Sample records for vancouver general hospital

  1. MASSACHUSETTS GENERAL HOSPITAL

    E-print Network

    Adams, Mark

    via queries from our Anesthesia Information Management System (AIMS) and other hospital databasesMASSACHUSETTS GENERAL HOSPITAL Page 1 of 4 HARVARD MEDICAL SCHOOL Position: Quality & Safety and efficacy of our practice, reporting this data out to department clinicians, senior leadership and hospital

  2. [Pro general hospital].

    PubMed

    Carreras-González, E; Marruecos-Sant, L

    2010-04-01

    Trauma operative systems were created in United States to optimize polytrauma patients' treatment. These systems include prehospital polytrauma care. They determine hospital requirements to treat this kind of patients, standardize physicians' training and implement hospital registries. Initially, this system was applied only in monographic centers. However, trauma services of General Hospitals that fulfill the requirements were authorized progressively by the American Surgery Academy to fulfill this function. This is the model followed in Europe at present. Accreditation requires the qualification of the stay, with specific health care resources and a detailed trauma program. The director is responsible for organizing the creation of the trauma teams, operating 24h, for teaching, protocols and guides and the coordination of pre-hospital emergency groups. In Spain, there is an extensive network of tertiary hospitals that have trauma programs and their consequent accreditation could make it possible to take advantage of their existing resources. An accreditation system should be elaborated in order to homogenize professional training in trauma emergencies and to create a National Polytraumatic Registry. The high level of technology of these hospitals and of their human resources that include all the medical, surgical specialties and central services provide an added value. Care to the trauma patients is complex and multidisciplinary. Thus, we believe that General Hospitals, within a traumas program, are the best setting to offer it with excellent conditions. PMID:19942318

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

    SciTech Connect

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

    1990-02-01

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

  4. 3. Hospital Point, general view toward Portsmouth Naval Hospital Building ...

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

    3. Hospital Point, general view toward Portsmouth Naval Hospital Building showing cannon (at left) and Saunders Monument (at right in distance), view to southwest - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  5. 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.

  6. Splenectomy in a general hospital.

    PubMed Central

    Glass, J M; Gilbert, J M

    1996-01-01

    Splenectomy is often performed in patients with malignant disease or trauma who are at a high risk of complications. In the long term, it increases the risk of infection by encapsulated bacteria. An audit was performed to determine the reasons for splenectomy in a district general hospital, to review the results and complications of surgery, and to see how often the patients were prescribed antibacterial prophylaxis. Twenty-eight patients underwent splenectomy in 3 years. The indication was haematological disease in 13 and trauma in four. In the remaining nine the spleen was removed either as part of a radical gastrectomy or during some other abdominal procedure. Six of the 28 patients had died, one within 30 days from disseminated intravascular coagulopathy following an emergency gastrectomy and splenectomy for haematemesis, two from progressive haematological malignant disease, two from non-haematological malignancy, and one from bronchopneumonia. Of the nine patients (32%) with complications, three required a further laparotomy. Most patients had been prescribed pneumococcal vaccine (85%) and prophylactic antibiotics (93%). PMID:8676317

  7. General Practice Teaching--Within the Hospital

    ERIC Educational Resources Information Center

    Drury, M.

    1976-01-01

    A program of integrated teaching by consultants and general practitioners is described. The teaching took place in the hospitals used for the purpose by the Medical Faculty of the University of Birmingham. (Author)

  8. Clinical training experience in district general hospitals

    PubMed Central

    MacFaul, R.; Jones, S.; Werneke, U.

    2000-01-01

    AIMS—To estimate the nature and quantity of clinical experience available for trainees in paediatrics or general practice in acute general hospitals of differing sizes in the UK. To discuss implications for training and service configuration taking account of current Royal College recommendations (a minimum of 1800 acute contacts each year and ideally covering a population of 450 000 to 500 000 people).?METHODS—Observed frequencies of diagnoses in Pinderfields Hospital, Wakefield were compared with those in five other hospitals in Yorkshire and four in the South of England, and with expected frequencies from a review of selected marker conditions using national routine and epidemiological data. Based on the Pinderfields data, we modelled expected frequencies of a wider range of diagnoses for different sized hospitals.?RESULTS—Small units (1800 or less acute referrals a year) provide adequate exposure to common conditions such as gastroenteritis (157per annum) and asthma (171 per annum) but encounter serious or unusual disease rarely. When modelled for units serving larger populations, numbers of such disorders remain small. For example, about 0.5% of admissions require intensive care to the level of ventilatory support. Medium size units offer a wide range of experience but differ little from those serving the population of 500 000 proposed as being optimal for training. This standard is not justified by the evidence in this review. Closing or amalgamating units on the scale necessary to achieve this ideal would be impractical as only five hospitals in England have a paediatric workload equivalent to this population; it would also raise issues of access and equity.?? PMID:10868998

  9. 284 SDSU General Catalog 2012-2013 Hospitality and Tourism

    E-print Network

    Gallo, Linda C.

    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

  10. Nurse endoscopy in a district general hospital.

    PubMed Central

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

    2003-01-01

    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

  11. Surgery in a district general hospital.

    PubMed

    Kiff, R S; Sykes, P A

    1991-02-01

    All operations performed in all surgical specialties in a district general hospital over a 4-week period were monitored. Although most elective operations were performed or supervised by trained staff, the service, particularly emergency care, was heavily dependent on incompletely trained doctors. Consultants, who operated on 41% of elective cases, were more likely to perform major operations. Supervision of junior surgeons for elective surgery was considered satisfactory. Thirty-one per cent of all major cases were performed by doctors in training, usually under supervision. However, 86% of all emergency operations were performed by trainee surgeons without consultant supervision. A consultant anaesthetist or clinical assistant attended all elective operating lists and either supervised or gave the anaesthetic. However, anaesthetists in training were not usually supervised for emergency cases outside normal working hours. It is worrying that one-third of all procedures were undertaken by surgeons who had been on duty for periods in excess of 24 h. PMID:2037999

  12. 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

  13. 178 SDSU General Catalog 2007-2008 Hospitality and Tourism

    E-print Network

    Gallo, Linda C.

    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

  14. SDSU General Catalog 2013-2014 289 Hospitality and Tourism

    E-print Network

    Gallo, Linda C.

    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

  15. SDSU General Catalog 2011-2012 281 Hospitality and Tourism

    E-print Network

    Gallo, Linda C.

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

  16. Breast reconstruction at a district general hospital.

    PubMed Central

    Evans, A A; Straker, V F; Rainsbury, R M

    1993-01-01

    Breast reconstruction is normally carried out by plastic surgeons, but the advent of permanent tissue expanders places post-mastectomy reconstruction within easy reach of the general surgeon. Nineteen patients underwent breast reconstruction between 1989 and 1991 using a subpectoral silicone-based, double lumen tissue expander. Assessment of results was by: (a) patient completed questionnaire; and (b) third party evaluation of standardized photographs. The mean operating time was 58 min (40-80 min) and mean hospital stay 3 days (2-7 days). Complications included one flap necrosis and one leaking injection port. Outpatient tissue expansion required an average of seven visits (4-11) and was completed in an average of 12 months (7-19). The injection port was subsequently removed under local anaesthetic as a day case. The fully dressed appearance following reconstruction was graded good or excellent by 100% of patients and in over 80% of third-party assessments. Equivalent figures for the appearance when wearing a bra were 93% and 60% and undressed 57% and 47%, respectively. All patients recommended the procedure but 25% found inflation uncomfortable. Subpectoral tissue expansion is a safe, cosmetically acceptable method of breast reconstruction which is associated with a high level of patient satisfaction. Images Figure 3. (a) Figure 3. (b) Figure 4. PMID:8258795

  17. Psychiatric disorder in hospital and general practice

    Microsoft Academic Search

    Brian Cooper

    1966-01-01

    Accepted clinical notions in psychiatry have been derived largely from the study of mental hospital case-material which, however, may be unrepresentative because of the selective factors influencing hospital admission. To obviate bias, it will be necessary to study cases identified in the community.

  18. Blood Drive Coordinator Packet Massachusetts General Hospital pg.2

    E-print Network

    Mootha, Vamsi K.

    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

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

    ERIC Educational Resources Information Center

    Hern, Matt

    2009-01-01

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

  20. SDSU General Catalog 2009-2010 263 Hospitality and Tourism

    E-print Network

    Gallo, Linda C.

    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 and sciences. Emphasis in global tourism management. Emphasis in hotel operations and management. Emphasis

  1. 282 SDSU General Catalog 2010-2011 Hospitality and Tourism

    E-print Network

    Gallo, Linda C.

