A hospital is a health care institution providing patient treatment with specialized medical and nursing staff and medical equipment. The best-known type of hospital is the general hospital, which has an emergency department to treat urgent health problems ranging from fire and accident victims to a sudden illness. A district hospital is the major health care facility in its region, with a large number of beds for intensive care and additional beds for patients who need long-term care. Specialized hospitals include trauma centers, rehabilitation hospitals, children's hospitals, seniors' hospitals, hospitals for dealing with specific medical needs such as psychiatric treatment and certain disease categories. Specialized hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified as general, specialty, or government depending on the sources of income received. A teaching hospital combines assistance to people with teaching to medical nurses; the medical facility smaller than a hospital is called a clinic.
Hospitals have a range of departments and specialist units such as cardiology. Some hospitals have outpatient departments and some have chronic treatment units. Common support units include a pharmacy and radiology. Hospitals are funded by the public sector, health organisations, health insurance companies, or charities, including direct charitable donations. Hospitals were founded and funded by religious orders, or by charitable individuals and leaders. Hospitals are staffed by professional physicians, surgeons and allied health practitioners, whereas in the past, this work was performed by the members of founding religious orders or by volunteers. However, there are various Catholic religious orders, such as the Alexians and the Bon Secours Sisters that still focus on hospital ministry in the late 1990s, as well as several other Christian denominations, including the Methodists and Lutherans, which run hospitals. In accordance with the original meaning of the word, hospitals were "places of hospitality", this meaning is still preserved in the names of some institutions such as the Royal Hospital Chelsea, established in 1681 as a retirement and nursing home for veteran soldiers.
During the Middle Ages, hospitals served different functions from modern institutions. Middle Ages hospitals were hostels for pilgrims, or hospital schools; the word "hospital" comes from the Latin hospes, signifying a foreigner, hence a guest. Another noun derived from this, hospitium came to signify hospitality, the relation between guest and shelterer, hospitality and hospitable reception. By metonymy the Latin word came to mean a guest-chamber, guest's lodging, an inn. Hospes is thus the root for the English words host hospitality, hospice and hotel; the latter modern word derives from Latin via the ancient French romance word hostel, which developed a silent s, which letter was removed from the word, the loss of, signified by a circumflex in the modern French word hôtel. The German word'Spital' shares similar roots; the grammar of the word differs depending on the dialect. In the United States, hospital requires an article; some patients go to a hospital just for diagnosis, treatment, or therapy and leave without staying overnight.
Hospitals are distinguished from other types of medical facilities by their ability to admit and care for inpatients whilst the others, which are smaller, are described as clinics. The best-known type of hospital is the general hospital known as an acute-care hospital; these facilities handle many kinds of disease and injury, have an emergency department or trauma center to deal with immediate and urgent threats to health. Larger cities may have several hospitals of facilities; some hospitals in the United States and Canada, have their own ambulance service. A district hospital is the major health care facility in its region, with large numbers of beds for intensive care, critical care, long-term care. In California, "district hospital" refers to a class of healthcare facility created shortly after World War II to address a shortage of hospital beds in many local communities. Today, district hospitals are the sole public hospitals in 19 of California's counties, are the sole locally-accessible hospital within nine additional counties in which one or more other hospitals are present at substantial distance from a local community.
Twenty-eight of California's rural hospitals and 20 of its critical-access hospitals are district hospitals. They are formed by local municipalities, have boards that are individually elected by their local communities, exist to serve local needs, they are a important provider of healthcare to uninsured patients and patients with Medi-Cal. In 2012, district hospitals provided $54 million in uncompensated care in California. Types of specialised hospitals incl
Spaniards, or the Spanish people, are a Romance ethnic group that are indigenous to Spain. They share a common Spanish culture, history and language. Within Spain, there are a number of nationalisms and regionalisms, reflecting the country's complex history and diverse culture. Although the official language of Spain is known as "Spanish", it is only one of the national languages of Spain, is less ambiguously known as Castilian, a standard language based on the medieval romance speech of the Kingdom of Castile in north and central Spain; the Spanish people's heritage includes the pre-Celts and Celts. There are several spoken regional languages, most notably Basque and Galician. There are many populations outside Spain with ancestors who emigrated from Spain and who share a Hispanic culture; the Roman Republic conquered Iberia during the 2nd and 1st centuries BC. As a result of Roman colonization, the majority of local languages, with the exception of Basque, stem from the Vulgar Latin; the Germanic Vandals and Suebi, with part of the Iranian Alans under King Respendial conquered the peninsula in 409 AD.
