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Ready: how to keep your customers coming back.

Customer service is a major, but often overlooked, issue in health care today. While other industries and organizations recognize how good customer relations can affect long-term success, many health care providers have yet to learn this valuable lesson. The Ritz-Carlton, which won the prestigious Baldridge Award for service, has a well-earned reputation for excellent customer service. Like health care providers, this hotel industry icon hires hourly workers, puts them in uniform and has them work in teams. Unlike health care, however, The Ritz-Carlton seems to be able to generate a much highe

Mortality in a northeastern Native American cohort, 1955-1984.

Patterns of mortality among members of the Seneca Nation of Indians between January 1, 1955, and December 31, 1984, were investigated. The study cohort consisted of all members of the Seneca Nation residing in New York State who were listed in the tribal rolls as of January 1, 1955 (n = 3,262). Deaths among cohort members were identified through a computer match against New York State vital records files. Sex-specific standardized mortality ratios (SMRs) were calculated on the basis of mortality patterns exhibited by the general population of New York State, exclusive of New York City. Seneca

Accentuating the positive.

The Society of Thoracic Surgeons is the largest organization representing our specialty. At this time, escalating costs of medical care and the public demand for accountability have given rise to a number of issues that must be faced. The Society is in a position to lead the medical profession in addressing many of these issues. We must present a united front for our specialty and resolve problems involving our training programs, manpower, federal regulations regarding medical devices, and the Federal Trade Commission's position on advertising. Additionally, the organization must address the i

Proficiency testing for official laboratories for 137Cs and 134Cs determination in soil.

Incidents involving the release of caesium radioactive isotopes into the environment have prompted the adoption of necessary measures to protect the public. A network of official laboratories has been established across Poland to routinely measure the level of radioactive contamination in food. The participation of nine selected laboratories in proficiency testing serves both to demonstrate competence and to confirm the reliability of results. The certified reference material IAEA-478 ″Radionuclides in Soil" was used for this testing. The value assigned from the certificate was determined on t

Postgraduate family medicine training in Southeast Asia.

Family medicine is a medical discipline that has been recognised globally for nearly six decades. Postgraduate family medicine training was introduced more recently in Southeast Asia. This article presents the characteristics of postgraduate family medicine training in eight Southeast Asian countries: Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam. The duration of training varies across countries and programmes within each country, ranging from 1 to 5 years. Completion of training leads to qualifications such as master's degree, diploma or certificate. Som

Cancer Mortality by Ethnicity in Colombia Between 2011 and 2022: A Population-Based Study.

ObjectivesTo examine cancer mortality rates in Colombia by ethnic groups (Indigenous, Rom, Raizal, Afro-Colombian, and Mestizo) and assess trends from 2011 to 2022.MethodsNational vital statistics from death certificates and the Colombian census data were used. Crude and direct age-standardized mortality rates were determined by ethnicity for the study period, by year, sex, and cancer type and Joinpoint analysis was conducted to examine trends.ResultsAge-standardized cancer mortality of Mestizos (60.1 per 100,000 population) was lower than in Rom and Raizales (557.3 and 77.7 per 100,000), and

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… Additionally, studies have evaluated the quality of vital statistics and death certificates [ 33 , 34 ]. One study found that as of 2016, less than 1% of deaths were not certified by physicians, with improvements in the quality of death certificates from 85.5% (1997) to 95.2% (2016) [ 34 ]. … Quality of Death Certification in Colombia . Colombia Médica ( 2018 ) 49 : 121 – 7 . 10.25100/cm.v49i1.3155 29983472 PMC6018815 35. Departamento Administrativo Nacional de Estadística . Estadísticas Vitales: Nacimientos Y Defunciones . Colombia : DANE ( 2016 ). …

A patient-centered approach to dietary supplements for patients with chronic liver disease.

The use of dietary supplements by patients with chronic liver disease is prevalent and rising. Despite the known risks of dietary supplement … supplements in patients with chronic liver disease, offering examples of independent resources and certifications to use this framework in clinical practice. We offer 3 common clinical scenarios to highlight how the use of this framework can improve communication and decision-making in clinical practice. By adapting principles from Integrative Medicine, this a …

Obesity Prevention in Early Life (OPEL) study: linking longitudinal data to capture obesity risk in the first 1000 days.

To develop robust prediction models for infant obesity risk, we need data spanning multiple levels of influence, including child clinical health outcomes (eg, height and weight), information about maternal pregnancy history, detailed sociodemographic information of parents and community-level factors. Few data sources contain all of this information. This manuscript describes the creation of the Obesity Prevention in Early Life (OPEL) database, a longitudinal, population-based database that links clinical data with birth certificates and geocoded area-level indicators for 19 437 children born

Plague, Religion and Urban Space in Sixteenth-Century Antwerp.

Antwerp's response to the outbreak of plague in the 1570s offers new insights into the effects of epidemics on urban communities in relation to their religious, economic, and spatial fabric. Antwerp's transition from a Catholic to Calvinist government in 1577, and back to Catholicism in 1585, allows us to study its reaction to and the effects of plague across religious boundaries within a short time span. Using GIS, we have compared various rich datasets concerning plague: the register of houses locked in quarantine; the health certificates issued by authorities; plague fatalities recorded in

[Driver's License and Welfare Systems for Epilepsy Patients].

