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132-399: The church is an imposing Romanesque structure situated high on the hill which the city climbs, but it lacks much of the spectacular decoration with which it was originally adorned, thanks to an ill-advised sixteenth-century reconstruction. According to legend, the cathedral was built on the site of an Etruscan temple of Hercules . Etruscan and Roman foundations can be seen on several of

264-421: A chargemaster ; however, these prices may be lower for health care obtained within healthcare networks . Legislation requires hospitals to provide care to patients in life-threatening emergency situations regardless of the patient's ability to pay. Privately funded hospitals which admit uninsured patients in emergency situations incur direct financial losses, such as in the aftermath of Hurricane Katrina . As

396-620: A medical records department , release of information department , technical support , clinical engineering , facilities management, plant operations , dining services, and security departments. The COVID-19 pandemic stimulated the development of virtual wards across the British NHS . Patients are managed at home, monitoring their own oxygen levels using an oxygen saturation probe if necessary and supported by telephone. West Hertfordshire Hospitals NHS Trust managed around 1200 patients at home between March and June 2020 and planned to continue

528-468: A pharmacy , pathology , and radiology . Hospitals are typically funded by public funding , health organizations ( for-profit or nonprofit), health insurance companies, or charities, including direct charitable donations. Historically, hospitals were often founded and funded by religious orders , or by charitable individuals and leaders. Hospitals are currently staffed by professional physicians, surgeons, nurses, and allied health practitioners . In

660-416: A production line . A teaching hospital delivers healthcare to patients as well as training to prospective medical professionals such as medical students and student nurses . It may be linked to a medical school or nursing school, and may be involved in medical research . Students may also observe clinical work in the hospital. Clinics generally provide only outpatient services, but some may have

792-577: A 12th-century Madonna and Child by an unknown artist; the work appears to be an earlier version of a famous painting in the Basilica di Santa Maria Maggiore in Rome. It has been moved here from a local parish church. The cathedral also possesses a baptismal font (1470) constructed initially by Francesco da Ancona with later additions. The piazza itself, although dominated by the cathedral and its campanile also possesses several other important buildings, including

924-455: A carved central jamb. Narrow doors and small windows might be surmounted by a solid stone lintel. Larger openings are nearly always arched. A characteristic feature of Romanesque architecture, both ecclesiastic and domestic, is the pairing of two arched windows or arcade openings, separated by a pillar or colonette and often set within a larger arch. Ocular windows are common in Italy, particularly in

1056-573: A common rule, living in a mutually dependent community, rather than as a group of hermits living in proximity but essentially separate, was established by the monk Benedict in the 6th century. The Benedictine monasteries spread from Italy throughout Europe, being always by far the most numerous in England. They were followed by the Cluniac order, the Cistercians , Carthusians and Augustinian Canons . During

1188-472: A disadvantage which the local bishops for years attempted to reverse by granting the cathedral special religious privileges. The cathedral was at the height of its significance during the middle and end of the thirteenth century, when it and the attached Palazzo dei Papi di Viterbo was the home of the papal throne following its flight from Rome and prior to its resettlement in Avignon . Two popes were buried in

1320-401: A few inpatient beds and a limited range of services that may otherwise be found in typical hospitals. A hospital contains one or more wards that house hospital beds for inpatients . It may also have acute services such as an emergency department , operating theatre , and intensive care unit , as well as a range of medical specialty departments. A well-equipped hospital may be classified as

1452-481: A few related medical specialties . Subtypes include rehabilitation hospitals , children's hospitals , seniors' ( geriatric ) hospitals, long-term acute care facilities , and hospitals for dealing with specific medical needs such as psychiatric problems (see psychiatric hospital ), cancer treatment , certain disease categories such as cardiac, oncology, or orthopedic problems, and so forth. In Germany , specialised hospitals are called Fachkrankenhaus ; an example

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1584-571: A great number of antique Roman columns were salvaged and reused in the interiors and on the porticos of churches. The most durable of these columns are of marble and have the stone horizontally bedded. The majority are vertically bedded and are sometimes of a variety of colours. They may have retained their original Roman capitals, generally of the Corinthian or Roman Composite style. Some buildings, like Santa Maria in Cosmedin (illustrated above) and

1716-509: A half-column supporting the arch. There are many variations on this theme, most notably at Durham Cathedral where the mouldings and shafts of the piers are of exceptional richness and the huge masonry columns are deeply incised with geometric patterns. Often the arrangement was made more complex by the complexity of the piers themselves, so that it was not piers and columns that alternated, but rather, piers of entirely different form from each other, such as those of Sant' Ambrogio, Milan , where

1848-413: A horizontal moulding representing a capital at the springing of the arch. Sometimes piers have vertical shafts attached to them, and may also have horizontal mouldings at the level of the base. Although basically rectangular, piers can often be of highly complex form, with half-segments of large hollow-core columns on the inner surface supporting the arch, or a clustered group of smaller shafts leading into

1980-604: A hospital bed, but be considered outpatient and "under observation" if not formally admitted. In the U.S., inpatient stays are covered under Medicare Part A, but a hospital might keep a patient under observation which is only covered under Medicare Part B, and subjects the patient to additional coinsurance costs. In 2013, the Center for Medicare and Medicaid Services (CMS) introduced a "two-midnight" rule for inpatient admissions, intended to reduce an increasing number of long-term "observation" stays being used for reimbursement. This rule

2112-449: A hospital just for diagnosis , treatment, or therapy and then leave (" outpatients ") without staying overnight; while others are "admitted" and stay overnight or for several days or weeks or months (" inpatients "). Hospitals are usually distinguished from other types of medical facilities by their ability to admit and care for inpatients whilst the others, which are smaller, are often described as clinics . The best-known type of hospital

