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1

Screening, detecting and enhancing the yield of previously undiagnosed hepatitis B and C in patients with acute medical admissions to hospital: A pilot project undertaken at the Vancouver General Hospital  

PubMed Central

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) represent an increasing health burden and morbidity in Canada. Viral hepatitis, specifically HCV, has high prevalence among persons born between 1945 and 1965, with 45% to 85% of infected adults asymptomatic and unaware of their infection. Screening has been shown to be cost effective in the detection and treatment of viral hepatitis. OBJECTIVE: To quantify incidence and identify undocumented HBV and HCV infection in hospitalized patients at a single centre with secondary analysis of risk factors as part of a quality improvement initiative. METHODS: A one-time antibody test was conducted in patients admitted to the acute medicine and gastroenterology services. RESULTS: Over a 12-week period, hospital screening for HBV and HCV was performed in 37.3% of 995 admitted patients. There was identification of 15 previously undiagnosed cases of HCV (4%) and 36 undocumented cases of occult (ie, antihepatitis B core antigen seropositive) or active (ie, hepatitis B surface antigen seropositive) HBV (9.7%). Among patients with positive screens, 60% of seropositive HCV patients had no identifiable risk factors. CONCLUSIONS: The prevalence of HBV and HCV infection among hospitalized patients in Vancouver was higher than that of the general population. Risk factors for contraction are often not identified. These results can be used as part of an ongoing discussion regarding a ‘seek and treat’ approach to the detection and treatment of chronic blood-borne viral illnesses. PMID:24945186

Kapeluto, Jordanna E; Kadatz, Matthew; Wormsbecker, Andrew; Sidhu, Kiran; Yoshida, Eric M

2014-01-01

2

Ethnic variation in the annual rates of adult inflammatory bowel disease in hospitalized patients in Vancouver, British Columbia  

PubMed Central

BACKGROUND: There is currently little available information regarding the impact of ethnicity on the clinical features of inflammatory bowel disease (IBD). Migrating populations and changing demographics in Vancouver, British Columbia (BC) provide a unique opportunity to examine the role of ethnicity in the prevalence, expression and complications of IBD. OBJECTIVES: To determine the demographics of IBD and its subtypes leading to hospitalization in the adult population of BC. METHODS: A one-year retrospective study was performed for all patients who presented acutely with IBD to Vancouver General Hospital from January 1, 2006 to December 31, 2006. Data regarding sex, age, ethnicity, IBD type and extent of disease, complications and management strategies were collected. Clinical data were confirmed by pathology and radiology reports. RESULTS: There were 186 cases of IBD comprising Crohn’s disease (CD) 56%, ulcerative colitis (UC) 43% and indeterminate colitis (1%) 1%. The annual rate of IBD cases warranting hospitalization in Caucasians was 12.9 per 100,000 persons (7.9 per 100,000 persons for CD and 5.0 per 100,000 persons for UC). This was in contrast to the annual rate of IBD in South Asians at 7.7 per 100,000 persons (1.0 per 100,000 persons for CD and 6.8 per 100,000 persons for UC) and in Pacific Asians at 2.1 per 100,000 persons (1.3 per 100,000 persons for CD, 0.8 per 100,000 persons for UC). The male to female ratio was higher in South Asians and Pacific Asians than in Caucasians. The extent of disease was significantly different across racial groups, as was the rate of complications. CONCLUSIONS: These early results suggest that there are ethnic disparities in the annual rates of IBD warranting hospitalization in the adult population of BC. There was a significantly higher rate of CD in the Caucasian population than in South Asian and Pacific Asian populations. The South Asian population had a higher rate of UC, with an increased rate of complications and male predominance. Interestingly, the rate of CD and UC was lowest in the Pacific Asian population. These racial differences – which were statistically significant – suggest a role for ethnodiversity and environmental changes in the prevalence of IBD in Vancouver. PMID:21321677

Mangat, Birinder K; Evaschesen, Chad; Lee, Tim; Yoshida, Eric M; Salh, Baljinder

2011-01-01

3

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

4

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

5

MASSACHUSETTS GENERAL HOSPITAL  

E-print Network

and efficacy of our practice, reporting this data out to department clinicians, senior leadership and hospital leadership, participating in process improvement and pay for performance initiatives to achieve needed and sometimes lead task forces formed by volunteer physicians, nurse anesthetists and administrators to address

Adams, Mark

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

Examining General Hospitals' Smoke-Free Policies  

ERIC Educational Resources Information Center

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

Whitman, Marilyn V.; Harbison, Phillip Adam

2010-01-01

8

Hospital Web site 'tops' in Louisiana. Hospital PR, marketing group cites East Jefferson General Hospital.  

PubMed

East Jefferson General Hospital in Metairie, La., launched a new Web site in October 2001. Its user-friendly home page offers links to hospital services, medical staff, and employer information. Its jobline is a powerful tool for recruitment. The site was awarded the 2002 Pelican Award for Best Consumer Web site by the Louisiana Society for Hospital Public Relations & Marketing. PMID:12238238

Rees, Tom

2002-01-01

9

Trends in paediatric sport- and recreation-related injuries: An injury surveillance study at the British Columbia Children’s Hospital (Vancouver, British Columbia) from 1992 to 2005  

PubMed Central

BACKGROUND: Sport- and recreation-related injuries are a major source of morbidity in the paediatric population. Long-term trends for these injuries are largely unknown. METHODS: A traumatic injury surveillance system (the Canadian Hospitals Injury Reporting and Prevention Program) was used to examine the demographics and trends of paediatric sports injuries in children who presented to or were directly admitted to the British Columbia Children’s Hospital (Vancouver, British Columbia) emergency department or intensive care unit from 1992 to 2005. RESULTS: Over the 14-year study period, there was a significant increase in sport- and recreation-related injuries among patients who presented to the British Columbia Children’s Hospital. Of 104,414 injuries between 1992 and 2005, 27,466 were related to sports and recreational activities. The number of sport-related injuries increased by 28%, while all-cause injuries did not change significantly. Males comprised 68% of the sport-related injuries, and both sexes displayed an increasing trend over time. Cycling, basketball, soccer and ice hockey were the top four injury-causing activities. The main body parts injured were the face, head and digits. CONCLUSIONS: Paediatric sports injuries significantly increased at the British Columbia Children’s Hospital over the 14-year study period. This is likely due to increased sport participation, increased risk associated with certain sports, or both. Trends in paediatric sports injury may be predicted by changes in popular media, possibly allowing prevention programs to help to avoid these injuries before they occur. PMID:22468125

Pakzad-Vaezi, Kaivon; Singhal, Ash

2011-01-01

10

Nurse endoscopy in a district general hospital.  

PubMed Central

INTRODUCTION: This study describes the first full year of independent practice by a newly appointed nurse endoscopist in a district general hospital. PATIENTS AND METHODS: Patients underwent either 'one stop' flexible sigmoidoscopy and barium enema or flexible sigmoidoscopy alone. Barium enema results, video photography, clinical follow-up, and histology were used to validate the results of the flexible sigmoidoscopy. One stop clinic: 161 endoscopies were performed, with 104 female patients (65%), and a mean age of 64 years. There was one failed endoscopy due to poor bowel preparation. Abnormalities were identified in 84% of endoscopies. Flexible sigmoidoscopy detected abnormalities not seen on the barium enema in 28 cases, all of which were polyps (18%). Barium enema identified one abnormality within reach of the flexible sigmoidoscope not identified at endoscopy (small polyp in sigmoid; 1%). Elective flexible sigmoidoscopy list: 121 endoscopies were performed, with 65 female patients (54%), and a mean age of 59 years. There were two failed endoscopy procedures, both attributed to poor bowel preparation. Two-thirds of patients had an abnormality on investigation. There were no complications in either group of patients. CONCLUSIONS: The nurse-led endoscopy service has been successfully initiated with a high completion rate for flexible sigmoidoscopies. All significant conditions were identified with 99% sensitivity. Nurse endoscopy is a safe, useful and practical procedure in the setting of this district general hospital. PMID:12831491

Goodfellow, P. B.; Fretwell, I. A.; Simms, J. M.

2003-01-01

11

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. Emphasis in tribal gaming operations and management. The Major Hospitality and tourism management

Gallo, Linda C.

12

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.

13

Hospital Junior Doctors: Survey at Northampton General Hospital  

PubMed Central

A survey of hospital junior doctors made in 1967–8 showed that there were many features of their work with which they were not content. These included career prospects, hours of work, and salaries. It is suggested that reorganization of the career structure and the provision of better-organized ancillary help would do much to improve the lives of hospital junior doctors. PMID:5801349

Redman, N. R.; Toby, J. P.; Peniket, J. B.

1969-01-01

14

Hospital Anxiety and Depression Scale (HADS): validation in a Greek general hospital sample  

Microsoft Academic Search

BACKGROUND: The Hospital Anxiety and Depression Scale (HADS) has been used in several languages to assess anxiety and depression in general hospital patients with good results. METHODS: The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens). The Beck Depression Inventory (BDI) and

Ioannis Michopoulos; Athanasios Douzenis; Christina Kalkavoura; Christos Christodoulou; Panayiota Michalopoulou; Georgia Kalemi; Katerina Fineti; Paulos Patapis; Konstantinos Protopapas; Lefteris Lykouras

2008-01-01

15

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

16

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 management. The Major Hospitality and tourism management is an interdisciplinary major which culminates management courses and theoretical and applied study of the broad hospitality and tourism industry, students

Gallo, Linda C.

17

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.

18

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.

19

SDSU General Catalog 2009-2010 263 Hospitality and Tourism  

E-print Network

SDSU General Catalog 2009-2010 263 HTM Hospitality and Tourism Management In the College Offered by the School Major in hospitality and tourism management with the B.S. degree in applied arts in tribal gaming operations and management. The Major Hospitality and tourism management

Gallo, Linda C.

20

Contribution of a general practitioner hospital: a further study  

Microsoft Academic Search

OBJECTIVE--To audit the workload of a general practitioner hospital and to compare the results with an earlier study. DESIGN--Prospective recording of discharges from the general practitioner hospital plus outpatient and casualty attendances and of all outpatient referrals and discharges from other hospitals of patients from Brecon Medical Group Practice during one year (1 June 1986-31 May 1987). SETTING--A large rural

R A Treasure; J A Davies

1990-01-01

21

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.

22

Future Role of the General Practitioner in the Hospital Service  

PubMed Central

A special subcommittee of the General Practitioner Liaison Committee of the Birmingham Regional Hospital Board used five attitude surveys of groups of general practitioners and a comprehensive study of other publications to determine the future role of the general practitioner in the hospital service. From these and other studies they concluded that, although not all general practitioners wished to participate in hospital work, there was an urgent need to provide suitable facilities and a proper career structure early after qualification for those who did, and that there should be hospital inpatient accommodation in which general practitioners can treat their own patients, preferably in association with consultant beds rather than in separate general-practitioner units. PMID:5762282

Evans, E. O.; McEwan, E. D.

1969-01-01

23

[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

24

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

25

The Best of Intentions. Interior Architecture: Massachusetts General Hospital  

ERIC Educational Resources Information Center

The Massachusetts General Hospital/Surgical and Special Services study, an information processing system for redesigning an outmoded existing hospital, structured information into small-scale elements that could be analyzed, reassembled into different solutions, and the solution selected that best accommodates all of the complex requirements. (MF)

Ryder, Sharon Lee

1974-01-01

26

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

27

East and north sides of building Fitzsimons General Hospital, ...  

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

East and north sides of building - Fitzsimons General Hospital, Golf Course Waiting Shelter, Southwest area of Golf Course, 700 feet Northeast of intersection of West Harlow Avenue & Peoria Street, Aurora, Adams County, CO

28

Comparing the stigma of mental illness in a general hospital with a state mental hospital  

Microsoft Academic Search

The stigma faced by psychiatric patients associated with the type of psychiatric facilities is controversial. This study was conducted to compare the stigma faced by patients with schizophrenia and non-schizophrenia psychiatric disorders in the outpatient departments of a state mental hospital with those in a general hospital in Singapore. A cross-sectional study involving two groups of outpatients in a state

Cornelia Y. I. Chee; Tze Pin Ng; Ee Heok Kua

2005-01-01

29

General Surgery Programs in Small Rural New York State Hospitals: A Pilot Survey of Hospital Administrators  

ERIC Educational Resources Information Center

Context: Hospitals play a central role in small rural communities and are frequently one of the major contributors to the local economy. Surgical services often account for a substantial proportion of hospital revenues. The current shortage of general surgeons practicing in rural communities may further threaten the financial viability of rural…

Zuckerman, Randall; Doty, Brit; Gold, Michael; Bordley, James; Dietz, Patrick; Jenkins, Paul; Heneghan, Steven

2006-01-01

30

Vancouver Aquarium Research & Conservation  

NSDL National Science Digital Library

Located in Vancouver, British Columbia, Canada, the Vancouver Aquarium conducts cutting edge cetacean, especially the killer whale, research, in addition to being a fully-accredited newly-expanded aquarium. Learn about their cetacean and sea lion studies, marine mammal rescue and rehabilitation, and killer whale adoption program. Site describes the killer whale mating patterns, genetic analysis, and long-term monitoring efforts of the Aquarium.

31

The dynamics of psychiatric bed use in general hospitals.  

PubMed

This study examines general hospitals' adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N = 7,831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100 % occupancy and with a reduction of mean length-of-stay. These results were confirmed in instrumental variables models. General hospitals may dynamically adjust bed utilization practices in response to changing psychiatric bed needs. An implication of this dynamic adjustment model is that bed shortages are likely to be local, transitory events. PMID:24756929

Slade, Eric P; Goldman, Howard H

2015-03-01

32

Bacteriology turnaround time in seven Malaysian general hospitals.  

PubMed

A turnaround time study was conducted for bacteriological culture tests in seven Malaysian general hospitals. The turnaround times were determined using a specially designed form that was completed by the ward staff. Doctors at these hospitals were also polled to find out whether they were satisfied with the promptness of bacteriological test reporting in their hospitals. The turnaround times obtained from this survey were found to be satisfactory taking into account the constraints of laboratory methods employed. Nevertheless only about a third of doctors expressed satisfaction with the timeliness of the bacteriological test reporting. Doctors and microbiologists should get together and agree on acceptable standards of turnaround times that are practical and reasonable. PMID:1469917

Lim, V K; Cheong, Y M

1992-06-01

33

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

PubMed

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

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

2012-01-01

34

Improving outpatient department efficiency: a randomized controlled trial comparing hospital and general-practice telephone reminders  

Microsoft Academic Search

Aims This study aimed to ascertain whether or not telephone reminders reduce non- attendance at hospital outpatient clinics and whether telephone reminders from general practitioners are more effective than those made from hospitals. Methods Outpatient department appointments for three general practitioners (GPs) over a three-month period, were randomized into three groups: 'Hospital', 'GP', and 'Control'. Patients in the Hospital and

Shane Reti

35

Hand surgery requirements in an average sized district general hospital.  

PubMed Central

To estimate the overt need for hand surgery in an average sized district general hospital and to assess the resources required to meet this need, data were collected prospectively on all new trauma and elective patients presenting from 1 June to 30 November 1989 to the Derby Hand Unit, Derbyshire Royal Infirmary, Derby. In all, 1740 new patients with hand disorders (1082 trauma and 658 elective) were seen. All were followed up for 6 months or until discharge. Based on the Derby Hand Unit practice, the overt need for hand surgery in an average sized district general hospital was estimated and the resources required to satisfy this need were defined. Such a hospital serving a population of 250,000 should expect about 23 new trauma patients and 17 new elective patients each week. To service this demand requires between three and six outpatient clinics, between three and eight inpatient beds and three operating sessions each week. The net annual cost of such a service in 1989-1990 would be 318,753 pounds. PMID:1616256

Dias, J. J.; Burke, F. D.; Lunn, P. G.; Bradley, M. J.

1992-01-01

36

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

37

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

Code of Federal Regulations, 2013 CFR

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

2013-07-01

38

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

Code of Federal Regulations, 2011 CFR

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

2011-07-01

39

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

Code of Federal Regulations, 2012 CFR

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

2012-07-01

40

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

Code of Federal Regulations, 2014 CFR

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

2014-07-01

41

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

Code of Federal Regulations, 2010 CFR

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

2010-07-01

42

Experience of pancreaticoduodenectomy in a district general hospital  

PubMed

AIMS: Long-term survival after surgery for pancreatic cancer remains very low and it is particularly important that minimal surgery-related morbidity and mortality rates are achieved. It has been stated that centres performing small numbers of proximal pancreaticoduodenectomies are likely to have high morbidity and mortality rates. The results of pancreatic surgery in a district general hospital are reported. METHODS: This was a retrospective analysis of all pancreaticoduodenectomies over 4 years. RESULTS: Twenty-one selected patients underwent proximal pancreaticoduodenectomy and two patients total pancreatectomy over a 4-year period from 1995 to 1999. The operations were performed by two surgeons with a special interest in upper gastrointestinal surgery. The median age was 62 (38-83) years. There were 14 men and nine women. Fifteen patients had adenocarcinoma of the head of the pancreas, five had ampullary carcinoma, one duodenal carcinoma and there was one case of chronic pancreatitis. Six patients had pylorus-preserving pancreaticoduodenectomy (PPPD) and 15 had a standard Whipple procedure. The median stay in hospital was 20 (13-26) days. Two patients had a pancreatic leak, one of whom developed an intra-abdominal abscess which was treated successfully by percutaneous drainage. Six patients experienced delayed gastric emptying, two of whom had PPPD. Both the 30-day and in-hospital mortality rates were zero. The median number of lymph nodes dissected was 12 and in 11 patients no nodal metastasis was found. CONCLUSIONS: It is possible to perform pancreatic surgery in a district general hospital and achieve results that are comparable to those of specialist centres. PMID:10718949

Akhtar; Perricone; Chang; Watson

2000-03-01

43

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.

44

Evolution of the Whipple procedure at the Massachusetts General Hospital  

PubMed Central

Background Since Allen O. Whipple published his seminal paper in 1935, the procedure that bears his name has been performed widely throughout the world and is now a common operation in major medical centers. The goal of this study was to investigate the evolution of pancreatoduodenectomy at the Massachusetts General Hospital (MGH). Methods We sought to identify all pancreatoduodenectomies performed at the MGH since 1935. Cases were obtained from a computerized database, hospital medical records, and the MGH historical archive. Demographics, diagnosis, intraoperative variables and short-term surgical outcomes were recorded. Results The first pancreatoduodenectomy at the MGH was carried out in 1941; since then, 2,050 Whipple procedures have been performed. Pancreatic ductal adenocarcinoma was the most frequent indication (36%). Pylorus preservation has been the most important variation in technique, accounting for 45% of Whipple procedures in the 1980s; observation of frequent delayed gastric emptying after this procedure led to decline in its use. Pancreatic fistula was the most frequent complication (13%). Operative blood replacement and reoperation rates have decreased markedly over time; the most frequent indication for reoperation was intra-abdominal bleeding. Mortality has decreased from 45% to 0.8%, with sepsis and hypovolemic shock being the most frequent causes of death. Mean duration of hospital stay has decreased from >30 to 9.5 days, along with an increasing readmission rate (currently 19%). Conclusion The Whipple procedure in the 21st century is a well-established operation. Improvements in operative technique and perioperative care have contributed in making it a safe operation that continues evolving. PMID:22770961

Castillo, Carlos Fernández-del; Morales-Oyarvide, Vicente; McGrath, Deborah; Wargo, Jennifer A.; Ferrone, Cristina R.; Thayer, Sarah P.; Lillemoe, Keith D.; Warshaw, Andrew L.

2013-01-01

45

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. PMID:25657858

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

2015-01-01

46

Environmental Scanning, Vancouver Community College.  

ERIC Educational Resources Information Center

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

Yao, Min

47

Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes  

Microsoft Academic Search

Background  The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings\\u000a by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose\\u000a of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent

Harry Minas; Ruzanna Zamzam; Marhani Midin; Alex Cohen

2011-01-01

48

Toshiba General Hospital PACS for routine in- and outpatient clinics  

NASA Astrophysics Data System (ADS)

The Toshiba General Hospital introduced a departmental RIS/PACS (Radiology Information System/Picture Archiving and Communication System) in the radiology department in May, 1993. It has been used routinely since that time. In order to provide efficient means for clinicians to find and read many images, the system has been expanded to the neurosurgery and urology clinics and wards since May, 1995, and five image referring workstations now provide digital images to clinicians. In this paper we discuss an algorithm for image migration, one of the key issues to accomplish the expansion to outpatient clinics successfully, and propose the WYWIWYG (what you want is what you get) image transfer logic. This is the logic used to transfer images that physicians require refer without increasing the traffic between the image server and referring workstations. We accomplish the WYWIWYG logic by prioritizing exams the physicians have not yet viewed and by finding historical exams according to the modality, anatomy, and marking. Clinicians gave us comments from their first use of the system and suggested that the PACS enables clinicians to review images more efficiently compared to a film-based system. Our experience suggests that it is a key to the effective application of PACS in outpatient clinics to incorporate consideration patterns of clinicians on the migration algorithm.

Toshimitsu, Akihiro; Okazaki, Nobuo; Kura, Hiroyuki; Nishihara, Eitaro; Tsubura, Shinichi

1996-05-01

49

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.

50

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

Code of Federal Regulations, 2012 CFR

...September 30, 1995; or (2) In the case of a hospital that changes the terms...systems for any period: (i) In the case of a hospital (other than a children's...such as fires, floods, earthquakes, or tornadoes. (5) For cost reporting periods...

2012-10-01

51

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

Code of Federal Regulations, 2014 CFR

...September 30, 1995; or (2) In the case of a hospital that changes the terms...systems for any period: (i) In the case of a hospital (other than a children's...such as fires, floods, earthquakes, or tornadoes. (5) For cost reporting periods...

2014-10-01

52

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

Code of Federal Regulations, 2011 CFR

...September 30, 1995; or (2) In the case of a hospital that changes the terms...systems for any period: (i) In the case of a hospital (other than a children's...such as fires, floods, earthquakes, or tornadoes. (5) For cost reporting periods...

2011-10-01

53

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

Code of Federal Regulations, 2010 CFR

...September 30, 1995; or (2) In the case of a hospital that changes the terms...systems for any period: (i) In the case of a hospital (other than a children's...such as fires, floods, earthquakes, or tornadoes. (5) For cost reporting periods...

2010-10-01

54

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

Code of Federal Regulations, 2013 CFR

...September 30, 1995; or (2) In the case of a hospital that changes the terms...systems for any period: (i) In the case of a hospital (other than a children's...such as fires, floods, earthquakes, or tornadoes. (5) For cost reporting periods...

2013-10-01

55

Hospitable archean climates simulated by a general circulation model.  

PubMed

Evidence from ancient sediments indicates that liquid water and primitive life were present during the Archean despite the faint young Sun. To date, studies of Archean climate typically utilize simplified one-dimensional models that ignore clouds and ice. Here, we use an atmospheric general circulation model coupled to a mixed-layer ocean model to simulate the climate circa 2.8 billion years ago when the Sun was 20% dimmer than it is today. Surface properties are assumed to be equal to those of the present day, while ocean heat transport varies as a function of sea ice extent. Present climate is duplicated with 0.06 bar of CO2 or alternatively with 0.02 bar of CO2 and 0.001 bar of CH4. Hot Archean climates, as implied by some isotopic reconstructions of ancient marine cherts, are unattainable even in our warmest simulation having 0.2 bar of CO2 and 0.001 bar of CH4. However, cooler climates with significant polar ice, but still dominated by open ocean, can be maintained with modest greenhouse gas amounts, posing no contradiction with CO2 constraints deduced from paleosols or with practical limitations on CH4 due to the formation of optically thick organic hazes. Our results indicate that a weak version of the faint young Sun paradox, requiring only that some portion of the planet's surface maintain liquid water, may be resolved with moderate greenhouse gas inventories. Thus, hospitable late Archean climates are easily obtained in our climate model. PMID:23808659

Wolf, E T; Toon, O B

2013-07-01

56

Comorbidity and its relevance on general hospital based mortality in major depressive disorder: a naturalistic 12-year follow-up in general hospital admissions.  

PubMed

Major depressive disorder (MDD) is associated with physical comorbidity, but the risk factors of general hospital-based mortality are unclear. Consequently, we investigated whether the burden of comorbidity and its relevance on in-hospital death differs between patients with and without MDD in a 12-year follow-up in general hospital admissions. During 1 January 2000 and 30 June 2012, 9604 MDD patients were admitted to three General Manchester Hospitals. All comorbidities with a prevalence ?1% were compared with those of 96,040 age-gender matched hospital controls. Risk factors of in-hospital death were identified using multivariate logistic regression analyses. Crude hospital-based mortality rates within the period under observation were 997/9604 (10.4%) in MDD patients and 8495/96,040 (8.8%) in controls. MDD patients compared to controls had a substantial higher burden of comorbidity. The highest comorbidities included hypertension, asthma, and anxiety disorders. Subsequently, twenty-six other diseases were disproportionally increased, many of them linked to chronic lung diseases and to diabetes. In deceased MDD patients, chronic obstructive pulmonary disease and type-2 diabetes mellitus were the most common comorbidities, contributing to 18.6% and 17.1% of deaths. Furthermore, fifteen physical diseases contributed to in-hospital death in the MDD population. However, there were no significant differences in their impact on mortality compared to controls in multivariate logistic regression analyses. Thus in one of the largest samples of MDD patients in general hospitals, MDD patients have a substantial higher burden of comorbidity compared to controls, but they succumb to the same physical diseases as their age-gender matched peers without MDD. PMID:24513499

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

2014-05-01

57

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

PubMed

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

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

2013-01-01

58

The management of suspected myocardial infarction by Scottish general practitioners with access to community hospital beds.  