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

  2. Fitzsimons General Hospital, Civilian Employee Housing, North end of North ...

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

    Fitzsimons General Hospital, Civilian Employee Housing, North end of North Hickey Street, 725 feet North-Northwest of intersection of North Hickey Street & West Loosley Avenue, Aurora, Adams County, CO

  3. Fitzsimons General Hospital, Women's Army Corps Recreation & Administration Building, ...

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

    Fitzsimons General Hospital, Women's Army Corps Recreation & Administration Building, North Hickey Street, west side, 75 feet north of intersection of West Pennington Avenue & North Hickey Street, Aurora, Adams County, CO

  4. Fitzsimons General Hospital, Civilian Employee Garage, North end of North ...

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

    Fitzsimons General Hospital, Civilian Employee Garage, North end of North Hickey Street, 775 feet North-Northwest of intersection of North Hickey Street & West Loosley Avenue, Aurora, Adams County, CO

  5. 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

  6. Vancouver's Transportation Innovations

    Microsoft Academic Search

    Gary Vlieg

    2009-01-01

    Vancouver, British Columbia, is the location of several innovative transportation projects. This article highlights several of these projects that reflect innovation in planning, design, procurement and funding. The projects include: a multiuse greenway that offers off-street paved and gravel paths, shared local street paths, and on-street bike lanes; improvement of a corridor that connects the city of Vancouver to Olympic

  7. The American General Hospital as a Complex Social System

    PubMed Central

    Georgopoulos, Basil S.; Matejko, Aleksander

    1967-01-01

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

  8. Changes in general hospital psychiatric care, 1980-1985.

    PubMed

    Kiesler, C A

    1991-04-01

    More than 60% of all inpatient psychiatric episodes occur in general hospitals. The need for psychologists' involvement in this important area is discussed. Changes in general hospital inpatient care from 1980 to 1985 are described. These include important and controversial changes in public policy, most notably Medicare's prospective payment system. Substantial changes in the de facto system occurred in patterns of diagnosis, sites of care, and the role of third-party payers. Implications for public policy and future investigations are drawn. PMID:2048799

  9. 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.

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

    PubMed

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

    1991-02-01

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

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

    PubMed Central

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

    1991-01-01

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

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

    PubMed Central

    Lewis, Thomas L.; Macks, Gerald C.

    1977-01-01

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

  13. Massachusetts General Hospital Cancer Center Advancing cancer care through groundbreaking research

    E-print Network

    de Bakker, Paul

    Massachusetts General Hospital Cancer Center Advancing cancer care through groundbreaking research Massachusetts General Hospital Cancer Center combines a commitment to further the most innovative scientific advancements to impact cancer care. An emphasis on delivering compassionate care to each individual patient

  14. Epidemiology of bacteraemia in Hamad general hospital, Qatar: a one year hospital-based study.

    PubMed

    Khan, Fahmi Yousef; Elshafie, Sittana S; Almaslamani, Muna; Abu-Khattab, Mohammed; El Hiday, A Haleem; Errayes, Mehdi; Almaslamani, Eman

    2010-11-01

    We conducted a one-year observational study from July 2007 to June 2008 to describe the epidemiology of bacteraemia at Hamad general hospital. During this period, a total of 452 episodes of bacteraemia occurred, which corresponds to a rate of 19/1000 hospital admissions. Most patients 58.8% (266/452) had community acquired bacteraemia, and primary bacteraemia accounted for 62.2% (281/452) of the cases. The most common source of bacteraemia was intravenous catheterization in 19.2% (87/452) but no source was identified in 42.9% (194/452) of the episodes. Gram-negative organisms were isolated in 63.1% (285/452) episodes with Escherichia coli being the most frequent 21.5% (97/452). Multidrug resistance was observed in 33.3% (7/21) of all Pseudomonas aeruginosa isolates, 50% (6/12) of Acinetobacter isolates and 28.6% (6/21) of Enterobacter isolates, whereas all ESBL producing Klebsiella spp. and E. coli were multiresistant. The percentages of oxacillin resistant coagulase negative Staphylococci isolates and methicillin-resistant Staphylococcus aureus isolates were 81.8% (27/33) and 13.2% (7/53) respectively. In hospital mortality was 22.5% (102/452), and inadequate treatment and septic shock were found to be independent predictors of mortality. Therefore, bloodstream infection surveillance is crucial to produce meaningful guidelines for prevention (e.g., catheter-related) and empirical treatment of bacteraemia in Qatar. PMID:21074495

  15. Establishment and Use of a General Practitioner Medical Unit in a District General Hospital

    PubMed Central

    Duncan, A. H.

    1972-01-01

    An analysis of the establishment and running of a general-practitioner medical unit in a district general hospital has shown that it fulfills a useful and positive role in the area health services and is well used. It shows that selectivity of admission can and does work and that the theoretical drawbacks to such a unit did not materialize in practice during the study. PMID:5078412

  16. Palliative care: experience with 156 cases in a general hospital.

    PubMed

    Khoo, S B

    2002-12-01

    The concept of Palliative Care is still quite new in Malaysia and there is a need to promote the awareness of its importance for patients with incurable and advanced illnesses, not only to the public but also to the nursing and medical professionals. These patients especially the poor ones very often have no one to turn to; they cannot afford to seek treatment from the private hospitals, they are turned away from acute General Hospitals and are told that there is nothing more to be done because their illnesses are no longer curable, they cannot pay for GPs to come to their homes, and there is difficulty in purchasing opiate drugs for pain relief. This is a retrospective observational study of the palliative care services we try to provide to those few patients referred to us. This study showed that out of the total of 156 patients, majority were Chinese, peak age between 50-59 years, referrals were mainly from the community and the Obstetrics + Gynaecology department, patients were referred rather late, 60% of patients died at home, most common malignancies being those of the breast, colorectal and cervix, common sites of metastases being the lungs, liver, bones, peritoneum and local infiltration, 87% of patients experienced pain, about 40% of patients were not fully aware of both diagnosis and prognosis, common drugs used being opiate analgesics followed by dexamethasone, H2 antagonist, antiemetics and NSAID. PMID:12733165

  17. Characteristics of the stroke alert process in a general Hospital

    PubMed Central

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

    2015-01-01

    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

  18. General practitioner participation in 'Morning Report' at a major teaching hospital.

    PubMed

    Carruthers, A

    1997-07-01

    General practitioners attending 'Morning Report' have provided information on the general practice management of a wide range of conditions and have promoted the benefits of improved communication between general practitioners and hospital doctors. By collecting data on a range of problems at the community hospital interface, they are in a position to identify and act upon issues with important implications for health care. This activity is recommended to all general practitioners working in association with a major hospital. PMID:9254951

  19. Stem cell transplantation programme at Singapore General Hospital.

    PubMed

    Koh, Mbc; Goh, Yt; Tan, Phc; Koh, Lp; Hwang, Wyk; Loh, Y; Tan, D; Ng, Hj; Chuah, C; Lim, Tj; Niam, M; Suck, G; Chan, M; Phang, Cy; Lee, Jj; Wee, V; Ng, Hy; Lim, Ch; Yiu, R; Kam, G; Ang, A; Linn, Yc

    2008-08-01

    The adult transplant programme at Singapore General Hospital (SGH) was established in 1985 and more than 820 transplants have been performed to date. An average of about 60 adult transplants (autologous and allogeneic) are performed each year. Transplants offered at SGH run the range from autologous to mismatched cord and unrelated transplants. Special interests of the transplant programme include non-myeloablative transplants in aplastic anaemia, cell therapy protocols including cytokine-induced killer cells, patterns of GVHD, cord blood transplantation for autoimmune diseases and graft engineering. A cGMP (good manufacturing practice) cell therapy laboratory was recently established to facilitate bench-to-bedside translational cell therapy trials. A BMT consortium has been formed among the various paediatric and adult transplant centres for harmonization of protocols and research activities. PMID:18724284

  20. The management of splenic injuries in a District General Hospital.

    PubMed

    Krahenbuhl, L; Berry, A R

    1994-08-01

    Between January 1987 and March 1992, 52 patients with splenic injuries were treated at Northampton General Hospital. Thirty-nine were men, 13 women with a mean age of 30 years (range 5-80 years). Splenic injuries were graded in severity from one to five using the organ injury scaling. Fifteen percent were Grade one injuries, 33% Grade two, 25% Grade three, 21% Grade four and only 6% Grade five. Forty (76%) of injured spleens required splenectomy, 6 (12%) had splenorrhaphy performed and 6 (12%) were conservatively treated. In 50% of Grade 1 injuries, 29% Grade 2 injuries and 23% of Grade 3 injuries the spleen was preserved either by nonoperative treatment or by splenorrhaphy. All of Grade 4 and 5 injuries required splenectomy. Methods for improving the rate of splenic conservation are discussed. PMID:7807460

  1. Treeline Dynamics on Southern Vancouver Island, British Columbia

    E-print Network

    Smith, Dan

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

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

    Microsoft Academic Search

    Harry Minas; Ruzanna Zamzam; Marhani Midin; Alex Cohen

    2011-01-01

    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

  3. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. ...safety zone: All waters of the Columbia River at Vancouver, Washington bounded by a line...shoreline to the point of origin. (b) Regulations. In...