2244-692: A hospital; Pennsylvania Hospital in Philadelphia opened in 1752, New York Hospital , now Weill Cornell Medical Center in New York City opened in 1771, and Massachusetts General Hospital in Boston opened in 1811. When the Vienna General Hospital opened in 1784 as the world's largest hospital, physicians acquired a new facility that gradually developed into one of the most important research centers. Another Enlightenment era charitable innovation

2376-602: A lack of living space within the walls, and resulted in a style of town house that was tall and narrow, often surrounding communal courtyards, as at San Gimignano in Tuscany and Bologna and Pavia in Lombardy . In Germany, the Holy Roman Emperors built a number of residences, fortified, but essentially palaces rather than castles, at strategic points and on trade routes. The Imperial Palace of Goslar (heavily restored in

2508-630: A large number remain either substantially intact or sympathetically restored, demonstrating the form, character and decoration of Romanesque church architecture. Romanesque architecture was the first distinctive style to spread across Europe since the Roman Empire . With the decline of Rome, Roman building methods survived to an extent in Western Europe, where successive Merovingian , Carolingian and Ottonian architects continued to build large stone buildings such as monastery churches and palaces. In

2640-400: A manner similar to the entire Orvieto Cathedral . During the mid-16th century, the cathedral was controlled by Cardinal Gambarra, scion of a wealthy Italian family, who paid for extensive reconstruction, including the demolition of the façade, roof and central apse (including a Papal tomb). He also created new chapels and replaced much of the internal art, wood and stone decorations as well as

2772-418: A monastic complex, with all its various monastic buildings and their functions labelled. The largest building is the church, the plan of which is distinctly Germanic, having an apse at both ends, an arrangement not generally seen elsewhere. Another feature of the church is its regular proportion, the square plan of the crossing tower providing a module for the rest of the plan. These features can both be seen at

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2904-489: A particularly important provider of healthcare to uninsured patients and patients with Medi-Cal (which is California's Medicaid program, serving low-income persons, some senior citizens , persons with disabilities , children in foster care , and pregnant women). In 2012, district hospitals provided $ 54 million in uncompensated care in California. A specialty hospital is primarily and exclusively dedicated to one or

3036-922: A phenomenon known as international healthcare accreditation , by groups such as Accreditation Canada in Canada , the Joint Commission in the U.S., the Trent Accreditation Scheme in Great Britain , and the Haute Autorité de santé (HAS) in France . In England , hospitals are monitored by the Care Quality Commission . In 2020, they turned their attention to hospital food standards after seven patient deaths from listeria linked to pre-packaged sandwiches and salads in 2019, saying "Nutrition and hydration

3168-462: A significantly greater number of patients. It has 3,000 beds and performs 3,000 paediatric cardiac operations annually, the largest number in the world for such a facility. Surgeons are paid on a fixed salary instead of per operation, thus when the number of procedures increases, the hospital is able to take advantage of economies of scale and reduce its cost per procedure. Each specialist may also become more efficient by working on one procedure like

3300-511: A single piece of stone were frequently used in Italy, as they had been in Roman and Early Christian architecture. They were also used, particularly in Germany, when they alternated between more massive piers. Arcades of columns cut from single pieces are also common in structures that do not bear massive weights of masonry, such as cloisters, where they are sometimes paired. In Italy, during this period,

3432-499: A third stage of window openings known as the clerestory rising above them. Arcading on a large scale generally fulfils a structural purpose, but it is also used, generally on a smaller scale, as a decorative feature, both internally and externally where it is frequently " blind arcading " with only a wall or a narrow passage behind it. In Romanesque architecture, piers were often employed to support arches. They were built of masonry and square or rectangular in section, generally having

3564-411: A trauma center. They may also have other services such as a hospital pharmacy , radiology , pathology , and medical laboratories . Some hospitals have outpatient departments such as behavioral health services, dentistry , and rehabilitation services . A hospital may also have a department of nursing , headed by a chief nursing officer or director of nursing . This department is responsible for

3696-463: Is Fachkrankenhaus Coswig (thoracic surgery). In India, specialty hospitals are known as super-specialty hospitals and are distinguished from multispecialty hospitals which are composed of several specialties. Specialised hospitals can help reduce health care costs compared to general hospitals. For example, Narayana Health 's cardiac unit in Bangalore specialises in cardiac surgery and allows for

3828-458: Is a rose window , although without any form of stained-glass decoration. There are two similar but smaller windows positioned further down over two smaller entrances aside the main entrance, again undecorated. Therefore, in total there are 33 windows. The only indication of the original decoration of the cathedral can be seen on the neighbouring campanile , which is clad in alternating bands of local white travertine and blue-green basalt stone in

3960-417: Is a direct imitation of Islamic architecture . At other late Romanesque churches such as Durham Cathedral , and Cefalù Cathedral , the pointed arch was introduced as a structural device in ribbed vaulting. Its increasing application was fundamental to the development of Gothic architecture . An arcade is a row of arches, supported on piers or columns. They occur in the interior of large churches, separating

4092-674: Is often divided into two periods known as the " First Romanesque " style and the "Romanesque" style. The difference is chiefly a matter of the expertise with which the buildings were constructed. The First Romanesque employed rubble walls, smaller windows and unvaulted roofs. A greater refinement marks the Second Romanesque, along with increased use of the vault and dressed stone. The walls of Romanesque buildings are often of massive thickness with few and comparatively small openings. They are often double shells, filled with rubble. The building material differs greatly across Europe, depending upon

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4224-508: Is one of simplicity when compared with the Gothic buildings that were to follow. The style can be identified right across Europe, despite regional characteristics and different materials. Many castles were built during this period, but they are greatly outnumbered by churches. The most significant are the great abbey churches, many of which are still standing, more or less complete and frequently in use. The enormous quantity of churches built in

