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1

Hospital admissions from the Surgical Day Care Centre of Vancouver General Hospital 1977–1987  

Microsoft Academic Search

The admissions to Vancouver General Hospital from its Surgical Day Care Centre were reviewed for the period I977 to 1987.\\u000a The overall mean rate of admission for the period was 0.28 per cent, for surgically-related admissions 0.22 per cent and for\\u000a anaesthesia-related admissions 0.07 per cent. The principal reasons for surgery-related admissions were postoperative bleeding,\\u000a complications, the need for further

Peter F. Fancourt-Smith; Jeffrey Hornstein; Leonard C. Jenkins

1990-01-01

2

Death within 48 hours of anaesthesia at the vancouver general hospital  

Microsoft Academic Search

A formal review of all deaths within 48 hours of an anaesthetic is done at the Vancouver General Hospital. All cases are reviewed\\u000a for significant contributory factors directly attributable to anaesthesia. This study presents the data of such a review of\\u000a 195.232 anaesthetics administered between 1973 and 1977. The overall incidence of 2.2 deaths per 1000 anaesthetics compares\\u000a favourably with

K. W. Turnbull; P. F. Fancourt-smith; G. C. Banting

1980-01-01

3

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

Microsoft Academic Search

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

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

1990-01-01

4

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

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

Zuberi, Daniyal M; Ptashnick, Melita B

2011-03-01

5

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

SciTech Connect

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.

Bates, D.V.; Baker-Anderson, M.; Sizto, R. (Univ. of British Columbia, Vancouver (Canada))

1990-02-01

6

Massachusetts General Hospital - Psychiatry Program  

NSDL National Science Digital Library

The Massachusetts General Hospital has organized a School of Psychiatry web site with a wealth of resources. The site is divided into three sections; Parents, Educators and Clinicians. The Educator section provides many useful resources from basic health information and disorder background to helping educators cope with teaching students with mental health issues in the classroom. This site will be a valuable resource for both educators and students in the field of Mental Health.

7

Lymphoproliferative disorders following allogeneic bone marrow transplantation: the Vancouver experience  

Microsoft Academic Search

Between June 1988 and May 1996, 428 patients underwent allogeneic BMT (288 related donor (RD) and 140 unrelated donor (UD)) at the Vancouver General Hospital. Eight patients (UD six and RD two) developed a post-transplant lymphoproliferative disorder (PTLD). Median age at BMT was 38 years (range 22–51). Five of the six UD allografts were T cell depleted. Cyclosporine ± methotrexate

INM Micallef; M Chhanabhai; JD Shepherd; HC Fung; SH Nantel; CL Toze; H-G Klingemann; HJ Sutherland; DE Hogge; TJ Nevill; A Le; MJ Barnett

1998-01-01

8

The MASSACHUSETTS GENERAL HOSPITAL SURGICAL SOCIETY  

E-print Network

. Both had had Har- vard college educations and had their residency programs inter- rupted by two yearsThe MASSACHUSETTS GENERAL HOSPITAL SURGICAL SOCIETY Newsletter THIRD MEETING OF THE MGH SURGICAL, as well as cardiology participate in this center. Significant increases in volume, as well as decreases

Mootha, Vamsi K.

9

[Intervention for suicide attempters in general hospitals].  

PubMed

The quality of care delivered to persons who attempt suicide and are transfered to a general hospital is a topic of debate in many Dutch hospitals. A working committee of the Medical Scientific Council of the National Organization for Quality Assurance in Hospitals (CBO) issued a report with practical guidelines on the skills and organizational context needed for proper diagnosis and treatment of this group of patients. In this article the main elements of the report are described: a definition of attempted suicide, judging of persons attempting suicide, minimal requirements for first-aid, organizational issues, development of protocols (covering somatic as well as psychiatric care) and the role of mental-health care professionals. PMID:1538817

Hengeveld, M W; Kerkhof, A J; van Rooijen, E

1992-02-22

10

284 SDSU General Catalog 2012-2013 Hospitality and Tourism  

E-print Network

284 SDSU General Catalog 2012-2013 Hospitality and Tourism Management In the College of Hospitality and Tourism Management Master of Science degree in hospitality and tourism management. Major in hospitality and tourism management with the B.S. degree in applied arts and sciences. Emphasis in global

Gallo, Linda C.

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

SDSU General Catalog 2011-2012 281 Hospitality and Tourism  

E-print Network

SDSU General Catalog 2011-2012 281 HTM Hospitality and Tourism Management In the College of Hospitality and Tourism Management Major in hospitality and tourism management with the B.S. degree in applied arts and sciences. Emphasis in global tourism management. Emphasis in hotel operations and management

Gallo, Linda C.

13

178 SDSU General Catalog 2007-2008 Hospitality and Tourism  

E-print Network

178 SDSU General Catalog 2007-2008 Hospitality and Tourism Management In the College: 619-594-4443 http://www.sdsu.edu/htm Faculty Hospitality and Tourism Management is administered by the Hospitality and Tourism Management Program Committee. The program draws on courses offered by the faculty

Gallo, Linda C.

14

SDSU General Catalog 2013-2014 289 Hospitality and Tourism  

E-print Network

SDSU General Catalog 2013-2014 289 HTM Hospitality and Tourism Management In the L. Robert Payne School of Hospitality and Tourism Management In the College of Professional Studies and Fine Arts OFFICE for Professional Development: Jeffries Offered by the L. Robert Payne School of Hospitality and Tourism Management

Gallo, Linda C.

15

Blood Drive Coordinator Packet Massachusetts General Hospital pg.2  

E-print Network

1 Blood Drive Coordinator Packet Massachusetts General Hospital pg.2 The MGH Bloodmobile pg.3 Facts about Blood Donation pg.4 Spreading the Word pg.5 Frequently Asked Questions and Tips pg.7 Schedule a Blood Drive pg.10 Eligibility Guidelines pg.11 #12;2 Massachusetts General Hospital

Mootha, Vamsi K.

16

[Communication between general practitioners and hospital interns at emergency admissions].  

PubMed

Communication between general practitioners and hospital interns serves as basis for the first in-hospital treatment of emergency admitted patients. The purpose of this study is to describe how this communication currently functions in Norway. The study was carried out by personal and focus group interviews with general practitioners and hospital interns, and questionnaire responses from 532 doctors. Both general practitioners (93%) and hospital interns (84%) claim that the general practitioner's information is usually valuable for the initial hospital treatment. 89% of the general practitioners and 65% of the interns (p < 0.01) responded affirmatively to general statements characterising the existing communication as good. However, 58% of the interns are of the opinion that there are many unnecessary referrals to the hospitals, and 47% respond that the general practitioners often refer a patient in order to get rid of a problem they should have been able to handle themselves. The interns single out simple problems with the referral letters, such as illegible handwriting, and left-out or unsorted information. This critical view can in part be explained by the sense of isolation, lack of autonomy and high work load that interns experience in their obligatory hospital year. We recommended that interns are invited to participate when hospital doctors and general practitioners meet. PMID:10402909

Frihagen, F; Hjortdahl, P; Kvamme, O J

1999-06-10

17

[General surgery in Paramaribo University Hospital].  

PubMed

Specific health problems in Surinam include high prevalence of infections, mostly gastrointestinal infections in young children, malaria and injuries due to violence. The public health care and medical and surgical training are hampered by a lack of funds, as are most things in the country. Relatively much of the surgery in Paramaribo University Hospital in 1991-1998 was performed because of complications of a diabetic foot (128.17%) and breast lesions (76.10%). No scientific research is being carried out either in the hospital or at the faculty of Anton de Kom University. Retrospective registration of operations may give a new impulse to scientific research. PMID:10608979

Konsten, J; Ketele, P O; Girjasing, R; Kootstra, G

1999-11-27

18

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

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…

Hern, Matt

2009-01-01

19

282 SDSU General Catalog 2010-2011 Hospitality and Tourism  

E-print Network

282 SDSU General Catalog 2010-2011 Hospitality and Tourism Management In the College and tourism management with the B.S. degree in applied arts and sciences. Emphasis in global tourism and management. The Major Hospitality and tourism management is an interdisciplinary major which culminates

Gallo, Linda C.

20

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

21

The American General Hospital as a Complex Social System  

PubMed Central

Based on data from and about the medical, nursing, and administrative staffs in a probability sample of general hospitals, involving 41 institutions and some 2,400 respondents, certain aspects of the hospital social system are examined in each of the following basic problem-areas: organizational and member goal attainment; availability and allocation of organizational resources; organizational coordination; social integration; intraorganizational strain; and organizational adaptation. These areas are examined separately and in relation to one another, as a basis for understanding and assessing the overall effectiveness of the hospital as a complex social organization. Hospital effectiveness is viewed in the context of open system theory, as a joint function of the relative success with which the organization handles its problems in these key areas. Findings concerning a number of social-psychological variables in each area are presented and discussed, with emphasis on the interdependence of the areas and on organizational issues and implications. The results show some of the basic strengths and weaknesses of the system. Important differences associated with hospital size and affiliation are also discussed to illustrate the typical profile of the American general hospital and significant variations from it. Similarly, differences among the principal groups in the system are presented, where appropriate. Finally, promising directions for future organizational research in the hospital field are briefly presented.

Georgopoulos, Basil S.; Matejko, Aleksander

1967-01-01

22

Treatment of atrial fibrillation in a district general hospital  

Microsoft Academic Search

OBJECTIVE--To assess current strategies used to investigate and manage acute atrial fibrillation in hospital. DESIGN--Prospective survey of all acute admissions over 6 months. SETTING--District general hospital serving a population of 230,000 in north east Glasgow. SUBJECTS--2686 patients admitted as emergency cases over 6 months. RESULTS--Of the 2686 patients, 170 (age range 38-95, mean (SD) 73.5 (10.6) years; 70 men (41%)

G. Y. Lip; K. N. Tean; F. G. Dunn

1994-01-01

23

Characteristics of psychiatric discharges from nonfederal, short-term specialty hospitals and general hospitals with and without psychiatric and chemical dependency units: the Hospital Discharge Survey data.  

PubMed Central

Hospitalization for mental disorders (Major Diagnostic Categories 19 and 20) was examined using the 1980 Hospital Discharge Survey (HDS) data. We added to the HDS data by noting whether each hospital had a specialized psychiatric and/or chemical dependency unit, especially noting short-term specialty psychiatric and chemical dependency hospitals. Of the approximately 1.7 million episodes with MDC-19 and -20 diagnoses in the nation's nonfederal short-term hospitals in 1980, 13.5 percent were in specialty hospitals. Of the remaining general hospital episodes: 31 percent occurred in hospitals with only psychiatric units, 5 percent in hospitals with only chemical dependency units, 31 percent in hospitals with both types of specialized treatment units, and 33 percent in hospitals with neither type of unit. The last figure is much less than previously thought. The five hospital types may be arrayed on a continuum of resource utilization and severity of cases treated, with general hospitals with no special units at one end, specialty hospitals at the other, and general hospitals with psychiatric or chemical dependency units intermediate. Presence or absence of a chemical dependency unit influences a hospital's profile in this regard, particularly for MDC-20. Future studies should take into account the presence of a chemical dependency unit. PMID:1846844

Kiesler, C A; Sibulkin, A E; Morton, T L; Simpkins, C G

1991-01-01

24

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

Code of Federal Regulations, 2010 CFR

...General provisions for hospitals located in Puerto Rico...MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective...System for Inpatient Hospital Capital Costs...

2010-10-01

25

Proximal gastric vagotomy: a district general hospital experience.  

PubMed Central

A district general hospital experience with proximal gastric vagotomy over a nine-year period is reported. One hundred and eight patients undergoing the operation for chronic duodenal ulcer were assessed. The follow-up period was 1-9 years (mean 4 years and 7 months). The results were graded using a modification of the classification of Visick (1948). Over 85% of our patients were satisfied with their results. (Visick 1 and 2). Recurrent ulceration was noted in 3.9% of our series (4 cases). There were no deaths and few complications. The technique used by us is described briefly and the role of proximal gastric vagotomy in a district general hospital is discussed. PMID:6859783

Wood, J. J.; Ryan, J. M.; Anders, C. J.

1983-01-01

26

Adaptation of a General Hospital Computerized Medical Information System to the Research Hospital Environment  

PubMed Central

The work described in this paper was undertaken with the objective of simplifying the process of clinical research data acquisition to enable researchers to analyze data conveniently, economically and comprehensively. Though the Clinical Center differs from the community general hospitals, and even the university medical centers in many respects, its day-to-day operations are closely parallel to those in other hospitals. Therefore, it was felt that it would be worthwhile to consider the installation of the type of computerized medical information system used in the general hospitals and to tailor it to the specific research data capture needs which are characteristic of the NIH. After describing areas of similarity and difference in comparisons between the general hospital and the Clinical Center from the data processing perspective, consideration is given to the research data capture needs for Clinical Center patients. Discussions of systems involving data capture while the patient is undergoing active treatment, as well as those which are best captured in batch processes, are discussed. Finally, the state of development and use of the comprehensive Clinical Information Utility for the NIH researchers is described, including examples of its use. The system described in the paper represents one of the first attempts to make post-discharge use of inpatient medical care data derived from an on-line real-time hospital-wide information system. Already the results obtained from the initial exercises using the Clinical Information Utility have shown that the availability of all patient care information in computer processable form, generated as a result of the clinical efforts, will have tremendous impact on the quality and timeliness of research data processing at the NIH.

Lewis, Thomas L.; Macks, Gerald C.

1977-01-01

27

Tampa General Hospital "blows the whistle on violence".  

PubMed

At Tampa General Hospital, the professionals in the marketing and media relations department know how to stage a press conference and to get the attention of the media. It goes to the adage when you're buying real estate: location, location, location. Once the journalists were assembled, Tampa General launched its campaign to fight street violence: "Blow the Whistle on Violence." Their timing was aided by the release of the FBI's annual Preliminary Crime Report citing Tampa as the second most dangerous city in which to live. Tampa General's news media specialist Stacey Winn reported that "the day went together just like a puzzle with all the pieces coming together." Those pieces and more are detailed in this issue's cover story on community involvement. Street crime and violence are not unique to Tampa, of course. But with so many victims ending up in Tampa General's emergency room, Winn noted that physicians and nurses felt personally responsible for contributing toward the prevention of cases ending up there. One important element in the hospital's press conference was an appearance by one of the victims of the violence they're striving to prevent. Her appearance and statement to the assembled media representatives significantly enhanced the presentation. "Blow the Whistle on Violence" was a low-cost program with a high return. The potential benefits are enormous. PMID:10152841

1995-01-01

28

Suicide attempt and the emergency room of the general hospital.  

PubMed

Data are presented on 270 consecutive cases of suicide attempts examined by a psychiatrist in a community general hospital's emergency room in Tel Aviv, Israel, during the years 1972--1974. The rates were 55:100,000, 42:100,000 and 33:100,000 respectively. The male-female ratio was 1:4. Predominantly young women having emotional problems used an overdosage of tranquillizers in an attempt to secure help. The second category of patients attempting suicide were males suffering from mental illness. PMID:750875

Hes, J P; Dor, T

1978-01-01

29

Southern Vancouver Island  

NSDL National Science Digital Library

Landsat satellite images of Southern Vancouver Island are among the collection of the Canada Centre for Remote Sensing's Images of Canada series (reviewed in the June 7, 2000 Scout Report for Science and Engineering). Below the full-color .jpeg images are tables documenting the satellites and sensors used, date of acquisition, image resolution, area (km), and links to a reference map. Educational, hyperlinked text about the featured region and close-ups of important topographic features accompany the images.

30

Incidence of nephrogenic systemic fibrosis at Chinese PLA General Hospital.  

PubMed

Magnetic resonance imaging (MRI), dermatology, and dermatopathology records were searched to determine the incidence of nephrogenic systemic fibrosis (NSF) at a large military hospital in China. Over the past 3.7 years, gadolinium-based contrast agent (GBCA)-enhanced MRI was performed with Gd-DTPA (n = 28,680) or MultiHance (n = 635) typically at slightly more than a standard dose, as most patients received a unit dose, 15 mL or 20 mL instead of a weight-based dose. This included 118 renal failure patients with estimated glomerular filtration rate (eGFR) less than 30 mL/min and 33 patients on chronic hemodialysis. Despite a diligent search involving rereview of histopathological sections in similarly diagnosed cases, there was no evidence that any patient developed nephrogenic systemic fibrosis. For the renal failure and hemodialysis patients, there were no clinical notes of unexplained rashes within 3 months following GBCA. The incidence of NSF in Chinese People Liberation Army General Hospital using gadolinium (Gd) in 29,315 patients, 151 with severe renal failure or hemodialysis, is thus far undetectable. J. Magn. Reson. Imaging 2009;30:1309-1312. (c) 2009 Wiley-Liss, Inc. PMID:19937931

Zou, Zhitong; Ma, Lin; Li, Hengjin

2009-12-01

31

Characteristics of the stroke alert process in a general Hospital  

PubMed Central

Background: The organized stroke alert is critical in quickly evaluating and treating patients with acute stroke. The purpose of this paper was to further understand how this process functions in a moderate sized general hospital by exploring the effects of patient location and time of day on the pace of evaluation and the eventual outcome of evaluation. Methods: Retrospective chart review. Results: The rate of stroke alerts depended on the time of day and patient location. There was a low probability (41%) that the eventual diagnosis was stroke after a stroke alert, but there was no effect of diagnosis on the pace of evaluation. The time between stroke alert and a computed tomography (CT) scan being read was shortest for patients in the emergency room (ER) and longer for patients in the intensive care unit (ICU) or medical/surgical floors. Patients evaluated on medical/surgical floors were less likely to receive tissue plasminogen activator (tPA) than those evaluated in the ER, even though the comorbidities were similar. This may be due to the greater severity of the comorbidities in patients who were already admitted to the hospital. Conclusion: The rate of tPA administration was lower for stroke alerts called from medical/surgical floors than from the ER. Stroke alerts were most frequent in late afternoon.

Stecker, Mark M.; Michel, Kathleen; Antaky, Karin; Wolin, Adam; Koyfman, Feliks

2015-01-01

32

[25 years of kidney replacement treatment at a general hospital].  

PubMed

Between February 1963 and January 1988, 174 patients were treated for acute and 307 for chronic renal failure by dialysis in the St. Joseph Hospital Eindhoven, a general hospital. Sixty-two per cent of the patients treated for acute renal failure had tubular necrosis as a cause. In the patients treated for end-stage renal disease the median age of the dialysis population increased from 37 to 62 years. Vascular renal disease and diabetes mellitus were more frequent during the last ten years. Because of the inflow of older people, the outflow by death increased strongly, while the outflow by transplantation remained stable during the last 15 years. Due to an active transplantation policy together with haemodialysis at home and CAPD, 66% of the total now living patient population could be discharged from the dialysis department. Infection and cardiovascular accidents were the major causes of morbidity and mortality among the dialysis and transplant patients. Overall survival curves of all treated patients showed a 5-year survival of 60% and a 10-year survival of 42%. PMID:2674733

Gerlag, P G; Berenschot, H; Deckers, P F

1989-07-01

33

[Confusion (delirium) in elderly patients of a general hospital.  

PubMed

Objective. Confusion in elderly patients is an urgent problem due to its high frequency both in psychiatric hospitals and general clinics. Authors studied the frequency of confusion, the psychopathological structure of these conditions and risk factors for their development in old age in elderly patients of a multiprofile hospital. Material and methods. 187 elderly patients (over 65 years old) were examined using psychopathological method, computed tomography (CT and MRI). Epidemiological evaluation of the cohort was performed as well. Results and conclusion. The frequency of confusion was 2.8% of the total number of inpatients (n=6788). Several psychopathological variants of confusion were singled out: delirious confusion (37.9%), amentia syndrome 18.7%, confabulation confusion (11.8%) and undifferentiated exogenous-organic psychosis (31.6%). The following factors were shown to increase the risk of confusion: the age above 85 years old, previous diagnosis of dementia or encephalopathy, comorbid pneumonia or urological infections. Confusion was most frequent in therapeutic and neurological departments. PMID:25042498

Kolpashchikov, I N; Gavrilova, S I

2014-01-01

34

Prospective multidisciplinary audit of obstetric general anaesthesia in a district general hospital.  

PubMed

In the 3 years leading up to March 2001, the general anaesthesia rate for emergency and elective caesarean sections at our hospital was higher than that recommended by the Royal College of Anaesthetists. There were also concerns regarding the quality of communication between surgeon and anaesthetist prior to emergency caesarean section. A multidisciplinary audit was undertaken on both the indications for obstetric general anaesthesia and quality of communication between staff members during the perioperative period between January and August 2002. The results of the audit highlighted potential serious shortfalls in communication and teamworking; however, there was insufficient information to assess the appropriateness of the indication for general anaesthesia. Following this audit recommendations were made to improve communication channels between the personnel on labour ward and this coincided with a reduction in the use of general anaesthesia. PMID:16147603

Shroff, R; Thompson, A C D; McCrum, A; Rees, S G O

2004-09-01

35

Treeline Dynamics on Southern Vancouver Island, British Columbia  

E-print Network

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

Smith, Dan

36

WSU Vancouver Historic Collection  

NSDL National Science Digital Library

This fun collection brings together items from three collections in the Washington State University (WSU) Vancouver Library Archive, including items from the WSU 20th Anniversary Oral History Project, campus environmental impact statements, and campus master plans. In a very real sense, it's a potpourri of materials that will interest folks who care about the built environment, sustainability, and the history of this corner of Washington. The oral histories are quite fascinating, as well as the Photographs area which offers a range of images documenting the history of this campus, including some remarkable aerial shots of southwestern Washington. Finally, the Ephemera section lives up to its name as it has everything from a 1992 course schedule to a curious pamphlet for a microcomputer seminar series in 1984.

37

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

Code of Federal Regulations, 2014 CFR

...care hospital prospective payment system under Subpart O of this...the Federal prospective payment rate as specified in...prospective rate, or to a new long-term care hospital...rehabilitation facility prospective payment system under subpart P of...

2014-10-01

38

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

Code of Federal Regulations, 2011 CFR

...care hospital prospective payment system under Subpart O of this...the Federal prospective payment rate as specified in...prospective rate, or to a new long-term care hospital...rehabilitation facility prospective payment system under subpart P of...

2011-10-01

39

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

Code of Federal Regulations, 2013 CFR

...care hospital prospective payment system under Subpart O of this...the Federal prospective payment rate as specified in...prospective rate, or to a new long-term care hospital...rehabilitation facility prospective payment system under subpart P of...

2013-10-01

40

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

Code of Federal Regulations, 2012 CFR

...care hospital prospective payment system under Subpart O of this...the Federal prospective payment rate as specified in...prospective rate, or to a new long-term care hospital...rehabilitation facility prospective payment system under subpart P of...

2012-10-01

41

Personal health records in a public hospital: experience at the HIV\\/AIDS clinic at San Francisco General Hospital  

Microsoft Academic Search

Personal health records (PHRs) are information repositories; however, PHRs may be less available to persons in the safety net setting. We deployed a free, secure, internet-based PHR for persons receiving care at the AIDS\\/HIV clinic at San Francisco General Hospital. In our initial rollout, 221 persons registered for the PHR. Compared to the entire clinic, these initial users were more

James S. Kahn; Joan F. Hilton; T. Van Nunnery; Skip Leasure; Kelly M. Bryant; C. Bradley Hare; David H. Thom

2010-01-01

42

Neuroimaging reports in a general hospital: Results from a quality-improvement program  

Microsoft Academic Search

ObjectiveNeurologists working in district general hospitals (DGHs) in the UK frequently rely on neuroimaging reports from general radiologists. Neuroradiologists and general radiologists may disagree in the interpretation of magnetic resonance imaging and computerized tomographs of brain and spine. We sought to analyse disagreements between reports from general radiologists and neuroradiologists in selected patients and to examine the impact of a

Mark O. McCarron; Carrie Sands; Peter McCarron

2010-01-01

43

Adult Routine Physical This health plan covers routine physical exams furnished by a General Hospital, Community  

E-print Network

Hospital, Community Health Center, Physician, Nurse Practitioner, Nurse Midwife or Independent Lab Immunizations (including flu shots and travel immunizations) Related lab tests and x-rays Blood tests to screen furnished by a General Hospital, Community Health Center, Physician, Nurse Practitioner or Independent Lab

Oppo, Delia W.

44

Massachusetts General Hospital Center for Women's Mental Health Clinical Research Coordinator Position Announcement  

E-print Network

Massachusetts General Hospital ­ Center for Women's Mental Health Clinical Research Coordinator Position Announcement Program Description: The Center for Women's Mental Health is a clinical medications during pregnancy; treatment for postpartum mood and anxiety disorders; treatment for premenstrual

Patel, Aniruddh D.

45

Effective clinical policies in a district general hospital.  

PubMed

Effective clinical practice in a hospital needs current knowledge together with the skills and right attitude; these should be applied continuously. Failure of this system can be due to ignorance or arrogance. We attempted to correct these deficiencies by formulating a set of policies which were enforced from 1962 to 1983. The policies related to the following: intensive care (including asthma, nutrition and organ donation), drug prescribing and resuscitation. We believe that these rules improved patient care and the standards of training; the prescribing policy also saved money. PMID:10345935

Gordon, I J; Jones, E S

1998-12-01

46

City Lights: Vancouver's Neon Heritage  

NSDL National Science Digital Library

Based on a physical exhibit earlier this year and walking tour developed by the city of Vancouver, this site explores the art and science of neon lights. The site is composed of three sections. The first takes visitors through an electronic version of the exhibit, with twenty-nine images which include brief captions. The tour section of the site offers a virtual stroll through neon Vancouver with twenty-three images. Finally, the neon science section explains what neon is and how neon lights are made.

47

The Warrens and other pioneering clinician pathologists of the Massachusetts General Hospital during its early years: an appreciation on the 200th anniversary of the hospital founding  

Microsoft Academic Search

To celebrate the bicentennial of the 1811 charter to establish the Massachusetts General Hospital, we tell the stories of the physicians and surgeons of the hospital who practiced pathology until the discipline was more firmly established with the recruitment of James Homer Wright who became the first full-time pathologist at the hospital in 1896. One of the two co-founders of

Robert H Young; David N Louis

2011-01-01

48

Implementation of a Prototype Generalized Network Technology for Hospitals *  

PubMed Central

A demonstration implementation of a distributed data processing hospital information system using an intelligent local area communications network (LACN) technology is described. This system is operational at the UCSF Medical Center and integrates four heterogeneous, stand-alone minicomputers. The applications systems are PID/Registration, Outpatient Pharmacy, Clinical Laboratory and Radiology/Medical Records. Functional autonomy of these systems has been maintained, and no operating system changes have been required. The LACN uses a fiber-optic communications medium and provides extensive communications protocol support within the network, based on the ISO/OSI Model. The architecture is reconfigurable and expandable. This paper describes system architectural issues, the applications environment and the local area network.

Tolchin, S. G.; Stewart, R. L.; Kahn, S. A.; Bergan, E. S.; Gafke, G. P.; Simborg, D. W.; Whiting-O'Keefe, Q. E.; Chadwick, M. G.; McCue, G. E.

1981-01-01

49

Injectional anthrax at a Scottish district general hospital.  

PubMed

SUMMARY This retrospective, descriptive case-series reviews the clinical presentations and significant laboratory findings of patients diagnosed with and treated for injectional anthrax (IA) since December 2009 at Monklands Hospital in Central Scotland and represents the largest series of IA cases to be described from a single location. Twenty-one patients who fulfilled National Anthrax Control Team standardized case definitions of confirmed, probable or possible IA are reported. All cases survived and none required limb amputation in contrast to an overall mortality of 28% being experienced for this condition in Scotland. We document the spectrum of presentations of soft tissue infection ranging from mild cases which were managed predominantly with oral antibiotics to severe cases with significant oedema, organ failure and coagulopathy. We describe the surgical management, intensive care management and antibiotic management including the first description of daptomycin being used to treat human anthrax. It is noted that some people who had injected heroin infected with Bacillus anthracis did not develop evidence of IA. Also highlighted are biochemical and haematological parameters which proved useful in identifying deteriorating patients who required greater levels of support and surgical debridement. PMID:25078285

Inverarity, D J; Forrester, V M; Cumming, J G R; Paterson, P J; Campbell, R J; Brooks, T J G; Carson, G L; Ruddy, J P

2014-07-31

50

Performance of European system for cardiac operative risk evaluation in Veterans General Hospital Kaohsiung cardiac surgery  

Microsoft Academic Search

BackgroundThe European System for Cardiac Operative Risk Evaluation (EuroSCORE) model is a widely-used risk prediction algorithm for in-hospital or 30-day mortality in adult cardiac surgery patients. Recent studies indicated that EuroSCORE tends to overpredict mortality. The aim of our study is to evaluate the validity of EuroSCORE in Veterans General Hospital Kaohsiung (VGHKS) cardiac surgery including a number of different

Hsin-Hung Shih; Pei-Luen Kang; Jun-Yen Pan; Tung-Ho Wu; Chieh-Ten Wu; Chun-Yao Lin; Yu-Hsin Lin; Wan-Ting Chou

2011-01-01

51

THE PATTERN OF ALCOHOL CONSUMPTION OF A GENERAL HOSPITAL POPULATION IN NORTH BELFAST  

Microsoft Academic Search

This study aimed to examine the pattern of alcohol use among those attending a General Hospital and to explore the perception of safe drinking. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was given for self-completion to all inpatients and outpatients on separate days and to all adults attending the Accident and Emergency Department (A&E) on both a midweek and

JOHN SHARKEY; DANIEL BRENNAN; PETER CURRAN

52

Researches regarding the Morton ether inhaler at Massachusetts General Hospital, Boston.  

PubMed

The Morton ether inhaler in the possession of Massachusetts General Hospital, Boston, MA, was traced back to 1906 when the earliest known photograph of it was published. The authors believe that the inhaler was given by William T. G. Morton, MD, to J. Mason Warren, MD, in January 1847. The inhaler was acquired by the Warren Anatomical Museum at an unknown date, loaned to Massachusetts General Hospital in October 1946, and placed on permanent loan to Massachusetts General Hospital in April 1948. Many documents relating to the inhaler have disappeared, and it was only identified in 2009 as the inhaler that probably belonged to J. Mason Warren, MD. The inhaler is not believed to be the one that Morton used on October 16, 1846, at Massachusetts General Hospital. It is the only known example of a Morton ether inhaler with valves (excluding replicas or reproduction inhalers) and is probably of similar design to the inhaler that Morton used on October 16, 1846. PMID:24036621

Haridas, Rajesh P; Mifflin, Jeffrey A

2013-11-01

53

Pancreatic Scanning as a Diagnostic Tool in the District General Hospital  

PubMed Central

The results of 200 radioisotope pancreatic scans in a general hospital show that 32 scans were recorded as “false positives,” though these included 13 patients with diabetes mellitus and nine who had had truncal vagotomy. There were no “false negatives.” Scanning is a useful diagnostic tool and a distinct advance on other tests more usually available for testing pancreatic function. PMID:4423700

Spencer, A. M.; Patel, M. P.; Smits, B. J.; Williams, J. D. F.

1974-01-01

54

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

ERIC Educational Resources Information Center

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…

Sugue-Castillo, Mariella

2009-01-01

55

Lisa Brown PT, DPT, NCS Massachusetts General Hospital Institute of Health Professions, Boston MA  

E-print Network

and readings to individuals with vestibular disorders, multiple sclerosis, traumatic brain injury, parkinson, Boston MA May 2008 to May 2009 Physical Therapy, transitional Doctorate Massachusetts General Hospital Institute of Health Professions, Boston, MA September 2006 to September 2008 Physical Therapy, Certificate

Guenther, Frank

56

Role of semiautomatic defibrillators in a general hospital: "Naples Heart Project".  

PubMed

In Italian hospitals, 85% of patients hospitalized in general medical wards who experience cardiac arrest die, while the incidence is much lower in patients in intensive care units. Defibrillation, in Italian hospitals, often occurs very late, either due to a lack of defibrillators, or due to architectural and structural barriers. The object of an in-hospital emergency service is to prevent and treat cardiac arrest without subsequent complications, such as brain damage, renal failure etc. The Naples Heart Project was based on a feasibility study of the in-hospital emergency service to evaluate and analyze problems associated with type of structure, departmental and institutional dislocation, internal practicability (architectural features and preferential ways), staff numbers and distribution, the calling system for emergency, and the equipment available. The Naples Heart Project began in July 2001, since then it has already created 835 BLSD first responders among the hospital staff; 440 were physicians and physicians still in training, 310 were nurses and 85 were administrative staff. PMID:15135195

Santomauro, Maurizio; Ottaviano, Luca; Borrelli, Alessio; De Lucia, Vincenzo; Riganti, Carla; Ferreira, Daniel; Chiariello, Massimo

2004-05-01

57

Autologous blood donation in a small general acute-care hospital.  

PubMed Central

Increased public concerns about infectious risk associated with homologous blood transfusions have led to a significant increase in autologous blood collections. In response, blood banks and large hospitals have implemented autologous blood donation programs (ABDPs). Small hospitals lack the technical resources and patient case loads to effectively institute ABDPs. A preoperative ABDP designed to increase availability and patient convenience--and, therefore, utilization--is described. The program created in a rural 90-bed general acute-care hospital processed 105 donors and collected 197 units over a 38-month period. The percentage of the collected units that were transfused was 44.7%, and only 6.1% of participating patients required homologous transfusions. Comparisons of hematological and clinical data with previously published results indicate that small-scale preoperative ABDPs are clinically effective, safe, and provide cost-efficient utilization of the safest blood supply available. PMID:7674344

Mott, L. S.; Jones, M. J.

1995-01-01

58

Adult General Psychiatric Patients Served in Nebraska's State Hospitals: Patient Characteristics and Needs.  

PubMed

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

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

2015-02-01

59

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

ERIC Educational Resources Information Center

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…

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

2014-01-01

60

Prediction of general hospital admission in people with dementia: cohort study.  

PubMed

Background People with dementia are extremely vulnerable in hospital and unscheduled admissions should be avoided if possible. Aims To identify any predictors of general hospital admission in people with dementia in a well-characterised national prospective cohort study. Method A cohort of 730 persons with dementia was drawn from the Scottish Dementia Research Interest Register (47.8% female; mean age 76.3 years, s.d. = 8.2, range 50-94), with a mean follow-up period of 1.2 years. Results In the age- and gender-adjusted multivariable model (n = 681; 251 admitted), Neuropsychiatric Inventory score (hazard ratio per s.d. disadvantage 1.21, 95% CI 1.08-1.36) was identified as an independent predictor of admission to hospital. Conclusions Neuropsychiatric symptoms in dementia, measured using the Neuropsychiatric Inventory, predict non-psychiatric hospital admission of people with dementia. Further studies are merited to test whether interventions to reduce such symptoms might reduce unscheduled admissions to acute hospitals. PMID:25395686

Russ, Tom C; Parra, Mario A; Lim, Alison E; Law, Emma; Connelly, Peter J; Starr, John M

2015-02-01

61

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

PubMed Central

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

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

2013-01-01

62

Vancouver Art Gallery: Emily Carr  

NSDL National Science Digital Library

Created by the Vancouver Art Gallery (with a little help from the Virtual Museum of Canada), this is possibly the largest, most comprehensive web site devoted to the works of Canada's beloved artist, Emily Carr. The site includes a featured works section, where, using Flash, visitors can view Carr's works arranged on a timeline and zoom in for more information. There is also an extensive biography of Carr, outlining all the phases of her varied career, such as her work as an artist, documenting the First Nations cultures of British Columbia using Native American motifs, painting magical forests and totems, as well as creating crafts such as bowls and rugs. Carr is also known as an author of books such as "Klee Wyck", Carr's tales of First Nations communities, and for her literary depictions of nineteenth-century Victoria. The search function of the web site searches all 1,688 works by Carr held by the Vancouver Art Gallery, and will retrieve digital images of Carr's paintings, drawings, crafts, and sketchbooks, many accompanied by captions, for example, Haida Totems, 1912 with a quote from Klee Wyck describing the totem's setting at Cha-atl on Queen Charlotte Island.

63

Dispersion of Expiratory Droplets in a General Hospital Ward with Ceiling Mixing Type Mechanical Ventilation System  

Microsoft Academic Search

This study investigated the dispersion characteristics of polydispersed droplets in a general hospital ward equipped with ceiling-mixing type ventilation system. Injections of water test droplets containing non-volatile content were produced. The injections simulate human coughs with a similar droplet size distribution (peak size at 12 ? m) and airflow rate (0.4 L\\/s). The dispersion of test droplets was measured in-situ

M. P. Wan; C. Y. H. Chao; Y. D. Ng; G. N. Sze To; W. C. Yu

2007-01-01

64

Neonatal SepsisA Survey of Eight Years' Experience at the Louisville General Hospital  

Microsoft Academic Search

Information from 50 infants with neonatal septicemia from the Louisville General Hospital during an eight-year period (1964-1972) is presented. Twenty-five infants had gram-positive and the other 25 had gram-negative organisms. E. coli (13 cases), Staphylococcus (10 cases), and hemolytic Streptococcus non-Group A (7 cases) were the most common causative microorganisms. Only one of the 25 infants with gram-positive sepsis died;

Leticia C. Alojipan; Billy F. Andrews

1975-01-01

65

IRS General Counsel Memorandum threatens some hospital-physician joint ventures.  