  4. 33 CFR 165.1314 - Safety Zone; Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. ...safety zone: All waters of the Columbia River at Vancouver, Washington bounded by a line...shoreline to the point of origin. (b) Regulations. In...

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. ...safety zone: All waters of the Columbia River at Vancouver, Washington bounded by a line...shoreline to the point of origin. (b) Regulations. In...

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. ...safety zone: All waters of the Columbia River at Vancouver, Washington bounded by a line...shoreline to the point of origin. (b) Regulations. In...

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

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...Fort Vancouver Fireworks Display, Columbia River, Vancouver, Washington. ...safety zone: All waters of the Columbia River at Vancouver, Washington bounded by a line...shoreline to the point of origin. (b) Regulations. In...

  8. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER BYLAWS BYLAW 1: THE GENERAL MANAGER BYLAW 11: FINANCE 1. Budget 2. Funds BYLAW 12: HONORARIA #12;Alma Mater Society of UBC Mater Society of UBC Vancouver BYLAWS -2011 Page 3 BYLAWS BYLAW 1: INTERPRETATION AND DEFINITIONS 1

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

    Microsoft Academic Search

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

    2008-01-01

    Rates of hospital-acquired staphylococcal infection in- creased throughout the 1990s; however, information is limit- ed on trends in community-onset staphylococcal disease in the United Kingdom. We used Hospital Episode Statistics to describe trends in hospital admissions for community-onset staphylococcal disease and national general practice data to describe trends in community prescribing for staphylo- coccal disease. Hospital admission rates for staphylocco-

  10. Toshiba General Hospital PACS for routine in- and outpatient clinics

    NASA Astrophysics Data System (ADS)

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

    1996-05-01

    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.

  11. The Hospital That Became a College: Sloan U.S. Army General Hospital, Montpelier, Vermont. Norwich University Library Occasional Paper No. 1.

    ERIC Educational Resources Information Center

    Shepard, William A.

    A historical review is presented of Sloan U.S. Army General Hospital, the second largest Union Army hospital in Vermont, which operated from June 1864 to October 1865. Sloan Hospital later became Vermont College, which in 1972 merged with Norwich University. Sloan Hospital operated during the last year and a half of the Civil War and consisted of…

  12. Anaplastic Thyroid Cancer: Experience of the Philippine General Hospital

    PubMed Central

    Jimeno, Cecilia Alegado; Paz-Pacheco, Elizabeth

    2015-01-01

    Background Anaplastic thyroid cancer (ATC) is a rare type of thyroid malignancy and one of the most aggressive solid tumors, responsible for between 14% and 50% of the total annual mortality associated with thyroid cancer. Methods A retrospective study was made of all ATC cases diagnosed by biopsy in the Philippine General Hospital between 2008 and 2013. Results A total of 15 patients were identified, with a median age at diagnosis of 63 years. All tumors were at least 6 cm in size upon diagnosis. All patients had a previous history of thyroid pathology, presenting with an average duration of 11 years. Eleven patients presented with cervical lymphadenopathies, whereas seven exhibited signs of distant metastases, for which the lungs appeared to be the most common site. More than 70% of the patients presented with a rapidly growing neck mass, leading to airway obstruction. Only three patients were treated using curative surgery; the majority received palliative and supportive forms of treatment. In addition, only three patients were offered radiotherapy. Chemotherapy was not offered to any patient. Only two patients were confirmed to still be alive during the study period. The median survival time for the other patients was 3 months; in the majority of cases the patient died within the first year following diagnosis. Conclusion Our experience with ATC demonstrated concordance with other institutions with respect to current clinical profile, presentation, and prognosis. An absence of distant metastases and lymph node involvement was associated with improved survival outcomes, whereas age at diagnosis and tumor size did not affect survival. Curative surgery offers the most effective means of prolonging survival. Radiotherapy and chemotherapy in combination with surgery represents a promising treatment strategy. PMID:26194079

  13. Changes in psychiatric inpatient treatment of children and youth in general hospitals: 1980-1985.

    PubMed

    Kiesler, C A; Simpkins, C

    1991-06-01

    Changes in the prevalence of inpatient psychiatric treatment of children and youth in short-term general hospitals between 1980 and 1985 were investigated. During that period, the locus of treatment of mental illness among children and youth shifted dramatically away from specialized facilities to general hospitals without psychiatric units. Among general hospitals without psychiatric units, the number of inpatient psychiatric episodes treated increased dramatically, patients' average length of stay almost doubled, and the total days of care provided more than tripled. The increased care was paid for primarily by Medicaid and commercial insurance. Total days of care for drug and alcohol problems among children and youth in general hospitals decreased substantially. The results suggest that general hospitals may be relying on psychiatric treatment to supplement revenues that were limited by Medicare's prospective payment system, which became effective during the period under study. PMID:1907594

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

    Microsoft Academic Search

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

    2010-01-01

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

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

    E-print Network

    Chapman, Michael S.

    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

  16. Causes of pneumonia presenting to a district general hospital.

    PubMed Central

    White, R J; Blainey, A D; Harrison, K J; Clarke, S K

    1981-01-01

    The incidence of bacterial, viral, mycoplasma, and rickettsial infections has been assessed prospectively in 210 adult patients with pneumonia who presented to a district hospital over a six-year period. One hundred and thirteen infective agents were detected in 103 patients. The agent most frequently detected was Mycoplasma pneumoniae which accounted for 30 infections. A bacterial pathogen was found in 43 patients. Streptococcus pneumoniae was the most common of these (24 patients); Staphylococcus aureus (eight), Haemophilus influenzae (four), Klebsiella spp (three), and Legionella pneumophila (three) were all less common. Chlamydial or rickettsial infections (Psittacosis or Q fever) were detected in nine patients. Viral infections were found in 31 patients (22 influenza A, four influenza B, two parainfluenza, and three respiratory syncytial virus). There were 10 patients in whom more than one pathogen was identified. In 107 patients no pathogens could be identified. Seventy-five per cent of these patients had either received antibiotics before entering hospital, or were unable to produce any sputum for culture. The incidence of bacterial pneumonia has probably therefore been underestimated. Nevertheless this survey does emphasise the importance of M pneumoniae as a pathogen in patients with pneumonia presenting to hospital. PMID:7314031

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

    E-print Network

    Price, Devon J. (Devon Jameson)

    2011-01-01

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

  18. Fitzsimons General Hospital, Bachelor Officers' Quarters/Officers' Club, West Harlowe Avenue, ...

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

    Fitzsimons General Hospital, Bachelor Officers' Quarters/Officers' Club, West Harlowe Avenue, South side, 200 feet West of intersection of West Harlow Avenue & South First Street, Aurora, Adams County, CO

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

    E-print Network

    Patel, Aniruddh D.

    Massachusetts General Hospital ­ Center for Women's Mental Health Clinical Research Coordinator the recruitment, screening and enrollment of research patients Conducting research visits with study Position Announcement Program Description: The Center for Women's Mental Health is a clinical

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

    Microsoft Academic Search

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

    2012-01-01

    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

  1. Convergence and divergence: Assessing criteria of consumer satisfaction across general practice, dental and hospital care settings

    Microsoft Academic Search

    Simon J. Williams; Michael Calnan

    1991-01-01

    This paper describes the results of the first-stage of a study carried out in the spring of 1988 in the South East of England. The study looked at general and specific aspects of consumer satisfaction with general practitioner services, general dental care services and hospital in-patients care. It also examined which specific consumer criteria were the key predictors of overall

  2. The Alma Mater Society of U.B.C. Vancouver January 9, 2013 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver January 9, 2013 PLACE: Council Chambers SUB Room 206 Mater Society of U.B.C. Vancouver January 9, 2013 PLACE: Council Chambers SUB Room 206 Page 2 of 4 (b THAT the Annual General Meeting of the Alma Mater Society be held Wednesday, February 27, 2013." K) Constituency

  3. Injectional anthrax at a Scottish district general hospital.

    PubMed

    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

    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

  4. The emergence of psychiatric departments as quasi-units in general hospitals.

    PubMed

    Kiesler, C A; Simpkins, C

    1991-12-01

    The organization of inpatient psychiatric treatment in general hospitals was investigated using data from the Hospital Discharge Surveys for 1980 and 1985 and definitions of psychiatric services used by the American Hospital Association and the National Institute of Mental Health. The definitions differ in that psychiatric services meeting the AHA definition are formally organized and physically separate units, while those meeting the NIMH definition may have a less formal structure. The number of psychiatric inpatient episodes in psychiatric departments as defined by NIMH increased sixfold between 1980 and 1985, while those in formal psychiatric units as defined by AHA decreased by 16 percent. The increase was completely accounted for by episodes of mental disorders; episodes of alcohol and drug disorders decreased in both settings. The implications of the psychiatric department as an entrepreneurial newcomer in the competitive general hospital market are discussed. PMID:1810859

  5. Referrals to hospital by general practitioners: a study of compliance and communication.

    PubMed Central

    McGlade, K. J.; Bradley, T.; Murphy, G. J.; Lundy, G. P.