4356-493: Is part of a patient's recovery." The World Health Organization reported in 2011 that being admitted to a hospital was far riskier than flying. Globally, the chance of a patient being subject to a treatment error in a hospital was about 10%, and the chance of death resulting from an error was about one in 300. according to Liam Donaldson . 7% of hospitalised patients in developed countries, and 10% in developing countries, acquire at least one health care-associated infection . In

4488-538: Is the general hospital, also known as an acute-care hospital. These facilities handle many kinds of disease and injury, and normally have an emergency department (sometimes known as "accident & emergency") or trauma center to deal with immediate and urgent threats to health. Larger cities may have several hospitals of varying sizes and facilities. Some hospitals, especially in the United States and Canada, have their own ambulance service. A district hospital typically

4620-432: Is the major health care facility in its region, with large numbers of beds for intensive care , critical care , and long-term care. In California, "district hospital" refers specifically to a class of healthcare facility created shortly after World War II to address a shortage of hospital beds in many local communities. Even today, district hospitals are the sole public hospitals in 19 of California's counties, and are

4752-573: Is the major health care facility in its region, with many beds for intensive care and additional beds for patients who need long-term care. Specialized hospitals include trauma centers , rehabilitation hospitals , children's hospitals , geriatric hospitals, and hospitals for specific medical needs, such as psychiatric hospitals for psychiatric treatment and other disease-specific categories. Specialized hospitals can help reduce health care costs compared to general hospitals. Hospitals are classified as general, specialty, or government depending on

4884-540: Is typical of the churches that were founded on the pilgrim route. The general impression given by Romanesque architecture, in both ecclesiastical and secular buildings, is one of massive solidity and strength. In contrast with both the preceding Roman and later Gothic architecture , in which the load-bearing structural members are, or appear to be, columns, pilasters and arches, Romanesque architecture, in common with Byzantine architecture , relies upon its walls, or sections of walls called piers. Romanesque architecture

5016-566: The Mahavamsa , the ancient chronicle of Sinhalese royalty, written in the sixth century AD, King Pandukabhaya of Sri Lanka (r. 437–367 BC) had lying-in-homes and hospitals (Sivikasotthi-Sala). A hospital and medical training center also existed at Gundeshapur , a major city in southwest of the Sassanid Persian Empire founded in AD 271 by Shapur I . In ancient Greece , temples dedicated to

5148-683: The Crusades , the military orders of the Knights Hospitaller and the Knights Templar were founded. The monasteries, which sometimes also functioned as cathedrals, and the cathedrals that had bodies of secular clergy often living in community, were a major source of power in Europe. Bishops and the abbots of important monasteries lived and functioned like princes. The monasteries were the major seats of learning of all sorts. Benedict had ordered that all

5280-690: The Kingdom of Germany giving rise to the Holy Roman Empire . The invasion of England by William, Duke of Normandy , in 1066, saw the building of both castles and churches that reinforced the Norman presence. Several significant churches that were built at this time were founded by rulers as seats of temporal and religious power, or places of coronation and burial. These include the Abbaye-Saint-Denis , Speyer Cathedral and Westminster Abbey (where little of

5412-557: The Latin hospes , signifying a stranger or foreigner, hence a guest. Another noun derived from this, hospitium came to signify hospitality, that is the relation between guest and shelterer, hospitality, friendliness, and hospitable reception. By metonymy , the Latin word then came to mean a guest-chamber, guest's lodging, an inn . Hospes is thus the root for the English words host (where

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5544-500: The Pyrenees and converged into a single stream to traverse north-western Spain. Along the route they were urged on by those pilgrims returning from the journey. On each of the routes abbeys such as those at Moissac , Toulouse , Roncesvalles , Conques , Limoges and Burgos catered for the flow of people and grew wealthy from the passing trade. Saint-Benoît-du-Sault , in the Berry province,

5676-503: The Second World War , during which the cathedral and the city were heavily damaged. The renovations of the cathedral along the centuries eliminated most of the original frescoes. The main works along apse are 18th-century pieces by the local painter Giovanni Francesco Romanelli and contemporaries. Only two notable early artworks survive, a Redentore benedicte ( Christ giving a blessing ) (1472) attributed to Gerolamo da Cremona and

5808-658: The Twelve Apostles . Santiago de Compostela , located in the Kingdom of Galicia (present day Galicia , Spain) became one of the most important pilgrimage destinations in Europe. Most of the pilgrims travelled the Way of St. James on foot, many of them barefooted as a sign of penance. They moved along one of the four main routes that passed through France, congregating for the journey at Jumièges , Paris, Vézelay , Cluny , Arles and St. Gall in Switzerland. They crossed two passes in

5940-415: The conclave tradition, taken from the Latin cum claves or with keys . The cardinals were taking so long picking a new pope following the death of Pope Clement IV in 1268 that their presence was bankrupting local businesses. This drove the infuriated local people to lock the cardinals inside the palace and to steal the roof, exposing those inside to the elements. They only returned the slates and unlocked

6072-489: The p was dropped for convenience of pronunciation) hospitality , hospice , hostel, and hotel . The latter modern word derives from Latin via the Old French romance word hostel , which developed a silent s , which letter was eventually removed from the word, the loss of which is signified by a circumflex in the modern French word hôtel . The German word Spital shares similar roots. Some patients go to

6204-463: The "Cluny II" rebuilding of 963 onwards has completely vanished, but we have a good idea of the design of "Cluny III" from 1088 to 1130, which until the Renaissance remained the largest building in Europe. However, the church of St. Sernin at Toulouse , 1080–1120, has remained intact and demonstrates the regularity of Romanesque design with its modular form, its massive appearance and the repetition of

6336-544: The 1970s and have since expanded rapidly across the United States. The Catholic Church is the largest non-government provider of health careservices in the world. It has around 18,000 clinics, 16,000 homes for the elderly and those with special needs, and 5,500 hospitals, with 65 percent of them located in developing countries. In 2010, the Church's Pontifical Council for the Pastoral Care of Health Care Workers said that