PubMed

To defend against the heightened scrutiny of hospital-physician relations expected from the IRS, hospital management should closely examine any activities now conducted with physicians to determine whether each activity, as organized and operated, furthers the hospital's charitable mission of promoting the health of its community, rather than merely enhancing the financial health of the institution itself. Any arrangements that do not appear to satisfy the principles enunciated in GCM 39862 should be examined to see if they should be restructured or dissolved. In structuring new transactions and examining existing arrangements, the following principles should be kept in mind: 1. Transactions should not be premised upon increased utilization or physician referrals. Enhancing or protecting market share, even for the purpose of preserving an institution's presence in the community, will likely no longer be accepted as a justification for pursuing joint venture arrangements. In justifying such ventures, management must distinguish between benefit to the community and benefit to the institution. 2. Transactions whereby existing services or equipment are "spun off" to a hospital-physician joint venture run a serious risk of enhanced IRS scrutiny. 3. Transactions creating or providing new facilities or services should be more favorably perceived, particularly where participants other than the hospital take an active role in managing the venture. Where the hospital is the sole general partner and merely manages what it would have managed had there been no physician investors, the question of why physicians are involved will likely be of greater concern than it has been in the past.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10118472

Driscoll, T L; Schieble, M T

1992-03-01

66

A Prospective Study of Reasons for Prolonged Hospitalizations on a General Medicine Teaching Service  

PubMed Central

BACKGROUND Delays in the care of hospitalized patients may lead to increased length of stay, iatrogenic complications, and costs. No study has characterized delays among general medicine inpatients in the current prospective payment era of care. OBJECTIVE To quantify and characterize delays in care which prolong hospitalizations for general medicine inpatients. DESIGN Prospective survey of senior residents. SETTING Urban tertiary care university-affiliated teaching hospital. PARTICIPANTS Sixteen senior residents were surveyed regarding 2,831 patient-days. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Data were collected on 97.6% (2,762) of patient-days eligible for evaluation. Three hundred seventy-three patient-days (13.5% of all hospital days) were judged unnecessary for acute inpatient care, and occurred because of delays in needed services. Sixty-three percent of these unnecessary days were due to nonmedical service delays and 37% were due to medical service delays. The vast majority of nonmedical service delays (84%) were due to difficulty finding a bed in a skilled nursing facility. Medical service delays were most often due to postponement of procedures (54%) and diagnostic test performance (21%) or interpretation (10%), and were significantly more common on weekend days (relative risk [RR], 1.49; P=.02). Indeed, nearly one fourth of unnecessary patient-days (24% overall, 88 patient-days) involved an inability to access medical services on a weekend day (Saturday or Sunday). CONCLUSIONS At our institution, a substantial number of hospital days were judged unnecessary for acute inpatient care and were attributable to delays in medical and nonmedical services. Future work is needed to develop and investigate measures to decrease delays. PMID:15836542

Carey, Mark R; Sheth, Heena; Scott Braithwaite, R

2005-01-01

67

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

PubMed Central

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

2012-01-01

68

ASPECTS OF PSYCHIATRIC MORBIDITY IN THE OUT PATIENT POPULATION OF A GENERAL HOSPITAL IN SRI LANKA  

PubMed Central

SUMMARY A psychiatric morbidity study of a general hospital outpatient department population in Sri Lanka was done. A two stage sampling method was used. Questions which differentiated the psychiatrically morbid group were identified. The disease pattern was compared and contrasted with that presenting at psychiatric facilities in the area. Neurotic illness, the commonest being hypochondriasis was found to predominate in the general outpatient psychiatrically ill population in contrast to the population at in and out patient psychiatric facilities where schizophrenia was the major diagnostic category. PMID:22058542

Nikapota, A. D.; Patrick, V.; Fernando, L. H. S.

1981-01-01

69

Increasing Hospitalizations and General Practice Prescriptions for Community-onset Staphylococcal Disease, England  

PubMed Central

Rates of hospital-acquired staphylococcal infection increased throughout the 1990s; however, information is limited on trends in community-onset staphylococcal disease in the United Kingdom. We used Hospital Episode Statistics to describe trends in hospital admissions for community-onset staphylococcal disease and national general practice data to describe trends in community prescribing for staphylococcal disease. Hospital admission rates for staphyloccocal septicemia, staphylococcal pneumonia, staphylococcal scalded-skin syndrome, and impetigo increased >5-fold. Admission rates increased 3-fold for abscesses and cellulitis and 1.5-fold for bone and joint infections. In primary care settings during 1991–2006, floxacillin prescriptions increased 1.8-fold and fusidic acid prescriptions 2.5-fold. The increases were not matched by increases in admission rates for control conditions. We identified a previously undescribed but major increase in pathogenic community-onset staphylococcal disease over the past 15 years. These trends are of concern given the international emergence of invasive community-onset staphylococcal infections. PMID:18439352

Knott, Felicity; Petersen, Irene; Livermore, David M.; Duckworth, Georgia; Islam, Amir; Johnson, Anne M.

2008-01-01

70

Trauma services requirements in a district general hospital serving a rural area.  

PubMed Central

OBJECTIVE--To assess the demands made on a regional trauma centre by a district trauma unit. DESIGN--Two part study. (1) Prospective analysis of one month's workload. (2) Retrospective analysis of one year's workload by using a computer based records system. Comparison of two sets of results. SETTING--Accident unit in Gwynedd Hospital, Bangor. PATIENTS--(1) All patients who attended the accident unit in August 1988. (2) All patients who attended the accident unit in the calendar year April 1988-April 1989. MAIN OUTCOME MEASURE--Workload of a district trauma unit. RESULTS--In August 1988 there were 2325 attendances; 2302 of these were analysed. In all, 1904 attendances were for trauma; 213 patients were admitted to the trauma ward and 103 required an operation that entailed incision. Patients who attended the unit had a mean (range) injury severity score of 2-13 (0-25). Only two patients had injuries that a district general hospital would not be expected to cope with (injury severity score greater than 20). In the year April 1988-April 1989, 21,007 patients attended the unit. In all, 17,958 attendances were for orthopaedic injuries or injuries caused by an accident; 1966 patients were admitted to the unit. CONCLUSIONS--Most trauma is musculoskeletal and relatively minor according to the injury severity score. All but a few injuries can be managed in district general hospitals. In their recent report the Royal College of Surgeons has overestimated the requirements that a British district general hospital would have of a regional trauma centre. PMID:2107928

Kinny, S J; Jones, D H

1990-01-01

71

Partnerships between Medical Centres and General Hospitals Providing Normal Care Standards in Gynaecology and Obstetrics in Germany  

PubMed Central

Hospital managers and the heads of medical departments are nowadays being faced with ever increasing demands. It is becoming difficult for some small hospitals to find highly experienced or even experienced medical staff, to provide specific health-care services at break-even prices and to maintain their position in competition with other hospitals. On the other hand, large hospitals are facing enormous pressure in the investment and costs fields. Cooperation could provide a solution for these problems. For an optimal strategic exploitation of the hospitals, their direction could be placed in the hands of a joint medical director. However, the directorship of two hospitals is associated both with opportunities and with risks. The present article illustrates the widely differing aspects of the cooperation between a medical centre and a general hospital providing standard care from both a theoretical point of view and on the basis of practical experience with an actual cooperation of this type in Heidelberg. PMID:25308978

Schütz, F.; Maleika, A.; Poeschl, J.; Domschke, C.; Seitz, H.; Beuter-Winkler, P.; Sohn, C.

2012-01-01

72

The impact of a geriatric assessment unit on a psychiatric consultation service in a general hospital.  

PubMed

The opening of a geriatric assessment unit (GAU) in a large general hospital has affected the number of elderly patients referred for psychiatric consultation, the type of psychopathology seen, and the training provided for psychiatric residents and interns on the consultation-liaison service. To examine these changes, the six months prior to the opening of the GAU are compared to the six months immediately following its opening. The number of patients age 65 or older referred and diagnoses made by the consulting psychiatrists were studied. The opening of the GAU significantly increased the number of elderly patients referred for psychiatric consultation. It was found that the GAU offered unique advantages in the assessment and treatment of elderly patients with certain psychiatric problems, and the advantages and limitations of different facilities within the general hospital for the psychiatric assessment and treatment of elderly patients are discussed. A case is presented which illustrates the interplay between the consultation-liaison psychiatrist and the geriatric service in the management of an elderly patient referred for consultation. The experience of this hospital in providing psychogeriatric training for residents and interns on the psychiatric consultation service is reviewed. PMID:10279533

Swenson, J R; Perez, E L

1986-01-01

73

Laboratory to Clinical Investigation of Carbapenem Resistant Acinetobacter baumannii Outbreak in a General Hospital  

PubMed Central

Background: The number of reported cases, infected with carbepenem resistant Acinetobacter baumannii (CRAb) and multi-drug resistant (MDR) Acinetobacter species had gradually increased in most PLA general hospital wards from April to June in 2007. Objectives: We have described the investigation of an outbreak of CRAb and MDR Acinetobacter in PLA general hospital, Beijing. The prospective and retrospective findings were identified and analyzed to study the infection causes. Materials and Methods: A. baumannii samples were collected from the patients and environment in each hospital unit. The onset times were recorded according to their case information. All samples were characterized by genotype and compared using pulsed-field gel electrophoresis (PFGE). The microorganism susceptibility was tested using the in vitro minimal inhibitory concentration (MIC) breakpoints method. Results: A total of 69 A. baumannii strains were successfully isolated from 53 patients. About 89.1% of them were resistant to ampicillin and 89.2% to cefotaxime and 75.4% to all standard antibiotics. PFGE analysis revealed that nine of the isolates had unique clones and the epidemic clone types were A, B and C. Conclusions: The A. baumannii outbreak, was caused by MDR A. baumannii. The strains had widely spread among 12 departments especially in surgical intensive care unit (SICU), emergency intensive care unit (EICU) and the department of respiratory disease. The outbreak was more likely caused by the A. baumannii infected or carrier patients and EICU was its origin. PMID:25147648

Guo-xin, Mo; Dan-yang, She; Xi-zhou, Guan; Jun-chang, Cui; Rui, Wang; Zhi-gang, Cui; Liang-an, Chen

2014-01-01

74

Hospitalization of influenza-like illness patients recommended by general practitioners in France between 1997 and 2010  

E-print Network

Page 1 Hospitalization of influenza-like illness patients recommended by general practitioners-hospitalization ratio; emerging pathogens; influenza pandemics; surveillance, severity. Corresponding author (present.pelat@gmail.com inserm-00709172,version1-18Jun2012 Author manuscript, published in "Influenza and Other Respiratory

75

Vancouver Sun APEC 97 news archive  

NSDL National Science Digital Library

The Vancouver Sun provides a comprehensive news archive of the issues and events at APEC 97, the APEC Leaders and Ministers meeting held in Vancouver, Canada from November 21 to November 25, 1997. APEC is a grouping of 18 Asia-Pacific economies formed in 1989 to promote trade and cooperation in the region. Traditionally, the APEC meeting has focused on trade issues, but this year's focus was the economic crisis in Southeast Asia and South Korea.

76

Pathways to psychiatric care in urban north China: a general hospital based study  

PubMed Central

Background Pathway studies highlight the help-seeking behaviors of patients with physical and mental illnesses. A number of studies in this field have been completed in various parts of the world. The purpose of this study is to explore the characteristics of the help-seeking pathways of patients with mental illness from urban north China at Mental Health Professional (MHP). Methods The pathway diagrams, which accounted for more than five percent of patients, were documented for 441 subjects using the translated version of the World Health Organization (WHO) pathway encounter form. The patterns and durations of care-seeking were analyzed in different diagnostic groups. The ?2-test and the Mann-Whitney U test were employed, as needed. Results Respondents visited the MHP through a variety of pathways. Approximately three-quarters of the patients took an indirect pathway (74.8% vs 25.2%, ?2?=?108.8, p?general hospitals (56.4% vs 4.1%, ?2?=?138.3, p?general hospitals (24.8% vs 4.1%, ?2?=?40.96, p?hospitals. Of the patients who first contacted with psychiatry hospital, 55.6% received a professional diagnosis and finally reached the MHP because of the poor treatment or high-cost medical care. Conclusions The majority of patients seek other pathways than to go to MHP directly and this may be due to stigma, and/or lack of knowledge. The study gives emphasis on the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders in the community health centers, the general hospitals system and by private practitioners. The pathway described by this study may be helpful while preparing mental health programs in the future. PMID:24020825

2013-01-01

77

Patient Profile: Inuvik General Hospital and Four Regional Nursing Stations, NWT  

PubMed Central

A five year retrospective study of the inpatient caseload at Inuvik General Hospital (July 1, 1973—July 1, 1978) and the total caseload at four regional nursing stations (July 1, 1974—July 1, 1979) was undertaken. The 20 most common diagnoses and the 10 most common causes of medical evacuation for Fort Norman, Fort Franklin, Fort Good Hope and Norman Wells are presented. The 50 most common diagnoses in Inuvik are compared to figures for Alberta, 1975. Industrialization of the north causes an increase in the frequency and severity of physical trauma and in the amount of psychological morbidity treated by health professionals. PMID:21297849

Ross, Colin; Jensen, Brian

1980-01-01

78

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

Code of Federal Regulations, 2010 CFR

...Fireworks Display, Columbia River, Vancouver, Washington...All waters of the Columbia River at Vancouver, Washington bounded by a line...Bay); thence north across the river thru the preferred channel buoy...Authority. In addition to 33 U.S.C. 1231, the...

2010-07-01

79

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

Code of Federal Regulations, 2012 CFR

...Fireworks Display, Columbia River, Vancouver, Washington...All waters of the Columbia River at Vancouver, Washington bounded by a line...Bay); thence north across the river thru the preferred channel buoy...Authority. In addition to 33 U.S.C. 1231, the...

2012-07-01

80

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

Code of Federal Regulations, 2013 CFR

...Fireworks Display, Columbia River, Vancouver, Washington...All waters of the Columbia River at Vancouver, Washington bounded by a line...Bay); thence north across the river thru the preferred channel buoy...Authority. In addition to 33 U.S.C. 1231, the...

2013-07-01

81

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

Code of Federal Regulations, 2011 CFR

...Fireworks Display, Columbia River, Vancouver, Washington...All waters of the Columbia River at Vancouver, Washington bounded by a line...Bay); thence north across the river thru the preferred channel buoy...Authority. In addition to 33 U.S.C. 1231, the...

2011-07-01

82

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

Code of Federal Regulations, 2014 CFR

...Fireworks Display, Columbia River, Vancouver, Washington...All waters of the Columbia River at Vancouver, Washington bounded by a line...Bay); thence north across the river thru the preferred channel buoy...Authority. In addition to 33 U.S.C. 1231, the...

2014-07-01

83

Referrals from general practice to hospital outpatient departments: a strategy for improvement.  

PubMed Central

OBJECTIVE--To determine the appropriateness of referrals from general practice to hospital outpatient departments. DESIGN--Prospective audit of referrals from a group practice over one year. SETTING--Six handed practice in a southern coastal town. SUBJECTS--All patients referred during the study period for whom a copy of the referral letter was available. MAIN OUTCOME MEASURES--The investigations carried out by the consultant that led to the diagnosis; the diagnosis reached; and the management. RESULTS--Of roughly 3000 patients referred during the year, 277 with various skin and soft tissue disorders could probably have been managed solely by the general practitioner. Referrals for cryotherapy (96 in this series) and diabetes (19) could probably also have been avoided by specialist training of the general practitioner. In addition, in cases of haematuria and prostatic hypertrophy (34 and 22 referrals) substantial time could have been saved for both the patient and the consultant had the general practitioner supplied the results of relevant investigations. Probably the most important outcome was the model that the study offered for other general practitioners to improve the appropriateness of referrals. CONCLUSION--This approach to determining the appropriateness of referrals benefits the general practitioners, the consultant, and the patient. PMID:2508890

Emmanuel, J.; Walter, N.

1989-01-01

84

Principal components and generalized linear modeling in the correlation between hospital admissions and air pollution  

PubMed Central

OBJECTIVE To analyze the association between concentrations of air pollutants and admissions for respiratory causes in children. METHODS Ecological time series study. Daily figures for hospital admissions of children aged < 6, and daily concentrations of air pollutants (PM10, SO2, NO2, O3 and CO) were analyzed in the Região da Grande Vitória, ES, Southeastern Brazil, from January 2005 to December 2010. For statistical analysis, two techniques were combined: Poisson regression with generalized additive models and principal model component analysis. Those analysis techniques complemented each other and provided more significant estimates in the estimation of relative risk. The models were adjusted for temporal trend, seasonality, day of the week, meteorological factors and autocorrelation. In the final adjustment of the model, it was necessary to include models of the Autoregressive Moving Average Models (p, q) type in the residuals in order to eliminate the autocorrelation structures present in the components. RESULTS For every 10:49 ?g/m3 increase (interquartile range) in levels of the pollutant PM10 there was a 3.0% increase in the relative risk estimated using the generalized additive model analysis of main components-seasonal autoregressive – while in the usual generalized additive model, the estimate was 2.0%. CONCLUSIONS Compared to the usual generalized additive model, in general, the proposed aspect of generalized additive model ? principal component analysis, showed better results in estimating relative risk and quality of fit. PMID:25119940

de Souza, Juliana Bottoni; Reisen, Valdério Anselmo; Santos, Jane Méri; Franco, Glaura Conceição

2014-01-01

85

[Pediatric intermediate care unit in general hospital: recent survey in French Polynesia].  

PubMed

In 2006, decrees relating to pediatric critical care defined the main rules of pediatric intermediate care units (PIMU). These units ensure continuous monitoring of children at risk of critical deterioration without requiring invasive support. In French Polynesia, a PIMU has been integrated into the general pediatric ward since the new hospital opened in November 2010. We conducted a prospective observational study of patients admitted to the PIMU depending on whether they were surgical patients or were secondarily transferred to the ICU or were transferred via long-distance medical air transport for specialized care. For the very first operational year, 199 children (median age, 3 years old) were admitted to the PIMU: for the most part respiratory (31.7%) and neurologic (23.6%) failures were involved. Surgical patients more often required a prosthesis or treatments associated with serious adverse effects than nonsurgical patients (respectively, 46% vs. 16%, P<0.01; 29% vs. 7%, P<0.01) and the length of the hospital stay was longer (5 days vs. 2, P<0.01). Patients who were secondarily transferred to the ICU had a higher admission Pediatric RISk of Mortality (PRISM) score (6 vs. 4, P<0.01) and required more treatments associated with serious adverse effects (50% vs. 20%, P<0.01) than nontransferred patients. The length of the hospital stay was longer (6days) for patients who underwent long-distance medical transport. In addition to PIMU defining criteria, the use of treatments associated with serious adverse effects should be considered risk factors of impaired prognosis in local practical procedures. Assessment of PIMU activity should take into account that intensive surgical care and geographical isolation are closely related to increased length of hospital stay. PMID:24503456

Gatti, H; Dauger, S; Sommet, J; Chenel, C; Naudin, J

2014-03-01

86

1. GENERAL VIEW OF PAIRED INTERSTATE BRIDGES FROM NORTH SHORE ...  

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

1. GENERAL VIEW OF PAIRED INTERSTATE BRIDGES FROM NORTH SHORE OF THE COLUMBIA RIVER LOOKING WEST - Vancouver-Portland Interstate Bridge, Interstate Route 5 Spanning Columbia River, Vancouver, Clark County, WA

87

Psychiatric Nurse Reports on the Quality of Psychiatric Care in General Hospitals  

PubMed Central

Although acute inpatient psychiatric care has changed dramatically over the past 2 decades, little is known about how these changes have affected the quality of care, psychiatric nurse staffing, or patient outcomes. The purpose of this report is to explore the quality of care, quality of the practice environment, and adverse events as assessed by psychiatric nurses in the general hospital setting. The study sample consisted of 456 registered nurses permanently assigned to psychiatric units, compared with a larger sample of 11 071 registered nurses who work permanently on medical, surgical, or medical-surgical units. Compared with nonpsychiatric nurses, psychiatric nurse characteristics reveal an older, more experienced workforce, with a higher proportion of male nurses. Nurses rated quality of patient care lower in the psychiatric specialty than in the medical-surgical specialty. Furthermore, psychiatric nurses reported significant concern about the readiness of patients for discharge and higher incidence of adverse events. They also experienced more verbal abuse, physical injuries, and complaints from patients and families. Collectively, the results from this study underscore the organizational problems and quality-of-care issues that cause psychiatric nurses in general hospital settings to evaluate their work environments negatively. PMID:18641503

Aiken, Linda H.

2008-01-01

88

77 FR 38004 - Drawbridge Operation Regulation; Columbia River, Vancouver, WA  

Federal Register 2010, 2011, 2012, 2013, 2014

...USCG-2012-0581] Drawbridge Operation Regulation; Columbia River, Vancouver, WA AGENCY: Coast Guard, DHS. ACTION: Notice of temporary...Columbia River, mile 106.5, between Portland, Oregon and Vancouver, Washington. This deviation is necessary to facilitate...

2012-06-26

89

77 FR 24146 - Drawbridge Operation Regulation; Columbia River, Vancouver, WA  

Federal Register 2010, 2011, 2012, 2013, 2014

...USCG-2012-0311] Drawbridge Operation Regulation; Columbia River, Vancouver, WA AGENCY: Coast Guard, DHS. ACTION: Notice of temporary...Railway Bridge across the Columbia River, mile 105.6, at Vancouver, WA. This deviation is necessary to accommodate...

2012-04-23

90

78 FR 23487 - Drawbridge Operation Regulation; Columbia River, Vancouver, WA  

Federal Register 2010, 2011, 2012, 2013, 2014

...USCG-2013-0253] Drawbridge Operation Regulation; Columbia River, Vancouver, WA AGENCY: Coast Guard, DHS. ACTION: Notice of deviation...Columbia River, mile 106.5, between Portland, Oregon and Vancouver, Washington. This deviation is necessary to facilitate...

2013-04-19

91

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

SciTech Connect

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.

Voudrias, Evangelos, E-mail: voudrias@env.duth.gr [Department of Environmental Engineering, Democritus University of Thrace, GR-671 00 Xanthi (Greece); Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini [Department of Environmental Engineering, Democritus University of Thrace, GR-671 00 Xanthi (Greece)

2012-07-15

92

FOLFIRINOX in Locally Advanced Pancreatic Cancer: The Massachusetts General Hospital Cancer Center Experience  

PubMed Central

The objective of our retrospective institutional experience is to report the overall response rate, R0 resection rate, progression-free survival, and safety/toxicity of neoadjuvant FOLFIRINOX (5-fluorouracil [5-FU], oxaliplatin, irinotecan, and leucovorin) and chemoradiation in patients with locally advanced pancreatic cancer (LAPC). Patients with LAPC treated with FOLFIRINOX were identified via the Massachusetts General Hospital Cancer Center pharmacy database. Demographic information, clinical characteristics, and safety/tolerability data were compiled. Formal radiographic review was performed to determine overall response rates (ORRs). Twenty-two patients with LAPC began treatment with FOLFIRINOX between July 2010 and February 2012. The ORR was 27.3%, and the median progression-free survival was 11.7 months. Five of 22 patients were able to undergo R0 resections following neoadjuvant FOLFIRINOX and chemoradiation. Three of the five patients have experienced distant recurrence within 5 months. Thirty-two percent of patients required at least one emergency department visit or hospitalization while being treated with FOLFIRINOX. FOLFIRINOX possesses substantial activity in patients with LAPC. The use of FOLFIRINOX was associated with conversion to resectability in >20% of patients. However, the recurrences following R0 resection in three of five patients and the toxicities observed with the use of this regimen raise important questions about how to best treat patients with LAPC. PMID:23657686

Blaszkowsky, Lawrence S.; McDermott, Shaunagh; Guimaraes, Alexander R.; Szymonifka, Jackie; Huynh, Mai Anh; Ferrone, Cristina R.; Wargo, Jennifer A.; Allen, Jill N.; Dias, Lauren E.; Kwak, Eunice L.; Lillemoe, Keith D.; Thayer, Sarah P.; Murphy, Janet E.; Zhu, Andrew X.; Sahani, Dushyant V.; Wo, Jennifer Y.; Clark, Jeffrey W.; Fernandez-del Castillo, Carlos; Ryan, David P.; Hong, Theodore S.

2013-01-01

93

The occurrence of Enterobacteriaceae producing KPC carbapenemases in a general hospital in Curacao  

PubMed Central

Background Although the presence of Carbapenemase-producing Enterobacteriaceae (CPE) are extensively documented in North and South America. CPE have not been reported from Curacao. However, recently intercontinental spread was suggested of a KPC carbapenemase producing Klebsiella pneumoniae in a patient in the United Kingdom with previous admission to a hospital in Curacao in 2009. Findings After the introduction of the CLSI 2010 revised breakpoints, seven patients with carbapenemase-producing Enterobacteriaceae were found in a general hospital in Curacao over a period of 16 months. Four patients carried KPC-2 positive Klebsiella pneumoniae, ST11. Two patients carried KPC-3 positive Klebsiella pneumoniae ST258 and one patient carried a KPC-3 positive Citrobacter freundii. Furthermore, our Klebsiella pneumoniae KPC-2 ST11 strain was matched to the Klebsiella pneumoniae KPC-2 ST11 strain in the United Kingdom. Conclusions Introduction of new laboratory methods, and adoption of new guidelines and breakpoints led to the first detection of CPE in Curacao. By matching our Klebsiella pneumoniae KPC-2 ST11 strain to a Klebsiella pneumoniae KPC-2 ST11 strain in the United Kingdom, we suggest that carbapenemase-producing Enterobacteriaceae are probably more prevalent in Curacao than previously recognized. PMID:25132965

2014-01-01

94

Medical Patients’ Treatment Decision Making Capacity: A Report from a General Hospital in Greece  

PubMed Central

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

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

2014-01-01

95

78 FR 15293 - Drawbridge Operation Regulations; Columbia River, Vancouver, WA  

Federal Register 2010, 2011, 2012, 2013, 2014

...Operation Regulations; Columbia River, Vancouver, WA AGENCY: Coast Guard, DHS. ACTION...the Columbia River, mile 105.6, at Vancouver, WA. This deviation is necessary to...Railway Bridge across the Columbia River at Vancouver, WA will be disabled and the...

2013-03-11

96

33 CFR 165.1308 - Columbia River, Vancouver, WA.  

Code of Federal Regulations, 2014 CFR

...2014-07-01 false Columbia River, Vancouver, WA. 165.1308 Section 165.1308...District § 165.1308 Columbia River, Vancouver, WA. (a) Location. The following...All waters of the Columbia River at Vancouver, Washington, bounded by a line commencing at the...

2014-07-01

97

33 CFR 165.1308 - Columbia River, Vancouver, WA.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 false Columbia River, Vancouver, WA. 165.1308 Section 165.1308...District § 165.1308 Columbia River, Vancouver, WA. (a) Location. The following...All waters of the Columbia River at Vancouver, Washington, bounded by a line commencing at the...

2010-07-01

98

33 CFR 165.1308 - Columbia River, Vancouver, WA.  

Code of Federal Regulations, 2011 CFR

...2011-07-01 false Columbia River, Vancouver, WA. 165.1308 Section 165.1308...District § 165.1308 Columbia River, Vancouver, WA. (a) Location. The following...All waters of the Columbia River at Vancouver, Washington, bounded by a line commencing at the...

2011-07-01

99

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

PubMed

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

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

2012-01-01

100

Predator discrimination and 'personality' in captive Vancouver Island marmots (Marmota vancouverensis)  

Microsoft Academic Search

A major impediment to recovering declining populations successfully is the mortality of reintroduced or translocated animals. We generally assume that captive-born animals may lose their antipredator behaviour abilities in captivity, but studies rarely compare predator recognition abilities of captive-born and wild- captured animals to test this. To identify whether predator discrimination abilities of the critically endangered Vancouver Island marmots Marmota

D. T. Blumstein; B.-D. Holland; J. C. Daniel

2006-01-01

101

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

Code of Federal Regulations, 2013 CFR

...MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico...prospective payment system for inpatient hospital capital-related...

2013-10-01

102

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

Code of Federal Regulations, 2012 CFR

...MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico...prospective payment system for inpatient hospital capital-related...

2012-10-01

103

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

Code of Federal Regulations, 2011 CFR

...MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE...Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico...prospective payment system for inpatient hospital capital-related...

2011-10-01

104

Contributing factors to influenza vaccine uptake in general hospitals: an explorative management questionnaire study from the Netherlands  

PubMed Central

Background The influenza vaccination rate in hospitals among health care workers in Europe remains low. As there is a lack of research about management factors we assessed factors reported by administrators of general hospitals that are associated with the influenza vaccine uptake among health care workers. Methods All 81 general hospitals in the Netherlands were approached to participate in a self-administered questionnaire study. The questionnaire was directed at the hospital administrators. The following factors were addressed: beliefs about the effectiveness of the influenza vaccine, whether the hospital had a written policy on influenza vaccination and how the hospital informed their staff about influenza vaccination. The questionnaire also included questions about mandatory vaccination, whether it was free of charge and how delivered as well as the vaccination campaign costs. The outcome of this one-season survey is the self-reported overall influenza vaccination rate of health care workers. Results In all, 79 of 81 hospitals that were approached were willing to participate and therefore received a questionnaire. Of these, 42 were returned (response rate 52%). Overall influenza vaccination rate among health care workers in our sample was 17.7% (95% confidence interval: 14.6% to 20.8%). Hospitals in which the administrators agreed with positive statements concerning the influenza vaccination had a slightly higher, but non-significant, vaccine uptake. There was a 9% higher vaccine uptake in hospitals that spent more than €1250,- on the vaccination campaign (24.0% versus 15.0%; 95% confidence interval from 0.7% to 17.3%). Conclusions Agreement with positive statements about management factors with regard to influenza vaccination were not associated with the uptake. More economic investments were related with a higher vaccine uptake; the reasons for this should be explored further. PMID:23259743

2012-01-01

105

Perceptions of Organizational Justice Among Nurses Working in University Hospitals of Shiraz: A Comparison Between General and Specialty Settings  

PubMed Central

Background: Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. Objectives: The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. Materials and Methods: In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards. Results: Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards. Conclusions: Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions. PMID:25414883

Hatam, Nahid; Fardid, Mozhgan; Kavosi, Zahra

2013-01-01

106

The Treatment of Anorexia Nervosa in a General Hospital: A Case Vignette of a Multi-Disciplinary General Hospital-Based Approach.  

ERIC Educational Resources Information Center

Describes anorexia nervosa as condition variable in etiology and resistant to treatment, which may lead to mortality in 5% of treated cases. Notes that efforts have been made for treating disorder in nonstigmatizing medical units outside psychiatric hospitals. Describes, through presentation of short case vignette, advantages of treating…

Kronenberg, J.; And Others

1994-01-01

107

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...

108

The Vancouver Obsessional Compulsive Inventory (VOCI)  

Microsoft Academic Search

The original Maudsley Obsessional Compulsive Inventory (MOCI) has been widely used and is considered to be one of the best available self-report instruments for measuring observable obsessive–compulsive problems such as washing and checking. However, it has several limitations and requires updating. Our revision of the MOCI, the Vancouver Obsessional Compulsive Inventory (VOCI), was designed to provide assessment of a range

Dana S. Thordarson; Adam S. Radomsky; S. Rachman; Roz Shafran; Craig N. Sawchuk; A. Ralph Hakstian

2004-01-01

109

Emergency Communications Plan Vancouver Point Grey Campus  

E-print Network

Emergency Communications Plan Vancouver Point Grey Campus June 3, 2013 UBC Public Affairs Risk Management Services #12;Emergency Communications Plan Page 2 Emergency Communications Plan 1. Introduction The Emergency Communications Plan (ECP) is intended to outline guidelines for quickly communicating with UBC

Michelson, David G.

110

Physical comorbidity and its relevance on mortality in schizophrenia: a naturalistic 12-year follow-up in general hospital admissions.  

PubMed

Schizophrenia is a major psychotic disorder with significant comorbidity and mortality. Patients with schizophrenia are said to suffer more type-2 diabetes mellitus (T2DM) and diabetogenic complications. However, there is little consistent evidence that comorbidity with physical diseases leads to excess mortality in schizophrenic patients. Consequently, we investigated whether the burden of physical comorbidity and its relevance on hospital mortality differed between patients with and without schizophrenia in a 12-year follow-up in general hospital admissions. During 1 January 2000 and 31 June 2012, 1418 adult patients with schizophrenia were admitted to three General Manchester NHS Hospitals. All comorbid diseases with a prevalemce ?1% were compared with those of 14,180 age- and gender-matched hospital controls. Risk factors, i.e. comorbid diseases that were predictors for general hospital mortality were identified using multivariate logistic regression analyses. Compared with controls, schizophrenic patients had a higher proportion of emergency admissions (69.8 vs. 43.0%), an extended average length of stay at index hospitalization (8.1 vs. 3.4 days), a higher number of hospital admissions (11.5 vs. 6.3), a shorter length of survival (1895 vs. 2161 days), and a nearly twofold increased mortality rate (18.0 vs. 9.7%). Schizophrenic patients suffered more depression, T2DM, alcohol abuse, asthma, COPD, and twenty-three more diseases, many of them diabetic-related complications or other environmentally influenced conditions. In contrast, hypertension, cataract, angina, and hyperlipidaemia were less prevalent in the schizophrenia population compared to the control population. In deceased schizophrenic patients, T2DM was the most frequently recorded comorbidity, contributing to 31.4% of hospital deaths (only 14.4% of schizophrenic patients with comorbid T2DM survived the study period). Further predictors of general hospital mortality in schizophrenia were found to be alcoholic liver disease (OR = 10.3), parkinsonism (OR = 5.0), T1DM (OR = 3.8), non-specific renal failure (OR = 3.5), ischaemic stroke (OR = 3.3), pneumonia (OR = 3.0), iron-deficiency anaemia (OR = 2.8), COPD (OR = 2.8), and bronchitis (OR = 2.6). There were no significant differences in their impact on hospital mortality compared to control subjects with the same diseases except parkinsonism which was associated with higher mortality in the schizophrenia population compared with the control population. The prevalence of parkinsonism was significantly elevated in the 255 deceased schizophrenic patients (5.5 %) than in those 1,163 surviving the study period (0.8 %, OR = 5.0) and deceased schizophrenic patients had significantly more suffered extrapyramidal symptoms than deceased control subjects (5.5 vs. 1.5 %). Therefore patients with schizophrenia have a higher burden of physical comorbidity that is associated with a worse outcome in a 12-year follow-up of mortality in general hospitals compared with hospital controls. However, schizophrenic patients die of the same physical diseases as their peers without schizophrenia. The most relevant physical risk factors of general hospital mortality are T2DM, COPD and infectious respiratory complications, iron-deficiency anaemia, T1DM, unspecific renal failure, ischaemic stroke, and alcoholic liver disease. Additionally, parkinsonism is a major risk factor for general hospital mortality in schizophrenia. Thus, optimal monitoring and management of acute T2DM and COPD with its infectious respiratory complications, as well as the accurate detection and management of iron-deficiency anaemia, of diabetic-related long-term micro- and macrovascular complications, of alcoholic liver disease, and of extrapyramidal symptoms are of utmost relevance in schizophrenia. PMID:23942824

Schoepf, Dieter; Uppal, Hardeep; Potluri, Rahul; Heun, Reinhard

2014-02-01

111

Nurses' experiences of caring for South Asian minority ethnic patients in a general hospital in England.  

PubMed

Healthcare provision for minority ethnic groups in the UK has generally revealed inequalities in access and differential service provision. British healthcare policy has started to address such issues. However, very few studies have specifically examined the experiences of nurses caring for minority ethnic patients. This paper focuses on the focus group interviews of a broader ethnographic study, aimed at describing nurses' experiences of caring for South Asian minority ethnic patients, in a general hospital in the south of England. A sample of 43 nurses of all grades from six medical wards took part in the focus groups: three ward sisters, 22 staff nurses and 18 care assistants; 40 participants were white, one was African-Caribbean and two were South Asian. Data analysis revealed eight themes: changes in service provision; false consciousness of equity; limited cultural knowledge; victim blaming; valuing of the relatives; denial of racism; ethnocentrism, and self-disclosure. The study revealed a good local service response to government policies in addressing inequality. However, there was a tendency to treat all minority ethnic patients the same, with evidence of ethnocentric practices, victim-blaming approaches and poor cultural competence in nursing staff, which raise questions about the quality of service provision. The study indicates that ongoing training and development in the area of cultural competence is necessary. PMID:16494664

Vydelingum, Vasso

2006-03-01

112

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

PubMed Central

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

2010-01-01

113

Water and nutrient budgets for Vancouver Lake, Vancouver, Washington, October 2010-October 2012  

USGS Publications Warehouse

Vancouver Lake, a large shallow lake in Clark County, near Vancouver, Washington, has been undergoing water-quality problems for decades. Recently, the biggest concern for the lake are the almost annual harmful cyanobacteria blooms that cause the lake to close for recreation for several weeks each summer. Despite decades of interest in improving the water quality of the lake, fundamental information on the timing and amount of water and nutrients entering and exiting the lake is lacking. In 2010, the U.S. Geological Survey conducted a 2-year field study to quantify water flows and nutrient loads in order to develop water and nutrient budgets for the lake. This report presents monthly and annual water and nutrient budgets from October 2010–October 2012 to identify major sources and sinks of nutrients. Lake River, a tidally influenced tributary to the lake, flows into and out of the lake almost daily and composed the greatest proportion of both the water and nutrient budgets for the lake, often at orders of magnitude greater than any other source. From the water budget, we identified precipitation, evaporation and groundwater inflow as minor components of the lake hydrologic cycle, each contributing 1 percent or less to the total water budget. Nutrient budgets were compiled monthly and annually for total nitrogen, total phosphorus, and orthophosphate; and, nitrogen loads were generally an order of magnitude greater than phosphorus loads across all sources. For total nitrogen, flow from Lake River at Felida, Washington, made up 88 percent of all inputs into the lake. For total phosphorus and orthophosphate, Lake River at Felida flowing into the lake was 91 and 76 percent of total inputs, respectively. Nutrient loads from precipitation and groundwater inflow were 1 percent or less of the total budgets. Nutrient inputs from Burnt Bridge Creek and Flushing Channel composed 12 percent of the total nitrogen budget, 8 percent of the total phosphorus budget, and 21 percent of the orthophosphate budget. We identified several data gaps and areas for future research, which include the need for better understanding nutrient inputs to the lake from sediment resuspension and better quantification of indirect nutrient inputs to the lake from Salmon Creek.

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

2014-01-01

114

Information provision after mild traumatic brain injury (MTBI): a survey of general practitioners and hospitals in New Zealand  

Microsoft Academic Search

Aims To determine the nature, extent, and quality of information provided by general practitioners (GPs) and hospital emergency departments to people after mild traumatic brain injury (MTBI). Method A survey was distributed throughout New Zealand to a representative sample of GPs and emergency departments (EDs). Results 244 valid surveys were returned, (229 from GPs and 15 from EDs), giving a

Catherine Moore; Janet Leathem

115

Charnley low-friction arthroplasty of the hip. Five to 25 years survivorship in a general hospital  

Microsoft Academic Search

BACKGROUND: Some studies have raised the question about whether the good results obtained with the Charnley prosthesis could be replicated at general hospitals when it comes to the frequency of early complications and failure rates, both of which would be higher than those published by centres devoted to hip arthroplasties. METHODS: We reviewed the results of 404 Low Friction Arthroplasties

Daniel Hernández-Vaquero; Abelardo Suárez-Vazquez; Jesus Fernandez-Lombardia

2008-01-01

116

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

ERIC Educational Resources Information Center

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…

Lewis, Sharna; Stenfert-Kroese, Biza

2010-01-01

117

Seroprevalence of Toxoplasma gondii infection and characteristics of seropositive patients in general hospitals in Daejeon, Korea.  