PubMed Central

General practitioners working in 20 community hospitals in Scotland participated in a survey of the management of myocardial infarction. During one year they suspected acute myocardial infarction in 451 patients. Of these patients, 278 (62%) were admitted to a community hospital, 125 (28%) to a district general hospital and 48 (11%) were kept at home. The main reasons given for admission to a community hospital were for monitoring and investigation, while the main reasons for admission to a district hospital rather than a community hospital were the relative youth of the patient and the severity of the illness. Acute myocardial infarction was confirmed in 323 (72%) cases, but in 26 (6%) cases the final diagnosis was other than ischaemic heart disease. Patients with acute myocardial infarction who entered a community hospital did so a median of two hours 25 minutes after the onset of symptoms. Among 18 patients admitted to a community hospital in whom resuscitation was attempted after cardiac arrest four (22%) were subsequently discharged from hospital. The mortality rate from acute myocardial infarction in the community studied was 171/418 (41%), of whom 95 died suddenly before coming under medical care. It is concluded that in rural areas of Scotland an acceptable standard of care for patients with acute myocardial infarction, including the administration of thrombolytic therapy, could be provided rapidly by general practitioners working in community hospitals. PMID:2121176

Liddell, R; Grant, J; Rawles, J

1990-01-01

59

Reducing elective general surgery cancellations at a Canadian hospital  

PubMed Central

Background In Canadian hospitals, which are typically financed by global annual budgets, overuse of operating rooms is a financial risk that is frequently managed by cancelling elective surgical procedures. It is uncertain how different scheduling rules affect the rate of elective surgery cancellations. Methods We used discrete event simulation modelling to represent perioperative processes at a hospital in Toronto, Canada. We tested the effects of the following 3 scenarios on the number of surgical cancellations: scheduling surgeons’ operating days based on their patients’ average length of stay in hospital, sequencing surgical procedures by average duration and variance, and increasing the number of post-surgical ward beds. Results The number of elective cancellations was reduced by scheduling surgeons whose patients had shorter average lengths of stay in hospital earlier in the week, sequencing shorter surgeries and those with less variance in duration earlier in the day, and by adding up to 2 additional beds to the postsurgical ward. Conclusion Discrete event simulation modelling can be used to develop strategies for improving efficiency in operating rooms. PMID:23351498

Azari-Rad, Solmaz; Yontef, Alanna L.; Aleman, Dionne M.; Urbach, David R.

2013-01-01

60

Hotel General Managers’ Perceptions of Business Ethics Education: Implications for Hospitality Educators, Professionals, and Students  

Microsoft Academic Search

Ethics is a growing concern in American society; consequently, business ethics is also becoming a concern in the hospitality industry. This article investigated the perceptions and preparations of hotel general managers toward teaching business ethics in their hotels and ethics education in college hospitality programs and within the hotel industry. For hotel professionals, business ethics is normally discussed or taught

Ronnie Yeh

2012-01-01

61

Geriatrician Clinician-Educator The Division of Hospital Medicine and Division of General Internal Medicine &  

E-print Network

Geriatrician Clinician-Educator The Division of Hospital Medicine and Division of General Internal Medicine & Geriatrics within the Department of Medicine at Oregon Health & Science University seek to an academic career. This position will be a joint appointment in the Divisions of Hospital Medicine

Chapman, Michael S.

62

A cost study of a general practioner hospital in the Netherlands  

Microsoft Academic Search

To perform a cost study of the first general practitioner (GP) hospital in the Netherlands. We conducted a cost study in a GP hospital in the Netherlands. Data on healthcare utilisation from 218 patients were collected for a period of one year. The costs of admission to the GP hosptial were compared with the expected costs of the alternative mode

Leona Hakkaart-Van Roijen; E. P. Moll van Charante; P. J. E. Bindels; C. J. J. M. IJzermans; F. F. H. Rutten

2004-01-01

63

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 for lead poisoning One baseline mammogram during the 5-year period a member is age 35 thru 39, and one furnished by a General Hospital, Community Health Center, Physician, Nurse Practitioner or Independent Lab

Oppo, Delia W.

64

WEIGHTS AND MEASUREMENTS OF VANCOUVER CANADA GEESE  

E-print Network

. ROBARDS The Vancouver Canada Goose (Branta canadeisisfulva) is the least studied of 10 subspeciesof CanadaWEIGHTS AND MEASUREMENTS OF VANCOUVER CANADA GEESE BY JOHN T. RATTI, DANIEL E. TIMM, AND FRED C measurementswere not recorded.Consequently, a study wasconductedto providethesedata on VancouverCanada Geese

65

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

E-print Network

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

Price, Devon J. (Devon Jameson)

2011-01-01

66

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.

67

Coronary Revascularization at Specialty Cardiac Hospitals and Peer General Hospitals in Black Medicare Beneficiaries  

Microsoft Academic Search

Background—Critics have raised concerns that specialty cardiac hospitals exacerbate racial disparities in cardiovascular care, but empirical data are limited. Methods and Results—We used administrative data from the Medicare Provider and Analysis Review Part A and Provider-of-Service files from 2002 to 2005. Multivariable logistic regression models were constructed to examine the likelihood of black Medicare patients being admitted to a cardiac

Brahmajee K. Nallamothu; Xin Lu; Mary S. Vaughan-Sarrazin; Peter Cram

2010-01-01

68

Evaluation retest on a hospital-refuse incinerator at Sutter General Hospital, Sacramento, California  

Microsoft Academic Search

An evaluation test program was conducted to evaluate the effect of incinerator design changes on emissions from the hospital-refuse incinerator. The test was conducted as a part of the California Air Resources Board's program to assess emissions from stationary sources. Daily average oxygen concentrations ranged from 12.1-15.6% and the daily average carbon dioxide concentrations ranged from 4.0-5.5%. Dioxin emissions ranged

A. Jenkins; P. Ouchida; G. Lew

1988-01-01

69

Satisfaction degree evaluation of the users of "Attikon" University General Hospital's library.  

PubMed

The ability of hospital medical libraries to meet users' needs is a complicated issue and has been examined by many surveys. The aim of this study is to evaluate the satisfaction degree of the users of "Attikon" University General Hospital's medical library. A questionnaire was used to collect the necessary information Although, in general, the users seems to be satisfied, some adjustments, such as up-to-date books, journals and computers, have to be made. PMID:23823452

Stamouli, Maria-Aggeliki; Balis, Charalampos; Georgakopoulou, Konstantina-Maria

2013-01-01

70

Patient and proxy measurement of quality of life among general hospital in-patients with dementia  

Microsoft Academic Search

Background: We aimed to investigate quality of life ratings among people with varying severity of dementia and their carers, recruited in general hospital.Method: We recruited 109 people with dementia, and their proxies (carers), from psychiatric referrals of inpatients in two general hospitals in England. From patients, we gathered data on quality of life (QoL-AD and EQ5-D) and depressive symptoms, and

Bart D. Sheehan; Ranjit Lall; Christopher Stinton; Kate Mitchell; Heather Gage; Caroline Holland; Jeanne Katz

2012-01-01

71

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

Microsoft Academic Search

OBJECTIVE--To determine the extent to which minor surgery undertaken by general practitioners after the introduction of the 1990 contract substituted for hospital outpatient workload. DESIGN--Before and after observational study. SETTING--Four English family health services authorities. SUBJECTS--Patients in 22 practice populations who were operated on by their general practitioner or referred to hospital for minor surgery during April to June 1990

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

1993-01-01

72

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

73

PORTAL: The Portland-Vancouver  

E-print Network

ITS PORTAL: The Portland-Vancouver Multimodal Transportation Data Archive Christopher Monsere · PORTAL overview · Freeway performance · Weigh-in-motion · Arterial performance · Conclusions 2 #12;ITS City Agency Private Firms University Regional Govern- ment 5 #12;ITS · PORTAL established 2004 ­ NSF

Bertini, Robert L.

74

Molding Transactional Data into Decision Making Information in the Medical Industry: The Case of Laberman General Hospital  

Microsoft Academic Search

This case is about constructing a data warehouse model for a hospital. The Chief Executive Officer (CEO) at Laberman General Hospital is facing a combination of business analysis and information sharing issues. The hospital is experiencing diminishing profitability and market share. Hospital management cannot analyze the problems and make effective decisions because of their inability to combine data from independent

Lael Dickinson; Irina Ilovici

2000-01-01

75

Injectional anthrax at a Scottish district general hospital.  

PubMed

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

2015-04-01

76

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

PubMed Central

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

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

2013-01-01

77

Vancouver Aquarium Marine Science Centre  

NSDL National Science Digital Library

Website offers information on logistics of the facility, schedules, events, rates, location, news, and activities for young children. Learning resources include on-site programs for all ages, community outreach, and guides for teachers (fees apply). The Ask Us section provides detailed answers for frequently asked question in a wide range of subjects. Center also features marine science courses for English as a Second Language (ESL) students. Located in Vancouver, British Columbia, Canada.

78

Metabolic control of diabetes in general practice clinics: comparison with a hospital clinic.  

PubMed Central

An assessment was made of the degree of metabolic control achieved in diabetic patients attending mini clinics run by general practitioners compared with that in matched diabetic patients attending a hospital clinic. Patients were grouped according to whether they were being treated with diet alone, an oral hypoglycaemic, insulin once daily, or insulin twice daily. Statistical analysis showed no significant difference between patients attending mini clinics and those attending the hospital clinic in retrospective mean blood glucose, retrospective mean glycosylated haemoglobin (HbA1), or prospective HbA1 concentrations. General practitioners providing diabetic care on an organised basis can achieve a degree of glycaemic control in diabetic patients equal to that reached by a hospital clinic. PMID:6434057

Singh, B M; Holland, M R; Thorn, P A

1984-01-01

79

PSYCHIATRIC UNITS IN GENERAL HOSPITALS—Problems in Development and Efficient Operation  

PubMed Central

An adequate 25-bed psychiatric unit can be housed in a wing of a general hospital. Even more important than physical facilities are competent personnel, to be headed by a chief psychiatrist and a psychiatric nurse supervisor, for the unit. Incorporating teaching facilities into the unit helps to integrate psychiatry into the other disciplines of medicine in a continuing educational program. Having psychiatric units in general hospitals enables many voluntary patients to be treated in early stages of the disorder, with a high proportion of recoveries. Medicolegal aspects and the lack of adequate coverage of mental disorders by voluntary prepayment health plans are serious problems in the economy of a unit. Improved hospital administration, expanded training programs, educational work by local mental health societies and modification of laws on malpractice and commitment will go far to help solve these problems. PMID:18732338

Bennett, A. E.

1960-01-01

80

The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed  

Microsoft Academic Search

Between April 1994 and May 1995 4000 adult patients admitted to selected specialties of a district general hospital were recruited to this study. Hospital-acquired infections presenting during the in-patient stay were identified using previously validated methods of surveillance, and information on daily resource use by both infected and uninfected patients was recorded and estimates of their cost derived. Linear regression

R. Plowman; N. Graves; M. A. S. Griffin; J. A. Roberts; A. V. Swan; B. Cookson; L. Taylor

2001-01-01

81

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

82

Patrón y costo del tratamiento antihipertensivo para pacientes ambulatorios en un hospital general  

Microsoft Academic Search

SUMMARY In our hospitals, the treatment of hypertension is highly variable and individualized, with prescriptions and costs that influence on treatment accessibility and compliance. OBJECTIVE: To know the class and costs of the antihypertensive therapy in a general hospi- tal. MATERIAL AND METHODS: A transversal and descriptive study was done on the prescription of antihypertensive drugs from ambula- tory patients

Marcela Juárez-García; Pedro José Ortiz-Saavedra; Leonidas Gutiérrez-Fernán-Segarra; Jorge Casas-Castańeda

2008-01-01

83

Prevalencia de fracturas mandibulares en el Hospital General de Medellín. Un estudio prospectivo. 2006 - 2007  

Microsoft Academic Search

Introduction and Objetives: The maxillofacial trauma is urgency treated daily of a multidisciplinary way; the most affected area is the jaw. The objective of this study was to describe the frequency and distribution of mandibular fractures treated by the Maxillofacial Surgery Department at the Medellin General Hospital during 2006. Materials and methods: A prospective descriptive study was carried out with

Mariluz Velásquez; Gustavo Ortiz

84

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

Microsoft Academic Search

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

Persefoni Lambrou; Nick Kontodimopoulos; Dimitris Niakas

2010-01-01

85

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

86

A comparison of hospital readmission rates between two general physicians with different outpatient review practices  

Microsoft Academic Search

BACKGROUND: There has been a relentless increase in emergency medical admissions in the UK over recent years. Many of these patients suffer with chronic conditions requiring continuing medical attention. We wished to determine whether conventional outpatient clinic follow up after discharge has any impact on the rate of readmission to hospital. METHODS: Two consultant general physicians with the same patient

Hugh C Rayner; R Mark Temple; Tim Marshall; Dianne Clarke

2002-01-01

87

The Massachusetts General Hospital (MGH) Hairpulling Scale: 2. Reliability and Validity  

Microsoft Academic Search

Assessment of symptom severity and change in chronic hairpulling has been limited by the absence of a psychometrically validated clinical rating scale. The Massachusetts General Hospital Hairpulling Scale demonstrated test-retest reliability, convergent and divergent validity, and sensitivity to change in hairpulling symptoms.

Richard L. O’Sullivan; Nancy J. Keuthen; Caroline F. Hayday; Joseph N. Ricciardi; Lynn Buttolph; Michael A. Jeni; Lee Baer

1995-01-01

88

Stakeholder perspectives on handovers between hospital staff and general practitioners: an evaluation through the microsystems lens  

PubMed Central

Background Much of the research on improving patient handovers has focused on enhancing communication within the hospital system, but there have been relatively few efforts aimed at addressing the challenges at the interface between the hospital and the primary care setting. Methods A qualitative thematic analysis using a clinical microsystems lens applied to 28 semi-structured key stakeholder interviews in the Netherlands. Data were organised into seven ‘virtual’ clinical microsystem datasets composed of patients, hospital-based physicians, hospital-based nurses and community-based general practitioners. Results Five themes that contributed to effective or ineffective handovers emerged from our analysis: (1) lack of adequate information; (2) healthcare professionals’ availability and opportunity for personal contact; (3) feedback, teaching and protocols related to handovers; (4) information technology facilitated communication solutions; and (5) the role and responsibility of patients. Our analysis suggests that each healthcare professional attempted to provide the best care possible, but did this largely in isolation, and without the benefit of the knowledge and expertise of the other members of the microsystem. Conclusions The microsystem approach offers an innovative organisational construct and approach to assess the gaps in ‘hospital to community’ patient handovers, by viewing the hospital to the community interface as a clinical microsystem continuum. Our application of the microsystem approach confirms and extends earlier findings about the impact of barriers on the continuity and safety of patient transitions and their impact on the quality of patient care. PMID:23118408

Göbel, Beryl; Zwart, Dorien; Hesselink, Gijs; Pijnenborg, Loes; Barach, Paul; Kalkman, Cor; Johnson, Julie K

2012-01-01

89

Study of patients absconding behavior in a general hospital at southern region of Iran  

PubMed Central

Background: Patients’ escape from hospital imposes a significant cost to patients as well as the health system. Besides, for these patients, exposure to adverse events (such as suicide, self-harm, violence and harm to hospital reputation) are more likely to occur compared to others. The present study aimed to determine the characteristics of the absconding patients in a general hospital through a case-control design in Shiraz, Iran. Methods: This case-control study was conducted on 413 absconded patients as case and 413 patients as control in a large general hospital in Shiraz, southern Iran. In this study, data on the case and control patients was collected from the medical records using a standard checklist in the period of 2011–3. Then, the data were analyzed using descriptive and analytical statistics, through SPSS 16. Results: The finding showed that 413 patients absconded (0.50%) and mean of age in case group was 40.98 ± 16.31 years. In univariate analysis, variables of gender [Odds Ratio (OR)= 2], ward (OR= 1.22), insurance status (OR= 0.41), job status (OR= 0.34) and residence expenditure were significant. However, in multivariate analysis significant variables were age (ORadj= 0.13), gender (ORadj= 2.15), self-employment/unemployed (ORadj= 0.47), emergency/admission (ORadj= 2.14), internal/admission (ORadj= 3.16), insurance status (ORadj= 4.49) and residence expenditure (ORadj= 1.15). Conclusion: Characteristics such as middle age, male gender, no insurance coverage, inability to afford hospital expenditures and admission in emergency department make patients more likely abscond from the hospital. Therefore, it may be necessary to focus efforts on high-risk groups and increase insurance coverage in the country to prevent absconding from hospital.

Khammarnia, Mohammad; Kassani, Aziz; Amiresmaili, Mohammadreza; Sadeghi, Ahmad; Karimi Jaberi, Zahra; Kavosi, Zahra

2015-01-01

90

Health System Responsiveness: A Case Study of General Hospitals in Iran  

PubMed Central

Background: Considering patients’ needs and expectations in the process of healthcare delivery improves the quality of services. This study aimed to investigate the responsiveness of general public and private hospitals in Mashhad, Iran. Methods: In this cross-sectional and explanatory study, hospitalized patients (with at least 2 days of stay) in general private and public hospitals in Mashhad were investigated. In total 425 patients (259 from private and 166 from public hospitals) were selected using a stratified and simple random sampling. Standard responsiveness questionnaire was used as the data collection tool. Data were analysed using descriptive statistics, independent t-tests and ANOVA by SPSS 16 at a significance level of 0.05. Results: Access to the social support during hospitalization as well as confidentiality of the patient’s information achieved the highest score (3.21±0.73) while the patient participation in decision-making process of treatment received the least score (2.34±1.24). Among the research population 1.6%, 4.1%, 17.6%, 63.3% and 13.2% commented on the responsiveness level as very low, low, moderate, good, and excellent, respectively. There was no significant difference between the overall responsiveness scores of public and private hospitals ( P ?0.05). Conclusion: The hospitals have enough potential to improve various aspects of their responsiveness. We suggest a number of measures can help improve the non-clinical aspects of care. These include: using educational courses to improve the knowledge and attitudes of medical and nonmedical staff, changing the resource allocation method, and using quality tools such as reengineering to modify the healthcare delivery processes. PMID:24596841

Ebrahimipour, Hossein; Vafaei Najjar, Ali; Khani Jahani, Ahmad; Pourtaleb, Arefeh; Javadi, Marzieh; Rezazadeh, Alireza; Vejdani, Marjan; Shirdel, Arash

2013-01-01

91

Coordinated Response to SARS, Vancouver, Canada  

PubMed Central

Two Canadian urban areas received travelers with severe acute respiratory syndrome (SARS) before the World Health Organization issued its alert. By July 2003, Vancouver had identified 5 cases (4 imported); Toronto reported 247 cases (3 imported) and 43 deaths. Baseline preparedness for pandemic threats may account for the absence of sustained transmission and fewer cases of SARS in Vancouver. PMID:16494736

Petric, Martin; Daly, Patricia; Parker, Robert A.; Bryce, Elizabeth; Doyle, Patrick W.; Noble, Michael A.; Roscoe, Diane L.; Tomblin, Joan; Yang, Tung C.; Krajden, Mel; Patrick, David M.; Pourbohloul, Babak; Goh, Swee Han; Bowie, William R.; Booth, Tim F.; Tweed, S. Aleina; Perry, Thomas L.; McGeer, Allison; Brunham, Robert C.

2006-01-01

92

Which factors decided general practitioners’ choice of hospital on behalf of their patients in an area with free choice of public hospital? A questionnaire study  

PubMed Central

Background Parts of New Public Management-reforms of the public sector depend on introduction of market-like mechanisms to manage the sector, like free choice of hospital. However, patients may delegate the choice of hospital to agents like general practitioners (GPs). We have investigated which factors Danish GPs reported as decisive for their choice of hospital on behalf of patients, and their utilisation of formal and informal data sources when they chose a hospital on behalf of patients. Methods Retrospective questionnaire study of all of the 474 GPs practising in three counties which constituted a single uptake area. Patients were free to choose a hospital in another county in the country. The GPs were asked about responsibility for choice of the latest three patients referred by the GP to hospital; which of 16 factors influenced the choice of hospital; which of 15 sources of information about clinical quality at various hospitals/departments were considered relevant, and how often were six sources of information about waiting time utilised. Results Fifty-one percent (240 GPs) filled in and returned the questionnaire. One hundred and eighty-three GPs (76%) reported that they perceived that they chose the hospital on behalf of the latest referred patient. Short distance to hospital was the most common reason for choice of hospital. The most frequently used source of information about quality at hospital departments was anecdotal reports from patients referred previously, and the most important source of information about waiting time was the hospitals’ letters of confirmation of referrals. Conclusions In an area with free choice of public hospital most GPs perceived that they chose the hospital on behalf of patients. Short distance to hospital was the factor which most often decided the GPs’ choice of hospital on behalf of patients. GPs attached little weight to official information on quality and service (waiting time) at hospitals or departments, focusing instead on informal sources like feedback from patients and colleagues and their experience with cooperation with the department or hospital. PMID:22630354

2012-01-01

93

Troponin T: role in altering patient management and enabling earlier discharge from a district general hospital.  

PubMed

The use of troponin T to facilitate early patient discharge was investigated in a prospective study in a district general hospital. Troponin T was measured in 91 patients admitted over a period of 6 months with chest pain but without evidence of myocardial infarction. The main outcome measure was length of hospital stay. A negative troponin T was found in 70 patients. Fifty of these were discharged within 24 h of the troponin result being available and they had a significantly shorter hospital stay than a case control group and a historical control group from the previous 6 months. Troponin T measurement has a role in altering patient management by enabling early discharge, resulting in significant cost savings and increasing bed availability. PMID:11269754

Owen, A; Khan, W; Griffiths, K D

2001-03-01

94

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

95

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.

96

General hospital services for deliberate self-poisoning: an expensive road to nowhere?  

PubMed Central

This study was designed to investigate the clinical and economic aspects of deliberate self-poisoning services in four teaching hospitals in Leeds, Leicester, Manchester and Nottingham. We investigated the management of the current self-harm episode, including direct in-hospital costs, in 456 individuals who presented to hospital on a total of 477 occasions with deliberate self-poisoning during a 4-week period in 1996. Fewer than half of the patients received specialist psychosocial assessment or follow-up. Patients were more likely to receive an assessment if they were already in contact with psychiatric services, had a history of previous overdoses, if they presented during working hours, or if they lived near the hospital. Patients who were admitted were nearly twice as likely to receive specialist assessment, and those who received a specialist assessment were nearly three times as likely to be offered follow-up. In-patient days and days on the intensive care unit accounted for 47% and 8% of the total costs, respectively. This study suggests that general hospital services are disorganised, with evidence of inequitable access to specialist assessment and aftercare. This state of affairs cannot be justified on financial or clinical grounds.???Keywords: self-poisoning; service provision PMID:10621900

Kapur, N.; House, A.; Creed, F.; Feldman, E.; Friedman, T.; Guthrie, E.

1999-01-01

97

Alcohol and drug misuse, risk of re-admission to a general hospital and psychiatric contact.  

PubMed

Patients with physical problems related to the use of alcohol or drugs often present to general hospitals in an unplanned, emergency fashion. In 2005, the Kerr report concluded that fundamental changes were needed in our approach, shifting the emphasis from a reactive to a more proactive, prevention-based model in the treatment of acute medical conditions. We studied patients who had at least one alcohol- or drug-related emergency admission, whose most recent admission was to Aberdeen Royal Infirmary and who, using the Scottish Patients at Risk of Re-admission and Admission (SPARRA) All Ages Tool, were thought to be at high risk of further emergency admission. We examined data sets derived from the National Health Service National Services Scotland Information Services Division, a Liaison Psychiatry database, data from the local psychiatric Patient Information Management System and data collected by the hospital alcohol liaison nurse to examine this group of patients further and consider the scope for any future intervention. Patients who have an alcohol- or drug-related emergency admission to the general hospital are at increased risk of re-admission. A substantial proportion of these patients has come into contact with the psychiatric services, often attracting a substance misuse and/or personality disorder diagnosis. A significant proportion also presents in the context of self-harm. In conclusion, this group of frequent hospital attenders may be difficult to engage but may benefit from more proactive intervention, a more joined-up management approach and the development of an enhanced general hospital alcohol liaison service. PMID:22408219

Goldbeck, R; Asif, M; Sanderson, M; Farquharson, C

2012-02-01

98

[Past and present issues of the pulmonary circulation in the General University Hospital in Prague].  

PubMed

The development of right heart catheterization is closely connected not only with its pioneer Werner Forssmann but also with the University Hospital in Prague. Shortly after Forssmann´s pioneering performance of catheterization, Dr. Otto Klein measured cardiac output using the Fick´s principle in 11 patients in University Hospital. In the 60s and 70s of last century, there was established an research group represented by Severin Daum, Frantisek Boudik, Vlastimil Jezek, Alois Ourednik and Zdenek Suso at 2nd Internal Clinic of General Cardiopulmonary Hospital. After 1999, the issue of pulmonary hypertension has been re-emerged by Professor Michal Aschermann and this had significant clinical implications. The highly specialized centre for pulmonary arterial hypertension (PAH) was found at the clinic and in Cardio Centre of General University Hospital it has been initiated a successful program of pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH) since 2004. Surgical treatment is also provided to patients from Slovakia. The number of patients, wide range of therapy and its results, including the excellent results of surgical treatment situates the centre among the most important centres in Europe dealing with pulmonary hypertension. PMID:25692831

Jansa, Pavel; Ambrož, David; Lindner, Jaroslav

2014-12-01

99

Relation between general practices' outpatient referral rates and rates of elective admission to hospital.  

PubMed Central

OBJECTIVE--To examine the variation in rates of admission to hospital among general practices, to determine the relation between referral rates and admission rates, and to assess the extent to which variations in outpatient referral rates might account for the different patterns of admission. DESIGN--A comparison of outpatient referral rates standardised for age and sex and rates of elective admission to hospital for six specialties individually and for all specialties combined. SETTING--19 General practices in three districts in Oxford Regional Health Authority with a combined practice population of 188 610. MAIN OUTCOME MEASURES--Estimated proportion of outpatient referrals resulting in admission to hospital, extent of variation in referral rates and admission rates among practices, and association between admissions and outpatient referrals. RESULTS--Patients referred to surgical specialties were more likely than those referred to medical specialties to be admitted after an outpatient referral. Overall, the estimated proportion of patients admitted after an outpatient referral was 42%. There were significant differences among the practices in referral rates and admission rates for most of the major specialties. The extent of systematic variance in admission rates (0.048) was similar to that in referral rates (0.037). Referral and admission rates were significantly associated for general surgery; ear, nose, and throat surgery; trauma and orthopaedics; and all specialties combined. For most specialties the practices with higher referral rates also had higher admission rates, casting doubt on the view that these practices were referring more patients unnecessarily. CONCLUSION--Rates of elective admission to hospital vary systematically among general practices. Variations in outpatient referral rates are an important determinant of variations in admission rates. PMID:2390622

Coulter, A; Seagroatt, V; McPherson, K

1990-01-01

100

Hydroview lens implant calcification: 186 exchanges at a district general hospital  

Microsoft Academic Search

AimThis paper describes the experience at a district general hospital of coping with an abrupt onset of calcification of Hydroview intraocular lens (IOL) implants requiring exchange surgery mostly for symptoms of glare, even though the visual acuities were relatively good.MethodsIn this retrospective study, the operative details of 174 consecutive lens exchanges by one surgeon were retrieved from the surgeon's notes.