6468-505: The 19th century) was built in the early 11th century by Otto III and Henry III, while the ruined Palace at Gelnhausen was received by Frederick Barbarossa prior to 1170. The movement of people and armies also brought about the building of bridges, some of which have survived, including the 12th-century bridge at Besalú , Catalonia , the 11th-century Puente de la Reina, Navarre and the Pont-Saint-Bénézet, Avignon . Across Europe,

6600-685: The 6th-century octagonal Byzantine Basilica of San Vitale in Ravenna being the inspiration for the greatest building of the Early Middle Ages in Europe, the Emperor Charlemagne 's Palatine Chapel, Aachen , Germany, built around the year AD 800. Dating shortly after the Palatine Chapel is a remarkable 9th-century Swiss manuscript known as the Plan of Saint Gall and showing a very detailed plan of

6732-607: The 8th and the 10th centuries in the Iberian Peninsula while " First Romanesque " is applied to buildings in north of Italy and Spain and parts of France that have Romanesque features but pre-date the influence of the Abbey of Cluny . The Romanesque style in England and Sicily is still referred to as Norman architecture . A "dazzling" style developed in Pisa in the mid-11th century is called " Pisan Romanesque ". Eric Fernie writes that by

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6864-547: The Alps, a very important group of large city churches survived largely intact. As monasticism spread across Europe, Romanesque churches sprang up in Scotland, Scandinavia, Poland, Hungary, Sicily, Serbia and Tunisia. Several important Romanesque churches were built in the Crusader kingdoms . The system of monasticism in which the religious become members of an order, with common ties and

6996-581: The Church manages 26% of the world's health care facilities. Modern hospitals derive funding from a variety of sources. They may be funded by private payment and health insurance or public expenditure , charitable donations . In the United Kingdom , the National Health Service delivers health care to legal residents funded by the state "free at the point of delivery", and emergency care free to anyone regardless of nationality or status. Due to

7128-496: The Classical than those in England. Hospital A hospital is a healthcare institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a sudden illness. A district hospital typically

7260-474: The Crusades could be suitably commemorated by their family in a work of stone and mortar. The Crusades resulted in the transfer of, among other things, a great number of Holy Relics of saints and apostles . Many churches, like Saint-Front, Périgueux , had their own home grown saint while others, most notably Santiago de Compostela , claimed the remains and the patronage of a powerful saint, in this case one of

7392-615: The French government sent two scholar administrators, Coulomb and Tenon , who had visited most of the hospitals in Europe. They were impressed and the "pavilion" design was copied in France and throughout Europe. English physician Thomas Percival (1740–1804) wrote a comprehensive system of medical conduct, Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons (1803) that set

7524-524: The Islamic world was built in 805 in Baghdad by Harun Al-Rashid . By the 10th century, Baghdad had five more hospitals, while Damascus had six hospitals by the 15th century, and Córdoba alone had 50 major hospitals, many exclusively for the military, by the end of the 15th century. The Islamic bimaristan served as a center of medical treatment, as well nursing home and lunatic asylum . It typically treated

7656-515: The Pre-Conquest church now remains). At a time when the remaining architectural structures of the Roman Empire were falling into decay and much of its learning and technology lost, the building of masonry domes and the carving of decorative architectural details continued unabated, though greatly evolved in style since the fall of Rome, in the enduring Byzantine Empire . The domed churches of Constantinople and Eastern Europe were to greatly affect

7788-531: The Proto-Romanesque St. Michael's Church, Hildesheim , 1001–1030. Architecture of a Romanesque style also developed simultaneously in the north of Italy, parts of France and in the Iberian Peninsula in the 10th century and prior to the later influence of the Abbey of Cluny . The style, sometimes called First Romanesque or Lombard Romanesque , is characterised by thick walls, lack of sculpture and

7920-529: The Roman population, were occasionally privately built in extremely wealthy Roman households located in the countryside for that family, although this practice seems to have ended in 80 AD. The declaration of Christianity as an accepted religion in the Roman Empire drove an expansion of the provision of care. Following the First Council of Nicaea in AD 325 construction of a hospital in every cathedral town

8052-486: The Romanesque period was succeeded by the still busier period of Gothic architecture, which partly or entirely rebuilt most Romanesque churches in prosperous areas like England and Portugal. The largest groups of Romanesque survivors are in areas that were less prosperous in subsequent periods, including parts of southern France , rural Spain and rural Italy. Survivals of unfortified Romanesque secular houses and palaces, and

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8184-407: The U.S., 1.7 million infections are acquired in hospital each year, leading to 100,000 deaths, figures much worse than in Europe where there were 4.5 million infections and 37,000 deaths. Modern hospital buildings are designed to minimise the effort of medical personnel and the possibility of contamination while maximising the efficiency of the whole system. Travel time for personnel within

8316-449: The administration of professional nursing practice, research , and policy for the hospital. Many units have both a nursing and a medical director that serve as administrators for their respective disciplines within that unit. For example, within an intensive care nursery, a medical director is responsible for physicians and medical care, while the nursing manager is responsible for all the nurses and nursing care. Support units may include

8448-448: The aisles helped to buttress the nave, if it was vaulted. In the cases where half-barrel vaults were used, they effectively became like flying buttresses . Often aisles extended through two storeys, rather than the one usual in Gothic architecture, so as to better support the weight of a vaulted nave. In the case of Durham Cathedral, flying buttresses have been employed, but are hidden inside

8580-451: The arcades that separate large interior spaces of castles, is the alternation of piers and columns. The most simple form that this takes is to have a column between each adjoining pier. Sometimes the columns are in multiples of two or three. At St. Michael's, Hildesheim , an A B B A alternation occurs in the nave while an A B A alternation can be seen in the transepts. At Jumièges there are tall drum columns between piers each of which has