PubMed

To figure out the epidemiological status and relevance with other diseases in toxoplasmosis, we checked serum IgG antibody titers of 1,265 patients and medical records of seropositive patients. Seropositive rates were 6.6% by latex agglutination test (LAT) and 6.7% by ELISA. No significant differences were detected between sexes and age groups. The peak seroprevalence was detected in the 40-49-year-old age group. According to clinical department, Toxoplasma-positive rates were high in patients in psychiatry, ophthalmology, health management, emergency medicine, and thoracic surgery. Major coincidental diseases in seropositive cases were malignant neoplasms, diabetes mellitus, arthritis, chronic hepatitis B, chronic renal diseases, schizophrenia, and acute lymphadenitis, in the order of frequency. In particular, some patients with chronic hepatitis B and malignant neoplasms had high antibody titers. These results revealed that the seroprevalence of toxoplasmosis in a general hospital-based study was similar to that in a community-based study, and T. gondii seropositivity may be associated with neoplasms, diabetes, and other chronic infections. PMID:19488418

Shin, Dae-Whan; Cha, Dong-Yeub; Hua, Quan Juan; Cha, Guang-Ho; Lee, Young-Ha

2009-06-01

118

Incidence and review of sessile serrated polyp reporting in a district general hospital in the UK.  

PubMed

The aim of this 4-year audit was to establish whether sessile serrated polyps/adenomas (SSP/A) were diagnosed in a district general hospital in the UK. The study also explored whether SSP/A in the right colon were misdiagnosed as hyperplastic polyps. A retrospective search of the computer records from 2009 to 2012 inclusive for all lesions diagnosed and coded as SSP/A and/or hyperplastic polyps proximal to the splenic flexure was undertaken. All slides were reviewed and a diagnosis of SSP/A made using the criteria recently suggested by the American College of Gastroenterology. Over the study period, no cases of SSP/A were made. On review of all hyperplastic polyps proximal to the splenic flexure, 13/31 in 2009, 17/40 in 2010, 19/48 in 2011 and 16/48 in 2012 were re-classified as SSP/A. The most likely reason for the under-diagnosis of SSP/A is lack of awareness of the lesion both clinically and by pathologists. Adequate biopsies and deeper sections are important to help make the diagnosis of SSP/A. This study shows that SSP/A are reasonably frequently encountered in non-specialist practice settings and that both clinicians and pathologist in this setting need to be aware of its existence. PMID:23982168

Dada, Mahomed; Wang, Lai Mun; Chetty, Runjan

2013-11-01

119

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

PubMed Central

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

2014-01-01

120

Library Services to Hospital Patients and Handicapped Readers Section. Libraries Serving the General Public Division. Papers.  

ERIC Educational Resources Information Center

Papers on library services to hospital personnel, hospital patients, and housebound or handicapped persons, which were presented at the 1983 International Federation of Library Associations (IFLA) conference, include: (1) "Education and Training for Health Care Librarianship," in which Antonia J. Bunch (United Kingdom) discusses the scope of and…

International Federation of Library Associations, The Hague (Netherlands).

121

Impact of a restorative dentistry service on the prescription of apical surgery in a district general hospital.  

PubMed Central

The case records of a group of patients who had undergone periapical surgery in a district general hospital were examined and compared with the criteria agreed by a group of hospital restorative dentists as to whether apical surgery was appropriate rather than, at least initially, a non-surgical treatment option. Only 65% of the patients met the audit criteria. As a result, changes have been made to clinical practice, including a greater involvement of restorative clinicians in the decision-making process when apical surgery is under consideration. PMID:8712654

Beckett, H.

1996-01-01

122

Anxiety disorders and physical comorbidity: increased prevalence but reduced relevance of specific risk factors for hospital-based mortality during a 12.5-year observation period in general hospital admissions.  

PubMed

Anxiety disorders (AD) are associated with an increase in physical comorbidities, but the effects of these diseases on hospital-based mortality are unclear. Consequently, we investigated whether the burden of physical comorbidity and its relevance on hospital-based mortality differed between individuals with and without AD during a 12.5-year observation period in general hospital admissions. During 1 January 2000 and 30 June 2012, 11,481 AD individuals were admitted to seven General Manchester Hospitals. All comorbidities with a prevalence ?1 % were compared with those of 114,810 randomly selected and group-matched hospital controls of the same age and gender, regardless of priority of diagnoses or specialized treatments. Comorbidities that increased the risk of hospital-based mortality (but not mortality outside of the hospital) were identified using multivariate logistic regression analyses. AD individuals compared to controls had a substantial excess comorbidity, but a reduced hospital-based mortality rate. Twenty-two physical comorbidities were increased in AD individuals compared with controls, which included cardiovascular diseases and their risk factors. The most frequent physical comorbidities in AD individuals were hypertension, asthma, cataract, and ischaemic heart disease. Risk factors for hospital-based mortality in AD individuals were lung cancer, alcoholic liver disease, respiratory failure, heart failure, pneumonia, bronchitis, non-specific dementia, breast cancer, COPD, gallbladder calculus, atrial fibrillation, and angina. The impact of atrial fibrillation, angina, and gallbladder calculus on hospital-based mortality was higher in AD individuals than in controls. In contrast, other mortality risk factors had an equal or lower impact on hospital-based mortality in sample comparisons. Therefore AD individuals have a higher burden of physical comorbidity that is associated with a reduced risk of general hospital-based mortality. Atrial fibrillation, angina, and gallbladder calculus are major risk factors for general hospital-based mortality in AD individuals. PMID:25472881

Schoepf, Dieter; Heun, Reinhard

2014-12-01

123

A cure for the soul? The benefit of live music in the general hospital.  

PubMed

From 2005 to 2006 a professional orchestra (the Irish Chamber Orchestra) performed in a university teaching hospital with the aims of bringing live music to patients who could not access traditional concert venues and of improving quality of life for patients and staff. This was the first time an orchestra was resident in a hospital in the Republic of Ireland. An independent contemporaneous evaluation was carried out to assess the benefit of live music for patients. Live music in hospital was found to enhance the quality of the aesthetic environment of the hospital, with both patients and staff stating that listening to live music helped them to relax, feel happier and more positive. Patients' perception of the hospital was affected positively by live music in waiting areas. Music was found to have strong emotional effect and the individual preferences and experiences of patients need to be carefully taken into account when programming music in hospital. Listening to live music while in hospital has positive benefits with few negative effects. PMID:18277736

Moss, H; Nolan, E; O'Neill, D

2007-01-01

124

Characteristics of patients with shingles admitted to a district general hospital.  

PubMed Central

Little is known about why some patients with shingles are admitted to hospital. We reviewed 72 case notes from a list of 80 patients admitted to hospital with shingles over a six-year period. Pain was the main complaint of the patients admitted, most of whom were elderly and lived alone. The commonest site of involvement in hospital admissions was the eye (herpes zoster ophthalmicus). Diagnosis of shingles was made after admission in 12 patients, eight of whom had originally been diagnosed as having an acute medical or surgical condition. We conclude that the prodromal phase of shingles may lead to misdiagnosis. Images Figure 1 Figure 2 PMID:9616491

Morgan, R.; King, D.

1998-01-01

125

77 FR 10618 - Eric Temple-Control Exemption-Portland Vancouver Junction Railroad, LLC  

Federal Register 2010, 2011, 2012, 2013, 2014

...Temple--Control Exemption--Portland Vancouver Junction Railroad, LLC Eric Temple...to acquire direct control of Portland Vancouver Junction Railroad, LLC (PVJR), a...Cent. Wash. R.R. and Portland Vancouver Junction R.R.--Corporate...

2012-02-22

126

Factors influencing integration of TB services in general hospitals in two regions of China: a qualitative study  

PubMed Central

Background In the majority of China, the Centre for Disease Control (CDC) at the county level provides both clinical and public health care for TB cases, with hospitals and other health facilities referring suspected TB cases to the CDC. In recent years, an integrated model has emerged, where the CDC remains the basic management unit for TB control, while a general hospital is designated to provide clinical care for TB patients. This study aims to explore the factors that influence the integration of TB services in general hospitals and generate knowledge to aid the scale-up of integration of TB services in China. Methods This study adopted a qualitative approach using interviews from sites in East and West China. Analysis was conducted using a thematic framework approach. Results The more prosperous site in East China was more coordinated and thus had a better method of resource allocation and more patient-orientated service, compared with the poorer site in the West. The development of public health organizations appeared to influence how effectively integration occurred. An understanding from staff that hospitals had better capacity to treat TB patients than CDCs was a strong rationale for integration. However, the economic and political interests might act as a barrier to effective integration. Both sites shared the same challenges of attracting and retaining a skilled workforce for the TB services. The role of the health bureau was more directive in the Western site, while a more participatory and collaborative approach was adopted in the Eastern site. Conclusion The process of integration identifies similarities and differences between sites in more affluent East China and poorer West China. Integration of TB services in the hospitals needs to address the challenges of stakeholder motivations and resource allocation. Effective inter-organizational collaboration could help to improve the efficiency and quality of TB service. Key words: TB control, service delivery, integration, hospitals, China. PMID:22276746

2012-01-01

127

Contact: James Fotheringham , Sheffield Kidney Institute, Northern General Hospital, UK -james.fotheringham@nhs.net Assessing the Cost of Parathyroidectomy as a Treatment for  

E-print Network

Contact: James Fotheringham , Sheffield Kidney Institute, Northern General Hospital, UK - james in Stage 5 Chronic Kidney Disease Fotheringham J1, Duenas A2, Rawdin A2, Wilkie M1, Harrison B3, Akehurst R2 1 Sheffield Kidney Institute, Northern General Hospital, UK; 2 ScHARR, University of Sheffield, UK

Oakley, Jeremy

128

VANCOUVER BOARD OF TRADE Go Global with UBC  

E-print Network

Business Partner September 15, 2010--Hyatt Regency Hotel [conversational ...] Thanks, Lindsay [Gordon, HSBC partly prepared him for--was sustainability. Economic, quickly #12;Vancouver Board of Trade Annual

Michelson, David G.

129

[General aspects and number of phases of the medication system in four brazilian hospitals].  

PubMed

This study identified and analyzed the medication systems in 04 university hospitals located in Recife, Ribeirão Preto, Goiânia and São Paulo, Brazil, after approval by the Research Ethics Committee and authorization by the hospital directors. Data were collected through a structured interview with one of the professionals in charge of the medication system and non-participant and direct observation during one week. The results indicated the points requiring improvement, such as the use of abbreviations, lack of standardization in medication administration times, lack of updated and complete information about the patient, the pharmacy's not working 24 hours a day in hospitals and others. 66 phases were shown in Hospital A, 58 in B, 70 in C, and 80 in D concerning the medication system. Simplifying the processes by reducing the number of phases is the key to reducing medication errors. PMID:15717078

Cassiani, Silvia Helena de Bortoli; Miasso, Adriana Inocenti; Silva, Ana Elisa Bauer de Camargo; Fakin, Flávio Trevisan; Oliveira, Regina Célia de

2004-01-01

130

The impact of a new regional air ambulance service on a large general hospital  

PubMed Central

Background Helicopter air ambulance crews are influenced in their selection of the destination hospital for their patients by several factors including: distance from the scene; facilities, on site specialties, and senior cover of the receiving hospital; and the proximity of the helicopter landing area to the emergency department (ED). Only a limited number of hospitals have landing sites adjacent to the ED from which patients can be taken directly into the department (primary landing sites). Helicopter crews will often elect to over fly hospitals that do not have primary landing sites because secondary land transfers will add delays in delivering patients. Birmingham Heartlands Hospital has an elevated helideck adjacent to the ED. In October 2003, the Warwickshire and Northamptonshire Air Ambulance (WNAA) service was launched; the hospital sits on the western periphery of the area served by the service. Methods Prospective data was collated on all patients brought by WNAA to Heartlands Hospital between 1 October 2003 and 31 August 2004. Results In the 10?month period after the launch of the service, the helicopter delivered 83 patients to the ED; 74 of these were "off patch". This additional workload generated 163 ward days, 19 operative procedures, and 85 intensive care unit, high dependency unit, or coronary care unit days. The direct costs of this additional workload approached £160?000. Conclusions In future discussions on the cost effectiveness of air ambulances, it will be important to consider both the direct and indirect costs to the receiving hospitals arising from the redistribution of emergency workload. PMID:16627838

Jenkinson, E; Currie, A; Bleetman, A

2006-01-01

131

Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status  

PubMed Central

Background Carpal tunnel syndrome (CTS) is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million) over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare). Incidence rates of in-hospital cases of CTS were estimated based on 1) codified demographic, diagnostic and intervention data in obligatory discharge records from all Italian public/private hospitals, archived (according to residence) on regional databases; 2) demographic general population data for each region. We compared (using the ?score test) age-sex-specific rates between married, unmarried, divorced and widowed subsets of the general population. We calculated standardized incidence ratios (SIRs) for married/unmarried men and women. Results Age-standardized incidence rates (per 100,000 person-years) of in-hospital cases of CTS were 166 in women and 44 in men (106 overall). Married subjects of both sexes showed higher age-specific rates with respect to unmarried men/women. SIRs were calculated comparing married vs unmarried rates of both sexes: 1.59 (95% confidence interval [95% CI], 1.57–1.60) in women, and 1.42 (95% CI, 1.40–1.45) in men. As compared with married women/men, widows/widowers both showed 2–3-fold higher incidence peaks during the fourth decade of life (beyond 50 years of age, widowed subjects showed similar trends to unmarried counterparts). Conclusion This large population-based study illustrates distinct age-related trends in men and women, and also raises the question whether marital status could be associated with CTS in the general population. PMID:18957090

Mattioli, Stefano; Baldasseroni, Alberto; Curti, Stefania; Cooke, Robin MT; Bena, Antonella; de Giacomi, Giovanna; dell'Omo, Marco; Fateh-Moghadam, Pirous; Melani, Carla; Biocca, Marco; Buiatti, Eva; Campo, Giuseppe; Zanardi, Francesca; Violante, Francesco S

2008-01-01

132

Factors affecting morbidity, mortality and survival in patients undergoing surgery for rectal cancer in a district general hospital.  

PubMed Central

INTRODUCTION: This is a review of elective rectal cancer surgery during 1993-1999 at a single district general hospital to investigate the variables that affected the care of these patients. PATIENTS AND METHODS: A retrospective study of patients presenting with rectal adenocarcinoma to a district general hospital where total mesorectal excision was practiced over a 7-year period was performed to identify factors associated with complications, death and disease recurrence. RESULTS: Sixty-one patients developed a total of 89 complications and 30-day mortality was 8.3%. Overall, 81% of all resections and 86% of potentially curative resections were free of tumour at the circumferential resection margin. A positive circumferential resection margin and 30-day mortality were both associated with increased postoperative blood transfusion volume. Twenty-nine recurrences were detected during the follow-up period (mean, 21.7 months) and circumferential margin involvement by tumour, Dukes' stage, pre-operative functional status (ASA grade) and length of hospital stay correlated with disease-free survival. CONCLUSIONS: Surgical outcomes in lower volume hospitals are comparable with those reported by larger centres. PMID:16176691

Macadam, Robert; Yeomans, Neil; Wilson, Jonathan; Case, William; White, Clive; Lovegrove, John; Lyndon, Philip

2005-01-01

133

The founding of Walter Reed General Hospital and the beginning of modern institutional army medical care in the United States.  

PubMed

When Walter Reed United States Army General Hospital opened its doors in 1909, the Spanish-American War had been over for a decade, World War I was in the unforeseeable future, and army hospital admission rates were steadily decreasing. The story of the founding of Walter Reed, which remained one of the flagship military health institutions in the United States until its 2011 closure, is a story about the complexities of the turn of the twentieth century. Broad historical factors-heightened imperial ambitions, a drive to modernize the army and its medical services, and a growing acceptance of hospitals as ideal places for treatment-explain why the institution was so urgently fought for and ultimately won funding at the particular moment it did. The justifications put forth for the establishment of Walter Reed indicate that the provision of publicly funded medical care for soldiers has been predicated not only on a sense of humanitarian commitment to those who serve, but on principles of military efficiency, thrift, pragmatism, and international competition. On a more general level, the story of Walter Reed's founding demonstrates a Progressive Era shift in health services for U.S. soldiers-from temporary, makeshift hospitals to permanent institutions with expansive goals. PMID:23839016

Adler, Jessica L

2014-10-01

134

High diversity of beta-lactamases in the General Hospital Vienna verified by whole genome sequencing and statistical analysis.  

PubMed

The detailed analysis of antibiotic resistance mechanisms is essential for understanding the underlying evolutionary processes, the implementation of appropriate intervention strategies and to guarantee efficient treatment options. In the present study, 110 ?-lactam-resistant, clinical isolates of Enterobacteriaceae sampled in 2011 in one of Europe's largest hospitals, the General Hospital Vienna, were screened for the presence of 31 ?-lactamase genes. Twenty of those isolates were selected for whole genome sequencing (WGS). In addition, the number of ?-lactamase genes was estimated using biostatistical models. The carbapenemase genes blaKPC-2, blaKPC-3, and blaVIM-4 were identified in carbapenem-resistant and intermediate susceptible isolates, blaOXA-72 in an extended-spectrum ?-lactamase (ESBL)-positive one. Furthermore, the observed high prevalence of the acquired blaDHA-1 and blaCMY AmpC ?-lactamase genes (70%) in phenotypically AmpC-positive isolates is alarming due to their capability to become carbapenem-resistant upon changes in membrane permeability. The statistical analyses revealed that approximately 55% of all ?-lactamase genes present in the General Hospital Vienna were detected by this study. In summary, this work gives a very detailed picture on the disseminated ?-lactamases and other resistance genes in one of Europe's largest hospitals. PMID:25159028

Bariši?, Ivan; Mitteregger, Dieter; Hirschl, Alexander M; Noehammer, Christa; Wiesinger-Mayr, Herbert

2014-10-01

135

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

USGS Publications Warehouse

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.

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

2014-01-01

136

Predictors of hip fracture mortality at a general hospital in South Brazil: an unacceptable surgical delay  

PubMed Central

OBJECTIVE: Hip fractures have been associated with increased mortality in the elderly. Several risk factors such as the time between the insult and the surgical repair have been associated with hip fracture mortality. Nevertheless, the risk of delayed surgical repair remains controversial. Few studies have examined this issue in Brazil. The aim of this study was to study the risk factors for death one year after hip fracture and in-hospital stay at a tertiary hospital in South Brazil. METHODS: A prospective cohort study was carried out from April 2005 to April 2011 at a tertiary university hospital at Santa Maria, Brazil. Subjects admitted for hip fracture who were 65 years of age or older were followed for one year. Information about fracture type, age, gender, clinical comorbidities, time to surgery, discharge, and American Society of Anesthesiologists score were recorded. Death was evaluated during the hospital stay and at one year. RESULTS: Four hundred and eighteen subjects were included in the final analysis. Of these, 4.3% died in-hospital and 15.3% were dead at one year. Time to surgery, American Society of Anesthesiologists score, Ischemic Heart Disease, and in-hospital stay were associated with death at one year in the univariate analysis. The American Society of Anesthesiologists score and time to surgery were one-year mortality predictors in the final regression model. In-hospital death was associated with American Society of Anesthesiologists score and age. CONCLUSION: Time to surgery is worryingly high at the South Brazil tertiary public health center studied here. Surgical delay is a risk factor that has the potential to be modified to improve mortality. PMID:24714833

Ribeiro, Tiango Aguiar; Premaor, Melissa Orlandin; Larangeira, João Alberto; Brito, Luiz Giulian; Luft, Michel; Guterres, Leonardo Waihrich; Monticielo, Odirlei André

2014-01-01

137

The epidemiology of tuberculosis in Phuentsholing General Hospital: a six-year retrospective study  

PubMed Central

Background This study was carried out to describe the epidemiology and treatment outcomes of TB infection in Bhutan at Phuentsholing General Hospital (PGH). Retrospective analysis of TB data was carried out using data from the TB registry of PGH from 2004–2009. Comparisons were made between TB, clinical presentation, diagnosis, and outcomes amongst male and female. Findings A total of 735 patients were analyzed, 12.4% (91) of whom were children (?14?years). The highest cases was reported in 2009 (148), lowest in 2004 (93). Males and females were equally infected with TB. The median age was 25?years, (range 11?months - 98?years; IQR?=?20-35). Extra-pulmonary Tuberculosis (EPT) 62.6% (57) was the commonest form of TB in children. Pleural effusion was more common in males 62.8% (27) (p?=?0.013). Smear positive pulmonary tuberculosis (SPPT) 54.3% (207) (p?=?0.02) and treatment defaulted 84.2% (16) (p?=?0.004) was higher in males. However, transfer-in cases 57.0% (90) (p?=?0.036) and treatment outcome-failure 92.3% (12) (p?=?0.002) were more in females than males. The cure rate for SPPT was 69.0% (293) and unknown treatment outcome for all forms of TB was 11.2% (82). Conclusion TB infection has increased over the study period; SPPT increased more than other two forms of TB. The majority of the TB patients were in the age group of 15–34?years. Males and females were equally infected with TB and children made up 12.4% of TB patients. The cure rate amongst SPPT was 69%, which is much lower than the national target of 85% set by National Tuberculosis Control Programme (NTCP). Further studies need to be undertaken to identify the risk factor for TB in the economically productive age group. There is a need for improvement in the services, recording and reporting so as to meet the target of cure rate of 85% in SPPT patients. PMID:22715941

2012-01-01

138

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

PubMed Central

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

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

2014-01-01

139

Klebsiella pneumoniae producing KPC carbapenemase in a district general hospital in the UK.  

PubMed

We report two patients with multidrug-resistant KPC-carbapenemase-producing Klebsiella pneumoniae urinary tract infections. A bla(KPC-2) gene was detected in both of the isolates by polymerase chain reaction and sequencing. The isolates had identical pulsed-field gel electrophoresis patterns and belonged to sequence type ST11. The index patient probably acquired the KPC-producing strain while in hospital in Curaçao, with subsequent nosocomial transmission to the second patient occurring in our hospital. We describe the interventions that were taken to prevent its further spread within the acute Trust and the community. PMID:21641083

Virgincar, N; Iyer, S; Stacey, A; Maharjan, S; Pike, R; Perry, C; Wyeth, J; Woodford, N

2011-08-01

140

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

PubMed

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

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

2011-10-01

141

School Choice in the "Stratilingual" City of Vancouver  

ERIC Educational Resources Information Center

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,…

Yoon, Ee-Seul; Gulson, Kalervo N.

2010-01-01

142

Oral versus intravenous antibiotics for community acquired lower respiratory tract infection in a general hospital: open, randomised controlled trial.  

PubMed Central

OBJECTIVE--To see whether there is a difference in outcome between patients treated with oral and intravenous antibiotics for lower respiratory tract infection. DESIGN--Open controlled trial in patients admitted consecutively and randomised to treatment with either oral co-amoxiclav, intravenous followed by oral co-amoxiclav, or intravenous followed by oral cephalosporins. SETTING--Large general hospital in Dublin. PATIENTS--541 patients admitted for lower respiratory tract infection during one year. Patients represented 87% of admissions with the diagnosis and excluded those who were immunocompromised and patients with severe life threatening infection. MAIN OUTCOME MEASURES--Cure, partial cure, extended antibiotic treatment, change of antibiotic, death, and cost and duration of hospital stay. RESULTS--There were no significant differences between the groups in clinical outcome or mortality (6%). However, patients randomised to oral co-amoxiclav had a significantly shorter hospital stay than the two groups given intravenous antibiotic (median 6 v 7 and 9 days respectively). In addition, oral antibiotics were cheaper, easier to administer, and if used routinely in the 800 or so patients admitted annually would lead to savings of around 176,000 pounds a year. CONCLUSIONS--Oral antibiotics in community acquired lower respiratory tract infection are at least as efficacious as intraveous therapy. Their use reduces labour and equipment costs and may lead to earlier discharge from hospital. PMID:7787537

Chan, R.; Hemeryck, L.; O'Regan, M.; Clancy, L.; Feely, J.

1995-01-01

143

A descriptive study of TB cases finding practices in the three largest public general hospitals in Vietnam  

PubMed Central

Background A project was implemented in 2010 to improve TB notification and TB screening and diagnostic routines in large general hospitals. The aims of present study was to assess baseline TB screening and diagnostic practices in the three largest general hospitals in Vietnam. Objectives To assess baseline TB screening and diagnostic practices in the three largest general hospitals in Vietnam. Method The study had three elements: 1) Focus group discussions with hospital physicians; 2) review of hospital records and structured interviews of people who had a chest X-ray on any indication; and 3) record reviews and structured interviews of people newly diagnosed with TB. Results The most commonly reported diagnostic pathway for pulmonary TB was chest X-ray followed by sputum-smear microscopy. Among 599 individuals who had a chest X-ray performed, 391 (65.1%) had recorded any abnormality, significantly higher in males (73.8%) than in females (54.7%), (p?2?weeks). Conclusion Chest X-ray is the preferred first test for TB in the largest hospitals in Vietnam. Chest X-ray is a sensitive screening tool for TB, which should be followed by a confirmatory TB test. While the majority of those with chest X-ray abnormalities are investigated with smear-microscopy, the high sputum-smear positivity ratio among them suggests that sputum-smear microscopy is done mainly for persons with quite clear TB signs or symptoms. TB screening and use of confirmatory diagnostic tests on wider indications seem warranted. PMID:22992212

2012-01-01

144

IBM Vocera -Delivering peak efficiencies and improved patient care at Kingston General Hospital  

E-print Network

or typing; simply push a button on the Vocera "badge" for instant communication. Nurses can call each other Overview: The Challenge Address manifested nursing shortage while delivering improved patient care,400-1,800 hospital staff The Benefit Significant reductions of time spent on communication, patient care coordination

145

The emergence of AIDS in Guatemala: inpatient experience at the Hospital General San Juan de Dios  

Microsoft Academic Search

Summary: Little is known about the effect of human immunode® ciency virus (HIV) infection on the Central American healthcare system. We describe HIV-related admissions in a Guatemalan medical service. The study was conducted at Guatemala City's largest public hospital. Data were derived from standardized data collection sheets maintained by the HIV testing service and by HIV clinic physicians. Data were

Blanca Samayoa; Eduardo Arathoon; Matthew Anderson; Jose Rodriguez; Evelyn Quattrini; Claudia Gordillo; Lucy Cotton

2003-01-01

146

UNIVERSITY OF CONNECTICUT HEALTH CENTER ~ JOHN DEMPSEY HOSPITAL GENERAL NURSING ORIENTATION ACTIVITY CHECKLIST  

E-print Network

Hospital Tower Role Definitions/Support Staff Delegation/Leadership/ANA Code of Ethics IV Lecture/ IV Skill HITECH UC Code of Conduct UC False Claims Act UC State Code of Ethics Fraud Awareness Corporate Lecture Phlebotomy Skill Validation Code Blue / Hands On Review of Cart Content Respiratory Department

Oliver, Douglas L.

147

Radial-growth forecasts for five high-elevation conifer species on Vancouver Island, British Columbia  

Microsoft Academic Search

Biologically-based deterministic multiple regression models are developed to investigate the consequences of future climates on the radial-growth response of five high-elevation conifer species on Vancouver Island. Historical climate data and tree-ring chronologies are used to establish robust relationships between climate and radial growth. Coupled general circulation modeled (CGCM) outputs are then used to provide monthly predictions of future climates from

Colin P Laroque; Dan J Smith

2003-01-01

148

BARRIERS AGAINST APPLICATION OF EVIDENCE-BASED MEDICINE IN GENERAL HOSPITALS IN ASEER REGION, KINGDOM OF SAUDI ARABIA  

PubMed Central

Objective: To explore the attitudes of doctors in the general hospitals and their application of evidence-based medicine (EBM) and to identify the barriers that hinder its use. Subjects and Methods: This study included 346 doctors in the general hospitals of Aseer. A questionnaire was designed to assess their awareness as well as the barriers that hinder their practice of EBM. A visual analogue scale was used to assess their attitude. Results: The attitudes of doctors toward aspects of EBM were generally positive. However, their use of EBM sources and application were generally poor. The main reasons for retrieving evidence were to keep them up-to-date (72.8%) and to help make clinical decisions (70.2%). The least mentioned reason for evidence retrieval was research (41.9%). Review of textbooks was the main method of evidence retrieval (71.1%), while a database search was the method least used (22.8%). The main barriers to the practice of EBM practice were “lack of facilities” followed by “lack of time”, while the barrier least mentioned was the “lack of interest”. Conclusions: Although doctors have positive attitudes toward EBM, their knowledge and application of EBM need much improvement. The main barriers to their application of EBM are the lack of facilities and the lack of time. Recommendations: The necessary infrastructure for the application of EBM should be made available for all medical staff. There is a need for special courses and hands-on workshops in general hospitals to address the necessary knowledge and skills of EBM are essential. PMID:23012182

Al-Gelban, Khalid S.; Al-Khaldi, Yahia M.; Al-Wadei, Abdullah M.; Mostafa, Ossama A.

2009-01-01

149

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 ...

150

The role of general practitioners in the pre hospital setting, as experienced by emergency medicine technicians: a qualitative study  

PubMed Central

Background Together with the ambulances staffed with emergency medical technicians (EMTs), general practitioners (GPs) on call are the primary resources for handling emergencies outside hospitals in Norway. The benefit of the GP accompanying the ambulance to pre-hospital calls is a matter of controversy in Norway. The purpose of the present study was to gain better insight into the EMT’s experiences with the role of the GPs in the care for critically ill patients in the pre-hospital setting. Methods We conducted four focus group interviews with EMTs at four different ambulance stations in Norway. Three of the stations were located at least 2 hours driving distance from the nearest hospital. The interviews were transcribed and analyzed using systematic text condensation. Results The EMTs described increasing confidence in emergency medicine during the last few years. However, they felt the need for GP participation in the ambulance when responding to a critically ill patient. The presence of GPs made the EMTs feel more confident, especially in unclear and difficult cases that did not fit into EMT guidelines. The main contributions of the GPs were described as diagnosis and decision-making. Bringing the physician to the patient shortened transportation time to the hospital and important medication could be started earlier. Several examples of sub-optimal treatment in the absence of the GP were given. The EMTs described discomfort with GPs not responding to the calls. They also experienced GPs responding to calls that did not function in the pre-hospital emergency setting. The EMTs reported a need for professional requirements for GPs taking part in out-of-hours work and mandatory interdisciplinary training on a regular basis. Conclusions EMTs want GPs to be present in challenging pre-hospital emergency settings. The presence of GPs is perceived as improving patient care. However, professional requirements are needed for GPs taking part in out-of-hours work, and the informants suggested a formalized area for training between EMTs and GPs on call. PMID:25145390

2014-01-01

151

Perception of nurse experts on the contribution of nursing interventions to NOC nursing outcomes in general hospitals in Korea.  

PubMed

The purpose of this study was to identify the perception of nurse experts on the contribution of nursing interventions to Nursing Outcomes Classification NOC nursing outcomes. A nursing outcome is a nursing-sensitive patient outcome primarily affected by nursing interventions. As one of the standardized language systems of nursing outcomes, the NOC must be examined for applicability before it is used in Korea. Data were collected in February and March 2003 using a 5-point Likert scale. For data collection, 230 quality improvement (QI) or quality assurance (QA) nurses from general hospitals in Korea were asked to rate the extent that nursing interventions contribute to each of the NOC nursing outcomes (2,000) in their hospitals. Ninety-six nurses from 63 hospitals responded and the response rate was 41.7%. Mean scores for perception of contribution of nursing interventions to each of the NOC nursing outcomes ranged from 2.18 to 4.54. Vital Signs Status had the highest score (M=4.54), and Abuse Recovery: Financial, the lowest score (M=2.18). Of the seven NOC domains, the mean score was highest for Physiologic Health (M=3.91) and lowest for Community Health (M=2.92). Of the 29 NOC classes, the mean score for perceived contribution was highest for Metabolic Regulation (M=4.32) and lowest for Community Well-Being (M=2.92). Participants perceived that nursing interventions in general hospitals in Korea contributed, at least to a certain extent, to most of the NOC nursing outcomes. Based on these results, NOC should have relatively good applicability in Korea. PMID:16037718

Lee, Byoungsook

2005-06-01

152

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

PubMed Central

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

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

2013-01-01

153

Quality of care for people with dementia in general hospitals: national cross-sectional audit of patient assessment.  

PubMed

There have been recent reports of poor quality care in the National Health Service in the UK, and older people with dementia are particularly vulnerable. This study aims to examine the quality of assessment of people with dementia admitted to hospital. Cross-sectional case-note audit of key physical and psychosocial assessments was carried out in 7,934 people with dementia who were discharged from 206 general hospitals. Most people had no record of a standardised assessment of their cognitive state (56.8%, 95% confidence interval [CI] = 55.8-58.0) or functioning (74.2%, 95% CI = 73.2-75.1). Information from carers was documented in 39.0% of cases (95% CI = 37.9-40.1). There was considerable variation across hospital sites. Key assessments were less likely when people were admitted to surgical wards. Assessments fall well below recommended standards especially with regard to social and cognitive functioning. Problems are particularly marked on surgical wards. PMID:25301908

Souza, Renata; Gandesha, Aarti; Hood, Chloe; Chaplin, Robert; Young, John; Crome, Peter; Crawford, Mike J

2014-10-01

154

Acute Interventions and Referral of Patients With Bipolar Disorder by the Psychiatric Consultation Liaison Service in a General Hospital in Germany: A Retrospective Analysis  

PubMed Central

Objective: To investigate the population of bipolar patients in a general hospital in Germany who required treatment by a consultant psychiatrist. Method: A retrospective analysis was conducted of the clinical records of 47 patients diagnosed with bipolar disorder (DSM-IV-TR criteria) who were treated by a consultant psychiatrist between 2009 and 2012 in one of the general hospitals of Charité Berlin, Campus Benjamin Franklin, Berlin, Germany. We investigated the sections of the hospital that requested psychiatric consultations for bipolar patients, the status of these patients, and their primary cause of treatment, as well as the intervention (including pharmacotherapy) recommended by the consultant psychiatrist. Results: For more than half of the patients, their psychiatric illness was either directly or indirectly the reason they presented to the hospital. The remaining bipolar patients were treated for various somatic illnesses unrelated to their bipolar disorder throughout the hospital, with a relative overrepresentation of patients in the neurology department. More than half of the patients were referred to a psychiatric hospital by the consultant psychiatrist. Benzodiazepines were the most commonly administered drugs for acute pharmacologic intervention. Conclusions: Psychiatric consultations are not frequently requested for bipolar patients compared to those with other psychiatric disorders. However, more than half of the bipolar patients needed further psychiatric treatment in a psychiatric hospital. This finding emphasizes the importance of psychiatric consultations in a general hospital for bipolar patients. The administration of benzodiazepines as an acute treatment seems to be the standard pharmacologic procedure, not a specific pharmacotherapy like mood stabilizers. PMID:25133062

Anderson, Christina

2014-01-01

155

Hospital discharge information after elective total hip or knee joint replacement surgery: A clinical audit of preferences among general practitioners.  

PubMed

The demand for elective joint replacement (EJR) surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP) and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee.GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale.Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate). All discharge information options were ranked as 'essential' by a proportion of respondents, ranging from 14.8-88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as 'useful' information (47.5-56.7%).GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff, hospital administrators and information technology staff, supported in parallel by education provided to junior medical staff. PMID:23173019

Briggs, Andrew M; Lee, Nadia; Sim, Moira; Leys, Toby J; Yates, Piers J

2012-01-01

156

A Comparison of Patients with Intellectual Disability Receiving Specialised and General Services in Ontario's Psychiatric Hospitals  

ERIC Educational Resources Information Center

Background: Over the years, the closure of institutions has meant that individuals with intellectual disabilities (IDs) must access mainstream (i.e. general) mental health services. However, concern that general services may not adequately meet the needs of patients with ID and mental illness has led to the development and implementation of more…

Lunsky, Y.; Bradley, E.; Durbin, J.; Koegl, C.

2008-01-01

157

Discrepancies between histology and serology for the diagnosis of coeliac disease in a district general hospital: is this an unrecognised problem in other hospitals?  

PubMed

The objective of this study was to assess the increasing number of patients with positive biopsies yet negative serology at Medway Hospital, Kent, through a retrospective data collection. All coeliac serology undertaken between 2003-5 (n=3056) with coeliac positive duodenal biopsy results (n=26) were compared. From the total number of patients with positive duodenal biopsies 10 (38.5%), 13 (50%) and 12 (46.2%) had negative anti-tTg, IgA anti-gliadin and IgG anti-gliadin serology respectively. When combining anti-tTG, IgG and IgA anti-gliadin to improve sensitivity, five patients (19.2%) had completely negative and six (23%) had equivocal serology results. This study shows that a small but significant number of cases of coeliac disease will be missed by relying on serology alone. As the diagnosis and management of disease shifts further towards general physicians and primary care, it is important that the limitations of serological testing are recognised. PMID:19728508

Sweis, Rami; Pee, Leon; Smith-Laing, Gray

2009-08-01

158

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

Federal Register 2010, 2011, 2012, 2013, 2014

...SECURITY Coast Guard 33 CFR Part 117 [Docket No. USCG-2012-0978] Drawbridge Operation Regulation; Columbia River, Vancouver, WA AGENCY: Coast Guard, DHS. ACTION: Notice of temporary deviation from...

2012-11-07

159

Recent Trends in Clinically Significant Nontuberculous Mycobacteria Isolates at a Korean General Hospital  

PubMed Central

Lung disease caused by nontuberculous mycobacteria (NTM) represents an increasing proportion of all mycobacterial diseases. We investigated recent occurrences of NTM and evaluated the clinical significance of NTM isolates from 752 respiratory specimens collected from patients at National Health Insurance Service Ilsan Hospital between January 2007 and May 2011. Specimens were incubated on solid and liquid media (BACTEC MGIT 960, BD, USA) for 6-8 weeks, and PCR and reverse blot hybridization were performed (REBA Myco-ID, Molecules & Diagnostics, Korea). Clinical features of the patients were reviewed through medical records. The most frequently isolated organism was Mycobacterium avium (46.7%), followed by M. intracellulare (14.8%), M. fortuitum (7.2%), and M. abscessus (6.6%). The most common mycobacteria among definitive cases of NTM lung disease were M. avium (42/351, 12.0%), M. intracellulare (19/111, 17.1%), M. abscessus (11/50, 22.0%), M. massiliense (4/13, 30.8%), and M. fortuitum (4/54, 7.4%). Clinically significant cases of NTM lung disease increased from 4 patients in 2007 to 32 in 2011. The mean patient age was 64 yr (range: 35-88 yr), and 58 (64%) patients were women. Patients suffered from cough, productive sputum, and hemoptysis. In summary, the most common mycobacteria causing NTM lung disease were M. avium and M. intracellulare; however, cases of M. massiliense and M. abscessus infection are on the rise in Korea. PMID:24422197

Kim, Hyun Soo; Lee, Sangsun; Kim, Young Ah

2014-01-01

160

The implosion of the Calgary General Hospital: ambient air quality issues.  

