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Sample records for vancouver general hospital

  1. The deleterious consequences of privatization and outsourcing for hospital support work: the experiences of contracted-out hospital cleaners and dietary aids in Vancouver, Canada.

    PubMed

    Zuberi, Daniyal M; Ptashnick, Melita B

    2011-03-01

    This article is based on the findings of the Hospital Support Workers Study, which includes in-depth interviews with 70 hospital housekeepers and dietary aids in Vancouver, British Columbia, Canada. As a result of provincial government legislation in 2003, all hospital-based support work in the Vancouver region was privatized and contracted out to three multinational corporations. The outsourcing of hospital support services is part of a larger global trend toward neoliberal policy reform in health care. This article presents the perceptions of hospital support workers about the consequences of contracting out on their work conditions, training, turnover rates and other issues that directly affect their quality of work and have important implications for patient health and well-being. The findings suggest serious negative consequences for the health care system as a result of the privatization and contracting out of hospital support services. PMID:21324410

  2. Asthma attack periodicity: A study of hospital emergency visits in Vancouver

    SciTech Connect

    Bates, D.V.; Baker-Anderson, M.; Sizto, R. )

    1990-02-01

    Attendances at the emergency departments of the nine acute care hospitals serving the Vancouver region, with a population of just under a million people, were recorded from July 1, 1984 to October 31, 1986. Of about 25,500 visits a month, 2.7% were for respiratory conditions; and of these, 41.3% were for asthma. Data from 11 air monitoring stations were also tabulated on a daily basis, giving mean maximal hourly values for SO2, NO2, and O3; daily aerosol sulfate measurements from one station were also analyzed, together with daily temperature data and measurements of the coefficient of haze. In 3 consecutive years, a peak in asthma attendances was noted, starting in the last week of September, and continuing for 3 weeks. In these periods, weekly visits for asthma reached 130 patients; during the rest of the year, the weekly visits for asthma varied between 30 and 90. This peak affected children and adults between the ages of 15 and 60, but no increase was seen in those over 60 years. Although pollution levels increased sharply in the fall, a day-by-day analysis showed that the rise in asthma attendances preceded the increase in NO chi and SO2 levels for the region, expressed as the mean of the hourly maxima across all stations. It seems unlikely that a specific pollen is responsible for this, or that house mite replication is the cause. Soya beans are not shipped out of Vancouver. The cause of the peak has not been identified. Variations in emergency visits by day of the week have been recorded; in children and in those aged 15-60, more visits occur on Sundays than on other days, but this does not occur in those over 60. Intercorrelations between environmental variables and emergency visits have been calculated separately for the periods May 1 to October 31, and November 1 to April 30.

  3. Factors Associated with Leaving Hospital against Medical Advice among People Who Use Illicit Drugs in Vancouver, Canada

    PubMed Central

    Ti, Lianping; Milloy, M-J; Buxton, Jane; McNeil, Ryan; Dobrer, Sabina; Hayashi, Kanna; Wood, Evan; Kerr, Thomas

    2015-01-01

    Background Leaving hospital against medical advice (AMA) is common among people who use illicit drugs (PWUD) and is associated with severe health-related harms and costs. However, little is known about the prevalence of and factors associated with leaving AMA among PWUD. Methods Data were collected through two Canadian prospective cohort studies involving PWUD between September 2005 and July 2011 and linked to a hospital admission/discharge database. Bivariable and multivariable generalized estimating equations were used to examine factors associated with leaving hospital AMA among PWUD who were hospitalized. Results Among 488 participants who experienced at least one hospitalization, 212 (43.4%) left the hospital AMA at least once during the study period. In multivariable analyses, factors positively and significantly associated with leaving hospital AMA included: unstable employment (AOR = 1.92; 95% confidence interval [CI]: 1.22–3.03); recent incarceration (AOR = 1.63; 95%CI: 1.07–2.49); ? daily heroin injection (AOR = 1.49; 95%CI: 1.05–2.11); and younger age per year younger (adjusted odds ratio [AOR] = 1.04; 95%CI: 1.02–1.06). Conclusions We found a substantial proportion of PWUD in this setting left hospital AMA and that various markers of risk and vulnerability were associated with this phenomenon. Our findings highlight the need to address substance abuse issues early following hospital admission. These findings further suggest a need to develop novel interventions to minimize PWUD leaving hospital prematurely. PMID:26509447

  4. [Family and psychiatric hospitalization in a general hospital].

    PubMed

    de Mello, Rita Mello; Schneider, Jacó Fernando

    2011-06-01

    This study aims to identify the reasons that lead relatives to hospitalize patients in a psychiatric unit of a general hospital. It is a qualitative study based on Alfred Schutz' phenomenological sociology. Fourteen relatives, each with one family member hospitalized, were interviewed from August to October 2009. The guiding question of the phenomenological interview was "What do you expect from psychiatric hospitalization in a general hospital?". Phenomenological sociology was used to understand and interpret the interviews. Statements showed three concrete categories, that lead to the reasons for: treatment guidelines and continuity; prospects for improvement; ideas about normality. This research shows the experiences of relatives, contributing with mental health professionals' reflection about their actions and about the involvement of families in a general hospital's psychiatric unit. PMID:21987981

  5. Examining General Hospitals' Smoke-Free Policies

    ERIC Educational Resources Information Center

    Whitman, Marilyn V.; Harbison, Phillip Adam

    2010-01-01

    Purpose: This paper aims to examine the level of smoke-free policies in general hospitals and the barriers faced in implementing restrictive policies banning smoking inside buildings and on surrounding grounds. Design/methodology/approach; A survey was developed to gather data on hospitals' current smoke-free policies, including the challenges…

  6. Acute Gout in Hospitalized patients in Sarawak General Hospital.

    PubMed

    Teh, C L; Chew, K F; Ling, G R

    2014-06-01

    we performed a prospective study of all hospitalized patients with a diagnosis of Gout in Sarawak General hospital from 1st July 2011 to 1st July 2012. There were a total of 126 patients in our study of which 112 (88.9%) were males. The majority of our patients were from the indigenous populations (71.7%). They have a mean age of 60.0 ± 14.2 years. Most of our patients were overweight (68%) with comorbities of hypertension (78.6%), Chronic Kidney Failure (48.4%), Type II diabetes Mellitus (30.2%), dyslipidemia (27.8%) and Ischaemic heart disease (11.9%). Polyarticular gouty arthritis was the main presenting pattern during hospitalization (88.1%). The mean length of stay for our patients was 9.8 ± 6.0 days which was significantly longer than the mean length of stay for other patients without gout (p<0.05). Only 17 patients had gout on admission and the majority developed gout during hospitalizations. Our patients were admitted respectively for medical problems (45.4%), surgical problems (28.6%) and orthopaedic problems (9.2%). Colchicine (73.8%) and steroid (40.5%) were the main stays of treatment for our patients. Our hospitalized gout patients were complicated patients with multiple comorbidities. PMID:25326353

  7. 3. General view of site from Lawrence General Hospital parking ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. General view of site from Lawrence General Hospital parking deck (former location of coating mill) showing north side of structures; view to southeast. - Champion-International Paper Company, West bank of Spicket River at Canal Street, Lawrence, Essex County, MA

  8. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Excluded hospitals and hospital units: General rules. 412.22 Section 412.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Hospital Services Subject to and Excluded From...

  9. 20. West Elevation and Section, Ward 'K', Letterman General Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    20. West Elevation and Section, Ward 'K', Letterman General Hospital, Presidio of San Francisco, Cal. Sheet No. 2. May 1917. BUILDING 1049. - Presidio of San Francisco, Letterman General Hospital, Building No. 12, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  10. 19. First and Second Floors. Ward 'K', Letterman General Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    19. First and Second Floors. Ward 'K', Letterman General Hospital, Presidio of San Francisco, Cal. Sheet No. 1. May 1917. BUILDING 1049. - Presidio of San Francisco, Letterman General Hospital, Building No. 12, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

  11. Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department Building, North of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Fitzsimons General Hospital, Physiotherapy & Electrocardiograph Department Building, North of Building No. 516, East of corridor connecting Building No. 511 to Building No. 515, Aurora, Adams County, CO

  12. Tourism, Tolerance, or Hospitality? An Assessment of a Native/Non-Native, Urban/Rural Youth Exchange Program between Fort Good Hope, NWT, and East Vancouver, BC

    ERIC Educational Resources Information Center

    Hern, Matt

    2009-01-01

    This article considers and assesses a youth exchange project between two community-based youth centers: The Purple Thistle Centre in East Vancouver, British Columbia, and the K'asho Got'ine Youth Centre in Fort Good Hope, Northwest Territories. Both centers serve primarily low-income youth, but after that the similarities are very few. The…

  13. Recommended Variables for the Multiple Stratification of General Hospitals

    PubMed Central

    Hess, Irene; Srikantan, K. S.

    1970-01-01

    Some characteristics of short-term general hospitals are examined in order to determine which variables, among those for which data are readily available, might be most useful for stratification when multipurpose samples of United States hospitals are to be selected. Illustrative tabulations are presented in which 1961 AHA data on 5078 general hospitals, grouped by hospital control and four approval classes, are distributed in six size classes, four geographic regions, three SMSA classifications, and nine geographic divisions. The tables and the recommendations based on them should be of value to those planning hospital studies when resources and time available for designing a sample are limited. PMID:5444867

  14. South side (red cross office entrance). Fitzsimons General Hospital, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    South side (red cross office entrance). - Fitzsimons General Hospital, Red Cross Building, South Eighth Street Bounded by West McAfee Avenue on South & West Harlow Avenue on North, Aurora, Adams County, CO

  15. A general-practitioner ward in a new district general hospital

    PubMed Central

    Woodward, J. W.

    1976-01-01

    So far there are relatively few general-practitioner wards in district general hospitals in the National Health Service. The work of one such general-practitioner ward at Queen Mary's Hospital, Sidcup, is described and the advantages of this system of care for patients and doctors discussed. PMID:978642

  16. An Emergency Psychiatric Service in a General Hospital

    PubMed Central

    Schwarz, Conrad J.; Tyhurst, James S.

    1964-01-01

    The same extensive range of general hospital facilities should be allocated to emergency psychiatric illness as are available for other medical conditions. During the study herein reported, for every three medical consultations in the emergency ward of a large general hospital, two psychiatric consultations were requested. Over a two-year period when 24-hour coverage by psychiatric consultants was instituted, such assessments increased from 148 to 340 (during the first four months of each year); the increase in police referrals was outstanding, rising from 16 to 105. The general wards of the hospital assumed greater responsibility for further medical treatment, while committal to the mental hospital declined. Many more psychiatric patients could have been treated in the general hospital if facilities had been available. The development of an emergency psychiatric service is not an easy process and co-ordination with other psychiatric resources is required. Residents in training face situations in the emergency ward which are not encountered in any other aspect of their clinical experience. PMID:14158957

  17. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 2012-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165...Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington....

  18. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 2011-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165...Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington....

  19. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 2013-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165...Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington....

  20. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165...Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington....

  1. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 2010-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165...Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington....

  2. The hospital component of vocational training for general practice.

    PubMed Central

    Bayley, T. J.

    1994-01-01

    Trainees and educationalists in general practice have some grounds for suggesting that the hospital component of vocational training should be restructured and teaching improved. However, the implications for other trainees and secondary care have to be considered. Changes that are needed include a curriculum for senior house officers in each specialty; appointment of training consultants with the necessary skills; and a different attitude by everyone towards study leave, including arrangements for funding. The optimum duration of hospital posts for trainees in general practice might be shorter than now, but the effects on others must be considered and competencies guaranteed in a briefer training period. Changes in the regulations for vocational training could help to improve specialist experience if trainees in general practice were allowed to be supernumerary. Alternatively, senior house officer posts for trainees in general practice could be split between secondary and primary care, thus encouraging a broader perspective. PMID:8019224

  3. Primary Supervision: Massachusetts General Hospital's child and adolescent psychiatry seminar

    ERIC Educational Resources Information Center

    Jellinek, Michael S.

    2007-01-01

    In this article, the author describes "Primary Supervision", a seminar he has led for approximately 20 years, which is designed for the entire class of nine first-year residents in Child and Adolescent Psychiatry training at Massachusetts General Hospital. The seminar meets for 1 hour each week throughout the first year. Through 900 hours of…

  4. General practice: the DREEM attachment? Comparing the educational environment of hospital and general practice placements.

    PubMed

    Kelly, Martina; Bennett, Deirdre; O'Flynn, Siun

    2012-01-01

    The clinical learning environment is changing. General practice placements are now a fundamental part of undergraduate medical education. There is growing recognition that changes in hospital work practices are altering the breadth of exposure available to students. Surprisingly little work has been done comparing the quality of clinical placements between the hospital and community using validated tools. Such comparisons inform curriculum planning and resource allocation. The aim of this study was to compare the quality of the educational environment experienced by junior medical students during hospital and general practice placements using a widely used tool. Following the introduction of a new integrated curriculum, all Year 3 students (n=108) completed a standardised evaluation instrument, the Dundee Ready Education Environment Measure (DREEM) at the end of each of their clinical attachments (two different hospital sites and one in general practice), giving a total of 324 questionnaires. All forms were analysed and input into Graphpad INSTAT version 3. Total DREEM scores as well as subscale scores were calculated for each site. These were compared across sites using a Mann-Whitney U non-parametric test. By comparison with international standards, clinical attachments in our new integrated curriculum were rated highly. In particular, attachments in general practice scored highly with a mean score of 156.6 and perform significantly better (P < 0.01) when compared with the mean score for hospital rotations of 149.0. Significant differences between general practice and hospital rotations exist in the domains of students' perceptions of atmosphere and students' social self-perceptions. Finally, significant differences also emerged in students' perceptions of teachers in general practice when compared to those in the hospital setting. These findings provide evidence of the high-quality educational environment afforded students in primary care. They challenge the traditional emphasis on hospital-based teaching and preempt the question - Is the community a better place for junior students to learn? PMID:22306143

  5. Improving paediatric high dependency provision at a district general hospital.

    PubMed

    Datt, Colette; Robinson, Kerry

    2007-09-01

    Increased pressure on paediatric facilities and increased demands on staff at a district general hospital led to the development of a paediatric high dependency facility. The objective of the development was to enable more effective and efficient management of resources and to optimise care delivery. The experience of setting up a high dependency facility at the Whittington Hospital is presented in this article along with data from the first nine months of operation. Over that period 57 children needed high dependency care, fewer than were predicted based on average figures. Of these, 49 children were treated in the HDU with one being treated on adult ITU and six on the general paediatric ward. Challenges in establishing the unit included staff concerns about increased workloads, nurses feeling isolated in the HDU area and the HDU label undermining confidence in caring for these children. Education and training, team working, networking with other units and an open management approach were among the strategies used in the development and to overcome challenges. Improved data about HDU patients is essential to support the development of high dependency provision in district general hospitals. PMID:17926769

  6. Environmental Scanning, Vancouver Community College.

    ERIC Educational Resources Information Center

    Yao, Min

    This 1994 environmental scanning report from Vancouver Community College (VCC) reviews the expected effects of the separation of VCC into a new Vancouver Community College and Langara College (LC). The report examines the projected service area student-intake capacity; student characteristics; population growth trends; other postsecondary…

  7. Treeline Dynamics on Southern Vancouver Island, British Columbia

    E-print Network

    Smith, Dan

    Vancouver Island marmot. Keywords: dendroecology, subalpine meadows, seedling establishment, tree rings, Vancouver Island, Vancouver Island marmot. *Corresponding author Western Geography, 10/11(2000/01), pp. 43

  8. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective...

  9. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective...

  10. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective...

  11. Financial management challenges for general hospital psychiatry 2001.

    PubMed

    Goldberg, R J

    2001-01-01

    Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability. PMID:11313073

  12. International Student Enrolment Vancouver Campus

    E-print Network

    Michelson, David G.

    International Student Enrolment Vancouver Campus Fall 2013 Planning and Institutional Research www ................................................................................................................................................................................................................... 3 Table 1.1 Type of International Enrolment................... .......................................................................................................................................... 3 Graph 1.1: 2013 International Student Enrolment by Program

  13. Paediatric inpatient utilisation in a district general hospital.

    PubMed Central

    Thakker, Y; Sheldon, T A; Long, R; MacFaul, R

    1994-01-01

    Paediatric inpatient utilisation in a district general hospital was studied for 20 general practices covering a population of 26,433 children. The factors influencing the rate and route of admission (general practitioner (GP) or accident and emergency department) were analysed for 894 emergency non-traumatic admissions over a 12 month period. The overall rate of acute, nontraumatic admission was 33.8/1000; 35% of these admissions were via the accident and emergency department. Asthma was the most common reason for admission (16.1%); 56.9% of the admissions resulted from respiratory tract illness and 44% were for an infective illness. There was a significant variation in the route and rate of admission across practices. Admission rates ranged from 10 to 70/1000 children under 15 and the proportion via the accident and emergency department from 19% to 85%. The proportion of admissions via the accident and emergency department for each practice was highly negatively correlated with the number of GPs in the practice, the number of children under 15 registered, and positively correlated with the unemployment rate attributed to the list. Using multiple logistic regression analysis, the risk of being admitted via the accident and emergency department relative to GP admission was shown to be higher for older children (odds ratio for each year of age 1.05) and less for children registered with large practices with more GPs (odds ratio for each extra GP 0.36) or practices with more children under 15 (odds ratio per extra child 0.9991). Access to hospital as measured by isochrone bars and social characteristics of the ward of residence of each child admitted were not associated with the route of admission. The admission rate for each practice was positively, but not statistically significantly, associated with the unemployment rate attributed to the list, the unemployment rate of the ward where the practice was located, and the percentage of admissions via accident and emergency, and negatively associated with the percentage of the list under 15 years. PMID:8048817

  14. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES... after October 1, 1997— (i) Separate governing body. The hospital has a governing body that is separate from the governing body of the hospital occupying space in the same building or on the same campus....

  15. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES... after October 1, 1997— (i) Separate governing body. The hospital has a governing body that is separate from the governing body of the hospital occupying space in the same building or on the same campus....

  16. [Burnout syndrome among general hospital nurses in Recife].

    PubMed

    Galindo, Renata Hirschle; Feliciano, Katia Virginia de Oliveira; Lima, Raitza Araújo dos Santos; de Souza, Ariani Impieri

    2012-04-01

    This descriptive, cross sectional, census study identified the occurrence of Burnout and some associated factors among nurses working in obstetrics & gynecology and pediatric care at a general tertiary hospital in Recife. Sixty-three nurses (98.4%) answered a self-administered questionnaire (sociodemographic aspects, working conditions, and Maslach Burnout Inventory). Chi-square was used in the analysis with a 95% confidence level. Most participants were female (92.1%), with up to five years in the career (68.2%), 52.5% in pediatric area. High levels of emotional stress (49.2%) and depersonalization (27.0%) were identified, as well as low professional fulfillment (4.8%), and 4.7% presented Burnout. The following factors wee associated: high levels of emotional stress and often/always perform tasks very quickly (p=0.039) and receiving a salary incompatible to the effort employed (p=0.016); high levels of depersonalization and with up to five years in this career (p=0.010) and often/always perform tasks very quickly (p=0.009). For 19.0%, at least two of the three dimensions pointed to high propensity to the syndrome. PMID:22576547

  17. A most unusual patient at the Massachusetts General Hospital.

    PubMed

    Ruhnke, Gregory W; Warshaw, Andrew L

    2011-12-01

    This year marks 200 years of patient care at the Massachusetts General Hospital (MGH). In celebration of this milestone, a unique Grand Rounds case is presented. A 450-year-old rotund man admitted 60 times presents with a classic triad of periumbilical pain, bilateral plantar burns, and a frozen scalp. Although this triad may at first strike a cord of familiarity among seasoned clinicians, the disease mechanism is truly noteworthy, being clarified only after a detailed occupational history. Ergo, the lessons hark back to the days of yesteryear, when the history and physical served as the cornerstone of Yuletide clinical diagnosis. A discussion of epidemiology and prognosis accompanies a detailed examination of the pathophysiholiday. Although some consider this patient uncouth, as you will see, he is quite a medical sleuth. The long-standing relationship between this patient and the MGH prompted his family to write a letter of appreciation, which will remind the reader of the meaning that our care brings to patients and their families. Harvey Cushing, who completed his internship at the MGH in 1895, professed "A physician is obligated to consider more than a diseased organ, more even than the whole man-he must view the man in his world." We hope this unusual Grand Rounds case intrigues you as it reminds you of Cushing's lesson and wishes you a joyous holiday season. PMID:22107737

  18. In a niche of time: do specialty hospitals outperform general services hospitals?

    PubMed

    Poole, LeJon; Davis, Jullet A; Gunby, Norris W

    2013-01-01

    Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services. The purpose of this research was to assess the financial effectiveness of the niche strategy. We theorize that firm and market-level factors concomitantly with the strategy of the hospital-niche versus traditional-are associated with financial performance. This research used 2 data sources, the 2003 Medicare Cost Report and the 2003 Area Resource File. The sample was limited to only for-profit, urban, nongovernmental hospitals (n = 995). The data were analyzed using hierarchical least squares regression. Financial performance was operationalized using the hospital's return on assets. The principal finding of this project is that niche hospitals had significantly higher performance than traditional facilities. From the organizational perspective, the niche strategy leads to better financial performance. From a societal perspective, the niche strategy provides increased focus and efficiencies through repetition. Despite the limited focus of this strategy, patients who can access these providers may experience better outcomes than patients in more traditional hospitals. PMID:23364413

  19. Readmissions due to traffic accidents at a general hospital 1

    PubMed Central

    Paiva, Luciana; Monteiro, Damiana Aparecida Trindade; Pompeo, Daniele Alcalá; Ciol, Márcia Aparecida; Dantas, Rosana Aparecida Spadotti; Rossi, Lídia Aparecida

    2015-01-01

    Abstract Objective: to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents. Methods: victims of multiple traumas due to traffic accidents were included, who were admitted to an Intensive Care Unit. Sociodemographic data, accident circumstances, body regions affected and cause of readmission were collected from the patient histories. Results: among the 109 victims of traffic accidents, the majority were young and adult men. Most hospitalizations due to accidents involved motorcycle drivers (56.9%). The causes of the return to the hospital were: need to continue the surgical treatment (63.2%), surgical site infection (26.3%) and fall related to the physical sequelae of the trauma (10.5%). The rehospitalization rate corresponded to 174/1,000 people/year. Conclusion: the hospital readmission rate in the study population is similar to the rates found in other studies. Victims of severe limb traumas need multiple surgical procedures, lengthier hospitalizations and extended rehabilitation. PMID:26444172

  20. Fiscal and service analyses in general hospital psychiatry.

    PubMed

    Kline, S A; Moldofsky, H

    1988-05-01

    Fiscal matters were analyzed in four specialized programmes of the Department of Psychiatry at the Toronto Western Hospital in order to plan for service and academic activities. The resultant analysis allowed for the establishment of criteria for growth and the evaluation of clinical service performance and goals. PMID:3133100

  1. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false General provisions for hospitals located in Puerto Rico. 412.370 Section 412.370 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for...

  2. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Register citations affecting § 412.22, see the List of CFR Sections Affected, which appears in the Finding... part 403 of this chapter. (3) Hospitals reimbursed in accordance with demonstration projects authorized under section 402(a) of Public Law 90-248 (42 U.S.C. 1395b-1) or section 222(a) of Public Law 92-603...

  3. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Register citations affecting § 412.22, see the List of CFR Sections Affected, which appears in the Finding... part 403 of this chapter. (3) Hospitals reimbursed in accordance with demonstration projects authorized under section 402(a) of Public Law 90-248 (42 U.S.C. 1395b-1) or section 222(a) of Public Law 92-603...

  4. Influenza Hospitalizations Among American Indian/Alaska Native People and in the United States General Population

    PubMed Central

    Gounder, Prabhu P.; Callinan, Laura S.; Holman, Robert C.; Cheng, Po-Yung; Bruce, Michael G.; Redd, John T.; Steiner, Claudia A.; Bresee, Joseph; Hennessy, Thomas W.

    2014-01-01

    Background. ?Historically, American Indian/Alaska Native (AI/AN) people have experienced a disproportionate burden of infectious disease morbidity compared with the general US population. We evaluated whether a disparity in influenza hospitalizations exists between AI/AN people and the general US population. Methods. ?We used Indian Health Service hospital discharge data (2001–2011) for AI/AN people and 13 State Inpatient Databases (2001–2008) to provide a comparison to the US population. Hospitalization rates were calculated by respiratory year (July–June). Influenza-specific hospitalizations were defined as discharges with any influenza diagnoses. Influenza-associated hospitalizations were calculated using negative binomial regression models that incorporated hospitalization and influenza laboratory surveillance data. Results. ?The mean influenza-specific hospitalization rate/100 000 persons/year during the 2001–2002 to 2007–2008 respiratory years was 18.6 for AI/AN people and 15.6 for the comparison US population. The age-adjusted influenza-associated hospitalization rate for AI/AN people (98.2; 95% confidence interval [CI], 51.6–317.8) was similar to the comparison US population (58.2; CI, 34.7–172.2). By age, influenza-associated hospitalization rates were significantly higher among AI/AN infants (<1 year) (1070.7; CI, 640.7–2969.5) than the comparison US infant population (210.2; CI, 153.5–478.5). Conclusions. ?American Indian/Alaska Native people had higher influenza-specific hospitalization rates than the comparison US population; a significant influenza-associated hospitalization rate disparity was detected only among AI/AN infants because of the wide CIs inherent to the model. Taken together, the influenza-specific and influenza-associated hospitalization rates suggest that AI/AN people might suffer disproportionately from influenza illness compared with the general US population. PMID:25734102

  5. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165.1314 Section 165.1314 Navigation and Navigable... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia...

  6. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165.1314 Section 165.1314 Navigation and Navigable... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia...

  7. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165.1314 Section 165.1314 Navigation and Navigable... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia...

  8. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165.1314 Section 165.1314 Navigation and Navigable... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia...

  9. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. 165.1314 Section 165.1314 Navigation and Navigable... Thirteenth Coast Guard District § 165.1314 Safety Zone; Fort Vancouver Fireworks Display, Columbia...

  10. Cost effectiveness of minor surgery in general practice: a prospective comparison with hospital practice.

    PubMed Central

    O'Cathain, A; Brazier, J E; Milner, P C; Fall, M

    1992-01-01

    The cost effectiveness of general practitioners undertaking minor surgery in their practices was determined in a prospective comparison of patients having minor surgery undertaken in five general practices over a 12 week period in 1989, and in the departments of dermatology and general surgery in Rotherham District General Hospital over a contemporaneous eight week period. There were no differences between the settings in the reported rates of wound infection or other complications and only one general practice patient was subsequently referred to hospital for specialist treatment. General practitioners sent a smaller proportion of specimens to a histopathology laboratory than hospital doctors (61% versus 90%, P less than 0.001); incorrectly diagnosed a larger proportion of malignant conditions as benign (10% versus 1%, P less than 0.05) and inadequately excised 5% of lesions where this never happened in hospital (difference not significant). General practice patients had shorter waiting times between referral and treatment, spent less time and money attending for treatment and more of them were satisfied with their treatment. The cost of a procedure undertaken in general practice was less than in hospital--pounds 33.53 versus pounds 45.54 for the excision of a lesion and pounds 3.00 versus pounds 3.22 for cryotherapy of a wart (1989-90 prices). Performing minor surgery in general practice would seem cost effective compared with a hospital setting. However, the risk of general practitioners inadequately excising a malignancy and not sending it to a histopathology laboratory must be addressed and the conclusion regarding cost effectiveness only applies where general practice is a substitute for the hospital setting and not an additional activity. PMID:1586525

  11. Managing variability to improve quality, capacity and cost in the perioperative process at Massachusetts General Hospital

    E-print Network

    Price, Devon J. (Devon Jameson)

    2011-01-01

    The widely held assumption is that to improve access and quality of health care, we need to spend more. In fact, that is not necessarily true. The results of this project, performed at Massachusetts General Hospital (MGH), ...

  12. Management of civilian gunshot wounds in a Nigerian general hospital.

    PubMed Central

    Onuba, O

    1987-01-01

    In a 3-year period (1981-1984), 52 male patients aged 10-60 years were treated for fresh gunshot wounds. The injuries varied from minor soft tissue injuries to major organ and tissue damage, and were all sustained by low-velocity missiles. Six of the patients (11.5%) died of their injuries or complications while 46 (88.46%) survived and were discharged after 1-15 weeks (a mean hospital time of 3 weeks). Some of the patients were treated before referral and for some there was a delay of more than 48 h before definitive specialist treatment. Mortality was related to the severity of wounding and the delay before treatment. PMID:3620058

  13. Pharmaceutical Service after the Fukushima Disaster: A Case Report of Soma General Hospital.

    PubMed

    Fukunaga, Hisanori; Momonoi, Toshiyuki; Kumakawa, Hiromi

    2016-01-01

      Despite being damaged by the 2011 Tohoku earthquake, tsunami, and nuclear disaster, Soma General Hospital, located approximately 40 km north of Fukushima Daiichi nuclear power plant, was able to fulfill its role as a key regional hospital in northeast Fukushima. To elucidate the pharmaceutical service in response to the disaster, we investigated the hospital's operations in 2011 according to the medical records and prescriptions. One of the difficulties that the department of pharmaceutical service faced at that time was the increase in emergency healthcare requests by evacuated patients from other hospitals and clinics. Herein, we propose the following countermeasures to be considered in future disaster preparations: (1) establishing a medical and pharmaceutical service coordinator for disaster relief; (2) sharing all local patients' medical information in emergencies (at least contraindicated drugs or allergy history); and (3) reviewing disaster stockpiles, especially pharmaceuticals (both at the hospital and in nearby locations). PMID:26725681

  14. An evaluation of the hospital component of general practice vocational training.

    PubMed Central

    Kearley, K

    1990-01-01

    The contribution of the hospital component of vocational training to the needs of the future general practitioner was investigated by undertaking semi-structured interviews with a representative sample of doctors involved. The findings indicated that, in general, training was failing to address objectives perceived to be important for general practice by the study sample. Problems related to the context and style of hospital training also emerged, which appeared to be limiting the learning potential of this type of experience for general practitioner trainees. It is apparent that there is a need to clarify priority objectives for the hospital component of vocational training, and ensure that it provides the opportunity to achieve them. PMID:2271261

  15. Control Costs, Enhance Quality, and Increase Revenue in Three Top General Public Hospitals in Beijing, China

    PubMed Central

    Zhao, Lue-Ping; Yu, Guo-Pei; Liu, Hui; Ma, Xie-Min; Wang, Jing; Kong, Gui-Lan; Li, Yi; Ma, Wen; Cui, Yong; Xu, Beibei; Yu, Na; Bao, Xiao-Yuan; Guo, Yu; Wang, Fei; Zhang, Jun; Li, Yan; Xie, Xue-Qin; Jiang, Bao-Guo; Ke, Yang

    2013-01-01

    Background With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. Methods We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS), cost per day (CPD), inpatient mortality rate (IMR), and length of stay (LOS), using a generalized additive model. Findings There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001), from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. Interpretations These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role. However, purely market-oriented health-care reform could also misguide future healthcare reform. PMID:23977243

  16. Minor surgery by general practitioners under the 1990 contract: effects on hospital workload.

    PubMed Central

    Lowy, A; Brazier, J; Fall, M; Thomas, K; Jones, N; Williams, B T

    1993-01-01

    OBJECTIVE--To determine the extent to which minor surgery undertaken by general practitioners after the introduction of the 1990 contract substituted for hospital outpatient workload. DESIGN--Before and after observational study. SETTING--Four English family health services authorities. SUBJECTS--Patients in 22 practice populations who were operated on by their general practitioner or referred to hospital for minor surgery during April to June 1990 or April to June 1991. MAIN OUTCOME MEASURES--Numbers of minor surgical procedures undertaken in general practice and in hospital, numbers of referrals to hospitals for conditions treatable by a minor surgical procedure, and the mix of diagnoses and procedures undertaken in each setting. RESULTS--General practitioners claimed reimbursement for 600 minor surgical procedures during April to June 1990 and for 847 during April to June 1991, an increase of 41%. Referrals to hospital for comparable conditions showed no compensatory decrease (385 during April to June 1990 and 388 during April to June 1991, 95% confidence interval for change in referrals -51 to 57), and the number of hospital procedures resulting from those referrals also remained constant (187 in the first period, 189 in the second, 95% confidence interval for change in procedures -36 to 40). The mix of procedures did not change significantly from one study period to the next in either setting. CONCLUSIONS--Many or all of the additional patients receiving minor surgery under the terms of the 1990 contract may not have previously been referred to hospital. General practitioners seem not to have systematically shifted towards treating the more trivial cases. The overall increase in minor surgical activity may reflect an improvement in accessibility of care or changes in patients' perceptions and attitudes. PMID:8374452

  17. General medical care and the education of internists in university hospitals. An evaluation of the teaching hospital general medicine group practice program.

    PubMed

    Kosecoff, J; Fink, A; Brook, R H; Davies, A R; Goldberg, G; Linn, L S; Clark, V A; Salisbury, P C

    1985-02-01

    Fifteen general internal medicine group practices in university teaching hospitals were studied to evaluate their primary care services and education. Data were collected over 9 months from physicians, patients, and medical records, and by observation. All institutions had closed their general medical clinics. Many patients being treated in group practices were very sick; 57% had hypertension; 21% were diabetic; and 45% could not work. Most were satisfied with their care. Care for acute problems from a health care provider in the practice was available quickly; regular physicians were harder to see. House staff and faculty spent little time in the practices. Few practices used teams; most used traditional attending and house staff models. Practice physicians could not easily determine when patients were seen in the institution's emergency department or were hospitalized. Quality of care standards were not uniformly met. Finally, the structure of academic centers appeared to inhibit the practices' performance, suggesting a need for further appraisal of relationships between university hospitals and their ambulatory care units. PMID:3966761

  18. What do Wessex general practitioners think about the structure of hospital vocational training?

    PubMed Central

    Little, P.

    1994-01-01

    OBJECTIVES--To assess the views of general practitioners about the structure and content of hospital vocational training and its relation to the training year. DESIGN--Postal questionnaire. SETTING--Wessex, England. SUBJECTS--General practitioner trainees undertaking practice training year (n = 144), course organisers (n = 22), and a random sample of two thirds of trainers (n = 135). RESULTS--Questionnaires were returned from 86% (260): 84% of trainees (121), 92% of trainers (124), and 68% of course organisers (15). Most respondents in all groups (84.3%, 95% confidence interval 79.7% to 88.8%) wanted more jobs lasting two and three months to allow a greater range of hospital specialties to be experienced and some of the training year to be carried out before hospital jobs (66.3%, 60.4% to 72.1%). Most hospital specialties were rated at least 6 out of 10 as "useful" for general practice training. A substantial minority of training posts did not have regular weekly teaching (166/541; 30.7%, 26.8% to 34.6%) and had no half day (224/541; 41.4%, 37.3% to 45.6%), and over half gave no study leave (293/541; 54.2%, 50.0% to 58.4%). CONCLUSIONS--The structure of hospital training should be reviewed as it does not reflect the views of most trainees, course organisers, or trainers. Individual posts need closer supervision to ensure the availability of basic training requirements. More trainees should be allowed to spend a short time in the general practice before hospital rotations and to choose a greater range of shorter jobs. PMID:8019223

  19. Metro Vancouver: Designing for Urban Food Production

    E-print Network

    Roehr, Daniel; Kunigk, Isabel

    2009-01-01

    system path for sustainable cities. White Paper Submittedsustainable development. Metro Vancouver: Designing for Urban Food Production In 1989 the Citysustainable neighborhood might look like at Southeast False Creek (SEFC). In 1999 the City

  20. Approved 7/18/13 WSU VANCOUVER

    E-print Network

    -plug adapters. U.L. approved power strips or surge protectors may work. (Call Facilities Operations://admin.vancouver.wsu.edu/facilities- operations/facility-services) Toasters not permitted Toaster ovens not permitted Halogen lamps not permitted

  1. Legal Outcomes of Sexually Abused Children Evaluated at the Philippine General Hospital Child Protection Unit

    ERIC Educational Resources Information Center

    Sugue-Castillo, Mariella

    2009-01-01

    Objectives: To describe the legal outcomes and factors associated with case reaching court and conviction for sexual abuse of children seen at the Philippine General Hospital Child Protection Unit (PGH-CPU) from 1997 to 2000. Methods: Mixed transdisciplinary research design combined longitudinal cohort with qualitative methods. Data were obtained…

  2. Each year Cell Press and the Massachusetts General Hospital organize a meeting focused on an

    E-print Network

    Kowalczykowski, Stephen C.

    Each year Cell Press and the Massachusetts General Hospital organize a meeting focused on an area and computational techniques used to study motion across systems. The rest of the meeting will explore four elements directions. Space will be limited, so early registration is encouraged. Speakers: Michael Dustin, New York

  3. Critical care research in a district general hospital: the first year.

    PubMed

    Camsooksai, Julie; Barnes, Helena; Reschreiter, Henrik

    2013-09-01

    Until recently, research in critical care units has usually taken place in university teaching hospitals. The 'general' critical care unit patient population is broader than this and the research needs to reflect this. As a general critical care unit in a district general hospital we wanted to set-up research within our own department, as part of the critical care team and part of our culture. With extensive background communication, drive and hard work, the support of the hospital Research and Development department was gained and Comprehensive Local Research Network funding successfully applied for. A research team was established and a model for the Research Nurse role was developed and implemented. This model is described. Participation in national trials commenced and the research portfolio is growing. Networking with other teams also proved valuable. Research has been established as part of the 'culture' of the day-to-day work and the staff have embraced this. Dedicated Research Nurse posts and education of the whole team have ensured successful implementation and recruitment of the studies. Experiences of the first year are shared and discussed here. Sharing experience of developing research within a critical care unit in a district general hospital, and a suggested model for a new Research Nurse role, may benefit other similar units in their efforts to establish research. PMID:23968441

  4. The Laboratory for Quantitative Medicine Massachusetts General Hospital/Harvard Medical School

    E-print Network

    Oliva, Aude

    The Laboratory for Quantitative Medicine Massachusetts General Hospital/Harvard Medical School Outcome, Screening and Treatment Analysis of Medical Usage and Cost among Cancer Patients Communication to understand disease, and especially cancer, and its treatment, using mathematics to answer practical questions

  5. Acute generalized weakness in patients referred to Amirkola Children’s Hospital from 2005 to 2010

    PubMed Central

    Salehiomran, Mohammad Reza; Naserkhaki, Somayeh; Hajiahmadi, Mahmoud

    2012-01-01

    Background: Diseases that cause acute flaccid paralysis (AFP) often progress rapidly, thus may cause life threatening complications, therefore, their diagnosis and cure are important. This study was carried out to investigate the causes of acute generalized weakness in children referred to Amirkola Children’s Hospital, in Babol, Iran. Methods: In this case series, the epidemiological causes of the disease and clinical features of 15 cases with acute generalized weakness from April 2005 to September 2010 were evaluated. The data were collected and analyzed. Results: The mean age of cases was 4.7±3.5 years. The male/female ratio was 2. Twenty cases had Guillain-Barre syndrome, two with myositis and one with periodic hyperkalemic paralysis. Conclusion: Guillain-Barre syndrome is the most common cause of AFP in children admitted due to acute generalized weakness in Amirkola Children’s Hospital. PMID:24358438

  6. Adult general psychiatric patients served in Nebraska's state hospitals: patient characteristics and needs.

    PubMed

    Watanabe-Galloway, Shinobu; Watkins, Kate; Ryan, Steve; Harvey, Jim; Shaffer, Blaine

    2015-02-01

    This study identified the characteristics and needs of adults discharged from state psychiatric hospitals. A retrospective analysis of data on patients discharged from adult psychiatric units of three state psychiatric hospitals in Nebraska 2005-2008 was conducted. Diagnoses were classified into six groups, and Axis III data from the state psychiatric hospitals provided information about medical comorbidity. Only 12% of admitted patients had private insurance or could pay for their own treatment. Almost all discharged patients (95%) had a diagnosis of serious mental illness, and substance abuse (68%) and personality disorder (68%) were common, as were significant general health problems. Fourteen percent of patients used emergency services five or more times during the study period. Greater efforts must be made to diagnose, treat, and monitor major somatic illnesses and to better understand the factors that contribute to readmission and emergency service use in this population. PMID:24691573

  7. The Difference in the Online Medical Information Searching Behaviors of Hospital Patients and Their Relatives versus the General Public

    ERIC Educational Resources Information Center

    Wang, Hung-Yuan; Liang, Jyh-Chong; Tsai, Chin-Chung

    2014-01-01

    The purpose of this study is two-fold: to explore the differences in online medical information searching behaviors, including evaluative standards and search strategies, of the general public (general group) and those of hospital patients and their relatives (hospital group); and to compare the predictive relationship between the evaluative…

  8. [Coverage of pointed acute coronary syndromes in the general hospital centers].

    PubMed

    Hanssen, M; Monassier, J P; Dujardin, J J; Hoden, S; Pedrazzini, L

    2002-11-01

    This study presents data on the management of acute coronary syndromes collected in a national registry organized by the french Collège national des cardiologues des hôpitaux généraux in September 2000. In all 86 institutions participated and data from 607 patients (mean age: 67 years; 413 men) were analysed. The final diagnosis was unstable angina in 38%, non-Q wave myocardial infarction in 21% and Q-wave myocardial infarction in 40.5%. Median time to admission was 4 h. At symptom onset, patients called their general practitioners in 46% of cases, emergency ambulatory units in 31% of cases and arrived to the hospital on their own in 23% of cases. Observance of the European Society of Cardiology guidelines was good for patients without ST segment elevation. In patients with ST segment elevation, 9% had pre-hospital thrombolysis, 28% hospital thrombolysis, and 27% had angioplasty within 48 h of admission, including 9% with rescue angioplasty. Overall, 57% of patients with ST segment elevation received reperfusion therapy. In hospital mortality was 6% for the whole cohort, and 11% for patients with acute myocardial infarctions. By multivariate analysis, predictors of in-hospital mortality were age, type of acute coronary syndrome, absence of beta-blocker therapy, and absence of coronary angiography. PMID:12515101

  9. Patient Safety in Tehran University of Medical Sciences’ General Hospitals, Iran

    PubMed Central

    ARAB, Mohammad; AKBARI SARI, Ali; MOVAHED KOR, Elham; HOSSEINI, Mostafa; TOLOUI RAKHSHAN, Shiva; EZATI, Mohammad

    2013-01-01

    Background It is important to focus on creating opportunities for patients’ participation at all levels of health systems in order to promote their ability to improve patient safety and quality of services. The general aim of this study was to determine patient safety level in Tehran University of Medical Sciences’ (TUMS) general hospitals, Tehran, Iran from patients’ perspective and to determine the contributory factors on their perspective. Methods: This was a cross-sectional study. In the spring 2011, the list of clinical departments of the six general hospitals affiliated to TUMS was obtained through the Website of TUMS. By using stratified random sampling, the sample size was calculated 300 patients. Data were collected by using a structured questionnaire and its validity and reliability were acceptable. Descriptive statistics, linear regression and logistic regression were used for analyzing the data. Results: Totally, 60% of patients were female. Patient safety was evaluated high by 60% of respondents. The unmarried or educated or employed individuals tend to score lower than others. Conclusion: TUMS’s general hospitals are enough safe from patients’ perspective, patient safety should be improved. In clinical governance, contributing patients’ perspective to the improvement of patient safety reforms is critical in generating new models of good practice. PMID:23641408

  10. [Investigation into drinking problem of patients who visited a general hospital in central and northern Okinawa].

    PubMed

    Nakai, Minori; Hotta, Hiroshi; Ootsuru, Taku; Hiejima, Shigeto; Murakami, Masaru; Yuzuriha, Takefumi; Kondo, Tsuyoshi

    2013-04-01

    In Japan, many problems related to alcohol are pointed out from before. We believe that there is a unique drinking culture in Okinawa, such as a large amount of alcohol. Therefore, we estimate many people in Okinawa have a drinking problem. We conducted a survey of patients who visited general hospital (medical or surgical or orthopedic) in 2007. The purpose of this study is to collect basic data for introducing alcoholics to specialized treatment as early as possible, detecting the person who drink large amounts of alcohol, performing early intervention for people who drink large amount of alcohol, and advancing cooperation with specialized medical agencies of alcohol. As a result, Among the patients who visited general hospital in Okinawa, many problem drinkers are concentrated in the young age. and they have strong fears of health. The possibility of early intervention with intervention techniques, such as brief intervention, has been suggested. PMID:23808321

  11. Noise at night in hospital general wards: a mapping of the literature.

    PubMed

    Fillary, Julie; Chaplin, Hema; Jones, Gill; Thompson, Angela; Holme, Anita; Wilson, Patricia

    English NHS inpatient surveys consistently identify that noise at night in hospitals and its impact on patients' sleep is a persisting problem that needs addressing. To identify how noise at night in hospital affects patients on general wards and the range of interventions aimed at reducing the problem, a systematic mapping of the literature was undertaken. All primary studies and relevant literature published January 2003-July 2013 were included. Key issues identified in the literature included noise levels and causes, impact on patient experience, and lack of staff awareness. Interventions to reduce noise were targeted at staff education, behaviour modification, care organisation and environmental solutions. The scoping suggested that when compared with specialist units, there is little evidence on effective interventions reducing disturbance from night-time noise on general wards. The available evidence suggests a whole systems approach should be adopted to aid quality sleep and promote recovery. PMID:26018021

  12. Preregistration rotation including general practice at St Mary's Hospital Medical School.

    PubMed Central

    Harris, C M; Dudley, H A; Jarman, B; Kidner, P H

    1985-01-01

    A rotation for the preregistration year which included medicine, surgery, and general practice started at St Mary's Hospital Medical School in August 1981. Initially approved by London University for an experimental period of three years, in 1984 it became an established rotation subject to normal review. Special arrangements were made for clinical work, supervision, prescribing, teaching, and other aspects of the general practice component. Data relating to the general practice consultations of the nine participating house officers show that they obtained wide experience, and their comments on the post itself were generally favourable. The four months spent in general practice were needed to allow time for the house officers to adapt to the new setting but did not seem to have an important effect on their experience in medicine and surgery. PMID:3924268

  13. Hospital Charges and Practice Patterns for General and Regional Anesthesia in Arthroscopic Anterior Cruciate Ligament Repair

    PubMed Central

    Foster, Brock D.; Terrell, Rodney; Montgomery, Scott R.; Wang, Jeffrey C.; Petrigliano, Frank A.; McAllister, David R.

    2013-01-01

    Background: Anesthetic use for arthroscopic anterior cruciate ligament (ACL) reconstruction may display variability in hospital charges and utilization in the United States. Purpose: To evaluate practice patterns and hospital charges for anesthesia in arthroscopic ACL reconstruction. Study Type: Cross-sectional study. Methods: The PearlDiver Patient Records Database, a national database of insurance billing records, was searched using the current procedural terminology (CPT) codes for arthroscopic ACL reconstruction in combination with different types of anesthesia. The search included the years between 2004 and 2009. Age, sex, number of procedures performed, geographic region, and hospital charges for each type of anesthesia were recorded and compared. Anesthetic types were categorized as general anesthesia (GA) only, GA with concomitant single femoral injection, GA with concomitant other regional anesthesia (RA), single femoral injection only, or other RA only. Results: Between 2004 and 2009, a total of 53,968 arthroscopic reconstructive procedures were identified. The mean per patient hospital charge for GA alone, GA in combination with single femoral injection, GA in combination with other RA, single femoral injection alone, and RA alone was $1065 (63% of cases), $1614 (29%), $1849 (4%), $630 (3%), and $612 (1%), respectively. The use of GA in combination with RA or single femoral nerve injection significantly increased during this time period (P = .004 and P < .001, respectively). Conclusion: The mean per patient hospital charges for arthroscopic ACL reconstruction varied with the mode of anesthesia utilized, where regional anesthetic techniques alone were least expensive. RA alone was utilized infrequently, and there was a significant increase in the rate of utilization of GA in combination with any form of RA. Clinical Relevance: This study provides information on current trends and hospital charges for anesthesia in arthroscopic ACL reconstruction. PMID:26535248

  14. Stenotrophomonas maltophilia Infections in a General Hospital: Patient Characteristics, Antimicrobial Susceptibility, and Treatment Outcome

    PubMed Central

    Samonis, George; Karageorgopoulos, Drosos E.; Maraki, Sofia; Levis, Panagiotis; Dimopoulou, Dimitra; Spernovasilis, Nikolaos A.; Kofteridis, Diamantis P.; Falagas, Matthew E.

    2012-01-01

    Introduction Stenotrophomonas maltophilia is acquiring increasing importance as a nosocomial pathogen. Methods We retrospectively studied the characteristics and outcome of patients with any type of S. maltophilia infection at the University Hospital of Heraklion, Crete, Greece, between 1/2005–12/2010. S. maltophilia antimicrobial susceptibility was tested with the agar dilution method. Prognostic factors for all-cause in-hospital mortality were assessed with multivariate logistic regression. Results Sixty-eight patients (median age: 70.5 years; 64.7% males) with S. maltophilia infection, not related to cystic fibrosis, were included. The 68 patients were hospitalized in medical (29.4%), surgical (26.5%), hematology/oncology departments (23.5%), or the intensive care units (ICU; 20.6%). The most frequent infection types were respiratory tract (54.4%), bloodstream (16.2%), skin/soft tissue (10.3%), and intra-abdominal (8.8%) infection. The S. maltophilia-associated infection was polymicrobial in 33.8% of the cases. In vitro susceptibility was higher to colistin (91.2%), trimethoprim/sulfamethoxazole and netilmicin (85.3% each), and ciprofloxacin (82.4%). The empirical and the targeted treatment regimens were microbiologically appropriate for 47.3% and 63.6% of the 55 patients with data available, respectively. Most patients received targeted therapy with a combination of agents other than trimethoprim/sulfamethoxazole. The crude mortality and the mortality and the S. maltophilia infection-related mortality were 14.7% and 4.4%, respectively. ICU hospitalization was the only independent prognostic factor for mortality. Conclusion S. maltophilia infection in a general hospital can be associated with a good prognosis, except for the patients hospitalized in the ICU. Combination reigmens with fluoroquinolones, colistin, or tigecycline could be alternative treatment options to trimethoprim/sulfamethoxazole. PMID:22624022

  15. Why are family carers of people with dementia dissatisfied with general hospital care? a qualitative study

    PubMed Central

    2012-01-01

    Background Families and other carers report widespread dissatisfaction with general hospital care for confused older people. Methods We undertook a qualitative interviews study of 35 family carers of 34 confused older patients to ascertain their experiences of care on geriatric and general medical, and orthopaedic wards of a large English hospital. Transcripts were analysed using a grounded theory approach. Themes identified in interviews were categorised, and used to build a model explaining dissatisfaction with care. Results The experience of hospital care was often negative. Key themes were events (illness leading to admission, experiences in the hospital, adverse occurrences including deterioration in health, or perceived poor care); expectations (which were sometimes unrealistic, usually unexplored by staff, and largely unmet from the carers’ perspective); and relationships with staff (poor communication and conflict over care). Expectations were influenced by prior experience. A cycle of discontent is proposed. Events (or ‘crises’) are associated with expectations. When these are unmet, carers become uncertain or suspicious, which leads to a period of ‘hyper vigilant monitoring’ during which carers seek out evidence of poor care, culminating in challenge, conflict with staff, or withdrawal, itself a crisis. The cycle could be completed early during the admission pathway, and multiple cycles within a single admission were seen. Conclusion People with dementia who have family carers should be considered together as a unit. Family carers are often stressed and tired, and need engaging and reassuring. They need to give and receive information about the care of the person with dementia, and offered the opportunity to participate in care whilst in hospital. Understanding the perspective of the family carer, and recognising elements of the ‘cycle of discontent’, could help ward staff anticipate carer needs, enable relationship building, to pre-empt or avoid dissatisfaction or conflict. PMID:23006826

  16. The role of rotavirus associated with pediatric gastroenteritis in a general hospital in Lagos, Nigeria

    PubMed Central

    Anochie, Philip Ifesinachi; Onyeneke, Edwina Chinwe; Asowata, Emmanuel Osaretin; Afocha, Ebelechukwu; Onyeozirila, Anthony Chidiebere; Ogu, Angelina Chinyere; Onyeneke, Bestman Chukwuemeka

    2013-01-01

    Introduction Bacterial, viral and parasitic agents have been implicated and confirmed as causative agents of gastroenteritis in children with ages below 5 years old. The major role of rotavirus as causative agent is not widely recognized within the public health community, particularly in developing countries. This study examined the role of rotavirus as a causative agent of childhood gastroenteritis in infants and young children below 5 years of age in a General Hospital in Lagos, Nigeria. Methods Parents and caregivers of children admitted to the hospital were interviewed using a structured questionnaire. Viral RNA was extracted from the stool samples collected and analyzed using RT-PCR for genotyping and agarose gel electrophoresis for identification of rotavirus electrophoretypes. Results Out of the 71 samples analyzed, 16 (22.5%) were positive for rotavirus. A total of 12 (75%) males and 4 (25%) females were positive for rotavirus gastroenteritis with most cases (7, 43.8%) distributed to the 13-24 months age group, followed closely by the 1-6 months age group, with 6 cases, 37.5%. Rotavirus G2 genotype was the most prevalent strain in the hospital (10 patients, 62.5%) followed by G1 (6 patients, 37.5%). These were the only rotavirus genotypes detected in the hospital. PMID:24432291

  17. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey

    PubMed Central

    Xing, Kai; Jiao, Mingli; Ma, Hongkun; Qiao, Hong; Hao, Yanhua; Li, Ye; Gao, Lijun; Sun, Hong; Kang, Zheng; Liang, Libo; Wu, Qunhong

    2015-01-01

    Purpose The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals. Methods A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%). Results A total of 106 of the 840 (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients’ relatives (62.3%), followed by the patient (22.6%); 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60) resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%). Most respondents (62.8%) did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting) with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats) was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc.). Conclusions Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue. PMID:26571388

  18. Tourism and Specific Risk Areas for Cryptococcus gattii, Vancouver Island, Canada

    PubMed Central

    Chambers, Catharine; MacDougall, Laura; Li, Min

    2008-01-01

    We compared travel histories of case-patients with Cryptococcus gattii infection during 1999–2006 to travel destinations of the general public on Vancouver Island, British Columbia, Canada. Findings validated and refined estimates of risk on the basis of place of residence and showed no spatial progression of risk areas on this island over time. PMID:18976570

  19. Multidisciplinary management of clubfeet using the Ponseti method in a district general hospital setting

    PubMed Central

    Binks, Katherine; Dunkley, Mia; Coates, Christopher

    2008-01-01

    Purpose Idiopathic congenital talipes equinovarus (CTEV) is a relatively common complex deformity of the foot that can be successfully managed by the Ponseti method. The purpose of this study was to see if the latter can be effectively administered by non-medical specialists outside a specialist or teaching hospital setting. Method Retrospective review of 24 children (39 feet) with idiopathic congenital talipes equinovarus managed by a physiotherapist-led service in a district general hospital. Results The median Pirani score at presentation was 4.5 (mean 4.2, range 1.5–6). The median Pirani score for feet requiring tenotomy was 6 (4.5–6), whereas feet not requiring tenotomy had a median Pirani score of 2.5 (1.5–5). A total of 18 feet (46%) underwent an Achilles tenotomy. Foot correction was achieved with an average of 3.4 (2–6) cast changes in the non-tenotomy group, and an average of 7.5 (5–13) in the tenotomy group. Successful initial correction of the deformity was achieved in 37 (95%) of the feet studied. One patient (2 feet, 5%) failed local conservative management, requiring tertiary referral. Two children (2 feet) have relapsed, requiring further serial casting. No children required open surgical release. Follow-up was for a mean of 31 months (17–50). Conclusions Early results suggest that a combined consultant/physiotherapist-delivered Ponseti service can be effectively and successfully administered in a district general hospital. PMID:19308543

  20. Value of the general health questionnaire in detecting psychiatric morbidity in a general hospital out-patient population.

    PubMed

    Bagadia, V N; Ayyar, K S; Lakdawala, P D; Susainathan, U; Pradhan, P V

    1985-10-01

    On administering the General Health Questionnaire (GHQ) in English, Gujarati and Marathi, to 500 non-acutely ill adult patients selected randomly from a General Hospital Out-patient Department, it was found that 57% scored high (12 and above), indicating the possibility of psychiatric morbidity in this group. On subjecting 50 of these patients to blind psychiatric evaluation a misclassification rate of 30% was observed with respect to the G. H. Q. 96% of the psychiatrically ill scored high on GHQ, 37% of those scoring high on G. H. Q. were psychiatrically normal. If this misclassification rate is lowered by suitable modifications such as reducing items pertaining to Group A of the G. H. Q., then this test will be very useful as a simple tool to detect psychiatric morbidity. PMID:21927123

  1. The final outcome of indeterminate cytology of thyroid nodules in a District General Hospital

    PubMed Central

    DODDI, S.; CHOHDA, E.; MAGHSOUDI, S.; SHEEHAN, L.; SINHA, A.; CHANDAK, P.; SINHA, P.