8712-400: The architectural style which flourished across Europe from the 11th to the 13th century, and is distinguished from the Gothic style that followed by semi-circular arches and more massive forms. The development of vaults from barrel and groin vaults to ribbed vaults was the main structural innovation of this period. The distinction between the style of architecture now known as Romanesque, and

8844-421: The architecture of certain towns, particularly through trade and through the Crusades . The most notable single building that demonstrates this is St Mark's Basilica , Venice , but there are many lesser-known examples, particularly in France, such as the church of Saint-Front , Périgueux and Angoulême Cathedral . Much of Europe was affected by feudalism in which peasants held tenure from local rulers over

8976-422: The arts were to be taught and practiced in the monasteries. Within the monasteries books were transcribed by hand, and few people outside the monasteries could read or write. In France, Burgundy was the centre of monasticism. The enormous and powerful monastery at Cluny was to have lasting effect on the layout of other monasteries and the design of their churches. Very little of the abbey church at Cluny remains;

9108-551: The atrium at San Clemente in Rome, may have an odd assortment of columns in which large capitals are placed on short columns and small capitals are placed on taller columns to even the height. Architectural compromises of this type are seen where materials have been salvaged from a number of buildings. Salvaged columns were also used to a lesser extent in France. In most parts of Europe, Romanesque columns were massive, as they supported thick upper walls with small windows, and sometimes heavy vaults. The most common method of construction

9240-459: The average length of stay, time to service, patient satisfaction, physician performance, patient readmission rate, inpatient mortality rate, and case mix index . In the United States , the number of hospitalizations grew to its peak in 1981 with 171 admissions per 1,000 Americans and 6,933 hospitals. This trend subsequently reversed, with the rate of hospitalization falling by more than 10% and

9372-407: The beginning of the 21st century there is "something like agreement" on the characteristics of the Romanesque style. Some researchers argue that due to an "astonishing diversity" of the Romanesque buildings, a unanimous definition is impossible: "[n]o single model, no single rule, ever seems adequate to prevail", and the Romanesque should be treated as a "collection of trends". Despite disagreement,

9504-404: The birth of specialised medicine. By the late 19th and early 20th centuries, medical advancements such as anesthesia and sterile techniques that could make surgery less risky, and the availability of more advanced diagnostic devices such as X-rays , continued to make hospitals a more attractive option for treatment. Modern hospitals measure various efficiency metrics such as occupancy rates,

9636-559: The building of castles at strategic points, many of them being constructed as strongholds of the Normans, descendants of the Vikings who invaded northern France under Rollo in 911. Political struggles also resulted in the fortification of many towns, or the rebuilding and strengthening of walls that remained from the Roman period. One of the most notable surviving fortifications is that of the city of Carcassonne . The enclosure of towns brought about

9768-450: The buildings facing the Piazza di San Lorenzo where the cathedral is situated. Before the 12th century, a parish church dedicated to Saint Lawrence had occupied the site of the cathedral. Even as this church was constructed, the town was already spreading northwards down the hill, leaving the plaza somewhat isolated on the highest edges of town, thus restricting its attraction to the townsfolk,

9900-569: The continent, making it the first pan-European architectural style since Imperial Roman architecture . Similarly to Gothic, the name of the style was transferred onto the contemporary Romanesque art . Combining features of ancient Roman and Byzantine buildings and other local traditions, Romanesque architecture is known by its massive quality, thick walls, round arches, sturdy pillars , barrel vaults , large towers and decorative arcading . Each building has clearly defined forms, frequently of very regular, symmetrical plan. The overall appearance

10032-567: The crown; this was the first instance of secular support being provided for medical institutions. In 1682, Charles II founded the Royal Hospital Chelsea as a retirement home for old soldiers known as Chelsea Pensioners , an instance of the use of the word "hospital" to mean an almshouse . Ten years later, Mary II founded the Royal Hospital for Seamen, Greenwich , with the same purpose. The voluntary hospital movement began in

10164-419: The development of the modern English meaning of the word involved primarily two steps: The French term " romane " was first used in the architectural sense by archaeologist Charles de Gerville in a letter of 18 December 1818 to Auguste Le Prévost to describe what Gerville sees as a debased Roman architecture . In an 1823 public lecture (published in 1824) Gerville's friend Arcisse de Caumont adopted

10296-529: The domestic quarters of monasteries are far rarer, but these used and adapted the features found in church buildings, on a domestic scale. The French term " romane " or the English Romanesque , meaning "in the manner of Romans", has been used to describe the architectural style of the Mediaeval era, preceding the more easily recognizable Gothic architecture, since early in the 19th century. It describes

10428-430: The door once a decision had been reached. The rest of the piazza is taken up by the ruins of the palace's loggia , half of which tumbled into the valley below around 1300 and was never repaired. 42°24′55″N 12°06′03″E  /  42.41528°N 12.10083°E  / 42.41528; 12.10083 Romanesque architecture Romanesque architecture is an architectural style of medieval Europe that

10560-412: The duomo : the first was Pope Alexander IV , whose tomb was bizarrely demolished during sixteenth-century renovations, and the location of his remains are now unknown; Pope John XXI is more clearly marked despite several relocations, with a handsome tombstone originally laid over him following his death in 1277 (when his study's ceiling in the papal palace attached to the cathedral suddenly collapsed into

10692-455: The early 18th century, with hospitals being founded in London by the 1720s, including Westminster Hospital (1719) promoted by the private bank C. Hoare & Co and Guy's Hospital (1724) funded from the bequest of the wealthy merchant, Thomas Guy . Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. St Bartholomew's in London