P Syam; P Byrne; G Lewis; T Husain; G Kleinmann; N Mamalis; D J Apple; T Rimmer

2008-01-01

101

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

PubMed Central

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

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

2012-01-01

102

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

103

The utilization of a paediatric emergency room in a general hospital in Kuwait.  

PubMed

A descriptive study was conducted in Al-Amiri Hospital, Kuwait to evaluate the use of the paediatric emergency room (PER) by children under 12 years of age over an 11-week period. Socio-demographic data on the families, reasons for the visits, the pattern of referral and the diagnoses were reviewed and analyzed. A total of 277 children were enrolled in the study, the majority of whom (81%) were generally well, only 4% requiring admission to hospital. The paediatrician in the emergency room considered that 64% of visits were not emergencies. Some form of treatment and one to two routine investigations were needed in 21% and 21.6%, respectively. Stated reasons for seeking medical care were: symptoms of the child (34%), unavailability of primary clinic at night (22%) and perceived better services in hospital (20%). The median of parental satisfaction at the end of the visit was 95%. We conclude that most visits to the PER at Al-Amiri Hospital are inappropriate and that intensive health education is required to improve use of the PER and to increase public awareness of the difference between primary care and paediatric emergency facilities. PMID:9578801

al-Hay, A A; Boresli, M; Shaltout, A A

1997-12-01

104

Dutch paediatrician's opinions about acute care for critically ill children in general hospitals.  

PubMed

Paediatricians in general hospitals have limited experience with critically ill children, due to the low incidence and their diversity in age, pathology and presentation. Consequently, adequate organization, training and materials and medication are of major importance. This voluntary and anonymous survey-based study was conducted to gain insight in the current status of these aspects. In June 2012, all 687 paediatricians employed at 84 general hospitals in The Netherlands received a hardcopy questionnaire with questions relating to demographics, organization, training and materials and medication concerning the acute care for critically ill children. Of the sent questionnaires, 41.3 % were eligible for analysis. According to the organization of the acute care of critically ill children, 73.9 % of the respondents indicated verbal agreements were made, of which 77.0 % stated that these were recorded in written protocols. Taskforces were present according to 64.5 % of our respondents. Of the respondents, 64.4 % were Advanced Paediatric Life Support (APLS) certified. Of the stated training scenarios, 90.8 % were available in their hospital, which were followed on a regular basis by 63.9 % of the paediatricians. Paediatric resuscitation carts were present on both emergency department and paediatric ward according to 95.1 %. Materials (37.7 %) and medication (45.3 %) were frequently lacking. Conclusion: Paediatricians from general hospitals in The Netherlands consider that acute care for critically ill children has to be improved in terms of organization, training and teamwork, and medication and materials. National guidelines concerning the organization and training may contribute to this improvement, as well as a standardized inventory list for paediatric resuscitation carts. PMID:25339423

van Sambeeck, Sam J; Martens, Sanne J; Hundscheid, Tim; Janssen, Etienne J; Vos, Gijs D

2014-10-23

105

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

106

Prevalence of nurses' smoking habits in psychiatric and general hospitals in China.  

PubMed

This study determined the prevalence of lifetime and current smoking and the correlates of current smoking in nurses working in psychiatric and general hospitals in China. Of 807 distributed questionnaires, 799 nurses who were working in two psychiatric hospitals (n=387, 48.4%), and one general hospital (n=412, 51.6%) had analyzable data. Socio-demographic, alcohol use and smoking data were collected with a self-reported questionnaire. Work-related stress was evaluated with the Nurse Stress Inventory. In the whole sample, the lifetime smoking prevalence was 7.6% (females=2.1% vs. males=48.9%, p<0.0001; psychiatric nurses=14.5% vs. non-psychiatric nurses=1.2%, p<0.0001). The prevalence of current smoking was 7.1% (females=2.1% vs. males=44.7%, p<0.0001; psychiatric nurses=13.4% vs. non-psychiatric nurses=1.2%, p<0.0001). In a multiple logistic regression analysis, age 30 years or older, male gender, having children, being a psychiatric nurse and alcohol consumption were positively associated with smoking, while being a nursing officer was negatively associated with smoking (r(2) = 0.513, p<0.0001). Considering the harmful effects of smoking as well as second-hand smoking in the presence of children, effective measures to promote smoking cessation for male, older and psychiatric nurses and those with children are warranted. PMID:24673786

An, Feng-Rong; Xiang, Yu-Tao; Yu, Liuyang; Ding, Yan-Ming; Ungvari, Gabor S; Chan, Sally Wai-Chi; Yu, Doris S F; Lai, Kelly Y C; Qi, Yun-Ke; Zeng, Jiao-Ying; Wu, Ping-Ping; Hou, Zhi-Jiaolong; Correll, Christoph U; Newhouse, Robin; Chiu, Helen F K

2014-04-01

107

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

108

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.

109

Factors associated with mortality in patients with exacerbation of chronic obstructive pulmonary disease hospitalized in General Medicine departments.  

PubMed

We aim to improve knowledge on risk factors that relate to mortality in subjects with exacerbation of chronic obstructive pulmonary disease (COPD) who are hospitalized in General Medicine departments. In a cross-sectional multicenter study, by means of a logistic regression analysis, we assessed the possible association of death during hospitalization with the following groups of variables of participating patients: sociodemographic features, treatment received prior to admission and during hospitalization, COPD-related clinical features recorded prior to admission, comorbidity diagnosed prior to admission, clinical data recorded during hospitalization, laboratory results recorded during hospitalization, and electrocardiographic findings recorded during hospitalization. A total of 398 patients was included; 353 (88.7%) were male, and the median age of the patients was 75 years. Of these patients, 21 (5.3%) died during hospitalization. Only 270 (67.8%) received inhaled ?(2) agonists during hospitalization, while 162 (40.7%) received angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. The median of predicted FEV(1) prior to admission was 42%. A total of 350 patients (87.9%) had been diagnosed with two or more comorbid conditions prior to admission. An association was found between increased risk of death during hospitalization and the previous diagnoses of pneumonia, coronary heart disease, and stroke. In conclusion, comorbidity is an important contributor to mortality among patients hospitalized in General Medicine departments because of COPD exacerbation. PMID:20886377

Roca, Bernardino; Almagro, Pedro; López, Francisco; Cabrera, Francisco J; Montero, Lorena; Morchón, David; Díez, Jesús; de la Iglesia, Fernando; Fernández, Mario; Castiella, Jesús; Zubillaga, Elena; Recio, Jesús; Soriano, Joan B

2011-02-01

110

Mechanical circulatory support with the ABIOMED BVS 5000: The Toronto General Hospital experience  

PubMed Central

BACKGROUND Acute hemodynamic collapse resulting in cardiogenic shock and impending end-organ failure is usually associated with certain death. The introduction of short-term mechanical circulatory support (MCS) devices offers potential therapy to these critically ill patients. The BVS 5000 device (ABIOMED Inc, USA) is widely used in the United States, but rarely in Canada, where device reimbursement remains a barrier. OBJECTIVE To present the Toronto General Hospital’s (Toronto, Ontario) initial five-year experience with this device to highlight the indications for use, common complications and overall success rates. METHODS AND RESULTS The institutional MCS database from 2001 to 2006 was reviewed, and 18 patients who received 30 devices in a variety of configurations were identified. The most common support configuration consisted of biventricular support (n=12), followed by isolated left ventricular support (n=4) and isolated right ventricular support in two recipients of an implantable long-term left ventricular assist device. Overall survival to device explant or transplant was 55% (n=10), of which five (50%) were successfully discharged from the hospital. The overall survival from device implant to hospital discharge was 28% (five of 18). The most common cause of death was multisystem organ failure. CONCLUSIONS MCS with the ABIOMED BVS 5000 can successfully resuscitate critically ill patients; however, earlier institution of this device would avoid irreversible end-organ injury, and lead to higher rates of device explant and hospital discharge. Short-term MCS devices should be available in all cardiac surgical centres in Canada to permit stabilization and evaluation of the acutely ill cardiac patient and subsequent management in a heart transplant facility. PMID:21076718

Lad, Vidyadhar; Elhenawy, Abdelsalam; Harwood, Steve; MacIver, Jane; Badiwala, Mitesh V; Vallelonga, Mark; Yau, Terrence M; Cusimano, Robert J; Delgado, Diego H; Ross, Heather J; Rao, Vivek

2010-01-01

111

Severe cutaneous reactions to drugs in the setting of a general hospital*  

PubMed Central

BACKGROUND Cutaneous drug reactions are frequently found. Assessing the clinical and epidemiological profile of severe forms is extremely relevant for their better recognition and management. Few studies have assessed the severe forms of cutaneous drug reactions in patients hospitalized in our setting. OBJECTIVES To assess the clinical and epidemiological aspects of severe cutaneous adverse reactions to drugs in a tertiary hospital in Porto Alegre, Brazil. METHODS All cases of severe cutaneous adverse reactions to drugs in patients hospitalized from January/2005 to December/2010 were retrospectively analyzed for clinical and epidemiological variables. Cases of Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, drug hypersensitivity syndrome or Drug Reaction with Eosinophilia and Systemic Symptoms and acute generalized exanthematous pustulosis were included. RESULTS An occurrence rate of 1 serious reaction for every 3,048 inpatients was found (total of 173,767 inpatients admitted in the period). Drug Reaction with Eosinophilia and Systemic Symptoms was the most frequent presentation. The drugs most frequently involved were anticonvulsants (40.4%), antibiotics (26.3%), and analgesics/anti-inflammatory drugs (10.5%). Thirty seven patients (64.9%) were admitted to hospital because of the cutaneous drug reaction. Ten patients (17.5%) died and in most of those (60%), the drug causing the reaction could not be determined. CONCLUSIONS The frequency of severe cutaneous adverse reactions to drugs in our setting is significant. Drug Reaction with Eosinophilia and Systemic Symptoms seems to be the most frequent presentation of severe cutaneous drug reactions. Most patients developed cutaneous drug reactions outside the hospital. Mortality rates were higher for Toxic Epidermal Necrolysis and this presentation significantly affected older people. Not knowing the drug causing the reaction was related to mortality. PMID:25184915

Grando, Luciana Rosa; Schmitt, Tatiana Aline Berger; Bakos, Renato Marchiori

2014-01-01

112

[Latent tuberculosis infection in healthcare personnel at a primary level general hospital in Catalonia, Spain].  

PubMed

The aim was to analyze the prevalence of latent tuberculosis infection and associated risk factors in healthcare personnel at the Hospital de Tortosa Verge de la Cinta (Tarragona, Spain). This was a cross-sectional study of 398 workers at this hospital who underwent tuberculin skin testing for latent tuberculosis infection (LTBI) between 2001 and 2012.We also analyzed the relationship between LTBI and age, sex, job and work area according to their risk of exposure to tuberculosis(high, low, uncertain). The total prevalence of LTBI in our sample was 11.1% (95%CI 8.3%-14.5%). LBTI was associated with age and work area. Multivariate analysis showed that the risk of LTBI increased by 6.4% per 1 year increase in age. The prevalence of LTBI in this population approximates that of the general population in Spain. PMID:24718632

Sol Vidiella, Josep; Catalán Gómez, Teresa; Callau Casanova, Cristina; Lejeune, Marylčne

2014-01-01

113

Randomised controlled trial of a brief alcohol intervention in a general hospital setting  

PubMed Central

Background The evidence suggests that brief alcohol-focused interventions, directed at hazardous and harmful drinkers in non-specialist settings such as primary care are effective in reducing alcohol consumption. However, there is a need for further research in the hospital setting. This is a randomised controlled trial to investigate the effectiveness of a 10-minute brief intervention amongst 'at risk’ drinkers admitted to general hospital wards. Unlike some previous trials, this trial is randomised, used blinded assessors, includes an intention-to-treat analysis, included female subjects and excluded people with alcohol dependence. Methods A total of 250 'at risk’ drinkers admitted to King’s College Hospital were identified using the Alcohol Use Disorders Identification Test (AUDIT). Some 154 subjects entered the study and were randomly allocated to the control and intervention groups. Subjects in the control group received no advice about their drinking whilst subjects in the intervention group received 10 minutes of simple advice on reducing alcohol consumption. Recruitment took place between 1995 and 1997. The primary outcome was the AUDIT questionnaire at 12 months. Secondary outcomes were a previous week’s Drinks Diary, questionnaires (General Health Questionnaire, Alcohol Problems Questionnaire and the Severity of Alcohol Dependence Questionnaire) and laboratory blood tests (gamma glutamyl transferase, mean cell volume and haemoglobin). Results At 3-month and 12-month follow-up, all participants were included in the intention-to-treat analysis. At both time points there was no evidence of an intervention effect that could be attributed to the brief intervention. Both the intervention and control groups had an improved AUDIT score and reduced levels of alcohol consumption as measured by a subjective Drinks Diary at 3 months which was maintained at 12 months. Conclusions This study has added further evidence on brief interventions in the hospital setting. In contrast to the recent Cochrane review by McQueen et al., the results of this study do not support the effectiveness of a brief alcohol intervention in general hospital wards. However our study was underpowered and there were flaws in the statistical analyses, and these limitations temper the strength of our conclusions. PMID:24148799

2013-01-01

114

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

PubMed

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

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

2010-01-01

115

[Forced medical treatment: existent law and its limitations in a general hospital].  

PubMed

The conditions in which we can provide medical treatment without informed consent are detailed in the Israeli Law for Treating the Mentally Ill [1991), and the Law of Patient Rights (1996). Our clinicaL experience in a general hospital indicates that the law does not provide a satisfactory solution in cases where the patient is actively resisting emergency treatment. This may be the case for patients suffering from dementia, personality disorders or substance abuse disorders. Not infrequently, the physician finds himself perplexed in face of a genuine ethical/juridical dilemma, without being able to use the law efficiently or, at times, even implement it pragmatically. in this article, we review the array of laws by which Israeli physicians in general, and psychiatrists in particular, operate upon when deciding to treat a patient against his will in a general hospital. We describe and discuss a clinicaL case that raises fundamental questions concerning the existing law. We also discuss other complex cases, such as anorexia, debating the possibility of coercing medical treatment on someone who is not mentally ill--psychotic according to Israeli juridical system. Finally, we raise a few ideas as to how the present condition can be improved. PMID:22164925

Nitzan, Uri; Lev-Ran, Shaul; Phenig, Shmuel

2011-04-01

116

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

117

[General internal medicine in hospital practice: the year 2013 put into perspective by residents].  

PubMed

2013 was full of significant advances in all areas of medicine, which may have an impact on daily practice in general internal medicine. From salt and water restriction in heart failure to transfusion threshold in upper gastrointestinal bleeding and fecal infusion in Clostridium difficile colitis; from new data in resuscitation and persistent questions in palliative care and intensive care medicine, through pneumology, nephrology and endocrinology, the literature has been rich in new considerations. Each year, the residents of the Department of internal medicine of the University hospital of Vaud (CHUV) meet to share their most interesting readings. Thirteen of them are reviewed and commented here. PMID:24624733

Giger, Aude; Barberini, Luc; Bruchez, Philippe; Castioni, Julien; Claude, Florian; Cosma Rochat, Monica; Gachoud, David; Gagliano, Mariangela; Greiser, Jens; Mieville, Anne; Rochat, Mathilde; Rouiller-Larpin, Nathalie; Santos, David; Vaucher, Julien; Sartori, Claudio

2014-01-22

118

Transduodenal exploration of the common bile duct in a district general hospital.  

PubMed

In an 8 year period 214 transduodenal explorations were undertaken in a district general hospital. These were performed on 208 patients and in 40 instances a combined supraduodenal and transduodenal approach was employed. There were 23 deaths in 208 patients, a mortality of 11%. Twelve deaths occurred in 64 patients who underwent negative exploration. Postoperative pancreatitis was the most common cause of death and the occurrence resulted in a 53% mortality. We conclude that the transduodenal operation should only be performed by experienced surgeons with definite proof of common bile duct stone, and when the standard supraduodenal approach is unsatisfactory. PMID:6721406

Cave-Bigley, D J; Aukland, P; Kane, J F; Hardy, E G

1984-05-01

119

Aural Foreign Bodies: Descriptive Study of 224 Patients in Al-Fallujah General Hospital, Iraq  

PubMed Central

Foreign bodies (FB) in the external auditory canal are relative medical emergency. The objective of this study was to describe the types of FB and their complications and to highlight on new FB not seen before which was the bluetooth devices that were used for cheating during high school examination in Al-Fallujah city. This was a two-year hospital-based descriptive study performed in the Department of Ear, Nose and Throat (ENT), Al-Fallujah General Hospital, from June 2011 to May 2013; during this period, 224 FB had been extracted from 224 patients. Beads were extracted from 68 patients (30.4%), cotton tips were extracted from 50 patients (22.3%), seeds and garlic were extracted from 31 patients (13.8%), papers were extracted from 27 patients (12.1%), insects were extracted from 24 patients (10.7%), button batteries were extracted from 13 patients (5.8%), and bluetooth devices were extracted from 7 patients (3.1%). Most of the cases did not develop complications (87.5%) during extraction. The main complications were canal abrasion (4.5%). Proper instrumentation allows the uncomplicated removal of many FB. The use of general anesthesia is preferred in very young children. Bluetooth device objects should be considered as new aural FB, especially in our territory. PMID:24368915

Al-juboori, Ahmad Nasrat

2013-01-01

120

[One year functioning of a psychiatric unit in a general hospital: analyses and reflections].  

PubMed

At a time where the organization of mental health care in Belgium is profoundly modified by the development of an ambulatory option, following as such the proposals of the WHO, it seemed interesting to measure the present functioning of a psychiatry unit located in a general hospital. Data concerning the psychiatry unit of C.H.U. Tivoli, at La Louvičre, were analyzed over a period of one year. The age pyramid followed a Gaussian curve, with a peak at age 45, a period of life considered as one of the most difficult in surveys over general life satisfaction. The main reasons for admission were: major depressive disorder, alcohol desintoxication, looked for isolation from the external world (either for physical or psychological reasons), diagnostic (morbidities and comorbidities) and therapeutic (complex treatment combinations) workups, anxious and psychotic decompensations, and systemic conflits (e.g. conflicts within the family). The number and duration of admissions showed peaks in september-october, january-february and june-july. The most current stay duration was 6 days. A subgroup completed an additional survey about the ideal localization for their care. 19 % would have opted for an ambulatory care if the choice would have been proposed. By contrast, it appears that hospitals, with their concentration of disciplines in the same location and relatively efficient organization, still has an important role to play in the future network in mental health care. PMID:25856967

2015-01-01

121

Aural foreign bodies: descriptive study of 224 patients in Al-fallujah general hospital, iraq.  

PubMed

Foreign bodies (FB) in the external auditory canal are relative medical emergency. The objective of this study was to describe the types of FB and their complications and to highlight on new FB not seen before which was the bluetooth devices that were used for cheating during high school examination in Al-Fallujah city. This was a two-year hospital-based descriptive study performed in the Department of Ear, Nose and Throat (ENT), Al-Fallujah General Hospital, from June 2011 to May 2013; during this period, 224 FB had been extracted from 224 patients. Beads were extracted from 68 patients (30.4%), cotton tips were extracted from 50 patients (22.3%), seeds and garlic were extracted from 31 patients (13.8%), papers were extracted from 27 patients (12.1%), insects were extracted from 24 patients (10.7%), button batteries were extracted from 13 patients (5.8%), and bluetooth devices were extracted from 7 patients (3.1%). Most of the cases did not develop complications (87.5%) during extraction. The main complications were canal abrasion (4.5%). Proper instrumentation allows the uncomplicated removal of many FB. The use of general anesthesia is preferred in very young children. Bluetooth device objects should be considered as new aural FB, especially in our territory. PMID:24368915

Al-Juboori, Ahmad Nasrat

2013-01-01

122

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

123

Bloodstream Infection among Children Presenting to a General Hospital Outpatient Clinic in Urban Nepal  

PubMed Central

Background There are limited data on the etiology and characteristics of bloodstream infections in children presenting in hospital outpatient settings in South Asia. Previous studies in Nepal have highlighted the importance of murine typhus as a cause of febrile illness in adults and enteric fever as a leading bacterial cause of fever among children admitted to hospital. Methods We prospectively studied a total of 1084 febrile children aged between 2 months and 14 years presenting to a general hospital outpatient department in Kathmandu Valley, Nepal, over two study periods (summer and winter). Blood from all patients was tested by conventional culture and by real-time PCR for Rickettsia typhi. Results Putative etiological agents for fever were identified in 164 (15%) patients. Salmonella enterica serovar Typhi (S. Typhi) was identified in 107 (10%), S. enterica serovar Paratyphi A (S. Paratyphi) in 30 (3%), Streptococcus pneumoniae in 6 (0.6%), S. enterica serovar Typhimurium in 2 (0.2%), Haemophilus influenzae type b in 1 (0.1%), and Escherichia coli in 1 (0.1%) patient. S. Typhi was the most common organism isolated from blood during both summer and winter. Twenty-two (2%) patients were PCR positive for R. typhi. No significant demographic, clinical and laboratory features distinguished culture positive enteric fever and murine typhus. Conclusions Salmonella infections are the leading cause of bloodstream infection among pediatric outpatients with fever in Kathmandu Valley. Extension of immunization programs against invasive bacterial disease to include the agents of enteric fever and pneumococcus could improve the health of children in Nepal. PMID:23115652

Pradhan, Rahul; Shrestha, Umesh; Gautam, Samir C.; Thorson, Stephen; Shrestha, Kabindra; Yadav, Bharat K.; Kelly, Dominic F.; Adhikari, Neelam; Pollard, Andrew J.; Murdoch, David R.

2012-01-01

124

Geoscape Vancouver: Living with our Geological Landscape  

NSDL National Science Digital Library

This site is about the geology and dynamic landscape of the Vancouver, British Columbia area. The people of Vancouver live where the Fraser River breaches the coastal mountains to reach the inland sea of the Strait of Georgia. This landscape is underlain by a variety of earth materials and is continually shaped by earth processes - a geological landscape or geoscape. The processes include colliding crustal plates and mountain-building, earthquakes, volcanic eruptions, landslides, and the work of water, and past glaciers. References are given to printed and web resources for additional information.

125

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

126

The quality of communication about older patients between hospital physicians and general practitioners: a panel study assessment  

Microsoft Academic Search

BACKGROUND: Optimal care of patients is dependent on good professional interaction between general practitioners and general hospital physicians. In Norway this is mainly based upon referral and discharge letters. The main objectives of this study were to assess the quality of the written communication between physicians and to estimate the number of patients that could have been treated at primary

Helge Garĺsen; Roar Johnsen

2007-01-01

127

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

128

Automatic coding of reasons for hospital referral from general medicine free-text reports.  

PubMed Central

Although the coding of medical data is expected to benefit both patients and the health care system, its implementation as a manual process often represents a poorly attractive workload for the physician. For epidemiological purpose, we developed a simple automatic coding system based on string matching, which was designed to process free-text sentences stating reasons for hospital referral, as collected from general practitioners (GPs). This system relied on a look-up table, built up from 2590 reports giving a single reason for referral, which were coded manually according to the International Classification of Primary Care (ICPC). We tested the system by entering 797 new reasons for referral. The match rate was estimated at 77%, and the accuracy rate, at 80% at code level and 92% at chapter level. This simple system is now routinely used by a national epidemiological network of sentinel physicians. PMID:11079931

Letrilliart, L.; Viboud, C.; Boëlle, P. Y.; Flahault, A.

2000-01-01

129

Beliefs and attitudes of interns at Ibadan General Hospitals concerning ten medical specialties.  

PubMed

Fifty-two interns at Ibadan general hospitals (89% response rate), participated in a study of their attitudes towards ten medical specialties. This involved completing a 40-item questionnaire. The highly preferred specialties (surgery, paediatrics, obstetrics and gynaecology, internal medicine) were those in which there was expectation of material rewards, societal appreciation, quick response of patients to treatment, and inspiration by teachers. The less preferred specialties were viewed negatively in these regards. The findings support the suggestion that, in order to give medical graduates a greater chance to see that the less preferred specialties can provide career fulfillment, interns should be allowed to spend part of their one year clinical rotation in radiology, pathology, psychiatry, anaesthesia and community medicine. PMID:7653401

Ohaeri, J U; Akinyinka, O O; Asuzu, M C

1994-12-01

130

The Massachusetts General Hospital acute stroke imaging algorithm: an experience and evidence based approach  

PubMed Central

The Massachusetts General Hospital Neuroradiology Division employed an experience and evidence based approach to develop a neuroimaging algorithm to best select patients with severe ischemic strokes caused by anterior circulation occlusions (ACOs) for intravenous tissue plasminogen activator and endovascular treatment. Methods found to be of value included the National Institutes of Health Stroke Scale (NIHSS), non-contrast CT, CT angiography (CTA) and diffusion MRI. Perfusion imaging by CT and MRI were found to be unnecessary for safe and effective triage of patients with severe ACOs. An algorithm was adopted that includes: non-contrast CT to identify hemorrhage and large hypodensity followed by CTA to identify the ACO; diffusion MRI to estimate the core infarct; and NIHSS in conjunction with diffusion data to estimate the clinical penumbra. PMID:23493340

González, Ramon Gilberto; Copen, William A; Schaefer, Pamela W; Lev, Michael H; Pomerantz, Stuart R; Rapalino, Otto; Chen, John W; Hunter, George J; Romero, Javier M; Buchbinder, Bradley R; Larvie, Mykol; Hirsch, Joshua Adam; Gupta, Rajiv

2013-01-01

131

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.  