    2015-01-01

    Background Diagnostic thyroid lobectomy is performed to resolve the dilemma of indeterminate (Thy3) cytology of thyroid nodules. But on final histology most nodules are benign thereby subjecting this group of patients to surgery with its associated risks. Aim To determine the proportion of cancers in patients with indeterminate thyroid nodules. Patients and methods This is a retrospective observational study of 621 patients who underwent fine needle aspiration cytology (FNAC) of their thyroid nodules over a 60 month period in a district general hospital. Patient demographics, cytology and final histology results were extracted from the hospital database. Results On final analysis, 48 patients had an indeterminate cytology (7.7%) and 12 patients had cancer in this group (25%) following diagnostic lobectomy. Conclusion Till an alternative robust technology becomes widely available we need to continue to perform diagnostic lobectomy in patients with indeterminate cytology in view of the high incidence of thyroid cancer in this group of patients. PMID:26188757

  2. [Suicidality at the general hospital – perspective of consultation and liaison psychiatry].

    PubMed

    Imboden, Christian; Hatzinger, Martin

    2015-10-01

    Suicidality is a common problem in the general hospital. Patients with comorbid psychiatric disorders or during a psychosocial crisis can develop suicidal ideation during their stay at the general hospital, especially if they suffer from chronic disease. Some somatic disorders, such as cancer, epilepsy, chronic obstructive pulmonary disease, asthma, stroke and chronic pain conditions are associated with an increased risk of suicide. The fact that (1) a major part of patients are treated in the emergency room (ER) after a suicide attempt and (2) a suicide attempt is the strongest predictor for later completed suicide emphasizes the importance of expertise in dealing with suicidal patients in the ER. In order to improve prevention of suicides and suicide attempts within the general hospital and after discharge it is important to educate staff concerning suicidality and enhance detection of suicidal patients. A consultation and liaison psychiatrist should always be involved when there are suicidal patients on wards and in the ER. Assessment of suicidal patients has always to include clear recommendations concerning patient safety and treatment of the underlying condition as well as specific approaches in dealing with suicidal thoughts. Safety measures can include close monitoring, constant observation, restriction to means of suicide, referral to a psychiatric clinic and treatment with sedatives, generally benzodiazepines. Psychiatric disorders are ideally treated according to guidelines and clear recommendations should be given concerning treatment after discharge. Specific psychotherapy for suicidal behaviour possibly reduces the risk of future suicides. A special situation is created by assisted suicides which attribute to suicides in the elderly with a recent increase in the Swiss population. In some cases, undiagnosed depression may contribute to the decision making process, hence, underlining the importance of improved detection and treatment of depression in the elderly. PMID:26423882

  3. Wireless technology in the evolution of patient monitoring on general hospital wards.

    PubMed

    Sahandi, R; Noroozi, S; Roushan, G; Heaslip, V; Liu, Y

    2010-01-01

    The evolution of patient monitoring on general hospital wards is discussed. Patients on general wards are monitored according to the severity of their conditions, which can be subjective at best. A report by the Commission for Healthcare Audit and Inspection in 2008 indicated dissatisfaction with patient monitoring. Commitment to providing quality health service by healthcare organizations encourages the implementation of other mechanisms for patient care. Remote patient monitoring (RPM), by supplementing the role of nurses, can improve efficiency and patient care on general wards. Developments in technology made it possible for wireless sensors to measure and transmit physiological data from patients to a control room for monitoring and recording. Two approaches in the application of wireless ZigBee sensor networks are discussed and their performances compared in a simulation environment. The role of RPM in early detection of deteriorating patients' conditions, reducing morbidity and mortality rates are also discussed. PMID:19929237

  4. Washington State University -Vancouver Formal Minor

    E-print Network

    Washington State University - Vancouver Formal Minor C o m m u n i c a t i o n It is strongly in residence at WSU or through WSU-approved education abroad or educational exchange courses. Students may in an Information Society COMJOUR 360: Writing For Television COM 105 [HUM]: Communication in Global Contexts

  5. Being Ethnic: Generation Italian Identity in Vancouver

    E-print Network

    Kavanagh, Karen L.

    Being Ethnic: 3rd Generation Italian Identity in Vancouver Eva Sajoo Research Associate INSTITUTE Survey Objectives Connections to Italy Language and Family The Meaning of Italian Identity Religion Social Perceptions of Italian Identity Di erence Social Bonds Preserving Italian Identity The Italian

  6. INTERPOLATING VANCOUVER'S DAILY AMBIENT PM 10 FIELD

    EPA Science Inventory

    In this article we develop a spatial predictive distribution for the ambient space- time response field of daily ambient PM10 in Vancouver, Canada. Observed responses have a consistent temporal pattern from one monitoring site to the next. We exploit this feature of the field b...

  7. Antipsychotics for delirium in the general hospital setting in consecutive 2453 inpatients: a prospective observational study

    PubMed Central

    Hatta, Kotaro; Kishi, Yasuhiro; Wada, Ken; Odawara, Toshinari; Takeuchi, Takashi; Shiganami, Takafumi; Tsuchida, Kazuo; Oshima, Yoshio; Uchimura, Naohisa; Akaho, Rie; Watanabe, Akira; Taira, Toshihiro; Nishimura, Katsuji; Hashimoto, Naoko; Usui, Chie; Nakamura, Hiroyuki

    2014-01-01

    Objective Attention to risk of antipsychotics for older patients with delirium has been paid. A clinical question was whether risk of antipsychotics for older patients with delirium would exceed efficacy of those even in the general hospital setting. Methods A prospective observational study proceeded over a 1-year period at 33 general hospitals, where at least one psychiatrist worked full time. Subjects were patients who developed delirium during their admission due to acute somatic diseases or surgery, and who received antipsychotics for delirium. The primary outcome was rates and kinds of serious adverse events. Results Among 2834 patients who developed delirium, 2453 patients received antipsychotics, such as risperidone (34%), quetiapine (32%), and parenteral haloperidol (20%), for delirium. Out of 2453 patients, 22 serious adverse events (0.9%) were reported. Aspiration pneumonia was the most frequent (17 patients, 0.7%), followed by cardiovascular events (4 patients, 0.2%) and venous thromboembolism (1 patient, 0.0%). There was no patient with a fracture or intracranial injury due to a fall. No one died because of antipsychotic side effects. The mean Clinical Global Impressions—Improvement Scale score was 2.02 (SD 1.09). Delirium was resolved within 1 week in more than half of the patients (54%). Conclusions In the general hospital setting under management including fine dosage adjustment and early detection of side effects, risk of antipsychotics for older patients with delirium might be low, in contrast to antipsychotics for dementia in the nursing home or outpatient settings. A point may be not how to avoid using antipsychotics but how to monitor their risk. PMID:23801358

  8. When Suicide Is Not Suicide: Self-induced Morbidity and Mortality in the General Hospital.

    PubMed

    Bostwick, J Michael

    2015-04-01

    Suicidal phenomena in the general hospital can take a variety of forms that can be parsed by taking into account whether or not the patient 1) intended to hasten death, and 2) included collaborators, including family and health care providers, in the decision to act. These two criteria can be used to distinguish entities as diverse as true suicide, non-compliance, euthanasia/physician-assisted suicide, and hospice/palliative care. Characterizing the nature of "suicide" events facilitates appropriate decision-making around management and disposition. PMID:25973265

  9. When Suicide Is Not Suicide: Self-induced Morbidity and Mortality in the General Hospital

    PubMed Central

    Bostwick, J. Michael

    2015-01-01

    Suicidal phenomena in the general hospital can take a variety of forms that can be parsed by taking into account whether or not the patient 1) intended to hasten death, and 2) included collaborators, including family and health care providers, in the decision to act. These two criteria can be used to distinguish entities as diverse as true suicide, non-compliance, euthanasia/physician-assisted suicide, and hospice/palliative care. Characterizing the nature of “suicide” events facilitates appropriate decision-making around management and disposition. PMID:25973265

  10. Preparation to care for confused older patients in general hospitals: a study of UK health professionals

    PubMed Central

    Griffiths, Amanda; Knight, Alec; Harwood, Rowan; Gladman, John R.F.

    2014-01-01

    Background and Objective: in the UK, two-thirds of patients in general hospitals are older than 70, of whom half have dementia or delirium or both. Our objective was to explore doctors, nurses and allied health professionals' perceptions of their preparation to care for confused older patients on general hospital wards. Methods: using a quota sampling strategy across 11 medical, geriatric and orthopaedic wards in a British teaching hospital, we conducted 60 semi-structured interviews with doctors, nurses and allied healthcare professionals and analysed the data using the Consensual Qualitative Research approach. Results: there was consensus among participants that education, induction and in-service training left them inadequately prepared and under-confident to care for confused older patients. Many doctors reported initial assessments of confused older patients as difficult. They admitted inadequate knowledge of mental health disorders, including the diagnostic features of delirium and dementia. Handling agitation and aggression were considered top priorities for training, particularly for nurses. Multidisciplinary team meetings were highly valued but were reported as too infrequent. Participants valued specialist input but reported difficulties gaining such support. Communication with confused patients was regarded as particularly challenging, both in terms of patients making their needs known, and staff conveying information to patients. Participants reported emotional and behavioural responses including frustration, stress, empathy, avoidance and low job satisfaction. Conclusion: our findings indicate that a revision of training across healthcare professions in the UK is required, and that increased specialist support should be provided, so that the workforce is properly prepared to care for older patients with cognitive problems. PMID:24165310

  11. Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece

    SciTech Connect

    Voudrias, Evangelos; Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini

    2012-07-15

    Highlights: Black-Right-Pointing-Pointer We studied pharmaceutical and chemical waste production in a Greek hospital. Black-Right-Pointing-Pointer Pharmaceutical waste comprised 3.9% w/w of total hazardous medical waste. Black-Right-Pointing-Pointer Unit production rate for total pharmaceutical waste was 12.4 {+-} 3.90 g/patient/d. Black-Right-Pointing-Pointer Chemical waste comprised 1.8% w/w of total hazardous medical waste. Black-Right-Pointing-Pointer Unit production rate for total chemical waste was 5.8 {+-} 2.2 g/patient/d. - Abstract: The objective of this work was to determine the composition and production rates of pharmaceutical and chemical waste produced by Xanthi General Hospital in Greece (XGH). This information is important to design and cost management systems for pharmaceutical and chemical waste, for safety and health considerations and for assessing environmental impact. A total of 233 kg pharmaceutical and 110 kg chemical waste was collected, manually separated and weighed over a period of five working weeks. The total production of pharmaceutical waste comprised 3.9% w/w of the total hazardous medical waste produced by the hospital. Total pharmaceutical waste was classified in three categories, vial waste comprising 51.1%, syringe waste with 11.4% and intravenous therapy (IV) waste with 37.5% w/w of the total. Vial pharmaceutical waste only was further classified in six major categories: antibiotics, digestive system drugs, analgesics, hormones, circulatory system drugs and 'other'. Production data below are presented as average (standard deviation in parenthesis). The unit production rates for total pharmaceutical waste for the hospital were 12.4 (3.90) g/patient/d and 24.6 (7.48) g/bed/d. The respective unit production rates were: (1) for vial waste 6.4 (1.6) g/patient/d and 13 (2.6) g/bed/d, (2) for syringe waste 1.4 (0.4) g/patient/d and 2.8 (0.8) g/bed/d and (3) for IV waste 4.6 (3.0) g/patient/d and 9.2 (5.9) g/bed/d. Total chemical waste was classified in four categories, chemical reagents comprising 18.2%, solvents with 52.3%, dyes and tracers with 18.2% and solid waste with 11.4% w/w of the total. The total production of chemical waste comprised 1.8% w/w of the total hazardous medical waste produced by the hospital. Thus, the sum of pharmaceutical and chemical waste was 5.7% w/w of the total hazardous medical waste produced by the hospital. The unit production rates for total chemical waste for the hospital were 5.8 (2.2) g/patient/d and 1.1 (0.4) g/exam/d. The respective unit production rates were: (1) for reagents 1.7 (2.4) g/patient/d and 0.3 (0.4) g/examination/d, (2) for solvents 248 (127) g/patient/d and 192 (101) g/examination/d, (3) for dyes and tracers 4.7 (1.4) g/patient/d and 2.5 (0.9) g/examination/d and (4) for solid waste 54 (28) g/patient/d and 42 (22) g/examination/d.

  12. Non-Invasive Continuous Respiratory Monitoring on General Hospital Wards: A Systematic Review

    PubMed Central

    van Loon, Kim; van Zaane, Bas; Bosch, Els J.; Kalkman, Cor J.; Peelen, Linda M.

    2015-01-01

    Background Failure to recognize acute deterioration in hospitalized patients may contribute to cardiopulmonary arrest, unscheduled intensive care unit admission and increased mortality. Purpose In this systematic review we aimed to determine whether continuous non-invasive respiratory monitoring improves early diagnosis of patient deterioration and reduces critical incidents on hospital wards. Data Sources Studies were retrieved from Medline, Embase, CINAHL, and the Cochrane library, searched from 1970 till October 25, 2014. Study Selection Electronic databases were searched using keywords and corresponding synonyms ‘ward’, ‘continuous’, ‘monitoring’ and ‘respiration’. Pediatric, fetal and animal studies were excluded. Data Extraction Since no validated tool is currently available for diagnostic or intervention studies with continuous monitoring, methodological quality was assessed with a modified tool based on modified STARD, CONSORT, and TREND statements. Data Synthesis Six intervention and five diagnostic studies were included, evaluating the use of eight different devices for continuous respiratory monitoring. Quantitative data synthesis was not possible because intervention, study design and outcomes differed considerably between studies. Outcomes estimates for the intervention studies ranged from RR 0.14 (0.03, 0.64) for cardiopulmonary resuscitation to RR 1.00 (0.41, 2.35) for unplanned ICU admission after introduction of continuous respiratory monitoring, Limitations The methodological quality of most studies was moderate, e.g. ‘before-after’ designs, incomplete reporting of primary outcomes, and incomplete clinical implementation of the monitoring system. Conclusions Based on the findings of this systematic review, implementation of routine continuous non-invasive respiratory monitoring on general hospital wards cannot yet be advocated as results are inconclusive, and methodological quality of the studies needs improvement. Future research in this area should focus on technology explicitly suitable for low care settings and tailored alarm and treatment algorithms. PMID:26658343

  13. Improving the management of sepsis in a district general hospital by implementing the ‘Sepsis Six’ recommendations

    PubMed Central

    Kumar, Prashant; Jordan, Mark; Caesar, Jenny; Miller, Sarah

    2015-01-01

    Sepsis is a common condition with a major global impact on healthcare resources and expenditure. The Surviving Sepsis Campaign has been vigorous in promoting internationally recognised pathways to improve the management of septic patients and decrease mortality. However, translating recommendations into practice is a challenging and complex task that requires a multi-faceted approach with sustained engagement from local stakeholders. Whilst working at a district general hospital in New Zealand, we were concerned by the seemingly inconsistent management of septic patients, often leading to long delays in the initiation of life-saving measures such as antibiotic, fluid, and oxygen administration. In our hospital there were no clear systems, protocols or guidelines in place for identifying and managing septic patients. We therefore launched the Sepsis Six resuscitation bundle of care in our hospital in an attempt to raise awareness amongst staff and improve the management of septic patients. We introduced a number of simple low-cost interventions that included educational sessions for junior doctors and nursing staff, as well as posters and modifications to phlebotomy trolleys that acted as visual reminders to implement the Sepsis Six bundle. Overall, we found there to a be a steady improvement in the delivery of the Sepsis Six bundle in septic patients with 63% of patients receiving appropriate care within one hour, compared to 29% prior to our interventions. However this did not translate to an improvement in patient mortality. This project forms part of an on going process to instigate a fundamental culture change among local healthcare professionals regarding the management of sepsis. Whilst we have demonstrated improved implementation of the Sepsis Six bundle, the key challenge remains to ensure that momentum of this project continues and forms a platform for sustainable clinical improvement in the long term.

  14. Continuity of care for orthopaedic patients in a district general hospital

    PubMed Central

    Kulloo, Praneta

    2014-01-01

    Continuity of care has been defined as a patient repeatedly consulting the same doctor and forming a therapeutic relationship. There is evidence that not only do patients value continuity of the care they receive but also that provider continuity is related to lower overall total healthcare costs and better healthcare outcomes. A retrospective audit was undertaken in James Paget Hospital, a district general hospital in East Anglia, England, to assess continuity of care from the preoperative clinic to surgery and subsequent postoperative follow-up in the orthopaedic department. Overall continuity of care by individual surgeon was 23% and by orthopaedic team (consultant and middle grade staff) 43% in the first audit cycle of 106 patients in 2008. In the second cycle in 2010, this improved to 24% and 56%, respectively, in a sample of 156 patients. Moreover, the continuity of care for trauma patients improved from 10% to 75%. Interventions which resulted in the improvement were change of on-call rota and the implementation of measures so that, following surgery, patients were allocated to the operating surgeon's clinic postoperatively. This completed audit cycle highlights the importance of continuity of care of patients and how efficient management led to a more patient centred delivery of healthcare.

  15. Medical patients' treatment decision making capacity: a report from a general hospital in Greece.

    PubMed

    Bilanakis, Nikolaos; Vratsista, Aikaterini; Athanasiou, Eleni; Niakas, Dimitris; Peritogiannis, Vaios

    2014-01-01

    This study aimed to assess the decision-making capacity for treatment of patients hospitalized in an internal medicine ward of a General Hospital in Greece, and to examine the views of treating physicians regarding patients' capacity. All consecutive admissions to an internal medicine ward within a month were evaluated. A total of 134 patients were approached and 78 patients were interviewed with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) and the Mini Mental State Examination (MMSE) questionnaire. Sixty-eight out of 134 patients (50.7%) were incompetent to decide upon their treatment. The majority of them (n=56, 41.8%) were obviously incapable because they were unconscious, or had such marked impairment that they could not give their own names, and the rest (n=12, 8.9%) were rated as incompetent according to their performance in the MacCAT-T. Neurological disorders, old age and altered cognitive function according to MMSE were negatively correlated with decision making capacity. Physicians sometimes failed to recognize patients' incapacity. Rates of decision-making incapacity for treatment in medical inpatients are high, and incapacity may go unrecognized by treating physicians. Combined patient evaluation with the use of the MacCAT-T and MMSE, could be useful for the determination of incapable patients. PMID:25505489

  16. Jim Peters' collapse in the 1954 Vancouver Empire Games marathon.

    PubMed

    Noakes, Tim; Mekler, Jackie; Pedoe, Dan Tunstall

    2008-08-01

    On 7 August 1954, the world 42 km marathon record holder, Jim Peters, collapsed repeatedly during the final 385 metres of the British Empire and Commonwealth Games marathon held in Vancouver, Canada. It has been assumed that Peters collapsed from heatstroke because he ran too fast and did not drink during the race, which was held in windless, cloudless conditions with a dry-bulb temperature of 28 degrees C. Hospital records made available to us indicate that Peters might not have suffered from exertional heatstroke, which classically produces a rectal temperature > 42 degrees C, cerebral effects and, usually, a fatal outcome without vigorous active cooling. Although Peters was unconscious on admission to hospital approximately 60 minutes after he was removed from the race, his rectal temperature was 39.4 degrees C and he recovered fully, even though he was managed conservatively and not actively cooled. We propose that Peters' collapse was more likely due to a combination of hyperthermia-induced fatigue which caused him to stop running; exercise-associated postural hypotension as a result of a low peripheral vascular resistance immediately he stopped running; and combined cerebral effects of hyperthermia, hypertonic hypernatraemia associated with dehydration, and perhaps undiagnosed hypoglycaemia. But none of these conditions should cause prolonged unconsciousness, raising the possibility that Peters might have suffered from a transient encephalopathy, the exact nature of which is not understood. PMID:18928034

  17. [Professional practice of nurses who care for cancer patients in general hospitals].

    PubMed

    da Silva, Josiane Travençolo; Matheus, Maria Clara Cassuli; Fustinoni, Suzete Maria; de Gutiérrez, Maria Gaby Rivero

    2012-01-01

    The present article discusses a qualitative study which aimed to understand the typical of nurses' professional practice caring for patient with cancer in general hospitals. In order to find out the reasons that motivate nurse's action, and to put in evidence what is original, significant, specific and typical about this phenomenon, we have taken into consideration the premises of the philosopher Alfred Schütz, which provide us with subsidies to unveil them. The data collected through semi-structured interviews reported that nurses admit not having the required theoretical knowledge and experience or enough practice to take care of a cancer patient. Thus, they don't feel capable of developing actions which may positively influence care on patients and their family members. PMID:23032337

  18. Discharge, water temperature, and selected meteorological data for Vancouver Lake, Vancouver, Washington, water years 2011-13

    USGS Publications Warehouse

    Foreman, James R.; Marshall, Cameron A.; Sheibley, Rich W.

    2014-01-01

    The U.S. Geological Survey partnered with the Vancouver Lake Watershed Partnership in a 2-year intensive study to quantify the movement of water and nutrients through Vancouver Lake in Vancouver, Washington. This report is intended to assist the Vancouver Lake Watershed Partnership in evaluating potential courses of action to mitigate seasonally driven blooms of harmful cyanobacteria and to improve overall water quality of the lake. This report contains stream discharge, lake water temperature, and selected meteorological data for water years 2011, 2012, and 2013 that were used to develop the water and nutrient budgets for the lake.

  19. Current Status of Management in Type 2 Diabetes Mellitus at General Hospitals in South Korea

    PubMed Central

    Jung, Jin-Hee; Lee, Jung-Hwa; Noh, Jin-Won; Park, Jeong-Eun; Kim, Hee-Sook; Yoo, Joo-Wha; Song, Bok-Rye; Lee, Jeong-rim; Hong, Myeong-Hee; Jang, Hyang-Mi; Na, Young; Lee, Hyun-Joo; Lee, Jeong-Mi; Kang, Yang-Gyo; Kim, Sun-Young

    2015-01-01

    Background In Korea, the prevalence, complications, and mortality rate of diabetes are rapidly increasing. However, investigations on the actual condition of diabetes management are very limited due to lack of nation-wide research or multicenter study. Hence, we have minutely inquired the current status of diabetes management and achievement of glucose target goal in general hospital offering education program. That way, we are able to furnish data for policy making of diabetes education and draw up guideline which may allow us to reduce the morbidity and mortality of diabetes. Methods The subjects consisted of 2,610 patients with type 2 diabetes who visited the 13 general hospital in Seoul or Gyeonggi region from March 19 to May 29, 2013. General characteristics, associated diseases, complications, and management status were investigated. Results The mean age was 61.0±11.6 years, body mass index was 25.0±3.3 kg/m2, and family history of diabetes was 50.5%. The mean duration of diabetes was 10.7±7.9 years and 53% received education about diabetes. The prevalence of hypertension and dyslipidemia were 59.2% and 65.5%, respectively, and 18.3% of the subjects were accompanied by liver disease. Diabetic retinopathy appeared in 31.6%, nephropathy in 28.1%, and neuropathy in 19.9% of the subjects. The mean glycosylated hemoglobin (HbA1c) level was 7.3%±1.3% and the achieving rate based on Korean Diabetes Association guideline (HbA1c <6.5%) was 24.8%, blood pressure (130/80 mm Hg or less) was 49.4%, and low density lipoprotein cholesterol (<100 mg/dL) was 63.6%. The reaching rate to the target level in four parameters (blood glucose, blood pressure, lipids, and body weight) was 7.8%. Conclusion The blood glucose control rate was lower than other parameters, and the implementation rate of diabetes education was only 53%. Thus more appropriate glucose control and systematic diabetes education are imperative. PMID:26301192

  20. [Health service aspects of psychosomatic inpatient treatment in a general hospital].

    PubMed

    de Cruppé, Werner; Martens, Ute; Löwe, Bernd; Herzog, Wolfgang; Eich, Wolfgang

    2005-08-01

    The study objective is to outline basic aspects of medical care service structure in the fields of psychosomatic medicine in a clinical acute-care setting. A total of 216 inpatients in a psychosomatic ward of a general hospital were investigated during a 32 months period using a retrospective study design. Referring physicians and clinics along with referral procedures, the waiting period, teamwork with other clinics, as well as patient and therapy characteristics are described. According to provisions of outpatient psychosocial care, general practitioners refer the majority of the inpatients (55 %), followed by other clinics (25 %) and psychosomatic and psychiatric outpatient specialists (20 %). An outpatient department along with a psychosomatic C-L service are key elements for a psychosomatic department to ensure coordination of the referral procedure. The average waiting period lasts 21 days, the average length of stay is 48 days. 60 % of the inpatients show somatic and psychiatric co morbidity. A psychopharmacological treatment has to be taken into consideration along with multi-modal psychotherapy in a third of all patients. PMID:16049875

  1. Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians

    PubMed Central

    Streit, Sven; Baumann, Philippe; Barth, Jürgen; Mattle, Heinrich P.; Arnold, Marcel; Bassetti, Claudio L.; Meli, Damian N.; Fischer, Urs

    2015-01-01

    Background Transient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates. Methods We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient’s risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients. Results Of the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations “very often”. Physicians most commonly gave these reasons for not making emergency referrals: patient’s advanced age; patient’s preference; patient was multimorbid; and, patient needed long-term care. Conclusions Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients. PMID:26284533

  2. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    PubMed Central

    2010-01-01

    Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p < 0.005). The medical staff showed statistically significantly lower job satisfaction compared to the nursing staff. Surgical sector nurses and those >55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested. PMID:21080954

  3. Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia

    PubMed Central

    Hokkam, Emad; Gonna, Abdelaziz; Zakaria, Ossama; El-shemally, Amany

    2015-01-01

    BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital (JGH) in the southwest corner of Saudi Arabia. METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies. RESULTS: The mean age of the patients was 25.3±16.8 years. Most (45.1%) of the patients were at age of 18–30 years. Males (64.3%) were affected by trauma more common than females. More than half (60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury (60%), followed by blunt trauma (30.9%) and then penetrating trauma (9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority (48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%. CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority. PMID:25802567

  4. School Choice in the "Stratilingual" City of Vancouver

    ERIC Educational Resources Information Center

    Yoon, Ee-Seul; Gulson, Kalervo N.

    2010-01-01

    This paper examines the links between language, social difference and political domination in the practices of parental school choice at the heart of a global city, Vancouver. Vancouver is a highly diverse city, especially in terms of language. Its inner city is replete with multiple languages whose exchange values are not equal. In this context,…

  5. An Investigation of Nursing Staff Attitudes and Emotional Reactions towards Patients with Intellectual Disability in a General Hospital Setting

    ERIC Educational Resources Information Center

    Lewis, Sharna; Stenfert-Kroese, Biza

    2010-01-01

    Background: It has been suggested that inequalities in health care for people with intellectual disabilities may be partly explained by negative attitudes of health professionals. This study aimed to investigate the attitudes and emotional reactions reported by nursing staff working in general hospitals towards caring for patients with…

  6. Nicole Campbell WSU Vancouver Library 14204 NE Salmon Creek Ave, Vancouver WA 98686 360-546-9687

    E-print Network

    of the Library's website, managing the authentication system, and maintaining access to databases, electronic as part of the Library's systems team. · Teach instruction sessions and workshops on libraryNicole Campbell WSU Vancouver Library 14204 NE Salmon Creek Ave, Vancouver WA 98686 360

  7. CONTENDING WITH SPACE-TIME INTERACTION IN THE SPATIAL PREDICTION OF POLLUTION: VANCOUVER'S HOURLY AMBIENT PM 10 FIELD

    EPA Science Inventory

    In this article we describe an approach for predicting average hourly concentrations of ambient PM10 in Vancouver. We know our solution also applies to hourly ozone fields and believe it may be quite generally applicable. We use a hierarchal Bayesian approach. At the primary ...

  8. Borderline Personality Disorder and Posttraumatic Stress Disorder at Psychiatric Discharge Predict General Hospital Admission for Self-Harm.

    PubMed

    Mellesdal, Liv; Gjestad, Rolf; Johnsen, Erik; Jørgensen, Hugo A; Oedegaard, Ketil J; Kroken, Rune A; Mehlum, Lars

    2015-12-01

    We investigated whether posttraumatic stress disorder (PTSD) was predictor of suicidal behavior even when adjusting for comorbid borderline personality disorder (BPD) and other salient risk factors. To study this, we randomly selected 308 patients admitted to a psychiatric hospital because of suicide risk. Baseline interviews were performed within the first days of the stay. Information concerning the number of self-harm admissions to general hospitals over the subsequent 6 months was retrieved through linkage with the regional hospital registers. A censored regression analysis of hospital admissions for self-harm indicated significant associations with both PTSD (? = .21, p < .001) and BPD (? = .27, p < .001). A structural model comprising two latent BPD factors, dysregulation and relationship problems, as well as PTSD and several other variables, demonstrated that PTSD was an important correlate of the number of self-harm admissions to general hospitals (B = 1.52, p < .01). Dysregulation was associated directly with self-harm (B = 0.28, p < .05), and also through PTSD. These results suggested that PTSD and related dysregulation problems could be important treatment targets for a reduction in the risk of severe self-harm in high-risk psychiatric patients. PMID:26581019

  9. Breastfeeding policy and practices at the general paediatric outpatient clinic of a teaching hospital in Lagos, Nigeria

    PubMed Central

    2014-01-01

    Background Hospitals have a role to play in supporting, protecting and promoting breastfeeding. The aim of this study was to describe hospital breastfeeding policy and practices and breastfeeding rates among mothers attending General Paediatric Outpatient Clinic at a tertiary hospital in Lagos, Nigeria. Methods This was a cross-sectional study involving paediatric nurses and doctors, as well as the mothers who brought their child to the General Paediatric Outpatient Clinic. Two sets of questionnaires, different in content, were administered to doctors and nurses, and to mothers of children aged 6-24 months, to assess hospital policy and breastfeeding rates, respectively. Stepwise multiple logistic regression analysis was used to examine factors associated with duration of breastfeeding. Results Although the hospital had a written breastfeeding policy copies of the policy were not clearly displayed in any of the units in the Paediatric department. Almost half the staff (48%; 60/125) were not aware of the policy. The hospital had no breastfeeding support group. Nearly three quarters (92/125) of the staff had received lactation management training. 36% (112/311) of mothers exclusively breastfed for six months, 42% (129/311) had stopped breastfeeding at the time of the survey. 67% (207/311) of babies were given infant formula, 85% (175/207) before 6 months. Women who had antenatal care in private hospitals and were Christian were more likely to breastfeed exclusively for 6 months. Low maternal education was the only factor associated with breastfeeding longer than 12 months. Conclusion Breastfeeding practices and policy implementation at this outpatient clinic were suboptimal. We have identified a need for interventions to increase knowledge of the benefits of breastfeeding and to provide support for its longer term duration. We suggest that BFHI be considered across all facilities concerned with infant and early child health to disseminate appropriate information and promote an increase in exclusive breastfeeding for six months as well as the duration of breastfeeding. PMID:25018776

  10. Seasonality of Admissions for Mania: Results From a General Hospital Psychiatric Unit in Pondicherry, India

    PubMed Central

    Sarkar, Siddharth

    2015-01-01

    Introduction: Bipolar disorder is affected by variables that modulate circadian rhythm, including seasonal variations. There is evidence of a seasonal pattern of admissions of mania in various geographical settings, though its timing varies by region and climate. Variables such as age and gender have been shown to affect seasonality in some studies. Methodology: Data on monthly admission patterns for mania at a general hospital psychiatry unit in Pondicherry, India, were collected for 4 years (2010–2013) and analyzed for seasonality and seasonal peaks. The effects of age and gender were analyzed separately. Results: There was overall evidence of a seasonal pattern of admissions for mania (P < .01, Friedman test for seasonality), with a peak beginning during the rainy season and ending before summer (P < .0.1, Ratchet circular scan test). Male sex (P < .005, Ratchet circular scan test) and age > 25 years (P < .005, Ratchet circular scan test) were specifically associated with this seasonal peak. Discussion: The effect of seasons on mania is complex and is modulated by a variety of variables. Our study is consistent with earlier research findings: a greater degree of seasonality for mania in men. It is possible that climatic and individual variables interact to determine seasonal patterns in bipolar disorder in a given setting.

  11. Evaluation of Potential Drug - Drug Interactions in General Medicine Ward of Teaching Hospital in Southern India

    PubMed Central

    Ahmad, Akram; Khan, Muhammad Umair; Ivan, Rahul; Dasari, Ram; Revanker, Megha; Pravina, A.; Kuriakose, Sheetal

    2015-01-01

    Background: Polypharmacy is considered as one of the major risk factors in precipitation of drug-drug interactions (DDIs). Patient population at high risk include the elderly and patients with co morbidities as they are usually prescribed with more number of drugs. Critical evaluation of such prescriptions by pharmacist could result in identification and reduction of such problems. Objective: The study aims to assess the prevalence, severity and significance of potential DDI (pDDI) in general medicine wards of South Indian tertiary care teaching hospital. Materials and Method: A prospective observational study was conducted in a general medicine ward for a period of six months (September 2012 to February 2013). The socio-demographic, clinical characteristics and medication prescribed was documented in a specially designed form. Analysis was carried out to assess the prevalence, severity and significance of identified pDDIs using Micromedex. Descriptive and Univariate analysis were used to report the findings. Results: A total of 404 case records reviewed, 78 (19.3%) patients had pDDIs. A total of 139 (34.4%) pDDIs were reported during the study period. Majority (53.95%, n=75) of the interactions were moderate in intensity and significant in nature (53.23%, n=74). Positive association between number of pDDIs and age was observed. Conclusion: The prevalence of pDDIs was 19.3% which is lesser then previously reported studies from India. Patient with more co-morbidities and elders were observed with more pDDIs. The study highlighted the need to effectively monitor and patients prevent pDDIs to improve patient safety. PMID:25859467

  12. Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

    PubMed Central

    Foote, Eric M.; Singleton, Rosalyn J.; Holman, Robert C.; Seeman, Sara M.; Steiner, Claudia A.; Bartholomew, Michael; Hennessy, Thomas W.

    2015-01-01

    Background The lower respiratory tract infection (LRTI)-associated hospitalization rate in American Indian and Alaska Native (AI/AN) children aged <5 years declined during 1998–2008, yet remained 1.6 times higher than the general US child population in 2006–2008. Purpose Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. Methods A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009–2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998–1999 rates prior to pneumococcal conjugate vaccine introduction. Results The average annual LRTI-associated hospitalization rate declined from 1998–1999 to 2009–2011 in AI/AN (35%, p<0.01) and the general US child population (19%, SE: 4.5%, p<0.01). The 2009–2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6–14.8). The Alaska (38.9) and Southwest regions (27.3) had the highest rates. The disparity was greatest for infant (<1 year) pneumonia-associated and 2009–2010 H1N1 influenza-associated hospitalizations. Conclusions Although the LRTI-associated hospitalization rate declined, the 2009–2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children. PMID:26547082

  13. Improving e-discharge letters for Permanent pacemaker insertions at Wansbeck General Hospital

    PubMed Central

    Taylor, Christopher

    2013-01-01

    670 patients attend Wansbeck General Hospital each year for elective and emergency permanent pacemaker insertion or modification. Elective patients for new devices attend the cardiology department on the day of procedure and are clerked onto the cardiology ward after insertion. Patients are discharged home the following day with a letter typed by a junior doctor. Prior to October 2011, junior doctors were unaware of any guidelines regarding content of discharge letters due to poor accessibility. Vital information such as pacemaker model and indication for implantation were frequently absent from the typed summaries. In October 2011, the cardiology department reviewed the guidelines establishing the information required in all discharge summaries for pacemaker implantation and these guidelines were published on the ward in an easy to follow proforma for any junior doctor typing letters. Eight essential criteria should be included in each letter; date and indication for insertion, pacemaker type, make and model, access route, complications, chest x-ray and device check results, and follow-up details. Finally, a copy of the letter was to be sent to the cardiology department for clinic follow-up. Ten letters were audited prior to the proforma being issued. 0 letters contained 100% of the required information. Main criteria missing in most letters included indication for insertion (50%), make of device (0%), the route of access (10%) and cc to cardiology department (0%). 70 letters were audited in October 2012, one year following introduction of the discharge proforma.100% of letters contained all of the eight essential criteria required by the departmental guidelines. 53% of the letters were also received by the cardiology department. In conclusion, a set of easy to follow guidelines in the form of a published document on the cardiology ward has produced dramatic improvement in the quality of e-discharge letters for patients undergoing permanent pacemaker implantation.

  14. Improving the quality of the surgical preoperative assessment in a district general hospital

    PubMed Central

    Koris, Jacob; Hopkins, Catherine

    2015-01-01

    At Leicester General Hospital, England, patients are assessed by a team of junior doctors for elective colorectal and hepatobiliary procedures. After a number of same day cancellations, a large discrepancy was identified between the findings at the preoperative assessment clinic and the anaesthetic assessment on the day of surgery. After a multidisciplinary meeting was held, three interventions were decided on with an aim to bring the preoperative assessment in line with the anaesthetic assessment. Firstly, a set of guidelines was written and introduced for the junior doctors to use as a reference when assessing patients. Secondly, a proforma was designed specifically to prompt users to include essential details which were being missed in the assessment, having audited 100 patients' notes. Thirdly, a preoperative investigation “calculator” was recommended for each patient to simplify compliance with the National Institute for Health and Care Excellence (NICE) guidance for preoperative assessment. Before and after each intervention was introduced, a cohort of 50 patients were followed looking for differences in findings in the history, examination, investigations, and fitness for surgery between the preoperative assessment in clinic and the anaesthetic assessment on the day of surgery. Initially 68% of patients were compliant for details in the history, 76% for examination, 32% for choice of preoperative investigations, and 100% for fitness for surgery decision. After all three interventions had been introduced, 96% of patients were compliant for history, 94% for examination findings, 88% had the correct choice of preoperative investigations, and 100% had the same decision on fitness for surgery. The interventions described proved to be cheap and effective methods of improving the quality of the preoperative assessment, bringing it in line with the anaesthetic assessment and reducing the risk of same day cancellations.

  15. What is the current state of care for older people with dementia in general hospitals? A literature review.

    PubMed

    Dewing, Jan; Dijk, Saskia

    2016-01-01

    This paper summarises a literature review focusing on the literature directly pertaining to the acute care of older people with dementia in general hospitals from 2007 onwards. Following thematic analysis, one overarching theme emerged: the consequences of being in hospital with seven related subthemes. Significantly, this review highlights that overall there remains mostly negative consequences and outcomes for people with dementia when they go into general hospitals. Although not admitted to hospital directly due to dementia, there are usually negative effects on the dementia condition from hospitalisation. The review suggests this is primarily because there is a tension between prioritisation of acute care for existing co-morbidities and person-centred dementia care. This is complicated by insufficient understanding of what constitutes person-centred care in an acute care context and a lack of the requisite knowledge and skills set in health care practitioners. The review also reveals a worrying lack of evidence for the effectiveness of mental health liaison posts and dementia care specialist posts in nursing. Finally, although specialist posts such as liaison and clinical nurse specialists and specialist units/shared care wards can enhance quality of care and reduce adverse consequences of hospitalisation (they do not significantly) impact on reducing length of stay or the cost of care. PMID:24459188

  16. Impact of the 1998 Gobi dust event on hospital admissions in the Lower Fraser Valley, British Columbia.

    PubMed

    Bennett, C M; McKendry, I G; Kelly, S; Denike, K; Koch, T

    2006-08-01

    The adverse public health impacts of anthropogenically derived particulate matter have been well documented, with measurable increases in both morbidity and mortality rates associated with high particulate matter pollution events. Most current research has focussed on the health impacts of anthropogenically derived particulate matter, and there is a distinct scarcity of literature that examines the role of naturally derived particulate matter and adverse health impacts in the urban context. This study of a Gobi desert dust event in the Greater Vancouver region of British Columbia, Canada, in spring of 1998 provided a unique opportunity to identify the adverse health effects related to naturally derived particulate matter in a large urban setting. Respiratory and cardiac hospitalizations were examined for a three-year period (January 1997 to December 1999), with the Gobi dust event occurring in late April 1998. A meteorological analogue was identified for spring 1997 in order to identify the public health impacts associated with anthropogenically derived particulate matter and those impacts associated with the presence of the Gobi desert dust. Results indicate that this Gobi dust event was not associated with an excess of hospitalizations in the Greater Vancouver region. Peak particulate matter concentrations of Gobi desert dust in the airshed were only associated with an additional one or two hospitalizations per 100,000 population for respiratory and cardiac illnesses, and these increases were not distinguishable from the 'normal' variability in hospitalization rates. Despite high particulate matter concentrations, fine particle size, presence of heavy metals in the dust and extended exposure periods, it appears that the Gobi desert dust event was not associated with significant risk to public health in Greater Vancouver, British Columbia. Therefore it is concluded that naturally derived particulate matter is more benign than particulate matter of anthropogenic origin, and thus poses a low risk to health for the general public. PMID:16483637

  17. The prevalence of mental health problems among older adults admitted as an emergency to a general hospital

    PubMed Central

    Goldberg, Sarah E.; Whittamore, Kathy H.; Harwood, Rowan H.; Bradshaw, Lucy E.; Gladman, John R. F.; Jones, Rob G.

    2012-01-01

    Background: a high prevalence of co-morbid mental health problems is reported among older adults admitted to general hospitals. Setting: an 1,800 bed teaching hospital. Design: consecutive general medical and trauma orthopaedic admissions aged 70 or older were screened for mental health problems. Those screening positive were invited to undergo further assessment, and were interviewed to complete a battery of health status measurements. Results: of 1,004 patients screened, 36% had no mental health problems or had anxiety alone. Of those screening positive 250 took part in the full study. Adjusting for the two-stage sampling design, 50% of admitted patients over 70 were cognitively impaired, 27% had delirium and 8–32% were depressed. Six percent had hallucinations, 8% delusions, 21% apathy and 9% agitation/aggression (of at least moderate severity). Of those with mental health problems, 47% were incontinent, 49% needed help with feeding and 44% needed major help to transfer. Interpretation: we confirm the high prevalence of mental health problems among older adults admitted to general hospitals. These patients have high levels of functional dependency, psychological and behavioural problems which have implications for how they are cared for. Services that identify these problems and offer therapeutic intervention should be evaluated. PMID:21890483

  18. A strategy for enhancing financial performance: a study of general acute care hospitals in South Korea.

    PubMed

    Choi, Mankyu; Lee, Keon-Hyung

    2008-01-01

    In this study, the determinants of hospital profitability were evaluated using a sample of 142 hospitals that had undergone hospital standardization inspections by the South Korea Hospital Association over the 4-year period from 1998 to 2001. The measures of profitability used as dependent variables in this study were pretax return on assets, after-tax return on assets, basic earning power, pretax operating margin, and after-tax operating margin. Among those determinants, it was found that ownership type, teaching status, inventory turnover, and the average charge per adjusted inpatient day positively and statistically significantly affected all 5 of these profitability measures. However, the labor expenses per adjusted inpatient day and administrative expenses per adjusted inpatient day negatively and statistically significantly affected all 5 profitability measures. The debt ratio negatively and statistically significantly affected all 5 profitability measures, with the exception of basic earning power. None of the market factors assessed were shown to significantly affect profitability. In conclusion, the results of this study suggest that the profitability of hospitals can be improved despite deteriorating external environmental conditions by facilitating the formation of sound financial structures with optimal capital supplies, optimizing the management of total assets with special emphasis placed on inventory management, and introducing efficient control of fixed costs including labor and administrative expenses. PMID:19011410

  19. Development of a Likelihood of Survival Scoring System for Hospitalized Equine Neonates Using Generalized Boosted Regression Modeling

    PubMed Central

    Dembek, Katarzyna A.; Hurcombe, Samuel D.; Frazer, Michele L.; Morresey, Peter R.; Toribio, Ramiro E.

    2014-01-01

    Background Medical management of critically ill equine neonates (foals) can be expensive and labor intensive. Predicting the odds of foal survival using clinical information could facilitate the decision-making process for owners and clinicians. Numerous prognostic indicators and mathematical models to predict outcome in foals have been published; however, a validated scoring method to predict survival in sick foals has not been reported. The goal of this study was to develop and validate a scoring system that can be used by clinicians to predict likelihood of survival of equine neonates based on clinical data obtained on admission. Methods and Results Data from 339 hospitalized foals of less than four days of age admitted to three equine hospitals were included to develop the model. Thirty seven variables including historical information, physical examination and laboratory findings were analyzed by generalized boosted regression modeling (GBM) to determine which ones would be included in the survival score. Of these, six variables were retained in the final model. The weight for each variable was calculated using a generalized linear model and the probability of survival for each total score was determined. The highest (7) and the lowest (0) scores represented 97% and 3% probability of survival, respectively. Accuracy of this survival score was validated in a prospective study on data from 283 hospitalized foals from the same three hospitals. Sensitivity, specificity, positive and negative predictive values for the survival score in the prospective population were 96%, 71%, 91%, and 85%, respectively. Conclusions The survival score developed in our study was validated in a large number of foals with a wide range of diseases and can be easily implemented using data available in most equine hospitals. GBM was a useful tool to develop the survival score. Further evaluations of this scoring system in field conditions are needed. PMID:25295600

  20. Teledermatology via a social networking web site: a pilot study between a general hospital and a rural clinic.

    PubMed

    Garcia-Romero, Maria Teresa; Prado, Fernanda; Dominguez-Cherit, Judith; Hojyo-Tomomka, Maria Teresa; Arenas, Roberto

    2011-10-01

    Teledermatology via a free public social networking Web site is a practical tool to provide attention to patients who do not have access to dermatologic care. In this pilot study, a general practitioner sent consults to a dermatology department at a general hospital via Facebook(®). Forty-four patients were seen and treatment was installed. We identified both simple-to-treat, common skin diseases and rare congenital diseases that require genetic counseling and more complex treatment. The majority of patients (75%) benefited with the diagnoses and treatments offered, thus avoiding unnecessary expenses or transportation to urban areas. PMID:21790270

  1. Distributions and Types of Multidrug-Resistant Acinetobacter baumannii in Different Departments of a General Hospital

    PubMed Central

    Qian, Yaner; Dong, Xuejun; Wang, Zongxin; Yang, Guocan; Liu, Qi

    2015-01-01

    Background: Acinetobacter baumannii is the most prevalent strain in hospitals and different clinical departments. Objectives: The current study aimed to investigate the genetic characteristics and resistance mechanisms of A. baumannii isolated from clinical samples in Shaoxing people’s hospital affiliated to Zhejiang University, Shaoxing, China. Patients and Methods: Acinetobacter baumannii strains were isolated from blood, phlegm and skin of the patients hospitalized in different departments as respiratory medicine, plastic surgery and intensive care unit (ICU). Multilocus sequence typing (MLST) was used to characterize the isolates. Kirby-Bauer test was used to evaluate antibiotic resistance of the bacteria. The expression of resistance inducing genes was detected by reverse transcription polymerase chain reaction (RT-PCR). The results were analyzed and compared. Results: Two bacterial types, ST208, and ST218, were identified in all 140 samples. The ST208 mainly came from ICU and department of respiratory medicine, while ST218 from department of plastic surgery; 70.21% of ST208 and 84.78% of ST218 were carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-susceptible Acinetobacter baumannii (CSAB), respectively. Multidrug-resistance genes in CRAB isolated from the hospital mainly included, oxa-23, oxa-5, intl 1 and qace?1-sul 1. Besides, the highest and lowest antibiotic resistance was observed in the strains isolated from blood samples and wounds, respectively. Conclusions: The distribution of AB varies in different clinical departments and samples. In the hospital under study, the main types of AB were ST208 and ST218. The genes which affect the ability of antibiotic-resistance were oxa-23, oxa-51, intl 1 and qace?1-sul 1. PMID:26487921

  2. Report on injuries sustained by patients treated at the Birmingham General Hospital following the recent bomb explosions.

    PubMed Central

    Waterworth, T A; Carr, M J

    1975-01-01

    As a result of recent bomb explosions a total of 82 patients were treated at the Birmingham General Hospital, 61 with minor injuries. Bomb injuries may be divided into three main groups due to the blast effect (such as blast lung and ruptured tympanic membranes), the flash (such as burns to the exposed part of the body), and shrapnel (which may cause a wide variety of injuries). The amount of warning of such explosions is usually minimal, and so the prepared accident schemes of most hospitals are inappropriate. If the disaster occurs outside normal working hours much responsibility initially falls on the resident staff. This report gives some idea of the type of injuries they are likely to see. Images FIG. 1 FIG. 2 PMID:1169088

  3. Carers for older people with co-morbid cognitive impairment in general hospital: characteristics and psychological well-being

    PubMed Central

    Bradshaw, Lucy E; Goldberg, Sarah E; Schneider, Justine M; Harwood, Rowan H

    2013-01-01

    Objective This analysis sought to describe the characteristics and well-being of carers of older people with mental health problems admitted to a general hospital. Methods General medical and trauma orthopaedic patients aged 70 years or older admitted to an acute general teaching hospital were screened for mental health problems. Those screened positive, together with a carer, were invited to undergo further assessment with a battery of health status measurements. Carers were interviewed to ascertain strain (caregiver strain index (CSI)), psychological distress (12-item General Health Questionnaire) and quality of life (EQ-5D). Results We recruited 250 patients to the study, of whom 180 were cognitively impaired and had carers willing to take part. After 6 months, 57 patients (32%) had died, and we followed up 100 carers. Carers' own health, in terms of mobility, usual activities, and anxiety, was poor in a third of cases. At the time of admission, high carer strain was common (42% with CSI ? 7), particularly among co-resident carers (55%). High levels of behavioural and psychiatric symptoms at baseline were associated with more carer strain and distress. At follow-up, carer strain and distress had reduced only slightly, with no difference in outcomes for carers of patients who moved from the community to a care home. Conclusion Hospital staff should be alert to sources of carer strain and offer carers practical advice and emotional support. Interventions are required to prevent and manage behavioural and psychiatric symptoms at the time of acute physical illness or to alleviate their effects on carers. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22887452

  4. The comparison of general health status between hemodialysis and kidney transplant patients in university hospitals of Ahvaz, Iran

    PubMed Central

    Boostani, Hatam; Ghorbani, Ali; heydarazadzadeh, Maryam

    2014-01-01

    Introduction: Patients undergoing chronic hemodialysis and kidney transplant patients will be afflicted with various mental and physical problems, which may affect their general health. Previous studies have shown that, general health level in these patients is lower than general population. However, definitive studies comparing the general health between the two groups of patients undergoing hemodialysis and kidney transplant recipients have not been done, yet. Objectives: In this study, we aimed to compare the general health between the two groups of chronic hemodialysis patients and kidney transplant recipients. Methods and Patients: This investigation was a cross-sectional descriptive-analytic study that has been conducted on 31 hemodialysis and 33 kidney transplant patients in two university hospitals of Ahvaz, Iran. Data were collected through a general health questionnaire (GHQ-28) and they were analyzed with SPSS software. Results: The mean score of general health was 28.8 and 27.57 in hemodialysis and kidney transplant patients, respectively. There was no statistically significant difference between the two groups, (p =0.7). Also, anxiety, serious depression, physical symptoms and social function were not significantly different between the two groups (p>0.5). Conclusion: In this study, no difference of general health level between hemodialysis and kidney transplantation was observed. PMID:25340160

  5. Development of Mobile Electronic Health Records Application in a Secondary General Hospital in Korea

    PubMed Central

    Park, Min Ah; Hong, Eunseok; Kim, Sunhyu; Ahn, Ryeok; Hong, Jungseok; Song, Seungyeol; Kim, Tak; Kim, Jeongkeun; Yeo, Seongwoon

    2013-01-01

    Objectives The recent evolution of mobile devices has opened new possibilities of providing strongly integrated mobile services in healthcare. The objective of this paper is to describe the decision driver, development, and implementation of an integrated mobile Electronic Health Record (EHR) application at Ulsan University Hospital. This application helps healthcare providers view patients' medical records and information without a stationary computer workstation. Methods We developed an integrated mobile application prototype that aimed to improve the mobility and usability of healthcare providers during their daily medical activities. The Android and iOS platform was used to create the mobile EHR application. The first working version was completed in 5 months and required 1,080 development hours. Results The mobile EHR application provides patient vital signs, patient data, text communication, and integrated EHR. The application allows our healthcare providers to know the status of patients within and outside the hospital environment. The application provides a consistent user environment on several compatible Android and iOS devices. A group of 10 beta testers has consistently used and maintained our copy of the application, suggesting user acceptance. Conclusions We are developing the integrated mobile EHR application with the goals of implementing an environment that is user-friendly, implementing a patient-centered system, and increasing the hospital's competitiveness. PMID:24523996

  6. Clinico-Pathological Discrepancies in a General University Hospital in São Paulo, Brazil

    PubMed Central

    Kotovicz, Fabiana; Mauad, Thais; Saldiva, Paulo H. N.