    1988-01-01

    To determine the extent of non-attendance at first hospital appointments 269 hospital referrals made in one practice over 14 weeks were analysed retrospectively. Non-attendance was more likely among patients referred to outpatient departments than to casualty or for admission. Fifteen per cent (41/269) of all patients and 20% (33/167) of outpatients failed to keep their initial appointments. Prolonged waiting times from referral to appointment were significantly related to non-attendance. Twenty weeks after the last referral had been made no communication had been received by the practice for 24% (61/252) of all referral letters received by the hospital. Minimum delays to appointments and improved communication between hospitals and general practitioners would help general practitioners to make appropriate referrals and improve compliance. PMID:3145071

  6. 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.

  7. Microbiological etiology of bacterial prostatitis in general hospital and primary care clinic in Korea

    PubMed Central

    Choi, Yong Sun; Kim, Kang Sup; Choi, Sae Woong; Kim, Seol; Bae, Woong Jin; Cho, Hyuk Jin; Hong, Sung-Hoo; Kim, Sae Woong; Hwang, Tae-Kon; Lee, Ji Youl

    2013-01-01

    Purpose: The National Institutes of Health classification of prostatitis reported the proportion of chronic bacterial prostatitis, especially category II, at 3% to 10%. Because of the polymerase chain reaction (PCR) diagnosis technique, chronic prostatitis syndrome (CPS) with a known bacterial origin has increased recently. In this study, we evaluated the proportion of chronic bacterial prostatitis in a general hospital and a primary care clinic (PCC) in addition to the distribution of the microorganism in chronic bacterial prostatitis in Korea. Methods: Two hundred and ninety-three patients were enrolled in this study. One hundred and five patients in the general hospital and 188 patients in the PCC were enrolled in the study. Using a questionnaire, all patients were checked for symptoms of urinalysis, expressed prostate secretion (EPS), EPS or V3 culture and PCR of EPS or VB3 for Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genetalia, and Trichomatis vaginalis. Results: In routine EPS or VB3 culture, 12 of 105 patients (11.4%) in the general hospital showed positive culture, but 77 of 188 patients (40.9%) in the PCC showed a positive culture. Escherichia coli, Streptococcus faecalis, Staphylococcus epidermidis, Staphylococcus hemolyticus, Staphylococcus aureus, and Pseudomonas were isolated in routine culture. In the PCR diagnosis, 37 of 105 patients (35.2%) in the general hospital were PCR positive, and 65 of 188 patients (34.5%) in the PCC were PCR positive. In the general hospital, C. trachomatis was the most common (49%), followed by U. urealyticum (24%), M. genetalia (16%), M. hominis (10%), and T. vaginalis (2%). In the PCC, U. urealyticum was the most common (45%), followed by C. trachomatis (34%), M. hominis (13%), M. genetalia (7%) and T. vaginalis (1%). The proportions of chronic bacterial prostatitis were 46.6% (49/105) and 67.5% (127/188) in the general hospital and PCC, respectively. Conclusions: The total portion of chronic bacterial prostatitis was 59.3% (174/293). Culture-positive patients in the PCC were significantly higher than in the general hospital, but the number of PCR positive patients in the PCC was the same as in the general hospital. PMID:24223415

  8. Preliminary survey report: control technology for ethylene oxide sterilization at Selby General Hospital, Marietta, Ohio

    SciTech Connect

    Kercher, S.L.; Mortimer, V.D.; Todd, W.F.

    1985-08-01

    A survey of control technology for reducing exposure during ethylene oxide sterilization was conducted at Selby General Hospital, Marietta, Ohio on August 30, 1984. The Central Services Department performed ethylene oxide sterilization for obstetrics, neonatal care, respiratory therapy, cytology, isolation cases, and surgery. Engineering controls consisted of isolation of the sterilizer and aerators, local exhaust ventilation, a continuous fresh air purge on the sterilization cycle, in chamber aeration of the sterilizers, and general exhaust ventilation of the Central Services Department and the sterilizer room. The author concludes that the Central Services Department has instituted control technology that minimizes employee exposure to ethylene-oxide. The hospital should be considered a candidate for an in-depth survey in a NIOSH study of control technology for ethylene oxide sterilization in hospitals.

  9. HOW DO NHS GENERAL HOSPITALS IN ENGLAND DEAL WITH PATIENTS WITH ALCOHOL-RELATED PROBLEMS? A QUESTIONNAIRE SURVEY

    Microsoft Academic Search

    LYNN OWENS; IAN T. GILMORE; MUNIR PIRMOHAMED

    Aims: Alcohol-related disease represents a major burden on hospitals. However, it is unclear whether hospitals have developed the necessary expertise and guidelines to deal with this burden. The aim of this survey was to determine what measures general hospital NHS Trusts in England had in place to deal with alcohol-related problems, including the employment of dedicated alcohol specialist nurses. Methods:

  10. Prospective Funding of General Hospitals in Norway—Incentives for Higher Production?

    Microsoft Academic Search

    Egil Kjerstad

    2003-01-01

    In Norway, a new system of Activity Based Financing (ABF) for general hospitals was introduced on a comprehensive basis in July 1997. The main purpose of the reform was to increase activity so that more patients could receive treatment more quickly without reducing the quality of care. In this paper we analyse whether the reform has had any significant effect

  11. Audit of results of operations for infantile pyloric stenosis in a district general hospital

    Microsoft Academic Search

    C A Eriksen; C J Anders

    1991-01-01

    Because of the proposal that infants with hypertrophic pyloric stenosis should only be treated by surgeons with an interest in paediatric surgery, we carried out a retrospective study to audit our experience in a district general hospital. Forty six infants over a five year period underwent pyloromyotomy. There were no deaths, and 36 infants (78%) made uneventful recoveries. Perforation of

  12. Job satisfaction and occupational stress in UK general hospital nursing staff

    Microsoft Academic Search

    Andrew Guppy; Tim Gutteridge

    1991-01-01

    This study investigated factors associated with the perceptions of stress reported by nurses in a general hospital environment in the UK. The levels and sources of stress experienced by nursing staff were examined in relation to the type of ward or department, and nursing grade. The association between reported stress and job satisfaction was also examined. By means of a

  13. The psychiatric inpatient treatment of children and youth in general hospitals.

    PubMed

    Kiesler, C A; Simpkins, C; Morton, T

    1989-12-01

    National attention has recently focused on the mental health needs and services of children and youth. The lack of outpatient services and their coordination has been noted, as well as the consequent press towards inpatient care. We describe the inpatient treatment of children and adolescents (ages 0-18) in short-term, non-Federal general hospitals in 1980. Nationally, 128,300 children were treated for mental disorders in general hospitals at an estimated cost of over $1.5 billion. Compared to adults, children were more likely to be treated in scatter beds (vs. specialty units); have a diagnosis of mental disorder (vs. alcohol/drug disorder); stay much longer; and pay with commercial insurance. Previous work focusing on psychiatric units of general hospitals identified less than 40% of the total episodes, a figure very similar to that for adults. The majority of psychiatric inpatient episodes for children and youth in the United States takes place in short-term general hospitals. Community psychologists need to be aware of national trends in inpatient care and be involved in the development and promulgation of alternative models of care. PMID:2636541

  14. The John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital

    E-print Network

    Mootha, Vamsi K.

    2007 The John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital 50.stoecklecenter.org reshaping primary care for a healthier future The John D. Stoeckle Center for PRIMARY CARE INNOVATION How You Can Help The need for outstanding primary care is great, and your charitable support

  15. The John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital

    E-print Network

    Mootha, Vamsi K.

    The John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital Center for Excellence in Primary Care University of California, San Francisco Primary Care: A Miracle of Modern Medicine with us! (see details, back cover) #12;Primary care: The foundation of our health care system may

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

    Microsoft Academic Search

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

    2002-01-01

    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

  17. Nonprofit to for-profit hospital transactions: all roads lead to the attorney general's office.

    PubMed

    Moore, B E

    1999-01-01

    As more and more hospitals travel the route from nonprofit to for-profit status, state attorneys general are increasingly playing the role of "traffic cop" along this rough and often contentious road. A better understanding of the attorney general's office and greater rapport with its officers is the "order of the day" for officers and directors looking to orchestrate such a transition. PMID:10094055

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

    PubMed Central

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

    2012-01-01

    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

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

    PubMed Central

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

    2013-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  1. 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.