Along with treatment, social life, including driving and welfare systems, are of great concern to patients with epilepsy. During treatment of epilepsy, guidance on these issues and actual treatment are two sides of the same coin, and both epileptologists and general neurosurgeons are required to have thorough knowledge of these issues. With regard to driving, Article 66 of the Road Traffic Law prohibits driving by persons who are likely to be incapable of normal driving. However, in epilepsy, legal criteria for driver's license eligibility has been established, and there are no legal problems

Confronting the Infodemic and Fake News to End Stigma and Discrimination in HIV/AIDS: Promoting Zero Discrimination Practices in Brazil With Massive Open Online Course.

INTRODUCTION: Overcoming misinformation is essential considering stigma and discrimination in the HIV/AIDS epidemic. This report presents the preliminary results of a health education strategy based on the massive open online course (MOOC) on Zero Discrimination in Brazil. METHODS: Case study describing the development of the MOOC and its validation using the Delphi technique. Pre- and posttests were administered. People who enrolled from October 2021 to March 2022 were included in the study. RESULTS AND DISCUSSION: MOOC was made available free of charge for mobile phones, tablets, and deskt

An Original Aspirin-Containing Carbonic Anhydrase 9 Inhibitor Overcomes Hypoxia-Induced Drug Resistance to Enhance the Efficacy of Myocardial Protection.

PURPOSE: Hypoxic microenvironment plays a vital role in myocardial ischemia injury, generally leading to the resistance of chemotherapeutic drugs. This induces an intriguing study on mechanism exploration and prodrug design to overcome the hypoxia-induced drug resistance. METHODS: In this study, we hypothesized that the overexpression of carbonic anhydrase 9 (CAIX) in myocardial cells is closely related to the drug resistance. Herein, bioinformatics analysis, gene knockdown, and overexpression assay certificated the correlation between CAIX overexpression and hypoxia. An original aspirin-cont

[Assessment of the possibility of application in laboratory practice of reagent kit for diagnosis of glanders and melioidosis by real-time polymerase chain reaction.].

The reagent kit AmpligenBurk-mallei/pseudomallei-RT PCR is designed for detecting in vitro diagnostics and differentiate the DNA of glanders and melioidosis pathogens by real-time multiplex PCR in biological (clinical) material and cultures of microorganisms, as well as environmental objects and solid food products (rice). During clinical testing diagnostic value of reagent kit AmpligenBurk-mallei/pseudomallei-RT PCR has been studied. Based on the results obtained, a high analytical sensitivity (1×103 microbe cells/ml) and specificity (100%) of PCR-RT with the developed reagent kit were establ

The death of Charlotte Brontë from hyperemesis gravidarum and refeeding syndrome: A new perspective.

Many theories have been advanced concerning the cause of Charlotte Brontë's death, none of which fully explain all the symptoms she experienced in the course of her final illness. Her death certificate records the cause of death as phthisis (tuberculosis), but there is no evidence, other than circumstantial, to support this diagnosis. A diagnosis of Addison's disease, caused by tuberculosis of the adrenals, has been proposed, but this is unlikely, since it does not fit well with two and a half months of severe anorexia, nausea and vomiting, followed by remission of these symptoms and eventual

[Routine pregnancy ultrasound scans can detect malformations. Multidisciplinary care of both the foetus and parent is required following diagnosed malformations].

Routine pregnancy ultrasound scans can detect malformations. Multidisciplinary care of both the foetus and parent is required following diagnosed malformations In Sweden, all women are invited to at least one ultrasound examination during pregnancy. The »Routine ultrasound screening« is usually performed by a midwife around 18 weeks of gestation. There are several aims of the examination: to check viability, to detect multiple fetuses, to determine the location of the placenta, to check the amount of amniotic fluid, to estimate the date of delivery (if this had not been done earlier) and to de

Amyotrophic lateral sclerosis surveillance in Baltimore and Philadelphia.

INTRODUCTION: Limited epidemiological data on amyotrophic lateral sclerosis (ALS) exist in defined geographic areas in the United States. METHODS: Neurologists submitted case reports for patients under their care between January 1, 2009, and December 31, 2011, who met the El Escorial criteria. Diagnosis was confirmed for a sample of cases by the consulting neurologist. Death certificate data were used for supplemental case identification. RESULTS: The 248 reported cases were most likely to be 50-69 years old, men, white, and non-Hispanic. The total crude average annual incidence rate was 1.4

Is knowledge of medicolegal issues concordant with heightened risk among doctors?

Spurred by the wave of consumerism, patients do not hesitate to drag the doctor to the court. It has now become essential for doctors to educate themselves on the laws relevant to medical practice. This study addresses some of the issues. Doctors in private practice, belonging to different specialities, were given a self administered questionnaire which was then analysed by the percentage of responses to each question. Only 3% of the respondents faced medicolegal problems at the time of the study. All of them were fighting charges of negligence from their patients. Most (97%) did not keep reco

Traditional healers formalised?

Traditional healers are the first to be called for help when illness strikes the majority of South Africans. Their communities have faith in their ability to cure or alleviate conditions managed by doctors, and much more. A visit to such practitioners' websites (they are up with the latest advertising technology!) shows that they promise help with providing more power, love, security or money, protection from evil people and spirits, enhancing one's sex life with penis enlargement and vagina tightening spells, etc. Contemplating such claims, it is easy to be dismissive of traditional healers.

Are we protected? Imported measles - on the way to eradication.

In accordance with the 2015 regional goal for measles and rubella elimination of the WHO European Region, only a few imported cases have been documented of both diseases in Hungary for years.This paper presents a case of a Hungarian woman, born in 1975, who received measles vaccination at age of 12 months and later at age of 11 years, according to her certificate of vaccination. In 2009, after arriving home from a vacation in Ireland, she developed acute measles infection with clinical symptoms. It was confirmed by the detection of measles specific IgM, IgA and IgG antibodies, and by detection