10824-420: The famous abbeys of Aux Dames and Les Hommes at Caen and Mont Saint-Michel date from this period, as well as the abbeys of the pilgrimage route to Santiago de Compostela . Many cathedrals owe their foundation to this date, with others beginning as abbey churches, and later becoming cathedrals. In England, of the cathedrals of ancient foundation, all were begun in this period with the exception of Salisbury, where

10956-454: The façade gable and are also seen in Germany. Later Romanesque churches may have wheel windows or rose windows with plate tracery . There are a very small number of buildings in the Romanesque style, such as Autun Cathedral in France and Monreale Cathedral in Sicily in which pointed arches have been used extensively, apparently for stylistic reasons. It is believed that in these cases there

11088-429: The healer-god Asclepius , known as Asclepeion functioned as centers of medical advice, prognosis, and healing. The Asclepeia spread to the Roman Empire . While public healthcare was non-existent in the Roman Empire, military hospitals called valetudinaria did exist stationed in military barracks and would serve the soldiers and slaves within the fort. Evidence exists that some civilian hospitals, while unavailable to

11220-517: The hospital and the transportation of patients between units is facilitated and minimised. The building also should be built to accommodate heavy departments such as radiology and operating rooms while space for special wiring, plumbing, and waste disposal must be allowed for in the design. However, many hospitals, even those considered "modern", are the product of continual and often badly managed growth over decades or even centuries, with utilitarian new sections added on as needs and finances dictate. As

11352-532: The hospitals. They also changed from being mere homes of refuge to being complex institutions for the provision and advancement of medicine and care for sick. The Charité was founded in Berlin in 1710 by King Frederick I of Prussia as a response to an outbreak of plague. Voluntary hospitals also spread to Colonial America ; Bellevue Hospital in New York City opened in 1736, first as a workhouse and then later as

11484-448: The label " roman " to describe the "degraded" European architecture from the 5th to the 13th centuries, in his Essai sur l'architecture religieuse du moyen-âge, particulièrement en Normandie , at a time when the actual dates of many of the buildings so described had not been ascertained: "The name Roman (esque) we give to this architecture, which should be universal as it is the same everywhere with slight local differences, also has

11616-432: The land that they farmed in exchange for military service . The result of this was that they could be called upon, not only for local and regional spats, but to follow their lord to travel across Europe to the Crusades, if they were required to do so. The Crusades , 1095–1270, brought about a very large movement of people and, with them, ideas and trade skills, particularly those involved in the building of fortifications and

11748-556: The late 11th and 12th centuries saw an unprecedented growth in the number of churches. A great number of these buildings, both large and small, remain, some almost intact and in others altered almost beyond recognition in later centuries. They include many very well known churches such as Santa Maria in Cosmedin in Rome, the Baptistery in Florence and San Zeno Maggiore in Verona. In France,

11880-458: The local stone and building traditions. In Italy, Poland, much of Germany and parts of the Netherlands, brick is generally used. Other areas saw extensive use of limestone, granite and flint. The building stone was often used in comparatively small and irregular pieces, bedded in thick mortar. Smooth ashlar masonry was not a distinguishing feature of the style (especially not in the earlier part of

12012-417: The medieval concept of Christian care evolved during the 16th and 17th centuries into a secular one. In England , after the dissolution of the monasteries in 1540 by King Henry VIII , the church abruptly ceased to be the supporter of hospitals, and only by direct petition from the citizens of London, were the hospitals St Bartholomew's , St Thomas's and St Mary of Bethlehem's (Bedlam) endowed directly by

12144-463: The merit of indicating its origin and is not new since it is used already to describe the language of the same period. Romance language is degenerated Latin language. Romanesque architecture is debased Roman architecture." The term " Pre-romanesque " is sometimes applied to architecture in Germany of the Carolingian and Ottonian periods and Visigothic , Mozarab and Asturian constructions between

12276-485: The metal working needed for the provision of arms, which was also applied to the fitting and decoration of buildings. The continual movement of people, rulers, nobles, bishops, abbots, craftsmen and peasants, was an important factor in creating a homogeneity in building methods and a recognizable Romanesque style , despite regional differences. Life became generally less secure after the Carolingian period. This resulted in

12408-481: The modern hospital was beginning to take shape with a proliferation of a variety of public and private hospital systems. By the 1870s, hospitals had more than trebled their original average intake of 3,000 patients. In continental Europe the new hospitals generally were built and run from public funds. The National Health Service , the principal provider of health care in the United Kingdom, was founded in 1948. During

12540-529: The modern profession of nursing during the Crimean War when she set an example of compassion, commitment to patient care and diligent and thoughtful hospital administration. The first official nurses' training programme, the Nightingale School for Nurses, was opened in 1860, with the mission of training nurses to work in hospitals, to work with the poor and to teach. Nightingale was instrumental in reforming

12672-451: The monks relocated from the Norman church at Old Sarum , and several, such as Canterbury , which were rebuilt on the site of Saxon churches. In Spain, the most famous church of the period is Santiago de Compostela . In Germany, the Rhine and its tributaries were the location of many Romanesque abbeys, notably Mainz , Worms , Speyer and Bamberg . In Cologne , then the largest city north of

12804-771: The more northern countries, Roman building styles and techniques had never been adopted except for official buildings, while in Scandinavia they were unknown. Although the round arch continued in use, the engineering skills required to vault large spaces and build large domes were lost. There was a loss of stylistic continuity, particularly apparent in the decline of the formal vocabulary of the Classical Orders . In Rome several great Constantinian basilicas continued in use as an inspiration to later builders. Some traditions of Roman architecture also survived in Byzantine architecture with

12936-560: The most rare, with only a handful of survivors in the United Kingdom, several clusters in France, isolated buildings across Europe and by far the largest number, often unidentified and altered over the centuries, in Italy. Many castles exist, the foundations of which date from the Romanesque period. Most have been substantially altered, and many are in ruins. By far the greatest number of surviving Romanesque buildings are churches. These range from tiny chapels to large cathedrals . Although many have been extended and altered in different styles,