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Jansa, Pavel; Ambrož, David; Lindner, Jaroslav

    2014-12-01

    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

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

    PubMed

    Driscoll, T L; Schieble, M T

    1992-03-01

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

  5. Knowledge and Attitude of 851 Nursing Personnel toward Depression in General Hospitals of Korea.

    PubMed

    Park, Seon-Cheol; Lee, Hwa-Young; Lee, Dong-Woo; Hahn, Sang-Woo; Park, Sang-Ho; Kim, Yeo-Ju; Choi, Jae Sung; Lee, Ho-Sung; Lee, Soyoung Irene; Na, Kyoung-Sae; Jung, Sung Won; Shim, Se-Hoon; Choi, Joonho; Paik, Jong-Woo; Kwon, Young-Joon

    2015-07-01

    Our study aimed to examine the knowledge and attitude of nursing personnel toward depression in general hospitals of Korea. A total of 851 nursing personnel enrolled at four university-affiliated general hospitals completed self-report questionnaires. Chi-square tests were used to compare the knowledge and attitude of registered or assistant nurses toward depression. In addition, binary logistic regression analysis was used to adjust for the following confounders: age-group and workplace. Registered and assistant nurses differed in their knowledge and attitude toward depression. The proportion of rational and/or correct responses were higher in registered nurses than assistant nurses for the following: constellation of depressive symptoms defined by DSM-IV (adjusted odds ratio [aOR], 3.876; P<0.001); suicide risk in depression recovery (aOR, 3.223; P=0.001) and psychological stress as a cause of depression (aOR, 4.370; P<0.001); the relationship between chronic physical disease and depression (aOR, 8.984; P<0.001); and other items. Our results suggest that in terms of the biological model of depression, the understanding of registered nurses is greater than that of assistant nurses. Moreover, specific psychiatric education programs for nursing personnel need to be developed in Korea. Our findings can contribute to the development of a general hospital-based model for early detection of depression in patients with chronic medical diseases. PMID:26130960

  6. Sense of coherence contributes to physical and mental health in general hospital patients in China.

    PubMed

    Li, Wentian; Leonhart, Rainer; Schaefert, Rainer; Zhao, Xudong; Zhang, Lan; Wei, Jing; Yang, Jianzhong; Wirsching, Michael; Larisch, Astrid; Fritzsche, Kurt

    2015-07-01

    The sense of coherence (SOC) may explain why some people become ill under stress whereas others remain healthy. SOC is strongly related to perceived health, particularly mental health. Little is known about the physical and mental health statuses associated with SOC among general hospital outpatients in China. This multicentre cross-sectional study analysed 491 outpatients from four large Chinese general hospitals located in Beijing, Shanghai, Chengdu and Kunming. Patients completed questionnaires examining their SOC (SOC-9), somatic symptom severity (PHQ-15), depression (PHQ-9), generalised anxiety disorder (GAD), health anxiety (WI-7), quality of life (QoL; SF-12) and socio-demographic and clinical characteristics. SOC was negatively correlated with daily-life impairment, symptom duration, somatic symptom severity, depression, GAD and health anxiety, but was positively correlated with age as well as physical and mental QoL. Using a multiple linear regression model, the three strongest correlates of SOC were mental QoL, depression and age. These three variables explained 52% of the variance. SOC may be an important contributor to both mental and physical health in Chinese general hospital outpatients, which is consistent with the results obtained for primary care patients in Western countries. Longitudinal studies are needed to investigate how SOC predicts physical and mental health statuses over time and how these statuses respond to treatment for low SOC. PMID:25200137

  7. Operative management of thyroid abnormalities in a general medical practice hospital in sub-Saharan Africa.

    PubMed

    OlaOlorun, D A; Meier, D E; Tarpley, J L

    2000-10-01

    This is a retrospective analysis of 82 patients undergoing thyroid operations in a general medical practice hospital in sub-Saharan Africa. All patients complained of neck swelling, and in 75% of patients this was the only symptom. Indications for operation included cosmesis in 74%, suspected malignancy in 13%, hyperthyroidism in 7% and pressure symptoms in 5%. Operative complications included recurrent laryngeal nerve injury in two (2.4%), wound haematoma in two (2.4%), wound infection in three (3.6%) and hypoparathyroidism in one (1.2%). There were no deaths and no instances of thyroid storm. Thyromegaly can be operatively managed in a hospital such as ours with a relatively low morbidity rate using conservative gland extirpation techniques. This conservative approach may result in under treatment for thyroid malignancies but should result in a lower incidence of recurrent nerve damage and hypoparathyroidism in the majority of people who undergo thyroidectomy solely for cosmetic indications. PMID:11075656

  8. Changes in diagnostic case mix in psychiatric care in general hospitals, 1980-85.

    PubMed

    Kiesler, C A; Simpkins, C

    1992-05-01

    The Hospital Discharge Survey of 1980 and 1985 was used to assess changes in diagnostic case mix of psychiatric inpatient care in short-term, nonfederal general hospitals. Information regarding presence of psychiatric and chemical dependency units was added to both surveys, and information regarding exemption from Medicare's PPS system was noted for 1985. The largest increase was in ICD-9 code 296 (affective disorder), which more than doubled in frequency, along with a similar decrease in Diagnosis-Related Group 426, depressive neurosis. One explanation for this sizable shift was "gaming the system." One cannot conclusively, however, distinguish between gaming the system and the effects of changing professional views of depression during this time period. Other variables potentially contributing to the effect are described as well. PMID:1601291

  9. Prevalence of dual diagnoses of mental and substance abuse disorders in general hospitals.

    PubMed

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

    1991-04-01

    Data from a 1980 discharge survey of general hospitals were analyzed to determine the prevalence of cases with coexisting diagnoses of mental and substance abuse disorders. Twelve percent of total cases (or 208,000 episodes) had dual diagnoses, a proportion similar to that found in another analysis of 1985 data. Of these cases, 55.5 percent had a primary diagnosis of an alcohol or drug disorder, most commonly alcohol- or drug-induced organic brain syndrome. Thirty-four percent of cases with a primary diagnosis of mental disorder had depressive neurosis, 24 percent had psychosis, and 19 percent had personality disorder. An additional 18.9 percent of all cases had two or more mental or substance abuse disorders. Dual-diagnosis cases had a shorter mean hospital stay than cases with mental disorder only. PMID:1904835

  10. [Standardized management of acupuncture-moxibustion clinic in Singapore General Hospital].

    PubMed

    Cui, Shu-Li; Tan, Kian Hian; Ong, Biauw Chi; Lim, Shih hui; Yong, Yang; Seah, Cheng Ngee; Huang, Youyi; Han, Seong Ng

    2014-02-01

    The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department. PMID:24796062

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

    E-print Network

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

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

    PubMed Central

    2013-01-01

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

  13. Prevention of latex allergy among health care workers and in the general population: latex protein content in devices commonly used in hospitals and general practice

    Microsoft Academic Search

    Michela Crippa; Luca Belleri; Gianni Mistrello; Chiara Tedoldi; Lorenzo Alessio

    2006-01-01

    Background: In this study the latex protein content in devices commonly used in hospitals and general practice were investigated. The main aim was to acquire information for preventing latex allergy in health care workers and in the general population. Methods: About 22 different types of medical devices and 23 devices commonly used in general practice were examined evaluating the total

  14. Randomised controlled trial of routine hospital clinic care versus routine general practice care for type II diabetics

    Microsoft Academic Search

    T M Hayes; J Harries

    1984-01-01

    Two hundred patients with type II diabetes were entered into a randomised controlled trial lasting five years to compare routine care of this condition by a hospital diabetic clinic with routine care in general practice. Fewer patients in the group being cared for by their general practitioner (general practice group) were regularly reviewed or had regular estimations of blood glucose

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

    PubMed Central

    Ross, Colin; Jensen, Brian

    1980-01-01

    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

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

    PubMed

    Bostwick, J Michael

    2015-04-01

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

  17. 33 CFR 165.1308 - Columbia River, Vancouver, WA.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...165.1308 Columbia River, Vancouver, WA. ...zone: All waters of the Columbia River at Vancouver, Washington, bounded...Datum: NAD 83]. (b) Effective dates. ...the Captain of the Port Columbia River....

  18. 33 CFR 165.1308 - Columbia River, Vancouver, WA.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...165.1308 Columbia River, Vancouver, WA. ...zone: All waters of the Columbia River at Vancouver, Washington, bounded...Datum: NAD 83]. (b) Effective dates. ...the Captain of the Port Columbia River....

