
37
64
60
40
78
70
77
0
0
1.1
0.8
4.1
5.3
1.1
4.5
5.3
5.3
13.9
24.1
22.6
15.0
29.3
26.3
28.9
0
2
15
21
13
25
54
57
74
97
73
66
110
161
158
174
170
0
0.8
5.6
7.9
4.9
9.4
20.3
21.4
27.8
36.5
27.4
24.8
41.4
60.5
59.4
65.4
63.9
266
264
248
243
242
227
209
197
178
155
156
136
96
65
30
22
19
100
99.3
93.3
91.4
91.0
85.3
78.6
74.1
66.9
58.3
58.6
51.1
36.1
24.5
11.3
8.3
7.1
Table 2: Recognized deficiencies as stated by consumers (n=88)
Recognized deficiencies No. %
Deficient drugs
Deficient medical examinations
Deficient investigations
Lack of sufficient medical staff
Overcrowding
Poor appointments or postponements
No chairs in the reception
Male nurse only
Lack of ultrasound
Antenatal examination were not on daily basis
Lack of private place for examination
Lack of sonic aid
75
41
38
35
25
24
10
5
5
5
5
3
85.2
46.6
43.2
39.8
28.4
27.3
11.3
5.7
5.7
5.7
5.7
3.4
5. Lack of cover sheets
Lack of toilets
Lack of water
Lack of cleanliness
3
2
2
2
3.4
2.3
2.3
2.3
Study two: Quality of care in surgical wards
The study was an attempt in the direction of evaluative efforts of quality of care in
surgical wards in the three main hospitals in Basrah City Al-Sadr Teaching Hospital,
Basrah General Hospital and Al-Mawanie General Hospital). The quality was
assessed with respect to patients satisfaction with care provided through direct
interviews. A total of patients were involved in the study. The results revealed minor
variations among hospitals. Consumers were satisfied with professional competence
of surgeons regarding diagnosis. They were very unsatisfied with information
disclosed to them about the type of operation, the expected postoperative
complications, expected duration of stay in hospital, surgical details and preoperative
education. On the other hand,
Consumers were satisfied with postoperative follow up visits, but dissatisfied with
prescriptions and postoperative management of pain. Consumers were satisfied with
nursing care but not with observation of IV fluid administration. They were less
satisfied with ancillary services. Table 3 gives an over all view of satisfaction with
care in surgical care in the three hospitals.
Table 3. Extent of patient satisfaction with surgical care in Basrah hospitals 1998.
Hospital Degree of satisfaction as expressed by patients
Doctor care Nursing care Ancilary care
Al-Sadr
Basrah General
Al-Mawanie
100%
94%
94%
96%
89%
94%
96%
87%
100%
Discussion
These and other relevant studies have provided insights into the milieu in which care
is provided and highlighted consumer's satisfaction towards specific components of
the health care in Basrah. Regarding antenatal care, eight dimensions of care were
studied. It was found that about three-quarters (74.1%) of women were generally
satisfied, while 21.4% were fairly satisfied and 4.5% were not satisfied. The overall
satisfaction was relatively good, probably because it was assessed by a single
question, while in case of multiple and specific questions, the respondents tend to
show more dissatisfaction.
The educational level of women might affect their satisfaction towards health
services. In this study, women with higher education were less satisfied as compared
to women with lower education. This might be explained by the difference in
women's expectations. In Al Turki study of patient satisfaction towards health
services provided by PHC centres in Saudi Arabia (7)
, the association of education
with satisfaction was significant, while in another study in the same place, it was not
significant (8)
.
6. This study showed a high level of satisfaction with humanity of medical team and the
doctor-patient relationship. This may be a real state, but it is possible that women
might have avoided criticism of the staff. At the same time 85% were satisfied with
doctor's care. The last result might suggest that satisfaction with humanity of medical
team is substantive.
Continuity of care is considered as a very important motivating factor for attending
antenatal care everywhere. Only about half of the women (58.3%) were satisfied with
continuous presence of doctors in charge. This is a universal problem because of
temporary absence or transfer of staff from one place to another. It is a well-
recognized cause of patient dissatisfaction with care (7)
and very likely to be a cause of
inadequate care utilization.