13068-444: The mouldings of the arch. Piers that occur at the intersection of two large arches, such as those under the crossing of the nave and transept, are commonly cruciform in shape, each arch having its own supporting rectangular pier at right angles to the other. Columns are an important structural feature of Romanesque architecture. Colonnettes and attached shafts are also used structurally and for decoration. Monolithic columns cut from

13200-399: The nature of the hospital, by improving sanitation standards and changing the image of the hospital from a place the sick would go to die, to an institution devoted to recuperation and healing. She also emphasised the importance of statistical measurement for determining the success rate of a given intervention and pushed for administrative reform at hospitals. By the late 19th century,

13332-568: The nature of the vault dictated that the alternate piers bore a great deal more weight than the intermediate ones and are thus very much larger. The foliate Corinthian style provided the inspiration for many Romanesque capitals, and the accuracy with which they were carved depended very much on the availability of original models, those in Italian churches such as Pisa Cathedral or church of Sant'Alessandro in Lucca and southern France being much closer to

13464-413: The nave from the aisles, and in large secular interiors spaces, such as the great hall of a castle, supporting the timbers of a roof or upper floor. Arcades also occur in cloisters and atriums, enclosing an open space. Arcades can occur in storeys or stages. While the arcade of a cloister is typically of a single stage, the arcade that divides the nave and aisles in a church is typically of two stages, with

13596-444: The need for hospitals to prioritise their limited resources, there is a tendency in countries with such systems for 'waiting lists' for non-crucial treatment, so those who can afford it may take out private health care to access treatment more quickly. In the United States , hospitals typically operate privately and in some cases on a for-profit basis, such as HCA Healthcare . The list of procedures and their prices are billed with

13728-542: The nineteenth century, the Second Viennese Medical School emerged with the contributions of physicians such as Carl Freiherr von Rokitansky , Josef Škoda , Ferdinand Ritter von Hebra , and Ignaz Philipp Semmelweis . Basic medical science expanded and specialisation advanced. Furthermore, the first dermatology, eye, as well as ear, nose, and throat clinics in the world were founded in Vienna , being considered as

13860-457: The number of US hospitals shrinking from 6,933 in 1981 to 5,534 in 2016. Occupancy rates also dropped from 77% in 1980 to 60% in 2013. Among the reasons for this are the increasing availability of more complex care elsewhere such as at home or the physicians' offices and also the less therapeutic and more life-threatening image of the hospitals in the eyes of the public. In the US, a patient may sleep in

13992-530: The original meaning of the word, hospitals were original "places of hospitality", and 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 in that they were almshouses for the poor, hostels for pilgrims , or hospital schools. The word "hospital" comes from

14124-573: The past, however, this work was usually 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

14256-406: The period), but it did occur, chiefly where easily worked limestone was available. Because of the massive nature of Romanesque walls, buttresses are not a highly significant feature, as they are in Gothic architecture. Romanesque buttresses are generally of flat square profile and do not project a great deal beyond the wall. In the case of aisled churches, barrel vaults, or half-barrel vaults over

14388-406: The poor, as the rich would have been treated in their own homes. Hospitals in this era were the first to require medical licenses for doctors, and compensation for negligence could be made. Hospitals were forbidden by law to turn away patients who were unable to pay. These hospitals were financially supported by waqfs , as well as state funds. In India, public hospitals existed at least since

14520-489: The presence of rhythmic ornamental arches known as a Lombard band . Charlemagne was crowned by Pope Leo III in Old St. Peter's Basilica on Christmas Day of 800, with an aim to re-establishing the old Roman Empire . Charlemagne's political successors continued to rule much of Europe, with a gradual emergence of the separate political states that were eventually to become welded into nations, either by allegiance or defeat, into

14652-412: The quality of health care has increasingly become an issue around the world, hospitals have increasingly had to pay serious attention to this matter. Independent external assessment of quality is one of the most powerful ways to assess this aspect of health care, and hospital accreditation is one means by which this is achieved. In many parts of the world such accreditation is sourced from other countries,

14784-513: The reign of Firuz Shah Tughlaq in the 14th century. The Mughal emperor Jahangir in the 17th century established hospitals in large cities at government expense with records showing salaries and grants for medicine being paid for by the government. In China, during the Song dynasty , the state began to take on social welfare functions previously provided by Buddhist monasteries and instituted public hospitals, hospices and dispensaries . In Europe

14916-433: The room below due to structural weaknesses as he slept). The cathedral as built in the twelfth century is east-facing and sits high on the hill with the attached Papal palace overlooking the town spread below. Its façade oddly contrasts with surrounding buildings as it is not built from local stone, but was instead constructed with imported materials during Gambarra's reconstruction. It is sparsely decorated, but at its centre

15048-517: The simple arched window motif. One of the effects of the Crusades , which were intended to wrest the Holy Places of the Levant from Islamic control, was to excite a great deal of religious fervour, which in turn inspired great building programs. The Nobility of Europe, upon safe return, thanked God by the building of a new church or the enhancement of an old one. Likewise, those who did not return from

15180-432: The sole locally accessible hospital within nine additional counties in which one or more other hospitals are present at a 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, and exist to serve local needs. They are

15312-470: The sources of income received. A teaching hospital combines assistance to people with teaching to health science students and auxiliary healthcare students. A health science facility smaller than a hospital is generally called a clinic. Hospitals have a range of departments (e.g. surgery and urgent care ) and specialist units such as cardiology . Some hospitals have outpatient departments and some have chronic treatment units. Common support units include

