671 research outputs found
Quality Management in Hospitals: Does it Contribute to High Quality of Care?
Health policy-makers all around the world are facing the problem of ever-increasing costs in health care. In additio
n, the demand for high quality care is greater than ever. Since there is no indication that these trends will stop in the near future, the policy-makers have to find methods to mitigate these problems. One possible solution is the development of efficient quality strategies, including external quality assessment and improvement systems that focus on clinical effectiveness, the implementation of evidence based practice, patient safety programs and clinical audit. The aim of this paper is to identify and summ arize research studies which investigate the impact of different quality strategies and quality improvement methods on healthcare activities and outcomes, and to determine if these are effective clinical methods or not. For this reason, a systematic search was carried out in various databases. The literature suggests that having an external quality assessment system does contribute to better health care. However, most of the studies focus on
accreditation alone, and only three relatively low sample studies compare accreditation with ISO certification. Related to clinical-effectiveness, limited relevant results were found. Health policy-makers should consider different quality models as valid methods to provide high quality of care in hospitals, but they should also be aware that the clinical effectiveness of these has not yet been proven. More outcome-oriented, high sample studies should be carried out which compare one technique to another and find out if some of them could be implemented simultaneously
A magyar futrinka (Carabus hungaricus Fabricius, 1792) elterjedése, természetvédelmi helyzete. (Nature conservation status of Carabus hungaricus in Hungary),
CikkĂŒnkben összesĂtettĂŒk majd tĂ©rinformatikai mĂłdszerekkel feldolgoztuk a magyar futrinka (Carabus hungaricus Fabricius, 1792) ĂĄltalunk fellelhetĆ adatait. IntenzĂv Ă©lvefogĂł csapdĂĄzĂĄst vĂ©geztĂŒnk 47 magyarorszĂĄgi helyszĂnen. Ezek közĂŒl összesen 42 helyen Ă©szleltĂŒk a magyar futrinka jelenlĂ©tĂ©t, ebbĆl 17 elĆfordulĂĄs Ășjnak szĂĄmĂt. MegĂĄllapĂtottuk, hogy hazĂĄnkban a magyar futrinka potenciĂĄlisan veszĂ©lyeztetett. A faj megĆrzĂ©se Ă©rdekĂ©ben tovĂĄbbi Natura 2000 hĂĄlĂłzatba tartozĂł terĂŒleteket volna cĂ©lszerƱ kijelölni. A magyar futrinka legerĆsebb populĂĄciĂłi homokpusztagyepekhez kötĆdnek, a sziklagyepi populĂĄciĂłk jĂłval kisebb egyedszĂĄmĂșak Ă©s sĂ©rĂŒlĂ©kenyek. Tapasztalataink szerint a faj erĆs, nagy egyedszĂĄmĂș populĂĄciĂłibĂłl kĂ©pesek pĂ©ldĂĄnyok elvĂĄndorolni, Ă©s kedvezĆ körĂŒlmĂ©nyek esetĂ©n ott megtelepedni
Characterization of lipid-A molecules by tandem mass spectrometry combined with chromatography
VilĂĄgszerte a kĂłrhĂĄzak intenzĂv osztĂĄlyain a vezetĆ halĂĄlozĂĄsi okok között szerepelnek
a bakteriĂĄlis vĂ©rĂĄramfertĆzĂ©sek. Ennek oka többek között az egyre kifinomultabb sebĂ©szeti,
transzplantåciós, immun- és kemoteråpiås eljåråsok mind szélesebb körben való elterjedése,
amelyek következmĂ©nyekĂ©nt a legyengĂtett immunrendszerrel rendelkezĆ betegek
bakteriĂĄlis fertĆzĂ©seknek valĂł kitettsĂ©ge jelentĆs mĂ©rtĂ©kben növekszik. Mi több, a
multirezisztens baktĂ©riumtörzsek globĂĄlis elterjedĂ©se rĂ©vĂ©n növekvĆ tendenciĂĄt mutat a
gyakran halĂĄlos kimenetelƱ szepszis (azaz a bakteriĂĄlis fertĆzĂ©sre adott szabĂĄlyozatlan
immunvĂĄlasz) kialakulĂĄsa.