PubMed

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 the hospital, John Collins Warren (famed primarily for being the surgeon at the first public demonstration of ether anesthesia) had a major interest in pathology; he published a book focused on gross pathology (1837) and began the important specimen collection subsequently known as the Warren Anatomical Museum at Harvard Medical School (HMS). An early physician, John Barnard Swett Jackson, became the first professor of pathology in the United States (1847) and was a noted collector whose specimens were added to the Warren Museum. Dr Jackson showed no interest in microscopy when it became available, but microscopy was promoted from circa the late 1840s at Harvard and likely at the hospital by Oliver Wendell Holmes, the famed essayist who was on the staff of the hospital and faculty at the medical school. Microscopy was probably first used at the Hospital with any frequency on examination of fluids by the first officially designated 'Microscopist,' John Bacon Jr, in 1851, and after the mid-1850s by Calvin Ellis on anatomic specimens; Ellis went on to pioneering reform of the HMS curriculum. Reginald Heber Fitz succeeded Ellis in 1871 and was the first to be officially designated as 'Pathologist' at the hospital. Fitz is remembered for two major contributions: his paper showing the nature of, and potential surgical cure for, the disease that he termed 'appendicitis'; and his description of acute pancreatitis. With the microscope now firmly entrenched and with the increase in surgery after Fitz's work on appendicitis, surgical pathology grew quickly. J Collins Warren, the grandson of the co-founder, had a major interest in pathology and in 1895 published an impressive volume entitled 'Surgical Pathology and Therapeutics.' Dr Warren had a major interest in breast disease and was a pioneer of needle biopsy in the evaluation of breast masses. In 1888, William Fiske Whitney joined the staff of the hospital and spent his nearly 30-year career practicing primarily as a surgical pathologist, making particular innovations in intraoperative consultation. The contributions of these individuals brought the field from a gross pathology-oriented discipline mostly oriented around teaching to a microscopy-dependent practice integral to patient care, and hence set the stage for the formal founding of the Pathology department in 1896. PMID:21926958

Young, Robert H; Louis, David N

2011-10-01

132

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

133

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

Code of Federal Regulations, 2010 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...

2010-10-01

134

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

135

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

Code of Federal Regulations, 2014 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...

2014-10-01

136

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

137

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...

138

A REGIONAL COLLEGE FOR VANCOUVER ISLAND.  

ERIC Educational Resources Information Center

AS ENVISIONED, THE REGIONAL COLLEGE IS JUSTIFIED BY THE MANY KINDS OF STUDENTS IT CAN SERVE AND THE VARIETY AND APPROPRIATENESS OF THE EDUCATIONAL SERVICES IT CAN OFFER. VANCOUVER ISLAND HAS TRANSPORTATION DIFFICULTIES, A MARKEDLY UNEVEN POPULATION, AND SPECIAL PROBLEMS IN FORESTRY EXPLOITATION. POPULATION GROWTH ON THE ISLAND HAS BEEN GREAT AND…

MARSH, LEONARD

139

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

140

Nosocomial infection, indices of intrinsic infection risk, and in-hospital mortality in general surgery  

Microsoft Academic Search

The objectives of this paper are to assess whether two indices of intrinsic infection risk (the SENIC and the NNIS index) predict in-hospital mortality and the attributable in-hospital mortality due to nosocomial infection in surgical patients. A prospective study on 4714 patients admitted to three hospitals has been carried out. The relative risk and its 95% confidence interval (CI) were

M. Delgado-rodríguez; A. Gomez-ortega; J. Llorca; M. Lecuona; T. Dierssen; M. Sillero-arenas; A. Sierra

1999-01-01

141

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

142

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

PubMed Central

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

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

2015-01-01

143

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

144

How do nurses working in hospital accident and emergency departments perceive local general practitioners? A study in six English hospitals  

Microsoft Academic Search

One hundred and forty-three Accident and Emergency nurses working in six departments in contrasting districts of England completed questionnaires about their perception of local general practice. Much of general practice was perceived as being performed unsatisfactorily. Out-of-hours accessibility, caring for patients with 'difficult' or psychosocial problems, advising on health service usage, and minor surgery and first aid were all thought

J Dale; J Green

1991-01-01

145

Leaving hospital against medical advice among HIV-positive patients  

Microsoft Academic Search

Background: Hospital discharge against medical advice, especially among substance-abusing populations, is a frustrating problem for health care pro- viders. Because of the high prevalence of injection drug use among HIV- positive patients admitted to hospital in Vancouver, we explored the factors as- sociated with leaving hospital against medical advice in this population. Methods: We reviewed records for all HIV\\/AIDS patients

Aslam H. Anis; Huiying Sun; Daphne P. Guh; Anita Palepu; Martin T. Schechter; Michael V. O'Shaughnessy

2002-01-01

146

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

147

CONFIDENTIAL Thank you for your interest in the Pancreas Transplant Program at Massachusetts General Hospital. Below is a list  

E-print Network

General Hospital. Below is a list of all of the medical records required for listing on the kidney/pancreas or pancreas after kidney transplant list, but only the tests indicated with an * are required to initiate meets criteria to be scheduled for a multidisciplinary kidney/pancreas or pancreas after kidney

Mootha, Vamsi K.

148

Psychiatric disorders in gynaecological, surgical and medical departments of general hospitals in an urban and a rural area of Austria  

Microsoft Academic Search

A total of 728 patients admitted to the medical, gynaecological and surgical departments of one urban and one rural general hospital in Austria were investigated for psychiatric morbidity. Using the Clinical Interview Schedule and its case criteria, the prevalence of psychiatric morbidity was found to be highest in medical departments (38.2%), followed by surgical departments (32.5%), and lowest in gynaecological

J. Wancata; N. Benda; M. Hajji; O. M. Lesch; C. Müller

1996-01-01

149

Job Title Social Worker / Case Manager II Employer/ Agency Harris Health System Lyndon B. Johnson General Hospital  

E-print Network

Job Title Social Worker / Case Manager II Employer/ Agency Harris Health System ­ Lyndon B. Johnson occasionally require some evening and/or weekend hours. Employer/Agency Harris Health System ­ Lyndon B. Johnson General Hospital Address 5656 Kelley Street City, State, Zip Houston, Texas 77026 Contact Person

Azevedo, Ricardo

150

An audit of “do not attempt resuscitation” decisions in two district general hospitals: do current guidelines need changing?  

Microsoft Academic Search

Introduction: Doctors in all specialties are involved in making “do not attempt resuscitation” (DNAR) decisions; this can be a difficult and challenging process. Guidelines exist to provide an ethical and legal framework for the process and documentation of these decisions.Objective: To audit the documentation of resuscitation decisions in a sample of medical inpatients from two district general hospitals.Method: A retrospective

Dylan Harris; Rachel Davies

2007-01-01

151

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

152

Home care for patients with suspected myocardial infarction: use made by general practitioners of a hospital team for initial management  

Microsoft Academic Search

Two hundred and sixty three general practitioners were offered the use of a hospital based service consisting of a medical senior house officer, a nurse attached to a coronary care unit, and a specially equipped ambulance estate car to help with the initial management of patients with suspected myocardial infarction who might be suitable for home care. One hundred and

J M Rowley; J R Hampton; J R Mitchell

1984-01-01

153

Application of a neural network for gentamicin concentration prediction in a general hospital population.  

PubMed

Neural network (NN) computation is computer modeling based in part on simulation of the structure and function of the brain. These modeling techniques have been found useful as pattern recognition tools. In the present study, data including age, sex, height, weight, serum creatinine concentration, dose, dosing interval, and time of measurement were collected from 240 patients with various diseases being treated with gentamicin in a general hospital setting. The patient records were randomly divided into two sets: a training set of 220 patients used to develop relationships between input and output variables (peak and trough plasma concentrations) and a testing set (blinded from the NN) of 20 to test the NN. The network model was the back-propagation, feed-forward model. Various networks were tested, and the most accurate networks for peak and trough (calculated as mean percent error, root mean squared error of the testing group, and tau value between observed and predicted values) were reported. The results indicate that NNs can predict gentamicin serum concentrations accurately from various input data over a range of patient ages and renal function and may offer advantages over traditional dose prediction methods for gentamicin. PMID:9029742

Corrigan, B W; Mayo, P R; Jamali, F

1997-02-01

154

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

PubMed Central

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

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

2015-01-01

155

Caring for people with dementia in general hospitals: an education curriculum from the Alzheimer's Society of Lower Saxony, Germany.  

PubMed

Since 2006, the Alzheimer's Society of Lower Saxony, Germany, has been working to improve care and medical treatment for people with cognitive impairment or dementia in general hospitals. An interdisciplinary team systematically worked on the topic for several years and presented results at various symposia. In 2011, a two-stage curriculum was completed and sent in combination with additional training documents to all hospitals and nursing training colleges in Lower Saxony, Germany. The manual comprised a two-step approach with a 14-h training for hospital staff and a 160-h training for qualification of trainers and dementia appointees/chaperones. In addition, the manual included a list of 13 essential points for "dealing with demented people in a general hospital," the information sheet of the German Alzheimer's Society on aspects requiring special attention when a demented person is admitted to a hospital, short descriptions of best practice models, a list of established speakers in the field, and a 30-min film. In 2012, the project won the "Preis für Engagement und Selbsthilfe" of the Hertie Foundation and the "Niedersächsischen Gesundheitspreis" awarded by the Lower Saxon Ministry for Social, Women, Family, and Health Affairs. PMID:23474868

Gurlit, S; Thiesemann, R; Wolff, B; Brommer, J; Gogol, M

2013-04-01

156

Cetacean Research at the Vancouver Aquarium  

NSDL National Science Digital Library

The Vancouver Aquarium conducts cutting edge cetacean, especially the killer whale, research in addition to being a fully-accredited newly-expanded aquarium. This website lets visitors learn about their cetacean and sea lion studies, marine mammal rescue and rehabilitation, and killer whale adoption program. The website describes the killer whale mating patterns, genetic analysis, and long-term monitoring efforts of the Aquarium.

157

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

158

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

159

Management of gastrointestinal carcinoid tumours - 10 years experience at a district general hospital  

PubMed Central

Background There is paucity of guidelines regarding management of gastrointestinal carcinoid tumours in district hospitals. Methods This study was undertaken at a district hospital to analyse the management pathway of gastrointestinal carcinoid tumours. Results Over a period of 10 years there were 35 patients, with an estimated annual incidence of 2.5 per 100,000 population. After a median follow up of 24 months, 22 (63%) patients were alive and disease free. Only 56% patients were referred to the regional neuro-endocrine multidisciplinary team. Conclusions Management of patients with carcinoid tumours in district hospitals needs streamling with increased utilisation of regional neuroendocrine multidisciplinary teams. PMID:22811879

Joypaul, Vickram B.

2012-01-01

160

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

161

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

162

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

PubMed

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

Dewing, Jan; Dijk, Saskia

2014-01-23

163

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, Joăo Alberto; Brito, Luiz Giulian; Luft, Michel; Guterres, Leonardo Waihrich; Monticielo, Odirlei André

2014-01-01

164

Stabilisation of critically ill children at the district general hospital prior to intensive care retrieval: a snapshot of current practice  

Microsoft Academic Search

ObjectiveTo describe current practice during stabilisation of children presenting with critical illness to the district general hospital (DGH), preceding retrieval to intensive care.DesignObservational study using prospectively collected transport data.SettingA centralised intensive care retrieval service in England and referring DGHs.PatientsEmergency transports to intensive care during 2-month epochs from 4 consecutive years (2005–2008).InterventionsNone.Main outcome measuresProportion of key airway, breathing, and circulatory and

S. Lampariello; M. Clement; A. P. Aralihond; D. Lutman; M. A. Montgomery; A. J. Petros; P. Ramnarayan

2010-01-01

165

Atmospheric Aerosol Size Distribution at Sumas Mountain, Vancouver, BC  

Microsoft Academic Search

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.

T. W. Chan; M. Mozurkewich

2002-01-01

166

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

167

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

168

Optimizing triage and hospitalization in adult general medical emergency patients: the triage project  

PubMed Central

Background Patients presenting to the emergency department (ED) currently face inacceptable delays in initial treatment, and long, costly hospital stays due to suboptimal initial triage and site-of-care decisions. Accurate ED triage should focus not only on initial treatment priority, but also on prediction of medical risk and nursing needs to improve site-of-care decisions and to simplify early discharge management. Different triage scores have been proposed, such as the Manchester triage system (MTS). Yet, these scores focus only on treatment priority, have suboptimal performance and lack validation in the Swiss health care system. Because the MTS will be introduced into clinical routine at the Kantonsspital Aarau, we propose a large prospective cohort study to optimize initial patient triage. Specifically, the aim of this trial is to derive a three-part triage algorithm to better predict (a) treatment priority; (b) medical risk and thus need for in-hospital treatment; (c) post-acute care needs of patients at the most proximal time point of ED admission. Methods/design Prospective, observational, multicenter, multi-national cohort study. We will include all consecutive medical patients seeking ED care into this observational registry. There will be no exclusions except for non-adult and non-medical patients. Vital signs will be recorded and left over blood samples will be stored for later batch analysis of blood markers. Upon ED admission, the post-acute care discharge score (PACD) will be recorded. Attending ED physicians will adjudicate triage priority based on all available results at the time of ED discharge to the medical ward. Patients will be reassessed daily during the hospital course for medical stability and readiness for discharge from the nurses and if involved social workers perspective. To assess outcomes, data from electronic medical records will be used and all patients will be contacted 30 days after hospital admission to assess vital and functional status, re-hospitalization, satisfaction with care and quality of life measures. We aim to include between 5000 and 7000 patients over one year of recruitment to derive the three-part triage algorithm. The respective main endpoints were defined as (a) initial triage priority (high vs. low priority) adjudicated by the attending ED physician at ED discharge, (b) adverse 30 day outcome (death or intensive care unit admission) within 30 days following ED admission to assess patients risk and thus need for in-hospital treatment and (c) post acute care needs after hospital discharge, defined as transfer of patients to a post-acute care institution, for early recognition and planning of post-acute care needs. Other outcomes are time to first physician contact, time to initiation of adequate medical therapy, time to social worker involvement, length of hospital stay, reasons for discharge delays, patient’s satisfaction with care, overall hospital costs and patients care needs after returning home. Discussion Using a reliable initial triage system for estimating initial treatment priority, need for in-hospital treatment and post-acute care needs is an innovative and persuasive approach for a more targeted and efficient management of medical patients in the ED. The proposed interdisciplinary , multi-national project has unprecedented potential to improve initial triage decisions and optimize resource allocation to the sickest patients from admission to discharge. The algorithms derived in this study will be compared in a later randomized controlled trial against a usual care control group in terms of resource use, length of hospital stay, overall costs and patient’s outcomes in terms of mortality, re-hospitalization, quality of life and satisfaction with care. Trial registration ClinicalTrials.gov Identifier, NCT01768494 PMID:23822525

2013-01-01

169

VANCOUVER FOREST REGION 2100 LABIEUX ROAD  

E-print Network

VANCOUVER FOREST REGION 2100 LABIEUX ROAD NANAIMO BC V9T 6E9 We s t e r n Wa h o o ( E u o n y m u s o c c i d e n t a l i s N u t t a l l e x To r r e y ) i n B r i t i s h C o l u m b i a Report to. Adolf Ceska, provided information about Western Wahoo and its location in British Columbia. Access

170

Service quality in the health care industry: how are hospitals evaluated by the general public?  

PubMed

This paper investigates the "expectations" aspect of service quality in the health care industry. Specifically, an examination is made of the importance of various hospital characteristics to consumers, the dimensionality of service quality, and the relative importance of these dimensions across demographic groups. The results suggest that the competency and the behavior of physicians are the most important characteristics in the minds of consumers. Moreover, it was found that hospitals are evaluated along: (1) interpersonal, (2) amenities, (3) capabilities, and (4) accessibility dimensions. These findings are consistent with previous research in this regard. Additionally, significant differences in the importance of these factors were found across respondent gender, age, income, and education. PMID:10125829

Elliott, K M; Hall, M C; Stiles, G W

1992-01-01

171

[Appropriate use of antibiotics--practices we should employ now: appropriate use of antibiotics for pharmacists in general hospitals].  

PubMed

An authorization system regarding infection has been devised for various occupations in the field of infection control. An infection control team (ICT) consists of authorized, specialized staff, and plays an important role in clinical practice, considering the appropriate use of antibiotics. Board-certified infection control pharmacy specialists also belong to this team. The appropriate use of antibiotics, which I emphasize, indicates the absence of the inappropriate selection of broad-spectrum agents and chronic administration, considering the following 3 points: the selection of antibiotics whose spectra involve causative bacteria (drug sensitivity), prescription of antibiotics using an appropriate administration method/dose based on their transfer to the infected site (pharmacokinetics), and relief of symptoms of infectious diseases (therapeutic effects). In this study, we introduce cases of pharmacists' intervention in Nakamura Memorial South Hospital with respect to the appropriate use of antibiotics by general hospital pharmacists. The contents of pharmacists' intervention included accompanying physicians on their rounds/support regarding prescription, therapeutic drug monitoring, the preparation of guidelines for the hospital use of antibiotics, culture data collection/preparation of antibiograms, ICT/Infection Control Committee (ICC) activities, hospital rounds, preparation of antibiotic injections, and gram staining of sputum. In the future, health care professionals should always consider the appropriate use of antibiotics, contributing to a medical environment in which current options can be maintained for future infectious disease treatment. PMID:20715514

Yamada, Kazunori

2010-07-01

172

Dental treatment for patients with physical or mental disability under general anesthesia at Tokyo Dental College Suidobashi Hospital.  

PubMed

Dental treatment for patients with physical or mental disability is often performed under general anesthesia due to level of cooperation with treatment, type and location of treatment, time required, or number of times patient is required to attend hospital. University hospitals are receiving an increasing number of requests from local private dentists and dental clinics to provide dental care for patients with physical or mental disability which can only be performed under general anesthesia. We carried out a retrospective survey of the routes of referral and types of dental treatment carried out in such patients under general anesthesia at Tokyo Dental College Suidobashi Hospital. The survey covered a 5-year, 9-month period from April 2006 to December 2011, during which 163 patients, comprising 106 men and 57 women, were treated. Their age ranged widely, from 2 to 53 years, with a high proportion (118 patients, 72.4%) being minors aged under 20. Among the total number of patients, 69 (42.3%) had disorders associated with mental retardation. One hundred and two patients (62.6%) had been referred from other medical institutions, with a particularly high number coming from public dental clinics for patients specializing in such patients. Conservative restorative procedures were performed in most cases (59.4%), with composite resin restorations being particularly frequent. After treatment, many patients returned to their referring medical institutions, which were responsible for subsequent management, but information on the posttreatment status was not available for some patients. Tokyo Dental College Suidobashi Hospital frequently collaborates with local medical institutions, and the present results suggest the importance of improving such collaboration. PMID:23318923

Ohtawa, Yumi; Tsujino, Keiichiro; Kubo, Shuhei; Ikeda, Masakazu

2012-01-01

173

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 ...

174

The role of the clinical psychologist on a burn unit in a general teaching hospital  

Microsoft Academic Search

This paper reviews the core skills that a clinical psychologist brings to a burn unit and suggests a model for optimal psychological management of burn patients, families, and staff. Recovery from a burn injury involves three stages that comprise (a) acute treatment of severe medical complications, (b) adjustment to hospitalization, and (c) long-term rehabilitation. Each stage contains numerous issues that

Richard A. Bryant; Stephen W. Touyz

1996-01-01

175

Hospital procedure volume and teaching status do not influence treatment and outcome measures of rectal cancer surgery in a large general population  

Microsoft Academic Search

A clear benefit of increased hospital procedure volume or teaching hospital status on outcomes of rectal cancer surgery has\\u000a yet to be shown. Few have examined treatment differences that may lead to varying outcomes. This study assessed the impact\\u000a of hospital procedure volume and teaching status on both treatment and outcome measures of rectal cancer surgery in a large\\u000a general

Marko Simunovic; Teresa To; Nancy Baxter; Andrew Balshem; Eric Ross; Zane Cohen; Robin McLeod; Paul Engstrom; Elin Sigurdson

2000-01-01

176

The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards  

PubMed Central

Aims Accurate recording of medication histories in hospital medical records (HMR) is important when patients are admitted to the hospital. Lack of registration of drugs can lead to unintended discontinuation of drugs and failure to detect drug related problems. We investigated the comprehensiveness of medication histories in HMR with regard to prescription drugs by comparing the registration of drugs in HMR with computerized pharmacy records obtained from the community pharmacy. Methods Patients admitted to the general ward of two acute care hospitals were included in the study after obtaining informed consent. We conducted an interview on drugs used just prior to hospitalization and extracted the medication history from the HMR. Pharmacy records were collected from the community pharmacists over a 1 year period before the admission. Drugs in the pharmacy records were defined as possibly used (PU-drugs) when they were dispensed before the admission date and had a theoretical enddate of 7 days before the admission date or later. If any PU-drug was not recorded in the HMR, we asked the patient whether they were using that drug or not. Results Data were obtained from 304 patients who had an average age of 71 (range 40–92) years. The total number of drugs according to the HMR was 1239, 43 of which were not used. When compared with the pharmacy records we found an extra 518 drugs that were not recorded in the HMR but were possibly in use. After verification with the patients, 410 of these were indeed in use bringing the total number of drugs in use to 1606. The type of drugs in use but not recorded in the HMR covered a broad spectrum and included many drugs considered to be important such as cardiovascular drugs (n = 67) and NSAIDs (n = 31). The percentages of patients with 0, 1, 2, 3, 4, 5–11 drugs not recorded in the HMR were 39, 28, 16, 8, 3.6 and 5.5, respectively. Of the 1606 drugs in use according to information from all sources, only 38 (2.4%) were not retrievable in the pharmacy records when the complete year prior to hospitalization was evaluated. Conclusions The medication history in the hospital medical record is often incomplete, as 25% of the prescription drugs in use is not recorded and 61% of all patients has one of more drugs not registered. Pharmacy records from the community pharmacist can be used to obtain more complete information on the medication history of patients admitted to the hospital. PMID:10848724

Lau, Hong Sang; Florax, Christa; Porsius, Arijan J; de Boer, Anthonius

2000-01-01

177

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

178

The Vancouver Obsessional Compulsive Inventory (VOCI).  

PubMed

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 of obsessions, compulsions, avoidance behaviour, and personality characteristics of known or theoretical importance in obsessive-compulsive disorder (OCD). The development of the VOCI is described, and we provide evidence of its reliability and validity. Our findings in samples of people with OCD, people with other anxiety disorders or depression, community adults, and undergraduate students suggest that the VOCI is a promising new measure. We anticipate that, like its predecessor, the VOCI will have widespread use in both research and clinical settings. PMID:15381439

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

2004-11-01

179

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

PubMed Central

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

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

2015-01-01

180

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

PubMed

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

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

2015-04-01

181

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

182

General surgery in a district hospital in Tajikistan: clinical impact of a partnership between visiting volunteers and host specialists  

PubMed Central

After the collapse of the Soviet Union and 5 years of civil war, health care services in Tajikistan are in disarray. Nongovernmental organizations are playing a key role in recovery programs. A group of volunteer physicians from the West went to Khorog General Hospital in the Pamiri mountains to establish a dialogue with their physician counterparts, recommend evidence-based best practice appropriate for local conditions, and reintroduce a culture of continuing medical education. The arrangements included a group visit to Khorog for 3 weeks annually over 3 years. In this article we describe the experiences of the 2 general surgeons attached to the group in the second year and the status of the partnership1 year later. PMID:14577704

Kassum, Diamond A.; Valji, Azim; Gulyazov, Shodi

2003-01-01

183

The completeness of medication histories in hospital medical records of patients admitted to general internal medicine wards: Completeness of medication in hospital medical records  

Microsoft Academic Search

Aims Accurate recording of medication histories in hospital medical records (HMR) is important when patients are admitted to the hospital. Lack of registration of drugs can lead to unintended discontinuation of drugs and failure to detect drug related problems. We investigated the comprehensiveness of medication histories in HMR with regard to prescription drugs by comparing the registration of drugs in

Hong Sang Lau; Christa Florax; Arijan J. Porsius; Anthonius De Boer

2001-01-01

184

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

PubMed

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

Lääperi, A L

1996-01-01

185

Clinical and demographic characteristics of adult emergency patients at the Taipei Veterans General Hospital.  

PubMed

In order to establish a database dealing with the clinical and demographic characteristics of an emergency department (ED) in a large teaching hospital, a prospective chart review study was conducted from April to September 1991. Attendance charts for the medical emergency room (MER) and surgical emergency room (SER) were checked and necessary information was entered in the computer. The information headings were triage classification, registration time, time to be seen, patient disposition, and impression. Of the 7,086 patients tracked in MER and 4,545 in SER, 3.5% vs 1.5% were classified as triage 1; 14.69% vs 9.48%, triage 2; 69.42% vs 79.22%, triage 3; and 12.41% vs 9.79%, triage 4. There were two peak hours (09:00 to 12:00 and 19:00 to 21:00) in MER, and one (16:00 to 17:00) in SER. The driving force behind these peak times was considered. The leading 15 diseases or chief complaints in MER and 20 in SER were described, showing that ED overcrowding was caused by the number of chronic diseases presented in MER. The broad based clinical and demographic characteristics of emergency patients were analyzed. A further study is warranted in order to improve the quality of care of patients visiting this unique ED. PMID:7915584

Hu, S C

1994-01-01

186

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

187

Characteristics of patients with definite septic arthritis at Hamad General Hospital, Qatar: a hospital-based study from 2006 to 2011.  