In turn, the Visigoths established themselves in Spain. The Iberian Peninsula was conquered and brought under the rule of the Arab Umayyads in 711 and by the Berber North African dynasties the Almohads and the Almoravids in the 11th and 12th centuries. Following the eight century Christian Reconquista against the Moors, the modern Spanish state was formed with the union of the Kingdoms of Castille and Aragon, the conquest of the last Muslim Nasrid Kingdom of Granada and the Canary Islands in the late 15th century. In the early 16th century the Kingdom of Navarre was conquered; as Spain expanded its empire in the Americas, religious minorities in Spain such as Jews and Muslims were either converted or expelled and the Catholic church fiercely persecuted heresy during a period known as the Spanish Inquisition. A small number of Spaniards descend from converted Jewish and North Africans, as a result of the 800 years of Moorish occupation of the Iberian Peninsula. In parallel, a wave of emigration to the Americas began, with over 1.86 million Spaniards emigrating to the Spanish Americas during the colonial period and the population of the Spanish Empire had risen to 16.8 million by the end of the 18th century In the post-colonial period, a further 3.5 million Spanish left for the Americas Argentina, Mexico, Chile, Puerto Rico and Cuba.
Spain is home to one of the largest communities of Romani people. The Government's statistical agency CIS estimated in 2007 that the number of Gitanos present in Spain is around one million; the Spanish Roma, which belong to the Iberian Kale subgroup, are a formerly-nomadic community, which spread across Western Asia, North Africa, Europe, first reaching Spain in the 15th century. The population of Spain is becoming diverse due to recent immigration. From 2000 to 2010, Spain had among the highest per capita immigration rates in the world and the second highest absolute net migration in the World and immigrants now make up about 10% of the population; the prolonged economic crisis between 2008 and 2015 reduced both immigration rates and the total number of foreigners in the country, Spain becoming once more a net emigrant country. The earliest modern humans inhabiting Spain are believed to have been Neolithic peoples who may have arrived in the Iberian Peninsula as early as 35,000–40,000 years ago.
In more recent times the Iberians are believed to have arrived or developed in the region between the 4th millennium BC and the 3rd millennium BC settling along the Mediterranean coast. Celts settled in Spain during the Iron Age; some of those tribes in North-central Spain, which had cultural contact with the Iberians, are called Celtiberians. In addition, a group known as the Tartessians and Turdetanians inhabited southwestern Spain and who are believed to have developed a separate civilization of Phoenician influence; the seafaring Phoenicians and Carthaginians successively founded trading colonies along the Mediterranean coast over a period of several centuries. The Second Punic War between the Carthaginians and Romans was fought in what is now Spain and Portugal; the Roman Republic conquered Iberia during the 2nd and 1st centuries BC transformed most of the region into a series of Latin-speaking provinces. As a result of Roman colonization, the majority of local languages, with the exception of Basque, stem from the Vulgar Latin, spoken in Hispania, which evolved into the modern languages of the Iberian Peninsula, including Castilian, which became the main lingua franca of Spain, is now known in most countries as Spanish.