  19. 33 CFR 165.1308 - Columbia River, Vancouver, WA.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...165.1308 Columbia River, Vancouver, WA. ...zone: All waters of the Columbia River at Vancouver, Washington, bounded...Datum: NAD 83]. (b) Effective dates. ...the Captain of the Port Columbia River....

  20. 33 CFR 165.1308 - Columbia River, Vancouver, WA.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...165.1308 Columbia River, Vancouver, WA. ...zone: All waters of the Columbia River at Vancouver, Washington, bounded...Datum: NAD 83]. (b) Effective dates. ...the Captain of the Port Columbia River....

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  3. Relationships between Depressive Symptoms and Endothelial Function Among Outpatients of a General Hospital in China.

    PubMed

    Shi, Hui; Feng, Guoshuang; Wang, Zhe; Zhou, Chunlian; Zhong, Guangzhen; Hu, Yongdong; Wang, Gang

    2015-01-01

    BACKGROUND This study aimed to investigate the endothelial function by reactive hyperemia index (RHI) in patients with depression, subjects recovering from depression, and subjects without a history of depression. MATERIAL AND METHODS Outpatients were recruited from a general hospital in China; 62 patients diagnosed with depression and the 17-item Hamilton Rating Scale for Depression (HAMD17) total scores ?17 were enrolled as the depression group, 62 patients with a history of depression, discontinuation of antidepressants therapy at least 3 months ago, and HAMD17 ?7 were recruited as remission group, and 62 subjects without a history of depression served as the control group (HAMD17 ?7). RESULTS The mean RHI was 1.93, 2.34, and 2.19 in depression, control, and remission groups, respectively, showing a significant difference among the 3 groups (P=0.0004). In addition, a marked difference in RHI was found between depression and control groups (P=0.0003) and between depression and remission groups (P=0.0270). However, there was no significant difference between remission and control groups (P=0.3363). CONCLUSIONS There is a relationship between depression and endothelial dysfunction in outpatients from a general hospital in China. The improvement of depression is synchronous with the improvement of endothelial function. PMID:26101428

  4. Epidemiology of Orthopaedic Trauma Admissions Over One Year in a District General Hospital in England

    PubMed Central

    Taylor, A; Young, A

    2015-01-01

    Introduction : Admission to district general hospitals in England has undergone change in recent years due to both an aging population and the reconfiguration of the major trauma network throughout the United Kingdom. Methods : We utilised a retrospective cohort study to analyse the epidemiology over a 12-month period at a district general hospital. Data was collected and divided into groups: upper limb, lower limb, vertebral disc disease, vertebral fracture, cellulitis without bone involvement and deep infection including metalwork. Results : 2817 patients were admitted over the 12-month period. There were 893 upper limb fractures, 1511 lower limb fractures, 126 vertebral disc disease, 55 vertebral fractures, 108 cellulitis without bone involvement and 124 deep infections with 19 admissions not specified due to coding. AN average of 242 patients were admitted each month with the majority admitted during the summer months. Conclusion : Although fractures make up the majority of the reason for which a person is admitted, there are also many other injuries/morbidities, which may necessitate admission. There is an increasing incidence of elderly osteoporotic fractures in females, which is balancing out the previously more common fractures seen in younger adults and adolescents. PMID:26069514

  5. Relationships between Depressive Symptoms and Endothelial Function Among Outpatients of a General Hospital in China

    PubMed Central

    Shi, Hui; Feng, Guoshuang; Wang, Zhe; Zhou, Chunlian; Zhong, Guangzhen; Hu, Yongdong; Wang, Gang

    2015-01-01

    Background This study aimed to investigate the endothelial function by reactive hyperemia index (RHI) in patients with depression, subjects recovering from depression, and subjects without a history of depression. Material/Methods Outpatients were recruited from a general hospital in China; 62 patients diagnosed with depression and the 17-item Hamilton Rating Scale for Depression (HAMD17) total scores ?17 were enrolled as the depression group, 62 patients with a history of depression, discontinuation of antidepressants therapy at least 3 months ago, and HAMD17 ?7 were recruited as remission group, and 62 subjects without a history of depression served as the control group (HAMD17 ?7). Results The mean RHI was 1.93, 2.34, and 2.19 in depression, control, and remission groups, respectively, showing a significant difference among the 3 groups (P=0.0004). In addition, a marked difference in RHI was found between depression and control groups (P=0.0003) and between depression and remission groups (P=0.0270). However, there was no significant difference between remission and control groups (P=0.3363). Conclusions There is a relationship between depression and endothelial dysfunction in outpatients from a general hospital in China. The improvement of depression is synchronous with the improvement of endothelial function. PMID:26101428

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

    Microsoft Academic Search

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

    2006-01-01

    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

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

    SciTech Connect

    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

    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.

  8. Hospital or general practice? Results of two experiments limiting the number of self referrals of patients with injuries to hospitals in The Netherlands.

    PubMed Central

    Sixma, H J; de Bakker, D H

    1996-01-01

    OBJECTIVE: To describe the results of two Dutch experiments aimed at limiting the number of self referrals to accident and emergency (A&E) departments of a newly opened hospital. METHODS: Basic design for both field experiments was a one group test-retest study, with the opening of a new hospital being the experimental factor. Data refer (1) to the number of patient contacts for acute somatic and non-somatic professional help with traumata and intoxications filled in on contact registration forms, and (2) to patient reports based on written questionnaires and interviews by telephone. RESULTS: Both studies show that it is possible to limit the number of self referrals, although it is important to be aware of possible side effects. The solution chosen in one of the cities, with patients visiting the A&E department being sent back to a general practitioner, was highly effective but resulted in a series of complaints from the public. This forced the authorities to abandon their original policy. The model chosen in the other city, with two specialized health centres serving as an alternative for the free A&E department of the new hospital, was somewhat less successful in preventing patients from going directly to a hospital, but was much more acceptable for the public. CONCLUSIONS: Both studies showed that controlling the number of self referrals to the A&E departments of hospitals is possible. However, the more rigid the model, the more difficult it will be to have this model accepted by patients. Based on arguments like cost-effectiveness, a better solution might be not to discourage people from going to the hospital with minor injuries, but to integrate primary health care (PHC) and hospital facilities. PMID:8832346

  9. 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.

  10. Effect of the Iranian hospital grading system on patients' and general practitioners' behaviour: an examination of awareness, belief and choice.

    PubMed

    Aryankhesal, Aidin; Sheldon, Trevor

    2010-08-01

    There is considerable international interest in the use of performance measurement and their public release in order to improve the quality of care. However, few studies have assessed stakeholders' awareness and use of performance data. Iranian hospitals have been graded annually since 1998 and hospital hotel charges vary by grade, but this system has never been evaluated. We conducted a cross-sectional survey of 104 outpatients at eight Teheran hospitals and 103 general practitioners (GPs) to assess the awareness of and attitudes towards hospital grading system. Only 5.8% of patients (95% CI: 1.3-10.3%) and 11.7% of GPs (95% CI: 5.5-17.9%) were aware of grading results. Patients' awareness was positively associated with their education level (P = 0.016). No patient used the grading results for choosing a hospital and only one GP (1%, 95% CI: 0-2%) reported using hospital grade to influence referral decisions. Patients were more influenced by hospitals' public reputation and that of their specialists. GPs believed that the grading system did not reflect the quality of care in hospitals. When developing performance measurement systems, public release of data should be accompanied by evaluation of its impact on awareness and health-care choices. PMID:20702891

  11. STUDY OF DROPOUTS FROM A PSYCHIATRIC CLINIC OF A GENERAL HOSPITAL

    PubMed Central

    Gill, H.P.S.; Singh, Gurmeet; Sharma, Kuldip C.

    1990-01-01

    SUMMARY During the study period of three months, out of 425 patients attending the psychiatric clinic of a general hospital, for the first time, 165 (38.8%) did not complete the treatment as prescribed by the doctors and were considered as dropouts. They were contacted at their homes to find out the reasons of the dropping out, were compared with patients, who completed the treatment fully on socio-demographic variables and attitude towards treatment. Dropouts significantly differed from treatment acceptors regarding their income, place of domicile and occupation. Maximum number of patients (59.9%) dropped out after the first visit. Dropouts were the maximum among epileptics, and minimum among the mentally retarded patients. Dropouts were dissatisfied with their experience at the clinic as treatment advised was not of their choice, and they feared bad side effects from ECT and drugs. Long distance of residence from clinic was an important reason for dropping out, besides social and economic reasons. PMID:21927444

  12. 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...