PubMed

The aim of this retrospective study was to determine the epidemiological and clinical characteristics, coexisting conditions, causative organisms, and outcomes of all adult patients 15 years of age or older who had definite septic arthritis at Hamad General Hospital, Qatar, from 2006 to 2011. During this period, 56 patients were diagnosed with septic arthritis (mean age ± SD, 49.0 ± 16.6 years). In 53 of 56 (94.6%) patients, arthritis was diagnosed in a single joint, while polyarthritis was diagnosed in 3 of 56 (5.4%) patients; the most commonly involved joint was the knee (40 of 59 joints, 67.7%). The most frequent coexisting condition was diabetes mellitus (24 of 56 patients, 42.8%). Joint pain and restriction of movement were reported by all patients. Gram-positive bacteria accounted for 36 of all 57 (63.0%) isolated microorganisms, and Staphylococcus aureus was the most common pathogen (20 of 57 microorganisms, 35.0%). Three cases of tuberculous arthritis were seen. The most favored antibiotic combinations were cloxacillin/ciprofloxacin, cefazolin/ciprofloxacin, and vancomycin/ciprofloxacin. Repeated needle aspiration, open joint drainage, and arthroscopic techniques were performed in 18 (32.1%), 22 (39.3%), and 11 (19.6%) of the 56 patients, respectively. The 30-day mortality was 3.6%, and the remaining patients showed clinical improvement upon discharge. In conclusion, there was no specific sign or symptom for diagnosing septic arthritis. Isolation of bacteria from the synovial fluid confirmed the diagnosis, and S. aureus and streptococci were the most common pathogens isolated. Prompt treatment with appropriate antibiotics and synovial drainage are mandatory to improve the outcome. PMID:23404237

Khan, Fahmi Yousef; Abu-Khattab, Mohammed; Baagar, Khalid; Mohamed, Shehab Fareed; Elgendy, Islam; Anand, Deshmukh; Malallah, Hani; Sanjay, Doiphode

2013-07-01

188

[Treatment outcome of alcoholics in a general hospital alcoholic clinic: effects of adopting moderation as a practical treatment goal].  

PubMed

It's almost 50 years since medical treatment for alcoholism began to be practiced in Japan in 1960s. Since then, treatment goal for alcohol use disorders has always been absolute abstinence, and only severe cases have been treated. Recently, many people are concerned about lifestyle-related diseases, suicides, depression, and drunken-driving accidents. Reduction in alcohol consumption of heavy drinkers began to draw attention, and brief motivational intervention study was launched at last in 2007 in Japan. In 2009 we set up alcohol clinic in a general hospital in order that the alcoholics may get easier access to their treatments. The basic roles of our alcohol satellite clinicare as follows: 1. Assessment and diagnosis of patient's alcohol-related problem are our primary role. 2. Referral to a specialized hospital is offered in case special treatments for alcohol dependence are needed. 3. Our standard treatment is a brief intervention, not exceeding 3 sessions, to enhance the patients' self-efficacy. 4. Our treatment goal is not limited to total abstinence. Moderation of drinking can also be a goal. We examined the treatment outcome to verify these roles and meanings. Of all the patients visited this hospital from 2009 to 2011, 77 patients were diagnosed as alcohol dependent. Out of those 77 patients, 21 patients set up a moderation of drinking as their temporal treatment goal and 10 achieved good outcome at the inquiry point of 8 to 41 (average: 22) months after intervention. This result suggests that moderation can be a practical treatment goal in some alcoholics. PMID:23659005

Muto, Takeo; Sunami, Takashi; Cho, Sachiko; Miyashita, Aya; Tsurumaru, Aiko; Yuzuriha, Takefumi

2013-02-01

189

A randomised trial deploying a simulation to investigate the impact of hospital discharge letters on patient care in general practice  

PubMed Central

Objective To determine how the timing and length of hospital discharge letters impact on the number of ongoing patient problems identified by general practitioners (GPs). Trial design GPs were randomised into four groups. Each viewed a video monologue of an actor-patient as he might present to his GP following a hospital admission with 10 problems. GPs were provided with a medical record as well as a long or short discharge letter, which was available when the video was viewed or 1?week later. GPs indicated if they would prescribe, refer or order tests for the patient's problems. Methods Setting Primary care. Participants Practising Australian GPs. Intervention A short or long hospital discharge letter enumerating patient problems. Outcome measure Number of ongoing patient problems out of 10 identified for management by the GPs. Randomisation 1:1 randomisation. Blinding (masking) Single-blind. Results Numbers randomised 59 GPs. Recruitment GPs were recruited from a network of 102 GPs across Australia. Numbers analysed 59 GPs. Outcome GPs who received the long letter immediately were more satisfied with this information (p<0.001). Those who received the letter immediately identified significantly more health problems (p=0.001). GPs who received a short, delayed discharge letter were less satisfied than those who received a longer delayed letter (p=0.03); however, both groups who received the delayed letter identified a similar number of health problems. GPs who were older, who practised in an inner regional area or who offered more patient sessions per week identified fewer health problems (p values <0.01, <0.05 and <0.05, respectively). Harms Nil. Conclusions Receiving information during patient consultation, as well as GP characteristics, influences the number of patient problems addressed. Trial registration number ACTRN12614000403639. PMID:25005597

Jiwa, Moyez; Meng, Xingqiong; O'Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita

2014-01-01

190

General Approach to High-Efficiency Simulation of Affinity Capillary Electrophoresis  

E-print Network

General Approach to High-Efficiency Simulation of Affinity Capillary Electrophoresis Ning Fang and David D. Y. Chen* Department of Chemistry, University of British Columbia, Vancouver, British Columbia

Chen, David D.Y.

191

Psychiatry residents’ opinions of a substance abuse rotation in a VA hospital general internal medicine unit  

Microsoft Academic Search

Written optional evaluation forms were devised to gather psychiatry residents’ opinions regarding their substance use disorder rotation in a general internal medicine unit. Over a 4?year period 24 residents completed that rotation and 83% (N = 20) completed the form. Of the responding residents, 95% (N = 19) rated an above?average satisfaction with the rotation and 90% (N = 18)

Hani Raoul Khouzam

2000-01-01

192

Psychiatry Residents' Opinions of a Substance Abuse Rotation in a VA Hospital General Internal Medicine Unit  

Microsoft Academic Search

Written optional evaluation forms were devised to gather psychiatry residents' opinions regarding their substance use disorder rotation in a general internal medicine unit. Over a 4-year period 24 residents completed that rotation and 83% (N = 20) completed the form. Of the responding residents, 95% (N = 19) rated an above-average satisfaction with the rotation and 90% (N = 18)

HaniRaoul Khouzam

2000-01-01

193

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

194

Left in the lurch. With Corrigan's recusal from hospital cases, HHS' inspector general's office has a gap at the top after months of indecision.  

PubMed

The nation's chief healthcare fraud-fighting unit felt another tremor when HHS Principal Deputy Inspector General Dara Corrigan, left, announced she is recusing herself from cases involving hospitals because she is job-hunting, Sen. Chuck Grassley called for the quick appointment of a permanent inspector general. PMID:15216609

Taylor, Mark

2004-06-01

195

Is Organizational Change Associated With Increased Rates of Readmission to General Hospital in Suicide Attempters? A 10Year Prospective Catchment Area Study  

Microsoft Academic Search

The objective of this study was to examine predictors for readmissions in patients admitted to a general hospital emergency ward for suicide attempts before and after organizational changes potentially affecting the chain of care. Socio-demographic and clinical variables were collected by clinicians from 1997 thru 2007. Data from the periods before and after 2004—when the hospital changed its catchment area—were

Lars Mehlum; Trond Jřrgensen; Lien My Diep; Latha Nrugham

2010-01-01

196

Low frequency earthquakes below southern Vancouver Island  

NASA Astrophysics Data System (ADS)

The nature and distribution of low frequency earthquakes (LFEs) in subduction zones provide insight into plate boundary deformation downdip of the locked seismogenic zone. We employ network autocorrelation detection to identify LFE families beneath southern Vancouver Island and environs. An initial suite of 5775 LFEs detected in 2004 and 2005 at a select set of 7 stations is grouped into 140 families using waveform cluster analysis. These families are used as templates within an iterative network cross correlation scheme to detect LFEs across different tremor episodes, incorporate new stations, and improve LFE template signal-to-noise ratio. As in southwest Japan, representative LFE locations define a relatively tight, dipping surface several km above the locus of intraslab seismicity, within a prominent, dipping low-velocity zone (LVZ). LFE polarizations for near-vertical source-receiver geometries possess a remarkably uniform dipolar signature indicative of point-source, double-couple excitation. Focal mechanisms determined fromP-wave first motions are characterized by a combination of strike-slip and thrust faulting. We suggest that LFEs and regular intraslab seismicity occur in distinct structural and stress regimes. The LVZ, inferred to represent weak, overpressured, porous and mylonitized metabasalts of oceanic crustal Layer 2, separates LFEs manifesting deformation within a plate boundary shear zone from intraslab earthquakes generated by tensional stresses and dehydration embrittlement within a more competent lower oceanic crustal Layer 3 and underlying mantle.

Bostock, M. G.; Royer, A. A.; Hearn, E. H.; Peacock, S. M.

2012-11-01

197

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. PMID:25678810

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

2015-01-01

198

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

199

Hospitality Management Hospitality Management  

E-print Network

Hospitality Management Hospitality Management Norm Faiola, Chair, 315-443-1710 Lyman Hall Faculty PROGRAM The Department of Hospitality Management requires a diversity of skills from many disciplines of the global hospitality industry. Academic Offerings HOSPITALITY AND FOOD SERVICE MANAGEMENT MINOR HOSPITALITY

McConnell, Terry

200

005. History of the recently established bronchoscopy unit of the pulmonology clinic of lamia’s general hospital  

PubMed Central

Objective The Bronchoscopy Unit of General Hospital of Lamia provides the necessity of six counties in Thessalia and Central Greece. The first bronchoscopy was performed during Christmas of 2012 while from the opening (February 14th, 2014), the unit is presenting an increasing activity (in number and variety of medical practice). Methods From December 21st in 2012 to September 15th in 2014, were performed 158 bronchoscopic examinations in 152 patients (hospitalized and outpatients), 130 men and 28 women, with an average age 72.4 (29 to 89) years old. There were accomplished 80 biopsies (bronchial, transbronchial), 83 brushing, collected 57 cultures for common bacteria and 86 for och-bacilli (acid-fast microscopy in 12), 20 conventional transbronchial needle aspiration (TBNA), two transbronchial biopsies, seven BAL, 25 bronchial toilets in elderly patients and were removed two foreign bodies (one bone segment surrounding by granulomatous tissue and one segment of animal bowel-“kokoretsi”). Results We observed gradual increase of the incoming patients [Quarterly: 5(1st-3rd/2013), 14(4th-6th/2013), 17(7th-9th/2013), 21(10th-12th/2013), 32(1st-3rd/2014), 38(4th-6th/2014), 31(6th-Middle 9th/2014)]. There were diagnosed 70 cases of lung cancer in 93 patients (75.3%) {12 small cell lung carcinoma (SCLC), 57 non-small cell lung carcinoma (NSCLC) [28 squamous, 25 adenocarcinomas, one combo (adeno- and squamous carcinoma), one BAC ??? two suspicious samples for cancer]}. 49/49 were diagnosed in evident endobronchial lesion (100%) and 21/44 in non-revealing bronchoscopy (47.8%). Biopsy confirmed diagnosis in 52/93, brushing in 31/93, ???? alone in 4/8 while washing alone in 3/93 patients. Five cases of active tuberculosis were diagnosed (4 M. ?uberculosis, 1 M. Smegmatis), two cases of sarcoidosis, one metastatic (uroepithelial) carcinoma, four cases of granulomatic tissue, one lipoid pneumonia, one sarcomatoid carcinoma of the lung, while the cultures isolated two samples with Pseudomonas A., two with Klebsiella sp., one with Acinetobacter ?., two with ?spergillus F., two with Nocardia A., and one with Haemophilus Infl. Conclusions The Broncoscopy Unit of General Hospital of Lamia attempts to help (in the basis of science and documented literature) patients of central Greece at the increasing need for endoscopic intervention and diagnosis of diseases of respiratory system, in paths of modern, interventional pulmonology.

Manos, Emmanouil; Gkika, Dimitrs; Kolovos, Dimitrios; Giannakou, Georgia; Pathiaki, Eirini; Mavromati, Evagelia; Divani, Smaroula; Vardouli, Anna; Tsiligrou, Vaina; Karkanis, Konstantinos; Angel, Jacob

2015-01-01

201

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.

202

Respiratory Syncytial Virus Hospitalizations Among American Indian and Alaska Native Infants and the General United States Infant Population  

Microsoft Academic Search

ABSTRACT. Objective. To determine the burden of respiratory syncytial virus (RSV) disease among Ameri- can Indian (AI) and Alaska Native (AN) infants, by ex- amining RSV-associated hospitalizations. Methods. Infant hospitalizations from 1997 through 2001 with RSV listed as a diagnosis were selected by using Indian Health Service\\/tribal hospital discharge data for AIs\\/ANs and National Hospital Discharge Sur- vey data for

Robert C. Holman; Aaron T. Curns; Mph James E. Cheek; Mph Joseph S. Bresee; Rosalyn J. Singleton; Mph Karen Carver; Larry J. Anderson

203

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

204

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.

205

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.

206

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

E-print Network

Factors limiting the early survivorship of Thuja plicata on northern Vancouver Island, British redcedar (Thuja plicata Donn ex D. Don), a late successional species on northern Vancouver Island, has thuya (Thuja plicata Donn ex D. Don), une espčce de fin de succession dans le Nord de l'île de Vancouver

Gilbert, Benjamin

207

Emergency department visit rates and patterns in Canada's Vancouver coastal health region.  

PubMed

This study used administrative health data to describe emergency department (ED) visits by residents from assisted living and nursing home facilities in the Vancouver Coastal Health region, British Columbia. We compared ED visit rates, the distribution of visits per resident, and ED dispositions of the assisted living and nursing home populations over a 3-year period (2005-2008). There were 13,051 individuals in our study population. Visit rates (95% confidence interval) were 124.8 (118.1-131.7) and 64.1 (62.9-65.3) visits per 100 resident years in assisted living and nursing home facilities respectively. A smaller proportion of ED visits by assisted living residents resulted in hospital admission compared to nursing home residents (45% vs. 48%, p < .01). The ED visit rate among assisted living residents is significantly higher compared to that among nursing home residents. Future research is needed into the underlying causes for this finding. PMID:24690211

McGregor, Margaret J; McGrail, Kimberlyn M; Abu-Laban, Riyad B; Ronald, Lisa A; Baumbusch, Jennifer; Andrusiek, Douglas; Cox, Michelle B

2014-06-01

208

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

209

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

PubMed Central

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

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

2015-01-01

210

Self-reported prevalence and severity of xerostomia and its related conditions in individuals attending hospital for general health examinations.  

PubMed

The aim of this study was to investigate the prevalence, severity, and relationships between xerostomia and its related symptoms in individuals who attended hospital for general health examinations. Participants included 883 men and 618 women aged between 30 and 60 years. History of symptoms during the previous 6 months, current symptoms, and severity of current symptoms were evaluated using a questionnaire that included questions about xerostomia, burning mouth, taste disturbance, and oral malodor. The prevalence of xerostomia and its related symptoms was 60.2%; the prevalence of oral malodor was 52.3%, xerostomia 33.0%, burning mouth 13.6%, and taste disturbance 12.5%. Men in their 30s and women in their 60s showed significantly higher prevalence and greater severity of xerostomia, burning mouth, and taste disturbance compared with their counterparts. The prevalence of xerostomia, burning mouth, and taste disturbance, and the severity of xerostomia increased significantly with age in women. The prevalence and severity of these four symptoms were significantly related and the association was the highest between burning mouth and taste disturbance. In conclusion, xerostomia and its related symptoms were highly prevalent at all ages. The prevalence and severity of these symptoms were closely related. PMID:24238864

Lee, E; Lee, Y-H; Kim, W; Kho, H-S

2014-04-01

211

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

212

Antibody screening & identification in the general patient population at a tertiary care hospital in New Delhi, India  

PubMed Central

Background & objectives: The development of alloantibodies can significantly complicate transfusion therapy and results in difficulties in cross-matching of blood. Most literature on alloimmunization is limited to multitransfused individuals, with very few studies on the general hospital patients. This study was aimed at assessing the frequency and type of unexpected red cell antibodies in the general patient population at a multispecialty tertiary care centre in New Delhi, India. Methods: The results of 49,077 antibody screening tests carried out on patients, from January 2009 to December 2012 were analyzed. The clinical and transfusion records were reviewed. The data were compiled and statistically analysed. Results: A total of 49,077 (29,917; 60.96% males and 19,160; 39.04% females) patient samples were screened for the presence of unexpected antibodies. Antibody screening was positive in 403 patients (0.82%). In the serum samples of 164 patients only autoantibodies were identified, 27 revealed autoantibodies with one or more underlying alloantibodies, while 212 patients had only alloantibody/ies in their serum. The overall alloimmunization rate was 0.49 per cent. Antibodies against the Rh system were the most frequent (64.1%), the most common alloantibody identified being anti E (37.2%), followed by anti D (19.2%). Interpretation & conclusions: Since clinically significant antibodies are frequently detected in our patient population, antibody screening and if required, identification is the need of the hour. Since antibodies against the common Rh and Kell blood group antigens are the most frequent, provision of Rh and Kell matched red cells may be of protective value. PMID:25366208

Makroo, Raj Nath; Bhatia, Aakanksha; Hegde, Vikas; Chowdhry, Mohit; Thakur, Uday Kumar; Rosamma, N.L.

2014-01-01

213

Massachusetts General Hospital  

Cancer.gov

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

214

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.

215

Massachusetts General Hospital  

Cancer.gov

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

216

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

217

Medical withdrawal management in Vancouver: Service description and evaluation  

Microsoft Academic Search

This study evaluates a medically managed inpatient detoxification service (Vancouver Detox (VD)) and investigates its clients' characteristics over a 1-year period. We present information on the daily operation at VD, and examine accessibility and efficiency of it from five perspectives: wait time, pretreatment attrition rate, treatment completion rate, length of stay (LOS), and occupancy rate (OR). In addition, we explore

Xin Li; Huiying Sun; Ajay Puri; David C. Marsh; Aslam H. Anis

2007-01-01

218

RISK MANAGEMENT FOR URBAN FLOW SLIDES IN NORTH VANCOUVER, CANADA  

Microsoft Academic Search

In the early morning of January 19, 2005, heavy rainfall triggered a rapid fill-slope failure at the crest of an escarpment in the District of North Vancouver, Canada. The landslide destroyed two homes, killing one person and seriously injuring another. Following the landslide, a program was implemented to quantify and manage the risk of loss of life arising from future

Michael Porter; Matthias Jakob; K. Wayne Savigny; Samuel Fougere

219

Fifty-Five Solvers in Vancouver: The SAT 2004 Competition  

E-print Network

Fifty-Five Solvers in Vancouver: The SAT 2004 Competition Daniel Le Berre1 and Laurent Simon2 1@lri.fr Abstract. For the third consecutive year, a SAT competition was orga- nized as a joint event with the SAT conference. With 55 solvers from 25 author groups, the competition was a clear success. One of the noticeable

Paris-Sud XI, Université de

220

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 (BMPs) for water conservation are used as evaluative criteria. These BMPs were drawn from California's urban water conservation system. This researched examines 4 case study municipalities from the GVRD

221

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

222

Sports medicine and coaching inseparable interests for Vancouver physician.  

PubMed Central

Dr. Doug Clement of Vancouver has devoted his career to sports medicine and the development of athletes. The former Olympic athlete keeps busy as codirector of the Sports Medicine Clinic and professor of medicine at the University of British Columbia, and as coach and mentor to several world-class runners. Images p328-a PMID:7614448

Newman, S

1995-01-01

223

Beyond Chinatown: The English Language Needs of Vancouver's Chinese Community  

ERIC Educational Resources Information Center

There are insufficient resources for providing instruction in English as a second or additional language for Vancouver's Chinese-speaking adult population. A pilot program designed to reach this population is described. The first volume of the series "Practical English," used in San Francisco, was revised for the pilot project. (SW)

Berwick, Richard; And Others

1978-01-01

224

Vancouver Community College Educational Plan, 1988-1993.  

ERIC Educational Resources Information Center

Vancouver Community College's (VCC's) educational plan for 1988-93 is set forth in this document. First, an outline is presented of VCC's current planning initiatives, including efforts related to controlled enrollment expansion, the demand for part-time studies, instructional quality, facility expansion, instructional innovation, management…

Gallagher, Paul

225

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

226

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

E-print Network

a higher rate of hospitalization and mortality. · Reduced exercise capacity1,2 ­ identifies those patients with increased risk for hospitalization and death. · Decreased exercise capacity is often attributed to an underlying cardiac etiology. · Abnormal lung function with restrictive lung disease pattern is also common

227

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

228

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

229

Extraintestinal Salmonellosis in a General Hospital (1991 to 1996): Relationships between Salmonella Genomic Groups and Clinical Presentations  

PubMed Central

Episodes of extraintestinal salmonellosis treated at a general hospital (1,522 beds) over a 6-year period (1991 to 1996) were characterized by the analysis of phenotypic and genotypic traits of Salmonella organisms and clinical data from medical reports. Extraintestinal salmonellosis accounted for 8% of all salmonellosis episodes. Fifty-two medical reports, dealing with 6 cases of typhoid fever, 32 cases of bacteremia, and 14 focal infections, were reviewed. All cases of typhoid fever except 1, 7 cases of bacteremia, and 5 focal infections were not related to any underlying disease or predisposing factors, while 25 cases of bacteremia and 9 focal infections were associated with some of these risk factors. All typhoid isolates and 65.4% of the nontyphoid isolates were susceptible to antimicrobials. Fifty-one nontyphoid strains were analyzed and assigned to 21 genomic groups, which were defined by serotype, combined ribotype, and combined randomly amplified polymorphic DNA type (each genomic group could include organisms differing in some phenotypic traits). The relationships between genomic groups and clinical presentations were traced. Organisms causing 22 episodes (17 episodes of bacteremia, 2 of pneumonia, 1 of peritonitis, 1 of pyelonephritis, and 1 of cystitis) belonged to a prevalent Salmonella enterica serotype Enteritidis genomic group, which included organisms assigned to four phage types, five biotypes, and four resistance patterns, causing infections in patients with and without risk factors. Seven other genomic groups, 4 Enteritidis groups (associated with both bacteremia and focal infections), 2 Typhimurium groups (one associated with bacteremia and the other with focal infections) and 1 Brandenburg group (associated with bacteremia) included two or more strains, and the remaining 13 genomic groups consisted of only one strain each. PMID:9774581

Rodríguez, Mercedes; de Diego, Isabel; Mendoza, M. Carmen

1998-01-01

230

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

231

Satisfaction survey in general hospital personnel involved in blood transfusion: implementation of the ISO 9001: 2000 standard.  

PubMed

As part of its policy of constant quality improvement, Etablissement francais du sang (EFS) des pays de la Loire (Pays de la Loire Regional Blood Transfusion Centre) carried out a satisfaction survey among the hospital personnel involved in prescribing and using immunohaematological tests and labile blood products (LBP). The polling tool selected by agreement between the Saint Nazaire's hospital management and Quality Assurance (QA) Department was a questionnaire that permitted item rating and free commentary. It addressed the personnel's perception of the quality of erythrocyte immunohaematological (EIH) testing and of the products administered, as well as their perception of the quality of communications with the local EFS. The questionnaire was sent to 26 physicians and 32 senior nurses in 15 hospital departments. The reply rate was 60% and expressed an 85% overall satisfaction level. Dissatisfaction causes were more specifically analysed, the main one involving LBP distribution in emergency situations. A joint undertaking by the EFS and the hospital led to the implementation of corrective measures, including the writing and implementation of a common standard operating procedure for emergency transfusion management. The results obtained demonstrated the feasibility of this type of survey and the interest, to a blood transfusion centre and the hospital personnel involved in transfusion, of assessing their very own perception of service quality. PMID:15564097

Chord-Auger, S; Tron de Bouchony, E; Moll, M C; Boudart, D; Folléa, G

2004-10-01

232

[Satisfaction survey in general hospital personnel involved in blood transfusion: implementation of the ISO 9001: 2000 standard].  

PubMed

As part of its policy of constant quality improvement, Etablissement Français du Sang (EFS) des Pays de la Loire (Pays de la Loire Regional blood transfusion institution) carried out a satisfaction survey among the hospital personnel involved in prescribing and using immuno-hematological tests and labile blood products. The polling tool selected by agreement between the hospital management and quality assurance department was a questionnaire that permitted item rating and free commentary. It addressed the personnel's perception of the quality of erythrocyte immuno-hematological (EIH) testing and of the products administered, as well as their perception of the quality of communications with the local EFS. The questionnaire was sent to 26 physicians and 32 senior nurses in 15 hospital departments. The reply rate was 60% and expressed a 85% overall satisfaction level. Dissatisfaction causes were more specifically analysed, the main one involving labile blood product distribution in emergency situations. A joint undertaking by the EFS and the hospital led to the implementation of corrective measures, including the writing and implementation of a common standard operating procedure for emergency transfusion management. The results obtained demonstrated the feasibility of this type of survey and the interest, to a blood transfusion centre and the hospital personnel involved in transfusion, of assessing their very own perception of service quality. PMID:15488729

Chord-Auger, S; de Bouchony, E Tron; Moll, M-C; Boudart, D; Folléa, G

2004-07-01

233

Adherence of Surgeons to Antimicrobial Prophylaxis Guidelines in a Tertiary General Hospital in a Rapidly Developing Country  

PubMed Central

Objectives. To assess the standard practice of care of surgeons regarding surgical antibiotic prophylaxis, to identify gaps, and to set recommendations. Methods. A retrospective analysis of data obtained from different surgical units in a single center in Qatar over a 3-month period in 2012. A total of 101 patients who underwent surgery and followed regimes for surgical prophylaxis as per hospital guidelines were included in the study. Results. The overall use of antibiotic was 89%, whereas the current practice did not match the recommended hospital protocols in 53.5% of cases. Prolonged antibiotics use (59.3%) was the commonest reason for nonadherence followed by the use of an alternative antibiotic to that recommended in the protocol (31.5%) and no prophylaxis was used in 9.2% of cases. The rate of compliance was significantly higher among clean surgery than clean contaminated group (P = 0.03). Forty-four percent of clean and 65% of clean-contaminated procedures showed noncompliance with the recommended surgical antimicrobial prophylaxis hospital guidelines. Conclusion. Lack of adherence to hospital protocols is not uncommon. This finding remains a challenge to encourage clinicians to follow hospital guidelines appropriately and to consistently apply the surgical antibiotic prophylaxis. The role of clinical pharmacist may facilitate this process across all surgical disciplines. PMID:24454349

Abdel-Aziz, Ahmed; El-Menyar, Ayman; Al-Thani, Hassan; Zarour, Ahmad; Asim, Mohammad; El-Enany, Rasha; Al-Tamimi, Haleema; Latifi, Rifat

2013-01-01

234

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

PubMed Central

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

Feng, Bin; Tan, Qingrong; Ji, Jianlin

2013-01-01

235

Erasing English Language Competency: African Migrants in Vancouver, Canada  

Microsoft Academic Search

This paper explores how the linguistic competency of English-speaking migrants from sub-Saharan Africa is challenged in Vancouver,\\u000a Canada. African migrants, particularly women, identify the problem of accent discrimination as a central feature of their\\u000a lives that results in systemic forms of inequality. Using Bourdieu’s concept of linguistic capital, the paper locates the\\u000a erasure of African migrants’ linguistic capital in the

Gillian Creese

2010-01-01

236

Community Arts Council of Vancouver Collection / Melva Dwyer (collector)  

E-print Network

1-1 1953 1-2 1954 1-3 1955 1-4 1956 1-5 1957 1-6 School of Music (1955-1957) 1-7 Committees (Standing) - Drama (1966-1968) 1-8 Committees (Standing) - Community Music (1968-1970) Special Projects 1-18 Censorship (1953) 1-19 Downtown Vancouver (1955-1976) 1-20 CAC Awards and Recognition British Columbia Art

Handy, Todd C.