PubMed

This paper discusses the implosion of a large inner-city hospital in Calgary, Alberta, Canada, on October 4, 1998. Stationary and mobile air monitoring conducted after the implosion indicated there were several short-term air quality issues, including significant temporal increases in total suspended particles, particulate matter (PM) with aerodynamic diameter less than or equal to 10 microm (PM10), PM with aerodynamic diameter less than or equal to 2.5 microm (PM2.5), asbestos, and airborne and settled lead. In addition, the implosion created a dust cloud that traveled much further than expected, out to 20 km. The ability of an implosion to effectively aerosolize building materials requires the removal of all friable and nonfriable forms of asbestos and all Pb-containing painted surfaces during pre-implosion preparatory work. Public advisories to mitigate personal exposure and indoor migration of the implosion dust cloud constituents should extend to 10 or 20 km around an implosion site. These findings point to a number of complex and problematic issues regarding implosions and safeguarding human health and suggest that implosions in metropolitan areas should be prohibited. Further work to characterize the public health risks of conventional versus implosion demolition is recommended. PMID:15704539

Stefani, Dennis; Wardman, Dennis; Lambert, Timothy

2005-01-01

161

Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia  

PubMed Central

Background Psychological disorders like depression and anxiety are potentially dangerous conditions. In the context of HIV/AIDS, this can influence health-seeking behavior or uptake of diagnosis and treatment for HIV/AIDS, add to the burden of disease for HIV patients, create difficulty in adherence to treatment, and increase the risk of mortality and morbidity. The objective of this study was to assess the prevalence and correlates of generalized psychological distress among HIV-infected subjects on antiretroviral treatment (ART). Design An institution-based cross-sectional study was conducted. Interviews were conducted with 500 patients initiating ART at Dilla Referral Hospital. Generalized psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS). A cutoff score ?19 was used to identify possible cases of patients with generalized psychological distress. Multivariable logistic regression analysis using SPSS Version 20 was performed to identify factors associated with psychological distress. Results The prevalence of generalized psychological distress among the population of this study was 11.2% (HADS?19). Factors independently associated with generalized psychological distress were moderate stress (OR=6.87, 95% CI 2.27–20.81), low social support (OR=10.17, 95% CI 2.85–36.29), number of negative life events of six and above (OR=3.99, 95% CI 1.77–8.99), not disclosing HIV status (OR=5.24, 95% CI 1.33–20.62), and CD4 cell count of <200 cells/mm3 (OR=1.98, 95% CI 0.45–0.83) and 200–499 cells/mm3 (OR=3.53, 95% CI 1.62–7.73). Conclusions This study provides prevalence of psychological distress lower than the prevalence of common mental disorders in Ethiopia and comparable to some other studies in sub-Saharan Africa. The findings are important in terms of their relevance to identifying high-risk groups for generalized psychological distress and preventing distress through integrating mental health services with HIV/AIDS care and support program. PMID:24852246

Tesfaye, Solomon H.; Bune, Girma T.

2014-01-01

162

A Comparison of Outpatients with Intellectual Disability Receiving Specialised and General Services in Ontario's Psychiatric Hospitals  

ERIC Educational Resources Information Center

Background: This study compares outpatients with intellectual disability (ID) receiving specialised services to outpatients with ID receiving general services in Ontario's tertiary mental healthcare system in terms of demographics, symptom profile, strengths and resources, and clinical service needs. Methods: A secondary analysis of Colorado…

Lunsky, Y.; Gracey, C.; Bradley, E.; Koegl, C.; Durbin, J.

2011-01-01

163

The flunitrazepam abuse prevention program at a general hospital in Taiwan: a descriptive study.  

PubMed

The Bureau of Controlled Drugs at Ministry of Health, Executive Yuan in Taiwan announced, on 1 April 2000, the schedules of controlled drugs with abuse potential and implemented a policy on 1 October 2000 to control them. Flunitrazepam (FM2), along with other two benzodiazepines (triazolam and brotizolam), is placed on Schedule III. The aim of the present study was to analyze the pattern of flunitrazepam prescriptions across all medical subspecialty departments at Taipei Medical University-Wan Fang Hospital (TMU-WFH), Taiwan. We analyzed 1170 prescriptions over 12 month period from 1 July 2000 to 31 May 2001. All prescription data were divided into three 4 month periods: period I was when the flunitrazepam prescription was not controlled, period II represented the time when flunitrazepam was placed on Schedule III and when physicians were required to use a special duplicated prescription form and period III was when the TMU-WFH started to set a stricter control for the prescription of flunitrazepam. The results indicated that the number of flunitrazepam prescriptions during period III had decreased significantly compared with period I (P < or = 0.05). Eventually, 45.7% of flunitrazepam-medicated patients were followed up monthly with a restriction of their flunitrazepam supply to no more than 14 days, 22.9% of patients were followed up fortnightly at clinics with a 14 day supply of flunitrazepam, 15.7% were followed up fortnightly with a 14 day restriction of flunitrazepam plus a non-flunitrazepan benzodiazepine supplement, 10.7% were referred to clinics within the Department of Psychiatry and 5% were switched from flunitrazepam to other drugs. PMID:12109961

Shen, Winston W; Chang, Cindy; Hsieh, Wen-chieh; Yeh, Chen-jung; Chiu, Fang-yi; Chuang, Yao-chin

2002-08-01

164

[Patients with psychotic disorders in forensic psychiatric hospitals: are there consequences for general psychiatry?].  

PubMed

We assessed data concerning demographic, criminological and psychiatric characteristics of all patients with disorders of the schizophrenic spectrum, who were detained in the forensic psychiatric departments of Mecklenburg-West Pomerania, a federal state of Germany, in 2007. Of the 202 patients of both clinics, 45 suffer from a disorder of the schizophrenic spectrum assessed in ICD-10: F20-F29, which corresponds to 22%. This level is markedly lower than in other regions of Germany. But similarly to results assessed in other federal states of Germany and in Austria there is a high rate of pre-treatment in general psychiatric institutions. It remains a relevant task for general psychiatry to establish adequate interventions for hostile and violent psychotic patients, especially for those with a double diagnosis, history of delinquency and social decline. PMID:20076938

Habermeyer, E; Wolff, R; Gillner, M; Strohm, R; Kutscher, S

2010-09-01

165

Attitudes and Relationship between Physicians and the Pharmaceutical Industry in a Public General Hospital in Lima, Peru  

PubMed Central

Background The interaction between physicians and the pharmaceutical industry influences physicians' attitudes and prescribing behavior. Although largely studied in the US, this topic has not been well studied in resource-poor settings, where a close relationship between physicians and industry still exists. Objective To describe physician interactions with and attitudes towards the pharmaceutical industry in a public general hospital in Lima, Peru. Design Descriptive, cross-sectional study through an anonymous, self-filled questionnaire distributed among faculty and trainee physicians of five different clinical departments working in a Peruvian public general hospital. A transcultural validation of an existing Spanish questionnaire was performed. Exposure to marketing activities, motivations to contact pharmaceutical representatives and attitudes towards industry were studied. Collected data was analyzed by degree of training, clinical department, gender and teaching status. Attitudes were measured on a four-point LIKERT scale. Results 155 physicians completed the survey, of which 148 were included in the study sample. 94.5% of attending physicians reported ongoing encounters with pharmaceutical representatives. The most common industry-related activities were receiving medical samples (91.2%), promotional material (87.8%) and attending meetings in restaurants (81.8%). Respondents considered medical samples and continuing medical education the most ethically acceptable benefits. We found significant differences between attendings and residents, and teaching and non-teaching attendings. An association between the amount of encounters with pharmaceutical representatives, and attitudes towards industry and acceptance of medical samples was found. Conclusions A close physician-industry relationship exists in the population under study. The contact is established mainly through pharmaceutical representatives. Medical samples are the most received and ethically accepted benefit. The attitudes of physicians on the ethical standards of acceptance of medical samples and other benefits are closely related with their exposure to the pharmaceutical industry. Future studies could explore the motivations of physicians working in resource-poor settings to maintain a close relationship with industry. PMID:24978481

De Ferrari, Aldo; Gentille, Cesar; Davalos, Long; Huayanay, Leandro; Malaga, German

2014-01-01

166

The epidemiological profile of pediatric patients admitted to the general intensive care unit in an Ethiopian university hospital  

PubMed Central

Background In least developing countries, there are few data on children’s critical care. This makes the provision of aid and improvement of outcome difficult. Objectives To describe admission and outcome patterns of children managed in a general intensive care unit at Jimma University Specialized Hospital (JUSH), Ethiopia, over a 5-year period. Methods A retrospective cross-sectional study design was used. All children from birth to 14 years of age who were admitted to the general ICU of the hospital from 2009–2013 were included. Patient charts and ICU documentation log were reviewed. Results A total of 170 children were admitted to the ICU of JUSH over the study period. The greater share was taken by males (54.7%), with a male-to-female ratio of 1.2:1. The overall mortality rate was 40%. The majority of the children were in the age range of 10–14 years (38.8%). Of the total number of patients admitted, 34.7% were trauma cases, 45.8% of whom died. The highest percentage, 69.5%, of trauma patients were admitted for head injuries. Among the trauma cases, burn and polytrauma were the second and third leading causes (15.3%) of admission. Postoperative patients and medical patients accounted for the rest of the admitted cases (28.2% and 27.6% of the cases respectively). Conclusion The leading cause of admission and death was trauma. Postoperative and medical causes of admission were also significant. The mortality rate in the ICU was very high, and this could be due to various factors. Further research benchmarking and interventions are highly recommended.

Abebe, Teshome; Girmay, Mullu; G/Michael, Girma; Tesfaye, Million

2015-01-01

167

Factors associated with nonattendance at clinical medicine scheduled outpatient appointments in a university general hospital  

PubMed Central

Introduction Nonattendance at scheduled outpatient appointments for primary care is a major health care problem worldwide. Our aim was to estimate the prevalence of nonattendance at scheduled appointments for outpatients seeking primary care, to identify associated factors and build a model that predicts nonattendance at scheduled appointments. Methods A cohort study of adult patients, who had a scheduled outpatient appointment for primary care, was conducted between January 2010 and July 2011, at the Italian Hospital of Buenos Aires. We evaluated the history and characteristics of these patients, and their scheduling and attendance at appointments. Patients were divided into two groups: those who attended their scheduled appointments, and those who did not. We estimated the odds ratios (OR) and corresponding 95% confidence intervals (95% CI), and generated a predictive model for nonattendance, with logistic regression, using factors associated with lack of attendance, and those considered clinically relevant. Alternative models were compared using Akaike’s Information Criterion. A generation cohort and a validation cohort were assigned randomly. Results Of 113,716 appointments included in the study, 25,687 were missed (22.7%; 95% CI: 22.34%–22.83%). We found a statistically significant association between nonattendance and age (OR: 0.99; 95% CI: 0.99–0.99), number of issues in the personal health record (OR: 0.98; 95% CI: 0.98–0.99), time between the request for and date of appointment (OR: 1; 95% CI: 1–1), history of nonattendance (OR: 1.07; 95% CI: 1.07–1.07), appointment scheduled later than 4 pm (OR: 1.30; 95% CI: 1.24–1.35), and specific days of the week (OR: 1.00; 95% CI: 1.06–1.1). The predictive model for nonattendance included characteristics of the patient requesting the appointment, the appointment request, and the actual appointment date. The area under the receiver operating characteristic curve of the predictive model in the generation cohort was 0.892 (95% CI: 0.890–0.894). Conclusion Evidence related to patient characteristics, and the identification of appointments with a higher likelihood of nonattendance, should promote guided strategies to reduce the rate of nonattendance, as well as to future research on this topic. The use of predictive models could further guide management strategies to reduce the rate of nonattendance. PMID:24235820

Giunta, Diego; Briatore, Agustina; Baum, Analía; Luna, Daniel; Waisman, Gabriel; de Quiros, Fernán Gonzalez Bernaldo

2013-01-01

168

Cost of hospital care for HIV/AIDS infected patients in three general reference hospitals in Lubumbashi, DR Congo: prospective cohort study  

PubMed Central

Introduction This article analyses the composition of healthcare costs for HIV/AIDS infected patients in a country with limited resources and attempts to identify the factors that influence these costs. The aims are to calculate medical care costs, analysing how they vary depending on patients’ income, and to evaluate the factors explaining healthcare consumption. Methods This is a prospective cohort study focusing on patients who were admitted to hospital for a short stay between January 2010 and June 2011, before their integration into a specialised program. The patients were selected randomly. Free consent was obtained from all participants. Data were analysed using the SPSS 19.0 software. The significance threshold was set at 5% and the CI (Confidence Interval) at 95%. We used Kruskal-Wallis tests, Fisher's exact test and multiple linear regression. Results We monitored 209 patients. Their average age was 36.37 years (SD: 8.72). The sex ratio was 0.58 and the women patients were generally younger than the male ones (p=0.011). The overall cost of healthcare amounted to $US 41,922. The cost of Antiretroviral Therapy represented 21.6% ($US 9,045). The price of para-clinical examinations represented 46% ($US 19,136) of the overall cost. The patient's average monthly income was $US 157.40 whereas the average direct cost per patient was$US 201.45. Both monthly income (t=4.385; p=0.0000) and education level (t=3.703 p=0.0003) were statistically significant predictive factors for healthcare consumption. The medical care costs for patients with opportunistic infections were nine times higher than those for patients who presented none. The presence of opportunistic infections increased healthcare consumption by approximately 31$ US (CI 95%: 15-46.9). Conclusion The average direct cost for patients on each short-term stay was higher than the average monthly income. To be able to access the necessary services, the patients need additional resources, which are derived from various sources. Monthly income and the level of education were both statistically significant predictors for healthcare consumption. The analysis allows us to extend the study by using different analytical accounting approaches such as by case and by pathology. PMID:24198878

Tshamba, Henri Mundongo; a Kaut, Clarence Mukeng; Kyalubile, Nono Mulubwa; Kakambal, Alphonse Kaij; Yav, Grevisse Ditend; Kaj, Françoise Malonga; Vancaillie, Didier

2013-01-01

169

Compared to the general population, adults with congenital heart disease (CHD) have a higher rate of hospitalization  

E-print Network

with increased risk for hospitalization and death. · Decreased exercise capacity is often attributed Heart Disease Program, Medical College of Wisconsin, Children's Hospital of Wisconsin · Abnormal a higher rate of hospitalization and mortality. · Reduced exercise capacity1,2 ­ identifies those patients

170

Pooled cataract waiting lists: views of hospital consultants, general practitioners and patients.  

PubMed

In the National Health Service general practitioners (GPs) usually refer patients to named consultants; thus, waiting times for a particular procedure can vary greatly even within a single centre. An alternative is to pool the waiting list, with patients treated in turn by the consultant available. We sought opinions on this strategy, from patients, GPs, and consultants, in relation to cataract surgery. Questionnaires were sent to 776 consultant ophthalmologists; telephone interviews were conducted with 50 randomly selected Birmingham GPs; and 85 Birmingham patients listed for cataract surgery were asked whether they would change consultant to be operated on sooner. 503 (64%) of the consultants responded. Of consultants, 30% favoured pooled lists and 67% were against. Of patients, 82% favoured pooled lists and 18% were against. Of GPs, 92% favoured pooled lists and 8% were against. Some consultants thought that pooled lists were suitable for routine cases but not for more complex cases. 82% of patients expressed willingness to change consultant in order to get an earlier operation. In units with surgeons whose cataract-surgery practices are similar, pooled lists are one way to maximize theatre use and equalize waiting times for routine cases. The model could be applied to other routine surgical procedures such as hip replacement, herniorrhaphy and prostatectomy. PMID:12461145

Ramchandani, Mahesh; Mirza, Salman; Sharma, Ash; Kirkby, Graham

2002-12-01

171

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.

172

Visit Vancouver! Apply by May 15 for an airfaire travel bursary. 2014 HISTORICAL THINKING SUMMER INSTITUTE  

E-print Network

the Museum of Vancouver meet with critical perspectives at our Historical Thinking travel bursary. 2014 HISTORICAL THINKING SUMMER INSTITUTE Museum of Vancouver as an academic course, or for non-credit professional development. Historical Thinking

Michelson, David G.

173

77 FR 33267 - Eric Temple-Control Exemption-Portland Vancouver Junction Railroad, LLC  

Federal Register 2010, 2011, 2012, 2013, 2014

...FD 35594] Eric Temple--Control Exemption--Portland Vancouver Junction Railroad, LLC AGENCY: Surface Transportation Board...notice of exemption to acquire direct control of Portland Vancouver Junction Railroad, LLC (PVJR), a wholly owned...

2012-06-05

174

Evaluation of Site Periods in the Metro Vancouver Region Using Microtremor Testing  

Microsoft Academic Search

\\u000a Metro Vancouver, located in British Columbia, Canada, comprises the city of Vancouver and twenty more municipalities of its\\u000a metropolitan area. The Metro Vancouver region has a population of about 2.25 million people and it is located in an area of\\u000a high seismicity. A future earthquake close to Metro Vancouver would cause tens of billions of dollars damage and would seriously

James Traber; Kenny Kutyn; Carlos E. Ventura; W. D. Liam Finn

175

Polyaxial Locked Implants in the Treatment of Type Vancouver B1 Periprosthetic Fractures of the Femur: Retrospective Clinical Examination in 58 Cases with Review of the Literature  

Microsoft Academic Search

\\u000a Abstract\\u000a   We concluded a retrospective study of the outcomes of a consecutive series of Vancouver B1 and C femoral injuries using two\\u000a specific locked implants. The study center is a dedicated trauma hospital with a large catchment area. Over a five-year period\\u000a we treated 58 patients with a periprosthetic fracture of the femur with an angular stable plate, defined as

Jan Meiners; Maximilian Faschingbauer; Christine Voigt; Christian Jürgens; Arndt P. Schulz

2010-01-01

176

21st International Aircraft Cabin Safety Symposium Vancouver, British Columbia, Canada, February 2 -5, 2004  

E-print Network

21st International Aircraft Cabin Safety Symposium Vancouver, British Columbia, Canada, February 2 International Aircraft Cabin Safety Symposium Vancouver, British Columbia, Canada, February 2 - 5, 2004 be performed correctly 2 #12;21st International Aircraft Cabin Safety Symposium Vancouver, British Columbia

177

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

Collins, Gary S.

178

General Hospital Psychiatry 29 (2007) 285-293 Title: Use of the PRIME-MD Patient Health Questionnaire for estimating the  

E-print Network

1 General Hospital Psychiatry 29 (2007) 285-293 Title: Use of the PRIME-MD Patient Health 5, France 2 Service Universitaire de Psychiatrie Adulte, Centre Hospitalier Universitaire, 39 av, NIHR Biomedical Research Centre, Institute of Psychiatry, Kings College, London SE5 8AF, UK

Paris-Sud XI, Université de

179

Specificity and sensitivity of SPECT myocardial perfusion studies at the Nuclear Medicine Department of the Limassol General Hospital in Cyprus  

NASA Astrophysics Data System (ADS)

The aim is to determine the sensitivity and specificity of Myocardial Perfusion Imaging (MPI) performed at the Nuclear Medicine Department of the Limassol General Hospital in Cyprus. Through a retrospective analysis, patient results obtained by MPI were compared to results obtained by Invasive Angiography. We analyzed data from 96 patients that underwent both MPI and Angiography during the years 2009-2010, with a maximum time interval of ± 9 months between the two types of medical exams. For 51 patients, the indication was the detection of CAD. For 45 patients, the indication was to assess viability and/or ischemia after MI, PCI or CABG. Out of 84 patients with CAD confirmed by angiography, 80 patients resulted in abnormal MPI (sensitivity of 95% and positive predictive value of 98%). Out of 12 patients with normal coronaries, 10 patients resulted in normal MPI (specificity of 83% and negative predictive value of 71%).In conclusion, for the patients with abnormal MPI and confirmed CAD, MPI was a useful aid for further therapy management.

Koumna, S.; Yiannakkaras, Ch; Avraamides, P.; Demetriadou, O.

2011-09-01

180

Mycobacterial species diversity at a general hospital on the island of Crete: first detection of Mycobacterium lentiflavum in Greece.  

PubMed

The objective of the present study was to investigate the diversity of mycobacterial isolates in a general hospital in Crete, Greece. 48 positive Lowenstein-Jensen cultures over a 3-y period were analysed by means of AccuProbe and GenoType assays. Non-tuberculous mycobacteria (NTM) comprised the majority of the isolates (56.3%, 27/48) vs 33.3% (16/48) of M. tuberculosis; 10.4% of the isolates could not be classified. Among NTM, M. lentiflavum was the predominant species isolated (9/27) followed by M. kansasii, M. gordonae and M. peregrinum, whereas no M. avium complex isolates were detected. This is the first detection of M. lentiflavum in Greece. The susceptibilities of the M. lentiflavum isolates to an extended panel of antibiotics were determined by the proportions method and the medical files of the 9 patients were reviewed. Three isolates were from urine, which is an unusual site. All strains exhibited multidrug resistance. The patients were adults with immunosuppression or predisposing conditions for NTM infection. Diagnosis of true infection was either not pursued or the patients died shortly after isolation. PMID:17852893

Neonakis, Ioannis K; Gitti, Zoe; Kourbeti, Irene S; Michelaki, Helen; Baritaki, Maria; Alevraki, Georgia; Papadomanolaki, Evangelia; Tsafaraki, Ekaterini; Tsouri, Anna; Baritaki, Stavroula; Krambovitis, Elias; Spandidos, Demetrios A

2007-01-01

181

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.

182

Do trauma systems work? A comparison of major trauma outcomes between Aberdeen Royal Infirmary and Massachusetts General Hospital.  

PubMed

Trauma is an important matter of public health and a major cause of mortality. Since the late 1980s trauma care provision in the United Kingdom is lacking when compared to the USA. This has been attributed to a lack of organisation of trauma care leading to the formation of trauma networks and Major Trauma Centres in England and Wales. The need for similar centres in Scotland is argued currently. We assessed the activity of two quite different trauma systems by obtaining access to comparative data from two hospitals, one in the USA and the other in Scotland. Aggregate data on 5604 patients at Aberdeen Royal Infirmary (ARI) from 1993 to 2002 was obtained from the Scottish Trauma Audit Group. A comparable data set of 16,178 patients from Massachusetts General Hospital (MGH). Direct comparison of patient demographics; injury type, mechanism and Injury Severity Score (ISS); mode of arrival; length of stay and mortality were made. Statistical analysis was carried out using Chi-squared and Cochran-Mantel-Haenszel. There were significant differences in the data sets. There was a higher proportion of penetrating injuries at MGH, (8.6% vs 2.6%) and more severely injured patients at MGH, patients with an ISS>16 accounted for nearly 22.1% of MGH patients compared to 14.0% at ARI. ISS 8-15 made up 54.6% of ARI trauma with 29.6% at MGH. Falls accounted for 50.1% at ARI and 37.9% at MGH. Despite the higher proportion of severe injuries at MGH and crude mortality rates showing no difference (4.9% ARI vs 5.2% MGH), pooled odds ratio of mortality was 1.4 (95% confidence interval 1.2-1.6) showing worse mortality outcomes at ARI compared to MGH. In conclusion, there were some differences in case mix between both data sets making direct comparison of the outcomes difficult, but the effect of consolidating major trauma on the proportion and number of severely injured patients treated in the American Level 1 centre was clear with a significant improvement in mortality in all injury severity groups. PMID:25270693

Morrissey, Brian E; Delaney, Ruth A; Johnstone, Alan J; Petrovick, Laurie; Smith, R Malcolm

2015-01-01

183

[Professional absenteeism in the pediatric service of the general hospital of Loandjili in Pointe-Noire (Congo)].  

PubMed

The supply and the quality of care dispensed in a service depend on the quality of the technical and human tray, but also from effective presence of the staff during the work time. The purpose of this study is to determine the absenteeism level of the paramedical staff in General Pediatric and Neonatology of Loandjili General Hospital (Pointe Noire) and identifying causes. A cross-sectional study has been conducted from January 1(st) to June 30(th) 2011 on 21 nurses in General Pediatric and 20 in Neonatology. The absenteeism level was obtained by the link of the number of missing days out of the number of the work days x 100. The absence was justified when it relieved from a reason informed by the administrative texts of the firm; and authorized when it requested the authorization of the administration of the firm. In total, 370 absences have been unregistered, the average absenteeism level was of 8.4%. The absence was justified in 242 cases (65.4%) and authorized in 178 cases (48.1%) which 84 times in writing and 94 times verbally. When the absence was justified, it was the fact of the disease of a member of the family in 82 cases, of the death or the burial of a member of the family in 81 cases, of the agent disease, 84 cases, or other reasons in the remains of cases. The absence occurred between 7 a.m. and 14 p.m. in 57.3%, 14 p.m. and 7 p.m.in, 25.7% and between 7 p.m. and 7 a.m. in 17.0%. The absenteeism was mainly observed (85.7%) for the nurses of about 30 years old and those (59.5%) whom the seniority in the service was inferior or equal 5 years. The absences justified were more observed (p< 10(-4)) for nurses of about 30 years old and those whom the seniority did not pass 5 years. The absenteeism of nurses constitutes a real social and administrative problem that deserves a particular attention considering its impact on the supply and the quality of cares. PMID:24046005

Tsiba, J B; Mabiala Babela, J R; Ngoulou, M N; Niambi Poaty, G; Moukouyou Ndombo, M; Moukassa, D

2013-10-01

184

Sighting of apparent Whooper Swan on Vancouver Island, British Columbia  

Microsoft Academic Search

A possible Whooper Swan (Cygnus cygnus) was photographed in flight in the Comox Valley, Vancouver Island, British Columbia, in January of 2008. It had been part of a group of Trumpeter Swans (Cygnus buccinator) feeding in a field. It appeared to be an adult or sub-adult bird with extensive yellowish markings on the bill, similar to those of a Whooper

Dianne Shuttleworth

185

Dendrochronological Mass Balance Reconstruction, Strathcona Provincial Park, Vancouver Island, Briti  

Microsoft Academic Search

A long-term proxy record of glacier mass balance was developed for Colonel Foster and Septimus glaciers on Vancouver Island, British Columbia, Canada. This was accomplished by analyzing the radial growth characteristics of climatically-sensitive mountain hemlock trees (Tsuga mertensiana), and by comparing this response with mass balance records from four glaciers in the Pacific Northwest. A strong (negative) relationship between the

Dave Lewis

186

Vancouver conference hailed as latest step in "revolution for children".  

PubMed Central

Physicians who organized a major conference on children's health in Vancouver this summer say it provided further evidence of the growing strength of a "revolution for children." The conference, which attracted 4000 delegates, followed up on earlier meetings held to improve the health care available to children around the world. PMID:7585381

LeBourdais, E

1995-01-01

187

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

E-print Network

13th World Conference on Earthquake Engineering Vancouver, B.C., Canada August 1-6, 2004 Paper No the 1994 Northridge in a 7-story reinforced concrete building located in the Los Angeles area. Nodal time with compression are illustrates for a small database of ground response records from six earthquakes recorded

Southern California, University of

188

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

ERIC Educational Resources Information Center

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…

Yoon, Ee-Seul

2011-01-01

189

WILDLIFE CONTROL AT VANCOUVER INTERNATIONAL AIRPORT: INTRODUCING BORDER COLLIES  

Microsoft Academic Search

Situated on an island located along a major Pacific Flyway, Vancouver International Airport (YVR) has developed a comprehensive wildlife management program in order to maintain a safe aircraft operating environment. YVR attracts a diverse range of bird species, including: ducks; gulls; herons; geese (Canada and Snow); sparrows; swallows; crows; starlings; owls; hawks; and eagles. The airport’s Wildlife Management Program consists

Dave Ball

2000-01-01

190

PLANNING FOR WATER CONSERVATION Greater Vancouver Regional District  

E-print Network

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

191

Reception Classes for Immigrant Students in Vancouver, Canada.  

ERIC Educational Resources Information Center

Addresses the question of how the education system responds to the needs of immigrant students on arrival in Vancouver, Canada, focusing on reception classes. The Oakridge Reception and Orientation Centre (OROC) was created to serve various functions for such students, including ascertaining their literacy backgrounds and assigning them to…

Gunderson, Lee

2002-01-01

192

Dance K-12 in the Vancouver Schools: Innovating, Advocating, Educating  

ERIC Educational Resources Information Center

A history of the outstanding K-12 dance program in Vancouver, Washington, is provided, including various strategies used to promote its growth from a few pilot elementary schools through middle schools to an arts magnet high school. Numerous changes have been weathered by the professional dance staff, including certification challenges instigated…

Gilsdorf, Rie Algeo

2004-01-01

193

Mathematical modelling of patient flows to predict critical care capacity required following the merger of two district general hospitals into one.  

PubMed

There is both medical and political drive to centralise secondary services in larger hospitals throughout the National Health Service. High-volume services in some areas of care have been shown to achieve better outcomes and efficiencies arising from economies of scale. We sought to produce a mathematical model using the historical critical care demand in two District General Hospitals to determine objectively the requisite critical care capacity in a newly built hospital. We also sought to determine how well the new single unit would be able to meet changes in demand. The intention is that the model should be generic and transferable for those looking to merge and rationalise services on to one site. One of the advantages of mathematical modelling is the ability to interrogate the model to investigate any number of different scenarios; some of these are presented. PMID:25267582

Williams, J; Dumont, S; Parry-Jones, J; Komenda, I; Griffiths, J; Knight, V

2015-01-01

194

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

PubMed Central

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

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

195

Incidence of tuberculous and non-tuberculous mycobacteria, differentiated by multiplex PCR, in clinical specimens of a large general hospital  

PubMed Central

OBJECTIVE: To determine the incidence of Mycobacterium tuberculosis complex and non-tuberculous mycobacterial isolates in the routine setting of a large general hospital using an "in-house" multiplex polymerase chain reaction method and to establish a paradigm for the definitive identification of mycobacteria isolated using semi-automated equipment. METHODS: Established tests, including polymerase chain reaction restriction enzyme analysis, PNB, and NAP inhibition tests as the gold standard, showed 100% agreement with an IS6110/hsp65 multiplex polymerase chain reaction when used to identify stock strains (n?=?117). RESULTS: In a subsequent study, 8,790 clinical specimens producing 476 isolates were evaluated with multiplex PCR and also showed 100% agreement in identification using PRA-polymerase chain reaction as the gold standard. The application of this technique to routine analysis was demonstrated in this study. A method was established with the initial application of multiplex PCR for all positive liquid cultures and the subsequent identification of non-tuberculous mycobacteria by polymerase chain reaction restriction enzyme analysis. In total, 77% of isolates belonged to the Mycobacterium tuberculosis complex, and 23% were non-tuberculous mycobacteria. CONCLUSIONS: Several non-tuberculous mycobacterial species were identified, primarily M. avium, but other potentially pathogenic species were also frequently observed, including M. fortuitum, M. abscessus, and M. kansasii. The expeditious communication of these data to the clinical staff was fundamental for the diagnosis of clinical cases. Even in settings where tuberculosis is of major importance, the incidence of non-tuberculous mycobacteria infection is substantial. PMID:23525313

Bensi, Eliane Picoli Alves; Panunto, Patricia Costa; de Carvalho Ramos, Marcelo

2013-01-01

196

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

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

Seroude, Laurent

197

The seasonal variation of Achilles tendon ruptures in Vancouver, Canada: a retrospective study  

PubMed Central

Objective To examine the seasonal distribution of tendon ruptures in a large cohort of patients from Vancouver, Canada. Design Retrospective chart review. Setting Acute Achilles tendon rupture cases that occurred from 1987 to 2010 at an academic hospital in Vancouver, Canada. Information was extracted from an orthopaedic database. Participants No direct contact was made with the participants. The following information was extracted from the OrthoTrauma database: age, sex, date of injury and season (winter, spring, summer and autumn), date of surgery if date of injury was unknown and type of injury (sport related or non-sport related/unspecified). Only acute Achilles tendon rupture cases were included; chronic cases were excluded along with those that were conservatively managed. Primary and secondary outcomes The primary outcome was to determine the seasonal pattern of Achilles tendon rupture. Secondary outcomes, such as differences in gender and mechanism of sport (non-sport vs sport related), were also assessed. Results There were 543 cases in total; 83% of the cases were men (average age 39.3) and 17% were women (average age 37.3). In total, 76% of cases were specified as sport related. The distribution of injuries varied significantly across seasons (?2, p<0.05), with significantly more cases occurring in spring. The increase in the number of cases in spring was due to sport-related injuries, whereas non-sport-related cases were distributed evenly throughout the year. Conclusions The seasonality of sport-related Achilles tendon ruptures should be considered when developing preventive strategies and when timing their delivery. PMID:24519875

Scott, Alex; Grewal, Navdeep; Guy, Pierre

2014-01-01

198

Hospitality Management Hospitality Management  

E-print Network

of the global hospitality industry. Academic Offerings HOSPITALITY AND FOOD SERVICE MANAGEMENT MINOR HOSPITALITY AND FOOD SERVICE MANAGEMENT MINOR Students pursuing programs in other areas of study may choose a minor Service Operations 4 OR NSD 225 Nutrition in Health 3 12 credits needed: HPM 300 Selected Topics: Advanced

McConnell, Terry

199

Style Matters: Manuscript requirements: the advance from Vancouver  

PubMed Central

The agreement on uniform requirements for manuscripts developed in January 1978 in Vancouver, British Columbia, by a small group of clinical editors is now adhered to by more than 130 journals. This development was reported at a meeting of the International Committee of Medical Journal Editors held at Leeds Castle, Kent, England, in October 1980. Suggestions for revision of the requirements document were reviewed, and closer consideration of possible changes was scheduled for October 1981. PMID:6108792

Huth, Edward

1981-01-01

200

2004/05 Industry-Sponsored Research Statistics UBC -Vancouver  

E-print Network

,743 1.9% 4.0% 50.3% 0.0% 45.7% College of Health Disciplines $4,405,961 10 0 0.0% 0 0 $0 0.0% n/a n/a n2004/05 Industry-Sponsored Research Statistics Faculty UBC - Vancouver Applied Science $26 with multiple faculties Value of Industry Sponsored Research % of Faculty Research Funding Principal

Ollivier-Gooch, Carl

201

Graveyard of the Pacific: The Shipwrecks of Vancouver Island  

NSDL National Science Digital Library

For those who make their living aboard large ships, there is always the fear of a potential shipwreck, especially when navigating dangerous passages. One of the latest sites from the Virtual Museum of Canada explores the various shipwrecks that have taken place around Vancouver Island, off the mainland of British Columbia, from the year 1803 to the present day. Here visitors will learn about the tales of survival from these doomed vessels, view an interactive map of the shipwrecks, and learn about the various hazards associated with the waters off Vancouver Island. The tales of survival are told in 10 stories disseminated through the site's own "Shipwreck Times", which takes quotes from interviews and historic newspaper articles to create a full portrait of each incident. The interactive shipwreck map is quite nice, as it allows visitors to learn about each shipwreck and to view photographs of the various wrecks in context. There is also an interactive game called "Wrecks", that allows visitors to navigate the icy oceans of Vancouver Island in an attempt to bring their cargo to a safe harbor.

202

Hostile interaction in a general hospital ward leading to disturbed behaviour and bulimia in anorexia nervosa: its successful management  

Microsoft Academic Search

A girl of 17 years with severe anorexia nervosa, treated on a medical ward in a teaching hospital, developed bulimia, stole food, was sometimes doubly incontinent, behaved angrily, and aroused the hostility of patients and staff. The growth of a vicious circle of hostility is described and it was hypothesized that the hostility had aggravated the bulimia. On the basis

S. I. Cohen

1978-01-01

203

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

ERIC Educational Resources Information Center

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…

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

2007-01-01

204

Motives for drinking, alcohol consumption, and alcohol-related consequences in a Vancouver youth sample.  

E-print Network

??This longitudinal investigation examined motives for alcohol use, alcohol consumption, and alcohol-related consequences in a Vancouver, British Columbia youth sample (n = 405). Secondary analyses… (more)

McIntosh, Kimberly Ann

2011-01-01

205

THE RELATIONSHIP BETWEEN SELF-REPORTED HEALTH STATUS AND SPIRITUALITY AMONG ADULT PATIENTS ATTENDING GENERAL OUTPATIENT CLINIC OF TERTIARY HOSPITAL IN IBADAN  

PubMed Central

Background: Spirituality is an important aspect of health that is not always addressed in modern day medical practice. This is related to lack of clarity about the nature of the concept, however its role in researches and health service provision is being revisited because of the evergreen importance. Objective: To determine the relationship between spirituality and selfreported health status of adult patients attending general outpatient clinic of University College Hospital, Ibadan, Nigeria. Methods: A cross-sectional descriptive study wherein interviewer administered questionnaire was applied on randomly selected 422 eligible and consenting adult patients attending general outpatient clinic of University College Hospital between 1st November, 2010 and 31st January, 2011. Their Spirituality and Heath status were assessed using spirituality scale and self reported health questionnaire respectively. Result: Of all the respondents, 270(64.0%) were females while 152(36.0%) were males with a ratio of 1.8:1, and mean age of 42.8±15.9. The overall mean spirituality score was 125.7 ± 12.1, the maximum obtainable score was 138. A total of 63(15.0%) respondents rated their health as excellent, 114 (27.0%) rated theirs as very good while 150 (35.5%) respondents considered theirs as good. Respondents who rated their health as good had significantly higher mean scores when compared with those who rated theirs as poor or fair (mean difference = 3.347, 95% C I = 0.552 to -6.142 p=0.019) Conclusion: The study revealed that perceived spiritual wellbeing is positively related to the patient's sense of general wellbeing. Therefore, there is need to give attention to patient's spiritual wellbeing during medical encounter in the hospital. PMID:25332698

Ibraheem, A.B.; Ibraheem, W.A.; Adebusoye, L.

2014-01-01

206

The University of Rochester Associated Hospitals Program in internal medicine. Seven years experience with an innovative city-wide residency for preparation of general internists.  