    2008-01-01

    INTRODUCTION The autopsy rate has continuously diminished over the past few decades, reducing the quality of medical care and the accuracy of statistical health data. OBJECTIVE To assess the accuracy of clinical diagnoses by comparing pre- and postmortem findings, and to identify potential risk factors for misdiagnoses. METHODS Retrospective evaluations performed between June 2001 and June 2003 in a 2500-bed tertiary university hospital in São Paulo, Brazil, including 288 patients who died at that institution and had a postmortem examination. RESULTS Clinical and autopsy records were reviewed and compared for categorization using the adapted Goldman criteria. The overall major and minor discrepancy rates were 16.3% and 28.1%, respectively. The most common missed diagnoses were pulmonary embolism, pneumonia, and myocardial infarction, and the most prevalent underlying diseases were infectious diseases, cerebro-cardiovascular conditions, and malignancies. Patients age 60 or older had an increased risk of diagnostic disagreement, as did female patients. The period of hospitalization, last admission unit at the hospital and underlying disease were not significantly related to the pre-mortem diagnostic accuracy. DISCUSSION The discrepancy rate found in this study is similar to those reported globally. The factors influencing diagnostic accuracy as well as the most commonly missed diagnoses are also consistent with the literature. CONCLUSION Autopsy remains a crucial tool for improving medical care, and effort must be focused on increasing its practice worldwide. PMID:18925315

  7. Socio Economic Status and Traumatic Brain Injury amongst Pediatric Populations: A Spatial Analysis in Greater Vancouver

    PubMed Central

    Amram, Ofer; Schuurman, Nadine; Pike, Ian; Yanchar, Natalie L; Friger, Michael; McBeth, Paul B.; Griesdale, Donald

    2015-01-01

    Introduction: Within Canada, injuries are the leading cause of death amongst children fourteen years of age and younger, and also one of the leading causes of morbidity. Low Socio Economic Status (SES) seems to be a strong indicator of a higher prevalence of injuries. This study aims to identify hotspots for pediatric Traumatic Brain Injury (TBI) and examines the relationship between SES and pediatric TBI rates in greater Vancouver, British Columbia (BC), Canada. Methods: Pediatric TBI data from the BC Trauma Registry (BCTR) was used to identify all pediatric TBI patients admitted to BC hospitals between the years 2000 and 2013. Spatial analysis was used to identify hotspots for pediatric TBI. Multivariate analysis was used to distinguish census variables that were correlated with rates of injury. Results: Six hundred and fifty three severe pediatric TBI injuries occurred within the BC Lower Mainland between 2000 and 2013. High rates of injury were concentrated in the East, while low rate clusters were most common in the West of the region (more affluent neighborhoods). A low level of education was the main predictor of a high rate of injury (OR = 1.13, 95% CI = 1.03–1.23, p-Value 0.009). Conclusion: While there was a clear relationship between different SES indicators and pediatric TBI rates in greater Vancouver, income-based SES indicators did not serve as good predictors within this region. PMID:26670241

  8. Physical symptoms in outpatients with psychiatric disorders consulting the general internal medicine division at a Japanese university hospital

    PubMed Central

    Ishikawa, Yukiko; Takeshima, Taro; Mise, Junichi; Ishikawa, Shizukiyo; Matsumura, Masami

    2015-01-01

    Purpose General practitioners have an important role in diagnosing a variety of patients, including psychiatric patients with complicated symptoms. We evaluated the relationship between physical symptoms and psychiatric disorders in general internal medicine (GIM) outpatients in a Japanese university hospital. Materials and methods We coded the symptoms and diagnoses of outpatients from medical documents using the International Classification of Primary Care, second edition (ICPC-2). The participants were new outpatients who consulted the GIM outpatient division at Jichi Medical University Hospital in Tochigi, Japan from January–June, 2012. We reviewed all medical documents and noted symptoms and diagnoses. These were coded using ICPC-2. Results A total of 1,194 participants were evaluated, 148 (12.4%) of whom were diagnosed as having psychiatric disorders. The prevalence of depression, anxiety disorder, and somatization was 19.6% (number [n] =29), 14.9% (n=22), and 14.2% (n=21), respectively, among the participants with psychiatric disorders. The presence of several particular symptoms was associated with having a psychiatric disorder as compared with the absence of these symptoms after adjusting for sex, age, and the presence of multiple symptoms (odds ratio [OR] =4.98 [95% confidence interval {CI}: 1.66–14.89] for palpitation; OR =4.36 [95% CI: 2.05–9.39] for dyspnea; OR =3.46 [95% CI: 1.43–8.36] for tiredness; and OR =2.99 [95% CI: 1.75–5.13] for headache). Conclusion Not only the psychiatric symptoms, but also some physical symptoms, were associated with psychiatric disorders in GIM outpatients at our university hospital. These results may be of help to general practitioners in appropriately approaching and managing patients with psychiatric disorders. PMID:26316801

  9. Use of bacteriology in anorectal sepsis as an indicator of anal fistula: experience in a distinct general hospital.

    PubMed Central

    Nicholls, G; Heaton, N D; Lewis, A M

    1990-01-01

    The bacteriology of anorectal sepsis in a district general hospital has been reviewed to see whether the information gained helped patient management. Forty-six patients with anorectal sepsis were reviewed, underlying fistulas were identified in nine patients (19.5%). Bacteroides species were not routinely subtyped in the department. It was found that isolation of unspecified Bacteroides species was not helpful in identifying those patients with underlying fistulas. Unless subtyping of Bacteroides species is specifically requested, pus from anorectal sepsis should not routinely be sent for bacteriology. PMID:2286960

  10. Pain, agitation, and behavioural problems in people with dementia admitted to general hospital wards: a longitudinal cohort study

    PubMed Central

    Sampson, Elizabeth L.; White, Nicola; Lord, Kathryn; Leurent, Baptiste; Vickerstaff, Victoria; Scott, Sharon; Jones, Louise

    2015-01-01

    Abstract Pain is underdetected and undertreated in people with dementia. We aimed to investigate the prevalence of pain in people with dementia admitted to general hospitals and explore the association between pain and behavioural and psychiatric symptoms of dementia (BPSD). We conducted a longitudinal cohort study of 230 people, aged above 70, with dementia and unplanned medical admissions to 2 UK hospitals. Participants were assessed at baseline and every 4 days for self-reported pain (yes/no question and FACES scale) and observed pain (Pain Assessment in Advanced Dementia scale [PAINAD]) at movement and at rest, for agitation (Cohen–Mansfield Agitating Inventory [CMAI]) and BPSD (Behavioural Pathology in Alzheimer Disease Scale [BEHAVE-AD]). On admission, 27% of participants self-reported pain rising to 39% on at least 1 occasion during admission. Half of them were able to complete the FACES scale, this proportion decreasing with more severe dementia. Using the PAINAD, 19% had pain at rest and 57% had pain on movement on at least 1 occasion (in 16%, this was persistent throughout the admission). In controlled analyses, pain was not associated with CMAI scores but was strongly associated with total BEHAVE-AD scores, both when pain was assessed on movement (? = 0.20, 95% confidence interval [CI] = 0.07-0.32, P = 0.002) and at rest (? = 0.41, 95% CI = 0.14-0.69, P = 0.003). The association was the strongest for aggression and anxiety. Pain was common in people with dementia admitted to the acute hospital and associated with BPSD. Improved pain management may reduce distressing behaviours and improve the quality of hospital care for people with dementia. PMID:25790457

  11. Directions to the WSU Vancouver campus: 14204 NE Salmon Creek Avenue

    E-print Network

    Directions to the WSU Vancouver campus: Address 14204 NE Salmon Creek Avenue Vancouver, Washington) and follow 134th Street as it turns into Salmon Creek Avenue. Follow the WSU Vancouver signs to the entrance Street exit. Turn left (east) onto 134th Street and follow as it turns into Salmon Creek Avenue. Follow

  12. The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain.

    PubMed

    Katz, Joel; Weinrib, Aliza; Fashler, Samantha R; Katznelzon, Rita; Shah, Bansi R; Ladak, Salima Sj; Jiang, Jiao; Li, Qing; McMillan, Kayla; Mina, Daniel Santa; Wentlandt, Kirsten; McRae, Karen; Tamir, Diana; Lyn, Sheldon; de Perrot, Marc; Rao, Vivek; Grant, David; Roche-Nagle, Graham; Cleary, Sean P; Hofer, Stefan Op; Gilbert, Ralph; Wijeysundera, Duminda; Ritvo, Paul; Janmohamed, Tahir; O'Leary, Gerald; Clarke, Hance

    2015-01-01

    Chronic postsurgical pain (CPSP), an often unanticipated result of necessary and even life-saving procedures, develops in 5-10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS) at Toronto General Hospital (TGH) is the first to comprehensively address the problem of CPSP at three stages: 1) preoperatively, 2) postoperatively in hospital, and 3) postoperatively in an outpatient setting for up to 6 months after surgery. Patients at high risk for CPSP are identified early and offered coordinated and comprehensive care by the multidisciplinary team consisting of pain physicians, advanced practice nurses, psychologists, and physiotherapists. Access to expert intervention through the Transitional Pain Service bypasses typically long wait times for surgical patients to be referred and seen in chronic pain clinics. This affords the opportunity to impact patients' pain trajectories, preventing the transition from acute to chronic pain, and reducing suffering, disability, and health care costs. In this report, we describe the workings of the Transitional Pain Service at Toronto General Hospital, including the clinical algorithm used to identify patients, and clinical services offered to patients as they transition through the stages of surgical recovery. We describe the role of the psychological treatment, which draws on innovations in Acceptance and Commitment Therapy that allow for brief and effective behavioral interventions to be applied transdiagnostically and preventatively. Finally, we describe our vision for future growth. PMID:26508886

  13. The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain

    PubMed Central

    Katz, Joel; Weinrib, Aliza; Fashler, Samantha R; Katznelzon, Rita; Shah, Bansi R; Ladak, Salima SJ; Jiang, Jiao; Li, Qing; McMillan, Kayla; Mina, Daniel Santa; Wentlandt, Kirsten; McRae, Karen; Tamir, Diana; Lyn, Sheldon; de Perrot, Marc; Rao, Vivek; Grant, David; Roche-Nagle, Graham; Cleary, Sean P; Hofer, Stefan OP; Gilbert, Ralph; Wijeysundera, Duminda; Ritvo, Paul; Janmohamed, Tahir; O’Leary, Gerald; Clarke, Hance

    2015-01-01

    Chronic postsurgical pain (CPSP), an often unanticipated result of necessary and even life-saving procedures, develops in 5–10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS) at Toronto General Hospital (TGH) is the first to comprehensively address the problem of CPSP at three stages: 1) preoperatively, 2) postoperatively in hospital, and 3) postoperatively in an outpatient setting for up to 6 months after surgery. Patients at high risk for CPSP are identified early and offered coordinated and comprehensive care by the multidisciplinary team consisting of pain physicians, advanced practice nurses, psychologists, and physiotherapists. Access to expert intervention through the Transitional Pain Service bypasses typically long wait times for surgical patients to be referred and seen in chronic pain clinics. This affords the opportunity to impact patients’ pain trajectories, preventing the transition from acute to chronic pain, and reducing suffering, disability, and health care costs. In this report, we describe the workings of the Transitional Pain Service at Toronto General Hospital, including the clinical algorithm used to identify patients, and clinical services offered to patients as they transition through the stages of surgical recovery. We describe the role of the psychological treatment, which draws on innovations in Acceptance and Commitment Therapy that allow for brief and effective behavioral interventions to be applied transdiagnostically and preventatively. Finally, we describe our vision for future growth. PMID:26508886

  14. Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

    PubMed

    Lääperi, A L

    1996-01-01

    The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and nonmonetary variables was developed. In it the radiologist, radiographer and examination-specific equipment costs were allocated to the examinations applying estimated cost equivalents. Some minor cost items were replaced by a general cost factor (GCF). The program is suitable for internal cost accounting of radiological departments as well as regional planning. If more accurate cost information is required, cost assignment employing the actual consumption of the resources and applying the principles of activity-based cost accounting is recommended. As an application of the cost accounting formula the average costs of the radiological examinations were calculated. In conventional radiography the average proportion of the cost factors in the total material was: personnel costs 43%, equipment costs 26%, material costs 7%, real estate costs 11%, administration and overheads 14%. The average total costs including radiologist costs in the hospitals were (FIM): conventional roentgen examinations 188, contrast medium examinations 695, ultrasound 296, mammography 315, roentgen examinations with mobile equipment 1578. The average total costs without radiologist costs in the public health centres were (FIM): conventional roentgen examinations 107, contrast medium examinations 988, ultrasound 203, mammography 557. The average currency rate of exchange in 1991 was USD 1 = FIM 4.046. The following formula is proposed for calculating the cost of a radiological examination (or a group of examinations) performed with a certain piece of equipment during a period of time (e.g. 1 year): a2/ sigma ax*ax+ b2/ sigma bx*bx+ d1/d5*dx+ e1 + [(c1+ c2) + d4 + (e2 - e3) + f5 + g1+ g2+ i]/n. PMID:8804226

  15. Chronic obstructive pulmonary disease hospital admissions and drugs—unexpected positive associations: a retrospective general practice cohort study

    PubMed Central

    Harries, Timothy H; Seed, Paul T; Jones, Simon; Schofield, Peter; White, Patrick

    2014-01-01

    Background: Increased prescribing of inhaled long-acting anti-muscarinic (LAMA) and combined inhaled long-acting ?2-agonist and corticosteroid (LABA+ICS) drugs for the treatment of chronic obstructive pulmonary disease (COPD) has led to hopes of reduced hospital admissions from this disease. Aims: To investigate the impact of rising primary care prescribing of LAMA and LABA+ICS drugs on COPD admissions. Methods: This retrospective cohort study of general practice COPD admission and prescribing data between 2007 and 2010 comprised a representative group of 806 English general practices (population 5,264,506). Outcome measures were practice rates of COPD patient admissions and prescription costs of LAMA and LABA+ICS. General practice characteristics were based on the UK quality and outcomes framework. Results: Rates of COPD admissions remained stable from 2001 to 2010. Practice-prescribing volumes of LAMA per practice patient and LABA+ICS per practice patient increased by 61 and 26%, respectively, between 2007 and 2010. Correlation between costs of LAMA and those of LABA+ICS increased year on year, and was the highest in 2010 (Pearson’s r=0.68; 95% confidence interval (CI), 0.64–0.72). Practice COPD admission rates were positively predicted by practice-prescribing volumes of LAMA (2010: B=1.23, 95% CI, 0.61–1.85) and of LABA+ICS (2010: B=0.32, 95% CI, 0.12–0.52) when controlling for practice list size, COPD prevalence and deprivation. Conclusion: The increase in the prescribing of LAMA and LABA+ICS inhalers was not associated with the predicted fall in hospital admission rates for COPD patients. The positive correlation between high practice COPD prescribing and high practice COPD admissions was not explained. PMID:24842126

  16. Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital.

    PubMed

    Fraser, Traci N; Blumenthal, Daniel M; Bernard, Kenneth; Iyasere, Christiana

    2015-07-01

    Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included "leading a team" (98% of residents), "confronting problem employees" (93%), "coaching and developing others" (93%), and "resolving interpersonal conflict" (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees. PMID:26130876

  17. Experience of shoulder dystocia in a district general hospital: what have we learnt?

    PubMed

    Soleymani Majd, H; Ismail, L; Iqbal, R

    2008-05-01

    Shoulder dystocia is an obstetric emergency that currently affects 0.6% of all deliveries in the UK. This potentially serious obstetric emergency requires early recognition and prompt involvement of appropriately trained personnel to deliver the baby safely and without delay. Failure to do so may result in significant neonatal and maternal morbidity, with ensuing litigation. As part of clinical governance, hospital trusts are under pressure to continually improve the quality of service provided to their patients. Meticulous and accurate documentation is the crucial first step. The second step is preparedness and practice. Although we are still not very good at being able to prevent or predict shoulder dystocia, when it occurs, we must be ready and able to deal with it effectively. This can best be accomplished through re-education and re-training of obstetric staff and the updating of Trust management protocols. By promptly acting in accordance with established evidence-based guidelines, we will improve our ability to carefully and competently manage deliveries complicated by shoulder dystocia. However, failing to do so will inevitably have dire repercussions for all. PMID:18604669

  18. Assessment of leadership training needs of internal medicine residents at the Massachusetts General Hospital

    PubMed Central

    Blumenthal, Daniel M.; Bernard, Kenneth; Iyasere, Christiana

    2015-01-01

    Internal medicine (IM) physicians, including residents, assume both formal and informal leadership roles that significantly impact clinical and organizational outcomes. However, most internists lack formal leadership training. In 2013 and 2014, we surveyed all rising second-year IM residents at a large northeastern academic medical center about their need for, and preferences regarding, leadership training. Fifty-five of 113 residents (49%) completed the survey. Forty-four residents (80% of respondents) reported a need for additional formal leadership training. A self-reported need for leadership training was not associated with respondents' gender or previous leadership training and experience. Commonly cited leadership skill needs included “leading a team” (98% of residents), “confronting problem employees” (93%), “coaching and developing others” (93%), and “resolving interpersonal conflict” (84%). Respondents preferred to learn about leadership using multiple teaching modalities. Fifty residents (91%) preferred to have a physician teach them about leadership, while 19 (35%) wanted instruction from a hospital manager. IM residents may not receive adequate leadership development education during pregraduate and postgraduate training. IM residents may be more likely to benefit from leadership training interventions that are physician-led, multimodal, and occur during the second year of residency. These findings can help inform the design of effective leadership development programs for physician trainees. PMID:26130876

  19. Vitamins A and E Deficiencies among Pregnant Women Attending Antenatal Care at General Hospital Dawakin Kudu, North-West Nigeria

    PubMed Central

    Ugwa, Emmanuel Ajuluchukwu

    2015-01-01

    Background: Vitamins A and E deficiency is prevalent in developing countries, and plasma levels are low in pregnancy. This study was undertaken to determine the serum Vitamins A and E status among pregnant women attending antenatal care at a General Hospital in Dawakin Kudu, Kano and to provide the necessary information needed to suggest the supplementation of Vitamins A and E during pregnancy. Methods: The study was done in General Hospital Dawakin Kudu Local Government Area. Dawakin Kudu, a rural community in Kano State is about 12 km from Kano metropolis which is the most populous city in Nigeria and commercial nerve center of Northern Nigeria. Most of the women are housewives, however, some engage in subsistent farming and petty trading. This was a prospective study of 200 pregnant women at various maternal ages, gestational ages, and parities. Informed consent was obtained from the participants. Research structured questionnaire was administered to 200 respondents which showed age and parity distributions. Determination of Serum Vitamins A and E was done using methods of Bessey, et al. and Tsen. Ethical approval for the research was obtained from General Hospital, Dawakin Kudu, Kano. Statistical Analysis Used: Data obtained were analyzed using SPSS version 17 statistical software (SPSS Inc., IL, Chicago, USA). Descriptive statistics was done. Mean serum Vitamins A and E concentration between trimesters were compared using two-way ANOVA and P < 0.05 was considered statistically significant. Results: Majority of the women were aged 20–39 years with mean of 23.67 ± 6.11. Most were in the 1–4 parity range. Mean birth weight was 2.42 ± 0.74 kg. Above 65% were deficient while 34.5% had normal levels of Vitamin A and 51% were deficient of serum Vitamin E. Serum Vitamins A and E levels showed a marked reduction from first through third trimester. The differences were statistically significant (P < 0.05). Conclusions: There is a significant reduction in the serum Vitamins A and E concentration throughout the period of pregnancy with the highest levels in the first trimester. Therefore, further studies should evaluate the value of Vitamins A and E supplementation during pregnancy especially for those whose fruit and vegetable consumption is inadequate. PMID:26288709

  20. 78 FR 28733 - Medical Devices; General Hospital and Personal Use Monitoring Devices; Classification of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ...-moderate risk'' or that general controls would be inadequate to control the risks and special controls to mitigate the risks cannot be developed. In response to a request to classify a device under either... risks to health associated with this type of ] device and the measures required to mitigate these...

  1. Improving the management of acute pancreatitis in a district general hospital

    PubMed Central

    Crowther, Nicola; Kahvo, Mia; Chana, Prem

    2015-01-01

    Acute pancreatitis is a common problem seen in the United Kingdom, with an incidence of 56.6 per 100,000 population.[1,2,3] Optimising management has been shown to reduce mortality and morbidity, and the British Society of Gastroenterology (BSG) published revised guidelines in 2005 to standardise treatment for this potentially life threatening condition.[4] The aim of this quality improvement project was to investigate and improve the initial management of acute pancreatitis in patients presenting to the Great Western Hospital (GWH) in Swindon between November 2012 and July 2013. Patients presenting to the surgical team during this time with a diagnosis of acute pancreatitis were identified for the initial data collection. Notes were prospectively reviewed and data collected allowing a comparison between management in GWH against BSG guidelines. Following this stage, a pro forma based on the 2005 guidelines was created and implemented, with the aim of raising awareness and standardising care among surgical staff. Following implementation of the pro forma, data collection was repeated between May and June 2013 to assess the impact of the intervention. Results revealed an improvement from 93% to 100% of patients receiving the correct diagnosis within 24 hours of presentation. Severity stratification within 48 hours of diagnosis improved from 75% to 88% and identification of aetiology also improved from 64% to 74%. The implementation of an acute pancreatitis management protocol and education of junior surgical staff has been shown to improve compliance with BSG guidelines at the GWH, and ultimately aims to improves patient care and outcomes.

  2. Evaluation of collaborative TB/HIV activities in a general hospital in Addis Ababa, Ethiopia

    PubMed Central

    2012-01-01

    Background Ethiopia has had mechanisms for TB/HIV collaborative activities since 2002. However, no published account has defined the role of these collaborative efforts in strengthening linkages between HIV and TB management units at the point-of-care level. Our objective was to assess the extent of linkages between the two programs at the patient management level at Zewditu Memorial Hospital in Addis Ababa, Ethiopia. Between January and December 2008, the registers of 241 TB patients were reviewed to determine the HIV testing rate, the treatment charts of 238 randomly selected patients were reviewed for providers' compliance with evaluation criteria, and exit interviews were conducted with 309 TB/HIV co-infected clients to validate providers' compliance. Results From register review, it was determined that the HIV testing acceptance rate was 95%, and that 70% of patients received post-test counseling. A review of the patient chart revealed that of 51 patients with a complaint of cough, duration for cough was recorded in 35 (68.6%) cases and cough > 2 weeks was recorded in 25 (49.0%) cases. Seventy two percent (18 of 25) were linked for sputum microscopy. Linkage to cotrimoxazole prophylactic treatment was 81%, but only 47% of eligible patients were linked to isoniazid preventive therapy (IPT). Correct diagnosis was accomplished at a rate of 100% for smear positive pulmonary TB, 23% for smear negative pulmonary TB and 88% for extra pulmonary TB patients. Both chart review and exit interviews indicated that history of TB contact and cough > 2 weeks predicted TB disease. Conclusion The rates of HIV testing and linkage to cotrimoxazole prophylactic therapy were high. Improvement is needed in the areas of recording patient information, screening HIV positives for TB, initiation of IPT, referral, linkages, and TB diagnostic capacity. PMID:22277087

  3. Intravenous midazolam sedation in pediatric diagnostic upper digestive endoscopy. A prospective study in a general hospital.

    PubMed

    Verhage, Jan; Mulder, Chris J J; Willekens, Frans L A

    2003-12-01

    The positive role of benzodiazepines (Midazolam) in conscious sedation in pediatric patients is widely known. However, problems concerning the role of sedation in diagnostic upper endoscopy are a matter for debate as little is known about dosage and timing. We prospectively evaluated the efficacy, safety and optimal intravenous sedation dosage of midazolam in 257 consecutive patients, aged 2 months to 18 years old, who underwent upper endoscopy of the gastrointestinal tract. The initial midazolam dosage was 0.2 mg/kg Bw (Body weight) i.v. for 1 minute and, if necessary, another 0.1 mg/kg Bw was administered 5 minutes later. If sedation was sufficient, the procedure would be started 4-5 minutes later; if not, another 0.1 - 0.2 mg/kg Bw would be administered. All procedures were performed by a pediatrician together with a gastroenterologist. No serious complications occurred in any of the procedures. Oxygen saturation (OS) was maintained at over 90%, if necessary with blowby oxygen. Flumazenil was administered to 7 children (OS < 90%). Endoscopy could not be completed in 1 child. All endoscopies were completed within 10 minutes. No unexpected hospital admissions were necessary. The mean midazolam dosage was 0.4 mg/kg Bw in patients up to 6 years, for the over 6 years-olds the mean dosage was decreased to 0,2 mg/kg Bw. Particular attention was paid to the importance of informing patients before the procedure. Endoscopic diagnostic procedures can be performed safely and effectively in children with intravenous sedation in a well equipped pediatric endoscopy unit. PMID:14726970

  4. World Conference on Earthquake Engineering Vancouver, B.C., Canada

    E-print Network

    Hamann, Bernd

    . Brown, Jr., Network for Earthquake Engineering Simulation. This four-year upgrade project represents13th World Conference on Earthquake Engineering Vancouver, B.C., Canada August 1-6, 2004 Paper No-hydraulic shaking table. This equipment has been used in geotechnical earthquake engineering research since 1994

  5. World Conference on Earthquake Engineering Vancouver, B.C., Canada

    E-print Network

    Stanford University

    13 th World Conference on Earthquake Engineering Vancouver, B.C., Canada August 1-6, 2004 Paper No. 1129 A MODULAR FRAMEWORK FOR EARTHQUAKE ENGINEERING ANALYSIS AND SIMULATIONS Jun PENG1 , Frank MCKENNA2 of finite element analysis (FEA) programs. The framework allows users easy access to the FEA program

  6. The Impact of "Sesame Street" on Primary Pupils in Vancouver.

    ERIC Educational Resources Information Center

    Ellis, E. N.; And Others

    The extent to which pupils at the primary level view Sesame Street and The Electric Company television programs and their impact on learning were studied. Questionnaires were directed to parents of children in eight kindergartens and to principals of the 34 elementary schools in Vancouver. At their homes, 95% of the kindergarten pupils had watched…

  7. 77 FR 66714 - Drawbridge Operation Regulation; Columbia River, Vancouver, WA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ... From the Federal Register Online via the Government Printing Office DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 117 Drawbridge Operation Regulation; Columbia River, Vancouver, WA AGENCY... current deviation states the lift span of the Murray Morgan Bridge across Thea Foss Waterway, mile...

  8. Mini Schools: The New "Global City Communities" of Vancouver

    ERIC Educational Resources Information Center

    Yoon, Ee-Seul

    2011-01-01

    In recent decades, under the mutually constitutive processes of neoliberal urbanization and globalization, Vancouver has radically transformed and become a serious contender for the title of "world-class city". Against the background of this socio-spatial force reconfiguring the city, I explore how the city's unique development of "mini…

  9. PLANNING FOR WATER CONSERVATION Greater Vancouver Regional District

    E-print Network

    . #12;ii APPROVAL #12;iii ABSTRACT Instances of water scarcity are recurring with greater frequencyPLANNING FOR WATER CONSERVATION Greater Vancouver Regional District by Andrew K. Doi B. A in urban areas around the globe, yet per capita water consumption continues to increase. Faced

  10. Mortality in a large community-based cohort of inner-city residents in Vancouver, Canada

    PubMed Central

    Raffa, Jesse D.; Lai, Calvin; Fischer, Benedikt; Krajden, Mel; Amin, Janaki; Walter, Scott R.; Dore, Gregory J.; Grebely, Jason; Tyndall, Mark W.

    2013-01-01

    Background The Downtown Eastside is a robust and densely populated neighbourhood in Vancouver, Canada, that is characterized by low-income housing and drug use and a high prevalence of HIV infection. We evaluated mortality and excess mortality among the broader community of individuals living in this neighbourhood. Methods The Community Health and Safety Evaluation is a community-based study of inner-city residents in the Downtown Eastside who were recruited in 2003 and 2004. Participants’ data were linked with data in provincial virology and mortality databases retrospectively and prospectively for the period 1991–2009. Mortality and standardized mortality ratios (SMRs) were calculated for the period 2003–2009 to compare death rates in the study population with rates in the population of Vancouver. Results Among 2913 participants, 374 deaths occurred, for an all-cause mortality of 223 per 10 000 person-years (95% confidence interval [CI] 201–247 per 10 000 person-years). Compared with the population of Vancouver, significant excess mortality was observed in the study population (SMR 7.1, 95% CI 6.4–7.9). Excess mortality was higher among women (SMR 15.4, 95% CI 12.8–18.5) than among men (SMR 5.8, 95% CI 5.1–6.6). Although crude mortality increased with age, excess mortality was greatest among participants less than 35 years old (SMR 13.2, 95% CI 9.4–18.5) and those 35–39 years old (SMR 13.3, 95% CI 10.3–17.1). Excess risk was also elevated among participants with hepatitis C virus (HCV), HIV and HCV/HIV infection, with SMRs of 5.9 (95% CI 4.9–7.1), 19.2 (95% CI 12.8–28.9) and 23.0 (95% CI 19.3–27.4), respectively. Interpretation Our study showed high mortality in this inner-city population, particularly when compared with the general population of Vancouver. Excess mortality was highest among women, younger participants and those infected with either HCV or HIV or both. PMID:25077106

  11. Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca

    PubMed Central

    Badre, Bouchra; Serhier, Zineb; El Arabi, Samira

    2014-01-01

    Introduction Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. Aim: To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco. Methods A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date. Results 127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5. Conclusion Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population. PMID:25328594

  12. Are patients with newly diagnosed breast cancer getting appropriate DEXA scans? A District General Hospital experience

    PubMed Central

    Dong, Huan; Dayananda, Pete; Preece, Shay-Anne; Carmichael, Amtul

    2015-01-01

    Breast cancer patients are often at high risk of fragility fractures partly due to adjuvant endocrine therapy such as aromatase inhibitors and chemotherapy. Baseline dual energy X-ray absorptiometry (DEXA) scanning is recommended as a standard of care in identifying patients who are at risk so they can be commenced on bone protective therapy. NICE guideline 80 – “Early and locally advanced breast cancer”[1] states that patients with early invasive breast cancer should have a baseline DEXA scan to assess BMD before the commencement of aromatase inhibitor treatment; if patients have treatment-induced menopause or are starting ovarian ablation/suppression therapy. We have audited the performance of a DGH against these guidelines with a target of 100% concordance. During a one year period (April 2012-April 2013), 100 patients with a new diagnosis of breast cancer were selected at random from the hospital coding database. 100 patients were chosen as this was a convenient sample size. We gathered information for these patients using electronic records, letters, and imaging. This showed a poor compliance of 38% against NICE guidelines. This in turn means that patients with low BMD at diagnosis of breast cancer are being under diagnosed and under treated, resulting in increased potential morbidity associated with fragility fractures. The interventions that resulted from this audit were: dissemination of these results to surgical and oncology departments, posters summarising the guidelines put up in breast clinics, and breast MDTs to discuss the need for DEXA scans for patients with breast cancer. A re-audit was performed for patients diagnosed with early, invasive breast cancer in January 2014 where a compliance of 90% was achieved. This represents a huge improvement in compliance from the baseline measure of 38%. In order to show that this improvement could be sustained, two further cycles were performed in February and March 2014, where the compliance was 92% and 100% respectively. Therefore the improvement in compliance was not only maintained but in fact the compliance increased even further during subsequent cycles. Hence we have achieved a large improvement in the quality of assessment of bone quality in breast cancer patients. Moreover, we have demonstrated the importance of the dissemination of information and education within a multidisciplinary setting.

  13. Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial)

    PubMed Central

    Tanajewski, Lukasz; Franklin, Matthew; Gkountouras, Georgios; Berdunov, Vladislav; Harwood, Rowan H.; Goldberg, Sarah E.; Bradshaw, Lucy E.; Gladman, John R. F.; Elliott, Rachel A.

    2015-01-01

    Background One in three hospital acute medical admissions is of an older person with cognitive impairment. Their outcomes are poor and the quality of their care in hospital has been criticised. A specialist unit to care for older people with delirium and dementia (the Medical and Mental Health Unit, MMHU) was developed and then tested in a randomised controlled trial where it delivered significantly higher quality of, and satisfaction with, care, but no significant benefits in terms of health status outcomes at three months. Objective To examine the cost-effectiveness of the MMHU for older people with delirium and dementia in general hospitals, compared with standard care. Methods Six hundred participants aged over 65 admitted for acute medical care, identified on admission as cognitively impaired, were randomised to the MMHU or to standard care on acute geriatric or general medical wards. Cost per quality adjusted life year (QALY) gained, at 3-month follow-up, was assessed in trial-based economic evaluation (599/600 participants, intervention: 309). Multiple imputation and complete-case sample analyses were employed to deal with missing QALY data (55%). Results The total adjusted health and social care costs, including direct costs of the intervention, at 3 months was £7714 and £7862 for MMHU and standard care groups, respectively (difference -£149 (95% confidence interval [CI]: -298, 4)). The difference in QALYs gained was 0.001 (95% CI: -0.006, 0.008). The probability that the intervention was dominant was 58%, and the probability that it was cost-saving with QALY loss was 39%. At £20,000/QALY threshold, the probability of cost-effectiveness was 94%, falling to 59% when cost-saving QALY loss cases were excluded. Conclusions The MMHU was strongly cost-effective using usual criteria, although considerably less so when the less acceptable situation with QALY loss and cost savings were excluded. Nevertheless, this model of care is worthy of further evaluation. Trial Registration ClinicalTrials.gov NCT01136148 PMID:26684872

  14. Risk factors associated with calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States.

    PubMed

    Okafor, Chika C; Lefebvre, Sandra L; Pearl, David L; Yang, Mingyin; Wang, Mansen; Blois, Shauna L; Lund, Elizabeth M; Dewey, Cate E

    2014-08-01

    Calcium oxalate urolithiasis results from the formation of aggregates of calcium salts in the urinary tract. Difficulties associated with effectively treating calcium oxalate urolithiasis and the proportional increase in the prevalence of calcium oxalate uroliths relative to other urolith types over the last 2 decades has increased the concern of clinicians about this disease. To determine factors associated with the development of calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States, a retrospective case-control study was performed. A national electronic database of medical records of all dogs evaluated between October 1, 2007 and December 31, 2010 at 787 general care veterinary hospitals in the United States was reviewed. Dogs were selected as cases at the first-time diagnosis of a laboratory-confirmed urolith comprised of at least 70% calcium oxalate (n=452). Two sets of control dogs with no history of urolithiasis diagnosis were randomly selected after the medical records of all remaining dogs were reviewed: urinalysis examination was a requirement in the selection of one set (n=1808) but was not required in the other set (n=1808). Historical information extracted included urolith composition, dog's diet, age, sex, neuter status, breed size category, hospital location, date of diagnosis, and urinalysis results. Multivariable analysis showed that the odds of first-time diagnosis of calcium oxalate urolithiasis were significantly (P<0.05) greater for dogs<7 years, males (OR: 7.77, 95% CI: 4.93-12.26), neutered (OR: 2.58, 1.44-4.63), toy- vs. medium-sized breeds (OR: 3.15, 1.90-5.22), small- vs. medium-sized breeds (OR: 3.05, 1.83-5.08), large- vs. medium-sized breeds (OR: 0.05, 0.01-0.19), and those with a diagnosis of cystitis within the previous year (OR: 6.49, 4.14-10.16). Urinary factors significantly associated with first-time diagnosis of calcium oxalate urolithiasis were acidic vs. basic pH (OR: 1.94, 1.22-3.10), presence of RBCs (OR: 6.20, 3.91-9.83) or WBCs (OR: 1.62, 1.03-2.54), and protein concentration>30 mg/dL (OR: 1.55, 1.04-2.30). Patient demographics and urinalysis results are important factors that can support risk assessment and early identification of canine oxalate urolithiasis. Therefore, periodic urolith screening and monitoring of urine parameters should be encouraged for dogs at risk of developing these uroliths. PMID:24834804

  15. National Hospital Discharge Survey

    Cancer.gov

    The National Hospital Discharge Survey (NHDS), which has been conducted annually since 1965, collects data from a sample of approximately 270,000 inpatient records acquired from a national sample of about 500 hospitals. Only hospitals with an average length of stay of fewer than 30 days for all patients, general hospitals, or children's general hospitals are included in the survey. Information collected includes diagnoses, surgical and nonsurgical procedures, prescription and over-the-counter drugs, immunizations, allergy shots, anesthetics, and dietary supplements.

  16. Apparent Temperature and Air Pollution vs. Elderly Population Mortality in Metro Vancouver

    PubMed Central

    Krsti?, Goran

    2011-01-01

    Background Meteorological conditions and air pollution in urban environments have been associated with general population and elderly mortality, showing seasonal variation. Objectives This study is designed to evaluate the relationship between apparent temperature (AT) and air pollution (PM2.5) vs. mortality in elderly population of Metro Vancouver. Methods Statistical analyses are performed on moving sum daily mortality rates vs. moving average AT and PM2.5 in 1-, 2-, 3-, 5-, and 7-day models for all seasons, warm temperatures above 15°C, and cold temperatures below 10°C. Results Approximately 37% of the variation in all-season mortality from circulatory and respiratory causes can be explained by the variation in 7-day moving average apparent temperature (r2?=?0.37, p<0.001). Although the analytical results from air pollution models show increasingly better prediction ability of longer time-intervals (r2?=?0.012, p<0.001 in a 7-day model), a very weak negative association between elderly mortality and air pollution is observed. Conclusions Apparent temperature is associated with mortality from respiratory and circulatory causes in elderly population of Metro Vancouver. In a changing climate, one may anticipate to observe potential health impacts from the projected high- and particularly from the low-temperature extremes. PMID:21980381

  17. A dose of bacteria early in life may help babies to live longer Sarah Staples. The Vancouver Sun Vancouver, B.C.:Aug 17, 2004. p. A6

    E-print Network

    Seroude, Laurent

    A dose of bacteria early in life may help babies to live longer Sarah Staples. The Vancouver Sun Vancouver, B.C.:Aug 17, 2004. p. A6 Abstract (Article Summary) "We derive nutrients from bacteria, and many systems and organisms need bacteria to properly develop. Exposure to [bacteria] is required to train

  18. The role of the Director Zmago Slokan in the development of Maribor General Hospital in the first period after the Second World War (1953-1970).

    PubMed

    Pivec, Gregor

    2015-12-01

    The author explores and explains the role of the director of Maribor General Hospital in the first period after Second World War. The period was problematic on account of the difficult economic situation and changes in the political system. On one hand the hospital suffered relatively large damage due to bombing attacks during the war and on the other it had to face numerous staffing problems, especially with a lack of physicians and trained nursing staff (from 1948 an executive order entered into force forbidding the nursing nuns from performing nursing care in hospitals). The change in the political system required the management of the hospital to be taken over by an individual who enjoyed the political, professional and economic trust of the then authorities. Based on his engagement during the Second World War, the director, Zmago Slokan, represented a form of guarantee for the political system of that time, which nevertheless wanted the quality-based, professional and economic progress of the hospital. Using his personal characteristics, professional medical and economic knowledge as well as political experience, he was able to manage different tendencies to continue the quality-based progress of the institution. Thus, he set a proper foundation for its development in the periods that followed, in the Socialist Federative Republic of Yugoslavia as well as in the independent Republic of Slovenia (after 1991). The author discusses the role of the director in the hospital's progress chronologically. PMID:26659911

  19. Prevalence of Depression among Type 2 Diabetic Outpatients in Black Lion General Specialized Hospital, Addis Ababa, Ethiopia

    PubMed Central

    Dejenie Habtewold, Tesfa; Radie, Yosef Tsige; Sharew, Nigussie Tadesse

    2015-01-01

    Background. The emotional consequences of diabetes have been scrutinized by a number of investigative teams and there are varying reports about the association of depression with type 2 diabetes mellitus. However, there is limited data about this in Ethiopia. Therefore, the purpose of this study was to assess the prevalence of comorbid depression among type 2 diabetic outpatients. Methods and Materials. Institution based cross-sectional study design was conducted on a random sample of 276 type 2 diabetic outpatients from Black Lion General Specialized Hospital. Systematic random sampling technique was used to get these individual patients from 920 type 2 diabetic outpatients who have an appointment during the data collection period. Patients' depression status was measured using Patient Health Questionnaire 9 (PHQ 9). Result. Totally 264 type 2 diabetic outpatients were interviewed with a response rate of 95.6%. The prevalence of depression among type 2 diabetic outpatients was 13%. Based on PHQ 9 score, 28.4% (75) fulfilled the criteria for mild depression, 12.1% (32) for moderate depression, 2.7% (7) for moderately severe depression, and 1.5% (4) for severe depression. But 45.8% (121) of patients had no clinically significant depression. Conclusion. This study demonstrated that depression is a common comorbid health problem in type 2 diabetic outpatients with a prevalence rate of 13%. PMID:25789172

  20. Massachusetts General Hospital

    Cancer.gov

    Advanced MRI methods may improve the ability to provide an accurate prognosis and potentially guide treatment choices for glioblastoma patients. The proposed research will help establish a common, standardized approach to acquisition and analysis of two forms of vascular MRI that have shown excellent promise. The investigators will do this by careful reduction of variability. These efforts will enable these advanced techniques to become more widely available and more appropriately establish their benefit to patients.

  1. Massachusetts General Hospital

    Cancer.gov

    The overall goal of this U24 application is to continue supporting a team of investigators to develop new and provide established, state-of-the-art high resolution mouse imaging techniques to local cancer investigators. The Harvard Small Animal Imaging Resource (SAIR) has a proven track record for innovation in molecular imaging and clinical translation, has served over 70 regional cancer investigators and currently performs imaging studies for over 40 cancer related base grants.

  2. Massachusetts General Hospital

    Cancer.gov

    Imaging sciences are at a stage at which in vivo imaging can occur at near micron resolutions with image specificity at the physiological, cellular and molecular level. Although the molecular basis of may diseases are well defined, we do not have a full understanding of the mechanism by which they develop in vivo nor have we fully harnessed the potential for translating advances in molecular science into clinical practice of imaging.

  3. Climatic Influences on Cryptoccoccus gattii Populations, Vancouver Island, Canada, 2002-2004.

    PubMed

    Uejio, Christopher K; Mak, Sunny; Manangan, Arie; Luber, George; Bartlett, Karen H

    2015-11-01

    Vancouver Island, Canada, reports the world's highest incidence of Cryptococcus gattii infection among humans and animals. To identify key biophysical factors modulating environmental concentrations, we evaluated monthly concentrations of C. gatti in air, soil, and trees over a 3-year period. The 2 study datasets were repeatedly measured plots and newly sampled plots. We used hierarchical generalized linear and mixed effect models to determine associations. Climate systematically influenced C. gattii concentrations in all environmental media tested; in soil and on trees, concentrations decreased when temperatures were warmer. Wind may be a key process that transferred C. gattii from soil into air and onto trees. C. gattii results for tree and air samples were more likely to be positive during periods of higher solar radiation. These results improve the understanding of the places and periods with the greatest C. gattii colonization. Refined risk projections may help susceptible persons avoid activities that disturb the topsoil during relatively cool summer days. PMID:26484590

  4. Climatic Influences on Cryptoccoccus gattii Populations, Vancouver Island, Canada, 2002–2004

    PubMed Central

    Mak, Sunny; Manangan, Arie; Luber, George; Bartlett, Karen H.

    2015-01-01

    Vancouver Island, Canada, reports the world’s highest incidence of Cryptococcus gattii infection among humans and animals. To identify key biophysical factors modulating environmental concentrations, we evaluated monthly concentrations of C. gatti in air, soil, and trees over a 3-year period. The 2 study datasets were repeatedly measured plots and newly sampled plots. We used hierarchical generalized linear and mixed effect models to determine associations. Climate systematically influenced C. gattii concentrations in all environmental media tested; in soil and on trees, concentrations decreased when temperatures were warmer. Wind may be a key process that transferred C. gattii from soil into air and onto trees. C. gattii results for tree and air samples were more likely to be positive during periods of higher solar radiation. These results improve the understanding of the places and periods with the greatest C. gattii colonization. Refined risk projections may help susceptible persons avoid activities that disturb the topsoil during relatively cool summer days. PMID:26484590

  5. Epidemiology of Suicide and Associated Socio-Demographic Factors in Emergency Department Patients in 7 General Hospitals in Northwestern China

    PubMed Central

    Zhao, Cheng-jin; Dang, Xing-bo; Su, Xiao-li; Bai, Jia; Ma, Long-yang

    2015-01-01

    Background This study aimed to illustrate the characteristics of suicide attempters treated in the Emergency Departments of 7 general hospitals in Xi’an and to provide relevant data for early psychological treatment. Material/Methods Between October 2010 and September 2014, 155 suicide attempters were treated in the Emergency Departments. Data were collected using a semi-structured questionnaire. Descriptive statistics, chi-square tests, and multivariate analyses were used to identify the factors associated with suicidal behaviors. Results Females outnumbered males at a ratio of 3.7 to 1. The greatest proportion of cases was in the age group of 21 to 30 years (52.9%). Patients who finished middle school or high school accounted for most of the suicide attempters (50.3%). The most common method used for attempted suicide was drug ingestion (86.5%). The majority of cases attempted suicide at home (74.8%) during the night. Marriage frustration, work and study problems, family fanaticism and conflict, somatic disease, and history of mental disorders were all significantly associated with suicide attempts. The ratio of patients to be discharged or to die were similar in occupation, marital status, and the place of suicide attempt; however, the results were different in gender, age, educational level, methods used for suicide, time of day, and reason. Conclusions Suicide is an important public health problem and is multidimensional in nature. Future studies with larger samples are expected to provide more specific knowledge of the effect of each social factor on the suicide risk in Chinese in order to improve the prevention of suicides. PMID:26369363

  6. Hypokalaemia: Improving the investigation, management and therapeutic monitoring of hypokalaemic medical inpatients at a district general hospital

    PubMed Central

    Jordan, Mark; Caesar, Jenny

    2015-01-01

    Hypokalaemia is prevalent in 20% of hospitalised patients. Furthermore, inadequate management of hypokalemia was identified in 24% of these patients. Associated with significant patient morbidity and mortality, the identification, investigation, and treatment of hypokalaemia was identified as an area for improvement in the management of medical inpatients. The project aims to measure the assessment, management, and therapeutic monitoring of medical inpatients with hypokalaemia in a district general hospital. All medical inpatients over a one week period who met the criteria for hypokalaemia (serum potassium <3.5 mmol/L on standard biochemical sample) were included in the audit. Patient's notes were located and evaluated to identify if they had mild, moderate, or severe hypokalaemia. Further data on ECG requests, repeat U&Es, serum magnesium analysis, treatment prescribed, and medication review dates was collated. A re-audit was completed after the introduction of a set of interventions which included a hypokalaemia treatment algorithm. Pre-intervention analysis of all medical inpatients, who met our inclusion criteria for hypokalaemia, identified 32 patients. 25 of these patients met the criteria for mild hypokalaemia (3.1–3.4 mmol/L) and 7 met the criteria for moderate hypokalaemia (2.5–3.0 mmol/L). Only 7/32 (22 %) patients were receiving adequate treatment based on trust guidelines. Post intervention results showed marked improvement in the management of patients with hypokalaemia. A total of 30 patients were identified in this post-intervention group. There were 16/30 patients who qualified as mild hypokalaemia (3.1–3.4 mmol/L) and 14/30 with moderate hypokalaemia (2.5–3.0 mmol/L). 19/30 (63%) patients in the post-intervention group were correctly prescribed appropriate medication doses consistent with the treatment algorithm. Following the initial success of the project, analysis at 3 months showed a positive trend for sustained improvement when compared to the pre-intervention results.

  7. Improving the quality of discharge summaries: implementing updated Academy of Medical Royal Colleges standards at a district general hospital.

    PubMed

    May-Miller, Hannah; Hayter, Joanne; Loewenthal, Lola; Hall, Louis; Hilbert, Rebecca; Quinn, Michael; Pearson, Nicola; Patel, Alisha; Law, Rebekah

    2015-01-01

    Quality of documentation is harder to quantify and incentivise, but it has a significant impact on patient care. Good discharge summaries facilitate continuity between secondary and primary care. The junior doctors' forum led this project to improve the quality of electronic discharge summaries (eDS). Baseline measurement revealed significant room for improvement. We measured the quality of 10 summaries per month (across all inpatient specialties), against 23 indicators from the revised Academy of Medical Royal Colleges (AoMRC) standards (2013) that were prioritised by GPs as a "minimum dataset". Junior doctors felt that the Trust's dual eDS systems were responsible for great variation in quality. This was confirmed by the results of a comparison audit of the systems in April 2014: one system greatly outperformed the other (57% mean compliance with iSoft clinical management (iCM) based system vs. 77% with InfoPath-based system). We recommended that the Trust move to a single eDS system, decommissioning the iCM-based system, and this proposal was approved by several Trust committees. We worked with information services, junior doctors, general practitioners and hospital physicians to develop and implement a generic template to further improve compliance with AoMRC standards. In August 2014, the iCM-based system was withdrawn, the new template went live, and training was delivered, coinciding with the changeover of junior doctors to minimise disruption. Median compliance increased from 66.7% to 77.8%. Quality of discharge summaries had improved across the specialties. There was a reduction in the number of complaints and positive qualitative feedback from general practitioners and junior doctors. Completion of discharge summaries within 24 hours was not affected by this change. There is still more to be done to improve quality; average compliance with the full AoMRC standards (39 indicators) is 59.5%. With the approval of the Trust executive committee further plan, do, study, act (PDSA) cycles are underway, working to improve the remaining specialty-specific templates. PMID:26734325

  8. Going Social at Vancouver Public Library: What the Virtual Branch Did Next

    ERIC Educational Resources Information Center

    Cahill, Kay

    2011-01-01

    Purpose: The purpose of this paper is to follow up on the 2009 publication "Building a virtual branch at Vancouver Public Library (VPL) using Web 2.0 tools" and to explore the work that VPL has been doing in the social media space over the past two years. Design/methodology/approach: Following the launch of its new web site in 2008, Vancouver

  9. Their Spirits Live within Us: Aboriginal Women in Downtown Eastside Vancouver Emerging into Visibility

    ERIC Educational Resources Information Center

    Culhane, Dara

    2003-01-01

    The intersection of Main and Hastings streets--known locally as "Pain and Wastings"--marks the heart of Vancouver's inner-city neighborhood: the Downtown Eastside. Since 1997, when the City of Vancouver Health Department declared a public health emergency in response to reports that HIV infection rates among residents exceeded those anywhere else…

  10. 4.9 NON-POINT SOURCE CONTAMINATION IN THE URBAN ENVIRONMENT OF GREATER VANCOUVER by Kenneth J. Hall

    E-print Network

    109 4.9 NON-POINT SOURCE CONTAMINATION IN THE URBAN ENVIRONMENT OF GREATER VANCOUVER 4.9 by Kenneth, Vancouver, B.C. NON-POINT SOURCE CONTAMINATION IN THE URBAN ENVIRONMENT OF GREATER VANCOUVER: A CASE STUDY- nity about the significant impacts of non-point sources of pollution on their urban waterways. #12

  11. An urban metabolism and ecological footprint assessment of Metro Vancouver.

    PubMed

    Moore, Jennie; Kissinger, Meidad; Rees, William E

    2013-07-30

    As the world urbanizes, the role of cities in determining sustainability outcomes grows in importance. Cities are the dominant form of human habitat, and most of the world's resources are either directly or indirectly consumed in cities. Sustainable city analysis and management requires understanding the demands a city places on a wider geographical area and its ecological resource base. We present a detailed, integrated urban metabolism of residential consumption and ecological footprint analysis of the Vancouver metropolitan region for the year 2006. Our overall goal is to demonstrate the application of a bottom-up ecological footprint analysis using an urban metabolism framework at a metropolitan, regional scale. Our specific objectives are: a) to quantify energy and material consumption using locally generated data and b) to relate these data to global ecological carrying capacity. Although water is the largest material flow through Metro Vancouver (424,860,000 m(3)), it has the smallest ecological footprint (23,100 gha). Food (2,636,850 tonnes) contributes the largest component to the ecological footprint (4,514,400 gha) which includes crop and grazing land as well as carbon sinks required to sequester emissions from food production and distribution. Transportation fuels (3,339,000 m(3)) associated with motor vehicle operation and passenger air travel comprises the second largest material flow through the region and the largest source of carbon dioxide emissions (7,577,000 tonnes). Transportation also accounts for the second largest component of the EF (2,323,200 gha). Buildings account for the largest electricity flow (17,515,150 MWh) and constitute the third largest component of the EF (1,779,240 gha). Consumables (2,400,000 tonnes) comprise the fourth largest component of the EF (1,414,440 gha). Metro Vancouver's total Ecological Footprint in 2006 was 10,071,670 gha, an area approximately 36 times larger than the region itself. The EFA reveals that cropland and carbon sinks (forested land required to sequester carbon dioxide emissions) account for 90% of Metro Vancouver's overall demand for biocapacity. The per capita ecological footprint is 4.76 gha, nearly three times the per capita global supply of biocapacity. Note that this value excludes national government services that operate outside the region and could account for up to an additional 2 gha/ca. PMID:23603775

  12. Needle Exchange and the HIV Epidemic in Vancouver: Lessons Learned from 15 years of research

    PubMed Central

    Hyshka, Elaine; Strathdee, Steffanie; Wood, Evan; Kerr, Thomas

    2012-01-01

    During the mid-1990s, Vancouver experienced a well characterized HIV outbreak among injection drug users (IDU) and many questioned how this could occur in the presence of a high volume needle exchange program (NEP). Specific concerns were fuelled by early research demonstrating that frequent needle exchange program attendees were more likely to be HIV positive than those who attended the NEP less frequently. Since then, some have misinterpreted this finding as evidence that NEPs are ineffective or potentially harmful. In light of continuing questions about the Vancouver HIV epidemic, we review 15 years of peer-reviewed research on Vancouver’s NEP to describe what has been learned through this work. Our review demonstrates that: 1) NEP attendance is not causally associated with HIV infection, 2) frequent attendees of Vancouver’s NEP have higher risk profiles which explain their increased risk of HIV seroconversion, and 3) a number of policy concerns, as well as the high prevalence of cocaine injecting contributed to the failure of the NEP to prevent the outbreak. Additionally, we highlight several improvements to Vancouver’s NEP that contributed to declines in syringe sharing and HIV incidence. Vancouver’s experience provides a number of important lessons regarding NEP. Keys to success include refocusing the NEP away from an emphasis on public order objectives by separating distribution and collection functions, removing syringe distribution limits and decentralizing and diversifying NEP services. Additionally, our review highlights the importance of context when implementing NEPs, as well as ongoing evaluation to identify factors that constrain or improve access to sterile syringes. PMID:22579215

  13. Habitat Evaluation Procedures (HEP) Report : Vancouver Lowlands Shillapoo Wildlife Area, 1994-1995 Technical Report.

    SciTech Connect

    Calkins, Brian; Anderson, Eric; Ashley, Paul

    1995-01-01

    This project was conducted as part of a comprehensive planning effort for the Vancouver Lowlands project area. The study was funded by The Bonneville Power Administration (BPA) and carried out by the Washington Department of Fish and Wildlife (WDFW). The Vancouver Lowlands is considered an area of high priority by WDFW and is being considered as a potential site for wildlife mitigation activities by BPA. The objectives of this study were to collect baseline information and determine current habitat values for the study area. A brief discussion of potential future management and a proposed listing of priorities for habitat protection are found near the end of this report. This report is a companion to a programmatic management plan being drafted for the area which will outline specific, management programs to improve habitat conditions based, in part, on this study. The following narratives, describing limiting habitat variables, carry recurring themes for each indicator species and habitat type. These recurring variables that limited habitat value include: Waterbodies that lack emergent and submerged vegetation; forest areas that lack natural shrub layers; a predominance of non-hydrophytic and less desirable non-native plants where shrubs are present; a general lack of cover for ground nesting and secure waterfowl nest sites (island type). Human disturbance was the variable that varied more than any other from site to site in the study area. One issue that the models we used do not truly deal with is the quantity and connectivity of habitat. The mallard and heron models deal with spatial relationships but for other species this may be as critical. Observation of habitat maps easily show that forested habitats are in short supply. Their continuity along Lake river and the Columbia has been broken by past development. Wetland distribution has also been affected by past development.

  14. Applicability of the Chinese Version of the Hypomania Symptom Checklist (HCL-32) Scale for Outpatients of Psychiatric Departments in General Hospitals

    PubMed Central

    Feng, Bin; Tan, Qingrong; Ji, Jianlin

    2013-01-01

    Objectives This study aimed to determine the suitability of the Chinese version of the Hypomania Symptom Checklist (HCL-32) scale for psychiatric department outpatients with mood disorders in Chinese general hospitals, and provide a theoretical basis for the application of the HCL-32 scale. Methods Outpatients with mood disorders receiving continuous treatment in the psychiatric medicine department of three top-ranking general hospitals in three cities completed scoring the HCL-32 scale. Results A total of 1010 patients were recruited. 417 were diagnosed with bipolar disorder (236 for type I and 181 for type II) and 593 were depression. Four factors with eigenvalues >1 were considered. Factor 1 with an eigenvalue of 5.5 was labeled “active/cheerful”. Factor 2 with an eigenvalue of 2.7 was labeled “adventurous/irritable.” The coefficient of internal consistency reliability of the HCL-32 total scale was 0.84, and the coefficients for factors 1 and 2 were 0.84 and 0.88, respectively. With the total score of HCL-32?14 as positive standard, the sensitivity of HCL-32 was calculated at 69.30% and the specificity was 97.81%. Conclusions Results showed that HCL-32 had a preferable reliability and validity and was suitable as auxiliary means for bipolar disorder screening in general hospitals. PMID:24116062

  15. [Human hydatidosis: general aspects and epidemiological situation in Chile according to hospital discharge and mandatory reporting from 2001 to 2005].

    PubMed

    Cortés, Sandra; Valle, Carla

    2010-08-01

    Human hydatidosis in Chile is described using as a source of information the Disease Notification Systems and hospital discharges between 2001 and 2005. To assess the extent of human infection we calculated incidence rates and hospital discharges during this period by geographical region. Incidence rate for the period was 2.2 per 100,000 inhabitants with higher rates in the regions of Coquimbo, La Araucania and Magallanes. The hospital discharge rate for the period was 6 per 100.000 inhabitants, being the most affected regions: La Araucania, Aysén and Magallanes. 58.8% of cases reported are from Echinococcus granulosus, while 43.6% were registered as unspecified echinococcosis. The notification system provides a real estimate of the magnitude of this disease, reporting cases with diagnostic confirmation. The rates obtained from the discharge system overestimate the magnitude of this disease. The improvement of the notification system and seroprevalence studies are recommended. PMID:21046718

  16. Starting a General Surgery Program at a Small Rural Critical Access Hospital: A Case Study from Southeastern Oregon

    ERIC Educational Resources Information Center

    Doty, Brit Cruse; Heneghan, Steven; Zuckerman, Randall

    2007-01-01

    Context: Surgical services are frequently unavailable in rural American communities. Therefore, rural residents often must travel long distances to receive surgical care. Rural hospitals commonly have difficulty providing surgical services despite potential economic benefits. Purpose: The purpose of this project was to identify the key challenges…

  17. Is organizational change associated with increased rates of readmission to general hospital in suicide attempters? A 10-year prospective catchment area study.

    PubMed

    Mehlum, Lars; Jørgensen, Trond; Diep, Lien My; Nrugham, Latha

    2010-01-01

    The objective of this study was to examine predictors for readmissions in patients admitted to a general hospital emergency ward for suicide attempts before and after organizational changes potentially affecting the chain of care. Socio-demographic and clinical variables were collected by clinicians from 1997 thru 2007. Data from the periods before and after 2004--when the hospital changed its catchment area--were compared. A substantial increase in readmission rates in the period after the organizational change was observed. This increase was not associated with any of the socio-demographic or clinical patient characteristics. Although no causal connection can be inferred, the observed association between organizational change and readmission rates could indicate that established post-discharge care systems for suicide attempters may be vulnerable to such change. PMID:20455152

  18. [Risk factors for falls and fractures at night in relation to lower urinary tract symptoms: a survey of outpatients and inpatients at a general hospital].