NormĂĄl körĂŒlmĂ©nyek között az emlĆs szervezetekben elĆfordulĂł Gram-negatĂv
baktĂ©riumok (pl: bĂ©lbaktĂ©riumok) pusztulĂĄsa sorĂĄn, a belĆlĂŒk felszabadulĂł unikĂĄlis Ă©s
heterogĂ©n szerkezetƱ foszfoglikolipideknek, az Ășgynevezett endotoxin molekulĂĄknak döntĆ
szerepĂŒk van a szervezet vĂ©dekezĆkĂ©pessĂ©gĂ©nek fenntartĂĄsĂĄban. A vĂ©rĂĄramba jutva, az ott
talĂĄlhatĂł immunsejtek felĂŒletĂ©n lĂ©vĆ, speciĂĄlis molekulĂĄris mintĂĄzatot felismerĆ
receptorokkal (Toll-szerƱ receptor) kölcsönhatĂĄsba lĂ©pve, a gazdaszervezet szĂĄmĂĄra elĆnyös
immunfolyamatokat indĂtanak be. Ugyanakkor a tĂșlzott mĂ©rtĂ©kƱ kitettsĂ©g (vĂ©rmĂ©rgezĂ©s)
esetĂ©n sĂșlyos szövĆdmĂ©nyeket elĆidĂ©zĆ endotoxĂ©mia alakul ki, aminek alapvetĆ szerepe van
az immunrendszer tĂșlfokozott mƱködĂ©sĂ©ben, következĂ©skĂ©pp a kialakulĂł szepszis
patogenitĂĄsĂĄban. Az endotoxinok emberi egĂ©szsĂ©gre gyakorolt hatĂĄsĂĄnak eme kettĆssĂ©ge
rĂ©vĂ©n jelentĆs kutatĂĄsi potenciĂĄlt rejtenek magukban mind az endotoxĂ©mia, illetve a szepszis
kezelĂ©se, mind pedig az immunrendszernek az egyĂ©b betegsĂ©gek megelĆzĂ©sĂ©ben,
lekĂŒzdĂ©sĂ©ben valĂł hatĂ©kony stimulĂĄlĂĄsa terĂ©n (pl: vakcina adjuvĂĄns fejlesztĂ©s). Mindezekhez
elengedhetetlen a pontos foszfoglikolipid szerkezetek Ă©s az ĂĄltaluk kivĂĄltott immunolĂłgiai
hatåsok kapcsolatånak megismerése.
A dolgozatban olyan Ășj analitikai megközelĂtĂ©seket mutatok be, amelyekkel
eredmĂ©nyesen feltĂĄrhatjuk a Gram-negatĂv eredetƱ foszfoglikolipidek termĂ©szetes
heterogenitåsåt, mennyiségi összetételét és az egyes molekulåk pontos szerkezetét. Az
endotoxin mintĂĄk ilyen jellegƱ ĂĄtfogĂł elemzĂ©se közelebb visz a gazdaszervezetben lĂ©vĆ
immunrendszer aktivålåsånak és a bakteriålis rezisztencia håtterének pontosabb
megértéséhez
The distribution, habitat, and the nature conservation value of a Natura 2000 beetle, Carabus hungaricus Fabricius, 1792 in Hungary.
Carabus hungaricus Fabricius, 1792 usually inhabits sandy grasslands and dolomitic grass-lands in Hungary. It is listed in the Habitat Directive and it is a characteristic species of the Pannonian biogeographic region. This paper summarizes all available data (literature data, personal communications, all available museum specimens, original research) on the current distribution of Carabus hungaricus in Hungary making use of GIS. The most numerous populations of this carabid beetle live in Pannonic sand steppe biotopes, the most vulnerable of the dolomitic grasslands. In Hungary, Carabus hungaricus is a vulnerable species according to the IUCN criteria. Known habitat types, habitat preferences, cooccurring ground beetle species, and endangering environmental factors are discussed
A magyar futrinka (Carabus hungaricus Fabricius, 1792) hazai elterjedĂ©se Ă©s Ă©lĆhelyei (Coleoptera: Carabidae)
Distribution and habitats of Carabus hungaricus Fabricius, 1792 in Hungary (Coleoptera: Carabidae) â Carabus hungaricus Fabricius, 1792 is a characteristic species of the Pannon Region, typically inhabiting sandy grasslands and dolomite grasslands in Hungary. Occurrences based on literature data, personal communications and all available specimens preserved in Hungarian collections are comprehensively listed. Most of the data are derived from specimens preserved in the Hungarian Natural History Museum, but also from several regional museums and amateur collectors. Specimen data are listed by counties. The history of the research on this species is critically