PubMed

The Associated Hospitals Program (AHP), with a total of 61 residents, engages the staff, patients and facilities of six hospitals and selected community health centers and private practices. The AHP in interlocked with separately accredited residencies in internal medicine in the participating hospitals and provides experiences, especially with ambulant patients, beyond those of more traditional programs in internal medicine. Strategies used by the AHP are minimally dependent upon grants from governmental and private sources for support of the basic three-year program. About one-third of the residents enter practice after completing the basic program; the larger share have a wide range of engagements in the fourth and fifth post-doctoral years for enhancement of clinical and teaching abilities and for critical study of health care. Eighty-seven, or 94 percent, of the 93 alumni are engaged in practice, and many also in teaching, of general internal medicine. Included in the 87 alumni are 12 of 18 residents who had two-year fellowships in medical subspecialties after completion of the AHP residency. The alumni have wide geographic distribution; 33 are practicing in communities with populations of less than 100,000 and 17 of these 33 are in communities of less than 25,000 persons. PMID:7046435

Napodano, R J; Young, L E

1982-06-01

207

Surgical Site Infection in General and Thoracic Surgery: Surveillance of 2?663 Cases in a Japanese Teaching Hospital  

Microsoft Academic Search

Purpose  We conducted a prospective survey of 2?663 surgical patients in a Japanese teaching hospital to look for any risk factors\\u000a predisposing to surgical site infection (SSI) other than the National Nosocomial Infection Surveillance (NNIS) System risk\\u000a indices; namely, performance status, operative time, wound classification, and endoscopic use.\\u000a \\u000a \\u000a \\u000a Methods  Our Infection Control Team recorded data for 5 years using the Japanese SSI

Junichi Yoshida; Masahiro Shinohara; Mikimasa Ishikawa; Kenichi Matsuo

2006-01-01

208

Everywhere and nowhereVancouver, fan pilgrimage and the urban imaginary  

Microsoft Academic Search

This article discusses fan pilgrimage, using as a case study the city of Vancouver, Canada — a location that has been used as the basis for several cult television series. It draws on theories of urban geography, particularly of postmodern suburbia (Edward Relph, Jean Baudrillard, Umberto Eco, Fredric Jameson, Edward Soja) to argue that while Vancouver may be valued by

Will Brooker

2007-01-01

209

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

ERIC Educational Resources Information Center

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…

Culhane, Dara

2003-01-01

210

Numerical Simulations of a Buoyancy-Driven Coastal Countercurrent off Vancouver Island  

Microsoft Academic Search

A three-dimensional prognostic numerical model has been developed to study the ocean circulation around Vancouver Island, British Columbia. In a series of simulations, the model is applied to examine the role of buoyancy forcing in the dynamics of the summer coastal countercurrent found off the west coast of Vancouver Island. The forcing is provided by the Fraser River discharge into

Diane Masson; Patrick F. Cummins

1999-01-01

211

An urban metabolism and ecological footprint assessment of Metro Vancouver.  

PubMed

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

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

2013-07-30

212

2008/09 Industry-Sponsored Research Statistics UBC -Vancouver  

E-print Network

% 0.0% 66.6% 33.4% 0.0% Management $41,000 8 0 0.0% 0 0 $0 0.0% n/a n/a n/a n/a VP Academic (Academic Units) $177,814 2 0 0.0% 0 0 $0 0.0% n/a n/a n/a n/a Total - Okanagan $10,014,936 149** 6 4.0% 6 5 $1602008/09 Industry-Sponsored Research Statistics Faculty UBC - Vancouver Applied Science $38

Ollivier-Gooch, Carl

213

An urban metabolism and ecological footprint assessment of Metro Vancouver Jennie Moore a,*, Meidad Kissinger a,b  

E-print Network

An urban metabolism and ecological footprint assessment of Metro Vancouver Jennie Moore a,*, Meidad through Metro Vancouver (424,860,000 m3 ), it has the smallest ecological footprint (23,100 gha). Food (2 of the EF (1,414,440 gha). Metro Vancouver's total Ecological Footprint in 2006 was 10,071,670 gha, an area

Pedersen, Tom

214

The view from out West: embeddedness, inter-personal relations and the development of an indigenous film industry in Vancouver  

Microsoft Academic Search

This paper considers the development of a particular cultural industry, the indigenous film and television production sector, in a specific locality, Vancouver (British Columbia, Canada). Vancouver’s film and television industry exhibits a high level of dependency on the location shooting of US funded productions, a relatively mobile form of foreign investment capital. As such, the development of locally developed and

Neil M. Coe

2000-01-01

215

Care in specialist medical and mental health unit compared with standard care for older people with cognitive impairment admitted to general hospital: randomised controlled trial (NIHR TEAM trial)  

PubMed Central

Objective To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment. Design Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system. Setting Large acute general hospital in the United Kingdom. Participants 600 patients aged over 65 admitted for acute medical care, identified as “confused” on admission. Interventions Participants were randomised to a specialist medical and mental health unit, designed to deliver best practice care for people with delirium or dementia, or to standard care (acute geriatric or general medical wards). Features of the specialist unit included joint staffing by medical and mental health professionals; enhanced staff training in delirium, dementia, and person centred dementia care; provision of organised purposeful activity; environmental modification to meet the needs of those with cognitive impairment; delirium prevention; and a proactive and inclusive approach to family carers. Main outcome measures Primary outcome: number of days spent at home over the 90 days after randomisation. Secondary outcomes: structured non-participant observations to ascertain patients’ experiences; satisfaction of family carers with hospital care. When possible, outcome assessment was blind to allocation. Results There was no significant difference in days spent at home between the specialist unit and standard care groups (median 51 v 45 days, 95% confidence interval for difference ?12 to 24; P=0.3). Median index hospital stay was 11 versus 11 days, mortality 22% versus 25% (?9% to 4%), readmission 32% versus 35% (?10% to 5%), and new admission to care home 20% versus 28% (?16% to 0) for the specialist unit and standard care groups, respectively. Patients returning home spent a median of 70.5 versus 71.0 days at home (?6.0 to 6.5). Patients on the specialist unit spent significantly more time with positive mood or engagement (79% v 68%, 2% to 20%; P=0.03) and experienced more staff interactions that met emotional and psychological needs (median 4 v 1 per observation; P<0.001). More family carers were satisfied with care (overall 91% v 83%, 2% to 15%; P=0.004), and severe dissatisfaction was reduced (5% v 10%, ?10% to 0%; P=0.05). Conclusions Specialist care for people with delirium and dementia improved the experience of patients and satisfaction of carers, but there were no convincing benefits in health status or service use. Patients’ experience and carers’ satisfaction might be more appropriate measures of success for frail older people approaching the end of life. Trial registration Clinical Trials NCT01136148 PMID:23819964

2013-01-01

216

Standard of care for type 2 diabetic patients in a public hospital general medical clinic: report of a self-audit.  

PubMed

We audited the standard of care provided to 200 consecutive type 2 diabetic patients attending our hospital general medical clinic. Data on diabetes related processes and outcome measures were collected. Annual testing rates (blood pressure 100%, fasting lipid profile 91.8%, HbA1c 69%) were higher compared to complications screening rates (Eye 69%, albuminuria 51%, foot 22.4%). Lifestyle intervention was lacking with BMI documented in 38.3% of patients and smoking history in 46%. Fifty percent and 41% of patients with HbA1c > 7.5% were referred to diabetes educator and dietitian respectively. For outcome measures, 26% of patients achieved HbA1c < or = 7%, 33% achieved BP < or = 130/80 while 56% achieved LDL < or = 2.6 mmol/L. Aspirin was prescribed in 78% and ACE inhibitor or angiotensin receptor blocker in 91.8% of patients. Lifestyle intervention and complication screening are the two major areas of deficiencies in the care of type 2 diabetic patients in our hospital general medical clinic. PMID:19248695

Tan, F; Chan, G; Wong, J S; Rozario, F

2008-08-01

217

Routes of hysterectomy in women with benign uterine disease in the Vancouver Coastal Health and Providence Health Care regions: a retrospective cohort analysis  

PubMed Central

Background Minimally invasive hysterectomies performed vaginally or laparoscopically are associated with decreased perioperative morbidity. We examined temporal trends and patient and hospital factors associated with the routes of hysterectomy used in the Vancouver Coastal Health and Providence Health Care regions in British Columbia. Methods We performed a retrospective cohort study of all women who had an elective hysterectomy for a benign indication between 2007 and 2011 in 8 hospitals in the region. Logistic regression modeling with mixed effects was used to estimate adjusted odds ratios and 95% confidence intervals for patient and hospital characteristics associated with the route of hysterectomy. Results The study involved 4372 women who underwent abdominal (52.3%), vaginal (25.5%) or laparoscopic (22.3%) hysterectomy. From 2007 to 2011, the number of abdominal hysterectomies performed decreased from 58.4% to 47.7%, the number of vaginal hysterectomies performed decreased from 27.5% to 21.1% and the number of laparoscopic hysterectomies performed increased from 14.2% to 31.2% (p < 0.001 for all trends). Patient factors associated with laparoscopic versus abdominal hysterectomy included young age, pain or prolapse indication, absence of fibroid indication, absence of concurrent gynecologic procedure, rural residence and lower socioeconomic status. Patient factors associated with vaginal hysterectomy included older age, prolapse indication and concurrent procedure for prolapse. Hospital location and size were not significantly associated with vaginal hysterectomy, but urban hospital location was associated with laparoscopic hysterectomy. Interpretation The proportion of minimally invasive hysterectomies is increasing and represents approximately half of all hysterectomies performed in the Vancouver Coastal Health and Providence Health Care regions. Vaginal hysterectomies are associated with patient characteristics, whereas laparoscopic hysterectomies are associated with patient and hospital characteristics. PMID:25485254

Lisonkova, Sarka; Allaire, Catherine; Williams, Christina; Yong, Paul; Joseph, K.S.

2014-01-01

218

Vancouver At Home: pragmatic randomized trials investigating Housing First for homeless and mentally ill adults  

PubMed Central

Background Individuals with mental illnesses are overrepresented among the homeless. Housing First (HF) has been shown to promote positive outcomes in this population. However, key questions remain unresolved, including: how to match support services to client needs, the benefits of housing in scattered sites versus single congregate building, and the effectiveness of HF with individuals actively using substances. The present study aimed to recruit two samples of homeless mentally ill participants who differed in the complexity of their needs. Study details, including recruitment, randomization, and follow-up, are presented. Methods Eligibility was based on homeless status and current mental disorder. Participants were classified as either moderate needs (MN) or high needs (HN). Those with MN were randomized to HF with Intensive Case Management (HF-ICM) or usual care. Those with HN were randomized to HF with Assertive Community Treatment (HF-ACT), congregate housing with support, or usual care. Participants were interviewed every 3 months for 2 years. Separate consent was sought to access administrative data. Results Participants met eligibility for either MN (n?=?200) or HN (n?=?297) and were randomized accordingly. Both samples were primarily male and white. Compared to participants designated MN, HN participants had higher rates of hospitalization for psychiatric reasons prior to randomization, were younger at the time of recruitment, younger when first homeless, more likely to meet criteria for substance dependence, and less likely to have completed high school. Across all study arms, between 92% and 100% of participants were followed over 24 months post-randomization. Minimal significant differences were found between study arms following randomization. 438 participants (88%) provided consent to access administrative data. Conclusion The study successfully recruited participants meeting criteria for homelessness and current mental disorder. Both MN and HN groups had high rates of substance dependence, suicidality, and physical illness. Randomization resulted in no meaningful detectable differences between study arms. Trial registration Current Controlled Trials: ISRCTN57595077 (Vancouver at Home study: Housing First plus Assertive Community Treatment versus congregate housing plus supports versus treatment as usual) and ISRCTN66721740 (Vancouver At Home study: Housing First plus Intensive Case Management versus treatment as usual). PMID:24176253

2013-01-01

219

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

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

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

2014-01-01

220

The Epidemiology of Pulmonary Nontuberculous Mycobacteria: Data from a General Hospital in Athens, Greece, 2007–2013  

PubMed Central

Background. The epidemiology of pulmonary nontuberculous mycobacteria (NTM) in Greece is largely unknown. Objectives. To determine the incidence and the demographic, microbiological, and clinical characteristics of patients with pulmonary NTM infection and pulmonary NTM disease. Methods. A retrospective review of the demographic, microbiological, and clinical characteristics of patients with NTM culture-positive respiratory specimens from January 2007 to May 2013. Results. A total of 120 patients were identified with at least one respiratory NTM isolate and 56 patients (46%) fulfilled the microbiological ATS/IDSA criteria for NTM disease. Of patients with adequate data, 16% fulfilled the complete ATS/IDSA criteria for NTM disease. The incidence of pulmonary NTM infection and disease was 18.9 and 8.8 per 100.000 inpatients and outpatients, respectively. The spectrum of NTM species was high (13 species) and predominated by M. avium-intracellulare complex (M. avium (13%), M. intracellulare (10%)), M. gordonae (14%), and M. fortuitum (12%). The ratio of isolation of NTM to M. tuberculosis in all hospitalized patients was 0.59. Conclusions. The first data on the epidemiology of pulmonary NTM in Athens, Greece, are presented. NTM infection is common in patients with chronic respiratory disease. However, only a significantly smaller proportion of patients fulfill the criteria for NTM disease. PMID:25132991

Papaioannou, Andriana I.; Paraskeua, Maria; Velentza, Ekaterini; Kanellopoulou, Maria; Filaditaki, Vasiliki; Karagiannidis, Napoleon

2014-01-01

221

IBCD: Development and Testing of a Checklist to Improve Quality of Care for Hospitalized General Medical Patients  

PubMed Central

Background Several studies have demonstrated the usefulness of medical checklists to improve quality of care in surgery and the ICU. The feasibility, effectiveness, and sustainability of a checklist was explored. Methods Literature on checklists and adherence to quality indicators in general medicine was reviewed to develop evidence-based measures for the IBCD checklist: (I) pneumococcal immunization (I), (B) pressure ulcers (bedsores), (C) catheter-associated urinary tract infections (CAUTIs), and (D) deep venous thrombosis (DVT) were considered conditions highly relevant to the quality of care in general medicine inpatients. The checklist was used by attending physicians during rounds to remind residents to perform four actions related to these measures. Charts were audited to document actions prompted by the checklist. Results The IBCD checklist was associated with significantly increased documentation of and adherence to care processes associated with these four quality indicators. Seventy percent (46/66) of general medicine teams during the intervention period of July 2010–March 2011 voluntarily used the IBCD checklist, for 1,168 (54%) of 2,161 patients. During the intervention period, average adherence for all four checklist items increased from 68% on admission to 82% after checklist use (p < .001). Average adherence after checklist use was also higher when compared to a historical control group from one year before implementation (82% versus 50%, p < .0001). In the six weeks after the checklist was transitioned to the electronic medical record (EMR), IBCD was noted in documentation of 133 (59%) of 226 patients admitted to general medicine. Conclusion A checklist is a useful and sustainable tool to improve adherence to, and documentation of, care processes specific to quality indicators in general medicine. PMID:23641534

Aspesi, Anthony V.; Kauffmann, Greg E.; Davis, Andrew M.; Schulwolf, Elizabeth M.; Press, Valerie G.; Stupay, Kristen L.; Lee, Janey J.; Arora, Vineet M.

2014-01-01

222

TOURISM AND HOSPITALITY MANAGEMENT (TOUR)  

E-print Network

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 integrates general management concepts with the professional knowledge that is required by the tourism

Calgary, University of

223

Ongoing spread of colistin-resistant Klebsiella pneumoniae in different wards of an acute general hospital, Italy, June to December 2011.  

PubMed

We describe polyclonal spread of colistin-resistant Klebsiella pneumoniae in an acute general hospital in Italy. Between June and December 2011, 58 colistin-resistant K. pneumoniae isolates were recovered from 28 patients admitted to different wards, but mainly in the intensive care units. All isolates were tested for drug susceptibility and the presence of beta-lactamase (bla) genes. Clonality was investigated by repetitive extragenic palindromic (rep)-PCR and multilocus sequence typing (MLST). Fifty-two isolates had minimum inhibitory concentrations (MICs) for colistin of 6-128 mg/L, carried bla(KPC3) and were attributed to sequence type ST258. The remaining six isolates were susceptible to carbapenems, exhibited MICs for colistin of 3-32 mg/L, and belonged to two different types, ST15 and ST273. Rep-PCR included all isolates in three clusters, one containing all ST258 KPC-3-producing isolates and two containing ST15 and ST273 isolates.Cross-transmission containment measures and intensification of staff and environmental hygiene could not stop the outbreak. Selective pressure and horizontal transmission probably contributed to emergence and spread of three different strains of colistin-resistant K. pneumoniae in the hospital. Strict implementation of the above measures and a wider awareness of the antimicrobial resistance threat are crucial to preserve the last therapeutic options of the multidrug-resistant Gram-negative infections. PMID:22913977

Mammina, C; Bonura, C; Di Bernardo, F; Aleo, A; Fasciana, T; Sodano, C; Saporito, M A; Verde, M S; Tetamo, R; Palma, D M

2012-01-01

224

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

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

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

225

Endocarditis in a large district general hospital: A study of the microbiological spectrum between 2000 and 2011.  

PubMed

Infective endocarditis is one of three common cardiac infections in the United Kingdom, in addition to myocarditis and pericarditis, with a reported incidence of 1.7 to 6.2 cases per 100,000 patient years. Infective endocarditis can often have serious consequences and a wide variety of organisms may be the causative pathogen. There are little published data regarding the exact spectrum of organisms that cause endocarditis in the United Kingdom and whether organisms such as streptococci still dominate. In the present study, all cases of endocarditis at the authors' institution, representing a typical nontertiary centre, were retrospectively examined and audited to provide a snapshot of the organism spectrum in these patients. The cases of more than 120 patients who were coded as having endocarditis by the institution's clinical coding department during the period between December 2000 and January 2011 were examined. Microbiological tests and clinical case notes of all patients were reviewed. Of the 101 patients diagnosed with and treated for endocarditis, 64 were male, with a mean age of 60.57 years. The most common organisms identified were Streptococcus species (31%), Staphylococcus aureus (27%) and Enterococcus faecalis (21%). The organisms with the highest associated mortality rate were S aureus and the 'other organism' group, which included non-HACEK group (Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella species) pathogens such as Candida albicans. Streptococcus species and S aureus remain the main cause of endocarditis in a typical hospital setting in the United Kingdom, although in a smaller proportion of cases than historical data suggests. Overall, mortality remains high, and the clinician should remain vigilant to endocarditis in any patient with a positive blood culture because the number of cases of endocarditis caused by less typical organisms are increasing. PMID:23592930

Ashrafi, Reza; McKay, Ewan; Ebden, Lloyd; Jones, Julia; Davis, Gershan K; Burgess, Malcolm I

2012-01-01

226

Endocarditis in a large district general hospital: A study of the microbiological spectrum between 2000 and 2011  

PubMed Central

Infective endocarditis is one of three common cardiac infections in the United Kingdom, in addition to myocarditis and pericarditis, with a reported incidence of 1.7 to 6.2 cases per 100,000 patient years. Infective endocarditis can often have serious consequences and a wide variety of organisms may be the causative pathogen. There are little published data regarding the exact spectrum of organisms that cause endocarditis in the United Kingdom and whether organisms such as streptococci still dominate. In the present study, all cases of endocarditis at the authors’ institution, representing a typical nontertiary centre, were retrospectively examined and audited to provide a snapshot of the organism spectrum in these patients. The cases of more than 120 patients who were coded as having endocarditis by the institution’s clinical coding department during the period between December 2000 and January 2011 were examined. Microbiological tests and clinical case notes of all patients were reviewed. Of the 101 patients diagnosed with and treated for endocarditis, 64 were male, with a mean age of 60.57 years. The most common organisms identified were Streptococcus species (31%), Staphylococcus aureus (27%) and Enterococcus faecalis (21%). The organisms with the highest associated mortality rate were S aureus and the ‘other organism’ group, which included non-HACEK group (Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens and Kingella species) pathogens such as Candida albicans. Streptococcus species and S aureus remain the main cause of endocarditis in a typical hospital setting in the United Kingdom, although in a smaller proportion of cases than historical data suggests. Overall, mortality remains high, and the clinician should remain vigilant to endocarditis in any patient with a positive blood culture because the number of cases of endocarditis caused by less typical organisms are increasing. PMID:23592930

Ashrafi, Reza; McKay, Ewan; Ebden, Lloyd; Jones, Julia; Davis, Gershan K; Burgess, Malcolm I

2012-01-01

227

Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India  

PubMed Central

Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW) management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices. PMID:25657950

Manar, Manish Kumar; Sahu, Krishna Kumar; Singh, Shivendra Kumar

2014-01-01

228

The role of El Niño southern oscillation (ENSO) on variations of monthly Plasmodium falciparum malaria cases at the cayenne general hospital, 1996-2009, French Guiana  

PubMed Central

Background Malaria remains a serious problem in French Guiana, which is at potential risk for drought linked with the El Niño Event and where there could be a risk of malaria epidemic after the onset of an El Niño event. Methods A time series analysis using ARIMA was developed to investigate temporal correlations between the monthly Plasmodium falciparum case numbers and El Niño Southern Oscillation (ENSO) as measured by the Southern Oscillation Index (SOI) at the Cayenne General Hospital between 1996 and 2009. Results The data showed a positive influence of El Niño at a lag of three months on P. falciparum cases (p < 0.001). The incorporation of SOI data in the ARIMA model reduced the AIC by 4%. Conclusions Although there is a statistical link, the predictive value of ENSO to modulate prevention intervention seems marginal in French Guiana. However, additional work should refine the regional dependence of malaria on the ENSO state. PMID:21513502

2011-01-01

229

Rates and risk of hospitalisation among patients with type 2 diabetes: retrospective cohort study using the UK General Practice Research Database linked to English Hospital Episode Statistics  

PubMed Central

Aims To investigate the rates and risk of hospitalisations in patients with type 2 diabetes (T2D) mellitus in England. Methods This retrospective population-based cohort study used computerised records from the General Practice Research Database linked to Hospital Episode Statistics data in England. Patients with T2D from January 2006 to December 2010 were selected. Primary outcome measures were all-cause, non-diabetes-related, diabetes-related and hypoglycaemia-related hospitalisations. Factors associated with all-cause and diabetes-related hospitalisations were investigated with Cox's proportional hazards models. Results Amongst 97,689 patients with T2D, approximately 60% had at least one hospitalisation during the 4-year study period. Rates of hospitalisation were as follows: all-cause, 33.9 per 100 patient-years (pt-yrs); non-diabetes-related, 29.1 per 100 pt-yrs; diabetes-related, 18.8 per 100 pt-yrs and hypoglycaemia, 0.3 per 100 pt-yrs. The risk of all-cause hospitalisation increased with hospitalisation in the previous year, insulin use and the presence of major comorbidities. The risk of a diabetes-related hospitalisation increased with age, female gender, insulin use, chronic renal insufficiency, hypoglycaemia (as diagnosed by a general practitioner) and diabetes-related hospitalisation in the previous year. Conclusions Patients with T2D are hospitalised at a considerably high rate for causes directly related with diabetes complications and stay longer in hospital. History of hospitalisation and complications of diabetes were found to be predictive of inpatient hospitalisations suggesting previous hospitalisation episodes could serve as points of intervention. This study highlights important areas for healthcare intervention and provides a reminder for vigilance when risk factors for hospitalisation in patients with T2D are present. PMID:24112108

Khalid, J M; Raluy-Callado, M; Curtis, B H; Boye, K S; Maguire, A; Reaney, M

2014-01-01

230

Combined determination of highly sensitive troponin T and copeptin for early exclusion of acute myocardial infarction: first experience in an emergency department of a general hospital  

PubMed Central

Background: The purpose of this observational study was to test the diagnostic performance of the Elecsys® troponin T high-sensitive system combined with copeptin measurement for early exclusion of acute myocardial infarction (MI) in clinical practice. Methods: Troponin T high-sensitive (diagnostic cutoff: <14 pg/mL) and copeptin (diagnostic cutoff: <14 pmol/L) levels were determined at admission in addition to other routine laboratory parameters in patients with suspected acute MI presenting to the emergency department of a general hospital over a period of five months. Results: Data from 142 consecutive patients (mean age 71.2 ± 13.5 years, 76 men) were analyzed. Final diagnoses were acute MI in 13 patients (nine ST elevation MI, four non-ST elevation MI, 9.2%) unstable angina pectoris in three (2.1%), cardiac symptoms not primarily associated with myocardial ischemia in 79 (55.6%), and noncardiac disease in 47 patients (33.1%). The patients with acute MI were younger and had higher troponin T high-sensitive and copeptin values than patients without acute MI. Seventeen patients had very high copeptin values (>150 pmol/L), one of whom had a level of >700 pmol/L and died of pulmonary embolism. A troponin T high-sensitive level of <14 pg/mL in combination with copeptin <14 pmol/L at initial presentation ruled out acute MI in 45 of the 142 patients (31.7%), each with a sensitivity and negative predictive value of 100%. Conclusion: According to this early experience, a single determination of troponin T high-sensitive and copeptin may enable early and accurate exclusion of acute MI in one third of patients, even in an emergency department of a general hospital. PMID:21915168

Lotze, Ulrich; Lemm, Holger; Heyer, Anke; Müller, Karin

2011-01-01

231

Cryptococcus gattii in wildlife of Vancouver Island, British Columbia, Canada.  

PubMed

Although Cryptococcus gattii has emerged as an important pathogen of humans and domestic animals on Vancouver Island, Canada since 1999; its distribution in regional wildlife species is largely unknown. Opportunistic sampling methods were employed to obtain nasal swabs for fungal culture from wild mammal species residing within the coastal Douglas fir biogeoclimatic zone on the southeast coast of the island. Samples were collected from 91 animals representing 14 species. Cryptococcus gattii was isolated from the nasal swabs of two eastern gray squirrels (Sciurus carolinensis) trapped in Duncan, British Columbia. The relative proportion of nasal colonization in wild mammal species is consistent with findings in domestic animals, suggesting that animals may be good indicators of environmental organisms. PMID:16699162

Duncan, C; Schwantje, H; Stephen, C; Campbell, J; Bartlett, K

2006-01-01

232

The Monitoring Network of the Vancouver 2010 Olympics  

NASA Astrophysics Data System (ADS)

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.

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

233

Frequency of Intensive Care Unit admission after elective interventional neuroradiological procedures under general anesthesia in a tertiary care hospital  

PubMed Central

Background: The aim of this study was to determine the frequency of patients admitted to Intensive Care Unit (ICU) after elective interventional neuroradiology (INR) procedures under general anesthesia. Materials and Methods: We retrospectively evaluated 121 patients underwent INR procedures performed with general anesthesia within a 5-year period. Information including demographics, aneurysm/arteriovenous malformations pathology (ruptured or un-ruptured), preoperative neurological status, co-morbidities, complications during procedure and postoperative admission in ICU were recorded on a predesigned form. Results: Elective INR procedure for both ruptured (n = 29, 24%) and un-ruptured (n = 85, 70.25%) aneurysms was performed. Rate of postoperative admission in ICU was significantly high in patients with preoperative ruptured aneurysm (P < 0.01). High rate of neurological deficit, sub-arachnoid hemorrhage (SAH) and hypertension in patients were significant factors of postoperative admission in ICU (P < 0.05). Out of 24 patients, 12 were admitted to ICU postoperatively because of procedure-related complications and 11 were sent due to preexisting significant co-morbidities with added complication of SAH. Conclusion: The authors conclude that patients without major co-morbidities, intraoperative complications, or complex aneurysm morphology can be safely observed in a regular ward rather than being admitted to the ICU. PMID:25558194

Shamim, Faisal; Asghar, Ali; Karam, Karima

2015-01-01

234

Contemporary use of bark for medicine by two Salishan native elders of southeast Vancouver Island, Canada.  

PubMed

Elders of the Saanich and Cowichan Coast Salish people of southern Vancouver Island treat, or have treated in the recent past, many ailments with bark preparations. Interviews with two elder Salishan women revealed that: respiratory ailments were treated with bark of Abies grandis, Arbutus menziesii, Cornus nuttallii, Prunus emarginata, Pseudotsuga menziesii and Quercus garryana; digestive tract ailments with the bark of Abies grandis, Alnus rubra, Arbutus menziesii, Malus fusca. Oemleria cerasiformis, Populus tremuloides, Pseudotsuga menziesii, Rhamnus purshianus and Rubus spectabilis; gynaecological problems with bark of Abies grandis, Arbutus menziesii, Populus tremuloides, Prunus emarginata, Pseudotsuga menziesii and Sambucus racemosa; and dermatological complaints with the bark of Mahonia spp., Rubus spectabilis, and Symphoricarpos albus. Tree barks have also been used to treat fevers, diabetes, kidney problems, sore eyes, and haemorrhaging, and also as general tonics. Two recipes for general-purpose multi-bark medicines are provided. In most cases, infusions or decoctions of barks are used. The medicines are drunk or applied externally as a wash. PMID:2345461

Turner, N J; Hebda, R J

1990-04-01

235

Stream-Associated Amphibian Habitat Assessment in the Portland-Vancouver Metropolitan Region.  

E-print Network

?? This study assessed the influence of landscape development on stream-associated amphibians in forested riparian areas within the Portland-Vancouver metropolitan region. Human alteration of landscapes… (more)

Dietrich, Andrew Evans

2012-01-01

236

Loss and Maintenance of First Language Skills: Case Studies of Hispanic Families in Vancouver.  

ERIC Educational Resources Information Center

Explores the loss and maintenance of Spanish in Hispanic children in Vancouver from the perspective of parents. Focuses on the experiences of Hispanic parents of children either developing bilingually (Spanish-English) or monolingually (English).(Author/VWL)

Guardado, Martin

2002-01-01

237

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...

238

Occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy at the Cantonal Hospital Zenica.  

PubMed

Dear Editor, We read with interest the article by ?erim et al. regarding the occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy (1). Similar to the results of previous studies, the authors found that the use of corticosteroids is associated with a higher incidence of cataract development and posterior subcapsular (PSC) cataract as most prevalent morphological type (2). Older age and heredity are the most important risk factors associated with different types of cataracts and females are at increased risk of cortical cataract (2,3). Myopia (? -1.0 D) and elevated intraocular pressure are also associated with an increased risk of nuclear and PSC cataracts (3). The major causal external risk factors influencing cataract formation include: smoking, excessive UV-B exposure, diabetes mellitus (DM) and steroidal treatment (2,3). There is also a significant relationship between the risk of cataracts and delivered corticosteroid dose (4). Lower monthly household income, lower education, hypercholesterolemia, hypertension and DM are independent risk factors for the development of any cataract type, while older age and DM are independent risk factors for the development of pure PSC (5). Elevated body mass index (BMI) and rapid weight gain may also increase the risk for age related cataract, especially PSC cataract (3,6). Other risk factors for PSC development also include hypertension, the use of amiodarone, thiazide diuretics, aspirin and vitamin E (2). For these reasons, we would kindly ask the authors to perform the correlations for age, gender, BMI, length and regimen of steroid use, cumulative steroid dose, the use of other systemic drugs, DM duration, spherical equivalent and intraocular pressure changes, with cataract occurrence and morphology between the groups. Without this information it would be difficult to hypothesize the direct steroid induced cataractogenesis, especially in the group on the steroid therapy >4 years, where all patients had iatrogenic diabetes. In these patients, it is the indirect impact of steroids on body metabolism that might initiate the cataractogenesis. These findings will significantly contribute to the paper's scientific value and contribution. Overall, we agree with ?erim et al. that general steroid therapy remains the important risk factor for cataract development and all patients should have regular ophthalmological control examinations. Other systemic risk factors such as BMI, DM, smoking history, duration of basic systemic disease and corticosteroid dose should be carefully monitored too. PMID:25669346

Zvorni?anin, Jasmin; Zvorni?anin, Edita

2015-02-01

239

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

PubMed Central

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

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

2014-01-01

240

The Massachusetts General Hospital Pulmonary Embolism Response Team (MGH PERT): creation of a multidisciplinary program to improve care of patients with massive and submassive pulmonary embolism.  

PubMed

New and innovative tools have emerged for the treatment of massive and submassive pulmonary embolism (PE). These novel treatments, when considered alongside existing therapy, such as anticoagulation, systemic intravenous thrombolysis, and open surgical pulmonary embolectomy, have the potential to improve patient outcomes. However, data comparing different treatment modalities are sparse, and guidelines provide only general advice for their use. Treatment decisions rest on clinician expertise and institutional resources. Because various medical and surgical specialties offer different perspectives and expertise, a multidisciplinary approach to patients with massive and submassive PE is required. To address this need, we created a novel multidisciplinary program - the Massachusetts General Hospital (MGH) Pulmonary Embolism Response Team (PERT) - which brings together multiple specialists to rapidly evaluate intermediate- and high-risk patients with PE, formulate a treatment plan, and mobilize the necessary resources to provide the highest level of care. Development of a clinical, educational, and research infrastructure, as well as the creation of a national PERT consortium, will make our experience available to other institutions and serve as a platform for future studies to improve the care of complex patients with massive and submassive PE. PMID:24566594

Provias, Tim; Dudzinski, David M; Jaff, Michael R; Rosenfield, Kenneth; Channick, Richard; Baker, Joshua; Weinberg, Ido; Donaldson, Cameron; Narayan, Rajeev; Rassi, Andrew N; Kabrhel, Christopher

2014-02-01

241

Improving Hospital Care and Collaborative Communications for the 21st Century: Key Recommendations for General Internal Medicine  

PubMed Central

Background Communication and collaboration failures can have negative impacts on the efficiency of both individual clinicians and health care system delivery as well as on the quality of patient care. Recognizing the problems associated with clinical and collaboration communication, health care professionals and organizations alike have begun to look at alternative communication technologies to address some of these inefficiencies and to improve interprofessional collaboration. Objective To develop recommendations that assist health care organizations in improving communication and collaboration in order to develop effective methods for evaluation. Methods An interprofessional meeting was held in a large urban city in Canada with 19 nationally and internationally renowned experts to discuss suitable recommendations for an ideal communication and collaboration system as well as a research framework for general internal medicine (GIM) environments. Results In designing an ideal GIM communication and collaboration system, attendees believed that the new system should possess attributes that aim to: a) improve workflow through prioritization of information and detection of individuals’ contextual situations; b) promote stronger interprofessional relationships with adequate exchange of information; c) enhance patient-centered care by allowing greater patient autonomy over their health care information; d) enable interoperability and scalability between and within institutions; and e) function across different platforms. In terms of evaluating the effects of technology in GIM settings, participants championed the use of rigorous scientific methods that span multiple perspectives and disciplines. Specifically, participants recommended that consistent measures and definitions need to be established so that these impacts can be examined across individual, group, and organizational levels. Conclusions Discussions from our meeting demonstrated the complexities of technological implementations in GIM settings. Recommendations on the design principles and research paradigms for an improved communication system are described. PMID:23612055

Lo, Vivian; Rossos, Peter; Kuziemsky, Craig; O’Leary, Kevin J; Cafazzo, Joseph A; Reeves, Scott; Wong, Brian M; Morra, Dante

2012-01-01

242

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

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

Reade, Cynthia; Stoltzfus, Jill; Mittal, Vikrant

2014-01-01

243

Factors associated with premature mortality among young injection drug users in Vancouver  

PubMed Central

Background Young injection drug users (IDUs) may be at increased risk of premature mortality due to the health risks associated with injection drug use including overdoses and infections. However, there has been little research conducted on mortality causes, rates and associations among this population. We undertook this study to investigate patterns of premature mortality, prior to age 30 years, among young IDUs. Methods Since 1996, 572 young (?29 years) IDUs have been enrolled in the Vancouver Injection Drug Users Study (VIDUS). Semi-annually, participants have completed an interviewer-administered questionnaire and have undergone serologic testing for HIV and hepatitis C (HCV). Mortality data have been continually updated through linkages with the Provincial Coroner's Office. Crude and age-specific mortality rates, standardized mortality ratios, and life expectancy measures were calculated using person-time methods. Predictors of mortality were identified using Cox regression analyses. Findings Twenty-two participants died prior to age 30 years during the follow-up period for an overall crude mortality rate of 1,368 per 100,000 person-years. Overall, young IDUs were 16.4 times (95% confidence interval [CI]; 9.1–27.1) more likely to die; young women IDUs were 54.1 times (95%CI; 29.6–90.8) and young men IDUs were 12.9 times (95%CI; 5.5, 25.3) more likely to die when compared to the Canadian non-IDU population of the same age. The leading observed cause of death among females was: homicide (N = 9); and among males: suicide (N = 3) and overdose (N = 3). In Cox regression analyses, factors associated with mortality were, HIV infection (Hazard Ratio [HR]: 4.55; CI: 1.92–10.80) and sex work (HR: 2.76; CI: 1.16–6.56). Interpretation Premature mortality was 13 and 54 times higher among young men and women who use injection drugs in Vancouver than among the general population in Canada. The majority of deaths among the women were attributable to homicide, suggesting that interventions should occur not only through harm reduction services but also through structural interventions at the legal and policy level. PMID:17201933

Miller, Cari L; Kerr, Thomas; Strathdee, Steffanie A; Li, Kathy; Wood, Evan

2007-01-01

244

Atmospheric Aerosol Size Distribution at Sumas Mountain, Vancouver, BC.  

NASA Astrophysics Data System (ADS)

Atmospheric size distributions provide fundamental information for studying atmospheric particle physics. To study and monitor the air quality in the Lower Fraser Valley, Vancouver, BC, Pacific 2001 field study was held in Vancouver during August 13th to September 1st 2001. As part of the Pacific 2001 study, aerosol size distributions were measured at Eagle Ridge, just east of Abbotsford, BC. Atmospheric particles were sampled from a 3/8-inch stainless steel tubing with an inverted U-shape inlet. The sample line located at 2 meters above the top of a trailer that has an elevation of 300 meters above sea level. Particles coming from the sample line were sized using a TSI 3071 Differential Mobility Analysis (DMA) and then counted by a TSI 3010 Condensation Nucleus Counter (CNC). The system measured atmospheric particles with diameters from 9.3 to 604 nm. Each five-minute scan consisted of 30 size bins increasing exponentially in size. All the data was corrected for CNC counting efficiency and multiple charging effects to represent a more realistic description of the size distribution. During the field study, 19 days of data for both sunny and rainy days were obtained. By comparing the measured total concentration from 10 nm and 6 nm onwards, identified local nucleation event was observed in 4 days. Clear observation of particle transport from other remote places to the monitoring site was observed in 13 days during the study. Nucleation mode particles were usually observed between 10 a.m. to noon in all sunny days. These nucleation mode particles are thought to due to nocturnal inversion. As that happen, pollutants that were accumulated overnight in the valley were transported up to the site, with the combination of the sunlight, trigger the formation of new particles. The formation of these nucleation mode particles was usually followed by a short particle growth period, which may last from two to five hours, except for one day, which this growth period extends to midnight. Owing to the high variability of the size distribution, to fit these data using multi-LogNormal distributions may result instability problem. To accomplish this, we have explored a new method to analyse the data. Applying the Principal Component Analysis (PCA) to the data may provide more stable distribution for describing the data. Furthermore, the PCA also provide a mean for reducing a massive data set to a manageable data set.