    PubMed

    Masui, Kimihiko; Yoshimura, Koji; Sakura, Yuma; Ito, Haruki; Yoshida, Toru; Mishina, Mutsuki; Okuno, Hiroshi

    2011-08-01

    We investigated potential risk factors, including factors related to lower urinary tract symptoms (LUTS), for falls and fractures at night among outpatients and inpatients in a general hospital, via a questionnaire. The questionnaire included items to record the age, sex, number of consulting doctors, history of 11 particular medical diseases, LUTS, sleep, and falls and fractures at night. We distributed the questionnaire to 1,334 patients 51 years old or older in our hospital. Of the questionnaires completed, 96.9% were valid for analysis. Multivariate analyses revealed that "drinking water before bedtime or while in bed" was the strongest risk factor (odds ratio?7.499) for bone fractures while "postural syncope" was the strongest risk factor (odds ratio?5.041, except past medical history) for falls. In terms of LUTS, urge incontinence was a significant risk factor for falls. PMID:21894077

  19. Sociodemographic disparities in access to addiction treatment among a cohort of Vancouver injection drug users.

    PubMed

    Wood, Evan; Li, Kathy; Palepu, Anita; Marsh, David C; Schechter, Martin T; Hogg, Robert S; Montaner, Julio S G; Kerr, Thomas

    2005-01-01

    Vancouver's explosive HIV epidemic among injection drug users (IDUs) has received international attention due to the presence of a large needle exchange program. The role of addiction treatment has not been evaluated in this setting. We evaluated factors associated with use of addiction treatment among a prospective cohort of Vancouver IDUs. Addiction treatment was negatively associated with Aboriginal ethnicity and unstable housing, both of which have been associated with HIV infection in previous studies. These findings demonstrate low levels of addiction treatment among Vancouver IDUs and suggest that programs may need to be targeted towards specific populations with poor access. PMID:16040375

  20. [Access, use and preferences of Information and Communication Technologies by physicians in a general hospital in Peru].

    PubMed

    Vásquez-Silva, Luis; Ticse, Ray; Alfaro-Carballido, Luz; Guerra-Castañon, Felix

    2015-01-01

    We assessed the access, use and preferences of information and communication technology (ICT) by physicians who practice at Cayetano Heredia National Hospital. The questionnaire explored the availability and skills of ICT, time, educational activities, search engines and technological applications most used as well as ICT preferences in education.211 physicians were surveyed; laptop use was 93%, tablet and smartphone use was 66% and 88%.68% have mobile Internet. Differences were evident in the frequency of use of ICT in 25-34 year old age group as well as a higher level of skills (p<0.05). 86% use PubMed, Facebook and WhatsApp as a means of exchanging images and data related to health, 50% participated in medical blogs, online courses or videoconferences. The use and access of ICT is common among doctors in this hospital and there is positive interest in its use in education. PMID:26338389

  1. Application of ATC/DDD methodology to eveluate of antibiotic use in a general hospital in Turkey

    PubMed Central

    2013-01-01

    Background The aim of this study is to evaluate in-house antibiotic use in a state hospital in Turkey with its cost, using the ATC/DDD index, which is an accepted standard method. Methods This study was performed as a point prevalence study in a state hospital with 372 beds. All in-house patients using antibiotics on July 19, 2011 were included in the study. Indications for antibiotic use and information about the patients were recorded on special forms. Antibiotic use and cost analysis were evaluated using the ATC/DDD index, which is also suggested by the WHO to be used in similar studies. Findings 147 patients out of 308 patients who were in-house were identified to use antibiotics with appropriate indications for prophylaxis or treatment in 61% of the patients. The rate of appropriate antibiotic use was identified to be in 78%, while this rate was 38.9% in surgical clinics. The daily cost of the antibiotics consumed on the date of the study was calculated as 4104.79 TL (=2476.80 USD). Discussion The rate of inappropriate use of antibiotics seems to be high in our hospital. This will result in both increased costs and also increased nosocomial infection rates with resistant species. Infectious disease specialists should take more active roles in the in-house antibiotic use, hospitals should prepare and implement their own principles of antibiotic use, and microbiology laboratories should be used more effectively. These measures would decrease the conspicuous shortcomings in the antibiotic use. PMID:24004538

  2. Bronson Methodist Hospital Founded in 1900, today Bronson Methodist Hospital

    E-print Network

    Bronson Methodist Hospital Founded in 1900, today Bronson Methodist Hospital (BMH) is a state provides care in virtually every specialty: cardiology (Heart Hospital at Bronson), general surgical's Hospital at Bronson), and adult critical care services. As a tertiary care center, BMH includes a Level I

  3. Urban policy engagement with social sustainability in metro Vancouver.

    PubMed

    Holden, Meg

    2012-01-01

    This article presents an analysis of social sustainability in comparative theoretical context and as a challenge to the post-political interpretation of sustainability in policy practice at the urban and regional scales. Metro Vancouver provides a case study for improving our understanding of the meaning of social sustainability as a framework for social policy in that it is among the handful of cities around the world currently working to define and enact social sustainability in governance terms. Results of this participant research provide evidence that some cities are politically engaging alternative development pathways using the concept of social sustainability. For sustainable development to retain its promise as an alternative policy framework for cities, social sustainability must be at the forefront. PMID:22500345

  4. Hospitality Hospitality/Foodservice: TBD

    E-print Network

    Dyer, Bill

    Hospitality Management Hospitality/Foodservice: TBD Food Science: TBD Recreation/Tourism: TBD Culinary Arts/Hospitality NTT: TBD SFBS Sustainable Food & Bioenergy Systems Faculty: Alison Harmon & Campus Restaurant Managed By: Gallatin College Program Director/ Hospitality Management Instructor

  5. The Monitoring Network of the Vancouver 2010 Olympics

    NASA Astrophysics Data System (ADS)

    Joe, Paul; Scott, Bill; Doyle, Chris; Isaac, George; Gultepe, Ismail; Forsyth, Douglas; Cober, Stewart; Campos, Edwin; Heckman, Ivan; Donaldson, Norman; Hudak, David; Rasmussen, Roy; Kucera, Paul; Stewart, Ron; Thériault, Julie M.; Fisico, Teresa; Rasmussen, Kristen L.; Carmichael, Hannah; Laplante, Alex; Bailey, Monika; Boudala, Faisal

    2014-01-01

    An innovative monitoring network was implemented to support the operational and science programs for the Vancouver 2010 Winter Olympics. It consisted of in situ weather stations on custom-designed platforms. The sensors included an HMP45C for temperature, humidity and pressure, a tipping bucket rain gauge, an acoustic snow depth sensor, a Pluvio 1 precipitation gauge and an anemometer placed at gauge height and at 10 m height. Modifications to commercial automated precipitation gauges were necessary for the heavy snowfall conditions. Advanced or emerging technologies were deployed to support scientific and nowcasting studies into precipitation intensity, typing, visibility and wind. The sensors included an FD12P visibility and precipitation sensor, a precipitation occurrence sensing system (POSS) present weather sensor, a Hotplate precipitation sensor and a Parsivel disdrometer. Data were collected at 1 min sampling intervals. A Doppler weather radar was deployed in a valley location and provided critical detailed low-level data. An X-band dual-polarized radar was deployed by the National Oceanic and Atmospheric Administration to monitor Vancouver and Cypress Mountain. Three remote sensing stations for vertical profiling were established. At the base of Whistler Mountain, a micro-rain radar, a 22-channel radiometer, a ceilometer, a Parsivel and a POSS were installed. At the base of Cypress Mountain, a micro-rain radar, a ceilometer, a low cost rain sensor (LCR by ATTEX) and a POSS were installed. At Squamish, a wind profiler and a POSS were installed. Weather sensors were mounted on the Whistler Village Gondola and on the Peak to Peak gondola. Sites were established along the Whistler Mountain slope and at other key locations. The combination of sites and instruments formed a comprehensive network to provide observations appropriate for nowcasting in winter complex terrain and investigate precipitation, visibility and wind processes. The contribution provides a detailed description of the network, their sensors, the innovations and some examples.

  6. The Potential of Distributed Cogeneration in Commercial Sites in the Greater Vancouver

    E-print Network

    The Potential of Distributed Cogeneration in Commercial Sites in the Greater Vancouver Regional of Resource Management PROJECT TITLE: The Potential of Distributed Cogeneration in Commercial Sites opportunities for systems that cogenerate useful heat and electricity. This form of distributed generation

  7. MOLECULAR EPIDEMIOLOGICAL STUDIES ON TWO CYCLOSPORIASIS OUTBREAKS IN VANCOUVER, BRITISH COLUMBIA

    EPA Science Inventory

    Two cyclosporiasis outbreaks in Vancouver, British Columbia (BC) were investigated using molegular epidemiology. The cause of the 1999 outbreak has not been identiifed whereas the 2001 oubreak has been linked epidemiologically to the consumption of Thai basil. The internal tran...

  8. A Novel early pregnancy assessment unit/Gynaecology assessment unit dashboard An experience from a UK district general hospital.

    PubMed

    Wahba, K; Shah, A; Hill, K; Hosni, M M

    2015-10-01

    The establishment of early pregnancy assessment units (EPAUs)/Gynaecology assessment units (GAUs) started more than 20 years ago in the UK to decrease hospital admissions of patients with early pregnancy problems. However, there are still wide variations in the quality of services provided by these units. The objective of this study was to create a method that can be used for continuous assessment of these units on a regular basis. We designed a dashboard covering all aspects of EPAU/GAU activities depending upon the early pregnancy unit association guidelines, and the department of health data and statistics. The EPAU/GAU dashboard has been used successfully in the early assessment pregnancy unit of Yeovil District hospital for few years and is still implemented until now. It is an excellent tool for continuous audit. It is a simple method that should be adopted by different EPAUs/GAUs for their objective assessment in order to improve the services provided by these units. PMID:25543529

  9. Examining the Impact of Case Management in Vancouver’s Downtown Community Court: A Quasi-Experimental Design

    PubMed Central

    Somers, Julian M.; Moniruzzaman, Akm; Rezansoff, Stefanie N.; Patterson, Michelle

    2014-01-01

    Background Problem solving courts (PSC) have been implemented internationally, with a common objective to prevent reoffending by addressing criminogenic needs and strengthening social determinants of health. There has been no empirical research on the effectiveness of community courts, which are a form of PSC designed to harness community resources and inter-disciplinary expertise to reduce recidivism in a geographic catchment area. Method We used the propensity score matching method to examine the effectiveness of Vancouver’s Downtown Community Court (DCC). We focused on the subset of DCC participants who were identified as having the highest criminogenic risk and were assigned to a case management team (CMT). A comparison group was derived using one-to-one matching on a large array variables including static and dynamic criminogenic factors, geography, and time. Reductions in offences (one year pre minus one year post) were compared between CMT and comparison groups. Results Compared to other DCC offenders, those triaged to CMT (9.5% of the DCC population) had significantly higher levels of healthcare, social service use, and justice system involvement over the ten years prior to the index offence. Compared to matched offenders who received traditional court outcomes, those assigned to CMT (n?=?249) exhibited significantly greater reductions in overall offending (p<0.001), primarily comprised of significant reductions in property offences (p<0.001). Conclusions Our findings indicate that CMT achieved significantly greater reductions in recidivism than traditional court among offenders with complex needs and high numbers of previous offences. Limitations of this research include a non-experimental design and one year follow up. Strengths include a robust matching process and extensive client level data spanning multiple sectors. Further research is needed to replicate the observed outcomes, to investigate the extension of community courts to settings with divergent offender needs and local resources, and to estimate potential cost avoidance attributable to this intervention. PMID:24599022

  10. Public health assessment for Vancouver water station No. 1 contamination, Vancouver, Clark County, Washington, Region 10. Cerclis No. WAD988519708. Preliminary report

    SciTech Connect

    Not Available

    1994-12-19

    Vancouver Water Station No. 1 site (WS1) is a municipal well field located in Vancouver, Clark County, Washington. Low concentrations of tetrachloroethylene were consistently found in water from WS1 production wells and reservoir. The site poses no apparent health hazard to users of the WS1 municipal water supply (residents, workers, and students) as a result of past exposure to low concentrations of tetrachloroethylene in drinking water. Past exposure to tetrachloroethylene may have occurred; however, because of volatilization, concentrations are anticipated to have been minimal and unlikely to cause adverse health effects.

  11. The Experiences of Adults with Intellectual Disabilities and Their Carers in General Hospitals: A Focus Group Study

    ERIC Educational Resources Information Center

    Gibbs, S. M.; Brown, M. J.; Muir, W. J.

    2008-01-01

    Background: People with intellectual disabilities (ID) have higher levels of health needs compared with the general population, many of which are unrecognised and unmet. While there has been interest and research into the primary health provision for this group, there has been a more limited focus on addressing their care received in general

  12. Audit of 149 consecutive carotid endarterectomies performed by a single surgeon in a district general hospital over a 12-year period.

    PubMed Central

    Tan, L. C.; Sutton, G. L.; Taffinder, N. J.; Perry, M.; Fail, T.

    1996-01-01

    Carotid endarterectomy has been established by two large randomised controlled trials (European Carotid Surgery Trial (ECST) and North American Symptomatic Carotid Endarterectomy Trial (NASCET)) as an important surgical procedure for the prevention of ischaemic strokes in patients presenting with transient cerebral ischaemia or non-disabling strokes attributable to severe ipsilateral carotid artery stenosis. The operation carries significant risk of death and stroke and it has been advocated by some that carotid endarterectomy should only be performed in a small number of designated regional centres in order to achieve good surgical results. It is doubtful that the regional centres alone can cope with the increasing numbers of patients requiring carotid endarterectomy and there is therefore a requirement for the procedure to be carried out by vascular surgeons in district general hospitals. It is important that surgical results are audited to ensure that comparable outcomes are achieved. We present an audit of our experience of carotid endarterectomy since 1981. A total of 149 consecutive carotid endarterectomies were performed by a single surgeon with a special interest in carotid surgery. The results are comparable to ECST with a 30-day mortality of 0% and an overall 30-day stroke rate of 5.7% (major strokes) for patients with severe, ie 70-99%, ipsilateral carotid artery stenoses. We have shown that carotid endarterectomy is an operation that can be performed safely and with good results by suitably trained surgeons in district general hospitals. PMID:8712647

  13. Bevacizumab-based therapy for colorectal cancer: experience from a large Canadian cohort at the Jewish General Hospital between 2004 and 2009

    PubMed Central

    Bouganim, N.; Mamo, A.; Wasserman, D.W.; Batist, G.; Metrakos, P.; Chaudhury, P.; Hassanain, M.; Kavan, P.

    2013-01-01

    Background Before its regulatory approval in Canada, bevacizumab to treat patients with colorectal cancer (crc) was accessed through the Bevacizumab Expanded Access Trial and a special-access program at the Jewish General Hospital. We retrospectively evaluated patient outcomes in that large cohort. Methods All patients (n = 196) had metastatic crc, were bevacizumab-naïve, and received bevacizumab in combination with chemotherapy at the Jewish General Hospital between 2004 and 2009. We collected patient demographics and clinical characteristics; relevant medical history, disease stage and tumour pathology at diagnosis; type, duration, and line of therapy; grades 3 and 4 adverse events (aes), time to disease progression (ttp), and overall survival (os) from diagnosis. Results Median follow-up was 36.0 months. Median ttp was 8.0 months [95% confidence interval (ci): 7.0 to 9.0 months). Median os was 41.0 months (95% ci: 36.0 to 47.0 months). Of the 40 grades 3 and 4 bevacizumab-related aes experienced by 38 patients (19.4%), the most common were thrombocytopenia (n = 17), deep-vein thrombosis (n = 6), pulmonary embolism (n = 4), and hypertension (n = 3). Conclusions In an expanded access setting, our data reflect the efficacy and safety of bevacizumab-based therapy in the controlled post-registration clinical trial setting. PMID:24155628

  14. Migrating towards a client server architecture: a successful application in a 2,200-bed general hospital.

    PubMed

    Lee, J S; Min, W K; Kim, J H

    1998-01-01

    Asan Medical Center (AMC) completed a major migration process of the hospital information system from a mainframe towards an open Unix client server architecture from August of 1993 to August of 1996. Along with the east wing extension of AMC, the number of inpatient beds is greatly increased from 1,000 to 2,200 and information transaction increased from 300,000 to 700,000. A gradual departmental migration strategy with local area network connection and data conversion between the two systems were applied. The successful migration process towards a client server architecture provided improved user interface, enhanced flexibility and productivity of the system, better integration with diverse medical devices and improved networking flexibility. PMID:10384594

  15. An Experimental High-Resolution Forecast System During the Vancouver 2010 Winter Olympic and Paralympic Games

    NASA Astrophysics Data System (ADS)

    Mailhot, J.; Milbrandt, J. A.; Giguère, A.; McTaggart-Cowan, R.; Erfani, A.; Denis, B.; Glazer, A.; Vallée, M.

    2014-01-01

    Environment Canada ran an experimental numerical weather prediction (NWP) system during the Vancouver 2010 Winter Olympic and Paralympic Games, consisting of nested high-resolution (down to 1-km horizontal grid-spacing) configurations of the GEM-LAM model, with improved geophysical fields, cloud microphysics and radiative transfer schemes, and several new diagnostic products such as density of falling snow, visibility, and peak wind gust strength. The performance of this experimental NWP system has been evaluated in these winter conditions over complex terrain using the enhanced mesoscale observing network in place during the Olympics. As compared to the forecasts from the operational regional 15-km GEM model, objective verification generally indicated significant added value of the higher-resolution models for near-surface meteorological variables (wind speed, air temperature, and dewpoint temperature) with the 1-km model providing the best forecast accuracy. Appreciable errors were noted in all models for the forecasts of wind direction and humidity near the surface. Subjective assessment of several cases also indicated that the experimental Olympic system was skillful at forecasting meteorological phenomena at high-resolution, both spatially and temporally, and provided enhanced guidance to the Olympic forecasters in terms of better timing of precipitation phase change, squall line passage, wind flow channeling, and visibility reduction due to fog and snow.

  16. Forest harvesting is associated with increased landslide activity during an extreme rainstorm on Vancouver Island, Canada

    NASA Astrophysics Data System (ADS)

    Goetz, J. N.; Guthrie, R. H.; Brenning, A.

    2014-08-01

    Safe operations of forest practices in mountainous regions require effective development planning to mitigate hazards posed by landslides. British Columbia, Canada, has for the past two decades implemented landslide risk management policies aimed at reducing the impacts of the forest industry on landslides; it is required that timber harvesting sites are evaluated for their potential or existing impacts on terrain stability. Statistical landslide susceptibility modelling can enhance this evaluation by geographically highlighting potential hazardous areas. In addition, these statistical models can also improve our understanding of regional landslide controlling factors. The purpose of this research was to explore the regional effects of forest harvesting activities, topography, precipitation and geology on landslides initiated during an extreme rainfall event in November 2006 on Vancouver Island, British Columbia. These effects were analysed with a nonparametric statistical method, the generalized additive model (GAM). Although topography was the strongest predictor of landslide initiation, low density forest interpreted as regrowth areas and proximity to forest service roads were jointly associated with a six- to nine-fold increase in the odds of landslide initiation, while accounting for other environmental cofounders. This result highlights the importance of continuing proper landslide risk management to control the effects of forest practices on landslide initiation.

  17. Forest harvesting is associated with increased landslide activity during an extreme rainstorm on Vancouver Island, Canada

    NASA Astrophysics Data System (ADS)

    Goetz, J. N.; Guthrie, R. H.; Brenning, A.

    2015-06-01

    Safe operations of forest practices in mountainous regions require effective development planning to mitigate hazards posed by landslides. British Columbia, Canada, has for the past 2 decades implemented landslide risk management policies aimed at reducing the impacts of the forestry industry on landslides. Consequently, it is required that timber harvesting sites be evaluated for their potential or existing impacts on terrain stability. Statistical landslide susceptibility modelling can enhance this evaluation by geographically highlighting potential hazardous areas. In addition, these statistical models can also improve our understanding of regional landslide controlling factors. The purpose of this research was to explore the regional effects of forest harvesting activities, topography, precipitation and geology on landslides initiated during an extreme rainfall event in November 2006 on Vancouver Island, British Columbia. These effects were analyzed with a nonparametric statistical method, the generalized additive model (GAM). Although topography was the strongest predictor of landslide initiation, low density forest interpreted as regrowth areas and proximity to forest service roads were jointly associated with a 6- to 9-fold increase in the odds of landslide initiation, while accounting for other environmental confounders. This result highlights the importance of continuing proper landslide risk management to control the effects of forest practices on landslide initiation.

  18. The use of the partograph in labor monitoring: a cross-sectional study among obstetric caregivers in General Hospital, Calabar, Cross River State, Nigeria

    PubMed Central

    Asibong, Udeme; Okokon, Ita B; Agan, Thomas U; Oku, Affiong; Opiah, Margaret; Essien, E James; Monjok, Emmanuel

    2014-01-01

    Background Prolonged and obstructed labor is a significant cause of maternal morbidity and mortality in Nigeria, one of the six countries contributing significantly to the global maternal mortality crisis. The use of the partograph would engender a remarkable reduction in the number of these deaths since abnormal markers in the progress of labor would be identified early on. Objective This study aimed to evaluate the non-physician obstetric caregivers’ (OCGs) knowledge of partograph use, assess the extent of its use, determine the factors that impede its usage, and unravel the relationship between years of experience and partograph use among the respondents (OCGs) in General Hospital, Calabar, Nigeria. Methodology Using a self-administered semi-structured questionnaire, a cross-sectional descriptive study was conducted among 130 purposely selected and consenting OCGs working in the General Hospital, Calabar, Nigeria. Results The majority of the respondents (70.8%) had good general knowledge of the partograph but lacked detailed and in-depth knowledge of the component parts of the partograph. Knowledge of partograph (?2=12.05, P=0.0001) and partograph availability (?2=56.5, P=0.0001) had a significant relationship with its utilization. Previous training (?2=9.43, P=0.002) was significantly related to knowledge of partograph. Factors affecting utilization were: little or no knowledge of the partograph (85.4%), nonavailability (70%), shortage of staff (61.5%), and the fact that it is time-consuming to use (30%). Conclusion Lack of detailed knowledge of the partograph, nonavailability of the partograph, poor staff numbers, and inadequate training are factors that work against the effective utilization of the partograph in the study facility. Usage of this tool for labor monitoring can be enhanced by periodic training, making partographs available in labor wards, provision of reasonable staff numbers, and mandatory institutional policy. PMID:25342920

  19. Evaluation of extremity pain in children using technetium-99m MDP bone scan: A general hospital experience

    SciTech Connect

    Park, H.M.; Rothschild, P.A.; Kernek, C.B.

    1984-01-01

    This study was undertaken to evaluate the efficacy of three-phase bone scan in detection of significant pathology i.e., osteomyelitis (OM), septic joint, cellulitis, etc., in children with symptoms of extremity pain. A total of 100 consecutive patients (age 9 days - 16 yrs, 63 boys and 37 girls) were studied. The authors reviewed their scans, x-rays and hospital records. The final diagnoses were based on the findings of needle aspiration, surgical drainage, biopsy, culture, and on the therapeutic response. In 87%, sufficiently long clinical follow-up was available to confirm the final diagnoses. In the remaining 13%, the symptoms resolved quickly and follow-up was not felt necessary. The scan was essential in pinpointing the lesions in pts with referred or nonlocalizing extremity pain. The +ve and -ve predictive values of the scan and OM were 89% and 96% respectively. One spiral fracture was misinterpreted as diffuse OM. One ''Subacute epiphyseal OM'' was not detected. In two cases, cellulitis and septic joint obscured underlying OM. Prior antibotic therapy resulted in one equivocal scan. Although less sensitive (29%) in early OM, radiographs play an important complimentary role. Bone scans detected underlying pathology for extremity pain in 61% of all pts studied.

  20. Association between Severe Dehydration in Rotavirus Diarrhea and Exclusive Breastfeeding among Infants at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

    PubMed Central

    Prasetyo, Dwi; Sabaroedin, Iesje Martiza; Ermaya, Yudith Setiati; Soenarto, Yati

    2015-01-01

    Background. Rotavirus is the leading cause of severe acute diarrhea in children. Infants who are exclusively breastfed develop fewer infections and have less severe illnesses. This study aimed to determine association between severe dehydration in rotavirus diarrhea and exclusive breastfeeding. Methods. This is a cross-sectional study in infants ? 6 months old with acute diarrhea in Dr. Hasan Sadikin Hospital, Bandung, Indonesia. Results. From 134 infants ? 6 months old with acute diarrhea enrolled from April 2009 to December 2012, there were 88 (65.6%) boys and 46 (34.4%) girls in this study. Rotavirus was detected in 60 (44.8 %), 32 (53.3%) of whom were exclusively breastfed. From rotavirus positive subjects, severe dehydration occurred in 4 (12.6%) exclusively breastfed infants and 6 (21.5%) not exclusively breastfed infants. No significant association was found between severe dehydration and exclusive breastfeeding (p = 0.491) in rotavirus diarrhea. Conclusions. In rotavirus diarrhea, there was no significant association between exclusive breastfeeding and severe dehydration. PMID:26612990

  1. Cost-effectiveness of collaborative care for chronically ill patients with comorbid depressive disorder in the general hospital setting, a randomised controlled trial

    PubMed Central

    Horn, Eva K; van Benthem, Tjeerd B; Hakkaart-van Roijen, Leona; van Marwijk, Harm WJ; Beekman, Aartjan TF; Rutten, Frans F; van der Feltz-Cornelis, Christina M

    2007-01-01

    Background Depressive disorder is one of the most common disorders, and is highly prevalent in chronically ill patients. The presence of comorbid depression has a negative influence on quality of life, health care costs, self-care, morbidity, and mortality. Early diagnosis and well-organized treatment of depression has a positive influence on these aspects. Earlier research in the USA has reported good results with regard to the treatment of depression with a collaborative care approach and an antidepressant algorithm. In the UK 'Problem Solving Treatment' has proved to be feasible. However, in the general hospital setting this approach has not yet been evaluated. Methods/Design CC: DIM (Collaborative Care: Depression Initiative in the Medical setting) is a two-armed randomised controlled trial with randomisation at patient level. The aim of the trial is to evaluate the treatment of depressive disorder in general hospitals in the Netherlands based on a collaborative care framework, including contracting, 'Problem Solving Treatment', antidepressant algorithm, and manual-guided self-help. 126 outpatients with diabetes mellitus, chronic obstructive pulmonary disease, or cardiovascular diseases will be randomised to either the intervention group or the control group. Patients will be included if they have been diagnosed with moderate to severe depression, based on the DSM-IV criteria in a two-step screening method. The intervention group will receive treatment based on the collaborative care approach; the control group will receive 'care as usual'. Baseline and follow-up measurements (after 3, 6, 9, and 12 months) will be performed by means of questionnaires. The primary outcome measure is severity of depressive symptoms, as measured with the PHQ-9. The secondary outcome measure is the cost-effectiveness of these treatments according to the TiC-P, the EuroQol and the SF-36. Discussion Earlier research has indicated that depressive disorder is a chronic, mostly recurrent illness, which tends to cluster with physical comorbidity. Even though the treatment of depressive disorder based on the guidelines for depression is proven effective, these guidelines are often insufficiently adhered to. Collaborative care and 'Problem Solving Treatment' will be specifically tailored to patients with depressive disorders and evaluated in a general hospital setting in the Netherlands. PMID:17324283

  2. The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals

    PubMed Central

    Wu, Robert C; Lo, Vivian; Morra, Dante; Wong, Brian M; Sargeant, Robert; Locke, Ken; Cavalcanti, Rodrigo; Quan, Sherman D; Rossos, Peter; Tran, Kim; Cheung, Mark

    2013-01-01

    Background Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness. Objectives To describe the effects of different communication interventions and their problems. Design Prospective observational case study using a mixed methods approach of quantitative and qualitative methods. Setting General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals. Participants Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards. Methods Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010. Results We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories. Conclusions Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems. PMID:23355461

  3. Exploring an Olympic "Legacy": Sport Participation in Canada before and after the 2010 Vancouver Winter Olympics.

    PubMed

    Perks, Thomas

    2015-11-01

    Guided by the notion of a trickle-down effect, the present study examines whether sport participation in Canada increased following the 2010 Winter Olympics in Vancouver. Comparing rates of sport participation prior to and following the Games using nationally representative data, the results suggest that the Olympics had almost no impact on sport participation in Canada, although there does appear to be a modest "bounce" in sport participation in the Vancouver area immediately following the Vancouver Games. As such, if the trickle-down effect did occur, the analysis suggests that the effect was locally situated, short-lived, and small. Inspirée par la notion de l'effet de retombée, la présente étude examine si la participation sportive au Canada a augmenté à la suite des Jeux olympiques d'hiver de 2010 à Vancouver. Les résultats de la comparaison des taux de participation au sport avant et après les Jeux utilisant des données représentatives au niveau national, suggèrent que les Jeux olympiques ont eu pratiquement aucun impact sur la participation sportive au Canada, même s'il semble y avoir un faible "rebond" dans la participation au sport dans la région de Vancouver immédiatement après les Jeux. Cela étant, si l'effet de retombée s'est produit, l'analyse suggère qu'il a été modeste et de courte durée et on l'a ressenti seulement localement. PMID:26577884

  4. Clinical pathways--an evaluation of its impact on the quality of care in an acute care general hospital in Singapore.

    PubMed

    Cheah, J

    2000-07-01

    A critical or clinical pathway defines the optimal care process, sequencing and timing of interventions by healthcare professionals for a particular diagnosis or procedure. It is a relatively new clinical process improvement tool that has been gaining popularity across hospitals and various healthcare organisations in many parts of the world. It is now slowly gaining momentum and popularity in Asia and Singapore. Clinical pathways are developed through collaborative efforts of clinicians, case managers, nurses, and other allied healthcare professionals with the aim of improving the quality of patient care, while minimising cost to the patient. Clinical pathways have been shown to reduce unnecessary variation in patient care, reduce delays in discharge through more efficient discharge planning, and improve the cost-effectiveness of clinical services. The approach and objectives of clinical pathways are consistent with those of total quality management (TQM) and continuous clinical quality improvement (CQI), and is essentially the application of these principles at the patient's bedside. However, despite the growing popularity of pathways, their impact on clinical outcomes and their clinical effectiveness remains largely untested and unproven through rigorous clinical trials. This paper begins with an overview of the nature of clinical pathways and the analysis of variances from the pathway, their benefits to the healthcare organisation, their application as a tool for CQI activities in direct relation to patient care, and their effectiveness in a variety of healthcare settings. The paper describes an evaluation of the impact of a clinical pathway on the quality of care for patients admitted for uncomplicated acute myocardial infarction (AMI) through an analysis of variances. The author carried out a one year evaluation of a clinical pathway on uncomplicated AMI in Changi General Hospital (CGH) to determine its effectiveness and impact on a defined set of outcomes. A before and after nonrandomized study of two groups of patients admitted to the Hospital for uncomplicated AMI was done. A total of 169 patients were managed on the clinical pathway compared to 100 patients in the control (historical comparison) group. Outcomes were compared between the two groups of patients. Restriction and matching of study subjects in both groups ensured that the patients selected were comparable in terms of severity of illness. The results showed that the patients on the clinical pathway and the comparison group were similar with respect to demographic variables, prevalence of risk factors and comorbidities. There was a statistically significant reduction in the average length of stay after implementation of the clinical pathway. This was achieved without any adverse effect on short term clinical outcomes such as in-hospital mortality, complication rate and morbidity. There were no significant difference in readmission rates at 6 months after discharge. The paper concludes that clinical pathways, implemented in the context of an acute care general hospital, is able to significantly improve care processes through better collaboration among healthcare professionals and improvements in work systems. PMID:11026801

  5. The Eocene Southern Vancouver Island Orocline --a response to seamount accretion and the cause of fold-and-thrust

    E-print Network

    Johnston, Stephen T.

    The Eocene Southern Vancouver Island Orocline -- a response to seamount accretion and the cause, the Eocene accretion of seamounts of the Crescent terrane. These findings demonstrate that oroclinal orogeny Elsevier Science B.V. All rights reserved. Keywords: Eocene Southern Vancouver Island Orocline; Seamount

  6. Reintroducing endangered Vancouver Island marmots: Survival and cause-specific mortality rates of captive-born versus wild-born individuals

    E-print Network

    Oli, Madan K.

    Reintroducing endangered Vancouver Island marmots: Survival and cause-specific mortality rates Marmota vancouverensis Population dynamics Radio-telemetry Reintroduction Survival Vancouver Island marmot a b s t r a c t Recovery of the endangered Vancouver Island marmot (Marmota vancouverensis

  7. Traveling to Canada for the Vancouver 2010 Winter Olympic and Paralympic Games.

    PubMed

    Heggie, Travis W

    2009-07-01

    The 21st Winter Olympic Games will be held in Vancouver, British Columbia, Canada from February 12 to 28, 2010. Following the Winter Olympic Games, the Winter Paralympic Games will be held from March 12 to 21, 2010. There will be 86 winter sporting events hosted in Vancouver with 5500 athletes staying in two Olympic Villages. Another 2800 members of the media, 25,000 volunteers, and 1 million spectators are expected in attendance. This paper reviews health and safety issues for all travelers to Canada for the 2010 Vancouver Winter Olympic Games with a specific focus on pre-travel planning, road and transportation safety in British Columbia, natural and environmental hazards, Olympic medical facilities, safety and security, and infectious disease. PMID:19717101

  8. Bayesian inversion of marine controlled source electromagnetic data offshore Vancouver Island, Canada

    NASA Astrophysics Data System (ADS)

    Gehrmann, Romina A. S.; Schwalenberg, Katrin; Riedel, Michael; Spence, George D.; Spieß, Volkhard; Dosso, Stan E.

    2016-01-01

    This paper applies nonlinear Bayesian inversion to marine controlled source electromagnetic (CSEM) data collected near two sites of the Integrated Ocean Drilling Program (IODP) Expedition 311 on the northern Cascadia Margin to investigate subseafloor resistivity structure related to gas hydrate deposits and cold vents. The Cascadia margin, off the west coast of Vancouver Island, Canada, has a large accretionary prism where sediments are under pressure due to convergent plate boundary tectonics. Gas hydrate deposits and cold vent structures have previously been investigated by various geophysical methods and seabed drilling. Here, we invert time-domain CSEM data collected at Sites U1328 and U1329 of IODP Expedition 311 using Bayesian methods to derive subsurface resistivity model parameters and uncertainties. The Bayesian information criterion is applied to determine the amount of structure (number of layers in a depth-dependent model) that can be resolved by the data. The parameter space is sampled with the Metropolis-Hastings algorithm in principal-component space, utilizing parallel tempering to ensure wider and efficient sampling and convergence. Nonlinear inversion allows analysis of uncertain acquisition parameters such as time delays between receiver and transmitter clocks as well as input electrical current amplitude. Marginalizing over these instrument parameters in the inversion accounts for their contribution to the geophysical model uncertainties. One-dimensional inversion of time-domain CSEM data collected at measurement sites along a survey line allows interpretation of the subsurface resistivity structure. The data sets can be generally explained by models with 1 to 3 layers. Inversion results at U1329, at the landward edge of the gas hydrate stability zone, indicate a sediment unconformity as well as potential cold vents which were previously unknown. The resistivities generally increase upslope due to sediment erosion along the slope. Inversion results at U1328 on the middle slope suggest several vent systems close to Bullseye vent in agreement with ongoing interdisciplinary observations.

  9. A prospective study of incidence of medication-related problems in general medicine ward of a tertiary care hospital

    PubMed Central

    Movva, Ramya; Jampani, Anusha; Nathani, Jyothsna; Pinnamaneni, Sri Harsha; Challa, Siva Reddy

    2015-01-01

    The study is aimed to assess the incidence of drug-related problems (DRPs) and provide pharmacist interventions for identified DRPs. A prospective, observational study was conducted among 189 patients with cardiovascular disease who were aged 18 years or older and admitted to the general medicine in-patient ward. During the 6 months study period, the incidence of DRPs was identified using Pharmaceutical Care Network Europe Foundation classification system version 6.2. A total of 189 patients were screened for DRPs. Among them, 130 patients have at least one DRP. A total of 416 DRPs were identified (on average, 2.2 DRPs per each patient). Of the 416 DRPs, 125 (30.04%) interventions were accepted, 7 (1.68%) interventions were not accepted, while remaining (68.26%) accepted but no action taken. The results of the study indicate that incidence of DRPs is substantial and pharmacist-led interventions resulted in resolution of DRPs. This represents the need for the active role of the clinical pharmacist in the developing countries like India.

  10. Occupational stress and mental health among nurses in a medical intensive care unit of a general hospital in Bandar Abbas in 2013

    PubMed Central

    Tajvar, Abdolhamid; Saraji, Gebraeil Nasl; Ghanbarnejad, Amin; Omidi, Leila; Hosseini, Seyed Sodabeh Seyed; Abadi, Ali Salehi Sahl

    2015-01-01

    Background: Many nurses have reported experiencing high levels of occupational stress in their work environment. Stress, as an outcome of stressful workplaces and tasks, affects nursing behavior in hospital wards. The objectives of this research were to determine the prevalence of occupational stress and mental health problems in nurses in the intensive care unit (ICU) at Shahid Mohammadi Hospital in Bandar Abbas in 2013 and to determine the relationship between occupational stress and mental health. Methods: This cross-sectional study was conducted in 2013 on all of the nurses working in ICU at Shahid Mohammadi Hospital located in Bandar Abbas, Iran. Seventy-two nurses were selected as the population for this study, and all of them were female. Two questionnaires were used in this study, i.e., General Health Questionnaire-28 (GHQ-28) for assessing mental health and an occupational stress test for assessing job stress. Furthermore, the relationship between occupational stress and mental health was examined. One-way analysis of variance (ANOVA), independent samples t-test, and Pearson’s product-moment correlation test were used to analyze the data. Results: High and moderate levels of occupational stress were experienced by 83.9% and 10.7% of ICU nurses, respectively. The prevalence of mental disorders, somatic symptoms, anxiety, social dysfunction, and depression were 58.9, 60.7, 62.5, 71.4, and 10.7%, respectively. The findings of the independent samples t-test showed that somatic symptoms had significant relationships with age and working experience (p = 0.01). According to the independent samples t-test, there were no significant differences between somatic symptoms and working different shifts (p > 0.05). Conclusions: There was a high prevalence of occupational stress among ICU nurses. There was a significant relationship between occupational stress and mental health. Future interventions are needed to codify a comprehensive health program in this field to reduce occupational stress and enhance nurses’ levels of mental health. PMID:26388976

  11. Suicide attempts and related factors in patients admitted to a general hospital: a ten-year cross-sectional study (1997-2007)

    PubMed Central

    2011-01-01

    Background Suicide and suicide attempts represent a severe problem for public health services. The aim of this study is to determine the socio-demographic and psychopathological variables associated with suicide attempts in the population admitted to a General Hospital. Methods An observational-descriptive study of patients admitted to the A Coruña University Hospital (Spain) during the period 1997-2007, assessed by the Consultation and Liaison Psychiatric Unit. We include n = 5,234 admissions from 4,509 patients. Among these admissions, n = 361 (6.9%) were subsequent to a suicide attempt. Admissions arising from a suicide attempt were compared with admissions occurring due to other reasons. Multivariate generalised estimating equation logistic regression models were used to examine factors associated with suicide attempts. Results Adjusting by age, gender, educational level, cohabitation status, being employed or unemployed, the psychiatric diagnosis at the time of the interview and the information on previous suicide attempts, we found that the variables associated with the risk of a suicide attempt were: age, psychiatric diagnosis and previous suicide attempts. The risk of suicide attempts decreases with age (OR = 0.969). Psychiatric diagnosis was associated with a higher risk of suicide attempts, with the highest risk being found for Mood or Affective Disorders (OR = 7.49), followed by Personality Disorders (OR = 7.31), and Schizophrenia and Other Psychotic Disorders (OR = 5.03). The strongest single predictive factor for suicide attempts was a prior history of attempts (OR = 23.63). Conclusions Age, psychopathological diagnosis and previous suicide attempts are determinants of suicide attempts. PMID:21453478

  12. The clinical pattern of renal diseases in the nephrology in-patient unit of the Yaounde General Hospital in Cameroon: a five-year audit

    PubMed Central

    Kaze, Francois Folefack; Ekokobe, Forbin Elias; Halle, Marie Patrice; Fouda, Hermine; Menanga, Alain Patrick; Ashuntantang, Gloria

    2015-01-01

    Introduction Kidney diseases are a growing worldwide problem and one of the major public health threats. We analyzed the spectrum of kidney diseases seen over a five-year period in the nephrology in-patient unit of the Yaounde general hospital. Methods This was a retrospective analysis of 225 medical records of patients admitted from January 2005 to December 2009 in the unit with a discharge diagnosis of kidney and urinary tract diseases. The first hospitalization was considered for patients admitted several times for the same disease. Socio-demographic and clinical patient data were recorded. Results The patients mean age was 44.8±16 years with 135 (60%) males and 211 (93.8%) emergency admissions. All 139 (61.8%) patients with chronic kidney disease (CKD) had chronic renal failure. Acute kidney injury (AKI) (28%), nephrotic syndrome (7.6%), renal colic (1.3%) and acute pyelonephritis (1.3%) were other patterns observed. Chronic glomerulonephritis (25.9%), hypertension (22.3%) and diabetes (20.1%) were the main etiological factors of CKD. All AKI patients were in stage RIFLE-F. AKI was secondary to parenchymal (58.7%), functional (25.4%) and obstructive (15.9%) etiologies. Black water fever (36.4%), sepsis (22.7%), drugs (18.2%), eclampsia (13.6%) and herbal concoctions (9.1%) were the etiologies of acute tubular necrosis while enterocolitis (56.2%), heart failure (31.3%) and digestive hemorrhage (12.5%) were the etiologies of functional AKI. Conclusion The clinical pattern of renal diseases is dominated by advanced CKD and AKI secondary to preventable causes. This study suggests a need for an array of actions including sensitization, continuous medical education and strengthening of the health system. PMID:26421100

  13. Human papillomavirus genotypes distribution by cervical cytologic status among women attending the General Hospital of Loandjili, Pointe-Noire, Southwest Congo (Brazzaville).

    PubMed

    Boumba, Luc Magloire Anicet; Qmichou, Zineb; Mouallif, Mustapha; Attaleb, Mohammed; El Mzibri, Mohammed; Hilali, Lahoucine; Donatien, Moukassa; Ennaji, Moulay Mustapha

    2015-10-01

    HPV infection is associated with cervical cancer, one of the major public health problems in developing countries. In the Republic of Congo, despite of the high age-standardized incidence rate estimated at 25.2 per 100,000 women, molecular epidemiology data on HPV infections are very limited. We investigated HPV genotypes distribution in cervical smears among patients attending the General Hospital of Loandjili, Southwest Congo. A cross-sectional hospital-based study was conducted on 321 women. Liquid-based cytology samples were collected for cytological diagnosis and HPV detection. Nested-PCR was performed using MY09/MY11 and GP5+/GP6+ primers with genotyping by direct sequencing. Type-specific PCR for HPV-6, -11, -16, -18, -31 and -33 was also used to assess multiple infections. Out of 321 women examined, 189 (58.8%) had normal cytology, 16 (5.0%) had ASCUS and 116 (36.1%) had cytological abnormalities. HPV-DNA was detected in 22 (11.6%), 6 (37.5%), and 104 (89.6%) normal cytology, ASCUS and cytological abnormalities respectively. HPV16 was the most prevalent genotype regardless of cytological status followed by HPV70 in women without lesions and HPV33 among those with lesions. HR-HPV prevalence varied significantly according to the cervical cytology (P?=?0.000). Among women without lesions, two peaks of HPV infections were observed in age group less than 30 years (60.0%) and in age group 50-59 years (7.1%). Age, age of first sex, multiple sexual partners and pregnancies were the risk factors for HPV infection in women without lesions. Our findings could be used as evidence data base for future epidemiological monitoring in this region. PMID:25963674

  14. Demographics, Clinical Characteristics, and Treatment of Aggressive Patients Admitted to the Acute Behavioral Unit of a Community General Hospital: A Prospective Observational Study

    PubMed Central

    Reade, Cynthia; Stoltzfus, Jill; Mittal, Vikrant

    2014-01-01

    Objective: Aggressive patients are not uncommon in acute inpatient behavioral health units of general hospitals. Prior research identifies various predictors associated with aggressive inpatient behavior. This prospective observational study examines the demographic and clinical characteristics of aggressive inpatients and the routine medications these patients were receiving at discharge. Method: Thirty-six adults diagnosed with a DSM-IV mental disorder who met 2 of 6 established inclusion criteria for high violence risk and a Clinical Global Impressions–Severity of Illness (CGI-S) scale score ? 4 were observed for a maximum of 28 days on the 23-bed case mix acute behavioral health unit of St Luke’s University Hospital, Bethlehem, Pennsylvania, from January 2012 to May 2013. Primary outcome measures were the Modified Overt Aggression Scale (MOAS) and CGI-S; secondary measures were symptom outcome measures and demographic and clinical characteristics data. Analysis was conducted using repeated measures methodology. Results: Younger males with a history of previous violence, psychiatric admissions, and symptoms of severe agitation were more at risk for aggressive behavior. Positive psychotic symptoms, a diagnosis of bipolar disorder, substance use, and comorbid personality disorders also increased risk. Significant improvements from baseline to last visit were observed for the CGI-S and MOAS (P < .001 for both), with a significant correlation between the MOAS and CGI-S at last visit (P < .001). Only the symptom of agitation was significantly correlated to MOAS scores at both baseline and last visit (P < .001). Conclusion: Patients significantly improved over time in both severity of illness and level of aggression. PMID:25317364

  15. Feasibility and efficacy of upper limb robotic rehabilitation in a1 sub-acute cervical spinal cord injury population2

    E-print Network

    Popovic, Milos R.

    Feasibility and efficacy of upper limb robotic rehabilitation in a1 sub-acute cervical spinal cord and Rehabilitation, University of British Columbia, Vancouver12 5. Spinal Cord Injury Center, University Hospital Spinal Cord Centre26 Vancouver General Hospital27 818 West 10th Avenue28 Vancouver, V5Z 1M9, Canada29 Tel

  16. Compare Hospitals

    MedlinePLUS

    ... visit Hospital Safety Score Home Employers & Purchasers Policy Leadership Hospitals Patients Licenses & Permissions About Leapfrog Search 2015 ... fare, resources used in caring for patients, and leadership and structures that promote patient safety. The Leapfrog ...

  17. Understanding hospitality.

    PubMed

    Patten, C S

    1994-03-01

    Bridging patient/"customer" issues and business aspects can be aided through developing a specific nursing basis for hospitality. The ancient practice of hospitality has evolved into three distinct levels: public, personal and therapeutic. Understanding these levels is helpful in integrating various dimensions of guest relations programs in hospitals into a more comprehensive vision. Hospitality issues must become a greater part of today's nursing management. PMID:8134046

  18. Washington State University Vancouver Mech 442/542 Advanced Thermal Systems Mechanical Engineering Spring 2013 Syllabus

    E-print Network

    and thermal management, microchannel heat transfer, energy resources, renewable energy, thermal systems. Thermal energy systems 5. Energy resources and renewable energy #12;Washington State University Vancouver energy systems Energy resources and renewable energy Exams Homework WSU-LO 7: Depth, breadth, an

  19. Too Much French? Not Enough French?: The Vancouver Olympics and a Very Canadian Language Ideological Debate

    ERIC Educational Resources Information Center

    Vessey, Rachelle

    2013-01-01

    This paper discusses a language ideological debate that took place in Canadian national newspapers following the opening ceremonies for the 2011 Vancouver Olympics. Reports on the insufficient use of French during the opening ceremonies sparked protest from politicians, official commentators, citizens and online newsreaders alike. Previous…

  20. Adventure Education and the Acculturation of First-Generation Chinese Canadians in Vancouver, Canada

    ERIC Educational Resources Information Center

    Lo, Simon; Gidlow, Bob; Cushman, Grant

    2014-01-01

    This article reports on research that demonstrates how parents in first-generation Chinese families in Vancouver, Canada, most of them from Hong Kong, control their children's involvement in local adventure education (AE) programs and in so doing minimize the likelihood of intergenerational culture conflict involving those children. The research…

  1. A made-in-Canada solution to E. coli 0157 outbreaks Vancouver Sun

    E-print Network

    van den Doel, Kees

    A made-in-Canada solution to E. coli 0157 outbreaks Vancouver Sun Tue Oct 23 2012 Page: A12 Section viable solution to avoiding such beef recalls as well as preventing E. coli O157 outbreaks - we should vaccinate cattle against E. coli O157: H7. Research shows this Canadian- discovered and commercialized

  2. Embracing a New Understanding of the City: The Museum of Vancouver's Vision in Action

    ERIC Educational Resources Information Center

    Gosselin, Viviane

    2013-01-01

    The Museum of Vancouver recently undertook a major rethinking of its role in the city. New interplays are being proposed between emerging conceptions of urbanity and civic participation, and the museum's collection and function as facilitator and advocate. This short paper provides a brief overview of the museum's recent transformation, situates…

  3. Invited Presentation, EdMedia '94 Vancouver, Canada page 1 Issues and Obstacles with Multimedia Authoring

    E-print Network

    , that of multimedia conference proceedings, multimedia courseware development and multimedia information kiosks. We with traditional teaching methods. Just as multimedia authoring systems vary, so do the users of these systems. NewInvited Presentation, EdMedia '94 Vancouver, Canada page 1 Issues and Obstacles with Multimedia

  4. Immigrants as Active Citizens: Exploring the Volunteering Experience of Chinese Immigrants in Vancouver

    ERIC Educational Resources Information Center

    Guo, Shibao

    2014-01-01

    Despite the fact that immigration has played an important role in transforming Canada into an ethno-culturally diverse and economically prosperous nation, immigrants themselves are often criticised as passive citizens. This study attempts to deconstruct this myth by investigating the volunteering experiences of Chinese immigrants in Vancouver. The…

  5. Educational Inclusion/Exclusion of Turkish Immigrant Youth in Vancouver, Canada: A Critical Analysis

    ERIC Educational Resources Information Center

    Kayaalp, Dilek

    2014-01-01

    This empirical research analyses an understudied population, Turkish immigrant youths' educational experiences of inclusion/exclusion in Vancouver. My information was gathered from in-depth interviews and participant observation with the first- and second-generation, Muslim and non-religious female and male Turkish immigrant youth from…

  6. 10TH INTERNATIONAL CONFERENCE ON MATHEMATICAL AND NUMERICAL ASPECTS OF WAVES VANCOUVER, CANADA, JULY 2529, 2011

    E-print Network

    Gordon, Dan

    10TH INTERNATIONAL CONFERENCE ON MATHEMATICAL AND NUMERICAL ASPECTS OF WAVES VANCOUVER, CANADA frequencies (large wave numbers) is a challenging com- putational task. Compounding the problem is the well differential equation (PDE). An additional problem with high wave numbers is the so-called "pollution" effect

  7. The City of Vancouver's Approach to Electric Vehicles: Malcolm Shield, Climate Policy Manager

    E-print Network

    California at Davis, University of

    1 The City of Vancouver's Approach to Electric Vehicles: 7 Pillars Malcolm Shield, Climate PolicyV ­ BCH Conservation Collaborative Identifies EVs as priority area City buys first Canadian plug-in Prius and leases first Canadian Mitsubishi EV CoV becomes (and still is) only Canadian member of `Project Get Ready

  8. Washington State University Vancouver Mech 303 Fluid Mechanics Mechanical Engineering Fall 2013 Syllabus

    E-print Network

    Washington State University Vancouver Mech 303 Fluid Mechanics Mechanical Engineering Fall 2013 Syllabus 1 Fluid Mechanics Course: Mech 303, Fluid Mechanics, 3 Credits Prerequisite: Dynamics (Mech 212: VECS 105 Textbook: Fundamentals of Fluid Mechanics, 7 th Edition By Munson, Okiishi, Huebsch

  9. WSU Vancouver App Guidelines We encourage you to work directly with the department of Marketing and

    E-print Network

    WSU Vancouver App Guidelines We encourage you to work directly with the department of Marketing and Communication as well as the Information Technology department before submitting apps to the iOS App Store, Google Play or Windows Marketplace. IMPORTANT: All apps must be sent for final approval to WSU Trademark

  10. Washington State University Vancouver Mech 515 Advanced Heat Transfer Mechanical Engineering Fall 2012 Syllabus

    E-print Network

    Washington State University Vancouver Mech 515 Advanced Heat Transfer Mechanical Engineering Fall 2012 Syllabus 1 Advanced Heat Transfer Course: Mech 515, Advanced Heat Transfer, 3 Credits Prerequisite: Graduate standing Heat Transfer (Mech 404 or equivalent) ­ recommended Advanced Fluid Mechanics (Mech 521

  11. Building a Virtual Branch at Vancouver Public Library Using Web 2.0 Tools

    ERIC Educational Resources Information Center

    Cahill, Kay

    2009-01-01

    Purpose: The purpose of this paper is to demonstrate the work undertaken by Vancouver Public Library (VPL) in an effort to convert its website into a true virtual branch, both through the functionality of the website itself and by extending its web presence on to external social networking sites. Design/methodology/approach: VPL worked with its…

  12. Engaging Language and Cultural Spaces: Latin American Parents' Reflections on Language Loss and Maintenance in Vancouver

    ERIC Educational Resources Information Center

    Guardado, Martin

    2006-01-01

    This qualitative study aims to explore the loss and maintenance of Spanish in Latin American children in Vancouver from the perspective of parents. It focuses on the experiences of children either developing bilingually (Spanish-English) or monolingually (English). The participating families were from Colombia, Guatemala, and El Salvador, and had…

  13. Vancouver Community College 1991 Discontinuant Follow-Up Outcomes Report (Occupational Programs).

    ERIC Educational Resources Information Center

    Yao, Min

    Each year, in order to determine the factors that influence student attrition, Vancouver Community College (VCC) selectively surveys former students who dropped out (discontinuants) of occupational programs on VCC's three main campuses. Former students were surveyed regarding their personal characteristics, main goals for coming to VCC, activities…

  14. Female Genital Mutilation in Infants and Young Girls: Report of Sixty Cases Observed at the General Hospital of Abobo (Abidjan, Cote D'Ivoire, West Africa)

    PubMed Central

    Plo, Kouie; Asse, Kouadio; Seï, Dohagneron; Yenan, John

    2014-01-01

    The practice of female genital mutilations continues to be recurrent in African communities despite the campaigns, fights, and laws to ban it. A survey was carried out in infants and young girls at the General Hospital of Abobo in Cote D'Ivoire. The purpose of the study was to describe the epidemiological aspects and clinical findings related to FGM in young patients. Four hundred nine (409) females aged from 1 to 12 years and their mothers entered the study after their consent. The results were that 60/409 patients (15%) were cut. The majority of the young females came from Muslim families (97%); the earlier age at FGM procedure in patients is less than 5 years: 87%. Amongst 409 mothers, 250 women underwent FGM which had other daughters cut. Women were mainly involved in the FGM and their motivations were virginity, chastity, body cleanliness, and fear of clitoris similar to penis. Only WHO types I and II were met. If there were no incidental events occurred at the time of the procedure, the obstetrical future of these young females would be compromised. With FGM being a harmful practice, health professionals and NGOs must unite their efforts in people education to abandon the procedure. PMID:24729789

  15. Female sexual dysfunction: A comparative study in drug naive 1st episode of depression in a general hospital of South Asia

    PubMed Central

    Roy, Payel; Manohar, Shivananda; Raman, Rajesh; Sathyanarayana Rao, T. S.; Darshan, M. S.

    2015-01-01

    Background: Women's sexual dysfunction is found to be highly prevalent in western and Indian literature. Limited studies are available on drug naive depression in western literature and in Indian population. Aim: To determine the prevalence rate and symptom profile of female sexual dysfunctions in patients with untreated depression. Design: A cross-sectional study in the psychiatry out-patient department of general hospital in South India. Materials and Methods: Following written informed consent female sexual functioning index (FSFI) and Arizona Sexual Experience Scale (ASEX) – female version and Hamilton Depression Rating Scale (HAMD - 17 item) on 30 cases and 30 controls was administered. Sociodemographic data, pattern and type of sexual dysfunctions were enquired. Data were analyzed using descriptive statistics, contingency co-efficient analysis and stepwise multiple regression. Results: The mean score of HAMD 17 item in study group was 19.13. The study showed that female sexual dysfunction was 70.3% in study group compared to 43.3% in control FSFI scores above 16 in HAMD had dysfunction of 76% with FSFI in study group. With ASEX-F sexual dysfunction was 73.3% in study compared to 20% in control. Scores above 16 in HAMD had 80% of sexual dysfunction with ASEX-F in study group. Conclusion: The study found that ASEX-F co-related better with HAMD 17 item. Following the onset of depression, the incidence of sexual dysfunction started at an early age in women. PMID:26600576

  16. Female genital mutilation in infants and young girls: report of sixty cases observed at the general hospital of abobo (abidjan, cote d'ivoire, west Africa).