  13. City of Vancouver Commemoration of the

    E-print Network

    Michelson, David G.

    are not able to live with people profoundly differently from ourselves? What point is there to creating green of a Vancouver whose diversity is as socially sustainable--as socially green-- as its green buildings and parks was a card-carrying white supremacist. Fortunate for me, I was a diligent soldier and this recruit, whose

  14. Wildlife Risk Management at Vancouver International Airport

    Microsoft Academic Search

    Gary F. Searing

    2005-01-01

    The Vancouver International Airport (YVR) is the second busiest airport in Canada. YVR is located on Sea Island in the Fraser River Estuary - a world-class wintering and staging area for hundreds of thousands of migratory birds. The Fraser Delta supports Canada’s largest wintering populations of waterfowl, shorebirds, and raptors. The large number of aircraft movements and the presence of

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

    PubMed Central

    Hatam, Nahid; Fardid, Mozhgan; Kavosi, Zahra

    2013-01-01

    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

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

    PubMed

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

    2014-02-01

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

  17. Pattern of traumatic brain injury treated by general surgeons in a tertiary referral hospital.

    PubMed

    Chattopadhyay, Shankar Das; Karmakar, Nisith Chandra; Sengupta, Ritankar; SenGupta, Tamal Kanti; Ray, Debasis; Basus, Shibaji

    2013-09-01

    The number of polytrauma patient with associated brain injury or commonly referred as 'head injury' has increased tremendously in recent times courtesy to road traffic accident or other causes. This prospective observational study was conducted in patients of head injury admitted through emergency in the department of general surgery in NRS Medical College, Kolkata during the year 2011 to determine the pattern of head injury patients admitted and nature of intervention. A total number of 3861 patients were admitted in a single year. Obviously this represents the tip of the iceburg. Traumatic brain injury was the highest in the age group of 31-40 years (33.5%) followed by 21-30 years (29.1%) in the most fruitful phase of life. The traumatic brain injury death was more common in males. The maximum number of cases was from rural areas ie, farmers and labours. To minimise the morbidity and mortality resulting from head injury there is need for better maintenance of roads, improvement of road visibility and lighting, rigid enforcement of traffic rules and imparting road safety education to school children. Despite valiant efforts and advancement in medical sciences and infrastructure in the form of neurosurgery departments and trauma care units to cope with the changing world of trauma, there still remains a huge responsibility and a definite part to be played by the general surgeons to manage head injury patient even in tertiary hospitals. PMID:24968524

  18. Knowledge of cardiopulmonary resuscitation among doctors at the Port Moresby General Hospital.

    PubMed

    Kila, Taita; Yockopua, Sam

    2012-01-01

    This descriptive questionnaire-based study carried out between 16 June and 30 September 2010 aimed to assess the knowledge among doctors at Port Moresby General Hospital of basic life support and cardiopulmonary resuscitation (CPR) for children and adults, based on Australian Resuscitation Council Guidelines. 87 (81%) of 107 questionnaires were returned from 15 consultants (17% of respondents), 51 registrars (59%)--of whom 39 (45%) were in training--and 21 resident medical officers (24%). The respondents were based in internal medicine, surgery, emergency medicine, anaesthetics, obstetrics and gynaecology, paediatrics and smaller disciplines (ear, nose and throat, ophthalmology, intensive care, radiology, psychiatry and pathology). Knowledge of CPR in this study population was uneven and overall inadequate. Only 51 respondents (59%) knew that basic CPR was a priority over intubation. 72 (83%) knew the correct compression: ventilation ratio for children but only 38 (44%) knew this for adults. 33 (38%) knew the correct compression rate for children and 29 (33%) for adults. 40 (46%) knew the correct compression depth for children and 35 (40%) for adults. 60 (69%) knew the sites for defibrillator pads. Knowledge of types of defibrillator and shockable rhythms was poor: 21 (24%) gave two correct arrhythmias for defibrillation and 44 (51%) gave one. Medical officers in training appeared to have better knowledge than their colleagues in postgraduate training programs. As a group, doctors working in emergency medicine, anaesthetics and intensive care had better knowledge of adult resuscitation than their counterparts in the other adult disciplines and had similar knowledge of paediatric resuscitation to that of their paediatric counterparts, although overall knowledge was incomplete in all groups. Basic life support (BLS) and advanced life support (ALS) flow charts for both children and adults should be highly visible throughout the hospital and there is a need for regular training in CPR. PMID:25338477

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Lewis, Sharna; Stenfert-Kroese, Biza

    2010-01-01

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

  1. The incidence of Cyclospora cayetanensis in stool samples submitted to a district general hospital.

    PubMed Central

    Clarke, S. C.; McIntyre, M.

    1996-01-01

    Cyclospora cayetanensis is the cause of a prolonged diarrhoeal syndrome. In the UK most cases are seen in travellers who have returned from countries in which the organism is endemic. The purpose of this investigation was to determine the incidence of C. cayetanensis in stool samples submitted to a district general hospital. A total of 6151 stools from 5374 different patients were screened for the presence of C. cayetanensis over a 1-year period using the modified Ziehl-Neelsen technique. Oocysts of C. cayetanensis were found in 7 stools (0.1%) from 4 patients (0.07%). All four patients were adult travellers who had visited countries in which C. cayetanensis is known to be endemic. In the population of this study, C. cayetanensis was found to be a rare cause of diarrhoea. Although C. cayetanensis infection should be considered in individuals of all ages who have lived in, or have travelled to endemic areas, there is no need to screen stool samples for the organism in those without such a travel history. PMID:8760968

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

    PubMed

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

    2008-08-01

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

  3. 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

    Schoepf, Dieter; Heun, Reinhard

    2015-08-01

    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

  4. 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.

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

    USGS Publications Warehouse

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

    2014-01-01

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

  6. The effects of the Medicare PPS on vulnerable subgroups of psychiatric patients treated in short-term general hospitals.

    PubMed

    DesHarnais, S I; Schumacher, D

    1991-08-01

    Changes in care in short-term general hospitals were monitored for three vulnerable subgroups of Medicare psychiatric patients: (1) those more than 75 years old, (2) those with comorbidities, and (3) those with one or more secondary diagnoses of psychiatric or substance abuse problems. Patterns of care studied for changes following institution of the Medicare Prospective Payment System (PPS) were volume of cases, average length of stay, discharge locations, and readmission rates. Results indicate that the changes occurring for the three subgroups were similar to the changes occurring for all Medicare psychiatric patients. After PPS was introduced in 1983, the average length of stay decreased, and a greater proportion of patients were discharged to other hospitals or home health care providers; however, rates of readmission to the same hospital did not increase. PMID:1945351

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

    PubMed Central

    2012-01-01

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

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

    PubMed Central

    Joypaul, Vickram B.

    2012-01-01

    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

  9. Approach to obstructive sleep apnea syndrome at Tokyo Dental College, Ichikawa General Hospital.

    PubMed

    Nakajima, Tsuneya; Hayama, Takashi; Ohkushi, Tetsushi; Nagatomo, Mariko; Ohkawa, Takashi; Ohta, Fumikazu; Matsuwaki, Yoshinori; Asaka, Daiya; Chiba, Shintarou; Endo, Makoto

    2004-08-01

    In this communication, we report the current status of OSAS (Obstructive Sleep Apnea Syndrome) in the southern region of Higashikatsushika around Ichikawa City, our effort to improve patient QOL as well as to establish diagnostic and therapeutic methods, and the results of a comparison of therapeutic options with the focus on improvement of compliance by using nCPAP (nasal continuous positive airway pressure). We examined 112 patients who visited the Otolaryngology Department at Tokyo Dental College, Ichikawa General Hospital, with the chief complaint of nocturnal snoring or sleep apnea from January 2001 to April 2003 and underwent all-night PSG (polysomnography). Based upon the results of these all-night PSGs, 89 and 23 patients were diagnosed as having OSAS and simple snoring, respectively. Using the AHI classification of severity, 58 and 31 patients were assessed as having severe OSAS and mild OSAS, respectively. (1) nCPAP was tried in 61 patients, and 39 patients (63%) were able to continue it. After the introduction of nCPAP, surgery was performed in 18 patients (30%). As a result, weaning from nCPAP was successfully achieved in 10 cases, compliance with nCPAP was improved in six cases, alleviation of symptoms (decreased pressure) was seen in one case, and aggravation was noted in one case. In addition, four patients (7%) unilaterally discontinued nCPAP. (2) Surgery was performed in 34 patients, and 18 of them had surgery after nCPAP was tried. (3) We asked the dental department to make OAs (oral appliances) for 31 patients but seven of them did not attend the department, so a total of 24 patients used OAs. Fourteen patients (58%) were able to tolerate an OA for 3 months or more. Based on these results, we are hoping to achieve a better control of OSAS by combining nCPAP and other modalities. PMID:15779461

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

    PubMed

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

    2014-10-01

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

  11. [The home palliative care transition manual for the regional cooperation from the general ward at Shizuoka Red Cross Hospital].

