U. S. Academic Medical Centers Under the Managed Health Care Environment

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

Active Alumni in Electrical Engineering Extracurricular Activities： Innovation and Social Responsibility

The project analyzes the student＇s participation in complementary activities such as Education Tutorial Program, Junior Company and Academic Center. These organizations have the goal to improve, expand and connect knowledge learned during classes with several practical activities. They can provide a huge integration between the students and the professors in order to achieve better results in the pedagogical, structural and organizational parts of an engineering major degree. Therefore, the project goes through the impact of each entity in the student＇s life and the advantages to professional future, focusing the presence of these organizations in the Electrical Engineering Course of Federal University of Rio Grande do Norte.

Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

AIM:To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city. METHODS:One hundred and forty-nine consecutive patients (M:F ratio=110:39,mean age 52 yrs,range 16-95) with peptic ulcer disease were investigated for clinical history (including age,sex,previous history of peptic ulcer,associated diseases,delayed abdominal surgery,ulcer site,operation type,shock on admission,postoperative general complications, and intra-abdominal and/or wound infections),serum analyses and radiological findings. RESULTS:The overall mortality rate was 4.0%.Among all factors,an age above 65 years,one or more associated diseases,delayed abdominal surgery,shock on admission, postoperative abdominal complications and/or wound infections,were significantly associated (x^2) with increased mortality in patients undergoing surgery (0.0001<P<0.03). CONCLUSION:Factors such as concomitant diseases,shock on admission,delayed surgery,and postoperative abdominal and wound infections are significantly associated with fatal outcomes and need careful evaluation within the general workup of patients admitted for perforated peptic ulcer.

Prognosis of the Patients in Resuscitation Field in Mali

Introduction:The patients whose vital prognosis is immediately threatened by one or several serious organs failures and consecutive to various pathologies are admitted in resuscitations(IUC).The rates of morbi-mortality are raised in Africa.Objective:To study the prognostic factors.Patient and Methods:It was about a transverse survey from January 2015 to April 2016 in the unit of polyvalent resuscitation of the service of anesthesia resuscitation of the academic hospital center of Gabriel Toure.It included all patient admitted for medico-surgical pathologies of more than three hours of hospitalization.It was about a consecutive recruitment of case.The Chi^(2) and Fisher tests were used for the comparison of our results with a p value=0.05 considered as meaningful.The consent of the patients or parents was gotten.The survey didn’t include a potentially dangerous act.Results:During the period,624 patients have been collected of which:50.4%were medical pathologies,19.4%surgical pathologies and 30.2%of gynéco-obstetric pathologies.At least a complication had occurred in 11.2%.Mortality was of 27%.The sex-ratio was of 0.51.The middle age was of 31.88±17,2 years with extremes of 2 years and 80 years.The met complications were:the scab,the syndrome of acute respiratory distress(ARD),the urinary infection,the pneumopathie,the shock,thrust hypertensive,stops cardio circulatory with respectively 35.1%,26.6%,22.3%,6.4%and 3.2%.The middle length of stays was of 4.83±5.32 days with extremes of 1 day to 29 days.Conclusion:The complications under hospitalization in unit(IUC)of resuscitation in Mali are a major challenge in term of prevention and management.The potentially non serious pathologies complicate themselves and compromise the vital prognosis.