    PubMed

    Plo, Kouie; Asse, Kouadio; Seï, Dohagneron; Yenan, John

    2014-01-01

    The practice of female genital mutilations continues to be recurrent in African communities despite the campaigns, fights, and laws to ban it. A survey was carried out in infants and young girls at the General Hospital of Abobo in Cote D'Ivoire. The purpose of the study was to describe the epidemiological aspects and clinical findings related to FGM in young patients. Four hundred nine (409) females aged from 1 to 12 years and their mothers entered the study after their consent. The results were that 60/409 patients (15%) were cut. The majority of the young females came from Muslim families (97%); the earlier age at FGM procedure in patients is less than 5 years: 87%. Amongst 409 mothers, 250 women underwent FGM which had other daughters cut. Women were mainly involved in the FGM and their motivations were virginity, chastity, body cleanliness, and fear of clitoris similar to penis. Only WHO types I and II were met. If there were no incidental events occurred at the time of the procedure, the obstetrical future of these young females would be compromised. With FGM being a harmful practice, health professionals and NGOs must unite their efforts in people education to abandon the procedure. PMID:24729789

  17. Parasuicide and drug self-poisoning: analysis of the epidemiological and clinical variables of the patients admitted to the Poisoning Treatment Centre (CAV), Niguarda General Hospital, Milan

    PubMed Central

    2005-01-01

    Epidemiological knowledge of parasuicides and drug self-poisoning is still limited by a lack of data. A number of preliminary studies, which require further analysis, evidenced that parasuicidal acts occur more often among females, that the peak rate is generally recorded between the ages of 15 and 34 years and psychotropic medications seems to be the most frequently used. The aim of this study was to describe the demographic and clinical variables of a sample of subjects admitted to the Posisoning Treatment Centre (CAV), Niguarda General Hospital, Milan, following drug self-poisoning. Furthermore, this study is aimed to identify the risk factors associated to parasuicidal gestures, with special care for the used drugs, the presence of psychiatric or organic disorders, alcoholism and drug addiction. The study included the 201 patients attending the CAV in 1999 and 2000 who satisfied the criteria of self-poisoning attempts: 106 cases in 1999 and 95 in 2000. The sample had a prevalence of females (64%). The peak rates of parasuicides from drug self-poisoning were reached between 21 and 30 years among the females, and 31 and 40 years among the males. 81.6% of the patients used one or more psychoactive drugs, the most frequent being the benzodiazepines (58.7%), classic neuroleptics (16.9%) and new-generation antidepressants (SSRIs, SNRIs, NARIs) (12.9%). The prevalence of mood disorders was higher among females (64% vs 42%), whereas schizophrenia was more frequently diagnosed in males (22% vs 10%). 61% (33%) had a history of previous attempted suicides. The presence of clinically relevant organic diseases was observed in 24.9% of the sample. PMID:15967050

  18. Disasters within hospitals.

    PubMed

    Aghababian, R; Lewis, C P; Gans, L; Curley, F J

    1994-04-01

    Hospital disaster planning should encompass events that affect the safety of the hospital environment and address those measures that ensure the availability of necessary services. Although most of the emphasis has been placed on general disaster planning, there is little written about disasters occurring within a hospital. In recent years, several incidents at our medical center involving fire, flood, and power failure resulted in a reevaluation of our preparedness to handle such situations. These experiences prompted this discussion and literature review of internal disaster plan because it is likely that at some time an internal emergency may occur. PMID:8161046

  19. MENTAL HOSPITALS IN INDIA

    PubMed Central

    Krishnamurthy, K.; Venugopal, D.; Alimchandani, A.K.

    2000-01-01

    This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present status The earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals. Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and grovernmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses. PMID:21407925

  20. Winter distribution, movements, and annual survival of radiomarked Vancouver Canada geese in Southeast Alaska

    USGS Publications Warehouse

    Hupp, J.W.; Hodges, J.I., Jr.; Conant, B.P.; Meixell, B.W.; Groves, D.J.

    2010-01-01

    Management of Pacific Flyway Canada geese (Branta canadensis) requires information on winter distribution of different populations. Recoveries of tarsus bands from Vancouver Canada geese (B. canadensis fulva) marked in southeast Alaska, USA, ???4 decades ago suggested that ???83% of the population was non-migratory and that annual adult survival was high (?? = 0.836). However, recovery distribution of tarsus bands was potentially biased due to geographic differences in harvest intensity in the Pacific Flyway. Also, winter distribution of Vancouver Canada geese could have shifted since the 1960s, as has occurred for some other populations of Canada geese. Because winter distribution and annual survival of this population had not recently been evaluated, we surgically implanted very high frequency radiotransmitters in 166 adult female Canada geese in southeast Alaska. We captured Vancouver Canada geese during molt at 2 sites where adults with goslings were present (breeding areas) and 2 sites where we observed nonbreeding birds only. During winter radiotracking flights in southeast Alaska, we detected 98% of 85 females marked at breeding areas and 83% of 70 females marked at nonbreeding sites, excluding 11 females that died prior to the onset of winter radiotracking. We detected no radiomarked females in coastal British Columbia, or western Washington and Oregon, USA. Most (70%) females moved ???30 km between November and March. Our model-averaged estimate of annual survival (?? = 0.844, SE = 0.050) was similar to the estimate of annual survival of geese marked from 1956 to 1960. Likely <2% of Vancouver Canada geese that nest in southeast Alaska migrate to winter areas in Oregon or Washington where they could intermix with Canada geese from other populations in the Pacific Flyway. Because annual survival of adult Vancouver Canada geese was high and showed evidence of long-term consistency, managers should examine how reproductive success and recruitment may affect the population. ?? The Wildlife Society.

  1. Winter distribution, movements, and annual survival of radiomarked Vancouver Canada geese in southeast Alaska

    USGS Publications Warehouse

    Hupp, Jerry W.; Hodges, John I., Jr.; Conant, Bruce P.; Meixell, Brandt W.; Groves, Debbie J.

    2010-01-01

    Management of Pacific Flyway Canada geese (Branta canadensis) requires information on winter distribution of different populations. Recoveries of tarsus bands from Vancouver Canada geese (B. canadensis fulva) marked in southeast Alaska, USA, ?4 decades ago suggested that ?83% of the population was non-migratory and that annual adult survival was high (? = 0.836). However, recovery distribution of tarsus bands was potentially biased due to geographic differences in harvest intensity in the Pacific Flyway. Also, winter distribution of Vancouver Canada geese could have shifted since the 1960s, as has occurred for some other populations of Canada geese. Because winter distribution and annual survival of this population had not recently been evaluated, we surgically implanted very high frequency radiotransmitters in 166 adult female Canada geese in southeast Alaska. We captured Vancouver Canada geese during molt at 2 sites where adults with goslings were present (breeding areas) and 2 sites where we observed nonbreeding birds only. During winter radiotracking flights in southeast Alaska, we detected 98% of 85 females marked at breeding areas and 83% of 70 females marked at nonbreeding sites, excluding 11 females that died prior to the onset of winter radiotracking. We detected no radiomarked females in coastal British Columbia, or western Washington and Oregon, USA. Most (70%) females moved ?30 km between November and March. Our model-averaged estimate of annual survival (? = 0.844, SE = 0.050) was similar to the estimate of annual survival of geese marked from 1956 to 1960. Likely <2% of Vancouver Canada geese that nest in southeast Alaska migrate to winter areas in Oregon or Washington where they could intermix with Canada geese from other populations in the Pacific Flyway. Because annual survival of adult Vancouver Canada geese was high and showed evidence of long-term consistency, managers should examine how reproductive success and recruitment may affect the population.

  2. The association between work ethics and attitudes towards organizational changes among the administrative, financial and support employees of general teaching hospitals

    PubMed Central

    Ravangard, Ramin; Sajjadnia, Zahra; Jafari, Abdosaleh; Shahsavan, Najme; Bahmaie, Jamshid; Bahadori, Mohammadkarim

    2014-01-01

    In order to achieve success in today’s competitive world, organizations should adapt to environmental changes. On the other hand, managers should have a set of values and ethical guidelines for their administrative and organizational functions. This study aimed to investigate the association between work ethics and attitudes towards organizational changes among the administrative, financial and support employees of general teaching hospitals affiliated to Shiraz University of Medical Sciences. This was an applied, cross-sectional and descriptive-analytic study conducted in 2013. A sample of 124 employees was selected using stratified sampling proportional to size and simple random sampling methods. Data were collected using 2 questionnaires measuring the dimensions of employees' work ethics (four dimensions) and attitudes towards organizational changes (three dimensions). The collected data were analyzed using SPSS 18.0 and statistical tests, including ANOVA, independent samples t-test, and Pearson’s correlation coefficient. A P < 0.05 was considered statistically significant. The maximum and minimum score of work ethic dimensions were related to being cooperative (4.60 ± 0.38) and dependable (4.29 ± 0.39) respectively. On the other hand, the maximum and minimum score of attitudes towards the various dimensions of organizational changes were related to the behavioral (3.83 ± 0.70) and the affective (3.55 ± 0.88) dimensions respectively. Furthermore, there was a significant relationship between the work ethics and education levels of the employees in this study (P = 0.003). Also, among work s dimensions, only being considerate had a significant association with attitudes towards organizational changes (P = 0.014) and their cognitive dimension (P = 0.005). To improve employees' work ethics and attitudes towards organizational changes, the following suggestions can be offered: training hospitals managers in participative management style and its application, as well as the importance of meeting the employees' needs and expectations based on their characteristics; familiarizing employees with the Islamic work ethic; educating employees on the importance of being considerate towards their colleagues and subordinates in the workplace, and reinforcing this desirable quality; and finally, clarifying the need for changes in the organization for all employees. PMID:25512831

  3. Fusion Power Associates, 2011 Annual Meeting 1 General Fusion

    E-print Network

    Fusion Power Associates, 2011 Annual Meeting 1 General Fusion #12;Fusion Power Associates, 2011 Annual Meeting 2 General Fusion Making commercially viable fusion power a reality. · Founded in 2002, based in Vancouver, Canada · Plan to demonstrate a fusion system capable of "net gain" within 3 years

  4. De novo and secondary acute myeloid leukemia in patients over the age of 65: a review of fifty-six successive and unselected cases from a general hospital.

    PubMed

    Bauduer, F; Ducout, L; Dastugue, N; Capdupuy, C; Renoux, M

    1999-10-01

    Fifty-six patients older than 65 (median age: 77, range: 65-91) were treated in our general hospital, between January 1991 and November 1995 with the diagnosis of AML. Twenty-five were de novo AML (45%). The other cases which were considered as secondary AML (sAML) occurred after: myelodysplastic syndromes (19 cases: 34%), myeloproliferative disorders (7: 13%) or therapy of malignancies (5: 9%). Distribution of FAB subtypes was: M0: 4, M1: 8, M2: 14, M4: 10, M4eo: 1, M5: 10, M6: 1, unclassified: 8. Twenty-seven patients (48%) (de novo: 18, sAML: 9) received conventional "3 + 5" or "3 +7" induction chemotherapy +/- consolidation and maintenance (group 1). Low-dose Ara-C was given in eighteen cases (32%) (group 2), miscellaneous single agents were prescribed in seven cases and two patients received only supportive care. Sixteen early deaths (ED) (<1 month) occurred (29%). Distribution of age, WHO-PS, hyperleukocytosis, ED and median survival (MS) (3 months) was equivalent in de novo and sAML. Fifteen CR were achieved including twelve patients from group 1 (no difference between age <75 versus >75 years) and three from group 2. The MS of CR patients was 13 months. Eleven patients survived more than one year (de novo: 8). M5 subtype, fever >38 degrees C, high LDH level, WHO-PS>2, CR non achievement were predictive of reduced survival. Besides conventional induction, investigational therapies currently remain the best antileukemic modalities. Age per se should not be an exclusion criteria for treatment. Our data underline the high frequency of sAML in the community. Of note, this common type AML is largely excluded from many trials. PMID:10706452

  5. Combined proton and photon irradiation for craniopharyngioma: Long-term results of the early cohort of patients treated at Harvard Cyclotron Laboratory and Massachusetts General Hospital

    SciTech Connect

    Fitzek, Markus M.; Linggood, Rita M.; Adams, Judy; Munzenrider, John E. . E-mail: jmunzenrider@partners.org

    2006-04-01

    Purpose: We report the results of the early cohort of patients treated for craniopharyngioma with combined proton-photon irradiation at the Massachusetts General Hospital and the Harvard Cyclotron Laboratory. Methods and Materials: Between 1981 and 1988, 15 patients with craniopharyngioma were treated in part or entirely with fractionated 160 MeV proton beam therapy. The group consisted of 5 children (median age, 15.9 years) and 10 adults (median age, 36.2 years). Median dose prescribed to the tumor was 56.9 cobalt Gray equivalent (CGE; 1 proton Gray = 1.1 CGE). The median proton component was 26.9 CGE. Patients were treated after documented recurrence after initial surgery (n = 6) or after subtotal resection or biopsy (n = 9). None had had prior radiation therapy. Results: Median observation period of surviving patients (n = 11) was 13.1 years from radiotherapy. One patient was lost to follow-up with tumor control after 5.2 years. Actuarial 10-year survival rate was 72%. Four patients have died 5-9.1 years after treatment, two from local failure. Actuarial 5- and 10-year local control rates were 93% and 85%, respectively. The functional status of the living adult patients is unaltered from their preradiotherapy status; all of them continued leading normal or near normal working lives. None of the patients treated as a child had experienced recurrence of tumor. One child shows learning difficulties and slight retardation, comparable to his preradiotherapy status. The others have professional achievements within the normal range. Conclusion: Results in terms of survival and local control are comparable with other contemporary series. Although no formal neuropsychological testing was performed, the surrogate measures of lifestyle and professional accomplishments appear to be satisfactory.

  6. A temporal comparison of PBDEs, OH-PBDEs, PCBs, and OH-PCBs in the serum of second trimester pregnant women recruited from San Francisco General Hospital, California

    PubMed Central

    Zota, Ami R.; Linderholm, Linda; Park, June-Soo; Petreas, Myrto; Guo, Tan; Privalsky, Martin L.; Zoeller, R. Thomas; Woodruff, Tracey J.

    2013-01-01

    Prenatal exposures to polybrominated diphenyl ethers (PBDEs) can harm neurodevelopment in humans and animals. In 2003–2004, PentaBDE and OctaBDE were banned in California and phased-out of US production; resulting impacts on human exposures are unknown. We previously reported that median serum concentrations of PBDEs and their metabolites (OH-PBDEs) among second trimester pregnant women recruited from San Francisco General Hospital (2008–2009; n=25) were the highest among pregnant women worldwide. We recruited another cohort from the same clinic in 2011–2012 (n=36) and now compare serum concentrations of PBDEs, OH-PBDEs, polychlorinated biphenyl ethers (PCBs) (structurally similar compounds banned in 1979), and OH-PCBs between two demographically similar cohorts. Between 2008–2009 and 2011–2012, adjusted least square geometric mean (LSGM) concentrations of ?PBDEs decreased 65% (95% CI: 18, 130) from 90.0 ng/g lipid (95% CI: 64.7,125.2) to 54.6 ng/g lipid (95% CI: 39.2, 76.2) (p=0.004); ? OH-PBDEs decreased six-fold (p<0.0001); and BDE-47, -99, and -100 declined more than BDE-153. There was a modest, non-significant (p=0.13) decline in LSGM concentrations of ?PCBs and minimal differences in ?OH-PCBs between 2008–2009 and 2011–2012. PBDE exposures are likely declining due to regulatory action, but the relative stability in PCB exposures suggests PBDE exposures may eventually plateau and persist for decades. PMID:24066858

  7. Trend in admissions, clinical features and outcome of preeclampsia and eclampsia as seen from the intensive care unit of the Douala General Hospital, Cameroon

    PubMed Central

    Priso, Eugene Belley; Njamen, Theophile Nana; Tchente, Charlotte Nguefack; Kana, Albert Justin; Landry, Tchuenkam; Tchawa, Ulrich Flore Nyaga; Hentchoya, Romuald; Beyiha, Gerard; Halle, Marie Patrice; Aminde, Leopold; Dzudie, Anastase

    2015-01-01

    Introduction Hypertensive disorders in pregnancy (HDP) are a major cause of maternal morbidity and mortality. We aimed at determining the trends in admission, profiles and outcomes of women admitted for preeclampsia and eclampsia to an intensive care unit (ICU) in Cameroon. Methods A retrospective study involving 74 women admitted to the ICU of the Douala General Hospital for severe preeclampsia and eclampsia from January 2007 to December 2014. Clinical profiles and outcome data were obtained from patient records. Statistical analysis was performed using SPSS version 20. Results Of the 74 women admitted to ICU (72.5% for eclampsia), mean age was 30.2years and the majority (90.5%) were aged 20-39 years. While overall trend in admission for HDP increased over the years, mortality remained stable. Mean gestational age (GA) on admission was 34.0 weeks (33.5 for preeclampsia vs 35.4 for eclampsia). Most patients presented with complications of which acute kidney injury was most frequent (66.7%). Visual problems were more common in patients with eclampsia compared to preeclampsia (p = 0.01). HELLP syndrome and acute pulmonary oedema (APO) were predominant in patients with preeclampsia, while cerebrovascular accidents (CVA) occurred more in patients with eclampsia. Overall mortality was 24.3%. Presence of APO was associated with mortality in multivariable analysis (O.R.= 0.03, p = 0,01). Conclusion Trends in admission for HDP were increasing with high but stable mortality rate. Patients presented late most of whom with complications. Interventions improving antenatal care services and multidisciplinary management approach may improve maternal outcome in patients with HDP. PMID:26523163

  8. Perceived organizational support and job involvement in the Iranian health care system: A case study of emergency room nurses in general hospitals

    PubMed Central

    Gorji, Hassan Abolghasem; Etemadi, Manal; Hoseini, Fatemeh

    2014-01-01

    Background and Objectives: Researchers believe that there are social exchanges between the employers and employees, because the employees would be interested in their organization and trust it based on how the organization values them and their welfare, comfort, and security. This belief is known as perceived organizational support that makes employees consider themselves as a part of their organization and have a commitment to it. The literature review is very limited in both variables in Iran and thus few studies also report the perceived organizational support and job involvement at the lower levels in our country. This research aimed at studying the levels of perceived organizational support and job involvement, relationship between this two, and the demographic factors relationship with both of them. Materials and Methods: This research was a descriptive analytical study conducted in 2012. The population included 123 emergency nurses in General Hospitals of Qom. Data were collected through Perceived Organizational Support and Job Involvement Questionnaires and analyzed using SPSS software, descriptive statistics and Spearman correlation and Chi-square test. Results: Both mean scores for perceived organizational support and job involvement were in average level, 146/12 and 35/38, respectively. There was a significant relationship between perceived organizational support and age, education, tenure, organizational position, and job shift. There was also a significant relationship between job involvement and age and education and finally between perceived organizational support and job involvement (P = 0/029). Discussion: The high correlation between perceived organizational support and job involvement indicates that the improvement of perceived organizational support are necessary through motivating the employees, showing interest in them, paying attention to them, respecting them, and providing development opportunity in the organization. These should be always considered by managers to improve job involvement PMID:25077151

  9. Evolving Healthcare Quality in Top Tertiary General Hospitals in China during the China Healthcare Reform (2010–2012) from the Perspective of Inpatient Mortality

    PubMed Central

    Ma, Xie-Min; Chen, Xiao-Hong; Wang, Ji-Shan; Lyman, Gary H.; Qu, Zhi; Ma, Wen; Song, Jing-Chen; Zhou, Chuan-Kun; Zhao, Lue Ping

    2015-01-01

    Healthcare reforms (HR) initiated by many countries impacts on healthcare systems worldwide. Being one of fast developing countries, China launched HR in 2009. Better understanding of its impact is helpful for China and others in further pursuit of HR. Here we evaluate inpatient mortality, a proxy to healthcare quality, in 43 top tertiary hospitals in China during this critical period. This is a hospital-based observational study with 8 million discharge summary reports (DSR) from 43 Chinese hospitals from 2010–2012. Using DSRs, we extract the vita status as the outcome, in addition to age, gender, diagnostic codes, and surgical codes. Nearly all hospitals have expanded their hospitalization capacities during this period. As of year 2010, inpatient mortality (IM) across hospitals varies widely from 2‰ to 20‰. Comparing IM of year 2011 and 2012 with 2010, the overall IM has been substantially reduced (OR = 0.883 and 0.766, p-values<0.001), showing steady improvements in healthcare quality. Surgical IM correlates with the overall IM (correlation = 0.60, p-value <0.001), but is less uniform. Over these years, surgical IM has also been steadily reduced (OR = 0.890 and 0.793, p-values<0.001). Further analyses of treatments on five major diseases and six major surgeries revealed that treatments of myocardial infarction, cerebral hemorrhage and cerebral infarction have significant improvement. Observed temporal and spatial variations demonstrate that there is a substantial disparity in healthcare quality across tertiary hospitals, and that these hospitals are rapidly improving healthcare quality. Evidence-based assessment shed light on the reform impact. Lessons learnt here are relevant to further refining HR. PMID:26624005

  10. Spring 2013 | Volume 3, number 2 &A MAgA zine of WAshington stAte Universit y vAncoUver

    E-print Network

    Gray Cougs study sharks off the washington Coast 9 steM: Cultivating eConoMiC reCovery in the region Vancouver, 14204 NE Salmon Creek Avenue, Vancouver, WA 98686-9600. Views expressed in NW Crimson & Gray.wsu.edu/connect or call (360) 546-9600. Send comments or questions to news@vancouver.wsu.edu Cover: A sevengill shark

  11. 42 CFR 495.104 - Incentive payments to eligible hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Incentive payments to eligible hospitals. 495.104 Section...ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...Incentive payments to eligible hospitals. (a) General rule. A qualifying hospital (as defined in...

  12. 42 CFR 495.104 - Incentive payments to eligible hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Incentive payments to eligible hospitals. 495.104 Section...ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...Incentive payments to eligible hospitals. (a) General rule. A qualifying hospital (as defined in...

  13. 42 CFR 495.104 - Incentive payments to eligible hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Incentive payments to eligible hospitals. 495.104 Section...ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...Incentive payments to eligible hospitals. (a) General rule. A qualifying hospital (as defined in...

  14. 42 CFR 495.104 - Incentive payments to eligible hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Incentive payments to eligible hospitals. 495.104 Section...ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...Incentive payments to eligible hospitals. (a) General rule. A qualifying hospital (as defined in...

  15. 42 CFR 495.104 - Incentive payments to eligible hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Incentive payments to eligible hospitals. 495.104 Section...ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...Incentive payments to eligible hospitals. (a) General rule. A qualifying hospital (as defined in...

  16. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  17. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  18. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  19. 45 CFR 211.10 - Termination of hospitalization.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... of the hospital finds that the eligible person hospitalized for mental illness (whether or not... accordance with laws governing hospitalization for mental illness as may be in force and generally...

  20. Alcohol and Drug Use Among Vancouver Secondary School Students: 1970, 1974 and 1978.

    ERIC Educational Resources Information Center

    Hollander, Marcus J.; Macurdy, E. Ann

    In 1970, 1974 and 1978 similar surveys of alcohol and drug use were conducted using 10% random samples of Vancouver secondary school students (grades 8-12). The reported use of alcohol increased from 61% in 1970 to 71% in 1974 and 78% in 1978, while the use of cannabis increased from 39% in 1970 to 42% in 1974 and 47% in 1978. The use of tobacco,…

  1. Hospitality Management Education and Training.

    ERIC Educational Resources Information Center

    Brotherton, Bob, Ed.; And Others

    1995-01-01

    Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…

  2. Factors associated with methadone maintenance therapy use among a cohort of polysubstance using injection drug users in Vancouver.

    PubMed

    Kerr, Thomas; Marsh, David; Li, Kathy; Montaner, Julio; Wood, Evan

    2005-12-12

    We identified methadone maintenance therapy (MMT) use during follow-up interviews and examined associations between MMT use and socio-demographic and drug-related variables using generalized estimating equations (GEE). Of the 1587 participants recruited into this cohort, 170 (11%) were enrolled in MMT at baseline and additional 498 (31%) initiated MMT during follow-up. Of those ever enrolled in MMT, 406 (61%) ceased MMT and re-initiated MMT on more than one occasion. The median treatment duration was 14.4 months. Factors that were negatively and significantly associated with MMT use in multivariate analyses included: Aboriginal ethnicity (adjusted odds ratio [AOR] = 0.40); recent incarceration (AOR = 0.79); sex trade involvement (AOR = 0.87); syringe lending (AOR = 0.72); heroin injection (AOR = 0.64), whereas female gender (AOR = 2.47), HIV positivity (AOR = 1.57), and crack cocaine smoking (AOR = 1.23) were positively and significantly associated with being on MMT. Unstable housing, syringe borrowing, non-fatal overdose, cocaine injection, and residence in Vancouver's Downtown Eastside were not associated with MMT use in multivariate analyses. Our study demonstrates high rates of initiation of and retention in MMT among local IDUs. While the use of MMT was associated with reductions in heroin use and HIV risk behavior, barriers to Aboriginal IDUs were evident, and the association with increased crack cocaine use deserves further study. PMID:15964714

  3. Vet Hospital 

    E-print Network

    Unknown

    2011-08-17

    there appears to be a substantial difference in terms of EHRs implementation and adoption among hospitals with different organizational characteristics and by end-users in different job categories, little has been studied about the relationship between EHR...

  4. Hospital philanthropy.

    PubMed

    Smith, Dean G; Clement, Jan P

    2013-01-01

    It remains an open question whether hospital spending on fundraising efforts to garner philanthropy is a good use of funds. Research and industry reports provide conflicting results. We describe the accounting and data challenges in analysis of hospital philanthropy, which include measurement of donations, measurement of fundraising expenses, and finding the relationships among organizations where these cash flows occur. With these challenges, finding conflicting results is not a surprise. PMID:23614267

  5. CCCG 2009, Vancouver, BC, August 1719, 2009 Generalized jewels and the point placement problem

    E-print Network

    Mukhopadhyay, Asish

    , known as the restriction site mapping. Biologists discovered that certain restriction enzymes cleave and Wilcox [6] that the restriction enzyme Hind II cleaves DNA sequences at the restriction sites GT- GCAC a DNA sequence at specific sites known as restriction sites. For example, it was discovered by Smith

  6. Opportunities and obstacles to collecting wildlife disease data for public health purposes: Results of a pilot study on Vancouver Island, British Columbia

    PubMed Central

    Stitt, Tyler; Mountifield, Julie; Stephen, Craig

    2007-01-01

    Existing sources of wildlife morbidity and mortality data were evaluated and 3 pilot active surveillance projects were undertaken to compare and contrast methods for collecting wildlife disease data on Vancouver Island for public health purposes. Few organizations could collect samples for diagnostic evaluation, fewer still maintained records, and none regularly characterized or reported wildlife disease for public health purposes. Wildlife rehabilitation centers encountered the greatest variety of wildlife from the largest geographic area and frequently received submissions from other organizations. Obstacles to participation included the following: permit restrictions; financial disincentives; staff safety; no mandate to collect relevant data; and lack of contact between wildlife and public health agencies. Despite these obstacles, modest investments in personnel allowed novel pathogens of public health concern to be tracked. Targeted surveillance for known pathogens in specific host species, rather than general surveys for unspecified pathogens, was judged to be a more effective and efficient way to provide useful public health data. PMID:17310627

  7. Hospital finance.

    PubMed

    Herman, M J

    1998-01-01

    This article summarizes key areas of focus for the analysis of risk in the hospital segment of the health care industry. The article is written from a commercial bank lending perspective. Both for-profit (C-corporations) and 501 (c)(3) not-for-profit segments are addressed. PMID:9612734

  8. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  9. Variation in Ground Shaking on the Fraser River Delta (Greater Vancouver, Canada)

    NASA Astrophysics Data System (ADS)

    Cassidy, J. F.; Rogers, G. R.

    2003-04-01

    The thick, soft soils of the Fraser River delta, just south of Vancouver, Canada, are home to critical infrastructure such as one of North America's busiest port facilities, Canada's second busiest airport, and key transportation and power-transmission facilities for 2-3 million people. This area is also one of the most seismically active regions in Canada. We have utilised recent three-component, digital records of recent moderate (1996 M=5.1 at 200 km distance, 1997 M=4.3 at 40 km distance) and large (2001 M=6.8 at 300 km distance) earthquakes to examine the response to seismic shaking in the greater Vancouver, region, with an emphasis on the site response of the Fraser River delta. These suites of accelerograms have relatively low amplitudes (maximums of 0.015g for the 1996 records, 0.024g for the 1997 records, and 0.035g for the 2001 records). The 1997 data set is significant as it contains the first three-component recordings made on bedrock in greater Vancouver, and the 2001 data set is significant as it contains long-period signal (1-10 second energy). Using the method of spectral ratios, we estimate the site response for each of the strong motion instrument soil sites. Our results show frequency-dependent amplification, with factors of up to 12 times (relative to competent bedrock) near the edge of the delta. Here, the amplification is observed over a relatively narrow frequency range of 1.5-4 Hz (0.25-0.67 s period). Near the centre of the delta(where the soft soils are thickest) peak amplification of 4-10 times(relative to competent bedrock) is measured. Relative to firm soil, the peak amplification ranges from 2-5 for the thick soil delta centre sites, and 2-6 for the delta edge sites. At higher frequencies, little or no amplification, and in many cases slight attenuation is observed. The more distant earthquakes (200-300 km) present a simpler and more predictable picture of ground motion variation than that of the 1997 earthquake (40 km distant). The Geological Survey of Canada is currently deploying a demonstration dense urban seismograph network (~1km spacing) which crosses the northern edge of the Fraser delta in the greater Vancouver area to address varying site response in more detail.

  10. A rare genotype of Cryptococcus gattii caused the cryptococcosis outbreak on Vancouver Island (British Columbia, Canada)

    PubMed Central

    Kidd, S. E.; Hagen, F.; Tscharke, R. L.; Huynh, M.; Bartlett, K. H.; Fyfe, M.; MacDougall, L.; Boekhout, T.; Kwon-Chung, K. J.; Meyer, W.

    2004-01-01

    Cryptococcus gattii causes life-threatening infection of the pulmonary and central nervous systems in hosts with normal immunity and traditionally has been considered to be restricted geographically to tropical and subtropical climates. The recent outbreak of C. gattii in the temperate climate of Vancouver Island, BC, Canada, led to a collaborative investigation. The objectives of the current study were to ascertain the environmental source of the outbreak infections, survey the molecular types of the outbreak and environmental cryptococcal isolates, and determine the extent of genetic diversity among the isolates. PCR-fingerprinting and amplified fragment length polymorphism (AFLP) were used to examine the genotypes, and mating assays were performed to determine the mating type of the isolates. All outbreak and environmental isolates belonged to C. gattii. Concordant results were obtained by using PCR-fingerprinting and AFLP analysis. The vast majority of clinical and veterinary infections were caused by isolates of the molecular type VGII/AFLP6, but two were caused by molecular type VGI/AFLP4. All environmental isolates belonged to molecular type VGII/AFLP6. Two or three subtypes were observed within VGII/AFLP6 among outbreak and environmental isolates. All mating-competent isolates were of the ?-mating type. The emergence of this usually tropical pathogen on Vancouver Island highlights the changing distribution of this genotype and emphasizes the importance of an ongoing collaborative effort to monitor the global epidemiology of this yeast. PMID:15572442

  11. Age and significance of earthquake-induced liquefaction near Vancouver, British Columbia, Canada

    USGS Publications Warehouse

    Clague, J.J.; Naesgaard, E.; Nelson, A.R.

    1997-01-01

    In late 1994, sand dykes, large sand blows, and deformed strata were exposed in the walls of an excavation at Annacis Island on the Fraser River delta near Vancouver, British Columbia. The features record liquefaction during a large earthquake about 1700 years ago; this was perhaps the largest earthquake to affect the Vancouver area in the last 3500 years. Similar, less well-dated features have been reported from several other sites on the Fraser delta and may be products of the same earthquake. Three radiocarbon ages that closely delimit the time of liquefaction on Annacis Island are similar to the most precise radiocarbon ages on coseismically subsided marsh soils at estuaries in southern Washington and Oregon. Both the liquefaction and the subsidence may have been produced by a single great plate-boundary earthquake at the Cascadia subduction zone. Alternatively, liquefaction at Annacis Island may have been caused by a large crustal or subcrustal earthquake of about the same age as a plate-boundary earthquake farther west. The data from Annacis Island and other sites on the Fraser delta suggest that earthquakes capable of producing extensive liquefaction in this area are rare events. Further, liquefaction analysis using historical seismicity suggests that current assessment procedures may overestimate liquefaction risk.

  12. Environmental factors associated with reproductive barrier breakdown in sympatric trout populations on Vancouver Island

    PubMed Central

    Heath, Daniel; Bettles, Cory M; Roff, Derek

    2010-01-01

    The incidence of hybridization between coastal cutthroat (Oncorhynchus clarki clarki) and rainbow trout (Oncorhynchus mykiss) varies widely among populations. The breakdown of reproductive isolation is of concern to managers, and raises the question: how have the two species retained their genetic and morphological divergence? Using a combination of mitochondrial DNA and nuclear DNA markers coupled with watershed attribute and disturbance data, we determined the distribution and frequency of trout hybridization on Vancouver Island, BC and the environmental factors associated with the hybridization. We found 284 hybrids (among 1004 fish) in 29 of 36 sampled populations. High variation in levels of hybridization was observed among populations, and no single environmental factor was found to dominate in determining hybridization levels. However, logging activity, urban infrastructure development, and stocking of hatchery rainbow trout played significant roles in determining hybridization levels, and populations in small watersheds are more at risk of reproductive barrier breakdown. This study illustrates that cutthroat–rainbow trout reproductive barrier breakdown is widespread on Vancouver Island and that anthropogenic disturbance plays a role in the process. As similar environmental disturbance is common in much of coastal trout habitat, large-scale hybridization may be occurring elsewhere and thus may represent a critical management issue for Pacific trout species. PMID:25567905

  13. Analysis of the Vancouver lung nodule malignancy model with respect to manual and automated segmentation

    NASA Astrophysics Data System (ADS)

    Wiemker, Rafael; Boroczky, Lilla; Bergtholdt, Martin; Klinder, Tobias

    2015-03-01

    The recently published Vancouver model for lung nodule malignancy prediction holds great promise as a practically feasible tool to mitigate the clinical decision problem of how to act on a lung nodule detected at baseline screening. It provides a formula to compute a probability of malignancy from only nine clinical and radiologic features. The feature values are provided by user interaction but in principle could also be automatically pre-filled by appropriate image processing algorithms and RIS requests. Nodule diameter is a feature with crucial influence on the predicted malignancy, and leads to uncertainty caused by inter-reader variability. The purpose of this paper is to analyze how strongly the malignancy prediction of a lung nodule found with CT screening is affected by the inter-reader variation of the nodule diameter estimation. To this aim we have estimated the magnitude of the malignancy variability by applying the Vancouver malignancy model to the LIDC-IDRI database which contains independent delineations from several readers. It can be shown that using fully automatic nodule segmentation can significantly lower the variability of the estimated malignancy, while demonstrating excellent agreement with the expert readers.

  14. A simple measure to improve the rates of thromboprophylaxis prescription post surgical fixation of neck of femur fractures in a district general hospital

    PubMed Central

    Sinha, Pranab; Najefi, Ali-Asgar; Hambidge, John

    2014-01-01

    Neck of femur (NOF) fractures are a major public health concern because of the ageing population and higher incidence of fragility fractures. NOF fractures are associated with high mortality and morbidity rates, and there is a high risk of venous thromboembolism (VTE) after hip fractures (Ref 1). Therefore thromboprophylaxis is vital. Current NICE guidelines advocate 28 – 35 days of thromboprophylaxis after NOF fractures (Ref 1, 2). It came to our attention that patients post NOF fixation were getting variable prescriptions in regards to their thromboprophylaxis. Therefore a retrospective study on prescription of thromboprophylaxis was conducted from October 2012 to February 2013 within the trauma and orthopaedics department at Queens Hospital, Romford. Data was collected on all NOF fractures from electronic discharge summaries. Basic descriptive statistics were used to analysis the data. There were 110 cases of NOF fractures during this period. 100 patients were included since two were discounted as they were already on long term anticoagulants and eight patients died in hospital. No thromboprophylaxis was prescribed for 15 patients (15%). Three patients (3%) were prescribed less than 28 days (mean 14 days, range (14 – 14 days)). 69 patients (69%) received 28 - 35 days of thromprophylaxis, whilst five patients (5%) received more than 35 days (mean 42 days, range 40 – 42 days). Formal departmental teaching and presentation of the findings was given after the initial study and a small label with the message, ‘POST NOF #: 28-35 days Enoxaparin’, was attached to the back of all the junior doctor work phones. After the intervention, data was collected from the period of 7th of January to 7th of February 2013. The second study showed that 50 patients were admitted with NOF fractures in this time period. Four patients died in hospital and three patients were discounted as they were on Warfarin. Two patients were not prescribed thromboprophylaxis (5%). 34 (79%) patients received 28 - 35 days, whereas seven patients (16%) received 42 days of thromboprophylaxis. The older patients with multiple co-morbidities and reduced mobility are at high risk of developing thromboembolism post NOF fixation. Our initial study identified inadequate prescription of thromboprophylaxis post NOF fractures. After introduction of simple measures such as the reminder label attached to phones, our repeat study found that there was improvement in prescription rates. Our study highlights that simple measures can increase awareness and improve patient safety.

  15. Vitamin D supplementation is associated with higher serum 25OHD in Asian and White infants living in Vancouver, Canada.

    PubMed

    Green, Tim J; Li, Wangyang; Barr, Susan I; Jahani, Mitra; Chapman, Gwen E

    2015-04-01

    To prevent rickets, the Health Canada and the American Academy of Pediatrics recommend that breastfed infants receive a daily vitamin D supplement of 10 ?g d(-1) . Compliance with this recommendation is variable and its effect on infant vitamin D status is unclear. We measured serum 25-hydroxyvitamin D (25OHD) in Asian immigrant (n=28) and White (n=37) mothers and their infants aged 2-4 months living in Vancouver (49°N). Mothers completed health and demographic questionnaires. All subjects were term infants who were primarily breastfed. Analysis of variance, ?(2) , multiple regression and logistic regression analysis were performed as appropriate. Mean 25OHD of the infants was 31 (95% confidence interval 28-34) ng mL(-1) . Only two infants had a 25OHD concentration indicative of deficiency, <10?ng mL(-1) . Of the infants, 14% (n=9) and 49% (n=32) were vitamin D insufficient based on two commonly used cut-offs of 20 and 30?ng mL(-1) , respectively. Fifty-eight (89%) infants had been given a vitamin D supplement. Mean 25OHD was 9.4?ng mL(-1) higher in infants consuming ?10??g?d(-1) of vitamin D from supplements vs. those consuming less (P=0.003). Mother's 25OHD, season, skin colour or ethnicity (Asian vs. White) did not influence infant 25OHD. The infants in our study, most of whom received vitamin D supplements, were generally protected against low 25OHD. The study was limited by sample size and the nature of the cross-sectional study design. PMID:23061469

  16. 99mTechnetium-labelled red blood cell scintigraphy as an alternative to angiography in the investigation of gastrointestinal bleeding: clinical experience in a district general hospital.

    PubMed Central

    Bearn, P.; Persad, R.; Wilson, N.; Flanagan, J.; Williams, T.

    1992-01-01

    99mTechnetium-labelled red blood cell scintigraphy (99mTc RBC scintigraphy) was used as the second-line investigation to localise bleeding in 23 patients (11 male, 12 female; mean age 67 years) presenting with active bleeding per rectum. Scintigraphy was available on a 24 h basis. A total of 18 patients had positive scans (78%). Surgery was performed urgently in 11 patients and the site of bleeding, as predicted by scintigraphy, was confirmed in 9 (82%). 99mTc RBC scintigraphy was less useful in patients who were not bleeding actively or who were being investigated for chronic anaemia. This study suggests that 99mTc RBC scintigraphy can play a useful role in the preoperative localisation of unexplained gastrointestinal bleeding in hospitals with nuclear medicine facilities, but confirms it has little place in the management of patients unless they are bleeding actively. PMID:1319696

  17. Evaluating the level of adherence to Ministry of Health guidelines in the management of Severe Acute Malnutrition at Garissa Provincial General hospital, Garissa, Kenya

    PubMed Central

    Warfa, Osman; Njai, Daniel; Ahmed, Laving; Admani, Bashir; Were, Fred; Wamalwa, Dalton; Osano, Boniface; Mburugu, Patrick; Mohamed, Musa

    2014-01-01

    Introduction Half of Kenya's high infant and under five mortality rates is due to malnutrition. Proper implementation of World Health Organization's (WHO) Evidence Based Guidelines (EBG) in management of severe acute malnutrition can reduce mortality rates to less than 5%. The objectives were to establish the level of adherence to WHO guideline and the proportion of children appropriately managed for severe acute malnutrition (steps 1-8) as per the WHO protocol in the management of severe acute malnutrition. This was a short longitudinal study of 96 children, aged 6-59 months admitted to the pediatric ward with diagnosis of severe acute malnutrition. Methods Data was extracted from patients’ medical files and recorded into an audit tool to compare care provided in this hospital with WHO guidelines. Results Non-edematous malnutrition was the commonest presentation (93.8%). A higher proportion (63.5%) of patients was male. Most (85.4%) of patients were younger than 2 years. Patients with non-edematous malnutrition were younger (mean age for non-edematous malnutrition was 16 (± 10.6) months versus 25 (± 13.7) months in edematous malnutrition). The commonest co- morbid condition was diarrhea (52.1%). Overall, 13 children died giving an inpatient case fatality rate of 13.5%. Appropriate management was documented in only 14.6% for hypoglycemia (step1), 5.2% for hypothermia (step 2) and 31.3% for dehydration (step 3). Conclusion The level of adherence to MOH guidelines was documented in 5 out of the 8 steps. Appropriate management of children with severe acute malnutrition was inadequate at Garissa hospital. PMID:25237411

  18. Year 1 Year 2 Year 3 Year 4 Children's Hospital of

    E-print Network

    Finley Jr., Russell L.

    Year 1 Year 2 Year 3 Year 4 July General Pediatric Children's Hospital of Michigan High Risk Obstetrics Hutzel Women's Hospital Biochemical Genetics Lab/Metabolic Clinic Harper Hospital/ Children's Hospital of Michigan Reproductive Genetics Hutzel Women's Hospital August General Pediatric Children

  19. A Search for Decolonizing Place-Based Pedagogies: An Exploration of Unheard Histories in Kitsilano Vancouver, B.C.

    ERIC Educational Resources Information Center

    Henry, Elizabeth Ruth

    2014-01-01

    This paper explores the ways that place-based pedagogies can facilitate dialogue on colonization, or some of the "dark matters" of environmental education, specifically by engaging non-Indigenous adults in decolonizing dialogues. I share findings from an action research project with Kitsilano Neighbourhood House in Vancouver, British…

  20. a0005 Attention: Change Blindness and Inattentional Blindness R A Rensink, University of British Columbia, Vancouver, BC, Canada

    E-print Network

    Rensink, Ronald A.

    a0005 Attention: Change Blindness and Inattentional Blindness R A Rensink, University of British Columbia, Vancouver, BC, Canada ã 2009 Elsevier Inc. All rights reserved. Glossary g0005 Change blindness attention is believed to be necessary to see change, with change blindness resulting if such attention

  1. In Workshop on Statistical and Computational Theories of Vision at International Conference on Computer Vision, Vancouver, July 13, 2001.

    E-print Network

    August, Jonas

    In Workshop on Statistical and Computational Theories of Vision at International Conference on Computer Vision, Vancouver, July 13, 2001. A Generative Model of Curve Images with a Completely.zucker@yale.edu Center for Computational Vision and Control Departments of Electrical Engineering and Computer Science

  2. Interpolating Vancouver's Daily Ambient PM10 Field Li Sun James V. Zidek Nhu D. Le Haluk Ozkaynak

    E-print Network

    Washington at Seattle, University of

    distribution for the ambient space - time response eld of daily ambient PM10 in Vancouver, Canada spatial predictive distribution for these residuals at unmonitored sites. By transforming the predicted are associated with acute negative health impacts. A panel of experts appointed by the UK Department

  3. Proceedings of the NARST 2004 Annual Meeting (Vancouver, BC, Canada) THE INFLUENCE OF WEB-BASED HOMEWORK ON QUANTITATIVE

    E-print Network

    Proceedings of the NARST 2004 Annual Meeting (Vancouver, BC, Canada) THE INFLUENCE OF WEB, Englemann, & Morrissey, 1993; Kashy, Morrissey, Tsai, & Wolfe, 1995; Morrisey, Kashy, & Tsai, National Association for Research in Science Teaching (NARST) April 1-3, 2004 #12;Proceedings of the NARST 2004 Annual

  4. Proceedings of the 23 Arctic Marine Oil Spill Program Meeting, Vancouver, Canada. Vol. 1., 59-68

    E-print Network

    Louchouarn, Patrick

    Proceedings of the 23 rd Arctic Marine Oil Spill Program Meeting, Vancouver, Canada. Vol. 1., 59 disks (n = 12). Although the TEM-based approach slightly overestimated the overall amount of spilled oil the variability. Using this method the estimates of spilled oil ranged 105±25% suggesting that the SPE

  5. Dear Professor Klein, I write on behalf of the Seriously Free Speech Committee-Vancouver (SFSC) to support

    E-print Network

    Klein, David

    debate on matters relating to Palestine and Israel. We were active in exposing attempts by some Canadian. Currently, the well-known "Disappearing Palestine" maps seen in several U.S. cities have been displayed on Vancouver buses and in metro stations; they have now been vandalized twice and remounted by the Palestine

  6. Deep Cove Canoe & Kayak Centre Ltd. 2156 Banbury Road. North Vancouver, BC V7G 2T1

    E-print Network

    Kavanagh, Karen L.

    -2268, Fax: (604) 987-2255 Web Site: www.deepcovekayak.com DEEP COVE CANOE AND KAYAK CENTRE LTD. ParentalDeep Cove Canoe & Kayak Centre Ltd. 2156 Banbury Road. North Vancouver, BC V7G 2T1 Ph: (604) 929/Tours/Rentals with Deep Cove Canoe and Kayak Centre DEEP COVE CANOE AND KAYAK CENTRE LIMITED (Herein described

  7. Use of specialty hospitals by Medicare beneficiaries, 1985

    PubMed Central

    Helbing, Charles; Latta, Viola B.

    1988-01-01

    Information is provided on the use and cost of inpatient services for Medicare beneficiaries discharged from participating specialty hospitals during 1985. Specialty hospitals include: psychiatric, general long-term, rehabilitation, children's, alcohol and drug, and Christian Science sanatoriums. Specialty units of short-stay hospitals are not included in the specialty hospital data presented in this article. PMID:10312520

  8. AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for the National Park Service: Fort Vancouver National Historic Site

    SciTech Connect

    Stephen Schey; Jim Francfort

    2014-03-01

    Battelle Energy Alliance, LLC, managing and operating contractor for the U.S. Department of Energy’s Idaho National Laboratory, is the lead laboratory for the U.S. Department of Energy’s Advanced Vehicle Testing. Battelle Energy Alliance, LLC contracted with Intertek Testing Services, North America (ITSNA) to collect data on federal fleet operations as part of the Advanced Vehicle Testing Activity’s Federal Fleet Vehicle Data Logging and Characterization study. The Advanced Vehicle Testing Activity study seeks to collect data to validate the use of advanced electric drive vehicle transportation. This report focuses on the Fort Vancouver National Historic Site (FVNHS) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of electric vehicles (EVs) into the agencies’ fleet. Individual observations of the selected vehicles provided the basis for recommendations related to EV adoption and whether a battery electric vehicle (BEV) or plug-in hybrid electric vehicle (PHEV) (collectively plug-in electric vehicles) could fulfill the mission requirements. FVNHS identified three vehicles in its fleet for consideration. While the FVNHS vehicles conduct many different missions, only two (i.e., support and pool missions) were selected by agency management to be part of this fleet evaluation. The logged vehicles included a pickup truck and a minivan. This report will show that BEVs and PHEVs are capable of performing the required missions and providing an alternative vehicle for both mission categories, because each has sufficient range for individual trips and time available each day for charging to accommodate multiple trips per day. These charging events could occur at the vehicle’s home base, high-use work areas, or in intermediate areas along routes that the vehicles frequently travel. Replacement of vehicles in the current fleet would result in significant reductions in emission of greenhouse gases and petroleum use, while also reducing fuel costs. The Vancouver, Washington area and neighboring Portland, Oregon are leaders in adoption of PEVs in the United States1. PEV charging stations, or more appropriately identified as electric vehicle supply equipment, located on the FVNHS facility would be a benefit for both FVNHS fleets and general public use. Fleet drivers and park visitors operating privately owned plug-in electric vehicles benefit by using the charging infrastructure. ITSNA recommends location analysis of the FVNHS site to identify the optimal station placement for electric vehicle supply equipment. ITSNA recognizes the support of Idaho National Laboratory and ICF International for their efforts to initiate communication with the National Parks Service and FVNHS for participation in this study. ITSNA is pleased to provide this report and is encouraged by the high interest and support from the National Park Service and FVNHS personnel

  9. Adult Partial Hospitalization JOHN DEMPSEY HOSPITAL

    E-print Network

    Oliver, Douglas L.

    Adult Partial Hospitalization Program JOHN DEMPSEY HOSPITAL CONTACT US For further information.uchc.edu. The Adult Partial Hospitalization Program is available Monday through Friday from 9 a.m. to 2:05 p.m. OUR LOCATION AND DIRECTIONS The Adult Partial Hospitalization Program is located on the 5th floor of the John

  10. Effect of recycling activities on the heating value of solid waste: case study of the Greater Vancouver Regional District (Metro Vancouver).

    PubMed

    Abedini, Ali R; Atwater, James W; Fu, George Yuzhu

    2012-08-01

    Two main goals of the integrated solid waste management system (ISWMS) of Metro Vancouver (MV) include further recycling of waste and energy recovery via incineration of waste. These two very common goals, however, are not always compatible enough to fit in an ISWMS depending on waste characteristics and details of recycling programs. This study showed that recent recycling activities in MV have negatively affected the net heating value (NHV) of municipal solid waste (MSW) in this regional district. Results show that meeting MV's goal for additional recycling of MSW by 2015 will further reduce the NHV of waste, if additional recycling activities are solely focused on more extensive recycling of packaging materials (e.g. paper and plastic). It is concluded that 50% additional recycling of paper and plastic in MV will increase the overall recycling rate to 70% (as targeted by the MV for 2015) and result in more than 8% reduction in NHV of MSW. This reduction translates to up to 2.3 million Canadian dollar (CAD$) less revenue at a potential waste-to-energy (WTE) plant with 500 000 tonnes year(-1) capacity. Properly designed recycling programmes, however, can make this functional element of ISWMS compatible with green goals of energy recovery from waste. Herein an explanation of how communities can increase their recycling activities without affecting the feasibility of potential WTE projects is presented. PMID:22700857

  11. Primary deforestation and regrowth on limestone slopes on Vancouver Island, British Columbia

    SciTech Connect

    Harding, K.A.; Ford, D.C. . Dept. of Geography)

    1992-01-01

    Limestones, well bedded and steeply dipping, are common in northern Vancouver Island. They have been glaciated and host a high density of postglacial karren (dissolution pits, grooves and troughs linked to underlying caves). There is rich, mature forest cover of western hemlock, silver fir and red cedar that is rooted in the karren or in overlying glacial deposits. Logging commenced around 1900 AD, intensifying after 1960 with clear cutting and (often) burning of slash. Impacts were investigated quantitatively by comparing sixteen limestone sites with eight on adjoining volcanic rocks. Some sites on each retained original forest, other were cleared. It was found that soil losses following logging are significantly greater on the limestones because of wash into karren (the epikarst zone). Regrowth is retarded on the limestones also; one site cleared in 1911 had regained approximately 17% of its original volume of timber 75 years later.

  12. Home Oxygen Program review: Regionalization in Vancouver Coastal Health and British Columbia.

    PubMed

    Sandberg, Dan

    2015-01-01

    Since its inception in the 1980s, the Home Oxygen Program in British Columbia was centrally managed by the Ministry of Health. Initially a small program with few clients across the province, it soon became a large program with many clients and increasing expenditures. A pilot program started in Victoria (British Columbia) in 1996 demonstrated that managing the program locally could offer better client care, better contract management and significant cost savings. In 2002, the pilot's model and recommendations were implemented in British Columbia's five health authorities. The present review details the experiences of regionalizing the program in the Vancouver Coastal Health authority. After fine adjustments to the model were developed and new contracts and criteria changes made, better care for clients was provided than the previous centralized model at a reduced cost to the taxpayer. PMID:26078624

  13. Home Oxygen Program review: Regionalization in Vancouver Coastal Health and British Columbia

    PubMed Central

    Sandberg, Dan

    2015-01-01

    Since its inception in the 1980s, the Home Oxygen Program in British Columbia was centrally managed by the Ministry of Health. Initially a small program with few clients across the province, it soon became a large program with many clients and increasing expenditures. A pilot program started in Victoria (British Columbia) in 1996 demonstrated that managing the program locally could offer better client care, better contract management and significant cost savings. In 2002, the pilot’s model and recommendations were implemented in British Columbia’s five health authorities. The present review details the experiences of regionalizing the program in the Vancouver Coastal Health authority. After fine adjustments to the model were developed and new contracts and criteria changes made, better care for clients was provided than the previous centralized model at a reduced cost to the taxpayer. PMID:26078624

  14. 2014 consensus statement from the first Economics of Physical Inactivity Consensus (EPIC) conference (Vancouver).

    PubMed

    Davis, Jennifer C; Verhagen, Evert; Bryan, Stirling; Liu-Ambrose, Teresa; Borland, Jeff; Buchner, David; Hendriks, Marike R C; Weiler, Richard; Morrow, James R; van Mechelen, Willem; Blair, Steven N; Pratt, Mike; Windt, Johann; al-Tunaiji, Hashel; Macri, Erin; Khan, Karim M

    2014-06-01

    This article describes major topics discussed from the 'Economics of Physical Inactivity Consensus Workshop' (EPIC), held in Vancouver, Canada, in April 2011. Specifically, we (1) detail existing evidence on effective physical inactivity prevention strategies; (2) introduce economic evaluation and its role in health policy decisions; (3) discuss key challenges in establishing and building health economic evaluation evidence (including accurate and reliable costs and clinical outcome measurement) and (4) provide insight into interpretation of economic evaluations in this critically important field. We found that most methodological challenges are related to (1) accurately and objectively valuing outcomes; (2) determining meaningful clinically important differences in objective measures of physical inactivity; (3) estimating investment and disinvestment costs and (4) addressing barriers to implementation. We propose that guidelines specific for economic evaluations of physical inactivity intervention studies are developed to ensure that related costs and effects are robustly, consistently and accurately measured. This will also facilitate comparisons among future economic evidence. PMID:24859181

  15. The determinants of hospital profitability.

    PubMed

    Gapenski, L C; Vogel, W B; Langland-Orban, B

    1993-01-01

    Although numerous studies related to hospital costs and financial condition have been conducted, no studies have specifically attempted to identify the underlying determinants of hospital profitability. If these factors are identified, hospital executives can focus their efforts on those aspects of operations that most affect profitability, and public policymakers can gain insights into the potential effects of alternative policy decisions on hospital financial viability. Our study uses multiple regression analysis with 22 hypothesized profitability determinants as independent variables and five profitability measures as dependent variables. The data set consists of 1989 data from 169 investor-owned and private not-for-profit general acute care hospitals in the state of Florida. The results provide evidence that selected managerial and patient-mix variables are predictors of profitability. Structural factors that are beyond the control of managers (organizational and community characteristics) appear to be less important in influencing profitability. These findings may be viewed positively by hospital executives since it appears profitability is not dictated by organizational or market factors but more strongly influenced by factors that, to some extent, can be influenced by hospital policies and practices. PMID:10127295

  16. Social influences upon injection initiation among street-involved youth in Vancouver, Canada: a qualitative study

    PubMed Central

    Small, Will; Fast, Danya; Krusi, Andrea; Wood, Evan; Kerr, Thomas

    2009-01-01

    Background Street-involved youth are a population at risk of adopting injection as a route of administration, and preventing the transition to injection drug use among street youth represents a public health priority. In order to inform epidemiological research and prevention efforts, we conducted a qualitative study to investigate the initiation of injection drug use among street-involved youth in Vancouver, Canada. Methods Qualitative interviews with street youth who inject drugs elicited descriptions of the adoption of injection as a route of administration. Interviewees were recruited from the At-Risk Youth Study (ARYS), a cohort of street-involved youth who use illicit drugs in Vancouver, Canada. Audio recorded interviews were transcribed verbatim and a thematic analysis was conducted. Results 26 youth aged 16 to 26 participated in this study, including 12 females. Among study participants the first injection episode frequently featured another drug user who facilitated the initiation of injecting. Youth narratives indicate that the transition into injecting is influenced by social interactions with drug using peers and evolving perceptions of injecting, and rejecting identification as an injector was important among youth who did not continue to inject. It appears that social conventions discouraging initiating young drug users into injection exist among established injectors, although this ethic is often ignored. Conclusion The importance of social relationships with other drug users within the adoption of injection drug use highlights the potential of social interventions to prevent injection initiation. Additionally, developing strategies to engage current injectors who are likely to initiate youth into injection could also benefit prevention efforts. PMID:19405977

  17. Hospitals as a `risk environment: An ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs

    PubMed Central

    McNeil, Ryan; Small, Will; Wood, Evan; Kerr, Thomas

    2014-01-01

    People who inject drugs (PWID) experience high levels of HIV/AIDS and hepatitis C (HCV) infection that, together with injection-related complications such as non-fatal overdose and injection-related infections, lead to frequent hospitalizations. However, injection drug-using populations are among those most likely to be discharged from hospital against medical advice, which significantly increases their likelihood of hospital readmission, longer overall hospital stays, and death. In spite of this, little research has been undertaken examining how social-structural forces operating within hospital settings shape the experiences of PWID in receiving care in hospitals and contribute to discharges against medical advice. This ethno-epidemiological study was undertaken in Vancouver, Canada to explore how the social-structural dynamics within hospitals function to produce discharges against medical advice among PWID. In-depth interviews were conducted with thirty PWID recruited from among participants in ongoing observational cohort studies of people who inject drugs who reported that they had been discharged from hospital against medical advice within the previous two years. Data were analyzed thematically, and by drawing on the `Risk Environment' framework and concepts of social violence. Our findings illustrate how intersecting social and structural factors led to inadequate pain and withdrawal management, which led to continued drug use in hospital settings. In turn, diverse forms of social control operating to regulate and prevent drug use in hospital settings amplified drug-related risks and increased the likelihood of discharge against medical advice. Given the significant morbidity and health care costs associated with discharge against medical advice among drug-using populations, there is an urgent need to reshape the social-structural contexts of hospital care for PWID by shifting emphasis toward evidence-based pain and drug treatment augmented by harm reduction supports, including supervised drug consumption services. PMID:24508718

  18. [Historical analysis of the hospital bed].