237

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

238

Treeline Dynamics on Southern Vancouver Island, British Columbia  

Microsoft Academic Search

This paper describes the nature of treeline dynamics and upper-elevation tree establishment patterns on southern Vancouver Island, British Columbia. We examined tree growth, climate and seedling relationships at three upper-elevation locations using standard dendroecolog- ical approaches. Our data suggest that this habitat has experienced species-specific pulses of tree establishment that have had a major impact on the character of the

Colin P. Laroque; David H. Lewis; Dan J. Smith

239

Habitat Associations of Vancouver Island Water Shrews in Restored and Natural Stream Habitats  

Microsoft Academic Search

The Vancouver Island water shrew (Sorex palustris brooksi)1 is a rare subspecies found only on Vancouver Island, British Columbia. It is a riparian specialist, specially adapted to a semi-aquatic lifestyle and strongly associated with the land\\/water interface. Human-related activities on Vancouver Island have resulted in the loss or degradation of habitat for S. p. brooksi. Mitigation efforts aimed at stream

VANESSA J. CRAIG; STEVEN F. WILSON

240

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.

241

An alcohol-focused intervention versus a healthy living intervention for problem drinkers identified in a general hospital setting (ADAPTA): study protocol for a randomized, controlled pilot trial  

PubMed Central

Background Alcohol misuse is a major cause of premature mortality and ill health. Although there is a high prevalence of alcohol problems among patients presenting to general hospital, many of these people are not help seekers and do not engage in specialist treatment. Hospital admission is an opportunity to steer people towards specialist treatment, which can reduce health-care utilization and costs to the public sector and produce substantial individual health and social benefits. Alcohol misuse is associated with other lifestyle problems, which are amenable to intervention. It has been suggested that the development of a healthy or balanced lifestyle is potentially beneficial for reducing or abstaining from alcohol use, and relapse prevention. The aim of the study is to test whether or not the offer of a choice of health-related lifestyle interventions is more acceptable, and therefore able to engage more problem drinkers in treatment, than an alcohol-focused intervention. Methods/design This is a pragmatic, randomized, controlled, open pilot study in a UK general hospital setting with concurrent economic evaluation and a qualitative component. Potential participants are those admitted to hospital with a diagnosis likely to be responsive to addiction interventions who score equal to or more than 16 on the Alcohol Use Disorders Identification Test (AUDIT). The main purpose of this pilot study is to evaluate the acceptability of two sorts of interventions (healthy living related versus alcohol focused) to the participants and to assess the components and processes of the design. Qualitative research will be undertaken to explore acceptability and the impact of the approach, assessment, recruitment and intervention on trial participants and non-participants. The effectiveness of the two treatments will be compared at 6 months using AUDIT scores as the primary outcome measure. There will be additional economic, qualitative and secondary outcome measurements. Discussion Development of the study was a collaboration between academics, commissioners and clinicians in general hospital and addiction services, made possible by the Collaboration in Leadership in Applied Health Research and Care (CLAHRC) program of research. CLAHRC was a necessary vehicle for overcoming the barriers to answering an important NHS question – how better to engage problem drinkers in a hospital setting. Trial registration ISRCTN47728072 PMID:23782907

2013-01-01

242

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

E-print Network

monitoring of influenza CHRs over the long term can help characterize at-risk populations for different viral and the presence of risk factors for pandemic A(H1N1) complications. RESULTS. The average PRH over the seasons 1997 risk factor for pandemic A(H1N1) complications that had the largest impact on hospitalization

243

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

244

Hospital demand for physicians.  

PubMed

This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

Morrisey, M A; Jensen, G A

1990-01-01

245

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

E-print Network

Interpolating Vancouver's Daily Ambient PM10 Field Li Sun James V. Zidek Nhu D. Le Haluk Ozkaynak the Center's primary funding. #12;Interpolating Vancouver's Daily Ambient PM10 Field Li Sun1 , James V Zidek1

Washington at Seattle, University of

246

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 19 April 2013 Keywords: Urban metabolism Ecological footprint Sustainability Regional planning a b, integrated urban metabolism of residential consumption and ecological footprint analysis of the Vancouver

Pedersen, Tom

247

General and visceral surgery practice in German hospitals: a real-time work analysis on surgeons’ work flow  

Microsoft Academic Search

Background  Surgeons have criticized the working conditions at German hospitals. They complain in particular about long working hours,\\u000a an inadequate salary for their work, insufficient training\\/supervision, and an increasing amount of time spent on administration\\u000a duties. Since these critics are only subjective perceptions, they should be compared to data that can be quantified more objectively\\u000a and accurately. In this study, we

Stefanie Mache; Ramona Kelm; Hartwig Bauer; Albert Nienhaus; Burghard F. Klapp; David A. Groneberg

2010-01-01

248

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

PubMed Central

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

2013-01-01

249

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

250

‘The Unbearable Lightness of Being Black’: Race, Class, and Victorian Vancouver First Lifeguard  

Microsoft Academic Search

In the late nineteenth and early twentieth centuries, a black man, Joe Fortes, received much admiration from the city of Vancouver's white population. Fortes’s life and career presents an interesting study of race and class not only in Vancouver but also in the larger North American society during this period. Around the turn of the twentieth century, a social hierarchy

John Wong

2011-01-01

251

Cutaneous diphtheria in the urban poor population of Vancouver, British Columbia, Canada: a 10-year review.  

PubMed

Between 1998 and 2007, records from 33 patients with cutaneous diphtheria from Vancouver's inner city were reviewed. Cases were associated with injection drug use and poverty. Coinfections with Staphylococcus aureus, Streptococcus pyogenes, and Arcanobacterium haemolyticum occurred. Corynebacterium diphtheriae is endemic in Vancouver's urban core, with strains of multilocus sequence type (MLST) 76 predominating. PMID:21525220

Lowe, C F; Bernard, K A; Romney, M G

2011-07-01

252

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

Microsoft Academic Search

This project was conducted as part of a comprehensive planning effort for the Vancouver Lowlands project area. The study was funded by The Bonneville Power Administration (BPA) and carried out by the Washington Department of Fish and Wildlife (WDFW). The Vancouver Lowlands is considered an area of high priority by WDFW and is being considered as a potential site for

Brian Calkins; Eric Anderson; Paul Ashley

1995-01-01

253

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

254

General practitioners' and hospital physicians' preference for morphine or oxycodone as first-time choice for a strong opioid: a National Register-based study.  

PubMed

The aim of this study was to characterize first-time oxycodone and morphine prescriptions in outpatients by type of prescriber and naivety in regard to strong opioids. All prescriptions for morphine and oxycodone in Denmark reported to the National Register of Medicinal Product Statistics in 2010 were analysed. If a patient had not had a prescription filled for the same drug within the last 2 years, the prescription was defined as a first-time prescription. Patients who had not received a prescription for strong opioids for 6 months prior to the date of redemption were classified as strong opioid naive. The odds ratio (OR) was calculated to investigate whether general practitioners (GPs) and hospital physicians had similar preferences for oxycodone over morphine for strong opioid-naive patients. We included 69,110 first-time prescriptions, of which 59,316 (86%) were for strong opioid-naive patients. Opioid-naive patients received 79% of the first-time prescriptions for morphine and 91% of the prescriptions for oxycodone. Hospital physicians had a greater preference for oxycodone over morphine than GPs (OR 1.34, 95% CI 1.29-1.39). However, GPs were responsible for approximately 61% of all first-time prescriptions for both oxycodone and morphine for strong opioid-naive patients. In conclusion, oxycodone is to a great extent prescribed as the first-choice strong opioid, and both GPs and hospital physicians seem to contribute to this prescribing pattern of strong opioids to outpatients. PMID:22805172

Poulsen, Karen K; Andersen, Stig E; Moreno, Sřren I; Glintborg, Dorte; Thirstrup, Steffen; Aagaard, Lise

2013-02-01

255

Activists decry physician disinterest in Lyme disease during Vancouver conference.  

PubMed Central

Although it was well advertised, few Canadian physicians attended a recent conference on Lyme disease in Vancouver. The apparent lack of interest upsets the president of the Lyme Borreliosis Society, who says many patients have been misdiagnosed, mistreated or untreated and "are now chronically disabled." Interestingly, the disease seems to be much more common in the US than Canada. In New York State, for instance, more than 26,000 cases have been diagnosed, but in nearby Ontario the total is only 200. PMID:7664235

LeBourdais, E

1995-01-01

256

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

257

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

258

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

SciTech Connect

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

Calkins, Brian; Anderson, Eric; Ashley, Paul

1995-01-01

259

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

PubMed Central

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

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

2012-01-01

260

V. Rialle*, N. Vuillerme*, A. Franco**, Y. Fouquet* *University and Universitary Hospital of Grenoble, France  

E-print Network

of Grenoble, France **University and Universitary Hospital of Nice, France French Society for Gerontechnology-health and gerontechnology applications: Axiological and diachronic dimensions ISG2010 International Society for Gerontechnology 7th World Conference Vancouver, Canada, 27-29 May 2010 1 #12;Summary Introduction "Does it work

Fouquet, Yannick

261

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

ERIC Educational Resources Information Center

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

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

2008-01-01

262

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

263

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

264

Provision of gastrointestinal endoscopy and related services for a district general hospital. Working Party of the Clinical Services Committee of the British Society of Gastroenterology.  

PubMed Central

(1) The number of endoscopic examinations performed is rising. Epidemiological data and the workload of well developed units show that annual requirements per head of population are approaching: Upper gastrointestinal 1 in 100 Flexible sigmoidoscopy 1 in 500 Colonoscopy 1 in 500 ERCP 1 in 2000 (2) Open access endoscopy to general practitioners is desirable and increasingly sought. For a district general hospital serving a population of 250,000, this workload entails about 3500 procedures annually, performed during 10 half day routine sessions plus emergency work. (3) High standards of training and experience are needed by all staff, who must work in purpose built accommodation designed to promote efficient and safe practice. (4) The endoscopy unit should be adjacent to day care facilities and near the x ray department. There should be easy access to wards. (5) An endoscopy unit needs at least two endoscopy rooms; a fully ventilated cleaning/disinfection area; rooms for patient reception, preparation, and recovery; and accommodation for administration, storage, and staff amenities. (6) The service should be consultant based. At least 10 clinical sessions are required, made up of six or more consultant sessions and two to four clinical assistant, hospital practitioner, or staff specialist sessions. Each consultant should be expected to commit at least two sessions weekly to endoscopy. Extra consultant sessions may be needed to provide an efficient service. (7) A specially trained nursing sister (grade G or H) and five other endoscopy nurses are needed to care for the patients; their work may be supplemented by care assistants. (8) A new post of endoscopy department assistant (analogous to an operating department assistant) is proposed to maintain and prepare instruments, and to give technical assistance during procedures. (9) A full time secretary should be employed. Records, appointments, and audit should be computer based. (10) ERCP needs the collaboration of an interventional radiologist working with high quality x ray equipment in a specially prepared radiology screening room. This facility may need to serve more than one hospital. (11) A gastrointestinal measurement laboratory can conveniently be combined with the endoscopy unit. In some hospitals one or more gastrointestinal measurement technicians may staff this laboratory. (12) An endoscopy unit is a service department analogous to a radiology department. It needs an annual budget. PMID:1991644

1991-01-01

265

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

266

[Occurrence of 16s rRNA methylase ArmA producing Enterobacteriaceae in a general hospital in Warsaw, Poland].  

PubMed

Resistance to gentamicin, amikacin and kanamycin was screened in 270 clinical isolates of Enterobacteriaceae originated from April 19 to May 19, 2010 in a regular hospital in Warsaw, Poland. Most of the isolated bacteria were considered pathogenic. Nineteen isolates (7%) were simultaneously resistant to two or three of the tested aminoglycosides. MICs of the three aminoglycosides ranged form 128 to 1024 mcg/ml for six isolates. These isolates were suspected to produce 16S rRNA methylase. Genes encoding for three methylases reported in Europe: ArmA, RmtB and RmtC were searched by PCR. The armA gene was detected in all of the six isolates. This group encompassed Enterobacter cloacae (n=4), Klebsiella pneumoniae (n=1) and Proteus mirabilis (n=1). Five isolates of this group carried the bla(CAX-M) gene for CTX-M type ESBL. The remaining isolate E. cloacae DM0340 was ESBL negative and lacked bla(CRX-M) that may suggest an altered genetic environment of the armA gene in this isolate. Our results showed that 2.2% of the tested isolates produced 16S rRNA methylase ArmA. This finding may argue for a high incidence of ArmA producing Enterobacteriaceae in Poland when compared to reports from other European countries. PMID:21114012

Piekarska, Katarzyna; Zacharczuk, Katarzyna; Bareja, Elzbieta; Olak, Monika; Szych, Jolanta; Jagielski, Marek; Wardak, Sebastian; Gierczy?ski, Rafal

2010-01-01

267

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

SciTech Connect

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

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

1984-01-01

268

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

269

Diathermy versus Scalpel Incision in a Heterogeneous Cohort of General Surgery Patients in a Nigerian Teaching Hospital  

PubMed Central

Background: The anecdotal fear of using cautery for surgical incisions is still common in surgical practice despite recent evidences. The aim of this study is to compare the results of electrocautery and the scalpel in skin incisions. Materials and Methods: This is a prospective randomized double blind study conducted in the Department of Surgery, of a teaching hospital in Ibadan. Patients were randomized to have either scalpel or electrocautery incisions. The duration used in making the skin incision; the incisional blood loss and the ensuing length and depth of the wound were noted. Postoperative pain; duration of wound healing and the occurrence of surgical site infection were also noted. Results: There were 197 patients consisting of the scalpel group (n = 98) and the electrocautery group (n = 99). The ages ranged from 16 to 73 years. The demography, case distribution and body mass index were similar in both groups. The mode of presentation was predominantly elective. The incision time was shorter in the electrocautery group (P < 0.001). The blood loss was less with the diathermy compared to the scalpel (6.53 ± 3.84 ml vs. 18.16 ± 7.36 ml, P < 0.001). The cumulative numerical rating scale score for pain was 12.65 (standard deviation [SD] 8.06) and 17.12 (SD 9.49) in the diathermy and scalpel groups respectively (P < 0.001). There was no statistically significant difference in wound infection and wound closure (epithelialization time) (P = 0.206). Conclusion: The use of electrocautery in making skin incision is associated with reduced incision time, incisional blood loss, and postoperative pain.

Ayandipo, Omobolaji O; Afuwape, Oludolapo O; Irabor, David; Oluwatosin, Odunayo M; Odigie, Vincent

2015-01-01

270

Compare Hospitals  

MedlinePLUS

2014 Leapfrog Hospital Survey Results Now Available Thank you for visiting the Leapfrog Hospital Survey Results Website. These results are based on surveys submitted by hospitals across the country that have demonstrated a commitment ...

271

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

272

Medical withdrawal management in Vancouver: service description and evaluation.  

PubMed

This study evaluates a medically managed inpatient detoxification service (Vancouver Detox (VD)) and investigates its clients' characteristics over a 1-year period. We present information on the daily operation at VD, and examine accessibility and efficiency of it from five perspectives: wait time, pretreatment attrition rate, treatment completion rate, length of stay (LOS), and occupancy rate (OR). In addition, we explore the impacts of seasonality and the monthly welfare check on the utilization of the service. Among 2294 referrals, 35% dropped out without engaging in treatment. Among those who were admitted to VD, 78% completed the treatment program. Shorter wait time and lower OR were found during the welfare check issuance period, and lower OR was found during summer. In addition, the patterns of utilization of VD were changed over the welfare check issuance period. Our analysis indicates that operational accessibility and efficiency at VD could be improved by specifically addressing these factors. PMID:16950571

Li, Xin; Sun, Huiying; Puri, Ajay; Marsh, David C; Anis, Aslam H

2007-05-01

273

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

274

The impact of having a loved one with alcohol consumption-related problems on subjective health status and health-risk behaviors in a general hospital sample.  

PubMed

Consecutively admitted inpatients of a general hospital in Northern Germany (N = 2903) completed a standardized screening questionnaire in 2005-2006 containing questions about alcohol consumption-related problems in loved ones, their own alcohol consumption, and other health-related aspects. Almost 26.2% reported having a loved one with alcohol consumption-related problems. The proportions of smokers and those who screened positively for at-risk consumption or alcohol abuse were significantly higher in those patients; they were significantly younger and reported worse overall states of health and emotional health. Since those patients showed a high risk of numerous health problems, psychological interventions were implemented. The study's limitation noted. PMID:20536354

Iwen, Julia; Bischof, Gallus; Reinhardt, Susa; Grothues, Janina; Hapke, Ulfert; John, Ulrich; Freyer-Adam, Jennis; Rumpf, Hans-Jürgen

2010-12-01

275

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

276

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

PubMed

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

Cheah, J

2000-07-01

277

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

278

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

279

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

280

American Hospital Association  

NSDL National Science Digital Library

Founded in 1898, the American Hospital Association (AHA) is the national umbrella organization that represents a wide range of hospitals and health care networks. While some of the siteâ??s contents are designed for health care professionals and executives, the general public and some scholars will find some of the features, such as their quarterly reports on the latest in hospital trends, quite valuable. A good place to start is the Resource Center section of the site, which contains helpful guides to locating the information on the site itself. There are a number of free resources available here, such as a fact sheet about Americaâ??s hospitals and studies, including â??The State of Americaâ??s Hospitals: Taking the Pulseâ?ť and â??Costs of Caring: Sources of Growth in Spending for Hospital Careâ?ť.

2005-01-01

281

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

282

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

283

Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital  

PubMed Central

Background: Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. Aims: The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. Settings and Design: This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. Materials and Methods: One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1st November 2013 to 30th April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. Statistical analysis used: The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P <0.05 was considered to be statistically significant. Results: The commonest dental illness was dental caries (22%). More than two-third of the patients had psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). Conclusions: This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

Ray, Pradip K; Ray (Bhattacharya), Sampa; Makhal, Manabendra; Majumder, Uttam; De, Shantanu; Ghosh, Subhankar

2015-01-01

284

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

285

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

PubMed Central

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

2011-01-01

286

Distal fixation with Wagner revision stem in treating Vancouver type B2 periprosthetic femur fractures in geriatric patients  

Microsoft Academic Search

Periprosthetic fractures around hip prostheses are difficult problems. We reviewed the results of treatment with Wagner revision stems in geriatric patients (? 65 years old) with Vancouver type B2 periprosthetic fractures. Over a 5-year period, 14 patients with Vancouver’s type B2 periprosthetic fractures in the proximal femur were revised. The mean follow-up for these patients was 58.5 months (range, 36

P. S Ko; J. J Lam; M. K Tio; O. B Lee; F. K Ip

2003-01-01

287

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

NASA Astrophysics Data System (ADS)

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

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

2014-08-01

288

Endolithic biodegradation of cool-water skeletal carbonates on Scott shelf, northwestern Vancouver Island, Canada  

NASA Astrophysics Data System (ADS)

Biodegradation of shell material is widespread in the cool-water skeletal carbonate deposits on Scott shelf, northwestern Vancouver Island, and is especially evident in the large aragonitic bivalves, Glycymeris and Humilaria, major primary sediment contributors. Ten types of endolithic microborings have been identified in the shells, including representatives of green algae (e.g., Ostreobium quekettii), blue-green algae (e.g., Plectonema terebrans, ?Scytonema sp.), fungi, bacteria and clionid sponges, as well as macroborings of phoronids, polychaetes and naticid gatropods. Microcrystalline carbonate is not precipitated in vacated bores. Boring physically weakens the shells, rendering them more prone to mechanical abrasion during sediment transport and bioturbation, and to biological abrasion by grazing benthos. Tumbling experiments demonstrate that the rate of carbonate mud production is much greater for bored as compared to fresh bivalve shells, and that mud production rates decrease with tumbling time because most endolithic microborings are confined to the periphery of grains. Boring also increases significantly the porosity and surface area of skeletal grains, and destroys their organic matrix, making them susceptible to maceration and dissolution on cool-water shelves. Fostered by the generally low rates of carbonate production and accumulation, many aragonitic bivalve shells on Scott shelf have become thoroughly degraded through a combination of endolithic microboring, maceration and dissolution within about 1000 years in ambient sea water. In geologic terms, such selective taphonomic loss of skeletal material may be considerable in ancient temperate-shelf limestones and should be evaluated when interpreting their paleoecology and paleoenvironments.

Young, Harvey R.; Nelson, Campbell S.

1988-11-01

289

Capillaria hepatica in wild Norway rats (Rattus norvegicus) from Vancouver, Canada.  

PubMed

Capillaria hepatica is a parasitic nematode that infects the liver of rats (Rattus spp.), and occasionally other mammalian species, including humans. Despite its broad geographic distribution and host range, the ecology of this parasite remains poorly understood. We characterized the ecology of C. hepatica in urban Norway rats (Rattus norvegicus) in Vancouver, Canada. The overall prevalence of C. hepatica among Norway rats was 36% (241/671); however, there was significant variation in prevalence among city blocks. Using a generalized linear mixed model to control for clustering by block (where OR is odds ratio and CI is confidence interval), we found C. hepatica infection was negatively associated with season (spring [OR=0.14, 95% CI=0.05-0.39]; summer [OR=0.14, 95% CI=0.03-0.61]; winter [OR=0.34, 95% CI=0.13-0.84], compared to fall) and positively associated with sexual maturity (OR: 7.29, 95% CI=3.98-13.36) and presence of cutaneous bite wounds (OR=1.87, 95% CI=1.11-3.16). Our understanding of the ecology of C. hepatica in rats is hindered by a paucity of data regarding the main mechanisms of transmission (e.g., environmental exposure vs. active cannibalism). However, associations among infection, season, maturity, and bite wounds could suggest that social interactions, possibly including cannibalism, may be important in transmission. PMID:24807174

Rothenburger, Jamie L; Himsworth, Chelsea G; Chang, Victoria; LeJeune, Manigandan; Leighton, Frederick A

2014-07-01

290

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.; Gigučre, A.; McTaggart-Cowan, R.; Erfani, A.; Denis, B.; Glazer, A.; Vallée, M.

2014-01-01

291

21 CFR 880.5120 - Manual adjustable hospital bed.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Manual adjustable hospital bed. 880.5120 Section 880.5120 ...CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices §...

2010-04-01

292

21 CFR 880.5140 - Pediatric hospital bed.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140 ...CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices §...

2010-04-01

293

Hospital Hints  

MedlinePLUS

... hospital. You will need: Bathrobe and slippers (put your name on each item); most hospitals provide special bed ... medicines , including prescription and over-the-counter drugs Your allergies Names and telephone numbers (home and business) to contact ...

294

Norovirus - hospital  

MedlinePLUS

... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ... to understand an outbreak, such as in a hospital setting. This test is done by collecting a ...

295

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; Seď, Dohagneron; Yenan, John

2014-01-01

296

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; Seď, Dohagneron; Yenan, John

2014-01-01

297

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

PubMed Central

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

2005-01-01

298

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

299

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

300

[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

301

The short-term effect on technical and scale efficiency of establishing regional health systems and general management in Greek NHS hospitals  

Microsoft Academic Search

ObjectivesThe Greek National Health System has been subjected to a reform initiative in 2001. The new legislation required hospitals to operate as administrative and economic decentralized units, under the control of newly established Regional Health Systems. In addition, Professional Managers have been appointed and signed “efficiency contracts”, which supposedly committed them to run the hospitals effectively and efficiently. The present

Vassilios Aletras; Nick Kontodimopoulos; Athanasios Zagouldoudis; Dimitris Niakas

2007-01-01

302

Generalized anxiety disorder  

MedlinePLUS

... TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, ... TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, ...

303

University of Illinois at Chicago College of Medicine and its Participating Hospitals  

E-print Network

; Advocate Christ Hospital and Medical Center, Advocate Illinois Masonic Medical Center, Advocate Lutheran Medical Center, Advocate Lutheran General Hospital, Children's Memorial Hospital of Chicago, Hartgrove and Medical Center, Advocate Illinois Masonic Medical Center, Advocate Lutheran General Hospital, Children

Alford, Simon

304

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

305

Mental hospitals in India.  