Delay and long waiting time is another factor for dissatisfaction, 29.3% of women in
this study were unsatisfied. This is similar to AL-Turki study (7)
where 28.8% of
attending patients to PHC centres in Saudi Arabia were dissatisfied with waiting time.
Similarly, satisfaction level regarding health education aspect was low. This finding is
similar to that shown by other studies (7-10)
. This can be attributed to lack of health
education resources and/or poor communication and advice.
These results agree with the results of a study of women's satisfaction with antenatal
care in North England. It was found that women were generally satisfied with
antenatal care, but factors which cause dissatisfaction were: lack of continuity of care,
quality of advice and waiting time (11)
.
Drug supply is always considered as an important factor for satisfaction. In the
present study 24% of women were unsatisfied with drugs and tonics supplied. In the
study of women's satisfaction about antenatal care in other governorates in Iraq, the
major reason for dissatisfaction was insufficient drugs(12)
. This is a complicated issue
because it is related to restriction of drug availability due to sanctions as well as to the
tendency of people to relate health to drug consumption.
Dissatisfaction was also expressed against the laboratory investigations in 14% of
women. This dissatisfaction is expected and probably substantive since laboratory
investigations were poor in PHC centres.
In general, this study showed almost similar overall satisfaction with services as
expressed in a similar study conducted in AlQurna, north of Basrah(8)
in which 73%
of antenatal care attendants were generally satisfied with services, but slightly lower
than those reported in the study conducted in other governorates in Iraq (12) where
82.2% of women were satisfied in general with services.
To improve antenatal care performance in primary health care centres , the authors
recommend redistribution or reallocation of medical staff according to the actual
need, establishment of better appointment system and time management , involvement
of staff in continuous educational programmes and encouraging provision of different
methods of health education ; and improving the logistic supply of antenatal care units
especially those that coincide with consumer’s expectations. Planners and high
authority leaders need to consider patients’ opinion and their reasons of unsatisfaction
while planning to improve health services. The adoption of the family health model
might be the solution towards better care and more consumer satisfaction.
Background references
1. Al-Taha MA. Evaluation of structure, process and outcome of maternal care at
district level in Basrah. PhD thesis, University of Basrah 2000.
7. 2. Al-Imara KAS, Yacoub AAH. Quality of care in surgical wards: Patients
perspectives. Diploma Report. University of Basrah 1998.
3. Cleary P, Mcneil BJ. Patient satisfaction as an indicator of quality of care.
Inquiry 1988; 25: 25-36.
4. Donabedian, A. Evaluating quality of medical care. Sited in: Cleary, P and
Mcneil BJ. Patient satisfaction as an indicator of quality of care. Inquiry 1988;
25: 25-36.
5. Patrick DL, Serivens E, and Chariton JRH. Disability and patient satisfaction
with medical care. Medical care 1983; 21: 1062- 1075.
6. Al Almaie SM, Al Dawood KM, Elzubeir AG. Patient's expectations and
satisfaction in a teaching hospital emergency department. Saudi Medical Journal
1998; 19(5): 561-565.
7. Holland W. Evaluation of health care. Oxford Medical publications. Oxford
New York Toronto 1984. pp: 8-30, 40.
8. WHO. Rapid evaluation method. Guidelines for MCH , family planning and
other health services. WHO/ MCH-FPP 1993.
9. Al Turki YA. Patient's satisfaction towards health services in primary health
care centres in Riyadh, Saudi Arabia. Journal of Bahrain Medical Society
2000; 12(2): 86-90.
10. Mansour A, AlOsimy M. Study of satisfaction among primary health care
patients in Saudi Arabia. Journal of Community Health 1993; 18(3): 163-172.
11. Makhdoom YM, AlZubeir AG, Hanif M. Satisfaction with health care
among primary health care centres in Alkhobar, Saudi Arabia. Saudi Medical
Journal 1997; 18(3): 227-230.
12.AlSa'ad ES. Evaluation of the MCH services in AlQurna district. Diploma
dissertation. Basrah 2000.
13. Williamson S, Thomson AM. Women's satisfaction with antenatal care in a
changing maternity services. Midwifery 1996 Dec.; 12(4): 198-204.
14. Ministry of Health. Rapid evaluation methods in maternal and child health
care. Baghdad 1997. (Unpublished document)