15444-547: The stained glass windows. Prominent amongst his new decorations were depictions of seafood, especially lobsters and prawns, giving the land-bound cathedral a strangely nautical look. (His name Gambarra translates as prawn from the Italian, and seafood featured heavily on his coat of arms). In 1861, a further bishop also replaced the ceiling, lowering it to disguise the intricate truss and beam work of Gambarra's creation. Many of these additions were later removed or replaced with what remains of original furnishings, especially following

15576-402: The standard for many textbooks. In the mid-19th century, hospitals and the medical profession became more professionalised, with a reorganisation of hospital management along more bureaucratic and administrative lines. The Apothecaries Act 1815 made it compulsory for medical students to practise for at least half a year at a hospital as part of their training. Florence Nightingale pioneered

15708-454: The style preceding Gothic was not recognized as a whole, and was instead, just like Gothic at the time, treated as a multitude of styles: Giorgio Vasari and Christopher Wren were writing about "Tuscan", "Saxon", or "Norman" architectures. The word Romanesque ("in the manner of Romans" ) appeared in English by 1666, and was used to designate what are now called Romance languages . Definition of Romanesque architecture changed over time;

15840-576: The succeeding style of Gothic architecture was recognised as early as the 15th century, as demonstrated by some artworks of that period. Robert Campin clearly presented the division in his Marriage of the Virgin ; on the left side, representing the Old Testament , the building is in the Romanesque style, while that on the right, representing the New Testament , is Gothic. Until the 19th century, however,

15972-555: The system after COVID-19, initially for respiratory patients. Mersey Care NHS Foundation Trust started a COVID Oximetry@Home service in April 2020. This enables them to monitor more than 5000 patients a day in their own homes. The technology allows nurses, carers, or patients to record and monitor vital signs such as blood oxygen levels. In early India , Fa Xian , a Chinese Buddhist monk who travelled across India c.  AD 400 , recorded examples of healing institutions. According to

16104-457: The term became a "common currency", and is universally accepted at least for convenience. Buildings of every type were constructed in the Romanesque style, with evidence remaining of simple domestic buildings, elegant town houses, grand palaces, commercial premises, civic buildings, castles, city walls, bridges, village churches, abbey churches, abbey complexes and large cathedrals. Of these types of buildings, domestic and commercial buildings are

16236-519: The town's oldest hospital in a medieval building which once housed the cathedral administration offices as well as providing a fortified townhouse for one of Italy's numerous feuding medieval families. The Etruscan foundations of this building are clearly visible from street level. To the south of the square, the House of Valentino della Pagnotta received a direct hit from an Allied bomb in World War Two but

16368-399: The triforium gallery. The arches used in Romanesque architecture are nearly always semicircular, for openings such as doors and windows, for vaults and for arcades. Wide doorways are usually surmounted by a semi-circular arch, except where a door with a lintel is set into a large arched recess and surmounted by a semi-circular "lunette" with decorative carving. These doors sometimes have

16500-426: Was a pioneer of hospital design in having "pavilions" to minimize the spread of infection. John Wesley visited in 1785, and commented "I never saw anything of the kind so complete; every part is so convenient, and so admirably neat. But there is nothing superfluous, and nothing purely ornamented, either within or without." This revolutionary design was made more widely known by John Howard , the philanthropist. In 1787

16632-456: Was begun, including among the earliest hospitals by Saint Sampson in Constantinople and by Basil, bishop of Caesarea in modern-day Turkey. By the twelfth century, Constantinople had two well-organised hospitals, staffed by doctors who were both male and female. Facilities included systematic treatment procedures and specialised wards for various diseases. The earliest general hospital in

16764-410: Was later dropped in 2018. In 2016 and 2017, healthcare reform and a continued decline in admissions resulted in US hospital-based healthcare systems performing poorly financially. Microhospitals, with bed capacities of between eight and fifty, are expanding in the United States. Similarly, freestanding emergency rooms, which transfer patients that require inpatient care to hospitals, were popularised in

16896-408: Was predominant in the 11th and 12th centuries. The style eventually developed into the Gothic style with the shape of the arches providing a simple distinction: the Romanesque is characterized by semicircular arches , while the Gothic is marked by the pointed arches . The Romanesque emerged nearly simultaneously in multiple countries (France, Germany, Italy, Spain); its examples can be found across

17028-522: Was rebuilt from 1730 to 1759, and the London Hospital, Whitechapel, opened in 1752. These hospitals represented a turning point in the function of the institution; they began to evolve from being basic places of care for the sick to becoming centers of medical innovation and discovery and the principal place for the education and training of prospective practitioners. Some of the era's greatest surgeons and doctors worked and passed on their knowledge at

17160-508: Was reconstructed to original specifications. The ground floor now houses the cathedral's gift shop. The piazza boasts several small fountains and a number of other medieval buildings, but it is dominated on its north-facing side by the Palazzo dei Papi di Viterbo , which was enlarged and reconstructed in 1266 following the Papal move to the city. The Palazzo was the original location of the initiation of

17292-850: Was the dispensary; these would issue the poor with medicines free of charge. The London Dispensary opened its doors in 1696 as the first such clinic in the British Empire . The idea was slow to catch on until the 1770s, when many such organisations began to appear, including the Public Dispensary of Edinburgh (1776), the Metropolitan Dispensary and Charitable Fund (1779) and the Finsbury Dispensary (1780). Dispensaries were also opened in New York 1771, Philadelphia 1786, and Boston 1796. The Royal Naval Hospital, Stonehouse , Plymouth ,

17424-430: Was to build them out of stone cylinders called drums, as in the crypt at Speyer Cathedral . Where really massive columns were called for, such as those at Durham Cathedral , they were constructed of ashlar masonry and the hollow core was filled with rubble. These huge untapered columns are sometimes ornamented with incised decorations. A common characteristic of Romanesque buildings, occurring both in churches and in

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