    PubMed

    Fajardo-Ortiz, Guillermo; Fajardo-Dolci, Germán

    2010-01-01

    Until now the bed has been the basic physical resource in hospitals. This type of furniture has served to study and treat patients, through out the centuries it has undergone changes in the materials they are made of dimensions, functionality, accessories, aesthetic, and design. The hospital bed history is not well known, there are thousands of documents about the evolution of hospitals, but not enough is known about hospital beds, a link between the past and the present. The medical, anthropological, technological, social, and economic dynamics and knowledge have produced a variety of beds in general and hospital beds in particular. From instinctive, rustic, poor and irregular "sites" that have differed in shape and size they had evolved into ergonomic equipment. The history of the hospital bed reflects the culture, techniques and human thinking. Current hospital beds include several types: for adults, for children, for labor, for intensive therapy, emergency purposes, census and non census beds etc. PMID:20957820

  19. 42 CFR 412.23 - Excluded hospitals: Classifications.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...facility as of October 1, 2011. (f) Cancer hospitals —(1) General rule. ...following criteria, it is classified as a cancer hospital and is excluded from the prospective...It was recognized as a comprehensive cancer center or clinical cancer research...

  20. 42 CFR 412.23 - Excluded hospitals: Classifications.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...facility as of October 1, 2011. (f) Cancer hospitals —(1) General rule. ...following criteria, it is classified as a cancer hospital and is excluded from the prospective...It was recognized as a comprehensive cancer center or clinical cancer research...

  1. 42 CFR 412.23 - Excluded hospitals: Classifications.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...facility as of October 1, 2011. (f) Cancer hospitals —(1) General rule. ...following criteria, it is classified as a cancer hospital and is excluded from the prospective...It was recognized as a comprehensive cancer center or clinical cancer research...

  2. Can hospitals compete on quality? : Hospital competition.

    PubMed

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples. PMID:25711185

  3. HOSPITALITY APPROVAL FORM DATE: __________________________

    E-print Network

    Maxwell, Bruce D.

    HOSPITALITY APPROVAL FORM DATE: __________________________ PERMISSION IS REQUESTED TO USE __ASMSU ___________________________________ DATE ______________ (Valid for FUNDS 426XXX through 429999 and 4WXXXX) *****THE HOSPITALITY APPROVAL refreshments or meals served during seminars, workshops, professional meetings, or conferences. Hospitality

  4. HOSPITALITY APPROVAL FORM DATE: __________________________

    E-print Network

    Maxwell, Bruce D.

    HOSPITALITY APPROVAL FORM DATE: __________________________ PERMISSION IS REQUESTED TO USE ___________________________________ DATE ______________ (Valid for FUNDS 426XXX through 429999 and 4WXXXX) *****THE HOSPITALITY APPROVAL refreshments or meals served during seminars, workshops, professional meetings, or conferences. Hospitality

  5. Cement-in-cement revision for selected Vancouver Type B1 femoral periprosthetic fractures: a biomechanical analysis.

    PubMed

    Brew, Christopher J; Wilson, Lance J; Whitehouse, Sarah L; Hubble, Matthew J W; Crawford, Ross W

    2013-03-01

    The aim of this study was to perform a biomechanical analysis of the cement-in-cement (c-in-c) technique for fixation of selected Vancouver Type B1 femoral periprosthetic fractures and to assess the degree of cement interposition at the fracture site. Six embalmed cadaveric femora were implanted with a cemented femoral stem. Vancouver Type B1 fractures were created by applying a combined axial and rotational load to failure. The femora were repaired using the c-in-c technique and reloaded to failure. The mean primary fracture torque was 117 Nm (SD 16.6, range 89-133). The mean revision fracture torque was 50 Nm (SD 16.6, range 29-74), which is above the torque previously observed for activities of daily living. Cement interposition at the fracture site was found to be minimal. PMID:23146585

  6. [From admission team to hospital bed management].

    PubMed

    Pochini, Angelo; Augellone, Elisa; Enei, Rosanna; Gaetani, Laura; Paolucci, Simona; Ursumando, Diana; Mitello, Lucia

    2013-01-01

    Reduction on number of hospital beds i.e. on patients' admission among hospitals in Lazio has lead to a reformulation of health service framework within Lazio indentifying hospital as the only place to go to treat acute and urgent diseases. San Camillo-Forlanini, the largest hospital in Rome, according to the regional health plan, the recovery plan and the redevelopment of network hospital has had a significant reduction of hospital beds leading, as consequence, to the need of an internal reorganization. In order to correctly address this issue, the management of the Hospital started in February 2008 a project, setting up a group made up by nursing coordinators which had as a main aim to manage the number of hospital beds needed for emergencies. This group has been called "Admission Team" and nurses within the group are familiar with hospital policies and organization. The team collaborates daily with physicians and nurses in  emergency room, in order to decide the most appropriate health care protocol for each patient. The project follows a specific methodology i.e. Systemic Analysis. Over the years this project has contributed to the improvement to a number of indicators and more generally to the health care within the hospital together with the enhancement of education of new managerial roles among health professional. In 2009, the Regional Council of Lazio has recognized this project as strategic within private and public hospitals. PMID:23900145

  7. Bibliography for the Hospitality Industry.

    ERIC Educational Resources Information Center

    Nelson, Elizabeth A.

    This annotated bibliography is a sample collection of reference materials in the hospitality industry suitable for a small academic library. It is assumed that the library has a general reference collection. Publication dates range from 1992-96, with two publication dates in the 1980s. No periodicals are included. The 41 reference materials are…

  8. Gay and bisexual men's awareness and knowledge of treatment as prevention: findings from the Momentum Health Study in Vancouver, Canada

    PubMed Central

    Carter, Allison; Lachowsky, Nathan; Rich, Ashleigh; Forrest, Jamie I; Sereda, Paul; Cui, Zishan; Roth, Eric; Kaida, Angela; Moore, David; Montaner, Julio SG; Hogg, Robert S

    2015-01-01

    Introduction Awareness and knowledge of treatment as prevention (TasP) was assessed among HIV-positive and HIV-negative gay, bisexual and other men who have sex with men (GBMSM) in Vancouver, Canada. Methods Baseline cross-sectional survey data were analyzed for GBMSM enrolled, via respondent-driven sampling (RDS), in the Momentum Health Study. TasP awareness was defined as ever versus never heard of the term “TasP.” Multivariable logistic regression identified covariates of TasP awareness. Among those aware of TasP, men's level of knowledge of TasP was explored through an examination of self-perceived knowledge levels, risk perceptions and short-answer definitions of TasP which were coded as “complete” if three TasP-related components were identified (i.e. HIV treatment, viral suppression and prevention of transmission). Information source was also assessed. Analyses were stratified by HIV status and RDS adjusted. Results Of 719 participants, 23% were HIV-positive, 68% Caucasian and median age was 33 (Interquartile range (IQR) 26,47). Overall, 46% heard of TasP with differences by HIV status [69% HIV-positive vs. 41% HIV-negative GBMSM (p<0.0001)]. In adjusted models: HIV-positive GBMSM were more likely to have heard of TasP if they were Canadian born, unemployed, not using party drugs and had higher CD4 counts; HIV-negative GBMSM were more likely to have heard of TasP if they were Caucasian (vs. Aboriginal), students, had higher education, a regular partner and multiple sexual partners. Among those aware of TasP 91% of HIV-positive and 69% of HIV-negative GBMSM (p<0.0001) felt they knew “a lot” or “a bit in general” about TasP; 64 and 41% (p=0.002) felt HIV treatment made the risk of transmission “a lot lower”; and 21 and 13% (p<0.0001) demonstrated “complete” TasP definitions. The leading information source was doctors (44%) for HIV-positive GBMSM and community agencies (38%) for HIV-negative GBMSM, followed by gay media for both populations (34%). Conclusions Nearly half of GBMSM in this study reported having heard of TasP, yet only 14% demonstrated complete understanding of the concept. Variations in TasP awareness and knowledge by HIV status, and key socio-demographic, behavioural and clinical factors, highlight a need for health communication strategies relevant to diverse communities of GBMSM in order to advance overall TasP health literacy. PMID:26268817

  9. Lifelines and Earthquake Hazards Along the Interstate 5 Urban Corridor: Cottage Grove, Oregon, to Vancouver, B.C.

    NASA Astrophysics Data System (ADS)

    Barnett, E. A.; Weaver, C. S.; Haugerud, R. A.; Ballantyne, D. B.; Wang, Y.; Wang, Z.; Madin, I. P.; Wells, R. E.; Darienzo, M.; Meagher, K. L.

    2002-12-01

    A new map series provides basic graphical representations of lifeline systems in relation to earthquake hazards along the economic and residential artery of the Pacific Northwest: the I-5 corridor from Cottage Grove, Oregon, to Vancouver, B.C. The lifeline systems that support the communities as well as local and regional commerce form a complex web of highways, railroads, pipelines, electrical power facilities, and ports, that cross areas of varying levels of earthquake hazards. This web depends on many components working together to make a functional system. Failure of one critical system component due to a large earthquake or other natural disaster can disable the system. Earthquakes tend to affect many systems at once, and the failure of one system, such as a highway, can impede the recovery of another system, such as an electrical power line. Therefore, understanding the geographical relationships between the lifeline systems, local communities, and earthquake hazards is an important element in the process of not only determining recovery priorities and strategies after an earthquake, but also for future planning purposes. The lifeline maps have a shaded-relief topographic background with integrated regional geology categorized as ground relatively susceptible or not susceptible to ground amplification, liquefaction and/or landslides in the event of an earthquake. The maps also show recent and historically important earthquakes estimated to be greater than magnitude 5. Lifeline systems superimposed on the geologic base are: major electrical transmission lines, water supply pipelines, major sewer pipelines and treatment plants, liquid fuel pipelines, natural gas pipelines, and major ports and airports. Map data are generalized in order to suit the needs of map users, ranging from the specialist to non-specialist. Accordingly, the maps do not provide site-specific information. The map presentation stresses the system nature of lifelines, as opposed to highlighting individual key structures and is meant to serve as an initial step in understanding the complex nature of lifeline systems. The four maps in this series are produced by the collective efforts of the authors and lifeline map users from local, state, and federal agencies, and private lifeline companies in the I-5 Urban Corridor of the Pacific Northwest.

  10. Hospital diversification and financial management.

    PubMed

    Eastaugh, S R

    1984-08-01

    Hospital diversification and its impact on the operating ratio are studied for 62 New York hospitals during the period 1974-1979. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as being jointly dependent. Institutional diversification is found to yield better financial position, and the better operating ratio allows the institution the wherewithal to diversify. The impact of external government planning and hospital competition are also measured. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification and divestiture, occasionally leading to closure or merger. These results should not be generalized beyond the New York State context. Restructuring of the organization, unrelated business ventures, and transactions with related organizations were not a problem in this sample. However, in 1983, many a new corporation is set up whose revenues do not become part of the hospital's and whose complex transactions conceal unallowable costs and maximize reimbursement. A number of hypotheses are advanced concerning hospital administrator's attitude toward risk. PMID:6471942

  11. A Theory of Hospital Financial Analysis

    PubMed Central

    Elnicki, Richard A.

    1969-01-01

    The problem of determining the financial status of a group of hospitals was posed by the Connecticut Regional Medical Program in 1967 with the question: Are Connecticut's general hospitals financially healthy? The economist assigned to explore the question here describes the economic concepts and the methodology from which models applicable to voluntary hospitals were developed, utilizing the accepted modes of analysis and standards of for-profit business. The basic index of financial health investigated is self-sufficiency, with plant liquidation, revenue control and the role of private payors, and cost control studied as factors affecting the financial status of hospitals. PMID:5799485

  12. Phylogenetic clustering of hepatitis C virus among people who inject drugs in Vancouver, Canada

    PubMed Central

    Jacka, B; Applegate, T; Krajden, M; Olmstead, A; Harrigan, PR; Marshall, BDL; DeBeck, K; Milloy, M-J; Lamoury, F; Pybus, OG; Lima, VD; Magiorkinis, G; Montoya, V; Montaner, J; Joy, J; Woods, C; Dobrer, S; Dore, GJ

    2014-01-01

    Little is known about factors associated with HCV transmission among people who inject drugs (PWID). Phylogenetic clustering and associated factors were evaluated among PWID in Vancouver, Canada. Data were derived from the Vancouver Injection Drug Users Study. Participants who were HCV antibody positive at enrolment and those with HCV antibody seroconversion during follow-up (1996 to 2012) were tested for HCV RNA and sequenced (Core-E2 region). Phylogenetic trees were inferred using maximum likelihood analysis and clusters were identified using ClusterPicker (90% bootstrap threshold, 0.05 genetic distance threshold). Factors associated with clustering were assessed using logistic regression. Among 655 eligible participants, HCV genotype prevalence was: G1a: 48% (n=313), G1b: 6% (n=41), G2a: 3% (n=20), G2b: 7% (n=46), G3a: 33% (n=213), G4a: <1% (n=4), G6a: 1% (n=8), G6e: <1% (n=1) and unclassifiable: 1% (n=9). The mean age was 36 years, 162 (25%) were female and 164 (25%) were HIV+. Among 501 participants with HCV G1a and G3a, 31% (n=156) were in a pair/cluster. Factors independently associated with phylogenetic clustering included: age <40 (vs. age ?40, adjusted odds ratio [AOR] = 1.64; 95% CI 1.03, 2.63), HIV infection (AOR = 1.82; 95% CI 1.18, 2.81), HCV seroconversion (AOR = 3.05; 95% CI 1.40, 6.66) and recent syringe borrowing (AOR 1.59; 95% CI 1.07, 2.36). Conclusion In this sample of PWID, one-third demonstrated phylogenetic clustering. Factors independently associated with phylogenetic clustering included younger age, recent HCV seroconversion, prevalent HIV infection, and recent syringe borrowing. Strategies to enhance the delivery of prevention and/or treatment strategies to those with HIV and recent HCV seroconversion should be explored, given an increased likelihood of HCV transmission in these sub-populations. PMID:25042607

  13. Analysis of Phytosterols and N-Alkanols in Atmospheric Organic Particulate Matter Collected in Vancouver During the Pacific 2001 Air Quality Study

    NASA Astrophysics Data System (ADS)

    Leithead, A.; Li, S.

    2002-12-01

    As part of Pacific 2001, HiVol samples were collected from 5 sites in the Vancouver area. The samples were extracted by accelerated solvent extraction (ACE), concentrated with nitrogen blow down, and separated into fractions by silica gel chromatography. For this portion of the study, an aliquot of one of the polar fraction was derivatized with BSTFA and analyzed by GC-FID and GC-MS. The results for n-alkanols and phytosterols will be reported and discussed. Previous studies have shown that the biogenic components of particulate matter are major constituents of the total organic material in atmospheric samples. Phytosterols are present in wood smoke, epicuticular waxes of many plants and microbial sources. In addition, cholesterol has been proposed as a potential tracer for emissions from cooking. The most abundant phytosterols are cholesterol, campesterol, stigmasterol and beta-sitosterol. It has been hypothesized that the phytosterol signature may be useful in identifying particulate matter from different source areas. The phytosterol signature for these samples will be reported and compared. The n-alkanol CPI and Cmax will also be reported. N-alkanols in atmospheric samples generally show a strong even to odd predominance indicating that their main source in particulate matter is biogenic. The n-alkanol signature for each sampling site will be compared.

  14. The Young Hospitalized Child.

    ERIC Educational Resources Information Center

    Winters, Anne

    This literature review examines the effects of hospitalization on the young child and suggests ways in which parents and hospital personnel can protect children from the potentially harmful emotional and intellectual effects of hospitalization. The history of attitudes toward the hospitalization of children is discussed. Children's emotional…

  15. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

    Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

    2004-01-01

    Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

  16. Financial and organizational determinants of hospital diversification into subacute care.

    PubMed Central

    Wheeler, J R; Burkhardt, J; Alexander, J A; Magnus, S A

    1999-01-01

    OBJECTIVE: To examine the financial, market, and organizational determinants of hospital diversification into subacute inpatient care by acute care hospitals in order to guide hospital managers in undertaking such diversification efforts. STUDY SETTING: All nongovernment, general, acute care, community hospitals that were operating during the years 1985 through 1991 (3,986 hospitals in total). DATA SOURCES: Cross-sectional, time-series data were drawn from the American Hospital Association's (AHA) Annual Survey of Hospitals, the Health Care Financing Administration's (HCFA) Medicare Cost Reports, a latitude and longitude listing for all community hospital addresses, and the Area Resource File (ARF) published in 1992, which provides county level environmental variables. STUDY DESIGN: The study is longitudinal, enabling the specification of temporal patterns in conversion, causal inferences, and the treatment of right-censoring problems. The unit of analysis is the individual hospital. KEY FINDINGS: Significant differences were found in the average level of subacute care offered by investor-owned versus tax-exempt hospitals. After controlling for selection bias, financial performance, risk, size, occupancy, and other variables, IO hospitals offered 31.3 percent less subacute care than did NFP hospitals. Financial performance and risk are predictors of IO hospitals' diversification into subacute care, but not of NFP hospitals' activities in this market. Resource availability appears to expedite expansion into subacute care for both types of hospitals. CONCLUSIONS: Investment criteria and strategy differ between investor-owned and tax-exempt hospitals. PMID:10201852

  17. Controlling Chaos: The Perceptions of Long-Term Crack Cocaine Users in Vancouver, British Columbia, Canada

    PubMed Central

    Kuo, Margot; Bungay, Vicky; Buxton, Jane A.

    2013-01-01

    People who smoke crack cocaine are described as chaotic and more likely to engage in risky sex, polysubstance use and contract infectious diseases. However, little is known about how individuals perceive smoking crack as compared to other forms of cocaine use, especially injection. We explored the lived experience of people who smoke crack cocaine. Six gender-specific focus groups (n = 31) of individuals who currently smoke crack in Vancouver, Canada, were conducted using a semi-structured interview guide. Focus groups were transcribed and analyzed by constant comparative methodology. We applied Rhodes' risk environment to the phenomenological understanding that individuals have regarding how crack has affected their lives. Subjects reported that smoking rather than injecting cocaine allows them to begin “controlling chaos” in their lives. Controlling chaos was self-defined using nontraditional measures such as the ability to maintain day-to-day commitments and housing stability. The phenomenological lens of smoking crack instead of injecting cocaine “to control chaos” contributes a novel perspective to our understanding of the crack-smoking population. This study examines narratives which add to prior reports of the association of crack smoking and increased chaos and suggests that, for some, inhaled crack may represent efforts towards self-directed harm reduction. PMID:24826370

  18. Self-management of pain among people who inject drugs in Vancouver

    PubMed Central

    Voon, Pauline; Callon, Cody; Nguyen, Paul; Dobrer, Sabina; Montaner, Julio; Wood, Evan; Kerr, Thomas

    2014-01-01

    SUMMARY Aims To evaluate factors and methods associated with self-management of pain among people who inject drugs (IDUs) in Vancouver (Canada). Patients & methods This cross-sectional study used bivariate statistics and multivariate logistic regression to analyze self-reported responses among 483 IDUs reporting moderate-to-extreme pain in two prospective cohort studies from 1 December 2012 to 31 May 2013. Results Median age was 49.6 years (interquartile range: 43.9–54.6 years), 33.1% of IDUs were female and 97.5% reported self-management of pain. Variables independently and positively associated with self-managed pain included having been refused a prescription for pain medication (adjusted odds ratio: 7.83; 95% CI: 1.64–37.3) and having ever been homeless (adjusted odds ratio: 3.70; 95% CI: 1.00–13.7). Common methods of self-management of pain included injecting heroin (52.7%) and obtaining diverted prescription pain medication from the street (65.0%). Conclusion Self-management of pain was common among IDUs who reported moderate-to-extreme pain in this setting, particularly among those who had been refused a prescription for pain medication and those who had ever been homeless. These data highlight the challenges of adequate pain management among IDUs. PMID:24641341

  19. Decision maker views on priority setting in the Vancouver Island Health Authority

    PubMed Central

    Dionne, Francois; Mitton, Craig; Smith, Neale; Donaldson, Cam

    2008-01-01

    Background Decisions regarding the allocation of available resources are a source of growing dissatisfaction for healthcare decision-makers. This dissatisfaction has led to increased interest in research on evidence-based resource allocation processes. An emerging area of interest has been the empirical analysis of the characteristics of existing and desired priority setting processes from the perspective of decision-makers. Methods We conducted in-depth, face-to-face interviews with 18 senior managers and medical directors with the Vancouver Island Health Authority, an integrated health care provider in British Columbia responsible for a population of approximately 730,000. Interviews were transcribed and content-analyzed, and major themes and sub-themes were identified and reported. Results Respondents identified nine key features of a desirable priority setting process: inclusion of baseline assessment, use of best evidence, clarity, consistency, clear and measurable criteria, dissemination of information, fair representation, alignment with the strategic direction and evaluation of results. Existing priority setting processes were found to be lacking on most of these desired features. In addition, respondents identified and explicated several factors that influence resource allocation, including political considerations and organizational culture and capacity. Conclusion This study makes a contribution to a growing body of knowledge which provides the type of contextual evidence that is required if priority setting processes are to be used successfully by health care decision-makers. PMID:18644152

  20. Opportunities to learn and barriers to change: crack cocaine use in the Downtown Eastside of Vancouver

    PubMed Central

    Boyd, Susan; Johnson, Joy L; Moffat, Barbara

    2008-01-01

    In 2004, a team comprised of researchers and service providers launched the Safer Crack Use, Outreach, Research and Education (SCORE) project in the Downtown Eastside of Vancouver, British Columbia, Canada. The project was aimed at developing a better understanding of the harms associated with crack cocaine smoking and determining the feasibility of introducing specific harm reduction strategies. Specifically, in partnership with the community, we constructed and distributed kits that contained harm reduction materials. We were particularly interested in understanding what people thought of these kits and how the kits contents were used. To obtain this information, we conducted 27 interviews with women and men who used crack cocaine and received safer crack kits. Four broad themes were generated from the data: 1) the context of crack use practices; 2) learning/transmission of harm reducon education; 3) changing practice; 4) barriers to change. This project suggests that harm reduction education is most successful when it is informed by current practices with crack use. In addition it is most effectively delivered through informal interactions with people who use crack and includes repeated demonstrations of harm reduction equipment by peers and outreach workers. This paper also suggests that barriers to harm reduction are systemic: lack of safe housing and private space shape crack use practices. PMID:19014696

  1. Multi-millennial streamflow dynamics in two forested watersheds on Vancouver Island, Canada

    NASA Astrophysics Data System (ADS)

    Brown, Kendrick J.; Schoups, Gerrit

    2015-05-01

    Holocene streamflow was reconstructed for two rivers on Vancouver Island, British Columbia, Canada in 500-yr intervals. The San Juan River watershed is located on the wetter western side of the island, whereas the Koksilah River watershed is positioned on the drier eastern side. Both watersheds are forested. To reconstruct streamflow, temporal changes in precipitation (estimated using a pollen-based transfer function) and evapotranspiration were established for each watershed and integrated into a water balance model, calibrated using modern data. While seasonal streamflow variability was maintained throughout the Holocene, with greater flow in the winter relative to the summer, the amount of discharge has changed markedly through time. Lowest simulated flow occurred in the earliest Holocene, with low-flow conditions beginning earlier in the year and extending later into the fall. Such conditions may have inhibited salmon from using many of the smaller rivers in the region. Streamflow steadily increased throughout the early Holocene so that by ca. 6500 cal yr before present near-modern flow regimes were established. As climate changes in the future, the San Juan and Koksilah watersheds are expected to remain as pluvial hydroclimatic regimes, though with an extended season of low flow similar to conditions during the early Holocene.

  2. Kelp forest size alters microbial community structure and function on Vancouver Island, Canada.

    PubMed

    Clasen, J L; Shurin, J B

    2015-03-01

    Bacteria are ubiquitous and important components of marine ecosystems, yet the interaction between bacteria and higher trophic levels remain poorly understood. The trophic cascade involving sea otters, urchins, and kelp in the North Pacific is a classic case of altered ecosystem states; however, its impacts on microbial communities are unknown. We investigated the response of microbial communities to variation in kelp abundance between regions with and without sea otter populations along the west coast of Vancouver Island, British Columbia, Canada. We compared bacterial community structure and function between regions with large and small kelp forests, including an subset of the bacterial community that produces alginate lyase, which allows direct utilization of kelp carbon. The abundance and activity of alginate-lyase-producing bacteria were 3.2 and 1.4 times higher, respectively, in the region with large kelp forests, and declined rapidly with increasing distance from kelp. Total bacterial abundance was 2.7 times greater, and bacteria grew faster and experienced more zooplankton grazing and viral-mediated mortality in the presence of large kelp forests. These patterns suggest that larger kelp forests produce more detritus and dissolved organic matter, which stimulate microbial activity. Our results indicate that variation in kelp forest size alters the community structure and productivity of microbes and contributes to the growing evidence that top predators interact with microbes and ecosystem processes through a cascade of indirect effects. PMID:26236881

  3. Hospitalizations of Children with Autism Increased from 1999 to 2009

    ERIC Educational Resources Information Center

    Nayfack, Aaron M.; Huffman, Lynne C.; Feldman, Heidi M.; Chan, Jia; Saynina, Olga; Wise, Paul H.

    2014-01-01

    We performed a retrospective analysis of hospital discharges for children with autism, in comparison to children with cerebral palsy, Down syndrome, mental retardation/intellectual disability, and the general population. Hospitalizations for autism increased nearly threefold over 10 years, especially at the oldest ages, while hospitalizations for…

  4. Hospitalizations of Adults with Intellectual Disability in Academic Medical Centers

    ERIC Educational Resources Information Center

    Ailey, Sarah H.; Johnson, Tricia; Fogg, Louis; Friese, Tanya R.

    2014-01-01

    Individuals with intellectual disability (ID) represent a small but important group of hospitalized patients who often have complex health care needs. Individuals with ID experience high rates of hospitalization for ambulatory-sensitive conditions and high rates of hospitalizations in general, even when in formal community care systems; however,…

  5. Financial management of hospitals.

    PubMed

    Speranzo, A J

    1984-05-01

    The effect of hospital reimbursement systems on the financial management of hospitals is briefly discussed, and the organization of hospital financial operations is reviewed. The implementation of Medicare prospective pricing will change the way in which hospital finances are managed. Health-care managers will be concerned with the profitability of product lines, or diagnosis-related groups, in future strategic planning efforts. The hospital's finance department consists of several traditional areas that exist in almost all financial organizations. The functions and interactions of these various areas are discussed in light of previous and current hospital reimbursement strategies. Staffing of the finance department and the duties of the hospital's chief financial officer are also described. The prospective pricing system of hospital reimbursement and increasing pressure from the business community to stem the rising costs of health care will produce changes in the medical and financial operations of the hospital industry over the next decade. PMID:6375357

  6. Better management of Irish hospitals.

    PubMed

    Brugha, C M

    1991-08-01

    The establishment of the Dublin Hospitals Initiative and the Efficiency Review Group as first steps in an "action" plan was based on the report in 1989 of the Commission of Health Funding which suggested that "the solution to the problem facing the Irish health services...(lies) primarily...in the way that services are planned, organised and delivered". Our health service is in transition from the phase of facility management into that of functional management. This will involve facing the fact of the limit on resources, introducing information systems and getting the co-operation of hospital doctors. The most senior executive in a hospital must firstly be a good general manager with sufficient power to manage. Hospitals should be divided into centres of responsibility made up of one or more centres of activity. Formal education for hospital administrators should be extended. There is a need for training at all levels, particularly of those administrative and medical staff who have direct interaction with the computer-based system. There should be a commitment to management development particularly by means of teamwork and action learning. PMID:1938310

  7. Regional Hospital Input Price Indexes

    PubMed Central

    Freeland, Mark S.; Schendler, Carol Ellen; Anderson, Gerard

    1981-01-01

    This paper describes the development of regional hospital input price indexes that is consistent with the general methodology used for the National Hospital Input Price Index. The feasibility of developing regional indexes was investigated because individuals inquired whether different regions experienced different rates of increase in hospital input prices. The regional indexes incorporate variations in cost-share weights (the amount an expense category contributes to total spending) associated with hospital type and location, and variations in the rate of input price increases for various regions. We found that between 1972 and 1979 none of the regional price indexes increased at average annual rates significantly different from the national rate. For the more recent period 1977 through 1979, the increase in one Census Region was significantly below the national rate. Further analyses indicated that variations in cost-share weights for various types of hospitals produced no substantial variations in the regional price indexes relative to the national index. We consider these findings preliminary because of limitations in the availability of current, relevant, and reliable data, especially for local area wage rate increases. PMID:10309557

  8. Department of Neurology Massachusetts General Hospital

    E-print Network

    Dickerson, Brad

    the power of tenacious advocates. We are consistently awed by the strength, perseverance and love to the anterior temporal and frontal lobes of the brain. FTD causes a gradual, progressive decline in behavior, language or other abilities that often has a younger age at onset, affecting people in their 50's and 60's

  9. The application of hospitality elements in hospitals.

    PubMed

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority. PMID:23424818

  10. Social structural factors that shape assisted injecting practices among injection drug users in Vancouver, Canada: a qualitative study

    PubMed Central

    2010-01-01

    Background Injection drug users (IDU) commonly seek manual assistance with illicit drug injections, a practice known to be associated with various health-related harms. We investigated the social structural factors that shape risks related to assisted injection and the harms that may result. Methods Twenty semi-structured qualitative interviews were conducted with IDU enrolled in the ACCESS or Vancouver Injection Drug Users Study (VIDUS) who reported requiring assistance injecting in the past six months. Audio-recorded interviews were transcribed verbatim and a thematic analysis was conducted. Results Barriers to self-injecting included a lack of knowledge of proper injecting technique, a loss of accessible veins, and drug withdrawal. The exchange of money or drugs for assistance with injecting was common. Harms experienced by IDU requiring assistance injecting included theft of the drug, missed injections, overdose, and risk of blood-borne disease transmission. Increased vulnerability to HIV/HCV infection within the context of intimate relationships was represented in participant narratives. IDU identified a lack of services available for those who require assistance injecting, with notable mention of restricted use of Vancouver's supervised injection facility. Conclusions This study documents numerous severe harms that arise from assisted injecting. Social structural factors that shape the risks related to assisted injection in the Vancouver context included intimate partner relations and social conventions requiring an exchange of goods for provision of injecting assistance. Health services for IDU who need help injecting should include targeted interventions, and supervised injection facilities should attempt to accommodate individuals who require assistance with injecting. PMID:20807442

  11. Smoking cessation for hospital inpatients

    PubMed Central

    Bickerstaffe, Gary

    2014-01-01

    People who smoke make up a significant number of those admitted to hospital (NICE 2014). Being admitted to hospital can present a unique opportunity to attempt to stop smoking. Many smokers find quitting very difficult (Rigotti et al 2007), in large part due to them living and working in environments that contain many cues and triggers associated with nicotine consumption and smoking behaviours. Hospitals generally do not contain such environmental prompts to smoke. In the community, smokers have access to numerous types of support including GP's, pharmacies and Stop Smoking Services (SSS). Once admitted to hospital access to such support is significantly diminished. Given that many patients may be highly motivated to attempt to stop smoking due to heightened concerns about their health and being in an environment not associated with their smoking habits, it seems prudent to ensure there is access to all the levels of smoking cessation support available outside of the hospital. Not providing such support neglects implementing an evidence based, cost-effective health intervention in a major health setting (NICE 2014). A SSS pathway was designed that enabled existing hospital healthcare staff to be trained to identify patients that smoke, ask if the patient is considering quitting or abstaining whilst in hospital. If motivated to quit or abstain, to complete an assessment. This being based around dependence to nicotine and motivation to quit. Access to all available stop smoking medications should be included. Medication should only be provided alongside some level of motivational support up to discharge. Training core staff was felt to be the best option. They are available outside of office hours and access hospital systems such as pharmacy more readily than satellite staff. On discharge the patient is ‘handed over’ to SSS for continued contact and support once at home. Over 200 staff are trained to complete the assessment and support inpatients to stop or abstain. Approximately 30-35 referrals are made to the local SSS each month, the quit rate at 4 weeks averaging around 40–45%. Most referrals are seen from cardiology and respiratory. All hospital departments should identify staff to be trained to offer cessation support to their patients .

  12. The Surface Urban Energy and Water Balance Scheme (SUEWS): Evaluation in Los Angeles and Vancouver

    NASA Astrophysics Data System (ADS)

    Järvi, L.; Grimmond, C. S. B.; Christen, A.

    2011-12-01

    SummaryAn urban energy and water balance model is presented which uses a small number of commonly measured meteorological variables and information about the surface cover. Rates of evaporation-interception for a single layer with multiple surface types (paved, buildings, coniferous trees and/or shrubs, deciduous trees and/or shrubs, irrigated grass, non-irrigated grass and water) are calculated. Below each surface type, except water, there is a single soil layer. At each time step the moisture state of each surface is calculated. Horizontal water movements at the surface and in the soil are incorporated. Particular attention is given to the surface conductance used to model evaporation and its parameters. The model is tested against direct flux measurements carried out over a number of years in Vancouver, Canada and Los Angeles, USA. At all measurement sites the model is able to simulate the net all-wave radiation and turbulent sensible and latent heat well (RMSE = 25-47 W m -2, 30-64 and 20-56 W m -2, respectively). The model reproduces the diurnal cycle of the turbulent fluxes but typically underestimates latent heat flux and overestimates sensible heat flux in the day time. The model tracks measured surface wetness and simulates the variations in soil moisture content. It is able to respond correctly to short-term events as well as annual changes. The largest uncertainty relates to the determination of surface conductance. The model has the potential be used for multiple applications; for example, to predict effects of regulation on urban water use, landscaping and planning scenarios, or to assess climate mitigation strategies.

  13. Magnitudes and moment-duration scaling of low-frequency earthquakes beneath southern Vancouver Island

    NASA Astrophysics Data System (ADS)

    Bostock, M. G.; Thomas, A. M.; Savard, G.; Chuang, L.; Rubin, A. M.

    2015-09-01

    We employ 130 low-frequency earthquake (LFE) templates representing tremor sources on the plate boundary below southern Vancouver Island to examine LFE magnitudes. Each template is assembled from hundreds to thousands of individual LFEs, representing over 269,000 independent detections from major episodic-tremor-and-slip (ETS) events between 2003 and 2013. Template displacement waveforms for direct P and S waves at near epicentral distances are remarkably simple at many stations, approaching the zero-phase, single pulse expected for a point dislocation source in a homogeneous medium. High spatiotemporal precision of template match-filtered detections facilitates precise alignment of individual LFE detections and analysis of waveforms. Upon correction for 1-D geometrical spreading, attenuation, free surface magnification and radiation pattern, we solve a large, sparse linear system for 3-D path corrections and LFE magnitudes for all detections corresponding to a single-ETS template. The spatiotemporal distribution of magnitudes indicates that typically half the total moment release occurs within the first 12-24 h of LFE activity during an ETS episode when tidal sensitivity is low. The remainder is released in bursts over several days, particularly as spatially extensive rapid tremor reversals (RTRs), during which tidal sensitivity is high. RTRs are characterized by large-magnitude LFEs and are most strongly expressed in the updip portions of the ETS transition zone and less organized at downdip levels. LFE magnitude-frequency relations are better described by power law than exponential distributions although they exhibit very high b values ?˜5. We examine LFE moment-duration scaling by generating templates using detections for limiting magnitude ranges (MW<1.5, MW?2.0). LFE duration displays a weaker dependence upon moment than expected for self-similarity, suggesting that LFE asperities are limited in fault dimension and that moment variation is dominated by slip. This behavior implies that LFEs exhibit a scaling distinct from both large-scale slow earthquakes and regular seismicity.

  14. Storm runoff as related to urbanization in the Portland, Oregon-Vancouver, Washington Area

    USGS Publications Warehouse

    Laenen, Antonius

    1980-01-01

    A series of equations was developed to provide a better method of determining flood frequencies in the Portland-Vancouver urban area than is now available. The resulting regression equations can be used to compute peak discharge and storm runoff with a standard error of estimate of approximately 30 percent. Basins used to define the regression equations ranged in size from 0.2 to 26 square miles. Those physical basin parameters that proved to be significant are: drainage area, effective impervious area, storage, rainfall intensity, basin slope, and soil infiltration. The equations indicate that total urbanization of an undeveloped basin can increase peak discharge as much as 3? times and almost double the volume of storm runoff. Impervious area, as delineated by mapping techniques, proved to be an inadequate physical parameter for use in the regression equations because builders and planners have devised many methods of routing storm runoff from impervious areas to the main channel (in effect, speeding up or slowing down the response to the storm). In some parts of the study area, storm runoff was diverted into dry wells and never entered the main channel. To define the effect of this rerouting, the digital model was used to find an effective impervious area that would 'best fit' the rainfall-runoff data. Field estimates to verify the effectiveness of the impervious area for two of the basins showed that optimizations were within 20 percent of those shown by the digital model. Users of these data who may find the effective impervious area a difficult, expensive, and time-consuming parameter to obtain have an alternative. The combination of land-use type I (parks, forests, and vacant lots) and Type II (agriculture) proved to be an excellent inverse indicator of impervious area. Land-use types I and II, coupled with the street-gutter density, an indication of effective routing, provide the user with alternative indices of urbanization.

  15. Tectonic setting of the Portland-Vancouver area, Oregon and Washington: constraints from low-altitude aeromagnetic data

    USGS Publications Warehouse

    Blakely, R.J.; Wells, R.E.; Yelin, T.S.; Madin, I.P.; Beeson, M.H.

    1995-01-01

    Seismic activity in the Portland-Vancouver metropolitan area may be associated with various mapped faults that locally offset volcanic basement of Eocene age and younger. This volcanic basement is concealed in most places by young deposits, vegetation, and urban development. The US Geological Survey conducted an aeromagnetic survey in September 1992 to investigate the extent of these mapped faults and possibly to help identify other seismic and volcanic hazards in the area. The survey was flown approximately 240 m above terrain, along flight lines spaced 460 m apart, and over an area about 50 ?? 50 km. -from Authors

  16. Late-Quaternary paleovegetation, paleoclimate and fire disturbance records from subalpine sites on Vancouver Island, British Columbia, Canada

    NASA Astrophysics Data System (ADS)

    Fitton, R. J.; Brown, K. J.; Hebda, R. J.

    2003-04-01

    Analyses of pollen, macrofossils and charcoal from subalpine lakes provide insight into past climatic changes as well as local factors affecting the sites, especially since steep precipitation and temperature gradients typify mountainous regions. Lake and bog cores collected from three sites on southern and central Vancouver Island (Porphyry and Walker lakes and Harris Lake Ridge Bog) were analysed for pollen, macrofossils and charcoal and the resulting data were used to reveal post-glacial changes in vegetation, climate and fire disturbance. The paleovegetation, paleoclimate, and fire disturbance records from Porphyry and Walker Lakes parallel those from low elevations during the post-glacial interval, suggesting that these sites responded strongly to regional forcing and were somewhat less sensitive to local forcing. Of notable interest is the upward migration of lowland taxa to these lakes during the warm dry early-Holocene. A change to cooler and moister conditions in the mid- and late-Holocene is subsequently characterised by downslope movement of species ranges and the establishment of modern subalpine communities. In contrast, Harris Lake Ridge Bog from central Vancouver Island has a more complicated history that exhibits strong local and regional influences. This site is less similar to lowland records despite a relatively similar ecotonal position as the other two sites. In the early-Holocene upslope movement of low elevation species is less obvious than at Porphyry and Walker lakes. In the mid- and late-Holocene forest composition changed around Harris Lake Ridge Bog as conditions cooled and moistened and taxa better suited to nutrient poor soils, such as Tsuga mertensiana and T. heterophylla expanded. At the same time, there is evidence to suggest that local switches between forest and heather communities were initiated by fire. Consequently, records from subalpine wetlands may provide more potential for detailed reconstruction of local in-stand vegetation dynamics than those from lakes. Studies from subalpine sites have application in forestry management, wildlife conservation, and archaeological reconstruction. For example, on Vancouver Island, the Vancouver Island marmot (Marmota vancouverensis) is near extinction and conservation of the species can benefit from understanding habitat dynamic at high elevations.

  17. Aerial Measurement of Radioxenon Concentration off the West Coast of Vancouver Island following the Fukushima Reactor Accident

    E-print Network

    L. E. Sinclair; H. C. J. Seywerd; R. Fortin; J. M. Carson; P. R. B. Saull; M. J. Coyle; R. A. Van Brabant; J. L. Buckle; S. M. Desjardins; R. M. Hall

    2011-06-20

    In response to the Fukushima nuclear reactor accident, on March 20th, 2011, Natural Resources Canada conducted aerial radiation surveys over water just off of the west coast of Vancouver Island. Dose-rate levels were found to be consistent with background radiation, however a clear signal due to Xe-133 was observed. Methods to extract Xe-133 count rates from the measured spectra, and to determine the corresponding Xe-133 volumetric concentration, were developed. The measurements indicate that Xe-133 concentrations on average lie in the range of 30 to 70 Bq/m3.

  18. University Hospitals for Sale.

    ERIC Educational Resources Information Center

    Culliton, Barbara J.

    1984-01-01

    Although faculty opposition stopped the sale of Harvard's McLean Hospital to the Hospital Corporation of America (HCA), a partnership remains a possibility. Issues related to the proposed sale as well as those affecting hospital economics are considered. Proposed terms of the sale are included. (JN)

  19. HOSPITALS FOR RURAL PEOPLE.

    ERIC Educational Resources Information Center

    MANNY, ELSIE S.; ROGERS, CHARLES E.

    MODERN ADVANCEMENTS IN MEDICAL SCIENCE HAVE PRECIPITATED THE NEED FOR ADEQUATE UP-TO-DATE HOSPITAL FACILITIES REASONABLY CLOSE TO ALL PEOPLE. RURAL COMMUNITIES HAVE UTILIZED FEDERAL AID, STATE AID, ASSISTANCE FROM FOUNDATIONS, CIVIC BONDS, AND VOLUNTEER CONTRIBUTIONS AND DRIVES TO ERECT AND EQUIP HOSPITALS. HOSPITAL CARE FOR RURAL PEOPLE USUALLY…

  20. HOSPITALITY AT BIRKBECK,

    E-print Network

    Crawford, Ian

    MENU HOSPITALITY AT BIRKBECK, UNIVERSITY OF LONDON 2014-15 EXTERNALPROVIDED BY #12;WELCOME to cancel this request with the supplier without cost. Any items used to serve hospitality that are damaged for hospitality is supplied in re- usable bottles. A charge of £5.00 will be levied to the booking

  1. HOSPITALITY APPROVAL FORM DATE: __________________________

    E-print Network

    Maxwell, Bruce D.

    HOSPITALITY APPROVAL FORM DATE: __________________________ PERMISSION IS REQUESTED TO USE HOSPITALITY APPROVAL FORM MUST BE APPROVED PRIOR TO THE DATE OF THE EVENT. NOTE: ALL EXPENSES MUST MEET, or conferences. Hospitality Form required for food over $30.00. (Account Code 62809) _____ Entertainment: Costs

  2. 2. View northwest of main hospital building complex, hospital building ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. View northwest of main hospital building complex, hospital building (Building 90), administration and clinical hospital building (Building 88), and hospital building (Building 91) - National Home for Disabled Volunteer Soldiers Western Branch, 4101 South Fourth Street, Leavenworth, Leavenworth County, KS

  3. Patients' perceptions of care are associated with quality of hospital care: a survey of 4605 hospitals.

    PubMed

    Stein, Spencer M; Day, Michael; Karia, Raj; Hutzler, Lorraine; Bosco, Joseph A

    2015-01-01

    Favorable patient experience and low complication rates have been proposed as essential components of patient-centered medical care. Patients' perception of care is a key performance metric and is used to determine payments to hospitals. It is unclear if there is a correlation between technical quality of care and patient satisfaction. The study authors correlated patient perceptions of care measured by the Hospital Consumer Assessment of Healthcare Providers and Systems scores with accepted quality of care indicators. The Hospital Compare database (4605 hospitals) was used to examine complication rates and patient-reported experience for hospitals across the nation in 2011. The majority of the correlations demonstrated an inverse relationship between patient experience and complication rates. This negative correlation suggests that reducing these complications can lead to a better hospital experience. Overall, these results suggest that patient experience is generally correlated with the quality of care provided. PMID:24740016

  4. Guide to Choosing a Hospital

    MedlinePLUS

    ... get started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Steps to Choosing a Hospital Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . 7–9 Hospital Quality Quick Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 A ... a Hospital 7 Steps to Choosing a Hospital Checklist STEP 1: Learn about the care you need ...

  5. Outdoor brothel culture: the un/making of a transsexual stroll in Vancouver's West End, 1975–1984.

    PubMed

    Ross, Becki

    2012-01-01

    In the mid-1970s, following a series of police raids on prostitution inside downtown nightclubs, a community of approximately 200 sex workers moved into Vancouver's West End neighborhood, where a small stroll had operated since the early 1970s. This paper examines the contributions made by three male-to-female (MTF) transsexuals of color to the culture of on-street prostitution in the West End. The trans women's stories address themes of fashion, working conditions, money, community formation, violence, and resistance to well-organized anti-prostitution forces. These recollections enable me to bridge and enrich trans history and prostitution history – two fields of inquiry that have under-represented the participation of trans women in the sex industry across the urban West. Acutely familiar with the hazards inherent in a criminalized, stigmatized trade, trans sex workers in the West End manufactured efficacious strategies of harm reduction, income generation, safety planning, and community building. Eschewing the label of “victim”, they leveraged their physical size and style, charisma, contempt towards pimps, earning capacity, and seniority as the first workers on the stroll to assume leadership within the broader constituency of “hookers on Davie Street”. I discover that their short-lived outdoor brothel culture offered only a temporary bulwark against the inevitability of eviction via legal injunction in July 1984, and the subsequent rise in lethal violence against all prostitutes in Vancouver, including MTF transsexuals. PMID:22611581

  6. Realizing User-Relevant Conceptual Model for the Ski Jump Venue of the Vancouver 2010 Winter Olympics

    NASA Astrophysics Data System (ADS)

    Teakles, Andrew; Mo, Ruping; Dierking, Carl F.; Emond, Chris; Smith, Trevor; McLennan, Neil; Joe, Paul I.

    2014-01-01

    As was the case for most other Olympic competitions, providing weather guidance for the ski jump and Nordic combined events involved its own set of unique challenges. The extent of these challenges was brought to light before the Vancouver 2010 Winter Olympics during a series of outflow wind events in the 2008/2009 winter season. The interactions with the race officials during the difficult race conditions brought on by the outflows provided a new perspective on the service delivery requirements for the upcoming Olympic Games. In particular, the turbulent nature of the winds and its impact on the ski jump practice events that season highlighted the need of race officials for nowcasting advice at very short time scales (from 2 min to 1 h) and forecast products tailored to their decision-making process. These realizations resulted in last minute modifications to the monitoring strategy leading up to the Olympic Games and required forecasters' conceptual models for flow within the Callaghan Valley to be downscaled further to reflect the evolution of turbulence at the ski jump site. The SNOW-V10 (Science of Nowcasting Olympic Weather for Vancouver 2010) team provided support for these efforts by supplying diagnostic case analyses of important events using numerical weather data and by enhancing the real-time monitoring capabilities at the ski jump venue.

  7. A GIS-based spatiotemporal analysis of violent trauma hotspots in Vancouver, Canada: identification, contextualisation and intervention

    PubMed Central

    Walker, Blake Byron; Schuurman, Nadine; Hameed, S Morad

    2014-01-01

    Background In 2002, the WHO declared interpersonal violence to be a leading public health problem. Previous research demonstrates that urban spaces with a high incidence of violent trauma (hotspots) correlate with features of built environment and social determinants. However, there are few studies that analyse injury data across the axes of both space and time to characterise injury–environment relationships. This paper describes a spatiotemporal analysis of violent injuries in Vancouver, Canada, from 2001 to 2008. Methods Using geographic information systems, 575 violent trauma incidents were mapped and analysed using kernel density estimation to identify hotspot locations. Patterns between space, time, victim age and sex and mechanism of injury were investigated with an exploratory approach. Results Several patterns in space and time were identified and described, corresponding to distinct neighbourhood characteristics. Violent trauma hotspots were most prevalent in Vancouver's nightclub district on Friday and Saturday nights, with higher rates in the most socioeconomically deprived neighbourhoods. Victim sex, age and mechanism of injury also formed strong patterns. Three neighbourhood profiles are presented using the dual axis of space/time to describe the hotspot environments. Conclusions This work posits the value of exploratory spatial data analysis using geographic information systems in trauma epidemiology studies and further suggests that using both space and time concurrently to understand urban environmental correlates of injury provides a more granular or higher resolution picture of risk. We discuss implications for injury prevention and control, focusing on education, regulation, the built environment and injury surveillance. PMID:24556240

  8. The clinical and integrated management of COPD. An official document of AIMAR (Interdisciplinary Association for Research in Lung Disease), AIPO (Italian Association of Hospital Pulmonologists), SIMER (Italian Society of Respiratory Medicine), SIMG (Italian Society of General Medicine)

    PubMed Central

    2014-01-01

    COPD is a chronic pathological condition of the respiratory system characterized by persistent and partially reversible airflow obstruction, to which variably contribute remodeling of bronchi (chronic bronchitis), bronchioles (small airway disease) and lung parenchyma (pulmonary emphysema). COPD can cause important systemic effects and be associated with complications and comorbidities. The diagnosis of COPD is based on the presence of respiratory symptoms and/or a history of exposure to risk factors, and the demonstration of airflow obstruction by spirometry. GARD of WHO has defined COPD "a preventable and treatable disease". The integration among general practitioner, chest physician as well as other specialists, whenever required, assures the best management of the COPD person, when specific targets to be achieved are well defined in a diagnostic and therapeutic route, previously designed and shared with appropriateness. The first-line pharmacologic treatment of COPD is represented by inhaled long-acting bronchodilators. In symptomatic patients, with pre-bronchodilator FEV1 < 60% predicted and ? 2 exacerbations/year, ICS may be added to LABA. The use of fixed-dose, single-inhaler combination may improve the adherence to treatment. Long term oxygen therapy (LTOT) is indicated in stable patients, at rest while receiving the best possible treatment, and exhibiting a PaO2???55 mmHg (SO2??55%. Respiratory rehabilitation is addressed to patients with chronic respiratory disease in all stages of severity who report symptoms and limitation of their daily activity. It must be integrated in an individual patient tailored treatment as it improves dyspnea, exercise performance, and quality of life. Acute exacerbation of COPD is a sudden worsening of usual symptoms in a person with COPD, over and beyond normal daily variability that requires treatment modification. The pharmacologic therapy can be applied at home and includes the administration of drugs used during the stable phase by increasing the dose or modifying the route, and adding, whenever required, drugs as antibiotics or systemic corticosteroids. In case of patients who because of COPD severity and/or of exacerbations do not respond promptly to treatment at home hospital admission should be considered. Patients with "severe" or "very severe" COPD who experience exacerbations should be carried out in respiratory unit, based on the severity of acute respiratory failure. An integrated system is required in the community in order to ensure adequate treatments also outside acute care hospital settings and rehabilitation centers. This article is being simultaneously published in Sarcoidosis Vasc Diffuse Lung Dis 2014, 31(Suppl. 1);3-21. PMID:25057359

  9. [Operation directions by comparing financial ratio of 22 provincial hospitals].

    PubMed

    Wang, J Y; Ko, Y C; Wang, J W; Jan, L C; Chang, F M; Lin, K C

    1996-12-01

    Even more restrictive regulations and reimbursement limits seem to be a very heavy burden and stress for most provincial hospitals, especially after the National Health Insurance System has been introduced. The purpose of this project to find a better, universal direction for these hospitals through three steps: 1) Using different financial and accounting ratio indexes to evaluate the general business performance of each hospital. 2) Taking a comprehensive questionnaire with senior managers of each hospital to know their concepts and attitudes concerning external environment and internal operation. 3) Comparing data's correlation and differentiation to ascertain better trends for future operation for all hospitals. The database for this project comes from two resources: 1) Government finance and budget reports of 22 provincial hospitals for the 1994 accounting calendar year. 2) The results of questionnaires returned by 274 senior managers of hospitals, and analysis of these by chi-square test. Through statistical comparison, a number of conclusions can be made: 1) Most hospitals have better operation efficiency if any professional hospital administrator is working for them. 2) The hospital with more comprehensive personnel system shows better business performance. 3) The hospital with routine and formal financial analysis reports always has better business performance. 4) The hospital with poor operational efficiency tends to get rid of restriction or limitation from government's system. 5) The hospital with good operational efficiency has more confidence and desire to improve and change. 6) The hospital with poor operational efficiency is more dependent on outside support from government. 7) The hospital with better business performance has more concern about the impact of malpractice around the hospital. In short, a hospital with poor business efficiency always has more pessimistic attitude and tends to rely on outside resource support. On the other hand, a hospital with more confidence, flexibility and readiness for internal improvement always demonstrates greater business efficiency. PMID:9011132

  10. Risk factors and outcomes associated with chronic obstructive pulmonary disease exacerbations requiring hospitalization

    PubMed Central

    Bahadori, Katayoun; FitzGerald, J Mark; Levy, Robert D; Fera, Tharwat; Swiston, John

    2009-01-01

    BACKGROUND: Acute respiratory exacerbations are the most frequent cause of medical visits, hospitalization and death for chronic obstructive pulmonary disease (COPD) patients and, thus, exert a significant social and economic burden on society. OBJECTIVE: To identify the risk factors associated with hospital readmission(s) for acute exacerbation(s) of COPD (AECOPD). METHODS: A review of admission records from three large urban hospitals in Vancouver, British Columbia, identified 310 consecutive patients admitted for an AECOPD between April 1, 2001, and December 31, 2002. Logistic regression analysis was performed to identify risk factors for readmissions following an AECOPD. RESULTS: During the study period, 38% of subjects were readmitted at least once. The mean (± SD) duration from the index admission to the first readmission was 5±4.08 months. Comparative analysis among the three hospitals identified a significant difference in readmission rates (54%, 36% and 18%, respectively). Logistic regression analysis revealed that preadmission home oxygen use (OR 2.55; 95%CI 1.45 to 4.42; P=0.001), history of a lung infection within the previous year (OR 1.73; 95% CI 1.01 to 2.97; P=0.048), other chronic respiratory disease (OR 1.78; 95% CI 1.06 to 2.99; P=0.03) and shorter length of hospital stay (OR 0.97; 95% CI 0.945 to 0.995; P=0.021) were independently associated with frequent readmissions for an AECOPD. CONCLUSIONS: Hospital readmission rates for AECOPD were high. Only four clinical factors were found to be independently associated with COPD readmission. There was significant variability in the readmission rate among hospitals. This variability may be a result of differences in the patient populations that each hospital serves or may reflect variability in health care delivery at different institutions. PMID:19707601

  11. Assessing beliefs and risk perceptions on smoking and smoking cessation in immigrant Chinese adult smokers residing in Vancouver, Canada: a cross-sectional study

    PubMed Central

    FitzGerald, J Mark; Poureslami, Iraj; Shum, Jessica

    2015-01-01

    Objectives We aimed to conduct culturally-based participatory research to assess cultural and belief contexts for smoking behaviours within Mandarin and Cantonese communities. Outcome variables were smoking-related knowledge, smoking patterns, attitudes and beliefs, and perceived barriers and facilitators to successful cessation. Design A community-based approach was applied involving smokers, community key-informants and professionals in study design and implementation. Initially, focus groups were conducted and findings were used to develop study instrument. Participants responded once to study questionnaire after informed consent. Setting Community based in the Greater Vancouver Area, Canada. Participants 16 Chinese smokers participated in focus groups and subsequently, 167 current Chinese immigrant (137 males and 30 females) smokers from Mandarin and Cantonese communities, recruited with the help of community agencies and collaborating physicians, were enrolled in a cross-sectional study. Results We found that a majority believed smoking was harmful on their health. Younger smokers (<35?years of age) did not mind smoking in front of young children compared to older smokers (?35?years of age) (p<0.001). People with high school or lower levels of education believed that they would benefit more from smoking than suffering from withdrawal symptoms compared to better educated smokers (p<0.05). Mandarin smokers were significantly more likely to encourage others to quit than Cantonese smokers (p<0.05). Many indicated not receiving adequate support from care providers and lack of access to culturally and linguistically appropriate cessation programmes impacted on their ability to quit smoking. Conclusions Our study highlighted the importance of tobacco beliefs and perceptions among Mandarin and Cantonese speaking immigrants with limited access to healthcare information and for younger smokers whose attention to health consequences of smoking may be limited as well. Study participants were generally aware of the health risks and were willing to quit. Access to appropriate cessation programmes would fulfil their willingness. PMID:25649211

  12. Partners for 20 years: Cape Cod Hospital and MEDITECH. Interview by Bill W. Childs.

    PubMed

    Kilroy, J E

    1989-08-01

    Cape Cod Hospital (CCH), a 228-bed general acute care non-profit community hospital in Hyannis, MA, has been a customer of Medical Information Technology (MEDITECH) for 20 years. This lasting relationship between a vendor and a hospital is rather unique as you will discover in this interview with John E. Kilroy, director of Information Systems at Cape Cod Hospital. PMID:10294243

  13. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false UR plan required for inpatient mental hospital...: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for inpatient mental hospital services. (a) The State plan must provide that each mental hospital...

