health care sectors

  • 文章类型: Journal Article
    背景:尽管在医疗保健部门无法观察到直接的温室气体排放,可能存在导致全球气候变化的间接排放。这项研究探讨了碳足迹的概念及其在理解人类活动对环境的影响方面的意义,通过门到门(GtoG)生命周期评估,特别强调医疗保健部门。交通运输,能源消耗,医院产生的固体废物是碳排放的主要来源。方法:不同的标准,指南和参数被用来估算一级和二级数据的排放量.GtoG中涉及的所有步骤和子步骤都在标准ISO14040:44指南中进行了访问和分析。对现有文献进行了广泛的回顾,以评估和验证二级数据。结果:发电机的总碳足迹,电力消耗,交通活动,液化石油气气瓶,发现光伏系统为58,780kg-CO2-eq/yr,519,794kg-CO2-eq/yr,272,375kg-CO2-eq/yr,44,494kg-CO2-eq/yr,分别为35,283kg-CO2-eq/yr,非生物降解固体废物的排放量为489,835kg-CO2/yr。局部空气污染物,如PM10、CO、SO2,NOX,还估计了发电机和运输产生的挥发性有机化合物。液体废物的CH4排放量为1177.344kgCH4/BOD年,可生物降解物质为3821.6954kgCH4/年。结论:医疗保健专业人员和政策制定者可以采取行动,通过实施最佳实践和鼓励可持续行为来减少该行业的碳足迹。这项研究可以作为进一步探索不仅在尼泊尔而且在南亚情景中医疗保健部门的间接排放的基础。
    UNASSIGNED: Though direct greenhouse gas emissions cannot be observed in health care sectors, there can exist indirect emissions contributing to global climate change. This study addresses the concept of the carbon footprint and its significance in understanding the environmental impact of human activities, with a specific emphasis on the healthcare sector through gate-to-gate (GtoG) life cycle assessment. Transportation, energy consumption, and solid waste generated by hospitals are the primary sources of carbon emissions.
    UNASSIGNED: Different standards, guidelines and parameters were used to estimate emissions from both the primary and secondary data. All steps and sub-steps involved in GtoG were accessed and analyzed within the standard ISO 14040:44 guideline. An extensive review of existing literature was carried out for the evaluation and verification of secondary data.
    UNASSIGNED: The total carbon footprint of generators, electricity consumption, transportation activities, LPG cylinders, PV systems was found to be 58,780 kg-CO2-eq/yr, 519,794 kg-CO2-eq/yr, 272,375 kg-CO2-eq/yr, 44,494 kg-CO2-eq/yr, 35,283 kg-CO2-eq/yr respectively and the emissions from non-biodegradable solid waste was found to be 489,835 kg-CO2/yr. Local air pollutants such as PM 10, CO, SO 2, NO X, and VOCs generated by generators and transportation were also estimated. The CH 4 emissions from liquid waste were 1177.344 kg CH 4/BOD yr, and those from biodegradables were 3821.6954 kg CH4/yr.
    UNASSIGNED: Healthcare professionals and policymakers can take action to reduce the sector\'s carbon footprint by implementing best practices and encouraging sustainable behavior. This study can be taken as foundation for further exploration of indirect emissions from healthcare sectors not only in Nepal but also in south Asian scenario.
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  • 文章类型: Journal Article
    Treatment in hospitals differs from treatment in rehabilitation centers from a legal perspective because German law mandates that in hospitals physicians and other qualified personnel must be on duty at all times. This is not required for inpatient rehabilitation centers. Since this Act was passed more than 30 years ago, more acute medical interventions are now carried out and the number of older people in the population has increased. As a result patients are nowadays older, more multimorbid and therefore have a greater risk for medical complications. This is especially true for postacute neurological care. For this reason, the original legal framework for neurological rehabilitation treatment has become questionable. Therefore, we prospectively tested how often patients in inpatient neurorehabilitation suffer from complications that require immediate attention by qualified personnel. In 759 patients observed over a period of 6 months we found 602 complications requiring immediate interventions by physicians (e.g. falls, urinary tract infections, other forms of fever, diarrhea associated with Clostridium difficile, pneumonia, respiratory insufficiency, sepsis, epileptic seizures and arrhythmia). On average at least three acute care interventions occurred per day at the facility examined. We conclude that neurological inpatient rehabilitation has outgrown its legal foundations and now incorporates hospital care.