Hispania emerged as an important part of the Roman Empire and produced notable historical figures such as Trajan, Hadrian and Quintilian. The Germanic Vandals and Suebi, with part of the Iranian Alans under King Respendial, arrived in the peninsula in 409 AD. Part of the Vandals with the remaining Alans, now under Geiseric in personal union removed themselves to North Africa after a few conflicts with another Germanic tribe, the Visigoths, who established in Toulouse supported Roman campaigns against the Vandals and Alans in 415–19 AD and became the dominant power in Iberia for three centuries; the Visigoths were romanized in the eastern Empire and Christians, so their integration withi
The Moorish Castle is the name given to a medieval fortification in Gibraltar comprising various buildings and fortified walls, with the dominant features being the Tower of Homage and the Gate House. Part of the castle itself housed the prison of Gibraltar until it was relocated in 2010; the Tower of Homage is visible to all visitors to Gibraltar. Although sometimes compared to the nearby alcazars in Spain, the Moorish Castle in Gibraltar was constructed by the Marinid dynasty, making it unique in the Iberian Peninsula. Gibraltar has always been of special significance to the numerous peoples and civilizations that have visited or occupied it over the ages, from the Neanderthal period, through the Classical and on to Moorish and the current British rule; the Moorish occupation is by far the longest in Gibraltar's recorded history, having lasted from 711 to 1309 and again from 1350 to 1462, a total of 710 years. The Moorish conquest of Spain was led by Tarik ibn Ziyad and Musa ibn Nusayr, who may have landed in Europe at or near Gibraltar.
Gibraltar thus became the stepping-stone to the Moorish conquests of most of Spain and part of France. This spectacular feat of arms took a mere twenty-one years, no mean task considering the distances and terrain involved, the fact that mechanical transport on land was not in use; the strategic importance of Gibraltar rose in the last years of the Moorish rule, after the successful Spanish reconquest of the entire Guadalquivir valley, Gibraltar became one of the key elements in communication between the Kingdom of Granada and Moorish domains in northwestern Africa. Construction of the Moorish Castle commenced in the 8th century AD, its walls enclosed a considerable area, reaching down from the upper part of the Rock of Gibraltar to the sea. The most conspicuous remaining parts of the Castle are the upper tower, or Tower of Homage, together with various terraces and battlements below it, the massive Gate House, with its cupola roof; the Tower of Homage is the highest tower of the period of Islamic rule in the Iberian Peninsula, the Qasbah of the Castle is the largest in the area.
The Castle itself played a prominent part in the Muslim invasion of the Iberian Peninsula, with Muslim forces overrunning a large portion of it in two years - an invasion which led to Islamic domination of parts of western Europe for more than seven centuries. It is therefore of historic significance not only for Gibraltar and Iberia, but for all of western Europe; the present Tower of Homage, most of what is visible today of the Castle, was rebuilt during the second Moorish period of occupation in the early 14th century, after its near destruction during a reconquest of Gibraltar by the Moors following a re-occupation by Spanish forces from 1309 to 1333. Today the Moorish Castle is one of the major tourist attractions of Gibraltar, it is shown on the reverse of the 1995 design of the Gibraltar five-pound banknote; the name "Moorish Castle" is used locally when referring to the residential area surrounding the Castle, location of the Moorish Castle Estate. Part of the castle itself housed the prison of Gibraltar until the prison was relocated in 2010.
Moorish Gibraltar History of Gibraltar
A morgue or mortuary is used for the storage of human corpses awaiting identification or removal for autopsy or respectful burial, cremation or other method. In modern times corpses have customarily been refrigerated to delay decomposition. Mortuary early 14c. From Anglo-French mortuarie "gift to a parish priest from a deceased parishioner," from Medieval Latin mortuarium, noun use of neuter of Late Latin adjective mortuarius "pertaining to the dead," from Latin mortuus, pp. of mori "to die". Meaning "place where bodies are kept temporarily" first recorded 1865, a euphemism for earlier English term "deadhouse." Morgue from the French morgue, which means'to look at solemnly, to defy'. First used to describe the inner wicket of a prison, where new prisoners were kept so that jailers and turnkeys could recognize them in the future, it took on its modern meaning in fifteenth-century Paris, being used to describe part of the Châtelet used for the storage and identification of unknown corpses. Morgue is predominantly used in North American English, while mortuary is more common in British English, although both terms are used interchangeably.