Chan, T. W.; Mozurkewich, M.

2002-12-01

245

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

NASA Astrophysics Data System (ADS)

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.

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

2014-01-01

246

21 CFR 880.5120 - Manual adjustable hospital bed.  

Code of Federal Regulations, 2010 CFR

...false Manual adjustable hospital bed. 880.5120 Section...AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

2010-04-01

247

21 CFR 880.5140 - Pediatric hospital bed.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Pediatric hospital bed. 880.5140 Section...AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

2010-04-01

248

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

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

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

2014-01-01

249

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

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

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

2014-01-01

250

Awareness and Practices of Oral Hygiene and its Relation to Sociodemographic Factors among Patients attending the General Outpatient Department in a Tertiary Care Hospital of Kolkata, India  

PubMed Central

Background: Periodontal diseases, dental caries, malocclusion, and oral cancer are the most prevalent dental diseases affecting people in the Indian community. Objective: The study was conducted to assess the awareness and practices on oral hygiene and its association with the sociodemographic factors among patients attending the general Outpatient Department (OPD). Materials and Methods: A cross-sectional study was conducted among 224 patients attending the general OPD of the SSKM Hospital, Kolkata, India, from 1 April to 30 April, 2013. The study tool was a pre-designed and pre-tested semi-structured schedule. Results: About 69.20% of the participants used a toothbrush with toothpaste as a method of cleaning their teeth; 35.71% brushed twice in a day; 33.03% brushed both in the morning and at bedtime; and 8.93% used mouthwash. About 40.62% visited the dentist during the last six months; among them 61.18% attended because of pain. Almost three-fourth of the participants knew that tooth decay and bad breath were the effects of not cleaning the teeth. It was known to 71.42, 63.39, 70.53, and 73.21% of the respondents, respectively, that excess sweet, cold drink, alcohol, and smoking/pan chewing were bad for dental health. Television was the source of knowledge to 57.14% of the participants and 35.71% acquired their knowledge from a dentist. Females, literates, urban residents, users of mouthwash, and regular visitors to the dentist had good oral hygiene practices. Conclusion: Oral health awareness and practices among the study population are poor and need to improve. PMID:25161965

Paul, Bobby; Basu, Mausumi; Dutta, Sinjita; Chattopadhyay, Sita; Sinha, Debasis; Misra, Raghunath

2014-01-01

251

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

PubMed Central

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

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

2014-01-01

252

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

PubMed

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

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

2014-01-01

253

[The founding of Zemun Hospital].  

PubMed

This year Zemun Hospital--Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia.The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the"Kontumac"--a quarantine established in 1730. Soon after, two more confessional hospitals were opened.The Serbian (Orthodox) Hospital was founded before 1769, whereas the German (Catholic) Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall--the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time.The final, physical merging of these hospitals was completed in 1795. PMID:25233701

Milanovi?, Jasmina; Milenkovi?, Sanja; Pavlovi?, Momcilo; Stojanovi?, Dragos

2014-01-01

254

A prospective study to examine the epidemiology of methicillin-resistant Staphylococcus aureus and Clostridium difficile contamination in the general environment of three community hospitals in southern Ontario, Canada  

PubMed Central

Background The hospital environment has been suggested as playing an important role in the transmission of hospital-associated (HA) pathogens. However, studies investigating the contamination of the hospital environment with methicillin-resistant Staphylococcus aureus (MRSA) or Clostridium difficile have generally focused on point prevalence studies of only a single pathogen. Research evaluating the roles of these two pathogens, concurrently, in the general hospital environment has not been conducted. The objectives of this study were to determine the prevalence and identify risk factors associated with MRSA and C. difficile contamination in the general environment of three community hospitals, prospectively. Methods Sampling of environmental surfaces distributed over the medicine and surgical wards at each hospital was conducted once a week for four consecutive weeks. Sterile electrostatic cloths were used for environmental sampling and information regarding the surface sampled was recorded. For MRSA, air sampling was also conducted. Enrichment culture was performed and spa typing was performed for all MRSA isolates. For C. difficile, isolates were characterized by ribotyping and investigated for the presence of toxin genes by PCR. Using logistic regression, the following risk factors were examined for MRSA or C. difficile contamination: type of surface sampled, surface material, surface location, and the presence/absence of the other HA pathogen under investigation. Results Overall, 11.8% (n=612) and 2.4% (n=552) of surfaces were positive for MRSA and C. difficile, respectively. Based on molecular typing, five different MRSA strains and eight different C. difficile ribotypes, including ribotypes 027 (15.4%) and 078 (7.7%), were identified in the hospital environment. Results from the logistic regression model indicate that compared to computer keyboards, the following surfaces had increased odds of being contaminated with MRSA: chair backs, hand rails, isolation carts, and sofas. Conclusions MRSA and C. difficile were identified from a variety of surfaces in the general hospital environment. Several surfaces had an increased risk of being contaminated with MRSA but further studies regarding contact rates, type of surface material, and the populations using these surfaces are warranted. PMID:23136936

2012-01-01

255

MENTAL HOSPITALS IN INDIA  

PubMed Central

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

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

2000-01-01

256

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

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

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

2013-01-01

257

The Alma Mater Society of U.B.C. Vancouver February 8, 2012 PLACE: Council Chambers SUB Room 206  

E-print Network

The Alma Mater Society of U.B.C. Vancouver February 8, 2012 PLACE: Council Chambers SUB Room 206 students to use that. #12;The Alma Mater Society of U.B.C. Vancouver February 8, 2012 PLACE: Council to $3 million in health claims; biggest number is for drugs; also for paramedical services, medical

Pulfrey, David L.

258

Comparison of analogue model and field station EM responses on Southern Vancouver Island  

NASA Astrophysics Data System (ADS)

Measurements of geomagnetic induction responses for a laboratory analogue model, that includes a simulation of the subducting Juan de Fuca Plate, are compared with those obtained at three sites on Vancouver Island. Good agreement between model and field responses at the central Vancouver Island site is observed over the period range 3-60 min, while at the east and west coastal sites, good agreement is achieved only for periods greater than 20 min. At shorter periods, departures of the observed responses from those of the model are possibly the result of upper crust inhomogeneities not replicated in the simulation, and the complex strait with its numerous small islands and its irregular coastlines inadequately simulated in the course model. Nevertheless, the analogue model results are consistent with the premise of a Juan de Fuca plate, underlain by the conductive asthenosphere, subducting at a shallow depth beneath Vancouver Island.

Dosso, H. W.; Chen, J.; Nienaber, W.

259

UBC Social Ecological Economic Development Studies (SEEDS) Student Report Scaling-Up On-Site Composting in the Student Union Building ~UBC Vancouver~  

E-print Network

-Site Composting in the Student Union Building ~UBC Vancouver~ GRS 397 August 26, 2014 891 1673 University-Site Composting in the Student Union Building ~UBC Vancouver~ 2 Conducted by: Emme Lee Conducted for: AMS;Author: Emme Lee Scaling-Up On-Site Composting in the Student Union Building ~UBC Vancouver~ 3 CONTEXT

260

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

E-print Network

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

Oli, Madan K.

261

Patients Hospitalized in General Wards via the Emergency Department: Early Identification of Predisposing Factors for Death or Unexpected Intensive Care Unit Admission—A Historical Prospective  

PubMed Central

Background. To identify, upon emergency department (ED) admission, predictors of unexpected death or unplanned intensive care/high dependency units (ICU/HDU) admission during the first 15 days of hospitalization on regular wards. Methods. Prospective cohort study in a medical-surgical adult ED in a teaching hospital, including consecutive patients hospitalized on regular wards after ED visit, and identification of predictors by logistic regression and Cox proportional hazards model. Results. Among 4,619 included patients, 77 (1.67%) target events were observed: 32 unexpected deaths and 45 unplanned transfers to an ICU/HDU. We identified 9 predictors of the target event including the oxygen administration on the ED, unknown current medications, and use of psychoactive drug(s). All predictors put the patients at risk during the first 15 days of hospitalization. A logistic model for hospital mortality prediction (death of all causes) still comprised oxygen administration on the ED, unknown current medications, and the use of psychoactive drug(s) as risk factors. Conclusion. The “use of oxygen therapy on the ED,” the “current use of psychoactive drug(s)”, and the “lack of knowledge of current medications taken by the patients” were important predisposing factors to severe adverse events during the 15 days of hospitalization on regular wards following the ED visit. PMID:24624300

Boulain, Thierry; Runge, Isabelle; Delorme, Nathalie; Bouju, Angèle; Valéry, Antoine

2014-01-01

262

An audit of the standard of response letters sent by hospital specialists to general dental practitioners following a referred patient's first appointment.  

PubMed Central

INTRODUCTION: To assess the standard of response letters issued by dental hospital departments according to the requirements of the recipient dentists. PATIENTS AND METHODS: A cross-sectional survey from a UK dental hospital. All response letters issued from hospital departments between 1 January and 1 March 2003 were copied. Fifteen letters were selected for each department on a chronological sampling frame. The hospital response letters were compared to dentists' requirements, as determined in a previous study. RESULTS: Almost all departments achieved a minimum total score of 80%. The scores across all of the departments together achieved over 90% for all items of information except those relating to time. The samples of the three departments to score over 90% were the only ones to include SHO letters. The sample of the department with the highest score contained the most SHO letters and no consultant letters. CONCLUSIONS: The content standard of response letters was consistently high, particularly those letters written by SHOs, and most were written within 18 days of the patient's appointment. The use of a previously conducted questionnaire survey of dentists' opinions provided a valid means of assessing the quality of the response letters from hospital specialists. PMID:16053683

Tomlinson, Pamela; McAndrew, Robert

2005-01-01

263

Common mental disorders and mortality in the West of Scotland Twenty-07 Study: comparing the General Health Questionnaire and the Hospital Anxiety and Depression Scale  

PubMed Central

Background While various measures of common mental disorders (CMD) have been found to be associated with mortality, a comparison of how different measures predict mortality may improve our understanding of the association. This paper compares how the Hospital Anxiety and Depression Scale (HADS) and the 30-item General Health Questionnaire (GHQ-30) predict all cause and cause-specific mortality. Methods Data on 2547 men and women from two cohorts, aged approximately 39 and 55?years, from the West of Scotland Twenty-07 Study who were followed up for mortality over an average of 18.9 (SD 5.0) years. Scores were calculated for HADS depression (HADS-D), HADS Anxiety (HADS-A) and GHQ-30. Cox Proportional Hazards Models were used to determine how each CMD measure predicted mortality. Results After adjusting for serious physical illness, smoking, social class, alcohol, obesity, pulse rate and living alone, HRs (95% CI) per SD increase in score for all-cause mortality were: 1.15 (1.07 to 1.25) for HADS-D; 1.13 (1.04 to 1.23) for GHQ-30 and 1.05 (0.96 to 1.14) for HADS-A. After the same adjustments, cardiovascular disease mortality was also related to HADS-D (HR 1.24 (1.07 to 1.43)), to GHQ-30 (HR 1.24 (1.11 to 1.40)) and to HADS-A (HR 1.15 (1.01 to 1.32)); respiratory mortality to GHQ-30 (HR 1.33 (1.13 to 1.55)) and mortality from other causes, excluding injuries, to HADS-D (HR 1.28 (1.05 to 1.55)). Conclusions There were associations between CMD and both all-cause and cause-specific mortality which were broadly similar for GHQ-30 and HADS-D and were still present after adjustment for important confounders and mediators. PMID:23543730

Hannah, Mary Kathleen; Batty, G David; Benzeval, Michaela

2013-01-01

264

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

265

Spatial aggregations of seabirds and their prey on the continental shelf off SW Vancouver Island  

Microsoft Academic Search

We investigated the spatial scales at which seabirds aggregate and associate with prey over the continental shelf off southwest Vancouver Island, British Columbia. Bird densities and hydroacoustic measures of prey abundance were recorded in all seasons from 1993 to 1995 from a vessel moving along fixed strip transects (mean distance 93 km; minimum spatial units 250 m). We used the

Alan E. Burger; Christine L. Hitchcock; Gail K. Davoren

2004-01-01

266

THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER  

E-print Network

THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society 6138 SUB, SECONDED TRISTAN: "That the minutes of August 3 be approved." ... Carried Emergency Medical Assistance Team the Safewalk Coordinator who would be responsible for oversight of the Emergency Medical Assistance Team

Pulfrey, David L.

267

Dendrochronological Mass Balance Reconstruction, Strathcona Provincial Park, Vancouver Island, British Columbia, Canada  

Microsoft Academic Search

A long-term proxy record of glacier mass balance was developed for Colonel Foster and Septimus glaciers on Vancouver Island, British Columbia, Canada. This was accomplished by analyzing the radial growth characteristics of climatically-sensitive mountain hemlock trees (Tsuga mertensiana), and by comparing this response with mass balance records from four glaciers in the Pacific Northwest. A strong (negative) relationship between the

Dave Lewis; Dan Smith

2004-01-01

268

The Contrasting Discourses in the Professional Lives of Educators in Vancouver, Canada  

ERIC Educational Resources Information Center

This study investigated the relationship between education policy changes and the working conditions of teachers and school leaders in Vancouver, Canada. We found that policy does shape educators' discourse about their work conditions. This shaping manifested itself in the emotions teachers experience as they attempt to construct their identity as…

Grimmett, Peter P.; Dagenais, Diane; D'Amico, Laura; Jacquet, Marianne; Ilieva, Roumi

2008-01-01

269

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

ERIC Educational Resources Information Center

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…

Vessey, Rachelle

2013-01-01

270

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

E-print Network

, multimedia authoring involves making hard choices, forecasting technological evolution and adaptingInvited Presentation, EdMedia '94 Vancouver, Canada page 1 Issues and Obstacles with Multimedia to software and hardware technology changes. It is, perhaps, an unstable field of endeavor for an academic

271

VANCOUVER LAKE: DREDGED MATERIAL DISPOSAL AND RETURN FLOW MANAGEMENT IN A LARGE LAKE DREDGING PROJECT  

Microsoft Academic Search

The restoration of Vancouver Lake required the dredging of 6.5 × 10mof material from the Lake, the construction of 17 km of land based retaining dikes to enclose 180 ha of disposal area, and the disposal of nearly 3 × 10mof material in the lake to form an island. The requirement that all dredge return flow be returned to the

Richard Raymond; Fred Cooper

1984-01-01

272

Application of transmission reliability assessment in probabilistic planning of BC Hydro Vancouver South Metro system  

Microsoft Academic Search

This paper presents a basic method of probabilistic transmission planning used in BC Hydro. The method is based on transmission system reliability evaluation and an overall economic analysis including damage cost due to system unreliability. Four alternatives for the Vancouver South Metro system of BC Hydro have been evaluated using the method: the first one is addition of a 230

W. Li; Y. Mansour; J. K. Korczynski; B. J. Mills

1995-01-01

273

Factors limiting the early survivorship of Thuja plicata on northern Vancouver Island, British Columbia  

Microsoft Academic Search

Adrian Weber, Benjamin Gilbert, J.P. (Hamish) Kimmins, and C.E. Prescott Abstract: Western redcedar (Thuja plicata Donn ex D. Don), a late successional species on northern Vancouver Island, has a low seedling survival in mature hemlock (Tsuga heterophylla (Raf.) Sarg.) - amabilis fir (Abies amabilis (Dougl. ex Loud.) Dougl. ex J. Forbes) (HA) stands. Shade, moss competition, and substrate were tested

Adrian Weber; Benjamin Gilbert; C. E. Prescott

2003-01-01

274

Suite102-6190 Agronomy Road Vancouver, B.C. V6T 1Z3  

E-print Network

Suite102- 6190 Agronomy Road Vancouver, B.C. V6T 1Z3 Phone: (604) 822-8595 Fax: (604) 822-5093 ADM this completed form to Dean Kuusela, Associate Director, Office of Research Services, #102-6190 Agronomy Road

Michelson, David G.

275

The role of compressive stresses in jointing on Vancouver Island, British Columbia  

Microsoft Academic Search

This study demonstrates that joint-parallel compressive stresses were integral to the development of joint sets on Vancouver Island, British Columbia. The mapped study area contains paleostress indicators in the form of calcareous concretions, which have multiple, internal fractures in precisely the same orientation as one of the surrounding joint sets in the sandstone matrix. Field and laboratory tests indicate that

Brad Bessinger; Neville G. W Cook; Larry Myer; Seiji Nakagawa; Kurt Nihei; Pascual Benito; Roberto Suarez-Rivera

2003-01-01

276

Forest Age and Relative Abundance of Pileated Woodpeckers on Southeastern Vancouver Island1  

Microsoft Academic Search

We estimated relative abundance of the pileated woodpeckers (Dryocopus pileatus) at four sites in the Coastal Western Hemlock Biogeoclimatic zone, on southeastern Vancouver Island during 1996-1997. The number of pileated woodpecker calls was correlated with age and structure of forests. Pileated woodpeckers did not use intensively managed forests < 80 years old that had low densities of dead wood (large

Carol L. Hartwig; Donald S. Eastman; Alton S. Harestad

2002-01-01

277

149th Meeting of the Acoustical Society of America, Vancouver, May 2005 Oldenburg University, acoustics group  

E-print Network

149th Meeting of the Acoustical Society of America, Vancouver, May 2005 Oldenburg University, acoustics group In situ measurement of absorption of acoustic material with a parametric source in air. Roland Kruse, Bastian Epp, Volker Mellert #12;149th Meeting of the Acoustical Society of America

Vormann, Matthias

278

Job Posting: In-Store Product Specialist Locations: Vancouver, Calgary, Edmonton, Winnipeg, Ottawa, Moncton, Halifax, and  

E-print Network

to promote Genuine Health products. This includes product sampling, communicating product features of the largest natural products companies in Canada. To apply: Please e-mail your résumé to resumes Job Posting: In-Store Product Specialist Locations: Vancouver, Calgary, Edmonton

279

Fluid Overpressure Distribution and Permeability Structure in the Cascadia Subduction Zone Under Southern Vancouver Island  

NASA Astrophysics Data System (ADS)

We develop hydrogeologic models to examine the fluid overpressure distribution in the northern Cascadia subduction zone resulting from dewatering of the subducting Juan de Fuca slab. Anomalous seismic velocities indicative of relatively high Poisson's ratios observed in the subducting crust at subduction zones, such as Cascadia and Nankai, have been interpreted to indicate fluid overpressure (Shelly et al., 2006; Audet et al., 2009; Peacock et al., 2011). In northern Cascadia, the inferred fluid overpressure beneath Vancouver Island disappears farther landward. One of the proposed mechanisms for the distribution of fluid overpressure is the down-dip change in the permeability of the plate boundary fault. In this scenario, permeability is low under Vancouver Island, limiting fluid escape from the slab; permeability increases farther landward, allowing more efficient fluid migration out of the subducting slab (Audet et al., 2009). We test this conceptual hydrogeologic model with numerical models of fluid transport. Our models include fluid sources from porosity loss and mineral dehydration reactions. The volume of dehydration-derived fluid release from the subducting crust is calculated using a thermal model for Cascadia and the thermodynamic calculation code Perple_X. Modeled fluid source magnitudes are highest in a ~50 km wide region of upper oceanic crust under Vancouver Island. The cessation of these fluid sources in the subducting slab further landward combined with fluid flow from the slab contribute to the landward dissipation of fluid overpressure, even in the absence of enhanced fault zone permeability landward of Vancouver Island.

Spinelli, G. A.; Wada, I.

2012-12-01

280

Downscaling of Precipitation over Vancouver Island using a Synoptic Typing Approach  

Microsoft Academic Search

A statistical downscaling technique is employed to link atmospheric circulation produced by an ensemble of global climate model (GCM) simulations over the twenty-first century to precipitation recorded at weather stations on Vancouver Island. Relationships between the different spatial scales are established with synoptic typing, coupled with non-homogeneous Markov models to simulate precipitation intensity and occurrence. Types are generated from daily

Stephen R. Sobie; Andrew J. Weaver

2012-01-01

281

Downscaling of Precipitation over Vancouver Island using a Synoptic Typing Approach  

Microsoft Academic Search

A statistical downscaling technique is employed to link atmospheric circulation produced by an ensemble of global climate model (GCM) simulations over the twenty-first century to precipitation recorded at weather stations on Vancouver Island. Relationships between the different spatial scales are established with synoptic typing, coupled with non-homogeneous Markov models to simulate precipitation intensity and occurrence. Types are generated from daily

Stephen R. Sobie; Andrew J. Weaver

2011-01-01

282

The Public Place of Central Libraries: Findings from Toronto and Vancouver.  

ERIC Educational Resources Information Center

Discussion of the social roles of public libraries focuses on the public use of central libraries in Toronto and Vancouver. Results support the notion that central libraries fulfill ideals of public place, and that private market interests represent a threat to its role as a public place. (Contains 99 references.) (Author/LRW)

Leckie, Gloria J.; Hopkins, Jeffrey

2002-01-01

283

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

ERIC Educational Resources Information Center

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…

Kayaalp, Dilek

2014-01-01

284

Tsunami Deposits beneath Tidal Marshes on Northwestern Vancouver Island, British Columbia  

Microsoft Academic Search

Two sand sheets underlying tidal marshes at Fair Harbour, Neroutsos Inlet, and Koprino Harbour on the northwestern coast of Vancouver Island, British Columbia, were probably deposited by tsunamis. The sand sheets become thinner and finer-grained landward, drape former land surfaces, contain marine microfossils, are locally graded or internally stratified, and can be correlated with earthquakes that generated tsunamis in the

Boyd E. Benson; Kurt A. Grimm; John J. Clague

1997-01-01

285

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

ERIC Educational Resources Information Center

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…

Cahill, Kay

2009-01-01

286

HIV infection and risk behaviours among young gay and bisexual men in Vancouver  

Microsoft Academic Search

Background: Young gay and bisexual men may perceive that the consequences of HIV infection have dramatically improved with the availability of highly active antiretroviral therapy. We therefore sought to identify trends in HIV infection rates and associated risk behaviours among young gay and bisexual men in Vancouver. Methods: Prospective cohort study involving gay and bisexual men aged 18-30 years who

Steffanie A. Strathdee; Stephen L. Martindale; Peter G. A. Cornelisse; Mary Lou Miller; Kevin J. P. Craib; Martin T. Schechter; Michael V. O'Shaughnessy; Robert S. Hogg

287

Implications for Counselling Asian Transnational Youth: The Experiences of Taiwanese Youth in Vancouver  

ERIC Educational Resources Information Center

Using a phenomenological approach, this study sought to explore the long-term psychological impact of families' transnational separation on children through the lenses of Taiwanese youth in Vancouver. Over time, most participants found themselves in a position of an "ambivalent outsider," with an increased sense of uncertainty about their…

Petersen, Leah; Park-Saltzman, Jeeseon

2010-01-01

288

How Much Do Multicultural Residents of Greater Vancouver Know about the Internet?  

ERIC Educational Resources Information Center

Vancouver high school honors and university award lists are crowded with Asian names. But do these abilities in face-to-face settings extend to the Internet, which is the centerpiece of distributed learning? The purpose of this study was to measure the extent to which Internet knowledge varied as a function of age, sex, and language spoken at…

Boshier, Roger; Kow, Janet Kushner; Huang, Yan

2006-01-01

289

Suburban-rural energy balance comparisons in summer for Vancouver, B.C  

Microsoft Academic Search

Simultaneous energy balance observations at a rural and a suburban site in Vancouver, B.C. during the summer of 1983 are presented. The study is a follow-up to that conducted in 1980. Many of the 1980 results were unexpected and the present study seeks to assess their representativeness. The net radiant, turbulent sensible, and rural soil heat flux densities were measured

H. A. Cleugh; T. R. Oke

1986-01-01

290

Sensible Heat Fluxes over an Urban Area--Vancouver, B.C  

Microsoft Academic Search

The use of the eddy correlation technique is demonstrated for the measurement of sensible heat transfer in an urban area. The problems of time and space sampling (in the horizontal and vertical) are investigated. Based on 27 summer days of observations from a roof-top site in the central built-up part of Vancouver, the diurnal variation of sensible heat transfer above

D. Yap; T. R. Oke

1974-01-01

291

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

Microsoft Academic Search

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

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

2004-01-01

292

Vancouver's Gasoline-Price Wars: An Empirical Exercise in Uncovering Supergame Strategies  

Microsoft Academic Search

The area investigated is a region of the Vancouver, British Columbia retail-gasoline market. Players are service-station managers who compete daily. Periodically, unanticipated demand shocks precipitate price wars. When shocks occur, the firms in the market must determine the new demand conditions and adjust their strategies. From an econometric point of view, slopes of intertemporal reaction functions are latent variables. The

Margaret E Slade

1992-01-01

293

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

ERIC Educational Resources Information Center

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…

Guardado, Martin

2006-01-01

294

Seasonal variability in meanders of the California current system off Vancouver Island  

Microsoft Academic Search

Satellite infrared image taken over the past few years reveal seasonal variations in the meanders of the California Current System (CCS) off Vancouver Island. The CCS exhibits meanders with wavelength between 120 and 150 km in both winter and spring, when the upper ocean current all flows northwestward or southeastward, respectively. In summer, the CCS includes the California Undercurrent, which

M. Ikeda; W. J. Emery; L. A. Mysak

1984-01-01

295

Taming Space: Drug use, HIV, and homemaking in Downtown Eastside Vancouver  

Microsoft Academic Search

This article explores ideas of home and place making that bear on the narrated realities of 14 women who are drug users living with HIV in Vancouver's Downtown Eastside. ‘Taming Space’ refers to the negotiations, transgressions and accommodations they make within particular spatial regimes. As residents of a ‘skid row’ district, research participants work to reconcile personal identities within representations

Leslie Robertson

2007-01-01

296

Hospital fundamentals.  

PubMed

Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID:24918827

Althausen, Peter L; Hill, Austin D; Mead, Lisa

2014-07-01

297

42 CFR 35.2 - Compliance with hospital rules.  

Code of Federal Regulations, 2010 CFR

... false Compliance with hospital rules. 35.2 Section... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General...35.2 Compliance with hospital rules. All patients...

2010-10-01

298

42 CFR 35.1 - Hospital and station rules.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Hospital and station rules. 35...PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES...CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.1 Hospital and station rules....

2010-10-01

299

Case Records of the Massachusetts General Hospital. Case 25-2014. A 37-year-old man with ulcerative colitis and bloody diarrhea.  

PubMed

A 37-year-old man with ulcerative colitis was admitted to the hospital because of abdominal cramping, diarrhea, hematochezia, fever to a peak temperature of 38.8 °C, and drenching night sweats. Several weeks earlier, he had performed home fecal transplantation. PMID:25119613

Hohmann, Elizabeth L; Ananthakrishnan, Ashwin N; Deshpande, Vikram

2014-08-14

300

The Energy Conservation Program for Schools and Hospitals Can Be More Effective. Report to the Congress of the United States by the Comptroller General.  

ERIC Educational Resources Information Center

The Schools and Hospital Program, funded through the National Energy Conservation Policy Act, is not an effective use of federal monies when compared to other Department of Energy (DOE) conservation programs. It is among the highest in cost, yet among the lowest in yielding energy savings. This report identifies changes which could increase…

Comptroller General of the U.S., Washington, DC.

301

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

USGS Publications Warehouse

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.

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

2010-01-01

302

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

USGS Publications Warehouse

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.

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

2010-01-01

303

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

E-print Network

, 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

Mukhopadhyay, Asish

304

Hospital-acquired infection with Streptococcus pneumoniae.  

PubMed

A prospective survey was carried out in the winter of 1983-84 to determine the incidence of hospital-acquired pneumococcal chest infection in a district general hospital. Twenty-one patients (of a total of 103 infected with Streptococcus pneumoniae) were assessed as having hospital-acquired infection. The implication of this and the need for further studies are discussed. PMID:2859331

Davies, A J; Dyas, A

1985-03-01

305

The Tenth Annual Ion Channel Retreat, Vancouver, Canada, June 25–27, 2012  

PubMed Central

Abstract Ten years after Aurora Biomed (Vancouver, British Columbia, Canada) hosted the inaugural Ion Channel Retreat, this event is recognized as a leading conference for ion channel researchers. Held annually in Vancouver, this meeting consistently provides an outlet for researchers to share their findings while learning about new concepts, methods, and technologies. Researchers use this forum to discuss and debate a spectrum of topics from ion channel research and technology to drug discovery and safety. The Retreat covered key subjects in the ion channel industry, including ion channels as disease targets, transient receptor protein channels as pain and disease targets, ion channels as pain targets, ion channel structure and function, ion channel screening technologies, cardiac safety and toxicology, and cardiac function and pharmacology. PMID:23679851

Kimlicka, Lynn; Liang, Sophia; Brugger, Saranna; Liang, Dong

2013-01-01

306

Late Quaternary dynamics of forest vegetation on northern Vancouver Island, British Columbia, Canada  

Microsoft Academic Search

Pollen analysis of radiocarbon-dated lake sediment from northern Vancouver Island, southwest British Columbia reveals regional changes in forest vegetation over the last 12,200 14C yr (14,900 cal yr). Between at least 12,200 and 11,700 14C yr BP (14,900–13,930 cal yr BP), open woodlands were dominated by Pinus contorta, Alnus crispa, and various ferns. As P. contorta decreased in abundance, Alnus

Terri Lacourse

2005-01-01

307

Fluid flow and origin of a carbonate mound offshore Vancouver Island: Seismic and heat flow constraints  

Microsoft Academic Search

A 1.5 km long, 1 km wide and 70–80 m high carbonate mound was identified on the mid-slope region of the subduction accretionary sedimentary prism offshore Vancouver Island ?3.5 km west of Ocean Drilling Program (ODP) Site 889 and Integrated Ocean Drilling Program (IODP) Site U1327. Seabed-video images show the presence of seafloor carbonate as well as chemosynthetic communities. A high-resolution single channel seismic

T. He; G. D. Spence; M. Riedel; R. D. Hyndman; N. R. Chapman

2007-01-01

308

Three rarely reported digeneans inhabiting amphibians from Vancouver Island, British Columbia, Canada.  

PubMed

Three rarely reported species of digeneans were collected in amphibian hosts from Diversion Reservoir, Sooke, Vancouver Island, British Columbia, Canada. The endangered anuran Rana aurora hosted Glypthelmins californiensis, Gorgoderina multilobata, and Megalodiscus microphagus. In addition, the anuran Pseudacris regilla and the caudatan Taricha granulosa hosted Megalodiscus microphagus. Gorgoderina multilobata has been reported only once since 1936 and has never been reported outside of California. We note several characters not previously reported for Gorgoderina multilobata and G. aurora. PMID:16419782

Zamparo, David; Brooks, Daniel R

2005-10-01

309

Vancouver's Corporate Complex and Producer Services Sector: Linkages and Divergence within a Provincial Staple Economy  

Microsoft Academic Search

LEY D. and HUTTON T (1987) Vancouver's corporate complex and producer services sector: linkages and divergence within a provincial staple economy, Reg. Studies21, 413–424. The paper considers the place of advanced services in contributing to uneven development between a metropolitan core and a regional hinterland in a provincial staple economy—British Columbia, Canada. While there is a close correlation between changes

David Ley; Thomas Hutton

1987-01-01

310

Academic Hospitality  

ERIC Educational Resources Information Center

Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

Phipps, Alison; Barnett, Ronald

2007-01-01

311

Community hospitals for the new millennium.  

PubMed

There is a lack of basic information regarding the numbers of and facilities offered by community hospitals. This survey identified 471 community hospitals in the United Kingdom containing 18,579 beds with 20% of general practitioners having admitting rights. The majority of hospitals provide a comprehensive range of rehabilitation services and consultant outpatient clinics. Community hospitals are potentially an important resource in providing intermediate care in the community. PMID:11217625

Seamark, D; Moore, B; Tucker, H; Church, J; Seamark, C

2001-02-01

312

21 CFR 880.5100 - AC-powered adjustable hospital bed.  

Code of Federal Regulations, 2010 CFR

... AC-powered adjustable hospital bed. 880.5100 Section...AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

2010-04-01

313

Hospital Greenspace Ninewells Hospital, Dundee  

E-print Network

. Getting Started ­ Project Steering Group Forestry Commission Scotland, NHS Tayside, Dundee City Council and population health and well-being, as well as sustainability and biodiversity4 . Certain natural environments in Scotland. The purpose of the pilot was to demonstrate that by greening hospital grounds you can connect

314

Virtual Hospital  

NSDL National Science Digital Library

Provided and maintained by the University of Iowa Health Care, the Virtual Hospital is designed as a "medical reference and health promotion tool for health care providers and patients." To that end, the site offers current and authoritative medical information for patients and professional and pedagogical information for health care providers. The former includes patient educational briefs browseable by organ system or by a topical list, a collection of peer-reviewed and annotated Web resources, an internal search engine, and archives of a column offering medical advice to middle-aged users. Resources in the health care provider section include several digital libraries aimed at certain specialties (Pediatrics, Pediatric Radiology, Family Medicine, and Medical Student); multimedia textbooks and teaching files grouped by organ system; lectures and publications; and clinical practice guidelines. Additional resources at the site include links to the Virtual Children's and Virtual Naval Hospitals, an internal search engine, and online continuing education courses.

315

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

PubMed Central

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

Stitt, Tyler; Mountifield, Julie; Stephen, Craig

2007-01-01

316

Cost characteristics of hospitals.  

PubMed

Modern hospitals are complex multi-product organisations. The analysis of a hospital's production and/or cost structure should therefore use the appropriate techniques. Flexible functional forms based on the neo-classical theory of the firm seem to be most suitable. Using neo-classical cost functions implicitly assumes minimisation of (variable) costs given that input prices and outputs are exogenous. Local and global properties of flexible functional forms and short-run versus long-run equilibrium are further issues that require thorough investigation. In order to put the results based on econometric estimations of cost functions in the right perspective, it is important to keep these considerations in mind when using flexible functional forms. The more recent studies seem to agree that hospitals generally do not operate in their long-run equilibrium (they tend to over-invest in capital (capacity and equipment)) and that it is therefore appropriate to estimate a short-run variable cost function. However, few studies explicitly take into account the implicit assumptions and restrictions embedded in the models they use. An alternative method to explain differences in costs uses management accounting techniques to identify the cost drivers of overhead costs. Related issues such as cost-shifting and cost-adjusting behaviour of hospitals and the influence of market structure on competition, prices and costs are also discussed shortly. PMID:12220092

Smet, Mike

2002-09-01

317

[The Central Navy Clinical Hospital celebrates 30th anniversary].  

PubMed

The article is devoted to the history of formation and development of the Central Navy Clinical Hospital (since 2010--3rd branch of Burdenko General Clinical Hospital) for the last 30 years. Nowadays normal bed capacity totals 600 beds, 30 medical and preventive units function in the hospital. Annually 11,000 patients receive treatment in the hospital. PMID:24000613

Maksimov, I B; Manu?lov, V M; Marchik, V V; Kozovo?, M Ia

2013-04-01

318

Adult Partial Hospitalization JOHN DEMPSEY HOSPITAL  

E-print Network

." The Adult Partial Hospitalization Program is a day treatment program specifically designed for the diagnosisAdult 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

Oliver, Douglas L.

319

The effect of hospital control strategies on physician satisfaction and physician-hospital conflict.  

PubMed Central

This article examines several strategies that hospitals use to control their medical staffs. Such strategies include placing physicians on salary, developing exclusive hospital affiliations with physicians, and involving physicians in decision-making bodies. Using regression techniques, we investigate which hospitals are more likely to utilize these strategies and whether such strategies are effective in promoting physician-hospital integration. Contrary to our expectations, corporate hospital structures (e.g., for-profit hospitals, membership in multihospital systems) generally do not employ these strategies more often and oftentimes employ them less. There is also little evidence that control strategies are effective levers for increasing physician satisfaction or decreasing physician-hospital conflict. We suggest that control strategies are useful for purposes other than promoting physician-hospital integration. Finally, hospital ownership appears to exert the biggest effect on physician satisfaction and conflict. PMID:2380074

Burns, L R; Andersen, R M; Shortell, S M

1990-01-01

320

Difficult decisions in times of constraint: Criteria based Resource Allocation in the Vancouver Coastal Health Authority  

PubMed Central

Objectives The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year 2010/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities division. Methods A standard approach to program budgeting and marginal analysis (PBMA) was taken with a priority setting working committee and a broader advisory panel. An experienced, non-vested internal project manager worked closely with the two-member external research team throughout the process. Face to face evaluation interviews were held with 10 decision makers immediately following the process. Results The recommendations of the working committee included the implementation of 44 disinvestment initiatives with an annualized value of CAD $4.9 million, as well as consideration of possible investments if the realized savings match expectations. Overall, decision makers viewed the process favorably and the primary aim of addressing the deficit gap was met. Discussion A key challenge was the tight timeline which likely lead to less evidence informed decision making then one would hope for. Despite this, decision makers felt that better decisions were made then had the process not been in place. In the end, this project adds value in finding that PBMA can be used to cover a deficit and minimize opportunity cost through systematic application of criteria whilst ensuring process fairness through focusing on communication, transparency and decision maker engagement. PMID:21756357

2011-01-01

321

UBC Social Ecological Economic Development Studies (SEEDS) Student Report Scaling-Up On-Site Composting in the Student Union Building ~UBC Vancouver~  

E-print Network

-Site Composting in the Student Union Building ~UBC Vancouver~ GRS 497B November 01, 2013 282 1667 University-Site Composting in the Student Union Building ~UBC Vancouver~ 2 Conducted by: Emme Lee Email: Phone: Conducted for: November 2013 #12;Author: Emme Lee Scaling-Up On-Site Composting in the Student Union Building ~UBC

322

WASHINGTON STATE UNIVERSITY COLLEGE OF NURSING 14204 NE Salmon Creek Ave | Vancouver, WA 98686 | (360) 546-9398 | nursing.wsu.edu  

E-print Network

, Writing/Communication, Diversity, Humanities and Arts. (Contact the nursing academic coordinator for UCOREWASHINGTON STATE UNIVERSITY COLLEGE OF NURSING 14204 NE Salmon Creek Ave | Vancouver, WA 98686 | (360) 546-9398 | nursing.wsu.edu RN-BSN STEPS TO APPLY ­ WSU VANCOUVER 1. Complete Preliminary

Collins, Gary S.