PubMed

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 statusThe 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

2000-04-01

306

Specialty hospitals emulating focused factories : A case study  

Microsoft Academic Search

Purpose – For 15 years general hospital managers faced new competition from for-profit specialty hospitals that operate on a “focused factory” model, which threaten to siphon-off the most profitable patients. This paper aims to discuss North American specialty hospitals and to review rising costs impact on general hospital operations. The focus is to discover whether specialty hospitals are more efficient

Sameer Kumar

2010-01-01

307

Correlates of a “do not hospitalize” designation  

PubMed Central

OBJECTIVE To explore what nursing home resident demographic, clinical, functional, and health services utilization characteristics influence a “do not hospitalize” designation. DESIGN Historical cohort study. SETTING Vancouver, BC. PARTICIPANTS Extended care residents in 2 hospital-based and 4 free-standing nursing homes who died between 2001 and 2007. MAIN OUTCOME MEASURES The designation of “do not hospitalize” on a resident’s chart. RESULTS Continuity of family physician care from admission to death (adjusted hazard ratio [AHR] 2.16, 95% confidence interval [CI] 1.33 to 3.49), a sudden and unexpected death (AHR 0.43, 95% CI 0.25 to 0.73), and age (AHR 1.02, 95% CI 1.01 to 1.02) were independently associated with a “do not hospitalize” designation. CONCLUSION The greater than 2-fold positive association of continuity of family physician care with a “do not hospitalize” designation is an interesting addition to the literature on how continuity of physician care matters. PMID:21075999

McGregor, Margaret; Pare, Dan; Wong, Areta; Cox, Michelle B.; Brasher, Penny

2010-01-01

308

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

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-squares 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 6-fold (p < 0.0001); and BDE-47, -99, and -100 declined more than BDE-153. There was a modest, nonsignificant (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

2013-10-15

309

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

310

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

SciTech Connect

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

Fitzek, Markus M. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Radiation Oncology Center, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, MA (United States); Linggood, Rita M. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Radiation Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (United States); Adams, Judy [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Munzenrider, John E. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States)]. E-mail: jmunzenrider@partners.org

2006-04-01

311

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

PubMed Central

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

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

2014-01-01

312

Updated Long-Term Outcomes and Prognostic Factors for Patients With Unresectable Locally Advanced Pancreatic Cancer Treated With Intraoperative Radiotherapy at the Massachusetts General Hospital, 1978 to 2010  

PubMed Central

BACKGROUND In the current study, the authors evaluated long-term outcomes, intraoperative radiotherapy (IORT)-related toxicity, and prognostic factors for overall survival (OS) among patients with unresectable locally advanced pancreatic cancer (LAPC) who received IORT as part of their treatment at the Massachusetts General Hospital (MGH). METHODS Medical records were reviewed for 194 consecutive patients with unresectable LAPC who were treated with IORT at MGH between 1978 and 2010. OS was calculated using the Kaplan-Meier method. Prognostic factors were evaluated at the univariate level by the log-rank test and at the multivariate level by the Cox proportional hazards model. Rates of disease progression and treatment toxicity were calculated. RESULTS The 1-year, 2-year, and 3-year survival rates were 49%, 16%, and 6%, respectively. Six patients (3%) survived for > 5 years. The median OS was 12.0 months. Among 183 patients with known post-IORT disease status, the 2-year local progression-free survival and distant metastasis-free survival rates were 41% and 28%, respectively. On multivariate analysis, an IORT applicator diameter ? 8 cm (hazards ratio [HR], 0.51; 95% confidence interval [95% CI], 0.30–0.84 [P = .009]), a Charlson age-comorbidity index ?3 (HR, 0.47; 95% CI, 0.31–0.73 [P = .001]), and receipt of chemotherapy (HR, 0.46; 95% CI, 0.33–0.66 [P < .001]) predicted improved OS. The median OS for patients with all 3 positive prognostic factors was 21.2 months. CONCLUSIONS Well-selected patients with LAPC with small tumors and low Charlson age-comorbidity indices can achieve good long-term survival outcomes with a treatment regimen that incorporates chemotherapy and IORT. PMID:24006012

Cai, Sophie; Hong, Theodore S.; Goldberg, Saveli I.; Castillo, Carlos Fernandez-del; Thayer, Sarah P.; Ferrone, Cristina R.; Ryan, David P.; Blaszkowsky, Lawrence S.; Kwak, Eunice L.; Willett, Christopher G.; Lillemoe, Keith D.; Warshaw, Andrew L.; Wo, Jennifer Y.

2014-01-01

313

Supervised injection sites: Health Canada approves Vancouver pilot sites, but concerns remain.  

PubMed

The paperwork has been processed, and Health Canada says that two pilot supervised injection sites (SISs) in Vancouver can now proceed, but operational funding for the site to be located in the Downtown Eastside has yet to be secured. Meanwhile, tired of waiting for the sanctioned SISs to open, community groups in Vancouver have begun to operate unsanctioned sites. There are also concerns that even if operational funding for the Downtown Eastside site is obtained, the pilot SIS project is too small in scope to make a major impact on public health in the area. PMID:14746291

Kerr, Thomas

2003-08-01

314

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

315

Going social at Vancouver Public Library: what the virtual branch did next  

Microsoft Academic Search

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

Kay Cahill

2011-01-01

316

June 14, 2011 Food security and climate change Vancouver forum starts today  

E-print Network

MEDIA TIP June 14, 2011 Food security and climate change ­ Vancouver forum starts today Finding out discussion on "Food Security: Preparing for Climate Change" that will be held tonight (June 14). Starting how British Columbia's climate is expected to change and how this will affect our future food supplies

Pedersen, Tom

317

The Alma Mater Society of U.B.C. Vancouver PLACE: Council Chambers  

E-print Network

The Alma Mater Society of U.B.C. Vancouver PLACE: Council Chambers August 29, 2012 SUB Room 206 to health and wellness. o Asking Council to help in connecting with students. #12;The Alma Mater Society sports. Also club sports; looking at a more robust club structure. Have to look at facilities and decide

Pulfrey, David L.

318

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

319

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

320

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

321

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

E-print Network

Columbia Colin P. Laroque, Dan J. Smith* University of Victoria Tree-Ring Laboratory, Department-growth response of five high-elevation conifer species on Vancouver Island. Historical climate data and tree-ring; Luckman et al., 1997) and elevated CO2 levels are suspected causal influences (Graumlich, 1991; Mc

Smith, Dan

322

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.

323

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

E-print Network

1 The City of Vancouver's Approach to Electric Vehicles: 7 Pillars Malcolm Shield, Climate Policy. Integrated EV Charging and Cellular Infrastructure Trial 6 #12;5. CoV Fleet EVs 7 · First Mitsubishi ElectricMiEVs), option on 17 more. 7 · 1 Car Share EV · City use during office hours · Public use during eve

California at Davis, University of

324

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

325

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

326

More money for Vancouver drug court, but future funding for all drug courts uncertain.  

PubMed

The federal government is providing an additional $200,000 to support the pilot drug treatment court project in Vancouver, B.C. The drug court is an alternative to criminal courts for people who commit crimes to support their drug use. People who plead guilty and promise to abstain from drugs qualify for the drug treatment court. PMID:19606550

2009-05-01

327

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

328

June 2, 2011 World leading authority on climate change Vancouver, one night only  

E-print Network

of climate change. "At a time when the public debate on global warming is rife with doubt and uninformedMEDIA TIP June 2, 2011 World leading authority on climate change ­ Vancouver, one night only of the UN Intergovernmental Panel on Climate Change (IPCC). He also heads the division of climate

Pedersen, Tom

329

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

330

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

331

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

332

oct.24, 1979. 2075 Wabrook Mall. Vancouver, B.C. V a 1W5.  

E-print Network

VOlUmC z5, Number 19. oct.24, 1979. 2075 Wabrook Mall. Vancouver, B.C. V a 1W5. 22MlS1. Jim Banham and Judith Walker, editon. ISSN 0497-2929. for achievement After careful consideration of 19 students, selection committees have named a fourth year medical student and two first year lawstudents winners of UBC

Farrell, Anthony P.

333

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

334

Assessing Student Outcomes via Follow-Up Survey: Training Effectiveness of Vancouver Community College.  

ERIC Educational Resources Information Center

As a means of obtaining information on educational outcomes and quality, Vancouver Community College (VCC) conducts annual follow-up surveys of former students, using one instrument for program completers and another for discontinuants (dropouts). For the 1990-91 survey, 3,685 graduates were surveyed 9 months after program completion, and 1,007…

Yao, Min

335

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

ERIC Educational Resources Information Center

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

Yao, Min

336

1991 Graduate Follow-Up Outcomes Report: Occupational Programs. Vancouver Community College.  

ERIC Educational Resources Information Center

In 1991, a follow-up survey was conducted in British Columbia of students who graduated from Vancouver Community College's (VCC's) occupational programs between July 1989 and June 1990. A total of 3,751 occupational graduates were surveyed regarding their educational goals, main activity at the time of the survey, desired employment location,…

Yao, Min

337

The electrical conductivity distribution beneath Vancouver Island: A region of active plate subduction  

SciTech Connect

Magnetotelluric (MT) and geomagnetic depth sounding (GDS) data were recorded at 25 locations across Vancouver Island, Canada, over the subducting Juan de Fuca plate. The GDS data respond to a number of local conductive features at frequencies above 10 Hz while at longer periods, the in-phase and quadrature induction arrows are colinear and are aligned approximately normal to the continental shelf with a maximum amplitude response near the southwest coast. Interpretation of the MT data show the presence of a conducting zone at depths greater than 20 km beneath Vancouver Island and correlating with a strong seismic reflector. Extensive testing with two dimensional models shows the MT and GDS data are consistent with a proposed geoelectrical structure containing a conducting layer extending from the Pacific Ocean, dipping beneath Vancouver Island, and in electrical contact with the mainland conductive region. The layer has a horizontal conductance of 200 S that may decrease to 100 S beneath the northeast side of Vancouver Island. Related geophysical studies suggest the conductive zone is above the actual thrust surface of the Juan de Fuca plate. The conducting layer is most likely the result of cracks and pores filled with saline fluids which are supplied by water subducted with the oceanic crust and by dehydration reactions. The presence of fluids has significant implications for thrust earthquakes and for metamorphic reactions that occur in subduction zones. The conductance of the upper mantle (between 90 and 390 km) is best modeled at approximately 1,500 S.

Kurtz, R.D.; Gupta, J.C. (Geological Survey of Canada, Ottawa, Ontario (Canada)); DeLaurier, J.M. (Geological Survey of Canada, Sidney, British Columbia (Canada))

1990-07-10

338

American Hospital Directory  

MedlinePLUS

... Outpatient Welcome Understanding and using Free Hospital Profiles Free Hospital Profiles How to look up a hospital ... more than 50 hospitals.) How to see the Free Hospital Profile The Free Hospital Profile is displayed ...

339

45 CFR 211.10 - Termination of hospitalization.  

Code of Federal Regulations, 2011 CFR

...hospital finds that the eligible person hospitalized for mental illness (whether or not pursuant to a judicial commitment...accordance with laws governing hospitalization for mental illness as may be in force and generally applicable in...

2011-10-01

340

45 CFR 211.10 - Termination of hospitalization.  

Code of Federal Regulations, 2013 CFR

...hospital finds that the eligible person hospitalized for mental illness (whether or not pursuant to a judicial commitment...accordance with laws governing hospitalization for mental illness as may be in force and generally applicable in...

2013-10-01

341

42 CFR 35.1 - Hospital and station rules.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Hospital and station rules. 35.1 Section...SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.1 Hospital and station rules. The officer in...

2010-10-01

342

42 CFR 35.2 - Compliance with hospital rules.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Compliance with hospital rules. 35.2 Section 35.2 ...SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.2 Compliance with hospital rules. All patients and...

2010-10-01

343

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

344

Clinical Supporting System in Large-scaled General Hospital with Customized Interface Layer between Electronic Patient Record System and Filemaker Pro  

Microsoft Academic Search

Clinical supporting system (CSS) is the utility software such as the cancer patient database or bedsore patient database designed by hospital staffs. Clinical supporting system is usually constructed and operated separately from electronic patient record (EPR) system, because clinical supporting system needs a flexible formation to fulfill the user's requests which is impossible by using the stiff vender-made EPR system.

Atsuhiko Okagaki; Yukihiro Koretsune; Ryohei Todo; H. Kusuoka

2007-01-01

345

Hospitality Management Education and Training.  

ERIC Educational Resources Information Center

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

Brotherton, Bob, Ed.; And Others

1995-01-01

346

Patrick Moore, chairman and chief scientist of Greenspirit Strate-gies Ltd., based in Vancouver, British Columbia, Canada, pre-  

E-print Network

Patrick Moore, chairman and chief scientist of Greenspirit Strate- gies Ltd., based in Vancouver "sustainable development" was adopted to describe the challenge of taking the new environmental values we had

Kammen, Daniel M.

347

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

348

Occurrence and structural characterization of gas hydrates associated with a cold vent field, offshore Vancouver Island  

Microsoft Academic Search

Gas hydrate samples recovered from a cold vent field offshore Vancouver Island were studied in detail both by macroscopic observations and instrumental methods (powder X-ray diffraction method (PXRD), nuclear magnetic resonance (NMR), and Raman spectroscopy). It was found that gas hydrates were massive from 2.64 to 2.94 m below seafloor (mbsf), elongated, nodular and tabular from 4.60 to 4.81 mbsf,

Hailong Lu; Igor Moudrakovski; Michael Riedel; George Spence; Regent Dutrisac; John Ripmeester; Fred Wright; Scott Dallimore

2005-01-01

349

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

350

Little Ice Age glacial activity in Strathcona Provincial Park, Vancouver Island, British Columbia, Canada  

Microsoft Academic Search

Dendroglaciological and lichenometric techniques are used to establish the Little Ice Age (LIA) history of two glaciers (Colonel Foster and Septimus) in Strathcona Provincial Park, Vancouver Island, British Columbia. Our lichenometric investigations were preceded by the development of a locally calibrated Rhizocarpon geographicum growth curve (1708-1998 A.D.). Documentation of a 3-4-year ecesis interval for both trees and lichen greatly reduces

Dave H. Lewis; Dan J. Smith

2004-01-01

351

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

352

A survey of under-18 year old and 20-29 year old primigravidae delivered at the Port Moresby General Hospital: a comparative study of their sociodemographic and sexuality characteristics and contraceptive knowledge and experience.  

PubMed

From July 1992 to August 1993, 330 under-18 year old primigravidae (cases) and 330 randomly selected 20-29 year old primigravidae (controls) who were delivered at the Port Moresby General Hospital were sequentially studied, using a standardized, pretested, precoded questionnaire. In stepwise logistic regression analysis, significantly more of the cases had menarche at less than 15 years of age, learned before menarche that sex causes pregnancy, were of highland origin, were unemployed, or had partners who were unemployed; significantly fewer of the cases thought that one sexual act could cause pregnancy, had knowledge of or had ever used a family planning method, or had planned this pregnancy. PMID:10365567

Klufio, C A; Amoa, A B; Rageau, O; Mola, G; Kariwiga, G

1997-03-01

353

The potential of hospital Website marketing.  

PubMed

In recent years, hospital website marketing has witnessed explosive growth. Industry experts cite an almost 100% growth in hospital website marketing over the last several years. At one time lagging in the adoption of Internet technology, hospitals have now begun making significant strides in catching up with other industries. In spite of the general proliferation of hospital websites, however, the full potential of the Internet with its unique characteristics has yet to be realized. In this paper, current trends fueling the growth of hospital website marketing are first explored. Secondly, barriers to realizing the potential of website marketing are investigated. Finally, recommendations for improving hospital website marketing are developed. PMID:11184435

Sanchez, P M

2000-01-01

354

Hospitality Management.  

ERIC Educational Resources Information Center

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

College of the Canyons, Valencia, CA.

355

21 CFR 880.5100 - AC-powered adjustable hospital bed.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false AC-powered adjustable hospital bed. 880.5100 Section 880.5100 ...CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices §...

2010-04-01

356

Hospital Greenspace Lawson Memorial Hospital,  

E-print Network

in the surrounding local community. This reduced the number to 15 facilities. Each of these was visited to ground in the Highlands where the greening of hospital space should be piloted. The clear ambition of the local community support Clinical credibility Community buy in Environmental expertise Project management support Funding

357

The vital role of the cottage community hospital  

PubMed Central

The history of general-practitioner hospitals is reviewed and a case made for their retention and extension. Among the advantages they provide are: a local service for patients, less expensive hospital care than is possible in a district general hospital, less travelling expenses for patients, valuable postgraduate education for doctors, and improvement of general-practitioner morale. PMID:702464

While, A. E.

1978-01-01

358

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

359

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.

360

Determinants of hospital utilization in the Netherlands.  

PubMed Central

Hospital use in the Netherlands is examined in a cross-section analysis of 1969 and 1971 data for 120 service regions. Elasticities of admissions with respect to bed supply and supply of general practitioners are calculated, and the substitutability of first level care (by general practitioners) for hospital care is considered. Substitution effects found indicate that the Dutch government's plan to reduce the ratio of hospital beds to population is feasible. PMID:1225868

van der Gaag, J; Rutten, F F; van Praag, B M

1975-01-01

361

Generalized London free energy for high-Tc vortex lattices Ian Affleck  

E-print Network

Generalized London free energy for high-Tc vortex lattices Ian Affleck Department of Physics Columbia, Vancouver, British Columbia, Canada V6T 1Z1 Received 21 August 1996 We generalize the London free-1829 97 50402-4 The London free energy provides a very simple way of studying the vortex lattice

Franz, Marcel

362

Going to the Hospital  

MedlinePLUS

... or music player with earphones Before a Planned Hospital Stay Keep in mind that hospitals are not ... a short time in the hospital. During the Hospital Stay While the person with Alzheimer’s is in ...

363

Surgical wound infections diagnosed after discharge from hospital: epidemiologic differences with in-hospital infections  

Microsoft Academic Search

Bacground: The purpose of this study was to study postoperative infections detected in hospital and after discharge and to identify risk factors for such infections.Methods: A prospective cohort study was used, with a follow-up of 30 days after hospital discharge, on 1483 patients admitted to the general surgery service of a tertiary care hospital. The main outcome measure was surgical

Marcelino Medina-Cuadros; María Sillero-Arenas; Gabriel Martínez-Gallego; Miguel Delgado-Rodríguez

1996-01-01

364

[In-vitro antibiotic resistance of hospital and non-hospital strains of Pseudomonas aeruginosa].  

PubMed

The AA report about the resistence towards antibiotics of 42 stocks of Pseudomonas aeruginosa isolated from hospitalized patients and of 18 stocks isolated from non hospitalized patients. The most active antibiotics are Gentamicine, Neomicine and Streptomicine. Interestingly towards Tobramicine no resistence has been detected. The stocks isolated from hospitalized patients have generally shown a higher resistence. PMID:121701

Ceddia, T; Marinucci, M C; Parravano, N

1979-03-30

365

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

366

42 CFR 412.200 - General provisions.  

Code of Federal Regulations, 2011 CFR

...Operating Costs for Hospitals Located in Puerto Rico § 412.200 General provisions...1, 1987, hospitals located in Puerto Rico are subject to the rules governing...part apply to hospitals located in Puerto Rico. Except for § 412.60,...

2011-10-01

367

42 CFR 412.200 - General provisions.  

Code of Federal Regulations, 2014 CFR

...Operating Costs for Hospitals Located in Puerto Rico § 412.200 General provisions...1, 1987, hospitals located in Puerto Rico are subject to the rules governing...part apply to hospitals located in Puerto Rico. Except for § 412.60,...

2014-10-01

368

42 CFR 412.200 - General provisions.  

Code of Federal Regulations, 2012 CFR

...Operating Costs for Hospitals Located in Puerto Rico § 412.200 General provisions...1, 1987, hospitals located in Puerto Rico are subject to the rules governing...part apply to hospitals located in Puerto Rico. Except for § 412.60,...

2012-10-01

369

Uncompensated Hospital Care: Charitable Mission or Profitable Business Decision?  

Microsoft Academic Search

Provision of hospital uncompensated care is generally assumed to be adversely affected as increased healthcare competition decreases demand for compensated hospital services. Economic theory, however, suggests the question is more complex. Non-profit hospitals are assumed in this paper to maximize utility as a function of uncompensated care, subject to the constraint that revenues cover costs. For-profit hospitals, in contrast, are

Dwayne A. Banks; Mary Paterson; Jeanne Wendel

1997-01-01

370

A Cross-Sectional Analysis of Hospital Profitability  

Microsoft Academic Search

This study used logit regression to discriminate between profitable and non-profitable hospitals. The specified model worked best for voluntary hospitals, and the classification results were consistently higher for profitable hospitals than for non-profitable hospitals. Only one financial variable, the operating margin, was consistently significant in each regression equation. The results challenged the “general consensus” that operating efficiency is uniform across

C. Lankford Walker

1993-01-01

371

Diabetic Peripheral Neuropathy in Ambulatory Patients with Type 2 Diabetes in a General Hospital in a Middle Income Country: A Cross-Sectional Study  

PubMed Central

Aim We aimed to estimate the morbidity rate and associated factors for diabetic peripheral neuropathy (DPN) in a low-middle income country setting. Methods Cross-sectional study, data was gathered at Peru's Ministry of Health national specialized hospital for endocrinological conditions through standardized interviews, anthropometric measurements and blood tests for glycated haemoglobin (HbA1c). DPN was evaluated using two techniques: the Semmes-Weinstein monofilament test and the diabetic neuropathy symptom score. Overall prevalence and 95% confidence intervals (95% CI) were calculated. Potential factors related to DPN explored included body mass index, years with disease (<10 vs. ?10 years), glycaemic control (HbA1c <7% vs. ?7%), microalbuminuria, retinopathy, and current pharmacological treatment. Multivariable analysis was performed using Poisson analysis to calculate prevalence ratios. Results DPN was observed in 73/129 (56.6%) patients. In multivariable analysis adjusted by age and sex, the prevalence ratio of neuropathy was 1.4 times higher (95% CI 1.07–1.88) in patients who took insulin plus metformin compared to patients who used one treatment alone, and 1.4 higher (95% CI 1.02–1.93) in patients with ?10 years of disease compared to those with a shorter duration of disease. Also we found some characteristics in foot evaluation associated to neuropathy such as deformities (p<0.001), onychomycosis (p?=?0.012), abnormal Achilles reflex (p<0.001), pain perception (p<0.001) and vibration perception (p<0.001). Conclusion DPN is highly frequent among patients with diabetes in a national specialized facility from Peru. Associated factors to DPN included being a diabetic patient for over ten years, and receiving insulin plus metformin PMID:24789071

Lazo, María de los Angeles; Bernabé-Ortiz, Antonio; Pinto, Miguel E.; Ticse, Ray; Malaga, German; Sacksteder, Katherine; Miranda, J. Jaime; Gilman, Robert H.

2014-01-01

372

A Human Right to Group Self-Identification?: Reflections on Nixon v. Vancouver Rape Relief  

Microsoft Academic Search

Résumé: Dans Nixon c. Vancouver Rape Relief Society, la Cour d’appel de Colombie-Britannique a maintenu le droit d’un groupe de féministes de s’identifier de façon à exclure les personnes qui n’avaient pas expérimenté le fait d’être traitées comme des filles ou des femmes. Le présent article contribue au débat en cours sur les limites de l’auto-identification d’un groupe en étudiant

Christine Boyle

2011-01-01

373

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

374

National survey of hospital patients.  

PubMed Central

OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened rather than how satisfied they were with treatment can elucidate the problems that exist and so enable them to be solved. PMID:7819893

Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

1994-01-01

375

Hospitals for sale.  

PubMed

The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve. PMID:21864058

Costello, Michael M; West, Daniel J; Ramirez, Bernardo

2011-01-01

376

Hospital management. The reflective practitioner.  

PubMed

Ian Campbell's paper, originally delivered at a conference on the development of 'The reflective practitioner' while he was Unit General Manager of Sunderland Royal Infirmary, describes the liaison between general and nurse managers in the hospital. Management must give a hospital organisation direction and must set the parameters of corporate and individual performance, but it must also be responsive to the feedback received from practising clinicians. The key concept is quality of service, and in this managers and practitioners can work together towards a common goal. PMID:1903962

Campbell, I

377

Do hospitals cross-subsidize?  

PubMed

Despite its salience as a regulatory tool to ensure the delivery of unprofitable medical services, cross-subsidization of services within hospital systems has been notoriously difficult to detect and quantify. We use repeated shocks to a profitable service in the market for hospital-based medical care to test for cross-subsidization of unprofitable services. Using patient-level data from general short-term hospitals in Arizona and Colorado before and after entry by cardiac specialty hospitals, we study how incumbent hospitals adjusted their provision of three uncontested services that are widely considered to be unprofitable. We estimate that the hospitals most exposed to entry reduced their provision of psychiatric, substance-abuse, and trauma care services at a rate of about one uncontested-service admission for every four cardiac admissions they stood to lose. Although entry by single-specialty hospitals may adversely affect the provision of unprofitable uncontested services, these findings warrant further evaluation of service-line cross-subsidization as a means to finance them. PMID:25062300

David, Guy; Lindrooth, Richard C; Helmchen, Lorens A; Burns, Lawton R

2014-09-01

378

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

379

Statistical and spatial analysis of land cover impact on selected Metro Vancouver, British Columbia watersheds.  

PubMed

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. PMID:23076660

Shupe, Scott

2013-01-01

380

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

381

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

382

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. PMID:25567905

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

2010-01-01

383

Trace Gas and Particulate Observations at the Marine Boundary Layer Site near Ucluelet on Vancouver Island  

NASA Astrophysics Data System (ADS)

In May 2010, a Marine Boundary Layer (MBL) station was established on the west coast of Vancouver Island near Ucluelet, B.C. Prevailing winds at the station are from the E to SE in the fall and winter and from the W to NW in the spring and summer. Observations of both trace gases (CO, O3, NOx, CO2, SO2...) as well as particulate measurements will be examined for background concentration of this MBL site and a number of interesting events including ozone depletion in the MBL and emission ratios from observed ship plumes both fresh and aged. Ozone concentrations have been observed to be reduced to 10-15ppb in the absence of NOx during the depletion events from background levels. The air measured at the site can be impacted by ships in the shipping lanes that converge into the Juan de Fuca Strait headed for Vancouver and Seattle as well as local fishing vessels. Emission ratios of both aged and fresh plumes will be examined.

Schiller, C. L.; Vingarzan, R.; Jones, K.; Leaitch, R.; Macdonald, A.; Mihele, C.; Graham, M.; Reid, K.

2011-12-01

384

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

PubMed

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

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

2015-04-01

385

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

386

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

387

A new species of Edaphodon (Chondrichthyes: Holocephali) from the Upper Cretaceous Haslam Formation, Vancouver Island, British Columbia, Canada  

Microsoft Academic Search

A complete dentition of Edaphodon hesperis, sp. nov., is described from the Upper Cretaceous (lower Campanian) Haslam Formation of Vancouver Island, British Columbia, Canada. It is one of the complete specimens for Edaphodon, most species of which are known only from incomplete toothplates. This is the first Cretaceous Edaphodon from western North America, extending the geographical range of the genus

Ji-Yeon Shin

2010-01-01

388

The Alma Mater Society of U.B.C. Vancouver February 15, 2012 PLACE: Council Chambers SUB Room 206  

E-print Network

(Ubyssey), Erik MacKinnon (Pharmacy), Sean Cregten (AVP Academic), Tim Fernandes (Film Society), RossThe Alma Mater Society of U.B.C. Vancouver February 15, 2012 PLACE: Council Chambers SUB Room 206 The Endowment Fund will reduce our dependence on fees and revenues. #12;The Alma Mater Society of U

Pulfrey, David L.