The euphemisms “Rose Cottage” and “Rainbow’s End” are sometimes used in British hospitals to enable discussion in front of patients, the latter for children. A person responsible for handling and washing bodies is now known as a diener, morgue attendant, or autopsy technician. There are two types of mortuary cold chambers: Positive temperatureBodies are kept between 2 °C and 4 °C. While this is used for keeping bodies for up to several weeks, it does not prevent decomposition, which continues at a slower rate than at room temperature. Negative temperatureBodies are kept at between −10 °C and −50 °C. Used at forensic institutes when a body has not been identified. At these temperatures the body is frozen and decomposition is much reduced. In some countries, the body of the deceased is embalmed before disposal, which makes refrigeration unnecessary. In many countries, the family of the deceased must make the burial within 72 hours of death, but in some other countries it is usual that burial takes place some weeks or months after the death.
This is why some corpses are kept as long in a funeral home. When the family has enough money to organize the ceremony, the corpse is taken from the cold chamber for burial. In some funeral homes, the morgue is in the same room, or directly adjacent to, the specially designed ovens, known as retorts, that are used in funerary cremation; some religions dictate. To honor these religious rites, many funeral homes install a viewing window, which allows the family to watch as the body is inserted into the retort. In this way, the family can honor their customs without entering the morgue. Oversized mortuary fridge spaces have been installed in British hospitals to cope with the increase in obesity. A waiting mortuary is a mortuary building designed for the purpose of confirming that deceased persons are deceased. Prior to the advent of modern methods of verifying death, people feared that they would be buried alive. To alleviate such fears, the deceased were housed for a time in waiting mortuaries, where attendants would watch for signs of life.
The corpses would be allowed to decompose prior to burial. Waiting mortuaries were most popular in 19th-century Germany, were large, ornate halls. A bell was strung to the corpses to alert attendants of any motion. Although there is no documented case of a person being saved from accidental burial in this way, it is sometimes erroneously believed that this was the origin of the phrase “saved by the bell”, whilst in fact, the phrase originates from the sport of boxing. In American English: Morgue is used to refer to the room in which newspaper or magazine publishers keep their back issues and other historical references, as they serve a similar purpose to human morgues. See Morgue file. Morgue is used in some science fiction books as the name for the armory aboard ships, when they contain some form of powered armor. Mortuary can refer to a funeral home. Body bag Diener Pathology Tissue digestion Toe tag Body farm
An operating theater is a facility within a hospital where surgical operations are carried out in an aseptic environment. The term "operating theatre" referred to a non-sterile, tiered theater or amphitheater in which students and other spectators could watch surgeons perform surgery. Contemporary operating rooms are devoid of a theatre setting, making the term "operating theater" a misnomer. There are only two old-style operating theaters left, both of which are preserved as part of museums. Operating rooms are spacious, easy to clean in a cleanroom, well-lit with overhead surgical lights, may have viewing screens and monitors. Operating rooms are windowless and feature controlled temperature and humidity. Special air handlers filter the air and maintain a elevated pressure. Electricity support has backup systems in case of a black-out. Rooms are supplied with wall suction and other anesthetic gases. Key equipment consists of the anesthesia cart. In addition, there are tables to set up instruments.
There is storage space for common surgical supplies. There are containers for disposables. Outside the operating room is a dedicated scrubbing area, used by surgeons, anesthetists, ODPs, nurses prior to surgery. An operating room will have a map to enable the terminal cleaner to realign the operating table and equipment to the desired layout during cleaning. Several operating rooms are part of the operating suite that forms a distinct section within a health-care facility. Besides the operating rooms and their wash rooms, it contains rooms for personnel to change and rest, preparation and recovery rooms and cleaning facilities, dedicated corridors, other supportive units. In larger facilities, the operating suite is climate- and air-controlled, separated from other departments so that only authorized personnel have access; the operating table in the center of the room can be raised and tilted in any direction. The operating room lights are over the table to provide bright light, without shadows, during surgery.
The anesthesia machine is at the head of the operating table. This machine has tubes that connect to the patient to assist them in breathing during surgery, built-in monitors that help control the mixture of gases in the breathing circuit; the anesthesia cart is next to the anesthesia machine. It contains the medications and other supplies that the anesthesiologist may need. Sterile instruments to be used during surgery are arranged on a stainless steel table. An electronic monitor; the pulse oximeter machine attaches to the patient's finger with an elastic band aid. It measures the amount of oxygen contained in the blood. Automated blood pressure measuring machine that automatically inflates the blood pressure cuff on patient's arm. An electrocautery machine uses high frequency electrical signals to cauterize or seal off blood vessels and may be used to cut through tissue with a minimal amount of bleeding. If surgery requires, a Heart-lung machine, or other specialized equipment, may be brought into the room.