323

Socioeconomic status and hospital utilization among younger adult pneumonia admissions at a Canadian hospital  

Microsoft Academic Search

BACKGROUND: Although the general association between socioeconomic status (SES) and hospitalization has been well established, few studies have considered the relationship between SES and hospital length of stay (LOS), and\\/or hospital re-admission. The primary objective of this study therefore, was to examine the relationship of SES to LOS and early re-admission among adult patients hospitalized with community-acquired pneumonia in a

Margaret J McGregor; Robert J Reid; Michael Schulzer; J Mark Fitzgerald; Adrian R Levy; Michelle B Cox

2006-01-01

324

Forest Age and Relative Abundance of Pileated Woodpeckers on Southeastern Vancouver Island 1  

E-print Network

We estimated relative abundance of the pileated woodpeckers (Dryocopus pileatus) at four sites in the Coastal Western Hemlock Biogeoclimatic zone, on southeastern Vancouver Island during 1996-1997. The number of pileated woodpecker calls was correlated with age and structure of forests. Pileated woodpeckers did not use intensively managed forests 140-year-old stands. However, their abundance in these forests did not differ significantly from that in early seral forests (49 percent> 80-year-old stands) or old forests (70 percent> 140-year-old stands).

Carol L. Hartwig; Donald S. Eastman; Alton S. Harestad

325

Rainfall-runoff data for selected basins, Portland, Oregon, and Vancouver, Washington, 1973-77  

USGS Publications Warehouse

In the Portland-Vancouver area, storms and floods are presently being studied in 16 basins with drainage areas ranging from 0.21 to 6.63 square miles and with various basin slopes, degrees of imperviousness, and mixes of land use. Fanno Creek basin in Portland has the longest period of rainfall-runoff record, starting in 1973; Tryon Creek basin in Portland is next with a record starting in 1974. Records in all other basins began in 1975. For each basin, data are tabulated for daily precipitation on a yearly basis and for 5-minute precipitation and 5-minute streamflow for selected storms. (Woodard-USGS)

Laenen, Antonius; Solin, Gary L.

1978-01-01

326

Evaluation of Ertapenem use with Impact Assessment on Extended-Spectrum Beta-Lactamases (ESBL) Production and Gram-Negative resistance in Singapore General Hospital (SGH)  

PubMed Central

Background Ertapenem (preferred choice for ESBL-producing organisms) use exhibited an increasing trend from 2006 to 2008. As extensive use of ertapenem might induce the mutation of resistant bacteria strains to ertapenem, we aimed to assess the appropriateness and impact of ertapenem-use, on ESBL production, the trends of gram-negative bacterial resistance and on the utilization of other antibiotics in our institution. Methods Inpatients who received a dose of ertapenem during 1 January 2006 to 31 December 2008, were reviewed. Pertinent patient clinical data was extracted from the pharmacy databases and assessed for appropriateness based on dose and indication. Relevant data from Network for Antimicrobial Resistance Surveillance (Singapore) (NARSS) was extracted, to cross-correlate with ertapenem via time series to assess its impact on hospital epidemiology, trends of gram-negative resistance and consumption of other antibiotics from 2006 to mid-2010. Results 906 cases were reviewed. Ertapenem therapy was appropriate in 72.4% (93.7% success rate). CNS adverse events were noted in 3.2%. Readmission rate (30-day) due to re-infection (same pathogen) was 5.5%. Fifty cases had cultures growing Pseudomonas aeruginosa within 30 days of ertapenem initiation, with 25 cases growing carbapenem-resistant Pseudomonas aeruginosa. Ertapenem use increased from 0.45 DDD/100 patient days in 2006 to 1.2 DDD/100 patient days in mid-2010. Overall, the increasing trend of ertapenem consumption correlated with 1) increasing incidence-densities of ciprofloxacin-resistant/cephalosporin-resistant E. coli at zero time lag; 2) increasing incidence-densities of ertapenem-resistant Escherichia. coli and Klebsiella spp. at zero time lag; 3) increasing incidence-density of carbapenem-resistant Pseudomonas aeruginosa, at zero time lag. Increasing ertapenem consumption was significantly correlated with decreasing consumption of cefepime (R2 = 0.37344) 3 months later. It was significantly correlated with a decrease in imipenem consumption (R2 = 0.31081), with no time lag but was correlated with subsequent increasing consumption of meropenem (R2 = 0.4092) 6 months later. Conclusion Ertapenem use was appropriate. Increasing Ertapenem consumption did not result in a decreasing trend of ESBL producing enterobacteriaceae and could result in the selection for multi-drug resistant bacteria. PMID:24195651

2013-01-01

327

West Penn Hospital /Allegheny General Hospital Medical Education Consortium  

E-print Network

, Responsibilities 26 Neurology Elective 27 Emergency Room Rotation 27 Geriatrics 28 Away Elective 38 Continuity Selective 2 months Geriatrics 1 month Patient Safety 2 weeks Night Teaching or Medical Officer of the Day 2

Juola, Patrick

328

Effect of Hospital-SNF Referral Linkages on Re-Hospitalization  

PubMed Central

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 to 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 a SNF were to increase by 10 percentage points, the likelihood of patients treated by that hospital-SNF pair to be re-hospitalized 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 post-discharge under the Affordable Care Act, hospitals may steer their patients preferentially to fewer SNFs. PMID:24134773

Foster, Andrew D.; Grabowski, David C.; Zinn, Jacqueline S.; Mor, Vincent

2013-01-01

329

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

USGS Publications Warehouse

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.

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

1997-01-01

330

Introduced bullfrogs and their parasites: Haematoloechus longiplexus (Trematoda) exploits diverse damselfly intermediate hosts on Vancouver Island.  

PubMed

The lung fluke, Haematoloechus longiplexus, is the most prevalent and abundant parasite of introduced bullfrogs on Vancouver Island, British Columbia, Canada. The ecological success of this trematode in invasive bullfrogs is related to the fluke's ability to utilize native intermediate hosts for transmission. The purpose of this study was to identify the odonate (dragonfly/damselfly) species involved in the transmission of H. longiplexus to the introduced bullfrog. The prevalences and mean intensities of 21 species of odonates (nymphs and adults) were examined for metacercariae infections. Haematoloechus longiplexus is a second intermediate host specialist, being found only in damselflies. Six damselfly species exhibiting the "climber" ecological habit were identified as second intermediate hosts of H. longiplexus. Enallagma carunculatum (prevalence = 75.0%, mean intensity = 17.2 ± 10.8), Ischnura cervula (65.2%, 8.9 ± 4.3), Ischnura perparva (45.5%, 15.4 ± 10.3), and Enallagma boreale (40.7%, 4.8 ± 7.8) were the most commonly infected damselfly species. Metacercariae were absent in damselflies collected from sites lacking bullfrogs. Haematoloechus longiplexus was likely introduced along with the bullfrog, and subsequently adapted to the physid snail and diverse damselfly intermediate hosts present in ponds on Vancouver Island. PMID:22924931

Novak, Colin W; Goater, Timothy M

2013-02-01

331

Hardware scale modelling of summertime patterns of urban dew and surface moisture in Vancouver, BC, Canada  

NASA Astrophysics Data System (ADS)

There is growing interest in dew as a potential source of fresh water, and also in the study of urban dew. In this research, a 1:8 scale, out-of-doors hardware model was constructed in Vancouver, BC, Canada, to study dew in an urban residential landscape. It consisted of three wooden houses (1.08 m tall), a paved street, small trees and a grassed urban park. The internal thermal mass (ITM) approach was used to scale the buildings. The model was validated to a first approximation using data from full-scale sites in Vancouver. It performed well. Results indicate that, while the primary control on dew deposition is weather, weather effects are modified by substrate type and site geometry. On nights with abundant dew (0.1-0.3 mm day -1), association was seen in the model between the distributions of surface temperature, sky view, and surface moisture (dew+guttation) accumulation on grass. The model roof was often a site of significant accumulation with a mean dewfall of 0.09 mm day -1. The amount of water that could potentially be collected from a roof is far less than that which may be collected from dense fog using fog nets. Nevertheless, dew is not a negligible term in the urban water balance and its potential for collection should not be lightly dismissed.

Richards, K.

332

Statistical and Spatial Analysis of Land Cover Impact on Selected Metro Vancouver, British Columbia Watersheds  

NASA Astrophysics Data System (ADS)

The Greater Vancouver area has undergone significant land use and land cover (LULC) change over the past several decades, often adversely affecting stream health and water quality, particularly in those areas that have undergone the most urbanization. In this study 30 years of historical LULC and water quality data were examined using GIS and statistical analysis to better understand these impacts and to help build a broader understanding of cause and effect relationships of changing LULC, especially since urbanization is increasingly occurring within sensitive watersheds at greater distances from the City of Vancouver. Urban, agriculture, and disturbed LULC data from 1976, 1986, and 2000 were examined within a number of watersheds and related to historical water quality data sampled from streams during similar time frames. Additional higher resolution 2006 LULC data from a smaller number of watersheds were then examined and compared to stream health data to investigate the sensitivity of LULC data resolution on monitoring watershed impact. While LULC impact can be clearly seen at both high and lower resolutions, issues of ambiguous land cover and land use designations can potentially affect the magnitude of the relationship.

Shupe, Scott

2013-01-01

333

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

PubMed Central

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.

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

2010-01-01

334

Dental treatment needs in vancouver inner-city elementary school-aged children.  

PubMed

Aims. To examine the dental treatment needs of inner-city Vancouver elementary school-aged children and relate them to sociodemographic characteristics. Methods. A census sampling comprising 562 children from six out of eight eligible schools was chosen (response rate was 65.4%). Dental treatment needs were assessed based on criteria from the World Health Organization. Results. Every third child examined needed at least one restorative treatment. A higher proportion of children born outside Canada were in need of more extensive dental treatments such as pulp care and extractions compared to the children born in Canada. There were no statistically significant differences in dental treatment needs between age, gender, or income groups or between children with or without dental insurance (Chi Squared P > 0.05). The best significant predictors (Linear Multiple Regression, P > 0.05) of higher dental treatment needs were being born outside Canada, gender, time of last dental visit, and family income. Having dental insurance did not associate with needing less treatment. Conclusion. A high level of unmet dental treatment needs (32%) was found in inner-city Vancouver elementary school-aged children. Children born outside Canada, particularly the ones who recently arrived to Canada, needed more extensive dental treatments than children born in Canada. PMID:23861684

Samim, F; Aleksejuniene, J; Zed, C; Salimi, N; Emperumal, C P

2013-01-01

335

Radioelectric brain stimulation in the treatment of generalized anxiety disorder with comorbid major depression in a psychiatric hospital: a pilot study  

PubMed Central

Background: Generalized anxiety disorder (GAD) is often presented with major depression (MD). GAD-MD can be a chronic and disabling condition, and patients suffering from this disorder often respond poorly to psychopharmacological treatment and experience side effects with medication. Therefore, there is a high demand for effective nonpharmacological therapy for GAD-MD patients. The current study explores the use of a radioelectric asymmetric conveyer (REAC) device in the treatment of GAD-MD. Methods: Participants were 24 patients diagnosed with GAD-MD being treated at a public psychiatric center. All patients were dissatisfied with their current pharmacological treatment. Patients were evaluated using the 21-item Hamilton Depression (HAM-D) rating scale and the Symptom Check List-90-Revised (SCL-90R) before and after REAC brain stimulation treatment cycles. Results: After REAC brain stimulation treatment, all patients experienced a significant reduction in anxiety and depression. These results were confirmed by physician examination, HAM-D scores, and SCL-90R total scores. Conclusion: These results indicate a role for REAC brain stimulation in the management of psychiatric conditions, specifically, GAD-MD comorbidity. REAC treatments are synergistic to drug therapy and appear to be helpful in reducing the side effects of medication. Future studies should evaluate the long-term effects of REAC treatment. PMID:21857785

Olivieri, Elisabetta Bourget; Vecchiato, Caterina; Ignaccolo, Nunziatina; Mannu, Piero; Castagna, Alessandro; Aravagli, Lucia; Fontani, Vania; Rinaldi, Salvatore

2011-01-01

336

42 CFR 412.23 - Excluded hospitals: Classifications.  

Code of Federal Regulations, 2011 CFR

...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...

2011-10-01

337

42 CFR 412.23 - Excluded hospitals: Classifications.  

Code of Federal Regulations, 2012 CFR

...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...

2012-10-01

338

42 CFR 412.23 - Excluded hospitals: Classifications.  

Code of Federal Regulations, 2014 CFR

...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...

2014-10-01

339

42 CFR 412.23 - Excluded hospitals: Classifications.  

Code of Federal Regulations, 2013 CFR

...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...

2013-10-01

340

42 CFR 482.2 - Provision of emergency services by nonparticipating hospitals.  

Code of Federal Regulations, 2010 CFR

...services by nonparticipating hospitals. 482.2 Section 482...MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...CONDITIONS OF PARTICIPATION FOR HOSPITALS General Provisions § 482...services by nonparticipating hospitals. (a) The services...

2010-10-01

341

Birds, Broom, Bunnies, and Biplanes: Conserving a Remnant Population of Coastal Vesper Sparrows at the Nanaimo Airport, Vancouver Island  

Microsoft Academic Search

Extended Abstract: The coastal vesper sparrow (Pooecetes gramineus affinis) forms a disjunct population of the vesper sparrow (Pooecetes gramineus), and breeds from southwestern Vancouver Island, British Columbia (B.C.) south through western Washington and Oregon to the extreme northwest of California (Beauchesne 2003). This subspecies was probably never common in British Columbia, and it is assumed that prior to European settlement,

TRUDY CHATWIN

2004-01-01

342

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

Microsoft Academic Search

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,

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

2003-01-01

343

1 2 3 3 2,4 Department of Zoology, University of British Columbia, Vancouver, BC, Canada; 2  

E-print Network

acid metabolism, fatty acids, hepatic portal vein cannulation, lipid metabolism, liver metabolism, University of British Columbia, Vancouver, BC, Canada For the first time, pre- and post-hepatic plasma lipid postprandial, revealed the time course of the plasma lipid profiles following a single meal (1% of body mass

Farrell, Anthony P.

344

The effects of logging on frequency and distribution of landslides in three watersheds on Vancouver Island, British Columbia  

Microsoft Academic Search

Three hundred and sixty three landslides in three watersheds that totaled 382 km2 were identified from air photographs, beginning at a date that preceded logging to the present. The three watersheds all lie on Vancouver Island; however, they have different precipitation regimes, topography, and amounts logged. Landslide areas in the watersheds varied in size from 200 m2 to more than

R. H. Guthrie

2002-01-01

345

Spatial Relationships between Western Blackheaded Budworm (Acleris gloverana) (Lepidoptera: Tortricidae) Defoliation Patterns and Habitat Zones on Vancouver Island, British Columbia  

Microsoft Academic Search

The western blackheaded budworm (Acleris gloverana (Walshingham)) is a cyclic defoliator of western hemlock (Tsuga heterophylla (Raf.) Sarg.). At least seven blackheaded budworm outbreaks have occurred in British Columbia and severe defoliation has been recorded during five of these outbreaks on Vancouver Island. Spatial patterns of past blackheaded budworm outbreaks on the Island were examined by overlaying them with biogeoclimatic

IMRE S. OTVOS; NEIL BORECKY; ROY F. SHEPHERD; ADAM DEWEY

346

Results of 3-D Travel Time Tomography Studies of the Gas Hydrate Bearing Sediments in Cascadia Region Offshore Vancouver Island  

Microsoft Academic Search

The COAMS'99 experiment was one of a series of seismic and other surveys designed to study the gas hydrate field offshore Vancouver Island near the ODP 889\\/890 drill site. The presence of the gas hydrate was proven by the occurrence of the Bottom Simulating Reflector (BSR) on the seismic sections as well as by physical recovery of the gas hydrate

M. M. Zykov; R. N. Chapman

2004-01-01

347

Characteristics of pileated woodpecker ( Dryocopus pileatus) cavity trees and their patches on southeastern Vancouver Island, British Columbia, Canada  

Microsoft Academic Search

Cavity trees and cavity patches (areas around cavity trees) used by pileated woodpeckers were located in Coastal Western Hemlock and Coastal Douglas-fir forest types on southeastern Vancouver Island during 1996 and 1997. Trees with active nests and with apparent pileated cavities (n=28) were larger than trees without cavities (n=200). Of the seven confirmed nest trees, three were grand fir (Abies

C. L. Hartwig; D. S Eastman; A. S Harestad

2004-01-01

348

UBC ReportsRETURN POSTAGE GUARANTEED VOLUME 11, NO. 2 VANCOUVER 8, B.C. MARCH-APRIL, 1965  

E-print Network

. Thestadium will replacethe present student-providedstadium which has been allocated as the site of a $350 7 I " .. I ` "" UBC ReportsRETURN POSTAGE GUARANTEED VOLUME 11, NO. 2 VANCOUVER 8, B.C. MARCH phase, Dentistrybuilding and expansion basic medical sci- ence facilitiesfordental stu- dents -$2

Farrell, Anthony P.

349

Foraminiferal evidence for the amount of coseismic subsidence during a late holocene earthquake on Vancouver Island, West Coast of Canada  

Microsoft Academic Search

Foraminiferal data from two sites, 6 km apart, on the shores of an inlet near Tofino on the west coast of Vancouver Island, British Columbia, allow estimates to be made of the amount of coseismic subsidence during a large earthquake 100–400 years ago. The sampled sediment succession at the two sites is similar; peat representing a former marsh surface is

Jean-Pierre Guilbault; John J. Clague; Martine Lapointe

1996-01-01

350

Three-Dimensional Model Simulations of Tides and Buoyancy Currents along the West Coast of Vancouver Island  

Microsoft Academic Search

A three-dimensional finite element model is used to calculate the barotropic tides and seasonal buoyancy flows off the western and northern coasts of Vancouver Island. The model buoyancy currents and the harmonics of eight tidal constituents are compared with those from previous models, and those from tide gauge and current meter observations. The rms differences between observed and calculated sea

Michael G. G. Foreman; Richard E. Thomson

1997-01-01

351

Double Bagged or Fries with That: Adolescents' Perceptions of the Job Market in Four Urban Vancouver Secondary Schools  

ERIC Educational Resources Information Center

This article critically examines adolescents' perceptions of the job market in Vancouver, British Columbia. Employing document analysis, interviews with teachers and students, and classroom observations, the article explores how adolescents in four urban schools understood the difference between having a job and a career in the context of the…

Benjamin, Amanda

2009-01-01

352

Unsafe injection practices in a cohort of injection drug users in Vancouver: Could safer injecting rooms help?  

Microsoft Academic Search

Background: In several European countries safer injecting rooms have reduced the public disorder and health-related problems of injection drug use. We explored factors associated with needle-sharing practices that could potentially be allevi- ated by the availability of safer injecting rooms in Canada. Methods: The Vancouver Injection Drug User Study is a prospective cohort study of injection drug users (IDUs) that

Evan Wood; Mark W. Tyndall; Patricia M. Spittal; Kathy Li; Thomas Kerr; Robert S. Hogg; Julio S. G. Montaner; Michael V. O'Shaughnessy; Martin T. Schechter

353

A review of geological records of large tsunamis at Vancouver Island, British Columbia, and implications for hazard  

Microsoft Academic Search

Large tsunamis strike the British Columbia coast an average of once every several hundred years. Some of the tsunamis, including one from Alaska in 1964, are the result of distant great earthquakes. Most, however, are triggered by earthquakes at the Cascadia subduction zone, which extends along the Pacific coast from Vancouver Island to northern California. Evidence of these tsunamis has

John J. Clague; Peter T. Bobrowsky; Ian Hutchinson

2000-01-01

354

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

SciTech Connect

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

Stephen Schey; Jim Francfort

2014-03-01

355

[From admission team to hospital bed management].  

PubMed

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

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

2013-01-01

356

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

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

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

2014-03-01

357

Hospital Charges of Potentially Preventable Pediatric Hospitalizations  

PubMed Central

Objectives Reducing the number of preventable hospitalizations represents a possible source of healthcare savings. However, the current literature lacks a description of the extent of potentially preventable pediatric hospitalizations. The study objectives are to (1) identify the charges and (2) demographic characteristics associated with potentially preventable pediatric hospitalizations. Methods Secondary analysis of the 2006 Kids’ Inpatient Database (weighted N=7,558,812). ICD-9-CM codes for 16 previously validated pediatric ambulatory care-sensitive (ACS) conditions identified potentially preventable hospitalizations; seven additional conditions reflected updated care guidelines. Outcome variables included number of admissions, hospitalization days, and hospital charges. Demographic and diagnostic variables associated with an ACS condition were compared with regression analyses using appropriate person-level weights. Results Pediatric ACS hospitalizations totaled $4.05B in charges and 1,087,570 hospitalization days in 2006. Two respiratory conditions—asthma and bacterial pneumonia—comprised 48.4% of ACS hospital charges and 46.7% of ACS hospitalization days. In multivariate analysis, variables associated with an ACS condition included: male gender (OR: 1.10; 95% CI: 1.07–1.13); race/ethnicity of black (OR: 1.22; 95% CI: 1.16–1.27) or Hispanic (OR: 1.12; 95% CI: 1.06–1.18); and emergency department (ED) as admission source (OR: 1.37; 95% CI: 1.27–1.48). Conclusions Respiratory conditions comprised the largest proportion of potentially preventable pediatric hospitalizations, totaling as much as $1.96B in hospital charges. Children hospitalized with an ACS condition tend to be male, non-white, and admitted through the ED. Future research to prevent pediatric hospitalizations should examine targeted interventions in the primary care setting, specifically around respiratory conditions and minority populations. PMID:22922047

Lu, Sam; Kuo, Dennis Z.

2014-01-01

358

A Theory of Hospital Financial Analysis  

PubMed Central

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

Elnicki, Richard A.

1969-01-01

359

The official logo of the Vancouver Winter Olympics gains new fans while also irking some  

NSDL National Science Digital Library

Vancouver Olympic Logo: A Smiling Marker Of Death?http://www.npr.org/templates/story/story.php?storyId=123851564Michelin Man Meets Stonehenge to Birth an Olympic Rock Starhttp://online.wsj.com/article/SB10001424052748703787304575075461809989010.htmlThis stacks up as art -- with a functional side toohttp://articles.latimes.com/2010/feb/19/sports/la-sp-olympics-rock19-2010feb19Olympic Heights School Inukshukhttp://www.vancouver2010.com/more-2010-information/education-programs/project-showcase/olympic-heights-school-inukshuk-_34008gd.htmlHistory of the Minute: Inukshukhttp://www.histori.ca/minutes/minute.do?id=10210Canadian Museum of Civilization: Places of Powerhttp://www.civilization.ca/cmc/exhibitions/archeo/inuksuit/inukinte.shtmlThe flag of the Nuvanut nation in Canada features a field that is half yellow, half white, decorated with a blue star in the upper right-hand corner. A powerful looking pile of rocks, known as an inukshuk, dominates the middle of the flag. These items are built by the Inuit peoples of the Canadian arctic, and as it is the official logo of the 2010 Winter Olympics, they have been garnering a great deal of attention lately. The logo has found its way onto all types of promotional materials, clothing items, and so on. Many tourists to Vancouver have also been making informal inukshuit (the plural of inukshuk) out of materials along beaches in and around the area. Of course, some have raised questions about the nature of this particular inukshuk. Peter Irniq, who has built many of these symbols over the years, says that the logo looks suspiciously human. Irniq says that an inukshuk would almost never take this form unless it was being used to indicate that someone had committed suicide or murdered someone at that particular location. Regardless, the building of inukshuit continue, and the Vancouver Aquarium recently unveiled a 10-foot high inukshuk made out of 4368 cans of sustainably fished salmon and tuna. The first link will take users to a National Public Radio segment from last week about the inukshuk's different variations. The second link leads visitors to a Wall Street Journal article from February 22 about the traditional and non-traditional forms of the inukshuk. Moving on, the third link leads to a piece from the Los Angeles Times which reports on the inukshuk-building style of one Zdzislaw "Ziggy" Groszek, an unemployed Polish maintenance man. The fourth link leads to a project on the Inuit offered up by the Olympic Heights School in Calgary done in the spirit of intellectual inquiry and in tribute to the Winter Olympics. The fifth link leads to a "History by the Minute" feature from the Canadian government on the inukshuk. Finally, the last link leads to an online exhibit from the Canadian Museum of Civilization that talks about "Places of Power" in Inuit society.

Grinnell, Max

2010-02-26

360

PrimaryChildrensHospital  

Cancer.gov

Located in the foothills of the Wasatch Mountains, Primary Children's Hospital is the children's hospital for Utah, Idaho, Wyoming, Nevada, and Montana. Our 289-bed hospital is equipped and staffed to care for children with complex illness and injury. Primary Children's is owned by Intermountain Healthcare and is the pediatric specialty teaching hospital for the University Of Utah School of Medicine.

361

Measuring Rural Hospital Quality  

ERIC Educational Resources Information Center

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…

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

2004-01-01

362

Improving Metabolic and Cardiovascular Health at an Early Psychosis Intervention Program in Vancouver, Canada  

PubMed Central

Psychotic disorders most commonly appear during the late teenage years and early adulthood. A focused and rapid clinical response by an integrated health team can help to improve the quality of life of the patient, leading to a better long-term prognosis. The Vancouver Coastal Health early psychosis intervention program covers a catchment area of approximately 800,000 people in the cities of Vancouver and Richmond, Canada. The program provides a multidisciplinary approach to supporting patients under the age of 30 who have recently experienced first-break psychosis. The program addresses the needs of the treatment environment, medication, and psychological therapies. A critical part of this support includes a program to specifically improve patients’ physical health. Physical health needs are addressed through a two-pronged, parallel approach. Patients receive routine metabolic health assessments during their first year in the program, where standard metabolic parameters are recorded. Based on the results of clinical interviews and laboratory tests, specific actionable interventions are recommended. The second key strategy is a program that promotes healthy lifestyle goal development. Patients work closely with occupational therapists to develop goals to improve cardiometabolic health. These programs are supported by an active research environment, where patients are able to engage in studies with a focus on improving their physical health. These studies include a longitudinal evaluation of the effects of integrated health coaching on maintaining cardiometabolic health in patients recently admitted to the program, as well as a clinical study that evaluates the effects of low versus higher metabolic risk antipsychotic drugs on central adiposity. An additional pharmacogenomic study is helping to identify genetic variants that may predict cardiometabolic changes following treatment with antipsychotic drugs. PMID:25249985

Fredrikson, Diane H.; Boyda, Heidi N.; Tse, Lurdes; Whitney, Zachary; Pattison, Mark A.; Ott, Fred J.; Hansen, Laura; Barr, Alasdair M.

2014-01-01

363

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

PubMed Central

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

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

2009-01-01

364

Calibration of a TLD-100 powder dosimetric system to verify the absorbed dose to water imparted by 137Cs sources in low dose rate brachytherapy at the oncology unit in the Hospital General de Mexico.  

PubMed

A thermoluminescence dosimetry (TLD) system was characterised at SSDL-ININ to verify the air-kerma strength (S(K)) and dose-to-water (D(W)) values for (137)Cs sources used in low dose rate (LDR) brachytherapy treatments at the Hospital General de Mexico (HGM). It consists of a Harshaw 3500 reader and a set of TLD-100 powder capsules. The samples of TLD-100 powder were calibrated in terms of D(W) vs. nC or nC mg(-1), and their dose response curves were corrected for supralinearity. The D(W) was calculated using the AAPM TG-43 formalism using S(K) for a CDCSM4 (137)Cs reference source. The S(K) value was obtained by using a NE 2611 chamber, and with two well chambers. The angular anisotropy factor was measured with the NE 2611 chamber for this source. The HGM irradiated TLD-100 powder capsules to a reference dose D(W) of 2 Gy with their (137)Cs sources. The percent deviations between the imparted and reference doses were 1.2% < or = Delta < or = 6.5%, which are consistent with the combined uncertainties: 5.6% < or = u(c) < or = 9.8% for D(W). PMID:16644958

Alvarez Romero, J T; Tovar Muñoz, V M; de León, B Salinas; Oviedo, J O Hernández; Barcenas, L Santillán; Milo, C Molero; Monterrubio, J Montoya

2006-01-01

365

Role statement: one hospital's experience.  

PubMed

This article is a case study of a strategic planning process used by one Edmonton teaching hospital to develop a five-year planning document or role statement. In contrast to hospital role statements that are typically composed in the organization by senior personnel, input was sought from other health care providers, affiliated organizations and community groups. The role statement has since been endorsed by the provincial government and is the primary reference document for future funding strategies. General conclusions and observations are offered regarding role statements and their development. PMID:10112304

O'Connell, P

1991-01-01

366

Competition among hospitals.  

PubMed

The traditional view of hospital competition has posited that hospitals compete primarily along 'quality' dimensions, in the form of fancy equipment to attract admitting physicians and pleasant surroundings to entice patients. Price competition among hospitals is thought to be non-existent. This paper estimates the effects of various hospital market characteristics on hospital prices and expenses in an attempt to determine the form of hospital competition. The results suggest that both price and quality competition are greater in markets that are less concentrated, although the net effect of the two on prices is insignificant. It appears, therefore, that, despite important distortions, hospital markets are not immune to standard competitive forces. PMID:10291477

Noether, M

1988-09-01

367

Safety-net hospitals.  

PubMed

Vulnerable populations, who have difficulty accessing the health care system, primarily receive their medical care from hospitals. Policy makers have struggled to ensure the survival of "safety-net hospitals," hospitals that provide a disproportionate share of care to these patient populations. The objective of this article is to develop measures to guide analysis and policy for urban safety-net hospitals. The authors developed three safety-net measures: the socioeconomic status of hospital service area, Medicaid intensity, and uncompensated care burden and its market share. Cluster analysis was used to identify break points that distinguish a safety-net hospital from a non-safety-net hospital. The measures developed were stable and independent, but a data-driven binary assignment of hospitals to a "safety-net" category was not supported. These analyses call into question the empirical basis for distinguishing a specific group of hospitals as safety-net hospitals. PMID:18640951

Zwanziger, Jack; Khan, Nasreen

2008-08-01

368

Designer drugs in the general hospital.  

PubMed

This article has reviewed the potential complications of acute intoxication and withdrawal from some of the more commonly used club, or designer, drugs. Although limited, acute use of these drugs is claimed by users to be benign, in the context of crowded raves and circuit parties, where multiple drugs may be used, hyperthermia, dehydration, and life-threatening reactions may occur. In addition, mounting evidence of the long-term effects of continued use of these drugs is cause for great concern. Finally, awareness of a severe withdrawal syndrome from GHB and its precursors is particularly important to psychiatrists of the medically ill, who may be called on to help in the management of these patients. PMID:11912942

Bialer, Philip A

2002-03-01

369

Blood Transfusion Service Massachusetts General Hospital  

E-print Network

than 12 mos ago Yes Jaundice as newborn Yes Measles, Mumps, Polio (oral), Small Pox, Yellow Fever more/Advil Yes Fainted once from giving blood Yes Birth control pills Yes Fever No IV street drugs No Flu

Mootha, Vamsi K.

370

Blood Transfusion Service Massachusetts General Hospital  

E-print Network

controlled w/ medication Yes Measles, Mumps, Polio (oral), Small Pox, Yellow Fever more than 2 wks ago Yes, no episode w/in 3 mos. Yes Aspirin/Advil Yes Fainted once from giving blood Yes Birth control pills Yes Fever

Mootha, Vamsi K.

371

Utilization of Facilities of a University Hospital  

PubMed Central

The lengths of hospital stay among adult inpatients discharged during 1962 from the medical and surgical specialty departments of a large urban university-affiliated general hospital have been examined. Data are shown comparing the durations of hospitalization of patients who had a private physician directly responsible for their hospital care (private patients) and of those who did not (staff patients). The relation between the lengths of stay of private patients and those of staff patients varied considerably from one hospital department to another. On the medical services, staff patients had longer hospital stays than did private patients, a discrepancy that could not be accounted for by differences between the two groups in age, race, sex, or source of payment for hospitalization and it is being studied further. A major cause of the apparent difference in lengths of hospitalization between private and staff surgical patients proved to be inconsistencies in the criteria used to define the terms “hospital admission” and “inpatient” among various patient groups. Some of the possible effects of variations in the definition of these terms and of the terms “medical patients” and “surgical patients” in hospital-use studies are discussed. Images Fig. 1 PMID:5915337

McCorkle, Lois P.

1966-01-01

372

Financial and organizational determinants of hospital diversification into subacute care.  

PubMed Central

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

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

1999-01-01

373

Hospitalizations of Children with Autism Increased from 1999 to 2009  

ERIC Educational Resources Information Center

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…

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

2014-01-01

374

Hospitalizations of Adults with Intellectual Disability in Academic Medical Centers  

ERIC Educational Resources Information Center

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,…

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

2014-01-01

375

Effectiveness of Inactivated Influenza Vaccines in Preventing Influenza-Associated Deaths and Hospitalizations among Ontario Residents Aged ?65 Years: Estimates with Generalized Linear Models Accounting for Healthy Vaccinee Effects  

PubMed Central

Background Estimates of the effectiveness of influenza vaccines in older adults may be biased because of difficulties identifying and adjusting for confounders of the vaccine-outcome association. We estimated vaccine effectiveness for prevention of serious influenza complications among older persons by using methods to account for underlying differences in risk for these complications. Methods We conducted a retrospective cohort study among Ontario residents aged ?65 years from September 1993 through September 2008. We linked weekly vaccination, hospitalization, and death records for 1.4 million community-dwelling persons aged ?65 years. Vaccine effectiveness was estimated by comparing ratios of outcome rates during weeks of high versus low influenza activity (defined by viral surveillance data) among vaccinated and unvaccinated subjects by using log-linear regression models that accounted for temperature and time trends with natural spline functions. Effectiveness was estimated for three influenza-associated outcomes: all-cause deaths, deaths occurring within 30 days of pneumonia/influenza hospitalizations, and pneumonia/influenza hospitalizations. Results During weeks when 5% of respiratory specimens tested positive for influenza A, vaccine effectiveness among persons aged ?65 years was 22% (95% confidence interval [CI], ?6%–42%) for all influenza-associated deaths, 25% (95% CI, 13%–37%) for deaths occurring within 30 days after an influenza-associated pneumonia/influenza hospitalization, and 19% (95% CI, 4%–31%) for influenza-associated pneumonia/influenza hospitalizations. Because small proportions of deaths, deaths after pneumonia/influenza hospitalizations, and pneumonia/influenza hospitalizations were associated with influenza virus circulation, we estimated that vaccination prevented 1.6%, 4.8%, and 4.1% of these outcomes, respectively. Conclusions By using confounding-reducing techniques with 15 years of provincial-level data including vaccination and health outcomes, we estimated that influenza vaccination prevented ?4% of influenza-associated hospitalizations and deaths occurring after hospitalizations among older adults in Ontario. PMID:24146855

Ridenhour, Benjamin J.; Campitelli, Michael A.; Kwong, Jeffrey C.; Rosella, Laura C.; Armstrong, Ben G.; Mangtani, Punam; Calzavara, Andrew J.; Shay, David K.

2013-01-01

376

Hospitable Classrooms: Biblical Hospitality and Inclusive Education  

ERIC Educational Resources Information Center

This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

Anderson, David W.

2011-01-01

377

Predicted short-term radial-growth changes of trees based on past climate on Vancouver Island, Briti  

Microsoft Academic Search

Tree-ring radial expansion estimator (TREE) is an integrated radial growth model that allows users to define short-term climate change scenarios to anticipate the impact upon mature trees found growing at high elevation on Vancouver Island, British Columbia. Five individualistic models were built to represent the radial growth behaviour of mountain hemlock (Tsuga mertensiana (Bong. ) Carr), yellow-cedar (Chamaecyparis nootkatensis (D.

Colin P. Laroque; Dan J. Smith

378

Patterns of within and between-colony microsatellite variation in the endangered Vancouver Island marmot ( Marmota vancouverensis ): implications for conservation  

Microsoft Academic Search

Among the 14 extant species of the genus Marmota the Vancouver Island marmot (Marmota vancouverensis) is the most endangered. In 2007 as few as 85 individuals were left in the wild, with an additional 162 individuals maintained\\u000a in captivity. To facilitate genetic monitoring of both wild and captive populations, polymorphic genetic markers were identified.\\u000a Thirty-three different microsatellite loci were tested

Luise Kruckenhauser; Andrew A. Bryant; Suzanne C. Griffin; Stephen J. Amish; Wilhelm Pinsker

2009-01-01

379

Extended Trochanteric Osteotomy for the Treatment of Vancouver B2\\/B3 Periprosthetic Fractures of the Femur  

Microsoft Academic Search

Periprosthetic femur fractures after total hip arthroplasty are a growing concern as their prevalence is expected to rise. A retrospective review was performed of all patients undergoing revision total hip arthroplasty with an extended trochanteric osteotomy (ETO) for treatment of a Vancouver B2\\/B3 fracture at our institution. Fourteen patients were identified having a minimum of 2-year follow-up. Clinical and radiographic

Brett R. Levine; Craig J. Della Valle; Paul Lewis; Richard A. Berger; Scott M. Sporer; Wayne Paprosky

2008-01-01

380

The application of hospitality elements in hospitals.  

PubMed

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

Wu, Ziqi; Robson, Stephani; Hollis, Brooke

2013-01-01

381

75 FR 44972 - Medicare and Medicaid Programs; Announcement of an Application From a Hospital Seeking To Enter...  

Federal Register 2010, 2011, 2012, 2013, 2014

...DEPARTMENT OF HEALTH AND HUMAN...an Application From a Hospital Seeking To Enter Into...SUMMARY: A hospital that had previously...requests comments from hospitals, OPOs, and the general...Medicaid Services, Department of Health and...

2010-07-30

382

Vancouver AIDS conference: special report. The global business response to AIDS: what is a "business-like" response, and is business responding enough?  