  14. 42 CFR 456.201 - UR plan required for inpatient mental hospital services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital...: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for inpatient mental hospital services. (a) The State plan must provide that each mental hospital...

  15. A 3D, finite element model for baroclinic circulation on the Vancouver Island continental shelf

    USGS Publications Warehouse

    Walters, R.A.; Foreman, M.G.G.

    1992-01-01

    This paper describes the development and application of a 3-dimensional model of the barotropic and baroclinic circulation on the continental shelf west of Vancouver Island, Canada. A previous study with a 2D barotropic model and field data revealed that several tidal constituents have a significant baroclinic component (the K1 in particular). Thus we embarked on another study with a 3D model to study the baroclinic effects on the residual and several selected tidal constituents. The 3D model uses a harmonic expansion in time and a finite element discretization in space. All nonlinear terms are retained, including quadratic bottom stress, advection and wave transport (continuity nonlinearity). The equations are solved as a global and a local problem, where the global problem is the solution of the wave equation formulation of the shallow water equations, and the local problem is the solution of the momentum equation for the vertical velocity profile. These equations are coupled to the advection-diffusion equation for density so that density gradient forcing is included in the momentum equations. However, the study presented here describes diagnostic calculations for the baroclinic residual circulation only. The model is sufficiently efficient that it encourages sensitivity testing with a large number of model runs. In this sense, the model is akin to an extension of analytical solutions to the domain of irregular geometry and bottom topography where this parameter space can be explored in some detail. In particular, the consequences of the sigma coordinate system used by the model are explored. Test cases using an idealized representation of the continental shelf, shelf break and shelf slope, lead to an estimation of the velocity errors caused by interpolation errors inherent in the sigma coordinate system. On the basis of these estimates, the computational grid used in the 2D model is found to have inadequate resolution. Thus a new grid is generated with increased accuracy in the region of the shelf break. However, even with increased resolution, spurious baroclinic circulation seaward of the shelf break and in the vicinity of Juan de Fuca canyon remained a significant problem when the pressure gradient terms were evaluated using the ?? coordinate system and using a realistic density profile. With the new grid, diagnostic calculations of the barotropic and baroclinic residual circulation are performed using forcing from the observed ??t (density) field and from the gradient of this field. ?? 1992.

  16. Quantifying non-indigenous species in accumulated ballast slurry residuals (swish) arriving at Vancouver, British Columbia

    NASA Astrophysics Data System (ADS)

    Sutherland, T. F.; Levings, C. D.

    2013-08-01

    Ballast tank “swish” samples were collected from ships following their arrival at Vancouver (British Columbia, Canada) after undergoing either a trans-oceanic or a Pacific-coastal voyage. The ballast swish consisted of a residual slurry mixture of sediment and water that remained trapped in ballast tanks following water discharge at port. The ballast tanks of 27 ships were sampled and ballast swish was found on 19 of the 27 ships. These ships were categorized according to ballast water management type: (1) Trans-oceanic = 7 trans-oceanic ships undergoing ballast water exchange (BWE) > 200 nm from shore; (2) Coastal-exchange = 7 Pacific-coastal ships traveling from ports south of Cape Blanco, Oregon undergoing coastal exchange > 50 nm from shore south of Cape Blanco; and (3) Coastal-no-exchange = 5 Pacific-coastal ships traveling from ports north of Cape Blanco, Oregon, without undergoing BWE. Invertebrate abundance and taxa richness were directly correlated with ballast-swish turbidity suggesting that highly-productive coastal source waters and ballast tank retention processes contributed to this trend. In turn, invertebrate taxa diversity increased with increasing invertebrate abundance. A Principal Component Analysis of the trans-oceanic data revealed that length of voyage showed a strong inverse relationship with invertebrate abundance for this category. Within the coastal-exchange voyage category, voyage length and ballast water age tended to be of the same magnitude and were directly correlated with both crustacean and nematode taxa. Finally, the coastal-no-exchange PCA results revealed that voyage length and salinity were inversely related due to the high number of river ports located at the southern border of the regulatory BWE exemption zone. Coastal voyages not undergoing BWE and undertaking a direct river-to-river route should be considered risky for the introduction of non-indigenous species, if the source waters contain potentially invasive species. Non-indigenous species were found in all 3 vector pathways, with the highest number of propagules and survivability potential arising from the coastal-no-exchange zone. Ballast “swish” may act as a repository for ballast water organisms within ballast water tanks and may be retained in the tanks over several discharge cycles.

  17. University Hospital Kobe University Hospital began as Kobe Hospital which first

    E-print Network

    Banbara, Mutsunori

    40 University Hospital Kobe University Hospital began as Kobe Hospital which first opened its doors in 1869. In 1944, Kobe Hospital became known as the Prefectural Kobe Hospital, affiliated with the Prefectural Medical College. In 1967, it was renamed once again as Kobe University Hospital, becoming

  18. Kna-Cohen, S. & Y. Bdard, 2001, M3Cat, Limiting Aggravation in Geospatial Metadata Cataloguing, Confrence GIS2001, 22-fvr., Vancouver, Canada

    E-print Network

    Kéna-Cohen, S. & Y. Bédard, 2001, M3Cat, Limiting Aggravation in Geospatial Metadata Cataloguing, Conférence GIS2001, 22-févr., Vancouver, Canada M3 Cat, Limiting Aggravation in Geospatial Metadata) 656-7411, E-mail yvan.bedard@scg.ulaval.ca ABSTRACT Timely access to accurate geospatial data

  19. Proceedings of the Ninth International Workshop on Parsing Technologies (IWPT), pages 3041, Vancouver, October 2005. c 2005 Association for Computational Linguistics

    E-print Network

    ­41, Vancouver, October 2005. c 2005 Association for Computational Linguistics Parsing with Soft and Hard similar improvements by imposing hard bounds on dependency length and (additionally) modeling, we propose a different reason to identify dependencies in candi- date parses: to evaluate

  20. Geodesic Based Ink Separation for Spectral Printing Behnam Bastani*, Brian Funt**, *Hewlett-Packard Company, San Diego, CA, USA **Simon Fraser University, Vancouver, BC, Canada

    E-print Network

    Funt, Brian

    Geodesic Based Ink Separation for Spectral Printing Behnam Bastani*, Brian Funt**, *Hewlett-Packard Company, San Diego, CA, USA **Simon Fraser University, Vancouver, BC, Canada Abstract An ink separation algorithm is introduced for printing with 6 to 9 inks. A spectral gamut mapping algorithm is also introduced

  1. Reflection on 10 Years of Community-Engaged Scholarship in the Faculty of Land and Food Systems at the University of British Columbia-Vancouver

    ERIC Educational Resources Information Center

    Rojas, Alejandro; Sipos, Yona; Valley, Will

    2012-01-01

    In this article, the authors describe a cultural transformation to embrace community-engaged scholarship by faculty members in the Faculty of Land and Food Systems at the University of British Columbia-Vancouver. They describe a transition from community-inquiry faculty projects to community-engaged action research projects achieved through…

  2. Yipida Entertainment is a Indie Entertainment Marketing Company with Corporate Offices in Vancouver, BC. As a Yipida Entertainment Inc. employee you will become part of a supportive,

    E-print Network

    Northern British Columbia, University of

    Yipida Entertainment is a Indie Entertainment Marketing Company with Corporate Offices, or with an easy commute to the Downtown Vancouver area Job Title: FrontEnd Developer Position Description optimisation for web/mobile Experience working with RESTful Web Services API integration (Facebook & Google

  3. Science 101 is a non-credit, barrier free Science community outreach program offered to adult residents of Vancouver's Downtown Eastside and other inner-city communities. Annually

    E-print Network

    Pulfrey, David L.

    residents of Vancouver's Downtown Eastside and other inner-city communities. Annually from May to August , 2015 3:00pm Earth Science Building ­ Room 5108 b. Wed March 25th , 2015 11:00am Michael Smith Labs ­ Room 237 c. Thurs April 2nd , 2015 1:00pm Michael Smith Labs ­ Room 237 #12;

  4. Appears in Color Perception: Philosophical, Psychological, Artistic and Computational Perspectives, Vancouver Studies in Cognitive Science Vol 9, ed. S. Davis, Oxford University

    E-print Network

    Funt, Brian

    Appears in Color Perception: Philosophical, Psychological, Artistic and Computational Perspectives are the ways in which colour can help in this process? #12;Appears in Color Perception: Philosophical, Psychological, Artistic and Computational Perspectives, Vancouver Studies in Cognitive Science Vol 9, ed. S

  5. In Third IEEE-CS Workshop on Perceptual Organization in Computer Vision at International Conference of Computer Vision, Vancouver, July 2001.

    E-print Network

    August, Jonas

    In Third IEEE-CS Workshop on Perceptual Organization in Computer Vision at International Conference of Computer Vision, Vancouver, July 2001. A Field Model for Contour Organization and Partial Di#11;erential of perceptual organization in computer vision have entrenched this discrete thinking, even to the extent

  6. Healthcare Spending and Performance of Specialty Hospitals: Nationwide Evidence from Colorectal-Anal Specialty Hospitals in South Korea

    PubMed Central

    Kim, Sun Jung; Lee, Sang Gyu; Kim, Tae Hyun

    2015-01-01

    Purpose Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital. Materials and Methods Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed. Results Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges. Conclusion Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out. PMID:26446659

  7. Characteristics of patients receiving long-term opioid therapy for chronic noncancer pain: a cross-sectional survey of patients attending the Pain Management Centre at Hamilton General Hospital, Hamilton, Ontario

    PubMed Central

    Mahmood, Hamza; Maqbool, Bilal; Maqbool, Amna; Zahran, Ali; Alwosaibai, Adnan; Alshaqaq, Eshaq; Persaud, Nav; Cooper, Lynn; Carol, Angela; Sumpton, Janice; McGinnis, Erin; Rosenbaum, Daniel; Lidster, Natalie; Buckley, D. Norman

    2015-01-01

    Background Characteristics of patients receiving long-term opioid therapy (? 6 months) for chronic noncancer pain are poorly understood. We conducted a cross-sectional survey of this patient population to explore demographic variables, pain relief, functional improvement, adverse effects and impressions of an educational pamphlet on long-term opioid therapy. Methods We invited 260 adult patients presenting to the Pain Management Centre at the Hamilton General Hospital, Hamilton, Ontario, with chronic noncancer pain to complete a 20-item survey. Patients who presented for procedures were not eligible for our study. We used adjusted logistic regression models to explore the association between higher morphine equivalent dose and pain relief, functional improvement, adverse events and employment. Results The survey was completed by 170 patients (a response rate of 65.4%). Most respondents (87.6%; 149 out of 170) were receiving long-term opioid therapy, and the median morphine equivalent dose was 180 mg daily (interquartile range 60?501). Most respondents reported at least modest (> 40%) opioid-specific pain relief (74.1%; 106 out of 143) and functional improvement (67.6%; 96 out of 142), and 46.5% (66 out of 142) reported troublesome adverse effects that they attributed to their opioid use. Most patients were receiving disability benefits (68.3%; 99 out of 145) and, among those respondents who were less than 65 years of age (90.3%; 131 out of 145), 10 (7.6%) were working full-time and 14 (10.7%) part-time. In our adjusted analyses, higher morphine equivalent dose was associated with greater self-reported functional improvement (odds ratio [OR] 1.45, 95% confidence interval [CI] 1.07?1.96) but not with pain relief (OR 1.38, 95% CI 1.00?1.89), troublesome adverse effects (OR 0.92, 95% CI 0.70?1.20) or employment (OR 0.80, 95% CI 0.56?1.15). Interpretation Most outpatients receiving long-term opioid therapy for chronic noncancer pain at a tertiary care chronic pain clinic reported at least moderate pain relief and functional improvement; however, adverse effects were common and few patients were engaged in competitive employment. PMID:26442231

  8. Welfare Checks, Drug Consumption, and Health: Evidence from Vancouver Injection Drug Users

    ERIC Educational Resources Information Center

    Riddell, Chris; Riddell, Rosemarie

    2006-01-01

    This paper investigates the link between welfare payments and drug use among injection drug users. The authors find an increase in the likelihood of an overdose in the days following check arrival, and in the probability of leaving the hospital against medical advice (AMA) on check day. Using the check arrival date as an instrument, we estimate…

  9. [The role of cooperating hospitals in homecare].

    PubMed

    Watanabe, Go; Nakayama, Shinya; Yamagiwa, Tetsuya; Ito, Satoko; Fukuda, Akiko; Yamaoka, Yoshio

    2013-12-01

    The Japan Baptist Medical Foundation forms a so-called hospice triangle, with a general ward, a hospice ward, and home hospice, and it is possible to provide palliative care in the desired place. The ratio of homecare is 65.0%, and there were 2 cases in which a physician was present at the time of death. The average number of home-visit medical treatments during the week prior to death was 3.7. The median value of the period of home-visit medical treatment is 36 days. The group of homecare patients who were temporarily hospitalized during the period of home-visit medical treatment was 17.1%, and the most common reason was exacerbation of symptoms related to the primary disease. The group of patients who were hospitalized in a hospice ward was 17.0%, and many were for the purpose of respite care or trial hospitalization. Because some patients are reluctant to be hospitalized in a hospice ward, it was thought that adding an option of hospitalizing in a cooperating hospital to the homecare support system would give patients peace of mind. In order to increase the use of homecare from now on, it was thought that even further education about homecare is necessary in addition to a support system of cooperating hospitals. PMID:24712142

  10. DRG coding practice: a nationwide hospital survey in Thailand

    PubMed Central

    2011-01-01

    Background Diagnosis Related Group (DRG) payment is preferred by healthcare reform in various countries but its implementation in resource-limited countries has not been fully explored. Objectives This study was aimed (1) to compare the characteristics of hospitals in Thailand that were audited with those that were not and (2) to develop a simplified scale to measure hospital coding practice. Methods A questionnaire survey was conducted of 920 hospitals in the Summary and Coding Audit Database (SCAD hospitals, all of which were audited in 2008 because of suspicious reports of possible DRG miscoding); the questionnaire also included 390 non-SCAD hospitals. The questionnaire asked about general demographics of the hospitals, hospital coding structure and process, and also included a set of 63 opinion-oriented items on the current hospital coding practice. Descriptive statistics and exploratory factor analysis (EFA) were used for data analysis. Results SCAD and Non-SCAD hospitals were different in many aspects, especially the number of medical statisticians, experience of medical statisticians and physicians, as well as number of certified coders. Factor analysis revealed a simplified 3-factor, 20-item model to assess hospital coding practice and classify hospital intention. Conclusion Hospital providers should not be assumed capable of producing high quality DRG codes, especially in resource-limited settings. PMID:22040256

  11. Effect of Hospital–SNF Referral Linkages on Rehospitalization

    PubMed Central

    Rahman, Momotazur; Foster, Andrew D; Grabowski, David C; Zinn, Jacqueline S; Mor, Vincent

    2013-01-01

    Objective. To determine whether the rate of rehospitalization is lower among patients discharged to skilled nursing facilities (SNFs) with which a hospital has a strong linkage. Data Sources/Collection. We used national Medicare enrollment, claims, and the Minimum Data Set to examine 2.8 million newly discharged patients to 15,063 SNFs from 2,477 general hospitals between 2004 and 2006. Study Design. We examined the relationship between the proportion of discharges from a hospital and alternative SNFs on the rehospitalization of patients treated by that hospital–SNF pair using an instrumental variable approach. We used distances to alternative SNFs from residence of the patients of the originating hospital as the instrument. Principal Findings. Our estimates suggest that if the proportion of a hospital's discharges to an SNF was to increase by 10 percentage points, the likelihood of patients treated by that hospital–SNF pair to be rehospitalized within 30 days would decline by 1.2 percentage points, largely driven by fewer rehospitalizations within a week of hospital discharge. Conclusions. Stronger hospital–SNF linkages, independent of hospital ownership, were found to reduce rehospitalization rates. As hospitals are held accountable for patients' outcomes postdischarge under the Affordable Care Act, hospitals may steer their patients preferentially to fewer SNFs. PMID:24134773

  12. Hospitality Services Reference Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  13. Hospitality Services. Curriculum Guide.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  14. Hospitality leads to endless

    E-print Network

    Sibille, Etienne

    Facilities Manager Food & Beverage Manager Food/Restaurant Critic Hotel Supplier Golf/Country Club ManagerA major is Hospitality Management leads to endless possibilities for travel, adventure, advancement, and networking opportunities. The Hospitality Management program prepare, students to handle multiple facets

  15. Handbook on Hospital Television.

    ERIC Educational Resources Information Center

    Prynne, T. A.

    Designed for both hospital personnel interested in television and audiovisual personnel entering the medical field, this handbook is a verbal and pictorial survey of what is being done with TV within the medical profession. After an introduction which answers technical questions about medical TV posed during the American Hospital Association's…

  16. Hospitality Occupations. Curriculum Guide.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

    This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

  17. Hospitality, Tourism, and Recreation.

    ERIC Educational Resources Information Center

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  18. Hospitality services generate revenue.

    PubMed

    Bizouati, S

    1993-01-01

    An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider. PMID:10127850

  19. Changes in service availability in california hospitals, 1995 to 2002.

    PubMed

    Kirby, Paul B; Spetz, Joanne; Maiuro, Lisa; Scheffler, Richard M

    2006-01-01

    Hospitals face serious financial challenges in the current healthcare marketplace. In response to these challenges, they may alter their service offerings, eliminating services that are perceived as money-losing or adding new services in areas where profitability is expected to be greater. Although research has examined hospital closures, the more subtle phenomenon of hospital service changes has not been systematically studied. This issue is important because different types of hospital service changes could have different effects on hospital financial viability: extensive service closures could contribute to a downward spiral leading to hospital closure, whereas adding new services might help improve a hospital's finances. This article' examines changes in hospital service availability in California general acute care hospitals between 1995 and 2002. Our major findings indicate that many California hospitals made changes in their service offerings during the study period, although few made extensive changes. Altogether, about half of the hospitals in our study population either closed or opened at least one service. Nearly one-fourth of the hospitals in our study population closed one or more services, whereas just under one-third opened one or more new services. However, the vast majority of the hospitals that closed or added a service made only one or two such changes. In addition, few hospitals both closed and opened services. The service closed most frequently was normal newborn labor and delivery (obstetrics), whereas inpatient rehabilitation was the most frequently opened service. Hospitals that made the most service changes tended to be small, rural, and financially troubled at the start of the study period. Among this group of hospitals, service closures were associated with continued financial deterioration, whereas new service openings were associated with improvements in key financial ratios. PMID:16479748

  20. Hospitality as an Environmental Metaphor.

    ERIC Educational Resources Information Center

    Horwood, Bert

    1991-01-01

    Compares stewardship and hospitality as they relate to the biosphere. Traces the origin of the word "hospitality," discusses cultural traditions of hospitality, and applies the concept of hospitality to the natural world. Considers forms of symbiosis in nature: commensals, mutualism, and parasitism. Hospitality promotes respect, humility, and…

  1. Hospital efficiency and debt.

    PubMed

    Bernet, Patrick Michael; Rosko, Michael D; Valdmanis, Vivian G

    2008-01-01

    U.S. Hospitals rely heavily on debt financing to fund major capital investments. Hospital efficiency is at least partly determined by the amount and quality of plant and equipment it uses. As such, a hospital's access to debt and credit rating may be related to its efficiency. This study explores this relationship using a broad sample of hospitals and associated bond issuance histories. Employing stochastic frontier analysis (SFA), we measure cost inefficiency to gauge the impact of debt issuance and debt rating. We find that hospitals with recent bond issues were less inefficient. Although we do not find a perfectly linear relationship between debt rating and inefficiency, we have evidence that hints at such a relation. Finally, we find an increase in inefficiency in the years following bond issues, consistent with the possibility of a debt death spiral. PMID:21110482

  2. JOHN DEMPSEY HOSPITAL Chief Executive Officer,

    E-print Network

    JOHN DEMPSEY HOSPITAL Chief Executive Officer, John Dempsey Hospital Anne Diamond Executive Vice President for Health Affairs (Interim) Andrew Agwunobi Manager, Hospital Administration (Dual Report, Perfusion Services (John Dempsey Hospital, Waterbury Hospital, St. Mary's Hospital, Connecticut Children

  3. Safety and Danger in Downtown Vancouver: Understandings of Place among Young People Entrenched in an Urban Drug Scene

    PubMed Central

    Fast, Danya; Shoveller, Jean; Shannon, Kate; Kerr, Thomas

    2009-01-01

    We undertook this qualitative study to examine young people's understandings of the physical and social landscape of the downtown drug scene in Vancouver, Canada. In-depth interviews were conducted with 38 young people ranging from 16 to 26 years of age. Using the concept of symbolic violence, we describe how one downtown neighborhood in particular powerfully symbolizes ‘risk’ among local youth, and how the idea of this neighborhood (and what happens when young people go there) informs experiences of marginalization in society's hierarchies. We also discuss the complex role played by social networks in transcending the geographical and conceptual boundaries between distinct downtown drug-using neighborhoods. Finally, we emphasize that young people's spatial tactics within this downtown landscape – the everyday movements they employ in order to maximize their safety – must be understood in the context of everyday violence and profound social suffering. PMID:19733496

  4. The impact of critical total quality management practices on hospital performance in the ministry of health hospitals in saudi arabia.

    PubMed

    Alaraki, Mohammad Shamsuddin

    2014-01-01

    Total Quality Management (TQM) offers a method for solving quality and patient safety problems and bringing significant improvement to hospital performance. However, only few studies have been conducted in this area in developing countries, particularly in Saudi Arabia. This research is carried out in an attempt to address this gap, exploring the impact of applying TQM practices on hospital performance in the Saudi Ministry of Health hospitals. The study has included 4 hospitals in Tabuk Region, namely, King Khaled Hospital, King Fahad Hospital, Maternity and Children Hospital, and Hagel General Hospital. The data collection was done by the researcher when 400 questionnaires were distributed using a convenient sampling technique to access the required data. The response rate was 67.25% of the total questionnaires distributed. The TQM practices used in the study were as follows: leadership, employee management, information analysis, training, customer focus, continuous improvement, process management, and supplier management. The findings of the research show a significant positive correlation between the 8 practices of TQM and hospital performance with a correlation coefficient r value of 0.9 (P = .0001). The study also reveals that Saudi hospitals are facing difficulties in engaging the clinical staff in their quality initiative. Moreover, our findings show that accredited hospitals have significantly applied TQM practices more than unaccredited hospitals. PMID:24368721

  5. Science of Nowcasting Olympic Weather for Vancouver 2010 (SNOW-V10): a World Weather Research Programme Project

    NASA Astrophysics Data System (ADS)

    Isaac, G. A.; Joe, P. I.; Mailhot, J.; Bailey, M.; Bélair, S.; Boudala, F. S.; Brugman, M.; Campos, E.; Carpenter, R. L.; Crawford, R. W.; Cober, S. G.; Denis, B.; Doyle, C.; Reeves, H. D.; Gultepe, I.; Haiden, T.; Heckman, I.; Huang, L. X.; Milbrandt, J. A.; Mo, R.; Rasmussen, R. M.; Smith, T.; Stewart, R. E.; Wang, D.; Wilson, L. J.

    2014-01-01

    A World Weather Research Programme (WWRP) project entitled the Science of Nowcasting Olympic Weather for Vancouver 2010 (SNOW-V10) was developed to be associated with the Vancouver 2010 Olympic and Paralympic Winter Games conducted between 12 February and 21 March 2010. The SNOW-V10 international team augmented the instrumentation associated with the Winter Games and several new numerical weather forecasting and nowcasting models were added. Both the additional observational and model data were available to the forecasters in real time. This was an excellent opportunity to demonstrate existing capability in nowcasting and to develop better techniques for short term (0-6 h) nowcasts of winter weather in complex terrain. Better techniques to forecast visibility, low cloud, wind gusts, precipitation rate and type were evaluated. The weather during the games was exceptionally variable with many periods of low visibility, low ceilings and precipitation in the form of both snow and rain. The data collected should improve our understanding of many physical phenomena such as the diabatic effects due to melting snow, wind flow around and over terrain, diurnal flow reversal in valleys associated with daytime heating, and precipitation reductions and increases due to local terrain. Many studies related to these phenomena are described in the Special Issue on SNOW-V10 for which this paper was written. Numerical weather prediction and nowcast models have been evaluated against the unique observational data set now available. It is anticipated that the data set and the knowledge learned as a result of SNOW-V10 will become a resource for other World Meteorological Organization member states who are interested in improving forecasts of winter weather.

  6. Cryptococcus gattii virulence composite: candidate genes revealed by microarray analysis of high and less virulent Vancouver island outbreak strains.

    PubMed

    Ngamskulrungroj, Popchai; Price, Jennifer; Sorrell, Tania; Perfect, John R; Meyer, Wieland

    2011-01-01

    Human and animal cryptococcosis due to an unusual molecular type of Cryptococcus gattii (VGII) emerged recently on Vancouver Island, Canada. Unlike C. neoformans, C. gattii causes disease mainly in immunocompetent hosts, despite producing a similar suite of virulence determinants. To investigate a potential relationship between the regulation of expression of a virulence gene composite and virulence, we took advantage of two subtypes of VGII (a and b), one highly virulent (R265) and one less virulent (R272), that were identified from the Vancouver outbreak. By expression microarray analysis, 202 genes showed at least a 2-fold difference in expression with 108 being up- and 94 being down-regulated in strain R265 compared with strain R272. Specifically, expression levels of genes encoding putative virulence factors (e.g. LAC1, LAC2, CAS3 and MPK1) and genes encoding proteins involved in cell wall assembly, carbohydrate and lipid metabolism were increased in strain R265, whereas genes involved in the regulation of mitosis and ergosterol biosynthesis were suppressed. In vitro phenotypic studies and transcription analysis confirmed the microarray results. Gene disruption of LAC1 and MPK1 revealed defects in melanin synthesis and cell wall integrity, respectively, where CAS3 was not essential for capsule production. Moreover, MPK1 also controls melanin and capsule production and causes a severe attenuation of the virulence in a murine inhalational model. Overall, this study provides the basis for further genetic studies to characterize the differences in the virulence composite of strains with minor evolutionary divergences in gene expression in the primary pathogen C. gattii, that have led to a major invasive fungal infection outbreak. PMID:21249145

  7. Welfare standards in hospital mergers.

    PubMed

    Katona, Katalin; Canoy, Marcel

    2013-08-01

    There is a broad literature on the consequences of applying different welfare standards in merger control. Total welfare is usually defined as the sum of consumer and provider surplus, i.e., potential external effects are not considered. The general result is then that consumer welfare is a more restrictive standard than total welfare, which is advantageous in certain situations. This relationship between the two standards is not necessarily true when the merger has significant external effects. We model mergers on hospital markets and allow for not-profit-maximizing behavior of providers and mandatory health insurance. Mandatory health insurance detaches the financial and consumption side of health care markets, and the concept consumer in merger control becomes non-evident. Patients not visiting the merging hospitals still are affected by price changes through their insurance premiums. External financial effects emerge on not directly affected consumers. We show that applying a restricted interpretation of consumer (neglecting externality) in health care merger control can reverse the relation between the two standards; consumer welfare standard can be weaker than total welfare. Consequently, applying the wrong standard can lead to both clearing socially undesirable and to blocking socially desirable mergers. The possible negative consequences of applying a simple consumer welfare standard in merger control can be even stronger when hospitals maximize quality and put less weight on financial considerations. We also investigate the implications of these results for the practice of merger control. PMID:22688439

  8. 22. Yorath, C. J. et al. Marine Multichannel Seismic Reflection, Gravity and Magnetic Profiles--Vancouver Island Continental Margin and Juan De Fuca Ridge (Open File Report 1661, Geological Survey of

    E-print Network

    Ostling, Annette

    --Vancouver Island Continental Margin and Juan De Fuca Ridge (Open File Report 1661, Geological Survey of Canada erosion along the Middle America convergent margin. Nature 404, 748­752 (2003). 29. Wells, R. E., Blakely

  9. 42 CFR 495.204 - Incentive payments to qualifying MA organizations for MA-EPs and MA-affiliated eligible hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...and MA-affiliated eligible hospitals. 495.204 Section 495...THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...and MA-affiliated eligible hospitals. (a) General rule...its qualifying MA-eligible hospitals. The incentive payment...

  10. 42 CFR 495.204 - Incentive payments to qualifying MA organizations for MA-EPs and MA-affiliated eligible hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...and MA-affiliated eligible hospitals. 495.204 Section 495...THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...and MA-affiliated eligible hospitals. (a) General rule...its qualifying MA-eligible hospitals. The incentive payment...

  11. 42 CFR 495.204 - Incentive payments to qualifying MA organizations for MA-EPs and MA-affiliated eligible hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...and MA-affiliated eligible hospitals. 495.204 Section 495...THE ELECTRONIC HEALTH RECORD TECHNOLOGY INCENTIVE PROGRAM Requirements...and MA-affiliated eligible hospitals. (a) General rule...its qualifying MA-eligible hospitals. The incentive payment...

  12. TOURISM AND HOSPITALITY MANAGEMENT (TOUR)

    E-print Network

    Calgary, University of

    TOURISM AND HOSPITALITY MANAGEMENT (TOUR) Bachelor of Commerce Degree The tourism industry & conferences, adventure tourism, travel trade, and tourism services. The Tourism and Hospitality concentration and hospitality industry. Graduates acquire knowledge and skills in communication, research, analysis, problem

  13. Hospitals' Internal Accountability

    PubMed Central

    Kraetschmer, Nancy; Jass, Janak; Woodman, Cheryl; Koo, Irene; Kromm, Seija K.; Deber, Raisa B.

    2014-01-01

    This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements. PMID:25305387

  14. 42 CFR 412.200 - General provisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Costs for Hospitals Located in Puerto Rico § 412.200 General provisions. Beginning with discharges occurring on or after October 1, 1987, hospitals located in Puerto Rico are subject to the rules governing... provisions of subparts A, B, C, F, G, and H of this part apply to hospitals located in Puerto Rico....

  15. Experience of Adults and Children in Hospitals

    ERIC Educational Resources Information Center

    Rokach, Ami; Parvini, Maneli

    2011-01-01

    This review article examines the experience, in general but especially, of hospitalised children. The technical, environmental and social aspects of a hospital are described. Being hospitalised, especially for a child, could be a terrifying and painful experience. This experience has been described and closely examined with the aim of helping…

  16. GUIDES TO POLLUTION PREVENTION: SELECTED HOSPITAL WASTE STREAMS

    EPA Science Inventory

    This document reviews the practices of general hospitals, identifies techniques that allow these companies to reduce wastes, and provides a set of self-audit checklists to assist hospital administrators and environmental compliance personnel in setting up a waste reduction progra...

  17. Hospital catering: for profit or not for profit?

    PubMed

    Stephenson, S

    1991-10-16

    When hospitals today hold budget meetings, the typical foodservice operation contributes more than the coffee and doughnuts. Many have found new dollars as well as positive public relations by offering catering programs. Southwest General Hospital, Cleveland, is one example. PMID:10115319

  18. Physicians in Hospital Emergency Departments. [Proceedings, New Jersey Training Program].

    ERIC Educational Resources Information Center

    Health Services and Mental Health Administration (DHEW), Rockville, MD. Div. of Emergency Health Services.

    This program was organized in response to the rapidly increasing demands placed upon the emergency departments of general hospitals, and in recognition of the fact that the crucial ingredient in emergency department services is physician capability. The training program was implemented for hospital department physicians and other interested…

  19. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  20. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  1. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  2. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  3. Innovations: Simulation in Nursing Education Smart HospitalTM Innovation

    E-print Network

    Huang, Haiying

    Innovations: Simulation in Nursing Education ­ Smart HospitalTM Innovation *An innovation to the particular nursing program or may be new to nursing education in general; a response to the needs at Arlington College of Nursing Simulation in Nursing Education ­ Smart HospitalTM 2. Type of Nursing

  4. Photograph of model projected new hospital building and new landscaping ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photograph of model projected new hospital building and new landscaping for area north of building 500. Model displayed on the mezzanine level of building 500. - Fitzsimons General Hospital, Bounded by East Colfax to south, Peoria Street to west, Denver City/County & Adams County Line to north, & U.S. Route 255 to east, Aurora, Adams County, CO

  5. Christiana Hospital, Newark, Delaware

    Cancer.gov

    Christiana Hospital, Newark, Delaware Helen F. Graham Cancer Center at Christiana Care 4755 Ogletown-Stanton Rd. Newark, DE 19718 (302) 733-1000 www.christianacare.org www.christianacare.org/hfgcc • Robert Laskowski, MD, President and CEO, Christiana

  6. Hospital-acquired pneumonia

    MedlinePLUS

    Nosocomial pneumonia; Ventilator-associated pneumonia; Health-care associated pneumonia; HCAP ... Hospital-acquired pneumonia can also be spread by health care workers, who can pass germs from their hands ...

  7. Hospital free cash flow.

    PubMed

    Kauer, R T; Silvers, J B

    1991-01-01

    Hospital managers may find it difficult to admit their investments have been suboptimal, but such investments often lead to poor returns and less future cash. Inappropriate use of free cash flow produces large transaction costs of exit. The relative efficiency of investor-owned and tax-exempt hospitals in the product market for hospital services is examined as the free cash flow theory is used to explore capital-market conditions of hospitals. Hypotheses concerning the current competitive conditions in the industry are set forth, and the implications of free cash flow for risk, capital-market efficiency, and the cost of capital to tax-exempt institution is compared to capital-market norms. PMID:1743965

  8. Practice Hospital Bed Safety

    MedlinePLUS

    ... Bed? Todd says that there is no standard definition for hospital beds, a fact that consumers shopping ... in retail stores that don’t meet the definition of medical devices under the law, but which ...

  9. Hospital Building - 11 

    E-print Network

    Unknown

    2006-06-22

    As natural resources are decreasing and environmental pollution is increasing, the buildings that play an important role in this problem should be constructed sustainably so their affects are kept to a minimum. Hospitals operate 24 hours a day...

  10. Veterinary Hospital - 7 

    E-print Network

    Unknown

    2005-06-30

    others, demonstrates their strength of character and selflessness. This project was not possible without each of you. My boss, Richard Weir, has given me an opportunity to work as a child life specialist with hospitalized children. He has allowed my... talents to find a home at work. I learn invaluable lessons through the families I encounter at the hospital. Thank you for your flexibility as I completed this task alongside my regular job. Janis and Regina allowed me the opportunity to learn about...

  11. Hospitals look to hospitality service firms to meet TQM goals.

    PubMed

    Hard, R

    1992-05-20

    Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals. PMID:1577450

  12. Hospital accreditation in Europe.

    PubMed

    Shaw, C

    1998-01-01

    Health service accreditation systems have explicit standards for organisation against which the participating hospital assesses itself before a structured visit by outside "surveyors". They submit a written report back to the hospital with commendations and recommendations for development prior to a follow-up survey. Accreditation may be awarded for a fixed term or may be with held by an independent assessment Board if the hospital does not meet a defined threshold of standards. In Europe, some government and medical organisations initially distanced themselves from the pilot hospital wide programmes, arguing that they would cost too much and undermine management, or that they were irrelevant to clinical practice. But gradually it became obvious that accreditation worked for hospitals; purchasers and insurers saw its potential for quality and resource management; and professional bodies recognised the links between clinical training, practice and outcome and the environment in which health care is provided. If nothing else, it offered a multi-professional bridge between the existing numerous fragmented systems such as inspecting (statutory safety), visiting (professional training), and monitoring (service contracts). The introduction of accreditation appears to benefit hospitals in many different countries and health systems and provides a vehicle for integrated quality management which is visible to funding agencies, government and the public. Interest is growing within Europe. PMID:10179643

  13. Pharmacotherapy for Hyperglycemia in Noncritically Ill Hospitalized Patients

    PubMed Central

    Mendez, Carlos E.; Umpierrez, Guillermo E.

    2014-01-01

    In Brief Hyperglycemia in the hospital setting affects 38-46% of noncritically ill hospitalized patients. Evidence from observational studies indicates that inpatient hyperglycemia, in patients with and without diabetes, is associated with increased risks of complications and mortality. Substantial evidence indicates that correction of hyperglycemia through insulin administration reduces hospital complications and mortality in critically ill patients, as well as in general medicine and surgery patients. This article provides a review of the evidence on the different therapies available for hyperglycemia management in noncritically ill hospitalized patients. PMID:26246777

  14. Chapter 21: special hospitals in neurology and neurosurgery.

    PubMed

    Sammet, Kai

    2010-01-01

    Central to medicine is often where care and treatment are provided. Whereas today hospitals are the main locations to deliver medical help, in history we find different places for care and treatment. This chapter deals with these different places beginning in antiquity and sketching, e.g., the Greek asclepieion or the Roman valetudinarium. The roots of the modern hospital lie in the Middle Ages. Byzantine, Islamic as well as Christian hospitals are described. Around 1800 the rise of the general hospital began. Three ways into modernity are sketched: the British, the German and the French development of hospitals during the 18th and 19th century. Subsequently the emergence of special hospitals in Great Britain and in Germany is depicted. Whereas in Great Britain neurology had its roots as a specialty at the Queen Square Hospital, development in Germany differed. Here we can find different special neurological departments in general hospitals. The description of the emergence of neurotraumatological and neurosurgical special hospitals follows. Particularly World War I had a deep impact on the development of those facilities. Finally the history of neurotraumatology and neurology in Great Britain and Germany after World War II is sketched. PMID:19892124

  15. U.S. hospital industry restructuring and the hospital safety net.

    PubMed

    Bazzoli, Gloria J; Manheim, Larry M; Waters, Teresa M

    2003-01-01

    The U.S. hospital industry was reshaped during the 1990s, with many hospitals becoming members of health systems and networks. Our research examines whether safety net hospitals (SNHs) were generally included or excluded from these arrangements, and the factors associated with their involvement. Our analysis draws on the earlier work of Alexander and Morrisey (1988), and not only studies factors affecting SNH participation in multihospital arrangements but also updates their earlier study. We constructed measures for hospital market conditions, management, and mission, and examined network and system affiliation patterns between 1994 and 1998. Our findings suggest that larger and more technically advanced hospitals joined systems in the 1990s, which contrasts with 1980s findings that smaller, financially weak institutions joined systems. Further, SNH participation in networks and systems was more common when hospitals faced less market pressure and where only a limited number of unaffiliated hospitals remained. If networks and systems are key parties in negotiating with private payers, SNHs may be going it alone in these negotiations in highly competitive markets. PMID:12836905

  16. Books for the Hospital Emergency Service

    PubMed Central

    Roy, Donald E.; Morgan, Virginia W.

    1966-01-01

    This is a list of books that should be available in either the hospital emergency room or the medical library. The forty-nine books listed are divided into the following categories: General, Surgery and Trauma, Burns, Cardiology, Dentistry, Disaster Medicine, First Aid, Geriatrics, Obstetrics, Pediatrics, Psychiatry, Toxicology, and Transportation. An asterisk has been placed before twelve books that are particularly recommended for the hospital emergency room as well as the medical library. The latest edition is given for each book, and, unless otherwise noted, each has been annotated by one of the authors. PMID:5945569

  17. Controlling for quality in the hospital cost function.

    PubMed

    Carey, Kathleen; Stefos, Theodore

    2011-06-01

    This paper explores the relationship between the cost and quality of hospital care from the perspective of applied microeconomics. It addresses both theoretical and practical complexities entailed in incorporating hospital quality into the estimation of hospital cost functions. That literature is extended with an empirical analysis that examines the use of 15 Patient Safety Indicators (PSIs) as measures of hospital quality. A total operating cost function is estimated on 2,848 observations from five states drawn from the period 2001 to 2007. In general, findings indicate that the PSIs are successful in capturing variation in hospital cost due to adverse patient safety events. Measures that rely on the aggregate number of adverse events summed over PSIs are found to be superior to risk-adjusted rates for individual PSIs. The marginal cost of an adverse event is estimated to be $22,413. The results contribute to a growing business case for inpatient safety in hospital services. PMID:21086051

  18. 1. Oblique view of east portion of Portsmouth Naval Hospital ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Oblique view of east portion of Portsmouth Naval Hospital Complex showing in middle ground, from left to right, Medical Ward A (HABS No. VA01287-G), Medical Ward B (HABS No. VA-1287-H), Medical Ward C (HABS No. VA-1287-I, Portsmouth Naval Hospital Building (HABS No. VA-1287-A), Hospital Point; and in foreground, from left to right, gardener's tool shed (HABS No. VA-1287-C), Service Building (HABS No. VA01287-D), garage (HABS No. VA-1287-F), Medical Officer's Quarters C (HABS No. VA-1287-B), and Medical Officer's Quarters B (HAQBS No. VA-1287-E), view to north from roof of 1960 high-rise hospital - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  19. Financial Analysis of National University Hospitals in Korea

    PubMed Central

    Lee, Munjae

    2015-01-01

    Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.

  20. Correlated Paleoseismic Interpretation of Turbidites from 3 Distinct Sedimentary Environments in the Cascadia Subduction Zone Off Vancouver Island Canada

    NASA Astrophysics Data System (ADS)

    Enkin, R. J.; Hamilton, T. S.; Rogers, G. C.

    2014-12-01

    Sedimentary sequences containing turbidites can provide important paleoseismic records. We present sedimentary records from 3 distinct sedimentary systems which provide a reliable well-dated paleseismic record. All 3 sites are subject to strong ground shaking in the event of a megathrust earthquake along the Cascadia Subduction Zone near Vancouver Island, Canada. Effingham Inlet is an anoxic fjord on the west coast of Vancouver Island with an age model based on radiocarbon dates from terrestrial plant material (no marine correction), the Mazama Ash, and sedimentation rates constrained by annual laminations [Dallimore et al. 2008, Enkin et al., 2013]. Barkley Canyon [Goldfinger et al., 2012], 150 km SW, has been sampled at the abyssal plain fan in front of a submarine canyon. Slipstream Slump [ms submitted], 40 km north of Barkley Canyon, is a well-preserved 3 km wide sedimentary failure from the frontal ridge of the Cascadia accretionary wedge. At Slipstream, given the 2300 m water depth and the thin weak crust at the outer edge of the accretionary wedge, megathrust earthquake shaking is the most likely trigger for the turbidity currents, with sediments sourced exclusively from the exposed slide scar. Correlations based on sedimentology and physical property logging are made between turbidites observed at Barkley Canyon and Slipstream Slump, and a mutually consistent age model is defined using only planktonic foraminiferal dates and Bayesian analysis with a Poisson-process sedimentation model. A young marine reservoir age of ?R=0 yr brings the top to the present and produces age correlations consistent with the thickest (>10 cm) Effingham Inlet turbidites. Correlations of physical property logs tie the Effingham Inlet record to the offshore, despite the extreme differences in the sedimentology. Having good marine geophysical data and well positioned core transects allows the facies analysis needed to interpret the turbidite record. This study provides a much needed link between the marine and terrestrial paleoseismic records. The combined paleoseismic record has 10 turbidites between 10.8 and 6.6 ka, after which the offshore sites became sediment-starved and only 2 or 3 more turbidites were deposited. The recurrence interval for the inferred Early Holocene megathrust earthquakes is 460 ± 140 years.

  1. Pertussis in hospitalized children.

    PubMed

    Gan, V N; Murphy, T V

    1990-10-01

    Before the whole-cell pertussis vaccine was available, Bordetella pertussis infections were an important cause of morbidity and mortality in infants. To determine the extent of continuing morbidity in an era of vaccination, a retrospective review was conducted of the records of neonates and infants hospitalized with pertussis infection at Parkland Memorial Hospital and Children's Medical Center, Dallas, Tex. During the 20 years from 1967 through 1986, 182 patients were younger than 24 months. Among 176 patients whose immunization history was recorded, 89% had received fewer than two doses of pertussis vaccine. The mean hospital stay was 7.4 days (range, 1 to 69 days). A convulsion occurred in 11 patients (6%). Apnea was reported in 45 patients (25%) and observed in the hospital in 26 (14%). Nine patients (5%) received mechanical ventilatory therapy. Intensive care monitoring was required in 18 patients (10%). Three (1.6%) died, all with secondary bacterial pneumonia. This hospital-based population indicates that pertussis continues to be a cause of serious morbidity and mortality in infants. PMID:2403094

  2. Integration between GPs and hospitals: lessons from a division-hospital program.

    PubMed

    Lloyd, J; Davies, G P; Harris, M

    2000-01-01

    The aim of the study reported here was to evaluate current initiatives in GP-hospital integration and highlight areas where further research, development and evaluation are required. Seven pre-existing GP-hospital programs were selected and given supplementary funding to allow for more effective evaluation. These local evaluations were then incorporated into a national program on GP-hospital collaboration. We found that the seven projects made substantial progress towards their goals, and in the process highlighted important aspects of successful collaboration. The collective evaluation of DHIP identified expected benefits of collaboration for patients (improved access to services, reduced anxiety, and fewer post discharge complications), for GPs (increased involvement in acute care and in hospital decision making), and for service organisations (stronger working relationships, increased capacity, and greater efficiency). Barriers to service integration were also identified, including the different cultures of Divisions and hospitals, their lack of internal coherence and the Commonwealth-state divide. The evaluation showed that much has been achieved in building the relationships and the capacity needed for GP-hospital collaboration, and that effective models exist. The current challenge is to extend successful models across health areas and make effective collaboration part of the normal system of care. Substantial progress towards integrated care relies on a shift from a focus on systems within general practice or hospital environments to a patient centred approach. This will require general practice, hospitals, community services and consumer organisations to form long term partnerships and move beyond their currently disjointed view of acute and community care. The development of practical indicators for integrated care will support the process and facilitate shared learning across Commonwealth and state divides. PMID:11256260

  3. The art of governance of Dutch hospitals.

    PubMed

    Hoek, H

    1999-01-01

    Hospitals in The Netherlands are governed by two boards: The Board of Directors, the legal representative of the hospital, responsible for strategic and operational business activities; and the Supervisory Board, made up of co-opted volunteers and responsible for checking and approving of the major decisions of the Board of Directors. The question which arises is whether the system of governance is able to function appropriately and guarantee enough concern about general health problems, moral and ethical questions and the interest of the patients. This paper investigate the successes and shortfalls of such a system of governance in Dutch hospitals. The results and conclusions determine that although copied from the corporate governance model, it does not function well in an environment where the influence of patients and the inhabitants of the region are of great importance and shareholders do not exist. PMID:10977190

  4. Facing the Recession: How Did Safety-Net Hospitals Fare Financially Compared with Their Peers?

    PubMed Central

    Reiter, Kristin L; Jiang, H Joanna; Wang, Jia

    2014-01-01

    Objective To examine the effect of the recession on the financial performance of safety-net versus non-safety-net hospitals. Data Sources/Study Setting Agency for Healthcare Research and Quality Hospital Cost and Utilization Project State Inpatient Databases, Medicare Cost Reports, American Hospital Association Annual Survey, InterStudy, and Area Health Resource File. Study Design Retrospective, longitudinal panel of hospitals, 2007–2011. Safety-net hospitals were identified using percentage of patients who were Medicaid or uninsured. Generalized estimating equations were used to estimate average effects of the recession on hospital operating and total margins, revenues and expenses in each year, 2008–2011, comparing safety-net with non-safety-net hospitals. Data Collection/Extraction Methods 1,453 urban, nonfederal, general acute hospitals in 32 states with complete data. Principal Findings Safety-net hospitals, as identified in 2007, had lower operating and total margins. The gap in operating margin between safety-net and non-safety-net hospitals was sustained throughout the recession; however, total margin was more negatively affected for non-safety-net hospitals in 2008. Higher percentages of Medicaid and uninsured patients were associated with lower revenue in private hospitals in all years, and lower revenue and expenses in public hospitals in 2011. Conclusions Safety-net hospitals may not be disproportionately vulnerable to macro-economic fluctuations, but their significantly lower margins leave less financial cushion to weather sustained financial pressure. PMID:25220012

  5. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... clinic services. 440.20 Section 440.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... services that are not generally furnished by most hospitals in the State. (b) Rural health clinic...

  6. A Unified Approach to Finding Good Stable Matchings in the Hospitals/Residents Setting

    E-print Network

    Cheng, Christine

    A Unified Approach to Finding Good Stable Matchings in the Hospitals/Residents Setting Christine Cheng Eric Mc Dermid Ichiro Suzuki February 5, 2008 Abstract The hospitals/residents (HR) problem for all our algorithms. 1 Introduction The hospitals/residents problem1 is a many-to-one generalization

  7. Condom use as situated in a risk context: women's experiences in the massage parlour industry in Vancouver, Canada.

    PubMed

    Handlovsky, Ingrid; Bungay, Vicky; Kolar, Kat

    2012-10-01

    Investigation into condom use in sex work has aroused interest in health promotion and illness prevention. Yet there remains a dearth of inquiry into condom use practices in the indoor sex industry, particularly in North America. We performed a thematic analysis of one aspect of the indoor sex work by drawing on data from a larger mixed-methods study that investigated women's health issues in the massage parlour industry in Vancouver, Canada. Using a risk context framework, condom use was approached as a socially situated practice constituted by supportive and constraining dynamics. Three analytic categories were identified: (1) the process of condom negotiation, (2) the availability of condoms and accessibility to information on STI and (3) financial vulnerability. Within these categories, several supportive dynamics (industry experience and personal ingenuity) and constraining dynamics (lack of agency support, client preferences, limited language proficiency and the legal system) were explored as interfacing influences on condom use. Initiatives to encourage condom use must recognise the role of context in order to more effectively support the health-promoting efforts of women in sex work. PMID:22900640

  8. Toward a cardiovascular pathology training report on the forum held in Vancouver, March 6, 2004, Society for Cardiovascular Pathology.

    PubMed

    Thiene, Gaetano; Becker, Anton E; Buja, L Maximilian; Fallon, John T; McManus, Bruce M; Schoen, Frederick J; Winters, Gayle L

    2005-01-01

    Cardiovascular pathology is a subspecialty of anatomic pathology that requires both clinical education and expertise in contemporary physiopathology. The Society for Cardiovascular Pathology sponsored a special workshop within the frame of the USCAP Annual Meeting, held in Vancouver, March 6-12, 2004, to address the present and future role of cardiovascular pathology in research, clinical care, and education. Clearly, the recruitment and training of young pathologists are crucial to this aim. The forum tried to answer a series of questions. First, is there room for cardiovascular pathologists and clinicopathologic correlations in the era of extraordinary advances of in vivo human body imaging? What is the evolving role of the autopsy? How can the cardiovascular pathologist simultaneously be an autopsy prosector, a surgical pathologist, a molecular pathologist, and an experimental pathologist? Is there a specific domain content for training in cardiovascular pathology and does it meet the constellation of market needs and demands? What are the experiences in Europe, North America and elsewhere? What is the influence of cardiovascular pathology in departments of pathology? Is the subdiscipline still a Cinderella in the anatomic theatre or a Princess with a double helix coat of arms? The Society for Cardiovascular Pathology is strongly committed to optimizing the academic and professional profile of the future generation of cardiovascular pathologists. This article reports the outcome of the forum and directions that may lead to a vibrant future for well-trained cardiovascular pathologists. PMID:16286040

  9. The Impact of Weather Forecasts of Various Lead Times on Snowmaking Decisions Made for the 2010 Vancouver Olympic Winter Games

    NASA Astrophysics Data System (ADS)

    Doyle, Chris

    2014-01-01

    The Vancouver 2010 Winter Olympics were held from 12 to 28 February 2010, and the Paralympic events followed 2 weeks later. During the Games, the weather posed a grave threat to the viability of one venue and created significant complications for the event schedule at others. Forecasts of weather with lead times ranging from minutes to days helped organizers minimize disruptions to sporting events and helped ensure all medal events were successfully completed. Of comparable importance, however, were the scenarios and forecasts of probable weather for the winter in advance of the Games. Forecasts of mild conditions at the time of the Games helped the Games' organizers mitigate what would have been very serious potential consequences for at least one venue. Snowmaking was one strategy employed well in advance of the Games to prepare for the expected conditions. This short study will focus on how operational decisions were made by the Games' organizers on the basis of both climatological and snowmaking forecasts during the pre-Games winter. An attempt will be made to quantify, economically, the value of some of the snowmaking forecasts made for the Games' operators. The results obtained indicate that although the economic value of the snowmaking forecast was difficult to determine, the Games' organizers valued the forecast information greatly. This suggests that further development of probabilistic forecasts for applications like pre-Games snowmaking would be worthwhile.

  10. Injection drug users’ involvement in drug dealing in the downtown eastside of Vancouver: Social organization and systemic violence

    PubMed Central

    Small, Will; Maher, Lisa; Lawlor, Jeff; Wood, Evan; Shannon, Kate; Kerr, Thomas

    2014-01-01

    Background Illicit drug markets are a key component of the risk environment surrounding injection drug use. However, relatively few studies have explored how injection drug users’ (IDUs) involvement in drug dealing shapes their experiences of drug market-related harm. This exploratory qualitative study aims to understand IDUs’ dealing activities and roles, as well as the perceived benefits and risks related to participation in illicit drug markets, including experiences of drug market violence. Methods Ten IDUs with extensive involvement in drug dealing activities were recruited from the Vancouver Injection Drug User Study (VIDUS) and participated in semi-structured qualitative interviews, which elicited discussion of experiences dealing drugs, perceived benefits and hazards related to dealing, and understandings of drug market violence. Results Participant's involvement in drug market activities included corporate sales, freelance or independent sales, and opportunistic sales termed “middling” as well as drug market-related hustles entailing selling bogus drugs and robbing dealers. Participants primarily dealt drugs to support their own illicit drug use, and we found that arrest and criminal justice involvement, hazards stemming from drug debts, and drug market-related violence were key risks related to dealing activities. Conclusion The challenges of managing personal consumption while selling drugs exacerbates the hazards associated with drug dealing. Efforts to address drug dealing among IDUs should consider both drug dependency and the material conditions that propel drug users towards dealing activities. Interventions should explore the potential of combining enhanced drug treatment programs with low threshold employment and alternative income generation opportunities. PMID:23664788

  11. Interior of Damaged Hospital

    USGS Multimedia Gallery

    The interior of this masonry-built hospital in Cauquenes, Chile had severe fracturing and partially collapsed interior walls following the M 8.8 earthquake on Feb. 27, 2010. This building will be torn down and replaced with a reinforced concrete building....

  12. Responsible Hospitality. Prevention Updates

    ERIC Educational Resources Information Center

    Colthurst, Tom

    2004-01-01

    Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

  13. Damaged Hospital Wing

    USGS Multimedia Gallery

    This two story hospital wing in Cauquenes, Chile suffered severe damage to the wall of the first floor as a result of the M 8.8 earthquake on Feb. 27, 2010. This building must be torn down. All patients were successfully evacuated at 3:34 AM after the earthquake shaking started....