Heart lung machine takes the temporary control of the heart and lung during the surgery maintaining the circulation of blood and oxygen content of the body Advances in technology now support Hybrid Operating Rooms, which integrate diagnostic imaging systems such as MRI and Cardiac Catheterization into the operating room to assist surgeons in specialized Neurological and Cardiac procedures. People in the operating room wear PPE to help prevent bacteria from infecting the surgical incision; this PPE includes the following: Similar to germless. A protective cap covering their hair Masks over their lower face, covering their mouths and noses with minimal gaps to prevent inhalation of plume or airborne microbes Shades or glasses over their eyes, including specialized colored glasses for use with different lasers. A fiber-optic headlight may be attached for greater visibility Sterile gloves. Protective covers on their shoes If x-rays are expected to be used, lead aprons/neck covers are used to prevent overexposure to radiationThe surgeon may wear special glasses that help him/her to see more clearly.
The circulating nurse and anesthesiologist will not wear a gown in the OR because they are not a part of the sterile team. They must keep a distance of 12-16 inches from person, or field. Early operating theatres in an educational setting had raised tables or chairs at the center for performing operations surrounded by steep tiers of standing stalls for students and other spectators to observe the case in progress; the surgeons wore street clothes with an apron to protect them from blood stains, they operated bare-handed with unsterilized instruments and supplies. The University of Padua began teaching medicine in 1222, it played a leading role in the identification and treatment of diseases and ailments, specializing in autopsies and the inner workings of the body. In 1884 German surgeon Gustav Neuber implemented a comprehensive set of restrictions to ensure sterilization and aseptic operating conditions through the use of gowns and shoe covers, all of which were cleansed in his newly invented autoclave.
In 1885 he designed and built a private hospital in the woods where the walls and hands, arms and faces of staff were wash
Cathedral of St. Mary the Crowned
The Cathedral of Saint Mary the Crowned is a Roman Catholic cathedral in Gibraltar. It is the primary centre of Catholic worship in the Diocese of Gibraltar; the original building of the current cathedral was built during the Spanish period. Just after the reconquest of the city to the Moors, the main mosque was decreed to be stripped of its Islamic past and consecrated as the parish church. However, under the rule of the Catholic Monarchs, the old building was demolished and a new church was erected, in Gothic style; the cathedral's small courtyard is the remnant of the larger Moorish court of the mosque. The Catholic Monarchs' coat of arms was placed in the courtyard; the cathedral extended to the opposite side of. The church of St. Mary the Crowned was the only Catholic church or institution, not ransacked by the troops that took over the city in 1704, it was protected by its staunch pastor, Juan Romero, his curate, his bell-ringer. Thus, it is the only place where Catholic worship has been taken place uninterruptedly from the definite Christian re-conquest of the town.
Due to the building being damaged during the 1779–1783 Great Siege, in 1790 the Governor of Gibraltar Sir Robert Boyd offered to rebuild the cathedral in return for part of the land on which the building stood in order to re-route Main Street. The route was re-modelled in 1801; the reconstruction took place in 1810 and the opportunity was taken to widen Main Street. The clock tower was added in 1820 and in 1931 restoration work was carried out on the cathedral and the current west façade erected to replace the poorer one built in 1810. In 1881 the Church of St Mary's was the site of nearly fifty arrests as the Governor of Gibraltar sent police and reassigned soldiers to support Bishop Canilla as he attempted to enter his own church. A self-appointed "Committee of Elders" had said that they intended to take possession of the church and install their own "chief priest" against the will of the Governor and the Catholic church. Camilla was sent to his church on 2 March 1881 with police protection to install him in his church.