PubMed

Approximately 40 businesses were represented at a 2-day meeting held immediately before the main Vancouver conference on the Global Business Response to AIDS. Only three companies were from the developing world, with the overwhelming majority being from Canada and the US. Companies in countries where many people are infected with HIV and where the number of AIDS cases is rapidly growing must be concerned about HIV/AIDS. However, in countries of low-level HIV prevalence and infection incidence, businesses may have less concern about HIV/AIDS unless their own employees are infected. Even then, the priority a company gives to coping with the HIV/AIDS pandemic will be determined largely by the importance of the positions of the infected employees. Businesses discussed whether HIV/AIDS merits special attention, the undesirability of screening prospective employees for HIV infection, company size and the ability to respond to the needs of sick employees, the roles of business in society, the general failure of businesses to incorporate HIV/AIDS issues into the mainstream of company operations, how businesses are coping with the HIV/AIDS epidemic, and the need for governments to form a regulatory framework in which businesses can work. Conference participants discussed which steps should be taken next and prepared a declaration for conference organizers, including a mission statement for the global business response to AIDS. PMID:12347384

Whiteside, A

1996-01-01

383

Specialty and Full-Service Hospitals: A Comparative Cost Analysis  

PubMed Central

Objective To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. Data Sources The primary data sources are the Medicare Cost Reports for 1998–2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. Study Design We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Principal Findings Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Conclusions Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors. PMID:18662170

Carey, Kathleen; Burgess, James F; Young, Gary J

2008-01-01

384

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

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

2014-01-01

385

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

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

Bettoncelli, Germano; Blasi, Francesco; Brusasco, Vito; Centanni, Stefano; Corrado, Antonio; De Benedetto, Fernando; De Michele, Fausto; Di Maria, Giuseppe U; Donner, Claudio F; Falcone, Franco; Mereu, Carlo; Nardini, Stefano; Pasqua, Franco; Polverino, Mario; Rossi, Andrea; Sanguinetti, Claudio M

2014-01-01

386

Biological characterization of a whale-fall near Vancouver Island, British Columbia, Canada  

NASA Astrophysics Data System (ADS)

Video analysis of a whale-fall discovered in the northeast Pacific Ocean, off Vancouver Island at a depth of 1288 m during ROV diving operations has identified 26 taxa of deep-sea benthic organisms inhabiting the seafloor immediately surrounding remnants of the whale skeleton. A photo-mosaic derived from high-definition video provides a quantitative visual record of the present condition of the site, the species richness, and substrate preference. Only the skull and caudal vertebrae remains of this large whale skeleton are estimated to have been approximately 16.5 m in length. Most organisms identified near the whale-fall are common benthic deep-sea fauna, typical of this water depth and seafloor composition. Much of this species richness comes from sessile suspension feeding cnidarians attached to the numerous glacial dropstones found throughout the area rather than the presence of the whale skeleton. Seep and bone specialists are rare (4 taxa) and may be, in part, a remnant population from a sulphophilic stage of whale-fall decomposition. Evidence of past colonization by Osedax sp. is visible on the remaining bones and we conclude that rapid degradation of the missing bones has occurred at this site as has been observed at whale-falls off central California in Monterey Canyon.

Lundsten, Lonny; Paull, Charles K.; Schlining, Kyra L.; McGann, Mary; Ussler, William, III

2010-07-01

387

Impacts of primary deforestation upon limestone slopes in northern Vancouver Island, British Columbia  

NASA Astrophysics Data System (ADS)

Effects of deforestation upon slopes in limestones and in volcanic rocks in the Benson River valley, northern Vancouver Island, have been investigated quantitatively. Postlogging soil erosion and vegetal regeneration success were assessed by measuring soil depth, percent bare rock and moss cover, and the numbers and diversity of trees, shrubs, and plants on 25 sampling sites, each containing ten measuring quadrats selected at random. Sixteen sites were on the Quatsino Formation, a well-karstified limestone, and nine on the Karmutsen Formation of basaltic lavas. Eight sites were of virgin forest, 16 were logged between 1970 and 1983, and one (on limestone) was logged in 1911. Both bedrock types were significantly affected by the cutting. There was greater loss of soil and an increase in bare rock on the limestones. Erosion was increased significantly by burning on the limestones but not on the volcanics. Within-group comparisons on the limestones determined that steeper slopes and harder burned areas suffered the most and are slowest to regenerate. Volume of timber on the 1911 site was 19 percent of that in similar uncut forest sites. It appears that complete recovery on the barren limestone slopes will require at least some centuries.

Harding, K. A.; Ford, D. C.

1993-06-01

388

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

PubMed Central

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

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

2013-01-01

389

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

PubMed Central

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

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

2014-01-01

390

Community mapping and respondent-driven sampling of gay and bisexual men's communities in Vancouver, Canada.  

PubMed

Literature suggests formative research is vital for those using respondent-driven sampling (RDS) to study hidden populations of interest. However, few authors have described in detail how different qualitative methodologies can address the objectives of formative research for understanding the social network properties of the study population, selecting seeds and adapting survey logistics to best fit the population. In this paper we describe the use of community mapping exercises as a tool within focus groups to collect data on social and sexual network characteristics of gay and bisexual men in the metropolitan area of Vancouver, Canada. Three key themes emerged from analysing community maps along with other formative research data: (1) connections between physical spaces and social networks of gay and bisexual men, (2) diversity in communities and (3) substance use linked to formation of sub-communities. We discuss how these themes informed the planning and operations of a longitudinal epidemiological cohort study recruited by RDS. We argue that using community mapping within formative research is a valuable qualitative tool for characterising network structures of a diverse and differentiated population of gay and bisexual men in a highly developed urban setting. PMID:24512070

Forrest, Jamie I; Stevenson, Benjamin; Rich, Ashleigh; Michelow, Warren; Pai, Jayaram; Jollimore, Jody; Raymond, H Fisher; Moore, David; Hogg, Robert S; Roth, Eric A

2014-02-10

391

Structure and agency: reflections from an exploratory study of Vancouver indoor sex workers.  

PubMed

Sex work research continues to be characterised by debates around decriminalization. Central to these debates are claims about the agency of those involved in the sex trade. Some researchers argue that individuals involved in the sex trade are victims of structural and interpersonal constraint, whilst others depict them as workers exercising choice. Drawing on structure-agency theory, a review of legal and media accounts of the sex trade and qualitative interviews with 21 indoor sex workers in Vancouver, Canada, we argue that both of these perspectives are insufficient. Rather than reducing the sex trade to part of a binary, we suggest that it is necessary to analyse sex work through the complex interplay of both structure and agency. Specifically, structural analyses undercover the numerous ways that sex workers are controlled, observed and influenced whilst agency perspectives elicit the means that sex workers continue to exercise control in spite of disadvantage. While we do not finalise decriminalisation debates, we do critique current Canadian laws for the lack of responsiveness to the lives of sex workers and their exploitative and contradictory stance on sex work. PMID:20967651

Bungay, Vicky; Halpin, Michael; Atchison, Chris; Johnston, Caitlin

2011-01-01

392

Application of transmission reliability assessment in probabilistic planning of BC Hydro Vancouver South Metro system  

SciTech Connect

This paper presents a basic method of probabilistic transmission planning used in BC Hydro. The method is based on transmission system reliability evaluation and an overall economic analysis including damage cost due to system unreliability. Four alternatives for the Vancouver South Metro system of BC Hydro have been evaluated using the method. The first one is addition of a 230 kV line, the second one local configuration changes (cuts and ties) in the 69 kV subsystem, the third one operational manipulation and the fourth one curtailable industrial load management. The third and the fourth alternatives can be considered as non-investment reinforcements. The results indicate that the cut-and-tie alternative in the 69 kv subsystem can provide the same reliability level as the 230 kV line addition but with much lower investment and therefore the initial 230 kV line addition could be deferred by 10 years. This deferral allows a major capital expenditure of $26.4 million (1997 $) to be avoided. The studies show that the application of quantitative transmission reliability assessment in power system planning can provide utilities with significant economic benefits.

Li, W.; Mansour, Y.; Korczynski, J.K.; Mills, B.J. [BC Hydro, Vancouver, British Columbia (Canada). Regional System Planning] [BC Hydro, Vancouver, British Columbia (Canada). Regional System Planning

1995-05-01

393

Theoretical and perceived balance of power inside Spanish public hospitals  

Microsoft Academic Search

BACKGROUND: The hierarchical pyramid inside Spanish public hospitals was radically changed by the Health Reform Law promulgated in 1986. According to it, the manpower of the hospitals was divided into three divisions (Medical, Nursing, General Services\\/Administration), which from then on occupied the same level, only subject to the general manager. Ten years after the implementation of the law, the present

Paloma Salvadores; José Schneider; Imanol Zubero

2001-01-01

394

The prevalence and correlates of the positive Androgen Deficiency in the Aging Male (ADAM) questionnaire among psychiatric outpatients: a cross-sectional survey of 176 men in a general hospital in Taiwan  

PubMed Central

Introduction The Androgen Deficiency in the Aging Male (ADAM) questionnaire is widely used to screen for late-onset hypogonadism. The positive response to the ADAM questionnaire (positive ADAM) has been associated with depression and poorer quality of life in a number of studies. It is unclear whether there is any value of the ADAM questionnaire in psychiatric populations. In this study, we aimed to determine the utility of the ADAM questionnaire in a convenient sample of male psychiatric outpatients. Methods One hundred and seventy-six men (mean age: 54.3 years; standard deviation: 10.7 years; range: 40–80 years) completed the ADAM questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Aging Males’ Symptoms (AMS) scale. Anxiety was defined as a HADS anxiety subscore ?8; depression as a HADS depression subscore ?8; and moderate/severe impairment of health-related quality of life (HQoL) as AMS ?37. ADAM, anxiety, and depression was used to model the moderate/severe impairment of HQoL. Results One hundred and sixty-four (93%) men had positive ADAM. Positive ADAM was associated with a lower body mass index (P<0.05) and moderate/severe impairment of HQoL (P<0.001), but was not associated with anxiety or depression (P>0.05). Positive ADAM was associated with five symptoms of the AMS scale: “decline of one’s feeling of general well-being”, “depressive mood”, and three sexual symptoms. In regression analysis, positive ADAM was associated with increased risk of moderate/severe impairment of HQoL (unadjusted odds ratio 20.1, 95% confidence interval 3.77–372, P<0.01), which remained significant with covariates of anxiety and depression (adjusted odds ratio 15.6, 95% confidence interval 2.52–309, P<0.05). Conclusion The ADAM questionnaire can be used to screen the sexual symptoms but not depression/anxiety in male psychiatric outpatients. Positive ADAM may indicate moderate/severe impairment of HQoL. PMID:25653527

Lee, Chin-Pang; Chen, Yu; Jiang, Kun-Hao; Chu, Chun-Lin; Hsu, Shih-Chieh; Chen, Jiun-Liang; Chen, Ching-Yen

2015-01-01

395

Dance\\/Movement Therapy with Hospitalized Children  

Microsoft Academic Search

Dance\\/movement therapy can play a significant role as an assessment and therapeutic tool for medically ill children who undergo short or long-term hospitalization. This paper describes the impact of illness on children's body image, the goals of dance\\/movement therapy and its application in an Israeli general hospital, with specific emphasis on pediatrics. Examples of individual cases illustrate the process of

Judith Mendelsohn

1999-01-01

396

Discovery of an Active Submarine Mud Volcano Along the Nootka Fault West of Vancouver Island  

NASA Astrophysics Data System (ADS)

Submarine mud volcanoes are a common feature in margin environments, but few of them have been documented in the Northeast Pacific. However, during a Hydrosweep bathymetric survey in July, 2001, and a follow-on sub-surface seismic survey in August two mud volcanoes were imaged along the Nootka Fault, 16-18 km west of Vancouver Island at a water depth of 2500 m. The southern volcano, called Maquinna, lies directly along the southern expression of the left lateral, strike slip Nootka Fault. It is 1.5 km across, has a breached caldera and two small summit craters, and it stands about 30 m above the seafloor. The base is bounded by a narrow moat, partially filled by Holocene sediments that are flat lying; older, underlying sediments show steep downwarping towards the sides of the volcano. Subsurface imaging shows a dramatic loss of reflectivity beneath the volcano mound, which may indicate significant mobilization of material. However, a very bright reflector is seen at about 400 m depth below the volcano. This reflector is too deep for stability of methane clathrate, and is interpreted as a zone of high fluid content. A CTD vertical cast above the summit of the volcano showed strong, co-registered thermal, particulate, and oxygen anomalies that extend 50 m up into the overlying water column. These data indicate that the volcano is actively venting warm hydrothermal fluids. The fluids are depleted in CO2, contain background concentrations of CH4, but show elevated H2 concentrations above ocean background water. Microscopic examination of the Nootka hydrothermal samples shows that they contain dense and morphologically diverse microbial communities in comparison to background seawater with cell densities of 106 cells/ml. Enrichment culturing indicates that these communities include both anaerobic and aerobic organisms, some of which are thermophilic with optimal growth temperatures in excess of 50 deg C. Some of these cultures can use methane oxidation as an energy source. Additional culturing experiments and analysis of preserved samples are underway to further characterize the microbes. To further understand the biogeochemical cycles at these sites, samples recently taken from piston cores and CTD casts in this region, are being surveyed for stable and radio carbon isotope signatures of CH4, dissolved inorganic carbon, organic carbon and phospholipid bacterial biomarkers. A second volcano lies ~ 8 km to the northwest of the Maquinna that has a less well defined seafloor expression. However, like Maquinna, seismic reflectivity is lost nearly completely beneath the mound, except for a very bright reflector at about 800 m depth. It is not yet known if this volcano is hydrothermally active. It is likely that high sediment accumulation and lateral tectonic compression associated with accretionary prism formation along the west coast of Vancouver Island support overpressuring of fluids at depth along the Nootka Fault zone, resulting in growth of the two volcanoes.

Riedel, M.; Riedel, M.; Kelly, D. S.; Delaney, J. R.; Spence, G. D.; Hyndman, R. D.; Hyndman, R. D.; Mayer, L.; Calder, B.; Lilley, M. D.; Olson, E. O.; Schrenk, M. O.; Coffin, R.

2001-12-01

397

Blood lead levels in children aged 24 to 36 months in Vancouver.  

PubMed Central

OBJECTIVES: To determine the blood lead levels in children and to identify risk factors for elevated levels. DESIGN: Cross-sectional study. SETTING: Vancouver. PARTICIPANTS: Random sample of children aged 24 to 36 months, born and still resident in Vancouver. The sample was stratified proportionally by the median annual family income in the census tract where each family resided. OUTCOME MEASURES: Blood lead levels and risk factors for elevated blood lead levels, determined from a questionnaire administered to parents. RESULTS: Of the children in the sample, 42% (178/422) were ineligible or could not be located. Of the remaining children, 73% (177/244) participated and adequate blood specimens were obtained from 172. The mean blood lead level was 0.29 mumol/L (standard deviation 0.13 mumol/L). (A blood lead level of 1 mumol/L is equivalent to 20.7 micrograms/dL.) The lowest level was 0.06 mumol/L, and the highest was 0.85 mumol/L. Of children with adequate samples, 8.1% (14/172) had blood lead levels of 0.48 mumol/L or higher, and 0.6% (1/172) had a level higher than 0.72 mumol/L. The logarithms of the levels were normally distributed, with a geometric mean (GM) of 0.26 mumol/L (geometric standard deviation 1.56). Of approximately 70 possible predictors of blood lead levels analysed, those that showed a statistically significant association (p < 0.05) with increased blood lead levels were soldering performed in the home as part of an electronics hobby (GM blood lead level 0.34 mumol/L, 95% confidence interval [CI] 0.27 to 0.39 mumol/L), aboriginal heritage (GM blood lead level 0.33 mumol/L, 95% CI 0.28 to 0.39 mumol/L), dwelling built before 1921 (GM blood lead level 0.32 mumol/L, 95% CI 0.28 to 0.37 mumol/L), age of water service connection to dwelling (predicted blood lead level 0.00087 mumol/L [95% CI 0.00005 to 0.00169 mumol/L] higher per year since service connection) and decreased stature (predicted blood lead level 0.018 mumol/L [95% CI 0.0353 to 0.0015 mumol/L] higher for every standard deviation below the age-specific mean height). CONCLUSIONS: This study found much lower blood lead levels in children than those found in previous Canadian studies. The authors believe that this result is not an artefact due to differences in population sampling or methods of collection of blood specimens. The study showed no clear risk factors for elevated blood lead levels: although a few factors had a statistically significant association with increased blood lead levels, the differences in levels were small and unimportant. PMID:7712420

Jin, A; Hertzman, C; Peck, S H; Lockitch, G

1995-01-01

398

First Results From PBO Strainmeters On The Olympic Peninsula And Vancouver Island, Canada.  

NASA Astrophysics Data System (ADS)

The Plate Boundary Observatory installed six Gladwin Tensor Strainmeters (GTSMs) on the Olympic peninsula in June and July 2005. Four boreholes are currently being drilled on Vancouver Island, Canada, with strainmeter installation planned for autumn 2005. Initial results from the strainmeters on the Olympic Peninsula indicate that all are measuring an accumulation of strain and that the phase and amplitudes of the M2 and O1 Earth tides and teleseisms are resolvable at some of the strainmeters after two months of operation. These six strainmeters and the four in Vancouver Island are well placed to capture any strain transients produced by the expected Cascadia slow earthquake. GTSMs, installed at depths of up to 250 m, measure changes in strain with a precision 1 ppb over periods of hours to months. They therefore bridge the spectrum of deformation not measurable by GPS or seismometers. GTSMs record strain at sample rates of 20 samples/second, 1 sample/second and 1 sample per 600 seconds. Rainfall, pore pressure atmospheric pressure, temperature and seismic data are also measured at the strainmeter site. The strain and environmental data flow at hourly intervals to UNAVCO's Boulder Data Collection Center (BDCC) via VSAT. At the BDCC it is converted to miniSEED and sent to the Northern California Earthquake Data Center (NCEDC) and to IRIS's Data Management Center (IRIS DMC) for archival via SEEDLink. In addition the raw data, in the data logger native format, are transferred to the archives via LDM. The strain data are processed at UNAVCO's Borehole Strainmeter Analysis Center (BSMAC), located at the PASSCAL Instrument Center at New Mexico Tech, in Socorro, NM. On arrival at the BSMAC the 1 sample/sec data are reviewed and spurious data and signals known to be introduced by non-tectonic activity are identified. The 1 sample/sec strain data are then reduced to 300-second interval in a multi-stage decimation process using minimum-phase decimate by 2, 3 and 5 causal filters. The data from each of the four gages within the strainmeter are then combined into areal and shear strains. Before strain transients or tectonic signals can be isolated in strain measurements three sets of corrections must be applied; an Earth tide correction, an atmospheric pressure correction and a borehole relaxation grout-curing correction. The Earth tides and the relation between atmospheric pressure and strain change are determined simultaneously for each gage from lowpass-filtered clean data using the program BAYTAP-G. The borehole-relaxation and grout-curing trend are modeled for each gage using a double exponential plus linear term. The parameters that describe these corrections are recalculated every 3 months. The time series corrections can then be generated for any sample interval over any time period. The final processing step is the conversion of the 300-second gage and tensor strain data into XML format, which also contains data quality and processing information. The XML files are archived along with the raw data at the DMC and NCEDC.

Hodgkinson, K.; Anderson, G.; Dittmann, T.; Gladwin, M.; Hasting, M.; Johnson, W.; Mee, M.; Mueller, B.; Venator, S.; Wright, J.

2005-12-01

399

Case records of the Massachusetts General Hospital. Case 35-2014: a 31-year-old woman with fevers, chest pain, and a history of HCV infection and substance-use disorder.  

PubMed

A 31-year-old woman with substance-use disorder was admitted to this hospital because of fevers and chest pain. CT of the chest revealed multiple thick-walled nodular opacities throughout both lungs. Diagnostic tests were performed, and management decisions were made. PMID:25390743

Wakeman, Sarah E; Ghoshhajra, Brian B; Dudzinski, David M; Wilens, Timothy; Slavin, Peter L

2014-11-13

400

Mid-Mountain Clouds at Whistler During the Vancouver 2010 Winter Olympics and Paralympics  

NASA Astrophysics Data System (ADS)

A comprehensive study of mid-mountain clouds and their impacts on the Vancouver 2010 Winter Olympics and Paralympics is presented. Mid-mountain clouds were frequently present on the Whistler alpine venue, as identified in an extensive archive of webcam images over a 45-day period from February 5 to March 21, 2010. These clouds posed serious forecast challenges and had significant impacts on some Olympic and Paralympic alpine skiing competitions. Under fair weather conditions, a diurnal upslope (anabatic) flow can work in concert with a diurnal temperature inversion aloft to produce a localized phenomenon known as "Harvey's Cloud" at Whistler. Two detailed case studies in this paper suggest that mid-mountain clouds can also develop in the area as a result of a moist valley flow interacting with a downslope flow descending from the mountaintop. A southerly inflow through the Sea-to-Sky corridor can be channeled by the local topography into a westerly upslope flow toward Whistler Mountain, resulting in orographic clouds on the alpine venue. Under favorable circumstances, these clouds are trapped to the mid-mountain zone by the leeward subsidence of an elevated southerly flow. The presence of the downslope subsidence was manifested by a distinguished dry layer observed on the top of the mid-mountain clouds in both cases. It is the subsidence-induced adiabatic warming that imposes a strong buoyant suppression to trap the mid-mountain cloud. On the other hand, the subsidence-induced dry layer has the potential to trigger evaporative instability to periodically breakup the mid-mountain cloud.

Mo, Ruping; Joe, Paul; Isaac, George A.; Gultepe, Ismail; Rasmussen, Roy; Milbrandt, Jason; McTaggart-Cowan, Ron; Mailhot, Jocelyn; Brugman, Melinda; Smith, Trevor; Scott, Bill

2014-01-01

401

Storm runoff as related to urbanization in the Portland, Oregon-Vancouver, Washington area  

USGS Publications Warehouse

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.

Laenen, Antonius

1980-01-01

402

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

USGS Publications Warehouse

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.

Laenen, Antonius

1980-01-01

403

Please cite this article in press as: Nelson, T.A., et al., Detecting spatial connections within a dendrochronological network on Vancouver Island, British Columbia. Dendrochronologia (2010), doi:10.1016/j.dendro.2010.08.002  

E-print Network

a dendrochronological network on Vancouver Island, British Columbia. Dendrochronologia (2010), doi:10.1016/j.dendro.2010 connections within a dendrochronological network on Vancouver Island, British Columbia Trisalyn A. Nelsona Dendrochronology Ring-width analysis Spatial autocorrelation Spatial­temporal pattern a b s t r a c

Smith, Dan

404

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

E-print Network

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.

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

405

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

USGS Publications Warehouse

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

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

1995-01-01

406

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

NASA Astrophysics Data System (ADS)

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.

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

2003-04-01

407

The effects of corporate restructuring on hospital policymaking.  

PubMed Central

Hospital corporate restructuring is the segmentation of assets or functions of the hospital into separate corporations. While these functions are almost always legally separated from the hospital, their impact on hospital policymaking may be far more direct. This study examines the effects of corporate restructuring by community hospitals on the structure, composition, and activity of hospital governing boards. In general, we expect that the policymaking function of the hospital will change to adapt to the multicorporate structure implemented under corporate restructuring, as well as the overlapping boards and diversified business responsibilities of the new corporate entity. Specifically, we hypothesize that the hospital board under corporate restructuring will conform more to the "corporate" model found in the business/industrial sector and less to the "philanthropic" model common to most community hospitals to date. Analysis of survey data from 1,037 hospitals undergoing corporate restructuring from 1979-1985 and a comparison group of 1,883 noncorporately restructured hospitals suggests general support for this hypothesis. Implications for health care governance and research are discussed. PMID:3384671

Alexander, J A; Morlock, L L; Gifford, B D

1988-01-01

408

Reasons for Hospital Admissions in Dementia Patients in Birmingham, UK, during 2002–2007  

Microsoft Academic Search

Background: There is a lack of evidence to explain why patients with dementia are admitted to a general hospital. Methods: Main reasons for hospitalisation were investigated in all patients admitted to a multi-ethnic general hospital during 2002–2007, by analysis of type of admission and primary diagnosis on admission. Anonymised data from the Hospital Activity Analysis Register was used to trace

Ammar Natalwala; Rahul Potluri; Hardeep Uppal; Reinhard Heun

2008-01-01

409

Hospitals are dangerous places.  

PubMed

Hospital fire dangers are real, widespread, and ever present, the article demonstrates, spelling out the locations, conditions, and ignition potentials which exist in such a setting. Knowledge of codes and standards, good maintenance practices, and frequent drills in fire prevention and suppression are among the practices recommended for keeping a hospital fire from becoming a disaster, the author says. PMID:20873506

de Richemond, Albert L

2010-01-01

410

Hospitality Services Reference Book.  

ERIC Educational Resources Information 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…

Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

411

Hospitality Services. Curriculum Guide.  

ERIC Educational Resources Information 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…

Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

412

Handbook on Hospital Television.  

ERIC Educational Resources Information Center

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…

Prynne, T. A.

413

Hospitality Occupations. Curriculum Guide.  

ERIC Educational Resources Information Center

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…

California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

414

Children's Hospital Los Angeles  

Cancer.gov

The Pediatric Psychology Program at Children's Hospital Los Angeles (CHLA) consists of outpatient and inpatient hospital-based services that provide therapeutic support and intervention to children and families. The pediatric psychology postdoctoral fellows will participate in varied clinical activities with child and adolescent patients and their families.

415

Infantile gastroesophageal reflux in a hospital setting  

PubMed Central

Background Gastroesophageal reflux is a common diagnosis in infants. Yet, there is no information on the demographics of those hospitalized with reflux. The aim of this study is to describe the demographics of children with gastroesophageal reflux discharged from the hospital during the first two years of life. Methods Retrospective chart review of children aged 0–2 years discharged between January 1, 1995 and December 31, 1999 with a diagnosis of reflux documented in their hospital chart prior to 12 months of age. Results Reflux was the seventh most common reason for hospitalization. About 50% of subjects with reflux had multiple hospitalizations. Of the 1,096 infants diagnosed with reflux about half were born prematurely. Reflux was the primary diagnosis for 21% of all infants; 10% of those born prematurely. The average length of stay for the subjects was longer than the hospital average. African Americans, 2.4% of the population, accounted for 29% of discharges. Caucasians, 86% of the population, were 66% of discharges. 21.8% of African Americans and 68.3% of Caucasians were diagnosed with reflux. 35% of mothers smoked, 27% worked and 48% had public insurance, compared to 22.2%, 57%, and 24% respectively of females in the general population. Conclusion Reflux is a common discharge diagnosis. Children who have primary reflux have longer than average hospital stays. About half had multiple admissions. Mothers of children with reflux are more likely to be less educated, receive public insurance, smoke, and be unemployed than the general female population in Western New York. Although African American children were disproportionately hospitalized, they were less likely to be diagnosed with reflux. PMID:18371208

Baker, Susan S; Roach, Christine M; Leonard, Michael S; Baker, Robert D

2008-01-01

416

What accounting leaves out of hospital financial management.  

PubMed

As PPS and other fixed-price initiatives replace cost-based reimbursement in the hospital industry, the burden of assuming the risk for business success or failure shifts from the payor to the hospital. As a consequence, theories of risk to the business firm which have found application in other industries now deserve attention by hospital management. Incorporating such risk concepts into hospital strategies and actions requires a view of financial management that goes beyond the generally accepted accounting principles of managing and assigning costs for maximum revenue and profitability. This article examines the financial theory of risk in business firms, illustrates the various components of risk as they apply to a hospital business, and discusses how the hospital management strategies of cost-reduction, marketing, diversification, and multiorganizational affiliation can alter the risk characteristics of a hospital business. PMID:10275567

Boles, K E; Glenn, J K

1986-01-01

417

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

PubMed Central

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

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

2014-01-01

418

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

PubMed

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

Ross, Becki

2012-01-01

419

Fixation of Vancouver B1 peri-prosthetic fractures by broad metal plates without the application of strut allografts.  

PubMed

The use of allograft struts and cerclage wire, possibly augmented by plate fixation, for the treatment of Vancouver type-B1 peri-prosthetic fractures around a total hip replacement has been strongly advocated. We examined our results using plate fixation without allograft struts and compared them with the results of the use of struts alone or when combined with plate fixation. Of 20 consecutive patients with type-B1 fractures treated by open reduction and plate fixation, 19 were available for follow-up. The fractures healed in 18 patients with a mean time to weight-bearing of ten weeks (4 to 19). There were no cases of infection or malunion. Nonunion occurred in one patient and required a second plate fixation to achieve union. Safe, cost-effective treatment of Vancouver type-B1 fractures can be performed by plate fixation without the addition of cortical struts. This procedure may allow earlier weight-bearing than allograft strut fixation alone. PMID:17075084

Old, A B; McGrory, B J; White, R R; Babikian, G M

2006-11-01

420

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

NASA Astrophysics Data System (ADS)

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.

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

2014-01-01

421

Quantifying non-indigenous species in accumulated ballast slurry residuals (swish) arriving at Vancouver, British Columbia  

NASA Astrophysics Data System (ADS)

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.

Sutherland, T. F.; Levings, C. D.

2013-08-01

422

A 3D, finite element model for baroclinic circulation on the Vancouver Island continental shelf  

USGS Publications Warehouse

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.

Walters, R.A.; Foreman, M.G.G.

1992-01-01

423

34. Photographic copy of historic drawing, "Naval Hospital and Battery ...  

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

34. Photographic copy of historic drawing, "Naval Hospital and Battery at Portsmouth, VA.," ca. 1862. (From Paul F. Moteelay and T. Campbell-Copeland's The Soldier in Our Civil War: A Pictorial History of the Conflict, 1861-1865. New York: Stanley Bradley Publishing Company, 1890, vol. 1, p. 320.) - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

424

Smoking behavior and attitudes toward smoking among hospital nurses.  

PubMed Central

We examined smoking prevalence, smoking behavior, and attitudes toward smoking in hospitals in 1,380 respondents among 1,719 registered nurses in a large urban teaching hospital. In this group, current prevalence of smoking in hospital nurses (22 per cent) was less than women in the general population (29 per cent). Smoking nurses were more likely than nonsmokers to hold attitudes which potentially reduce their efficacy in helping patients to stop smoking. PMID:3777295

Becker, D M; Myers, A H; Sacci, M; Weida, S; Swank, R; Levine, D M; Pearson, T A

1986-01-01

425

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

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

FitzGerald, J Mark; Poureslami, Iraj; Shum, Jessica

2015-01-01

426

Welfare Checks, Drug Consumption, and Health: Evidence from Vancouver Injection Drug Users  

ERIC Educational Resources Information Center

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…

Riddell, Chris; Riddell, Rosemarie

2006-01-01

427

Radiation Protection Guidance Hospital Staff  

E-print Network

Children's Hospital and Veterans Affairs Palo Alto Health Care System requires each individual user Hospital and Clinics, Lucile Packard Children's Hospital And Veterans Affairs Palo Alto Health Care System December 2010 Last revision August 23, 2012

Kay, Mark A.

428

Hospitality HRM: past, present and the future  

Microsoft Academic Search

Purpose – This paper aims to review the past, current and future trends in human resource management (HRM) in the hospitality industry, with a specific focus on large international hotels. The setting of this review is within the context of general HRM theory development. Design\\/methodology\\/approach – This paper provides a detailed review of the literature, background, issues and trends in

Michael C. G. Davidson; Ruth McPhail; Shane Barry

2011-01-01

429

Physicians in Hospital Emergency Departments. [Proceedings, New Jersey Training Program].  

ERIC Educational Resources Information Center

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…

Health Services and Mental Health Administration (DHEW), Rockville, MD. Div. of Emergency Health Services.

430

Customer satisfaction and its measurement in hospitality enterprises  

Microsoft Academic Search

Reviews and discusses the topic of customer satisfaction and its application to the hospitality and tourism industries. Defines the concept and analyzes its importance to services in general and to hospitality\\/tourism services in particular. Following a discussion on the dimensions and attributes of satisfaction, lists the main methods of measuring satisfaction and concludes with a review of global and cross-cultural

Abraham Pizam; Taylor Ellis

1999-01-01

431

Event Report: Computational Aesthetics 2011 in Vancouver, Canada, Au-gust 57, 2011, sponsored by Eurographics, in collaboration with ACM SIG-  

E-print Network

Event Report: Computational Aesthetics 2011 in Vancouver, Canada, Au- gust 5­7, 2011, sponsored by Eurographics, in collaboration with ACM SIG- GRAPH The Eurographics Workshop on Computational Aesthetics. Computational Aesthetics seeks to bridge the analytic and synthetic by integrating aspects of computer science

Paris-Sud XI, Université de

432

CART Decision-Tree Statistical Analysis and Prediction of Summer Season Maximum Surface Ozone for the Vancouver, Montreal, and Atlantic Regions of Canada  

Microsoft Academic Search

Prediction of daily maximum surface ozone (O3) concentration was begun by Environment Canada in the spring of 1993 for the Vancouver, Montreal, and Atlantic regions in order to advise the public of expected air quality. Forecasts have been issued for southern Ontario for many years by the province of Ontario, but this is a new undertaking in other parts of

William R. Burrows; Mario Benjamin; Stephen Beauchamp; Edward R. Lord; Douglas McCollor; Bruce Thomson

1995-01-01

433

Verification of an ENSO-Based Long-Range Prediction of Anomalous Weather Conditions During the Vancouver 2010 Olympics and Paralympics  

NASA Astrophysics Data System (ADS)

A brief review of the anomalous weather conditions during the Vancouver 2010 Winter Olympic and Paralympic Games and the efforts to predict these anomalies based on some preceding El Niño-Southern Oscillation (ENSO) signals are presented. It is shown that the Olympic Games were held under extraordinarily warm conditions in February 2010, with monthly mean temperature anomalies of +2.2 °C in Vancouver and +2.8 °C in Whistler, ranking respectively as the highest and the second highest in the past 30 years (1981-2010). The warm conditions continued, but became less anomalous, in March 2010 for the Paralympic Games. While the precipitation amounts in the area remained near normal through this winter, the lack of snow due to warm conditions created numerous media headlines and practical problems for the alpine competitions. A statistical model was developed on the premise that February and March temperatures in the Vancouver area could be predicted using an ENSO signal with considerable lead time. This model successfully predicted the warmer-than-normal, lower-snowfall conditions for the Vancouver 2010 Winter Olympics and Paralympics.

Mo, Ruping; Joe, Paul I.; Doyle, Chris; Whitfield, Paul H.

2014-01-01

434

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

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…

Rojas, Alejandro; Sipos, Yona; Valley, Will

2012-01-01

435

Mail to: Cathy Ebbehoj UBC School of Nursing | T201-2211 Wesbrook Mall | Vancouver, BC V6T 2B5  

E-print Network

Mail to: Cathy Ebbehoj UBC School of Nursing | T201-2211 Wesbrook Mall | Vancouver, BC V6T 2B5 Ph: 604-822-7468 | Fax: 604-822-7466 | cathy.ebbehoj@nursing.ubc.ca UBC School of Nursing | Alumni Recognition Awards SAVE THE DATE | School of Nursing Gala | May 7, 2015 UBC Alumni Centre Award of Distinction

436

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, and usually do not work properly in any language other than English. The M3 CAT (Multistandard, Multilingual

437

Hospital free cash flow.  

PubMed

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

Kauer, R T; Silvers, J B

1991-01-01

438

Going to the Hospital  

MedlinePLUS

... specialists can help explain something a doctor or nurse will do, like place an IV or take someone to the operating ... will probably have some tests while you're in the hospital — not the kind you take in ...

439

American Hospital Directory  

MedlinePLUS

... Sources | Updates | Order Information | Login Quick Search: Quick Search Enter keywords to look up a hospital. Just ... or National Provider Identifier (NPI). Advanced Search: Advanced Search Click the Search button and you will be ...

440

Surgery, Hospitals, and Medications  

MedlinePLUS

... products that are not commonly stocked in hospital pharmacies. Examples include: Salagen ® , Evoxac®, and Restasis® Eye drops, ... prescription and OTC medications/products in their labeled pharmacy container or packaging. This is important in case ...

441

Drug Overdose Deaths, Hospitalizations,  

E-print Network

Drug Overdose Deaths, Hospitalizations, and Emergency Department Visits in Kentucky, 2000 - 2012 #12; Kentucky Injury Preven on and Research Center Drug Overdose Deaths, Hospitaliza ons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Drug overdose deaths, 20002012

MacAdam, Keith

442

Cornell Hospitality Quarterly  

NSDL National Science Digital Library

Created by the Cornell University Center for Hospitality Research and managed by Sage Publications, this e-journal provides âÂÂapplied research theories about important industry trends and timely topics in lodging, restaurant, and tourism management.â Though most articles are only available through a paid subscription, each quarter editors select a featured article, all of which are available on this site after a brief, free registration. Article topics include wine selection, revenue management, customer satisfaction measurement, hotel pricing, and computer simulation in hospitality education. This is an excellent resource for soon-to-be hospitality managers and administrators as well as for educators to keep informed of current trends in hospitality education.

2007-03-22

443

Reducing Avoidable Hospitalizations  

E-print Network

of cooperation with members of the interdisciplinary team including medical doctors, nurses, social work staff hospitalizations require the collaboration of the entire interdisciplinary team, as well as providing education

von der Heydt, Rüdiger

444

[Ryazan hospital--80 years].  

PubMed

In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area. PMID:22558855

Klimov, A S; Gromov, M F

2012-02-01

445

American Hospital Association  

MedlinePLUS

... 2014-2016 AHA Strategic Plan History Organization AHA Awards Careers Get to Know the AHA.org Web Site Membership Become a Member Hospital & Health System Membership Associate Membership Personal Membership Groups Member Constituency ...

446

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

447

Fast tracking hospital construction.  

PubMed

Hospital leaders should consider four factors in determining whether to fast track a hospital construction project: Expectations of project length, quality, and cost. Whether decisions can be made quickly as issues arise. Their own time commitment to the project, as well as that of architects, engineers, construction managers, and others. The extent to which they are willing to share with the design and construction teams how and why decisions are being made. PMID:23513759

Quirk, Andrew

2013-03-01

448

Reducing hospital readmissions.  

PubMed

This column is designed to provide a nursing perspective on new hospital quality measurements. Future articles will cover the various quality indicators hospitals face and the role of the nurse in meeting mandated benchmarks. Reader responses to this column are welcome and will help to make it more useful to nurses in meeting the challenges posed by health care reform and changing Medicare reimbursement programs. PMID:25545534

Brooks, Jo Ann

2015-01-01

449

45 CFR 211.10 - Termination of hospitalization.  

Code of Federal Regulations, 2014 CFR

...FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES CARE...MENTALLY ILL NATIONALS OF THE UNITED STATES, RETURNED FROM FOREIGN...person hospitalized for mental illness (whether or...generally applicable in the State in which the...

2014-10-01

450

45 CFR 211.10 - Termination of hospitalization.  

Code of Federal Regulations, 2012 CFR

...FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES CARE...MENTALLY ILL NATIONALS OF THE UNITED STATES, RETURNED FROM FOREIGN...person hospitalized for mental illness (whether or...generally applicable in the State in which the...

2012-10-01

451