  14. Conceptual Change and Killer Whales: Constructing Ecological Values for Animals at the Vancouver Aquarium.

    ERIC Educational Resources Information Center

    Kelsey, Elin

    1991-01-01

    Examines how the aquarium has attempted to move from a transfer view of knowledge to a constructivist approach in its most popular general public program--the killer whale presentation. The process of change that staff underwent is similar to conceptual change processes among learners of science. Describes constructivist strategies of conceptual…

  15. Hospital Teaching Intensity, Patient Race, and Surgical Outcomes

    PubMed Central

    Silber, Jeffrey H.; Rosenbaum, Paul R.; Romano, Patrick S.; Rosen, Amy K.; Wang, Yanli; Teng, Yun; Halenar, Michael J.; Even-Shoshan, Orit; Volpp, Kevin G.

    2009-01-01

    Objectives To determine if the lower mortality often observed in teaching-intensive hospitals is due to lower complication rates or lower death rates after complications (failure-to-rescue), and whether the benefits at these hospitals accrue equally to white and black patients, since blacks receive a disproportionate share of their care at teaching-intensive hospitals. Design A retrospective study of patient outcomes and teaching intensity using logistic regression models, with and without adjusting for hospital fixed and random effects. Main Outcome Measures 30-day mortality, in-hospital complications and failure-to-rescue (“FTR”, the probability of death following complications). Setting 3,270 acute care hospitals in the United States. Patients Medicare claims on general, orthopedic and vascular surgery admissions in the U.S. for 2000 – 2005 (N = 4,658,954 unique patients). Results Combining all surgeries, compared to non-teaching hospitals, patients at very major teaching hospitals demonstrated a 15% lower odds of death (P<0.0001), no difference in complications, and a 15% lower odds of death after complications (FTR) (P<0.0001). These relative benefits associated with higher RB ratio were not experienced by black patients, for whom the odds of mortality and FTR are similar at teaching and non-teaching hospitals, a pattern that is significantly different from that of white patients (P<0.0001). Conclusions Survival after surgery is higher at hospitals with higher teaching intensity. Improved survival is due to lower mortality after complications (better FTR), and generally not due to fewer complications. However, this better survival and FTR at teaching intensive hospitals is seen for whites, not for blacks. PMID:19221321

  16. Improving Hospital Discharge Time

    PubMed Central

    El-Eid, Ghada R.; Kaddoum, Roland; Tamim, Hani; Hitti, Eveline A.

    2015-01-01

    Abstract Delays in discharging patients can impact hospital and emergency department (ED) throughput. The discharge process is complex and involves setting specific challenges that limit generalizability of solutions. The aim of this study was to assess the effectiveness of using Six Sigma methods to improve the patient discharge process. This is a quantitative pre and post-intervention study. Three hundred and eighty-six bed tertiary care hospital. A series of Six Sigma driven interventions over a 10-month period. The primary outcome was discharge time (time from discharge order to patient leaving the room). Secondary outcome measures included percent of patients whose discharge order was written before noon, percent of patients leaving the room by noon, hospital length of stay (LOS), and LOS of admitted ED patients. Discharge time decreased by 22.7% from 2.2?hours during the preintervention period to 1.7?hours post-intervention (P?Hospital LOS dropped from 3.4 to 3.1 days postintervention (P?hospital was significantly lower in the postintervention period (6.9?±?7.8 vs 5.9?±?7.7?hours; P?

  17. [Leadership in the hospital].

    PubMed

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments. PMID:19545081

  18. Management of hospitals solid waste in Khartoum State.

    PubMed

    Saad, Suhair A Gayoum

    2013-10-01

    This research had been conducted during year 2012 to review existing data on hospital waste management for some of Khartoum town hospitals and to try to produce appropriate proposals acceptable for waste management and final treatment methods. The overall status of hospital waste management in Khartoum has been assessed through direct visits and designated questionnaires. Eight main hospitals were covered in the study with an overall bed capacity of 2,978. The current waste management practice observed at all studied hospitals was that most of waste, office, general, food, construction debris, and hazardous chemical materials were all mixed together as they are generated, collected, and finally disposed of. Only a small portion of waste in some hospitals (part of potentially infectious, body parts, and sharps) are collected separately and treated in a central incinerator. The estimated value of per bed generation rate in the studied hospitals was found to be 0.87 kg/day, which lies within the range for the low-income countries. In all studied hospitals, it was found that workers were working under very poor unsafe conditions with very low salaries ($35 to $45 per month on average). About 90 % were completely illiterate or had very low education levels. At the national level, no laws considering hospital waste, or even hazardous waste, were found; only some federal general environmental regulations and some procedures from town and city localities for controlling general municipal waste exist. At the hospital level, no policies or rules were found, except in the radiotherapy center, where they manage radioactive wastes under the laws of the Sudanese Atomic Agency. Urgent actions are needed for the remediation and prevention of hazards associated with this type of waste. PMID:23644667

  19. Hospitals--East meets West--reflections on international hospital co-operation.

    PubMed

    Schutyser, K

    1996-01-01

    On the European scene, particularly in the Member States of the European Union, the social system and the healthcare system as essential part of it are under demographic and economic pression and in full change. Hospitals being important partners in the healthcare network are rethinking their role and re-orienting their mission. Co-operation is a key issue both within the hospital with its multiple interprofessional relationships around the patients and outside the hospital with the variety of partners of the local healthcare network, with the general public and with the competent authorities. Change and co-operation are the keywords in the HOPE operation which the HCEC started in synergy with WHO Europe within a year after the Wall in Berlin was broken down in November 1989. Whatever the importance of East-West Co-operation between hospitals may be, it can not separate the paneuropean hospitals from the rest of the world. Hospitals and their national and international associations could play an exemplary role in the real active management of the changes at world level and in the prevention of poverty and violence. PMID:10172947

  20. Management of wastes from hospitals: A case study in Pakistan.

    PubMed

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

    2016-01-01

    Proper management of hospital waste is a critical concern in many countries of the world. Pakistan is the sixth most populous country in the world, with one of the highest urbanisation and population growth rates in South Asia. Data and analyses regarding hospital waste management practices in Pakistan are scarce in scientific literature. This study was meant to determine waste management practices at selected hospitals in a major city in Pakistan, Gujranwala. A total of 12 different hospitals were selected for the survey, which involved quantification of waste generation rates and investigation of waste management practices. The results were analysed using linear regression. The weighted average total, general and infectious hospital waste generation rates were found to be 0.667, 0.497 and 0.17?kg?bed-day(-1), respectively. Of the total, 73.85% consisted of general, 25.8% consisted of hazardous infectious and 0.87% consisted of sharps waste. The general waste consisted of 15.76% paper, 13.41% plastic, 21.77% textiles, 6.47% glass, 1.99% rubber, 0.44% metal and 40.17% others. Linear regression showed that waste generation increased with occupancy and decreased with number of beds. Small, private and specialised hospitals had relatively greater waste generation rates. Poor waste segregation, storage and transportation practices were observed at all surveyed hospitals. PMID:26628050

  1. General Education GENERAL EDUCATION

    E-print Network

    Stuart, Steven J.

    37 General Education GENERAL EDUCATION An undergraduate student whose enrollment in a curriculum occurs after May 15, 2005, must fulfill the general education requirements in effect at that time in curricular or general education requirements shall be considered under the curriculum year change

  2. Use of Social Media by Western European Hospitals: Longitudinal Study

    PubMed Central

    Berben, Sivera AA; Samsom, Melvin; Engelen, Lucien JLPG; Schoonhoven, Lisette

    2012-01-01

    Background Patients increasingly use social media to communicate. Their stories could support quality improvements in participatory health care and could support patient-centered care. Active use of social media by health care institutions could also speed up communication and information provision to patients and their families, thus increasing quality even more. Hospitals seem to be becoming aware of the benefits social media could offer. Data from the United States show that hospitals increasingly use social media, but it is unknown whether and how Western European hospitals use social media. Objective To identify to what extent Western European hospitals use social media. Methods In this longitudinal study, we explored the use of social media by hospitals in 12 Western European countries through an Internet search. We collected data for each country during the following three time periods: April to August 2009, August to December 2010, and April to July 2011. Results We included 873 hospitals from 12 Western European countries, of which 732 were general hospitals and 141 were university hospitals. The number of included hospitals per country ranged from 6 in Luxembourg to 347 in Germany. We found hospitals using social media in all countries. The use of social media increased significantly over time, especially for YouTube (n = 19, 2% to n = 172, 19.7%), LinkedIn (n =179, 20.5% to n = 278, 31.8%), and Facebook (n = 85, 10% to n = 585, 67.0%). Differences in social media usage between the included countries were significant. Conclusions Social media awareness in Western European hospitals is growing, as well as its use. Social media usage differs significantly between countries. Except for the Netherlands and the United Kingdom, the group of hospitals that is using social media remains small. Usage of LinkedIn for recruitment shows the awareness of the potential of social media. Future research is needed to investigate how social media lead to improved health care. PMID:22549016

  3. An examination of competition and efficiency for hospital industry in Turkey.

    PubMed

    Özgen Narc?, Hacer; Ozcan, Yasar A; ?ahin, ?smet; Tarcan, Menderes; Narc?, Mustafa

    2015-12-01

    The two particular reforms that have been undertaken under the Health Transformation Program in Turkey are enhancing efficiency and increasing competition. However, there is a lack of information about the relationship between competition and hospital efficiency. The purpose of this paper is to analyze the effect of competition on technical efficiency for the hospital industry in Turkey. The target population included all public and private general hospitals that were open in 2010 in Turkey (n?=?1,224). From these, 1,103 hospitals met the selection criteria and were included in the study. Data were obtained from the Turkish Statistical Institute, the Ministry of Health, and through a field survey. Technical efficiency of hospitals was estimated using Data Envelopment Analysis with five outputs and five inputs. The intensity of competition among hospitals was measured by objective and subjective measures. Objective competition was measured using the Hirschman-Herfindahl Index, and subjective competition was measured based on the perceptions of top level hospital managers. Multivariate Tobit regression was used to investigate the relationship between competition and efficiency while controlling the effects of demand and supply characteristics of the market and the hospital traits. Efficiency results showed that 17 % of hospitals were technically efficient. Regression analyses portrayed that the degree of competition among general hospitals did not have a statistically significant relationship with hospitals' technical efficiency. To conclude, hospital efficiency in Turkey does not seem to be affected by the intensity of competition among hospitals. PMID:25515038

  4. UConn Health John Dempsey Hospital

    E-print Network

    Oliver, Douglas L.

    UConn Health John Dempsey Hospital Department of Pharmacy (Patient Identification) Pharmacy Note: Initial IV Vancomycin Dosing per Collaborative Practice Protocol Baseline Patient Demographics, Clinical/0000 Page 1 of 2 #12;UConn Health John Dempsey Hospital Department of Pharmacy (Patient Identification

  5. Understanding the effects of nurses, patients' hospital rooms, and patients' perception of control on the perceived quality of a hospital.

    PubMed

    Gotlieb, J B

    2000-01-01

    Service marketing researchers suggest that the physical environment, the people, and the process strongly affect consumers' judgements when they evaluate services. Previous research has rarely applied this general framework to help identify specific hospital variables that affect the perceived quality of a hospital. This article presents a proposed model and empirical evidence that is based upon this general framework. That is, this article reports the results of a study which found that the physical environment (i.e., patients' perception of their hospital rooms) and people (i.e., patients' perception of nurses) affected patients' perception of hospital quality. The process (i.e., patients' perception of control over the process) did not directly affect their perception of hospital quality. However, patients' perception of control over the process and their perception of their hospital rooms affected their perception of their nurses. Consequently, this research suggests that the general framework identified by service marketing researchers can be applied to help understand how patients develop their perception of hospital quality. PMID:11184431

  6. Hospitality Services. Student Activity Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This student activity book contains pencil-and-paper activities for use in a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The activities are organized into 29 chapters on the following topics: hospitality services industry; professional ethics; organization/management structures in…

  7. Childrens Hospital Inservice Education Curriculum.

    ERIC Educational Resources Information Center

    Lutz, Joan

    A description is provided of a 15-month, in-service nursing education program at Childrens Hospital (Los Angeles, California). The first sections of the paper describe Childrens Hospital and provide a rationale for the hospital-based program. A listing of program goals and objectives is also provided, indicating that the curriculum is designed to…

  8. Library Hospitality: Some Preliminary Considerations

    ERIC Educational Resources Information Center

    Johnson, Eric D. M.; Kazmer, Michelle M.

    2011-01-01

    Library scholars and practitioners have frequently reflected on the various factors that in combination make up a hospitable library, but there has been little theoretical synthesis of the notion of the library as a place of hospitality. The hospitality industry provides a rich vein of theoretical material from which to draw definitions of…

  9. St. Jude Children's Research Hospital

    Cancer.gov

    St. Jude Children’s Research Hospital was founded in 1962. The Cancer Center received its NCI designation in 1977 and was awarded status as a comprehensive cancer center by NCI in 2008. The hospital’s mission is to advance cures and means of prevention for pediatric catastrophic diseases through research and treatment.

  10. Hospitality Studies: Escaping the Tyranny?

    ERIC Educational Resources Information Center

    Lashley, Conrad

    2015-01-01

    Purpose: The purpose of this paper is to explore current strands in hospitality management education and research, and suggest that future programs should reflect a more social science informed content. Design/methodology/approach: The paper reviews current research in hospitality management education and in the study of hospitality and…

  11. The conundrum of charitability: reassessing tax exemption for hospitals.

    PubMed

    Hyman, D A

    1990-01-01

    Tax exemption is an ancient, honorable and expensive tradition. Tax exemption for hospitals is all of these three, but it also places in sharp focus a fundamental problem with tax exemption in general. Organizations can retain their tax exemption while changing circumstances or expectations undermine the rationale that led to the exemption in the first place. Hospitals are perhaps the best example of this problem. The dramatic changes in the health care environment have eliminated most of the characteristics of a hospital that originally persuaded the citizenry to grant it an exemption. Hospitals have entered into competition with tax-paying businesses, and have increasingly behaved like competitive actors. Such conduct may well be beneficial, but it does not follow that tax exemption is appropriate. Rather than an undifferentiated subsidy, a shift to focused goals will provide charitable hospitals with the opportunity and incentive to "do the right thing." PMID:2278243

  12. Missed opportunities: childhood learning disabilities as early indicators of risk among homeless adults with mental illness in Vancouver, British Columbia

    PubMed Central

    Patterson, Michelle Louise; Moniruzzaman, Akm; Frankish, Charles James; Somers, Julian M

    2012-01-01

    Objectives It is well documented that early-learning problems and poor academic achievement adversely impact child development and a wide range of adult outcomes; however, these indicators have received scant attention among homeless adults. This study examines self-reported learning disabilities (LD) in childhood as predictors of duration of homelessness, mental and substance use disorders, physical health, and service utilisation in a sample of homeless adults with current mental illness. Design This study was conducted using the baseline sample from a randomised controlled trial (RCT). Setting Participants were sampled from the community in Vancouver, British Columbia. Participants The total sample included 497 adult participants who met criteria for absolute homelessness or precarious housing and a current mental disorder based on a structured diagnostic interview. Learning disabilities in childhood were assessed by asking adult participants whether they thought they had an LD in childhood and if anyone had told them they had an LD. Only participants who responded positively to both questions (n=133) were included in the analyses. Outcome measures Primary outcomes include current mental disorders, substance use disorders, physical health, service utilisation and duration of homelessness. Results In multivariable regression models, self-reported LD during childhood independently predicted self-reported educational attainment and lifetime duration of homelessness as well as a range of mental health, physical health and substance use problems, but did not predict reported health or justice service utilisation. Conclusions Childhood learning problems are overrepresented among homeless adults with complex comorbidities and long histories of homelessness. Our findings are consistent with a growing body of literature indicating that adverse childhood events are potent risk factors for a number of adult health and psychiatric problems, including substance abuse. Trials registration number This trial has been registered with the International Standard Randomised Control Trial Number Register and assigned ISRCTN42520374. PMID:23175737

  13. Hospital mergers and market overlap.

    PubMed Central

    Brooks, G R; Jones, V G

    1997-01-01

    OBJECTIVE: To address two questions: What are the characteristics of hospitals that affect the likelihood of their being involved in a merger? What characteristics of particular pairs of hospitals affect the likelihood of the pair engaging in a merger? DATA SOURCES/STUDY SETTING: Hospitals in the 12 county region surrounding the San Francisco Bay during the period 1983 to 1992 were the focus of the study. Data were drawn from secondary sources, including the Lexis/Nexis database, the American Hospital Association, and the Office of Statewide Health Planning and Development of the State of California. STUDY DESIGN: Seventeen hospital mergers during the study period were identified. A random sample of pairs of hospitals that did not merge was drawn to establish a statistically efficient control set. Models constructed from hypotheses regarding hospital and market characteristics believed to be related to merger likelihood were tested using logistic regression analysis. DATA COLLECTION: See Data Sources/Study Setting. PRINCIPAL FINDINGS: The analysis shows that the likelihood of a merger between a particular pair of hospitals is positively related to the degree of market overlap that exists between them. Furthermore, market overlap and performance difference interact in their effect on merger likelihood. In an analysis of individual hospitals, conditions of rivalry, hospital market share, and hospital size were not found to influence the likelihood that a hospital will engage in a merger. CONCLUSIONS: Mergers between hospitals are not driven directly by considerations of market power or efficiency as much as by the existence of specific merger opportunities in the hospitals' local markets. Market overlap is a condition that enables a merger to occur, but other factors, such as the relative performance levels of the hospitals in question and their ownership and teaching status, also play a role in influencing the likelihood that a merger will in fact take place. PMID:9018212

  14. Performance evaluation of hospitals that provide care in the public health system, Brazil.

    PubMed

    Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

    2015-01-01

    OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals. PMID:26247385

  15. Performance evaluation of hospitals that provide care in the public health system, Brazil

    PubMed Central

    Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

    2015-01-01

    OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System. METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimento s de Saúde (National Registry of Health Facilities), 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA) and Bonferroni correction. RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed. CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals. PMID:26247385

  16. Optimism about breakthroughs in the age of targeted therapy: the Canadian Lung Cancer Conference 2014; Vancouver, British Columbia; February 7, 2014

    PubMed Central

    Melosky, B.; Ho, C.

    2014-01-01

    The Canadian Lung Cancer Conference 2014, held in Vancouver, British Columbia, was an opportunity for Canadian lung cancer researchers and treatment experts to meet and discuss current breakthroughs and paradigm shifts in the field. The full-day program featured lectures, discussion, and debates, with ample time for informal networking. We are already looking forward to next year’s meeting (scheduled for February 6, 2015), where we expect to discuss and reflect on some of the latest results and breakthroughs from both the American Society of Clinical Oncology and the European Society for Medical Oncology.

  17. Explaining racial/ethnic disparities in use of high-volume hospitals: decision-making complexity and local hospital environments.

    PubMed

    Kronebusch, Karl; Gray, Bradford H; Schlesinger, Mark

    2014-01-01

    Racial/ethnic minorities are less likely to use higher-quality hospitals than whites. We propose that a higher level of information-related complexity in their local hospital environments compounds the effects of discrimination and more limited access to services, contributing to racial/ethnic disparities in hospital use. While minorities live closer than whites to high-volume hospitals, minorities also face greater choice complexity and live in neighborhoods with lower levels of medical experience. Our empirical results reveal that it is generally the overall context associated with proximity, choice complexity, and local experience, rather than differential sensitivity to these factors, that provides a partial explanation of the disparity gap in high-volume hospital use. PMID:25316717

  18. Virtual Pediatric Hospital

    MedlinePLUS

    ... Assistant? Last revised on January 21, 2015 Related Digital Libraries Pediatric GeneralPediatrics.com - the general pediatrician's view of the Internet PediatricEducation.org - a pediatric digital library and learning collaboratory intended to serve as a ...

  19. Children in Foster Care: Before, during, and after Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Persi, Joe; Sisson, Megan

    2008-01-01

    Although it is generally accepted that foster children are at greater risk for mental health problems than are children in the general population, very little is known about the smaller group of foster children admitted to psychiatric hospitals. The present study sought to determine whether foster children admitted to inpatient care are a distinct…

  20. Hospital Acquisitions Before Healthcare Reform.

    PubMed

    McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun

    2015-01-01

    The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities. PMID:26554263

  1. In-Hospital Ischemic Stroke

    PubMed Central

    2015-01-01

    Between 2.2% and 17% of all strokes have symptom onset during hospitalization in a patient originally admitted for another diagnosis or procedure. These in-hospital strokes represent a unique population with different risk factors, more mimics, and substantially worsened outcomes compared to community-onset strokes. The fact that these strokes manifest during the acute care hospitalization, in patients with higher rates of thrombolytic contraindications, creates distinct challenges for treatment. However, the best evidence suggests benefit to treating appropriately selected in-hospital ischemic strokes with thrombolysis. Evidence points toward a “quality gap” for in-hospital stroke with longer in-hospital delays to evaluation and treatment, lower rates of evaluation for etiology, and decreased adherence to consensus quality process measures of care. This quality gap for in-hospital stroke represents a focused opportunity for quality improvement. PMID:26288675

  2. Hospitals, market share, and consolidation.

    PubMed

    Cutler, David M; Scott Morton, Fiona

    2013-11-13

    A large reduction in use of inpatient care combined with the incentives in the Affordable Care Act is leading to significant consolidation in the hospital industry. What was once a set of independent hospitals having arms-length relationships with physicians and clinicians who provide ambulatory care is becoming a small number of locally integrated health systems, generally built around large, prestigious academic medical centers. The typical region in the United States has 3 to 5 consolidated health systems, spanning a wide range of care settings, and a smaller fringe of health care centers outside those systems. Consolidated health systems have advantages and drawbacks. The advantages include the ability to coordinate care across different practitioners and sites of care. Offsetting this is the potential for higher prices resulting from greater market power. Market power increases because it is difficult for insurers to bargain successfully with one of only a few health systems. Antitrust authorities are examining these consolidated systems as they form, but broad conclusions are difficult to draw because typically the creation of a system will generate both benefit and harm and each set of facts will be different. Moreover, the remedies traditionally used (eg, blocking the transaction or requiring that the parties divest assets) by antitrust authorities in cases of net harm are limited. For this reason, local governments may want to introduce new policies that help ensure consumers gain protection in the event of consolidation, such as insurance products that charge consumers more for high-priced clinicians and health care centers, bundling payments to clinicians and health care organizations to eliminate the incentives of big institutions to simply provide more care, and establishing area-specific price or spending targets. PMID:24219952

  3. CDRP - Funded Institutions - Singing River Hospital System

    Cancer.gov

    The Singing River Hospital System (SRHS) began in 1931 as Jackson County Hospital. The facility was the first community owned and operated hospital in Mississippi, and had 23 beds. Several additions to the hospital took place until, in 1958, a new 122-bed hospital was built and opened, and renamed Singing River Hospital. In 1968, the hospital system concept was created to include Ocean Springs Hospital in Ocean Springs Mississippi. SRHS has evolved steadily and significantly over the years.

  4. [Military hospital in Bjelovar from 1900].

    PubMed

    Habek, Dubravko; Fures, Rajko

    2014-01-01

    The new main military hospital building in Bjelovar, built in 1900-1901, was designed to provide full medical services to its patients, as it had patient rooms for soldiers and officers, doctor's office, a pharmacy, a laboratory, a kitchen with a dining room, toilet facilities, and storage for food and firewood in the basement. The building's right wing accommodated regimental doctors on the ground floor. The first floor had patient rooms with sanitary facilities and rooms for paramedics. In the hospital park there was a separate building for infectious diseases, auxiliary buildings, a disinfection facility, and a mortuary. For 35 years before World War 2, it had functioned as a military hospital with brief intervals when it provided services to the general public and outpatients. During the War it resumed its primary function and continued providing health care for the military until it was demolished in the late 1970s. This article is a contribution to the existing literature about military health care in Croatia, as there have been no earlier records about the Bjelovar hospital. PMID:25310612

  5. Hospital department cost and employment increases: 1980-92.

    PubMed

    Cromwell, J; Butrica, B

    1995-01-01

    Hospital costs have continued to rise at rates well in excess of inflation generally, even after the introduction of Medicare's per case prospective payment system (PPS). This article uses a hospital subscriber microcost reporting system to show trends in costs, wages, labor hours, and outputs for more than 50 individual departments from 1980-92. Descriptive results show dramatic growth in the operating room, catheter lab, and other technologically driven cost centers. Administrative costs also increased rapidly through 1988, but slowed thereafter. The paperwork billing and collection burden of hospitals is estimated to be $6 billion in 1992, or approximately 4 percent of total expenses. PMID:10153468

  6. A Bill of Rights for Hospitalized Older Adults.

    PubMed

    Mezey, Mathy D; Mitty, Ethel

    2011-03-01

    Acute-care hospitals have few structures, programs, or staff prepared to address the special needs of older adults. To address this issue, the Hartford Institute for Geriatric Nursing [including the Nurses Improving Care for Hospitalized Elders (NICHE) program] and the Coalition of Geriatric Nursing Organizations proposed language for a Bill of Rights for Hospitalized Older Adults. The Bill of Rights moves from general value statements to the specific knowledge, skills, and actions necessary to provide quality of care to older adults. The authors describe the development and testing of the Bill of Rights and suggest steps for its adoption and dissemination. PMID:21336039

  7. Assessing the Effectiveness of Informational Video Clips on Iranian Immigrants' Attitudes Toward and Intention to Use the BC HealthGuide Program in the Greater Vancouver Area

    PubMed Central

    Poureslami, Iraj; Rootman, Irving; Balka, Ellen

    2007-01-01

    Background Consumer-directed health information resources hold great potential for improving public health and easing the demand on health systems. Their value, however, depends largely on the ability of their intended users to access and use them effectively. Little is known about whether British Columbia's ethnocultural communities are using the British Columbia (BC) Ministry of Health's BC HealthGuide (BCHG) program, and if so, when and for what purposes they use the services, as well as level of satisfaction with and users' perceptions of the resources. This study investigated attitudes toward and perceptions of the BCHG program, as well as use patterns and satisfaction levels, within the Iranian community of the Greater Vancouver Area (GVA) – among BC's largest and fastest-growing Middle Eastern immigrant communities – and explored a model for introducing the BCHG program to ethnic communities in the GVA and BC. Methods In a 2-stage quasi-experimental design, with a combination of quantitative and qualitative research methods, data obtained from structured telephone surveys, in-person interviews, and focus groups involving a randomly selected sample of the target population were analyzed before and after intervention with audiovisual health information: a series of culturally relevant informative video clips developed by direct participation of the community and aired on local television channels in the fall of 2004. Key Findings There was low awareness and low utilization of the BCHG program among participants at the beginning of this study. Furthermore, many participants in the initial stage of this study cautioned that self-care resources in general are unsuited to Iranian culture, due to widespread distrust of health advice received via telephone or the Internet, and due to the strong value placed on health advice received directly from a professional medical doctor. Nonetheless, attitudes, perceptions, and self-reported utilization rates of the BCHG program improved substantially among the participants of this study following the screening of culturally appropriate, targeted promotional videos. Participants almost unanimously reported that watching the videos had encouraged them to use the BCHG program, and that they intended to promote the resources to others. In addition, the majority of participants who had accessed at least one of the BCHG program resources reported being satisfied with the services that they had received, and improved utilization rates were maintained at the follow-up focus group stage. At the same time, participants cautioned that gaining the confidence of the wider Iranian community in BC and increasing service utilization will require considerable time and effort. In particular, they suggested using a variety of media and communication channels, carefully selecting the health messengers, and targeting messages to specific community subgroups. Conclusions The findings of this study strongly suggest that Iranians living in the GVA are open to alternatives to routine healthcare services, including the use of preventive and self-care resources. However, awareness levels and utilization rates of the BCHG program among the GVA's Iranian immigrant population have until now been low. The noticeable and sustained improvement to attitudes, perceptions, and self-reported utilization rates of the BCHG program among Iranian participants in this study after watching culturally appropriate promotional videos indicates the potential to modify cultural beliefs in regard to the delivery of preventive health information if the relevant messages are delivered appropriately. By carefully considering the demographic and cultural characteristics of the various ethnic communities living in BC, and by targeting promotional activities and services directly to these individual communities, the BCHG program could improve awareness and utilization rates within these communities. PMID:17435621

  8. Fast Facts on U.S. Hospitals

    MedlinePLUS

    ... 3,003 Number of Community Hospitals in a System *** 3,144 Number of Community Hospitals in a Network **** 1,582 *Registered hospitals are those hospitals that meet AHA's criteria for registration as a hospital facility. Registered hospitals include AHA ...

  9. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    PubMed

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department. PMID:26338391

  10. Hospital drug formularies and use of hospital services.

    PubMed

    Sloan, F A; Gordon, G S; Cocks, D L

    1993-10-01

    Many hospitals have introduced formularies to reduce hospital pharmacy expense, among other reasons. This study provides empirical evidence of the influence of hospital formulary restrictions on pharmacy charges, all other hospital charges, and on length of stay, using a survey of hospital drug policies and hospital discharge data from Washington State in 1989. Limiting the number of drugs in particular therapeutic categories reduced total charges incurred for gastrointestinal disease and asthma patients, increased total charges for cardiovascular disease patients, and had no effect on charges for infectious diseases patients. Restricting availability of drugs reduced pharmacy charges, but these savings tended to be offset by increases in other charges. Combining the categories, we found that restricting availability of drugs did not affect charges. We conclude that across-the-board restrictions do not result in cost savings, although savings may be realized for particular drug categories. PMID:8412389

  11. Lower Mortality in Magnet Hospitals

    PubMed Central

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

    2014-01-01

    Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082

  12. Hospital dental practice in special patients

    PubMed Central

    Silvestre-Rangil, Javier; Espín-Gálvez, Fernando

    2014-01-01

    Dental patients with special needs are people with different systemic diseases, multiple disorders or severe physical and/or mental disabilities. A Medline search was made, yielding a total of 29 articles that served as the basis for this study, which offers a brief description of the dental intervention protocols in medically compromised patients. Dental treatment in patients with special needs, whether presenting medical problems or disabilities, is sometimes complex. For this reason the hospital should be regarded as the ideal setting for the care of these individuals. Before starting any dental intervention, a correct patient evaluation is needed, based on a correct anamnesis, medical records and interconsultation reports, and with due assessment of the medical risks involved. The hospital setting offers the advantage of access to electronic medical records and to data referred to any complementary tests that may have been made, and we moreover have the possibility of performing treatments under general anesthesia. In this context, ambulatory major surgery is the best approach when considering general anesthesia in patients of this kind. Key words:Hospital dentistry, special patients, medically compromised patients. PMID:24121921

  13. Performance of skin biopsies by general practitioners.

    PubMed Central

    McWilliam, L J; Knox, F; Wilkinson, N; Oogarah, P

    1991-01-01

    OBJECTIVE--To evaluate and appraise skin biopsies performed by general practitioners and compare their performance with that of hospital doctors. DESIGN--Retrospective analysis of histology records. SETTING--University hospital. SUBJECTS--Records of 292 skin biopsy specimens obtained by general practitioners and 324 specimens obtained by general and plastic surgeons. MAIN OUTCOME MEASURES--Clinical and pathological diagnoses and completeness of excision. RESULTS--The number of specimens received from hospital surgeons and general practitioners increased over the study period; the proportion of specimens from general practitioners rose from 17/1268 (1.3%) in 1984 to 201/2387 (8.7%) in 1990. The range of diagnoses was similar among hospital and general practitioner cases, although malignancy was commoner in hospital cases (63/324 (19%) v 14/292 (5%) in general practitioner cases; chi 2 = 28, p less than 0.00001). Completeness of excision was less common among general practitioners than hospital surgeons (150/233 (3/15 malignant) v 195/232 (57/63); chi 2 = 22, p less than 0.00001). CONCLUSIONS--The increase in minor surgery has implications for the staffing and finance of histopathology departments. General practitioners must be given proper training in performing skin biopsies, and all specimens should be sent for examination. PMID:1747616

  14. Influence of Hospital and Nursing Home Quality on Hospital Readmissions

    PubMed Central

    Thomas, Kali S.; Rahman, Momotazur; Mor, Vincent; Intrator, Orna

    2015-01-01

    Objectives To determine whether the quality of the hospital and of the nursing home (NH) to which a patient was discharged were related to the likelihood of rehospitalization. Study Design Retrospective cohort study of 1,382,477 individual hospitalizations discharged to 15,356 NHs from 3683 hospitals between 2006 and 2008. Methods Data come from Medicare claims and enrollment records, Minimum Data Set, Online Survey Certification and Reporting Dataset, Hospital Compare, and the American Hospital Association Database. Cross-classified random effects models were used to test the association of hospital and NH quality measures and the likelihood of 30-day rehospitalization. Results Patients discharged from higher-quality hospitals (as indicated by higher scores on their accountability process measures and high nurse staffing levels) and patients who received care in higher-quality NHs (as indicated by high nurse staffing levels and lower deficiency scores) were less likely to be rehospitalized within 30 days. Conclusions The passage of the Affordable Care Act changed the accountability of hospitals for patients’ outcomes after discharge. This study highlights the joint accountability of hospitals and NHs for rehospitalization of patients. PMID:25730351

  15. Union Density and Hospital Outcomes.

    PubMed

    Koys, Daniel J; Martin, Wm Marty; LaVan, Helen; Katz, Marsha

    2015-01-01

    The authors address the hospital outcomes of patient satisfaction, healthcare quality, and net income per bed. They define union density as the percentage of a hospital's employees who are in unions, healthcare quality as its 30-day acute myocardial infraction (AMI; heart attack) mortality rate, and patient satisfaction as its overall Hospital Consumer Assessment of Healthcare Providers and Systems score. Using a random sample of 84 union and 84 nonunion hospitals from across the United States, multiple regression analyses show that union density is negatively related to patient satisfaction. Union density is not related to healthcare quality as measured by the AMI mortality rate or to net income per bed. This implies that unions per se are not good or bad for hospitals. The authors suggest that it is better for hospital administrators to take a Balanced Scorecard approach and be concerned about employee satisfaction, patient satisfaction, healthcare quality, and net income. PMID:26652043

  16. An exploration for deep-sea fish sounds off Vancouver Island from the NEPTUNE Canada ocean observing system

    NASA Astrophysics Data System (ADS)

    Wall, Carrie C.; Rountree, Rodney A.; Pomerleau, Corinne; Juanes, Francis

    2014-01-01

    Our understanding of the significance of sound production to the ecology of deep-sea fish communities has improved little since anatomical surveys in the 1950s first suggested that sound production is widespread among slope-water fishes. The recent implementation of cabled ocean observatory networks around the world that include passive acoustic recording instruments provides scientists an opportunity to search for evidence of deep-sea fish sounds. We examined deep-sea acoustic recordings made at the NEPTUNE Canada Barkley Canyon Axis Pod (985 m) located off the west coast of Vancouver Island in the Northeast Pacific between June 2010 and May 2011 to determine the presence of fish sounds. A subset of over 300 5-min files was examined by selecting one day each month and analyzing one file for each hour over the 24 h day. Despite the frequent occurrence of marine mammal sounds, no examples of fish sounds were identified. However, we report examples of isolated unknown sounds that might be produced by fish, invertebrates, or more likely marine mammals. This finding is in direct contrast to recent smaller studies in the Atlantic where potential fish sounds appear to be more common. A review of the literature indicates 32 species found off British Columbia that potentially produce sound could occur in depths greater than 700 m but of these only Anoplopoma fimbria and Coryphaenoides spp. have been previously reported at the site. The lack of fish sounds observed here may be directly related to the low diversity and abundance of fishes present at the Barkley Canyon site. Other contributing factors include possible masking of low amplitude biological signals by self-generated noise from the platform instrumentation and ship noise. We suggest that examination of data both from noise-reduced ocean observatories around the world and from dedicated instrument surveys designed to search for deep-sea fish sounds to provide a larger-scale, more conclusive investigation into the role, or potential lack thereof, of sound production.

  17. Can Hospital Cultural Competency Reduce Disparities in Patient Experiences with Care?

    PubMed Central

    Weech-Maldonado, Robert; Elliott, Marc N.; Pradhan, Rohit; Schiller, Cameron; Hall, Allyson; Hays, Ron D.

    2013-01-01

    Background Cultural competency has been espoused as an organizational strategy to reduce health disparities in care. Objective To examine the relationship between hospital cultural competency and inpatient experiences with care. Research Design The first model predicted Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores from hospital random effects, plus fixed effects for hospital cultural competency, individual race/ethnicity/language, and case-mix variables. The second model tested if the association between a hospital’s cultural competency and HCAHPS scores differed for minority and non-Hispanic white patients. Subjects The National CAHPS® Benchmarking Database’s (NCBD) HCAHPS Surveys and the Cultural Competency Assessment Tool of Hospitals (CCATH) Surveys for California hospitals were merged, resulting in 66 hospitals and 19,583 HCAHPS respondents in 2006. Measures Dependent variables include ten HCAHPS measures: six composites (communication with doctors, communication with nurses, staff responsiveness, pain control, communication about medications, and discharge information), two individual items (cleanliness, and quietness of patient rooms), and two global items (overall hospital rating, and whether patient would recommend hospital). Results Hospitals with greater cultural competency have better HCAHPS scores for doctor communication, hospital rating, and hospital recommendation. Furthermore, HCAHPS scores for minorities were higher at hospitals with greater cultural competency on four other dimensions: nurse communication, staff responsiveness, quiet room, and pain control. Conclusions Greater hospital cultural competency may improve overall patient experiences, but may particularly benefit minorities in their interactions with nurses and hospital staff. Such effort may not only serve longstanding goals of reducing racial/ethnic disparities in inpatient experience, but may also contribute to general quality improvement. PMID:23064277

  18. How consumers view hospital advertising.

    PubMed

    Andaleeb, S S

    1994-01-01

    This paper examines consumer attitudes toward hospital advertising. The results do not support recent findings in other professional fields that consumers are favorably disposed toward this marketing activity. From a demographic perspective, there were differences in attitudes based on gender, age, and education. Income levels had no significant relationship with attitudes. However, consistent results were found on the relative proportion of consumers who were able to recall hospital advertisements. Mostly, they recalled hospital ads seen on TV and newspapers. PMID:10137174

  19. IK Brunel's Crimean war hospital.

    PubMed

    Merridew, C G

    2014-07-01

    "Those wonderful huts…" (Florence Nightingale). This is the story of the British Civil Hospital, erected in 1855 at Renkioi on the south Dardanelles coast of Turkey. The spectacular hospital was a portable one designed by British engineer IK Brunel. It was his only health-related project, and it was known as a Civil Hospital because its staff were all civilians, despite its patients being military. PMID:25196954

  20. RFID solution benefits Cambridge hospital.

    PubMed

    James, Andrew

    2013-10-01

    Keeping track of thousands of pieces of equipment in a busy hospital environment is a considerable challenge, but, according to RFID tagging and asset tracking specialist, Harland Simon, RFID technology can make the task considerably simpler. Here Andrew James, the company's RFID sales manager, describes the positive benefits the technology has brought the Medical Equipment Library (MEL) at Addenbrooke's Hospital, one of the world's most famous teaching hospitals. PMID:24341115

  1. Barriers to hospital and tuberculosis programme collaboration in China: context matters

    PubMed Central

    Zou, Guanyang; King, Rebecca; Walley, John; Yin, Jia; Sun, Qiang; Wei, Xiaolin

    2015-01-01

    Background In many developing countries, programmes for ‘diseases of social importance’, such as tuberculosis (TB), have traditionally been organised as vertical services. In most of China, general hospitals are required to report and refer suspected TB cases to the TB programme for standardised diagnosis and treatment. General hospitals are the major contacts of health services for the TB patients. Despite the implementation of public–public/private mix, directly observed treatment, short-course, TB reporting and referral still remain a challenge. Objective This study aims to identify barriers to the collaboration between the TB programme and general hospitals in China. Design This is a qualitative study conducted in two purposefully selected counties in China: one in Zhejiang, a more affluent eastern province, and another in Guangxi, a poorer southwest province. Sixteen in-depth interviews were conducted and triangulated with document review and field notes. An open systems perspective, which views organisations as social systems, was adopted. Results The most perceived problem appeared to be untimely reporting and referral associated with non-standardised prescriptions and hospitalisation by the general hospitals. These problems could be due to the financial incentives of the general hospitals, poor supervision from the TB programme to general hospitals, and lack of technical support from the TB programme to the general hospitals. However, contextual factors, such as different funding natures of different organisations, the prevalent medical and relationship cultures, and limited TB funding, could constrain the processes of collaboration between the TB programme and the general hospitals. Conclusions The challenges in the TB programme and general hospital collaboration are rooted in the context. Improving collaboration should reduce the potential mistrust of the two organisations by aligning their interests, improving training, and improving supervision of TB control in the hospitals. In particular, effective regulatory mechanisms are crucial to alleviate the negative impact of the contextual factors and ensure smooth collaboration. PMID:26408404

  2. Hospital-acquired infection: present and future impact and need for positive action

    PubMed Central

    Westwood, J. C. N.; Legacé, S.; Mitchell, M. A.

    1974-01-01

    Surveillance of infections at the Ottawa General Hospital between September 1, 1971 and August 31, 1972 showed that the overall infection rate was 13.5% of which 5.6% was community-acquired while 7.9% was of nosocomial origin. These figures are comparable to those for equivalent hospitals in the United States and lower than those reported from the Boston City Hospital, but they nevertheless indicate that over half the infected patients in the hospital were infected after admission. Urinary tract infections accounted for 44.8% of all nosocomial infections and clearly dominated the picture. The postoperative wound infection rate was 3.9% and accounted for only 18% of nosocomial infections. It is probable that these findings are representative of general hospitals throughout Canada and indicate conditions which will not long be tolerated. The knowledge and techniques exist for the prevention of all hospital cross-infection and much autogenous infection. Specific measures are suggested for working towards this goal. These are (1) the replacement of archaic hospitals and hospital facilities, (2) the establishment in every hospital of an efficient surveillance program, (3) the institution of good catheterization and catheter care techniques, and (4) the establishment by hospitals of a quality control program whereby a specific explanation is required for every infection occurring within the hospital. PMID:4493988

  3. Glycemic control and diabetes management in hospitalized patients in Brazil

    PubMed Central

    2013-01-01

    Background The importance of tight blood glucose control among outpatients with diabetes mellitus is well established, however, the management of diabetes in the hospital setting is generally considered secondary in importance. This study sought to assess glycemic control and diabetes management in adult patients admitted to hospitals in Brazil. Methods A cross-sectional and nationwide survey was conducted from July 2010 to January 2012. Eligible cases were 18 years of age or older, had a diagnosis of diabetes and a hospitalization length of stay ?72 hours. Socio-demographic information, hospitalization details, and data on diabetes diagnosis, management and treatment were collected for all patients by chart review. Information on all blood glucose (BG) readings for a maximum of 20 consecutive days of hospitalization was recorded for each patient. Results Overall, 2,399 patients were surveyed in 24 hospitals located in 13 cities from all five Brazilian regions. The prevalence of patients presenting hyperglycemic (BG >180 mg/dL) or hypoglycemic (BG <70 mg/dL) events was 89.4% and 30.9% in patients in general wards, and 88.2% and 27.7% in those in Intensive Care Units (ICUs), respectively. In addition, a BG measure >180 mg/dL was recorded in two-thirds of the patient-days. A high proportion of patients were treated with sliding-scale insulin regimen alone in the general wards (52.0%) and in the ICUs (69.2%), and only 35.7% and 3.9% received appropriate insulin therapy in general wards (basal + bolus insulin) and in ICUs (continuous IV insulin), respectively. Conclusions Inpatient glycemic control and diabetes management needs improvement. Opportunities to improve care in Brazilian hospitals include expanded use of intravenous insulin and subcutaneous basal-bolus insulin protocols, avoiding use of sliding-scale insulin alone, increased frequency of blood glucose monitoring, and institution wide quality improvement efforts targeting both physician and nursing behavior. PMID:24499564

  4. Use of Smartphones in Hospitals.

    PubMed

    Thomairy, Noora Al; Mummaneni, Mounica; Alsalamah, Sami; Moussa, Nicole; Coustasse, Alberto

    2015-01-01

    Mobile technology has begun to change the landscape of the medical profession, with more than two-thirds of physicians regularly using smartphones. Smartphones have allowed health care professionals and the general public to communicate more efficiently, collect data, and facilitate clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of smartphone use among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into 7 categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology, which were chosen based on the documented use of smartphone application in different health care practices. A last section of patient safety and issues with confidentiality is also described. This study suggests that smartphones have been playing an increasingly important role in health care. Medical professionals have become more dependent upon medical smartphone applications. However, concerns of patient safety and confidentiality will likely lead to increased oversight of mobile device use by regulatory agencies and accrediting bodies. PMID:26506291

  5. 2015 MERS outbreak in Korea: hospital-to-hospital transmission

    PubMed Central

    Ki, Moran

    2015-01-01

    The distinct characteristic of the Middle East Respiratory Syndrome (MERS) outbreak in South Korea is that it not only involves intra-hospital transmission, but it also involves hospital-to-hospital transmission. It has been the largest MERS outbreak outside the Middle East, with 186 confirmed cases and, among them, 36 fatal cases as of July 26, 2015. All confirmed cases are suspected to be hospital-acquired infections except one case of household transmission and two cases still undergoing examination. The Korean health care system has been the major factor shaping the unique characteristics of the outbreak. Taking this as an opportunity, the Korean government should carefully assess the fundamental problems of the vulnerability to hospital infection and make short- as well as long-term plans for countermeasures. In addition, it is hoped that this journal, Epidemiology and Health, becomes a place where various topics regarding MERS can be discussed and shared. PMID:26212508

  6. Use of and Communication about Dietary Supplements Among Hospitalized Patients

    PubMed Central

    Faurot, Keturah R.; Gaylord, Susan A.

    2008-01-01

    BACKGROUND Use of dietary supplements (DS) is common in the United States; however little is known about the use of DS specifically in hospitalized patients. OBJECTIVE The goal of this study is to begin to characterize trends in DS use by hospitalized patients and to assess the degree of patient–physician communication about use of DS that occurs during hospitalization. DESIGN This is a cross-sectional, observational pilot study. PARTICIPANTS Participants were admitted to the general internal medicine or geriatrics service by house staff residents; those ? 18 years of age who were medically stable, cognitively intact and fluent in English and/or Spanish were invited to participate in the study. RESULTS Nearly 80% of hospitalized patients reported use of DS, with 52% reporting use of non-vitamin/non-mineral DS. During the admission process, physicians documented inquiring about DS use only 20% of the time. While the majority of patients had no concern about temporarily discontinuing their DS during hospitalization, 13% of patients reported that they believed there was nothing wrong with continued use of DS while hospitalized regardless of the recommendations provided by their inpatient physicians. CONCLUSIONS Use of DS in hospitalized patients is common, and communication between patients and physicians regarding their use is limited. PMID:19096896

  7. Predicting days in hospital using health insurance claims.

    PubMed

    Xie, Yang; Schreier, Gunter; Chang, David C W; Neubauer, Sandra; Liu, Ying; Redmond, Stephen J; Lovell, Nigel H

    2015-07-01

    Health-care administrators worldwide are striving to lower the cost of care while improving the quality of care given. Hospitalization is the largest component of health expenditure. Therefore, earlier identification of those at higher risk of being hospitalized would help health-care administrators and health insurers to develop better plans and strategies. In this paper, a method was developed, using large-scale health insurance claims data, to predict the number of hospitalization days in a population. We utilized a regression decision tree algorithm, along with insurance claim data from 242?075 individuals over three years, to provide predictions of number of days in hospital in the third year, based on hospital admissions and procedure claims data. The proposed method performs well in the general population as well as in subpopulations. Results indicate that the proposed model significantly improves predictions over two established baseline methods (predicting a constant number of days for each customer and using the number of days in hospital of the previous year as the forecast for the following year). A reasonable predictive accuracy (AUC =0.843) was achieved for the whole population. Analysis of two subpopulations-namely elderly persons aged 63 years or older in 2011 and patients hospitalized for at least one day in the previous year-revealed that the medical information (e.g., diagnosis codes) contributed more to predictions for these two subpopulations, in comparison to the population as a whole. PMID:25680222

  8. Rural Hospital Ownership: Medical Service Provision, Market Mix, and Spillover Effects

    PubMed Central

    Horwitz, Jill R; Nichols, Austin

    2011-01-01

    Objective To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. Data Sources/Study Setting Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File, and primary data collection for geographic coordinates. The sample includes all nonfederal, general medical, and surgical hospitals located outside of metropolitan statistical areas and within the continental United States from 1988 to 2005. Study Design We estimate multivariate regression models to examine the effects of (1) hospital ownership and (2) hospital ownership mix within rural hospital markets on profitable versus unprofitable medical service offerings. Principal Findings Rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors. Conclusions Rural hospital ownership affects medical service provision at the hospital and market levels. Nonprofit hospital regulation should reflect both the direct and spillover effects of ownership. PMID:21639860

  9. Assessment of pharmaceutical waste management at selected hospitals and homes in Ghana.

    PubMed

    Sasu, Samuel; Kümmerer, Klaus; Kranert, Martin

    2012-06-01

    The practice of use and disposal of waste from pharmaceuticals compromises the safety of the environment as well as representing a serious health risk, as they may accumulate and stay active for a long time in the aquatic environment. This article therefore presents the outcome of a study on pharmaceutical waste management practices at homes and hospitals in Ghana. The study was conducted at five healthcare institutions randomly selected in Ghana, namely two teaching hospitals (hospital A, hospital B), one regional hospital (hospital C), one district hospital (hospital D) and one quasi-governmental hospital (hospital E). Apart from hospital E which currently has a pharmaceutical waste separation programmr as well as drug return programme called DUMP (Disposal of Unused Medicines Program), all other hospitals visited do not have any separate collection and disposal programme for pharmaceutical waste. A survey was also carried out among the general public, involving the questioning of randomly selected participants in order to investigate the household disposal of unused and expired pharmaceuticals. The results from the survey showed that more than half of the respondents confirmed having unused, left-over or expired medicines at home and over 75% disposed of pharmaceutical waste through the normal waste bins which end up in the landfills or dump sites. PMID:22081380

  10. Achieving better in-hospital and after-hospital care of patients with acute cardiac disease.

    PubMed

    Scott, Ian A; Denaro, Charles P; Bennett, Cameron J; Hickey, Annabel C; Mudge, Alison M; Flores, Judy L; Sanders, Daniela C J; Thiele, Justine M; Wenck, Beres; Bennett, John W; Jones, Mark A

    2004-05-17

    In patients hospitalised with acute coronary syndromes (ACS) and congestive heart failure (CHF), evidence suggests opportunities for improving in-hospital and after-hospital care, patient self-care, and hospital-community integration. A multidisciplinary quality improvement program was designed and instigated in Brisbane in October 2000 involving 250 clinicians at three teaching hospitals, 1080 general practitioners (GPs) from five Divisions of General Practice, 1594 patients with ACS and 904 patients with CHF. Quality improvement interventions were implemented over 17 months after a 6-month baseline period and included: clinical decision support (clinical practice guidelines, reminders, checklists, clinical pathways); educational interventions (seminars, academic detailing); regular performance feedback; patient self-management strategies; and hospital-community integration (discharge referral summaries; community pharmacist liaison; patient prompts to attend GPs). Using a before-after study design to assess program impact, significantly more program patients compared with historical controls received: ACS: Angiotensin-converting enzyme (ACE) inhibitors and lipid-lowering agents at discharge, aspirin and beta-blockers at 3 months after discharge, inpatient cardiac counselling, and referral to outpatient cardiac rehabilitation. CHF: Assessment for reversible precipitants, use of prophylaxis for deep-venous thrombosis, beta-blockers at discharge, ACE inhibitors at 6 months after discharge, imaging of left ventricular function, and optimal management of blood pressure levels. Risk-adjusted mortality rates at 6 and 12 months decreased, respectively, from 9.8% to 7.4% (P = 0.06) and from 13.4% to 10.1% (P = 0.06) for patients with ACS and from 22.8% to 15.2% (P < 0.001) and from 32.8% to 22.4% (P = 0.005) for patients with CHF. Quality improvement programs that feature multifaceted interventions across the continuum of care can change clinical culture, optimise care and improve clinical outcomes. PMID:15139843

  11. Latex in the Hospital Environment

    MedlinePLUS

    LATEX in the Hospital Environment Updated Fall 2015 This list provides a guide to some of the most common objects containing latex and offers some ... remover–Sepha Pharm) 1 LATEX in the Hospital Environment (continued) Frequently contains LATEX OR/Infection Control masks, ...

  12. Psychiatric Hospitalization and Academic Performance

    ERIC Educational Resources Information Center

    Ganz, Varda Peller; Pao, Jane

    1978-01-01

    Studies of college students hospitalized for psychiatric disturbances revealed that diagnosis did not significantly affect academic performance, nor did leave of absence following hospitalization ensure better re-entry adjustment. It is recommended that students be evaluated individually and be allowed to re-enter as soon as the acute illness…

  13. Faculty Internships for Hospitality Instructors

    ERIC Educational Resources Information Center

    Lynn, Christine; Hales, Jonathan A; Wiener, Paul

    2007-01-01

    Internships can help hospitality faculty build industry relationships while also ensuring the best and most current training for their students. Many hospitality organizations have structured faculty internships available or are willing to work with faculty to provide individualized internship opportunities. Career and technical educators in…

  14. Management of the Hospital Environment

    ERIC Educational Resources Information Center

    Turner, Alvis G.

    1976-01-01

    Hospital studies indicate the need for an environmental/sanitarian specialist for control of nosocomial infection and maintenance of a quality environment. The author recommends these requirements for certification as a hospital environmentalist: academic studies including toxicology, epidemiology, hygiene, management, and an internship in…

  15. Comparing Candidate Hospital Report Cards

    SciTech Connect

    Burr, T.L.; Rivenburgh, R.D.; Scovel, J.C.; White, J.M.

    1997-12-31

    We present graphical and analytical methods that focus on multivariate outlier detection applied to the hospital report cards data. No two methods agree which hospitals are unusually good or bad, so we also present ways to compare the agreement between two methods. We identify factors that have a significant impact on the scoring.

  16. Main Hospital Car Park 7 (staff only)

    E-print Network

    Qu, Rong

    Pedestrian Underpass Children's Hospital Main Hospital Car Park 7 (staff only) Opening Spring 2009 Entrance to Hospital Site Entrance to Building Bike Rack No Entry KEY TO SYMBOLS HOSPITAL SITE MAP `BIG YELLOW BUS' Patient Transport On-site Pick-up & Drop-off point Bus route Hospital Link Bus Stop Patient

  17. Elec 331 -Hospital Safety Residential Wiring Basics

    E-print Network

    Pulfrey, David L.

    Elec 331 - Hospital Safety 1 Residential Wiring Basics (Hospital Safety) Power Distribution #12;Elec 331 - Hospital Safety 2 Distribution Transformer Distribution Transformer #12;Elec 331 - Hospital - Hospital Safety 4 Breaker Panel · Copper ­ Gnd Bus · White ­ Reference Bus ­ Connection to GND · ONLY here

  18. Does governance matter? Board configuration and performance in not-for-profit hospitals.

    PubMed

    Alexander, Jeffrey A; Lee, Shoou-Yih D

    2006-01-01

    As performance accountabilities, external oversight, and market competition among not-for-profit (NFP) hospitals have grown, governing boards have been given a more central leadership role. This article examines these boards' effectiveness, particularly how their configuration influenced a range of performance outcomes in NFP community hospitals. Results indicate that hospitals governed by boards using a corporate governance model, versus hospitals governed by philanthropic-style boards, were likely to be more efficient and have more admissions and a larger share of the local market. Occupancy and cash flow were generally unrelated to hospitals' governing board configuration. However, effects of governance configuration were more pronounced in freestanding and public NFP hospitals compared with system-affiliated and private NFP hospitals, respectively. PMID:17096640

  19. Solid waste management in the hospitality industry: a review.

    PubMed

    Pirani, Sanaa I; Arafat, Hassan A

    2014-12-15

    Solid waste management is a key aspect of the environmental management of establishments belonging to the hospitality sector. In this study, we reviewed literature in this area, examining the current status of waste management for the hospitality sector, in general, with a focus on food waste management in particular. We specifically examined the for-profit subdivision of the hospitality sector, comprising primarily of hotels and restaurants. An account is given of the causes of the different types of waste encountered in this sector and what strategies may be used to reduce them. These strategies are further highlighted in terms of initiatives and practices which are already being implemented around the world to facilitate sustainable waste management. We also recommended a general waste management procedure to be followed by properties of the hospitality sector and described how waste mapping, an innovative yet simple strategy, can significantly reduce the waste generation of a hotel. Generally, we found that not many scholarly publications are available in this area of research. More studies need to be carried out on the implementation of sustainable waste management for the hospitality industry in different parts of the world and the challenges and opportunities involved. PMID:25194519

  20. 78 FR 38679 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-27

    ...Hospitals and the Long Term Care Hospital Prospective Payment System...Requirements for Specific Providers; Hospital Conditions of Participation...MS-DRG classifications and new technology add-on payments. Eva Fung...corrections regarding the Hospital Readmission Reduction...