389

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

E-print Network

that proactive management programs could be developed to ameliorate the negative effects of the human activities109 4.9 NON-POINT SOURCE CONTAMINATION IN THE URBAN ENVIRONMENT OF GREATER VANCOUVER 4.9 by Kenneth Brewer, Mark Sekela and Bruce Thomson Aquatic and Atmospheric Sciences Division, Environment Canada

390

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

391

Scoters and other birds feeding on purple varnish clams: Some observations at Spanish Banks, Vancouver, British Columbia  

Microsoft Academic Search

An unusually large number of Surf Scoters (Melanitta perspicillata) and White-winged Scoters (M. fusca) were observed diving and feeding on the introduced purple varnish clam (Nuttallia obscurata) along Spanish Banks, Vancouver, in February 2006. At low tide, gulls and crows were seen consuming clams they found exposed and dying on the beaches. Features observed in the beach sand and meteorological

J. M. Ryder

392

The competitive role of Gaultheria shallon on planted western hemlock and western red cedar saplings on northern Vancouver Island  

Microsoft Academic Search

The presence of competing vegetation, particularly salal (Gaultheria shallon Pursh), was studied in relation to growth (measured as height and root collar diameter) of western hemlock (Tsuga heterophylla (Raf.) Sarg.) and western red cedar (Thuja plicata Donn) saplings planted in cedar-hemlock (CH) and hemlock-amabilis fir (HA) phases of an ecosystem type on northern Vancouver Island in British Columbia, Canada. The

L. H. Fraser; C. P. Chanway; Roy Turkington

1995-01-01

393

Trend analysis of ground level ozone in the greater Vancouver\\/Fraser Valley area of British Columbia  

Microsoft Academic Search

A multiple linear regression model incorporating meteorological parameters, annual cycles and random error due to serial correlation was used to investigate the annual and summer season ozone trends between 1985 and 2000 at five stations in the Greater Vancouver\\/Fraser Valley area of southern British Columbia. Results indicate that although average daily maximum ozone concentrations were relatively low compared to many

Roxanne Vingarzan; Bill Taylor

2003-01-01

394

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

E-print Network

. The case of the Exxon Valdez in Alaska or the Erika recently in South Brittany (France), are vivid examplesProceedings of the 23 rd Arctic Marine Oil Spill Program Meeting, Vancouver, Canada. Vol. 1., 59, nine oil loadings (Exxon #6 fuel oil: 3 to 38 mg/cm2 ) were sub sampled with C18-SPE disks

Louchouarn, Patrick

395

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

396

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

397

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

398

Effects of Habitat Fragmentation and Forest Edges on Predators of Marbled Murrelets and Other Forest Birds on Southwest Vancouver Island  

Microsoft Academic Search

We recorded the occurrence and relative abundance of potential predators of the threatened marbled murrelet (Brachyramphus marmoratus) in the Carmanah, Walbran, and Klanawa Valleys on southwest Vancouver Island, British Columbia. Data covering multiple years (1994-2000) came from two series of dawn surveys used to monitor murrelet activities (45 stations in total), and two series of point counts (190 stations). Steller's

ALAN E. BURGER; MICHELLE M. MASSELINK; ANGELINE R. TILLMANNS; R. SZABO; MATHEW FARNHOLTZ; MARTIN J. KRKOSEK

2004-01-01

399

Site history affects soil and plant 15 N natural abundances ( ? ? ? ? 15 N) in forests of northern Vancouver  

Microsoft Academic Search

Summary 1. About 10 years after establishment, plantations of Western Redcedar ( Thuja plicata Donn ex D. Don) on northern Vancouver Island, British Columbia become nutrient deficient and chlorotic, grow slowly, and are susceptible to invasion by the ericaceous shrub Salal ( Gaultheria shallon Pursh.). 2. To test the hypothesis that ? 15 N can be related to site histories

S. X. CHANG; L. L. HANDLEY

400

Preparing for Further Introduction of Computing Technology in Vancouver Community College Instruction. Report of the Instructional Computing Committee.  

ERIC Educational Resources Information Center

After examining the impact of changing technology on postsecondary instruction and on the tools needed for instruction, this report analyzes the status and offers recommendations concerning the future of instructional computing at Vancouver Community College (VCC) in British Columbia. Section I focuses on the use of computers in community college…

Vancouver Community Coll., British Columbia.

401

Troy Day,University of Toronto, Ontario, Canada Sarah P Otto, University of British Columbia, Vancouver, Canada  

E-print Network

are injurious, I have called Natural Selection, or Survival of the Fittest (Darwin, 1859). All current uses the term `fittest' to describe those individuals that are best able to survive (most viable) and reproduce Columbia, Vancouver, Canada Fitness is a measure of the survival and reproductive success of an entity

Otto, Sarah

402

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

403

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

Code of Federal Regulations, 2010 CFR

...emergency services by nonparticipating hospitals. 482.2 Section 482.2 Public...CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS General Provisions § 482.2 Provision...emergency services by nonparticipating hospitals. (a) The services of an...

2010-10-01

404

42 CFR 456.101 - UR plan required for inpatient hospital services.  

Code of Federal Regulations, 2010 CFR

...false UR plan required for inpatient hospital services. 456.101 Section 456...UTILIZATION CONTROL Utilization Control: Hospitals Utilization Review (ur) Plan: General...101 UR plan required for inpatient hospital services. (a) A State plan...

2010-10-01

405

42 CFR 412.109 - Special treatment: Essential access community hospitals (EACHs).  

Code of Federal Regulations, 2010 CFR

...treatment: Essential access community hospitals (EACHs). 412.109 Section 412...PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of Certain...treatment: Essential access community hospitals (EACHs). (a) General rule....

2010-10-01

406

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

PubMed Central

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

2014-01-01

407

Generalized anxiety disorder - self-care  

MedlinePLUS

... TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry . 1st ed. Philadelphia, ... TA, Rosenbaum JF, Fava M, et al., eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry . 1st ed. Philadelphia, ...

408

Bibliography for the Hospitality Industry.  

ERIC Educational Resources Information Center

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

Nelson, Elizabeth A.

409

Radiobiological Intercomparison of the 160 MeV and 230 MeV Proton Therapy Beams at the Harvard Cyclotron Laboratory and at Massachusetts General Hospital.  

PubMed

The purpose of this study was to determine the relative biological effectiveness (RBE) along the axis of two range-modulated proton beams (160 and 230 MeV). Both the depth and the dose dependence of RBE were investigated. Chinese hamster V79-WNRE cells, suspended in medium containing gelatin and cooled to 2°C, were used to obtain complete survival curves at multiple positions throughout the entrance and 10 cm spread-out Bragg peak (SOBP). Simultaneous measurements of the survival response to (60)Co gamma rays served as the reference data for the proton RBE determinations. For both beams the RBE increased significantly with depth in the 10 cm SOBP, particularly in the distal half of the SOBP, then rose even more sharply at the distal edge, the most distal position measured. At a 4 Gy dose of gamma radiation (S = 0.34) the average RBE values for the entrance, proximal half, distal half and distal edge were 1.07 ± 0.01, 1.10 ± 0.01, 1.17 ± 0.01 and 1.21 ± 0.01, respectively, and essentially the same for both beams. At a 2 Gy dose of gamma radiation (S = 0.71) the average RBE values rose to 1.13 ± 0.03, 1.15 ± 0.02, 1.26 ± 0.02 and 1.30 ± 0.02, respectively, for the same four regions of the SOBP. The difference between the 4 Gy and 2 Gy RBE values reflects the dose dependence of RBE as measured in these V79-WNRE cells, which have a low ?/? value, as do other widely used cell lines that also show dose-dependent RBE values. Late-responding tissues are also characterized by low ?/? values, so it is possible that these cell lines may be predictive for the response of such tissues (e.g., spinal cord, optic nerve, kidney, liver, lung). However, in the very small number of studies of late-responding tissues performed to date there appears to be no evidence of an increased RBE for protons at low doses. Similarly, RBE measurements using early responding in vivo systems (mostly mouse jejunum, an early-responding tissue which has a large ?/? ?10 Gy) have generally shown little or no detectable dose dependence. It is useful to compare the RBE values reported here to the commonly used generic clinical RBE of 1.1, which assumes no dependence on depth or on dose. Our proximal RBEs obviously avoid the depth-related increase in RBE and for doses of 4 Gy or more, the low-dose increase in RBE is also minimized, as shown in this article. Thus the proximal RBE at a 4 Gy dose of 1.10 ± 0.01, quoted above, represents an interesting point of congruence with the clinical RBE for conditions where it could reasonably be expected in the measurements reported here. The depth dependence of RBE reported here is consistent with the majority of measurements, both in vitro and in vivo, by other investigators. The dose dependence of RBE, on the other hand, is tissue specific but has not yet been demonstrated for protons by RBE values in late-responding normal tissue systems. This indicates a need for additional RBE determination as function of dose, especially in late-responding tissues. PMID:25587741

Wouters, Bradly G; Skarsgard, Lloyd D; Gerweck, Leo E; Carabe-Fernandez, Alejandro; Wong, Michelle; Durand, Ralph E; Nielson, Deanna; Bussiere, Marc R; Wagner, Miles; Biggs, Peter; Paganetti, Harald; Suit, Herman D

2015-02-01

410

Treating nicotine dependence in mental health hospitals  

Microsoft Academic Search

Although guidelines for the treatment of nicotine dependence have been implemented in general hospital settings, treatment does not occur systematically in mental health hospitals. A number of barriers to treatment exist, including ambivalent staff attitudes, the prevalence of staff who smoke, a lack of education and training in nicotine dependence treatment, a lack of nicotine replacement therapy use and knowledge

P. Wye; J. Bowman; J. Wiggers; M. Freund; L. Wolfenden; E. Stockings

2011-01-01

411

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

SciTech Connect

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

Harding, K.A.; Ford, D.C. (McMaster Univ., Hamilton, Ontario (Canada). Dept. of Geography)

1992-01-01

412

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

413

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

PubMed

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

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

2014-06-01

414

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

415

The determination of alternative hospital classifications.  

PubMed Central

The problem of determining alternative hospital classifications when explicit constraints are recognized in the classification process is discussed. It is argued that such constraints are an integral part of most hospital classification processes and should be handled directly. A methodology based on cluster analysis, which can directly accommodate any number of specific constraints that might be imposed on the classification process, is described. A number of these possible constraints are presented. To illustrate the process, the methodology is applied to a data set of 200 short-term general hospitals; empirical results are presented that demonstrate the potential effects of various constraints on the hospital classification process. PMID:7263274

Klastorin, T D; Watts, C A

1981-01-01

416

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

417

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.

418

Hospital marketing revisited.  

PubMed

With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature. PMID:10283019

Costello, M M

1987-05-01

419

Outcome of Late Second Trimester Emergency Cerclage in Patients with Advanced Cervical Dilatation with Bulging Amniotic Membranes: A Report of Six Cases Managed at the Douala General Hospital, Cameroon  

PubMed Central

Purpose. To show the feasibility of emergency late second trimester cerclage with advanced cervical dilatation and bulging of amniotic membranes. Setting. Department of Obstetrics and Gynecology of the Douala General Hospital. Method. This is a retrospective study of case files of patients who underwent emergency late second trimester cerclage with advanced cervical dilatation, some with bulging of fetal membranes between June 2003 and June 2010. The modified Shirodkar technique was employed in all the cases. Results. Altogether, six patients (100%) underwent late second trimester cervical cerclage between 24 and 26 weeks of gestational age. Four cases (66.7%) carried on their pregnancies to term that resulted in healthy live-born babies all delivered vaginally. The other two cases (33.3%) presented with preterm premature rupture of fetal membranes (PPROM) which led us to undo the stitch with eventual delivery of live-born premature fetuses which died in the neonatal intensive care unit because of complications of prematurity and neonatal infection. Conclusion. In experienced hands and in the absence of other risk factors like infection, the success rates of this procedure are encouraging with improved prognosis. Finally, the modified Shirodkar technique yielded excellent results in our series. PMID:24371527

Egbe, Thomas Obinchemti; Nana Njamen, Theophile; Halle Ekane, Gregory; Tsingaing, Jacques Kamgaing; Tchente, Charlotte Nguefack; Beyiha, Gerard; Barla, Esther; Nyemb, Ernest

2013-01-01

420

Analysis of dental treatment performed by dental residents at General Dentistry Department of Tokyo Dental College Chiba Hospital over 6 years following introduction of mandatory dental clinical training system.  

PubMed

Six years have passed since the introduction of legislation mandating at least 1 year of clinical training for those who have passed the national dentist examination. To determine whether clinical training has been appropriately implemented at the General Dentistry Department of Tokyo Dental College Chiba Hospital, a managed-type clinical training facility, the number of patients treated and types of dental and dental technical work performed by dental residents trained by the department were summarized and analyzed. The number of patients treated per dental resident increased from 11 in 2006 to 15 in 2011. By treatment type, periodontic treatment was the most frequently performed throughout the study period, followed by endodontic treatment. Conservation treatment, prosthodontic treatment with crowns/bridges, and prosthodontic treatment with dentures were performed at a similar moderate frequency, while oral surgical treatment was performed least frequently throughout the study period. The frequency of periodontic treatment increased slightly, whereas that of endodontic treatment decreased slightly or remained almost unchanged after introduction of the mandatory clinical training system. When the distribution of dental treatment performed at our department was compared with that of dental treatment performed by general dentists across Japan in 2011, our department showed a slightly lower frequency of periodontic treatment and higher frequency of endodontic treatment than the national total, whereas the frequency of other types of treatment was similar between the two populations. These results demonstrated that appropriate clinical training has been provided by our department to meet the purpose of offering dentists the opportunity to acquire the basic diagnostic and treatment abilities that would enable them to provide appropriate treatment for injuries and diseases frequently encountered in daily practice. The study also revealed some problems, such as a decreasing number of residents engaging in dental technical work each year. For additional improvement in the quality of dental clinical training, more analyses are needed to further identify and address potential problems in the system. PMID:24334632

Yamakura, Daiki; Takahashi, Toshiyuki; Kameyama, Atsushi; Noro, Akio; Sugiyama, Toshiko; Kondo, Yoshihiro; Sugiyama, Setsuko; Haruyama, Akiko; Takeda, Tomotaka; Nakajima, Kazunori

2013-01-01

421

The MASSACHUSETTS GENERAL HOSPITAL SURGICAL SOCIETY  

E-print Network

in morbidity and mortality were quite noteworthy. Innovative ways to increase donor organs that the MGH has their contributions in research. Their fertile imaginative minds produce results that stimulate others to pursue

Mootha, Vamsi K.

422

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.

423

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.

424

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

425

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

426

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

427

DIVISION OF GRADUATE DENTAL EDUCATION Department of Hospital Dentistry  

E-print Network

I DIVISION OF GRADUATE DENTAL EDUCATION Department of Hospital Dentistry ROYAL UNIVERSITY HOSPITAL/COLLEGE OF DENTISTRY UNIVERSITY OF SASKATCHEWAN Room 1860-103 Hospital Drive Saskatoon, Sk., S7N 0W8 Phone: 306 for appointment as a General Practice Resident (G.P.R.) with the Department of Dentistry & the College

Saskatchewan, University of

428

Greek hospitals: how well their resources are used  

Microsoft Academic Search

The paper concerns the use of different estimation methods (parametric and non-parametric), jointly or individually, as means of ascertaining relative efficiency, as well as specific estimates of the efficient marginal costs of hospital services (inpatient days in medical care, inpatient days in surgical area, etc.) of public, general and teaching hospitals in Greece. In addition, the efficient cost of hospitals

Dimitris I. Giokas

2001-01-01

429

Hospital eTool: Hazards and Controls Found in the Hospital Setting  

MedlinePLUS

... of Medical Lasers Health Effects Use of Medical Lasers General Employer Employee Additional Information Downloads Hospital eTool ... conditions" for today's workers, and mandates that employers provide a safe work environment for employees. Hospitals and personal care facilities employ approximately 1.6 million workers at 21,000 work sites. There are many occupational health and safety hazards throughout the hospital. This eTool* focuses on ...

430

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

PubMed

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

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

2013-03-01

431

The competitive role of Gaultheria shallon on planted western hemlock and western red cedar saplings on northern Vancouver Island  

Microsoft Academic Search

The presence of competing vegetation, particularly salal (Gaultheria shallon F'ursh), was studied in relation to growth (measured as height and root collar diameter) of western hemlock (Tsugu heterophylla (Raf.) Sarg.) and western red cedar (Thuju plicutu Dorm) saplings planted in cedar-hemlock (CH) and hemlock-amabilis fir (HA) phases of an ecosystem type on northern Vancouver Island in British Columbia, Canada. The

L. H. Fraser af; C. P. Chanway; Roy Turkington

1995-01-01

432

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

433

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

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. Don)

Colin P. Laroque; Dan J. Smith

2005-01-01

434

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

435

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

436

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

437

MAPUniversity Hospital Directions from University Hospital to  

E-print Network

Physical Therapy (Level 6) Patient Rooms 2000­2999 (Level 2) 3000­3999 (Level 3) 4000­4999 (Level 4) 5000version 1 MAPUniversity Hospital version 7 Directions from University Hospital to: Huntsman Cancer provides non-clinical services such as photocopying, faxing, phone access and hotel accommodations for out

Feschotte, Cedric

438

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

439

Central line infections - hospitals  

MedlinePLUS

... and increase how long you are in the hospital. Your central line needs special care to prevent ... The hospital staff will use aseptic technique when a central line is put in your chest or arm. Aseptic ...

440

Help prevent hospital errors  

MedlinePLUS

A hospital error is when there is a mistake in your medical care. Errors can be made in your: ... Surgery Diagnosis Equipment Lab and other test reports Hospital errors are a leading cause of death. Doctors ...

441

Hospitals and health systems: the best of times and the worst of times.  

PubMed

Hospitals and health systems, whether general acute care hospitals or specialty-driven hospitals, are attempting to prosper in a unique time. This year, hospitals throughout the country will see increased reimbursement for hospital inpatient services, rather than decreased reimbursement. Many hospitals are examining a multitude of options for debt financing and a number of the nation's hospitals are in the process of renovating, expanding, or replacing their current hospitals. Further, more private equity and venture capital funds are pursuing hospital investments than seen in several years. Despite the positive signals stemming from many of the country's hospitals, this remains a time of tremendous uncertainty and risk in the hospital industry. This article discusses five strategic and development issues facing many hospitals and addresses how hospitals can prepare for the future should the current climate, supportive of growth, development, investment, and debt financing, change. PMID:18975727

Becker, Scott; Koch, Elissa

2006-01-01

442

Children's Hospital Medical Center  

E-print Network

UNIVERSITY COMMONS Children's Hospital Medical Center Children's Hospital Medical Research Center Complex Radiation Safety HealthProfessions Building WherryHall Veterans Affairs Medical Center VAMC VAMC ShrinersHospital forChildren Shriners Garage Cincinnati Dept of Health LoganHall Medical Sciences Building

Papautsky, Ian

443

Children's Hospital Medical Center  

E-print Network

UNIVERSITY COMMONS Children's Hospital Medical Center Children's Hospital Medical Research Center WherryHall Veterans Affairs Medical Center VAMC VAMC VAMC VAMC VAMC Holmes CHMC CHMC Children's Hospital Vontz Center Hamilton Co. Coroner Kettering Lab Complex Radiation Safety HealthProfessions Building

Papautsky, Ian

444

Children's Hospital Medical Center  

E-print Network

UNIVERSITY COMMONS Children's Hospital Medical Center Children's Hospital Medical Research Center Affairs Medical Center VAMC VAMC VAMC VAMC VAMC Holmes CHMC CHMC Children's Hospital Garage CHMC Kingsgate Co. Coroner Kettering Lab Complex Radiation Safety HealthProfessions Building WherryHall Veterans

Papautsky, Ian

445

Modeling a Hospital Organization  

Microsoft Academic Search

A multidimensional input-output model of a hospital's components is developed which, because it tracks the flows of people, materials, and services, can be used for long-range planning and resource allocation, and dynamic simulation of the hospital. The model also allows the determination of shadow prices, and hence, the profitability of the various hospital components.

William V. Gudaitis; Robert A. Brown

1975-01-01

446

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

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

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

447

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

448

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

NASA Astrophysics Data System (ADS)

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 rubra and more shade-tolerant conifers (i.e., Picea and Tsuga mertensiana) increased. Increases in T. mertensiana, P. contorta, and A. crispa pollen accumulation rates (PARs) between 10,600 and 10,400 14C yr BP (11,660-11,480 cal yr BP) reflect a cool and moist climate during the Younger Dryas chronozone. Orbitally induced warming around 10,000 14C yr BP (11,090 cal yr BP) allowed the northward extension of Pseudotsuga menziesii, although Picea, Tsuga heterophylla, and A. rubra dominated early Holocene forests. By 7500 14C yr BP (8215 cal yr BP), shade-tolerant T. heterophylla was the dominant forest tree. Cupressaceae ( Thuja plicata and Chamaecyparis nootkatensis) was present by 7500 14C yr BP but reached its maximum after 3500 14C yr BP (3600 cal yr BP), when a cooler and wetter regional climate facilitated the development of temperate rainforest. The highest rates of vegetation change are associated with Lateglacial climate change and species with rapid growth rates and short life spans.

Lacourse, Terri

2005-01-01

449

How many HIV infections are prevented by Vancouver Canada's supervised injection facility?  

PubMed

Mathematical modelling analyses of drug injection-related HIV risk reduction interventions can provide policy makers, researchers, and others with important information that would be difficult to obtain through other means. The validity of the results of mathematical modelling analyses that rely on secondary data sources critically depends on the model(s) employed in the analyses and the parameter values used to populate the models. A recent article in the International Journal of Drug Policy by Andresen and Boyd (2010: 70-76) utilised four different mathematical models of injection-related HIV transmission to estimate the number of HIV infections prevented by Vancouver Canada's Insite supervised injection facility (SIF). The present article reviews and critiques the mathematical models utilised in the Andresen and Boyd article, then describes an alternative-and potentially more accurate-method for estimating the impact of the Insite SIF. This model indicates that the SIF prevents approximately 5-6 infections per year, with a plausible range of 4-8 prevented infections. These estimates are far smaller than suggested by Andresen and Boyd (19-57 prevented infections). PMID:21450450

Pinkerton, Steven D

2011-05-01

450

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

451

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

PubMed Central

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

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

2008-01-01

452

Preface: Proceedings of the Workshop on Mechanical Behavior of Glassy Materials (Vancouver, 21 23 July 2007)  

NASA Astrophysics Data System (ADS)

This special issue highlights some of the research topics presented at the workshop on Mechanical Behavior of Glassy Materials, which took place in Vancouver, Canada from 21-23 July 2007. The workshop was organized under the auspices of the Pacific Institute of Theoretical Physics (PITP) with support from the Pacific Institute of Mathematical Sciences (PIMS) and Simon Fraser University (SFU). During this three-day event, 23 invited lectures were presented to an international group of about 40 participants. The full conference program as well as an archive of all presentations can be found online at www.pitp.physics.ubc.ca/confs/glass07/ The aim of the workshop was to bring together theorists and experimentalists working on glassy systems, with mechanical properties as the unifying theme. The talks touched on many aspects of the glass problem, from theories of the glass transition and mode coupling approaches to glassy dynamics, to spin glasses, simulations and theories of amorphous plasticity, the universal origin of ageing and dynamical heterogeneity in glasses, and glassy phenomena in biological systems. The interplay of ideas from high- and low-temperature (quantum) regimes of glasses led to lively discussions that brought researchers in both communities to explore similarities and differences in their respective ideas and physical systems. Progress was made on several fronts, and we hope that everyone involved left with some new perspective on their particular corner of interest in a class of problems that continues to present many challenges.

Rottler, Joerg; Kennett, Malcolm; Stamp, Philip

2008-06-01

453

Prediction of noise levels and annoyance from aircraft run-ups at Vancouver International Airport.  

PubMed

Annoyance complaints resulting from engine run-ups have been increasing at Vancouver International Airport for several years. To assist the Airport in managing run-up noise levels, a prediction tool based on a Green's function parabolic equation (GFPE) model has been consolidated, evaluated, and applied. It was extended to include more realistic atmospheric and ground input parameters. Measurements were made of the noise-radiation characteristics of a CRJ200 jet aircraft. The GFPE model was validated by comparing predictions with results in the literature. A sensitivity analysis showed that predicted levels are relatively insensitive to small variations in geometry and ground impedance, but relatively sensitive to variations in wind speed, atmosphere type, and aircraft heading and power setting. Predicted noise levels were compared with levels measured at noise monitoring terminals. For the four cases for which all input information was available, agreement was within 10 dBA. For events for which some information had to be estimated, predictions were within 20 dBA. The predicted annoyance corresponding to the run-up events considered ranged from 1.8% to 9.5% of people awoken, suggesting that noise complaints can be expected. PMID:17902830

Scherebnyj, Katrina; Hodgson, Murray

2007-10-01

454

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

455

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

456

Pattern of ophthalmological accidents and emergencies presenting to hospitals  

Microsoft Academic Search

STUDY OBJECTIVE--To investigate the numbers and characteristics of patients with ophthalmological accidents and emergencies presenting to hospitals. DESIGN--Prospective survey over eight weeks. SETTING--Two general and one ophthalmic accident and emergency departments, two general outpatient departments, and an eye hospital ward consulting room (all in two teaching hospitals) in Newcastle upon Tyne. MEASUREMENTS AND MAIN RESULTS--Consultation numbers by age, sex, health

R S Bhopal; D W Parkin; R F Gillie; K H Han

1993-01-01

457

Nutrition: What Hospitality Students Think and Know  

Microsoft Academic Search

The purpose of this research was to determine the nutrition knowledge level of students in four-year hospitality programs in Texas, their attitudes toward nutrition in general (general attitudes), and their attitudes toward the role of nutrition in commercial foodservice (restaurant attitudes). Correlations between knowledge and attitudes and differences based on gender, age, college classification, and completion of a college nutrition

Agnes R. Bruce; Joyce I. Nies

1994-01-01