When the new force came to the church they found it was occupied by 200 men and the police had to make four dozen arrests to establish order. Not only did Camilla now have possession of his church but he was the owner as the governor arranged for the title deeds to be given to the new titular Bishop; until the 19th century, anyone who died in Gibraltar had the right to be buried under the cathedral floor. Bishops are buried in a crypt beneath the statue of Our Lady of Europe. In 1943, Władysław Sikorski's coffin lay in state here, after his plane crashed into the sea just off Gibraltar. San Roque, Cádiz Cathedral information and photos of interior Illustrated article
The Gibraltar pound is the currency of Gibraltar. It is pegged to – and exchangeable with – the British pound sterling at par value. Coins and banknotes of the Gibraltar pound are printed by the Government of Gibraltar; until 1872, the currency situation in Gibraltar was complicated, with a system based on the real being employed which encompassed British and Gibraltarian coins. From 1825, the real was tied to the pound at the rate of 1 Spanish dollar to 4 shillings 4 pence. In 1872, the Spanish currency became the sole legal tender in Gibraltar. In 1898, the Spanish–American War made the Spanish peseta drop alarmingly and the pound was introduced as the sole currency of Gibraltar in the form of British coins and banknotes. In 1898, the British pound was made sole legal tender, although the Spanish peseta continued in circulation until the Spanish Civil War. Since 1927, Gibraltar has issued its own banknotes and, since 1988, its own coins. Gibraltar decimalised in 1971 at the same time as the UK, replacing the system of 1 pound = 20 shillings = 240 pence with one of 1 pound = 100 pence.
The since repealed Currency Notes Act 1934, conferred on the Government of Gibraltar the right to print its own notes. Notes issued are either backed by Bank of England notes at a rate of one pound to one pound sterling, or can be backed by securities issued by the Government of Gibraltar. Although Gibraltar notes are denominated in "pounds sterling", they are not legal tender anywhere in the United Kingdom. Gibraltar's coins are the same weight and metal as British coins, although the designs are different, they are found in circulation across Britain. Under the Currency Notes Act 2011 the notes and coins issued by the Government of Gibraltar are legal tender and current coin within Gibraltar. British coins and Bank of England notes circulate in Gibraltar and are universally accepted and interchangeable with Gibraltarian issues. In 1988, coins in denominations of 1, 2, 5, 10, 20 and 50 pence and 1 pound were introduced which bore specific designs for and the name of Gibraltar, they were the same sizes and compositions as the corresponding British coins, with 2 pound coins introduced in 1999.
A new coin of 5 pounds was issued in 2010 with the inscription "Elizabeth II · Queen of Gibraltar". This issue caused controversy in Spain, where the title of King of Gibraltar corresponds to the crown of Castile; the £2 coin has featured a new design every year since its introduction, as it depicts each of the 12 Labours of Hercules. In 2004 the Government of Gibraltar minted a new edition of its coins to commemorate the tercentenary of British Gibraltar. At the outbreak of World War I, Gibraltar was forced to issue banknotes to prevent paying out sterling or gold; these notes were issued under emergency wartime legislation, Ordinance 10 of 1914. At first the typeset notes were signed by hand by Treasurer Greenwood, though he used stamps; the notes bore the embossed stamp of the Anglo-Egyptian Bank Ltd. and circulated alongside British Territory notes. The 1914 notes were issued in denominations of 2s, 10s, £1, £5 and £50; the 2s and £50 notes were not continued when a new series of notes was introduced in 1927.
The 10s note was replaced by the 50p coin during the process of decimalization. In 1975, £10 and £20 notes were introduced, followed by £50 in 1986; the £1 note was discontinued in 1988. In 1995, a new series of notes was introduced which, for the first time, bore the words "pounds sterling" rather than just "pounds"; the government of Gibraltar introduced a new series of banknotes beginning with the £10 and £50 notes issued on July 8, 2010. On May 11, 2011, the £5, £20 and £100 notes were issued. Economy of Gibraltar Currency board Christopher Ironside, OBE, coin designer: reverse design of the 25 New Pence coin, Barbary ape. Banknotes of Gibraltar: Catalog of Gibraltar Shillings and Pounds The current banknotes of Gibraltar