    UNASSIGNED: Behandlungen in einem Krankenhaus unterscheiden sich von Behandlungen in einer Rehabilitationsklinik rechtlich dadurch, dass den Patienten im Krankenhaus jederzeitige Hilfe durch Ärzte und anderes qualifiziertes Personal zur Verfügung stehen muss – in der Rehabilitationsklinik hingegen nicht. Seit der Abfassung der zugehörigen Sozialgesetze vor über 30 Jahren werden mehr akutmedizinische Interventionen durchgeführt und die Zahl der Älteren in der Bevölkerung hat zugenommen. Infolgedessen sind Patienten heute älter und multimorbider und dadurch komplikationsgefährdeter. Dies gilt insbesondere für die postakute neurologische Versorgung. Deswegen sind die ursprünglichen Rahmenkonzepte für neurologische Rehabilitationsbehandlung fragwürdig geworden. Wir untersuchten daher prospektiv, wie häufig Patienten in der neurologischen Anschlussrehabilitation akute Komplikationen entwickelten und sofortiger Hilfe durch qualifiziertes Personal bedurften. Wir fanden unter 759 innerhalb einer sechsmonatigen Beobachtungsperiode behandelten Patienten 602 krankenhausmedizinische Komplikationen (Stürze, akute Harnwegsinfekte, Fieber anderer Art, Clostridium-difficile-Diarrhöen, Pneumonien, respiratorische Insuffizienz, Septitiden, epileptische Anfälle und Herzrhythmusstörungen). Insgesamt musste so in der untersuchten Einrichtung im Mittel mehr als dreimal pro Tag akutmedizinisch interveniert werden. Wir schlussfolgern, dass neurologische Anschlussrehabilitation dem bisherigen sozialgesetzlichen Rahmen entwachsen ist und Krankenhausbehandlung umfasst.
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  • 文章类型: Journal Article
    OBJECTIVE: The goal of this paper was to improve our understanding of nursing shortages across the variety of health care sectors and how this may affect the agenda for addressing nursing shortages. A health care sector comprises a number of health care services for one particular type of patient care, for example, the hospital care sector.
    BACKGROUND: Most Western countries are shifting health care services from hospital care towards community and home care, thus increasing nursing workforce challenges in home and community care. In order to implement appropriate policy responses to nursing workforce challenges, we need to know if these challenges are caused by maldistribution of nurses and/or the scarcity of nurses in general.
    RESULTS: Focusing on the Netherlands, we reviewed articles based on data of a labour market research programme and/or data from the Dutch Employed Persons\' Insurance Administration Agency. The data were analysed using a data synthesis approach.
    RESULTS: Nursing shortages are unevenly distributed across the various health care sectors. Shortages of practical nurses are caused by maldistribution, with a long-term projected surplus of practical nurses in hospitals and projected shortages in nursing/convalescent homes and home care. Shortages of first-level registered nurses are caused by general scarcity in the long term, mainly in hospitals and home care.
    CONCLUSIONS: Nursing workforce challenges are caused by a maldistribution of nurses and the scarcity of nurses in general. To implement appropriate policy responses to nursing workforce challenges, integrated health care workforce planning is necessary.
    CONCLUSIONS: Integrated workforce planning models could forecast the impact of health care transformation plans and guide national policy decisions on transitioning programmes. Effective transitioning programmes are required to address nursing shortages and to diminish maldistribution. In addition, increased recruitment and retention as well as new models of care are required to address the scarcity of nurses in general.
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