reviewed in two sections: the historical data (from 1800, the first record to 1949) and the modern research (1950 to the present). Known habitat types, habitat preferences, seasonal activity, endangering environmental factors are
discussed in details
Jelenkori folyĂłvizi felszĂnformĂĄlĂł tevĂ©kenysĂ©g Ă©s a szabĂĄlyozĂĄsok hatĂĄsainak vizsgĂĄlata a TiszĂĄn Ă©s a Maroson = Fluvial processes and the effects of river regulation works on the Tisza and Maros Rivers
A kutatĂĄs cĂ©lja a meder Ă©s a hullĂĄmterek fejlĆdĂ©sĂ©nek vizsgĂĄlata. Terveink szerint a mĂ©rĂ©seket a TiszĂĄn Ă©s a Maroson vĂ©geztĂŒk volna, de kĂ©sĆbb kiterjesztettĂŒk a HernĂĄdra Ă©s a DrĂĄvĂĄra is. A mederfejlĆdĂ©st a meder morfometriai paramĂ©tereinek hosszĂștĂĄvĂș alakulĂĄsa alapjĂĄn mĂ©rtĂŒk, Ă©s vizsgĂĄltuk befolyĂĄsolĂł tĂ©nyezĆit is (vĂzĂĄllĂĄs-tartĂłssĂĄg, vĂzjĂĄrĂĄs vĂĄltozĂĄs, partfal-ĂĄllĂ©konysĂĄg, növĂ©nyzet, tektonizmus Ă©s emberi lĂ©tesĂtmĂ©nyek). A kanyarulatfejlĆdĂ©st rĂ©szletesebben vizsgĂĄltuk, ugyanis a TiszĂĄn egyre szƱkebb Ă©s kisebb kanyarulatok alakultak ki, rontva a meder vĂzszĂĄllĂtĂł kĂ©pessĂ©gĂ©t. A mederszelvĂ©ny Ă©s a vĂzsebessĂ©g profilok alakulĂĄsĂĄt ĂĄrvizekkor Ă©s egy hidrolĂłgiai Ă©v sorĂĄn vizsgĂĄltuk, megĂĄllapĂtva, hogy a meder a legmĂ©lyebb az ĂĄradĂł idĆszak vĂ©gĂ©n, mĂg tetĆzĂ©skor megkezdĆdik az akkumulĂĄciĂł, amit az izotachok fel- Ă©s leszĂĄllĂĄsa is alĂĄtĂĄmaszt. A hullĂĄmterek vĂĄltozĂĄsainak vizsgĂĄlatakor az akkumulĂĄciĂł mĂ©rtĂ©kĂ©nek meghatĂĄrozĂĄsĂĄra illetve az ezt befolyĂĄsolĂł tĂ©nyezĆk vizsgĂĄlatĂĄra koncentrĂĄltunk. MegĂĄllapĂtottuk, hogy minden ĂĄrhullĂĄm egyedi mĂłdon viselkedik, igen eltĂ©rĆ mennyisĂ©gƱ ĂŒledĂ©ket halmoz fel, bĂĄr a felhalmozott ĂŒledĂ©k mintĂĄzata Ă©s szemcseösszetĂ©tele hasonlĂł. HosszĂștĂĄvĂș akkumulĂĄciĂłt az ĂŒledĂ©k vizsgĂĄlatĂĄval Ă©s DDM segĂtsĂ©gĂ©vel mĂ©rtĂŒnk. Az akkumulĂĄciĂłt befolyĂĄsolĂł növĂ©nyzeti Ă©rdessĂ©g alakulĂĄsĂĄt a 2006-os ĂĄrvĂz sorĂĄn sebessĂ©gprofilok felvĂ©telĂ©vel Ă©s hosszĂș tĂĄvon is vizsgĂĄltuk, megĂĄllapĂtva, hogy ez az egyik olyan kulcsfontossĂĄgĂș tĂ©nyezĆ, ami az ĂĄrterek vĂzvezetĆ kĂ©pessĂ©gĂ©t rontja. | The aim of the research was to measure the rate of active fluvial processes. Measurements were carried out on the Tisza, Maros, HernĂĄd and DrĂĄva Rivers. The long-term channel development was studied by morphometric parameters and its influencing factors were also evaluated (i.e. stage frequency, regime alterations, bank stability, vegetation, tectonism and human activity). Meander development was studied in details, as the bends of the Tisza tend to be narrower and smaller decreasing the water transport capacity of the channel. The cross-sectional changes and velocity profiles were evaluated during floods and within a hydrological year. Scour and velocity is the greatest in the end of the rising stage of a flood, but during the peak-flood period accumulation is dominant as the velocity profile shifts upwards. During the analysis of floodplain development the process of aggradation and its influencing factors were studied in details. Each flood is unique, as the amount of deposited sediment varied within great scale, however, the pattern and grain-size distribution of the sedimentation was similar. Long-term floodplain accumulation was measured using sediment profiles and DTM. Vegetational roughness as an influencing factor was evaluated by velocity measurements during the 2006 flood and by patch analysis. We concluded that vegetational roughness is the most important factor in decreasing the flood conductivity of the floodplains
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