    PubMed

    Shiraishi, Ko

    2007-12-01

    Recently, a home palliative care has been recommended for terminal stage cancer patients. However, a few clinics are available providing a home palliative care. As a result of that, there have been many cases of the terminal stage cancer patients who could not receive a peace of mind care and die peacefully at home. Home palliative care has been promoted in Shizuoka City by starting Shizuoka city regional cooperation conference of cancer management with a help from Shizuoka city medical association and the general hospital. It is important to have the knowledge and technique put into practice by clinics and home visiting nurses for a further improvement of the palliative care. In order to transfer patient smoothly, the palliative care team conference is held in the general ward and the homecare transition manual is used at the hospital. An application of homecare insurance, the visiting doctor and nurse are arranged in parallel to management of physical and psychological symptoms of the patient, the visiting doctor and nurse are arranged. Before a patient is discharged from the hospital, the meeting will be held among the ward staff, visiting nurse and the patient's family. We intervened 8 cases from April to July 2007. Six out of 8 cases were transferred to home, and 2 patients were died at home. The home care transition manual will be shared with other hospitals from now on. PMID:20443259

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

    Microsoft Academic Search

    Colin P Laroque; Dan J Smith

    2003-01-01

    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

  13. WSU Vancouver Internal Research Mini-Grant Guidelines and Application

    E-print Network

    Collins, Gary S.

    WSU Vancouver Internal Research Mini-Grant Guidelines and Application Spring 2014 Application State University Vancouver (WSUV) Research Mini-Grant is to stimulate faculty research productivity not previously received a WSUV Research Mini-Grant will be given special consideration. · Individual

  14. A Follow-Up Study of Psychiatric Consultations in the General Hospital: What Happens to Patients after Discharge?

    Microsoft Academic Search

    M. Rigatelli; L. Casolari; I. Massari; S. Ferrari

    2001-01-01

    Background: An appropriate follow-up is considered essential in the consultation-liaison psychiatry setting, but it is often neglected. This study evaluated the effectiveness of the psychiatric consultation process in the general hospital, by investigating what occurred to patients 3–5 months after discharge. Methods: We used a three-part questionnaire: (1) the results of the consultation process; (2) a telephone interview with patients,

  15. Incidence of trampoline related pediatric fractures in a large district general hospital in the United Kingdom: lessons to be learnt

    Microsoft Academic Search

    K K Bhangal; D Neen; R Dodds

    2006-01-01

    Aim: To test the observation that the incidence of trampoline related pediatric fractures is increasing—both nationally and in a large district general hospital.Method: A retrospective analysis was undertaken of patient records establishing mechanism of injury of pediatric fractures over three consecutive summers from 2000–03. Theatre records of fractures treated operatively were used as the initial data source.Results: A statistically significant

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

    PubMed Central

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

    2014-01-01

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

  17. Problem Description General Formulation Project Sequencing Problem Stochastic PSP Next Steps Modelling Hospital Patient Mix Decisions.

    E-print Network

    Al Hanbali, Ahmad

    Problem Description General Formulation Project Sequencing Problem Stochastic PSP Next Steps General Formulation Project Sequencing Problem Stochastic PSP Next Steps Background · My Background · Logi Operating Rooms #12;Problem Description General Formulation Project Sequencing Problem Stochastic PSP Next

  18. [Implementation of an assisted electronic prescription system applied to parenteral nutrition in a general hospital].

    PubMed

    Bermejo Vicedo, T; Delgado Tellez de Cepeda, L; Navarro Cano, P; Vázquez Martínez, C; Zamarrón Cuesta, I; Morejon Bootello, E; Balso Barro, J

    2005-01-01

    Integrated and shared information systems allow obtaining a high degree of information about processes, costs and outcomes, and considerably reducing prescription errors. Assisted electronic prescription, in the setting of total parenteral nutrition, integrated with other hospital databases and with the hospital drugs management system, is a tool that allows increasing patient' safety (by reducing prescription errors), improving quality assistance, improving information systems and information management and the efficiency of used resources. In this work, implementation of an assisted electronic prescription system applied to parenteral nutrition in a hospital and processes reengineering performed in the nutrition setting are described. This implementation was performed by medical staff from the Nutrition and Diet Department and pharmacists from the Pharmacy Department of Ramón y Cajal Hospital using "Nutriwin" computer software. For two months prior and after its implementation, a follow-up of time consumed in the circuit prescription-validation-elaboration-dispensation of parenteral nutrition formulas has been performed. After implementation, treatment orders reach on average 1 h and 15 minutes sooner the Pharmacy Department; by avoiding transcription, a saving of 3 min per nutrition formula calculations is achieved, besides reducing potential errors; elaboration of nutrition formulas can be started on average 1 h and 20 minutes sooner as compared to manual prescription. Besides, the staff that writes down the prescription may know in real time the nutritional profile for each patient in the current episode and the patient's historic. Electronic prescription of treatment orders in this area has represented for our hospital an optimization of the employed resources, a reduction of potential errors that may occur, an improvement in consumption management, and an increase in the whole process quality. PMID:15989063

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

    2014-01-01

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

  1. A four-stage evaluation of the Paediatric Yorkhill Malnutrition Score in a tertiary paediatric hospital and a district general hospital.

    PubMed

    Gerasimidis, Konstantinos; Keane, Orla; Macleod, Isobel; Flynn, Diana M; Wright, Charlotte M

    2010-09-01

    Paediatric in-patients are at high risk of malnutrition but validated paediatric screening tools suitable for use by nursing staff are scarce. The present study aimed to assess the diagnostic accuracy of the new Paediatric Yorkhill Malnutrition Score (PYMS). During a pilot introduction in a tertiary referral hospital and a district general hospital, two research dietitians assessed the validity of the PYMS by comparing the nursing screening outcome with a full dietetic assessment, anthropometry and body composition measurements. An additional PYMS form was completed by the research dietitians to assess its inter-rater reliability with the nursing staff and for comparison with the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Paediatric Subjective Global Nutritional Assessment (SGNA). Of the 247 children studied, the nurse-rated PYMS identified 59% of those rated at high risk by full dietetic assessment. Of those rated at high risk by the nursing PYMS, 47% were confirmed as high risk on full assessment. The PYMS showed moderate agreement with the full assessment (kappa = 0.46) and inter-rater reliability (kappa = 0.53) with the research dietitians. Children who screened as high risk for malnutrition had significantly lower lean mass index than those at moderate or low risk, but no difference in fat. When completed by the research dietitians, the PYMS showed similar sensitivity to the STAMP, but a higher positive predictive value. The SGNA had higher specificity than the PYMS but much lower sensitivity. The PYMS screening tool is an acceptable screening tool for identifying children at risk of malnutrition without producing unmanageable numbers of false-positive cases. PMID:20398432

  2. Clinico-Pathological Discrepancies in a General University Hospital in Săo Paulo, Brazil

    PubMed Central

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

    2008-01-01

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

  3. Oxacilin-resistant Coagulase-negative staphylococci (CoNS) bacteremia in a general hospital at Săo Paulo city, Brasil.

    PubMed

    d'Azevedo, P A; Secchi, C; Antunes, A L S; Sales, T; Silva, F M; Tranchesi, R; Pignatari, A C C

    2008-10-01

    In the last decades, coagulase-negative staphylococci (CoNS), especially Staphylococcus epidermidis have become an important cause of bloodstream infections. In addition, rates of methicillin-resistance among CoNS have increased substantially, leading to the use of glicopeptides for therapy. The objective of this study was to evaluate eleven consecutives clinically relevant cases of oxacillin-resistant CoNS bacteremia in a general hospital localized in Săo Paulo city, Brazil. Five different species were identified by different phenotypic methods, including S. epidermidis (5), S. haemolyticus (3), S. hominis (1), S. warneri (1) and S. cohnii subsp urealyticus (1). A variety of Pulsed Field Gel Electrophoresis profiles was observed by macrorestriction DNA analysis in S. epidermidis isolates, but two of three S. haemolyticus isolates presented the same profile. These data indicated the heterogeneity of the CoNS isolates, suggesting that horizontal dissemination of these microorganisms in the investigated hospital was not frequent. One S. epidermidis and one S. haemolyticus isolates were resistant to teicoplanin and susceptible to vancomycin. The selective pressure due to the use of teicoplanin in this hospital is relevant. PMID:24031279

  4. Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: A retrospective study

    PubMed Central

    Rioja, Eva; Cernicchiaro, Natalia; Costa, Maria Carolina; Valverde, Alexander

    2012-01-01

    This study investigated associations between perioperative factors and probability of death and length of hospitalization of mares with dystocia that survived following general anesthesia. Demographics and perioperative characteristics from 65 mares were reviewed retrospectively and used in a risk factor analysis. Mortality rate was 21.5% during the first 24 h post-anesthesia. The mean ± standard deviation number of days of hospitalization of surviving mares was 6.3 ± 5.4 d. Several factors were found in the univariable analysis to be significantly associated (P < 0.1) with increased probability of perianesthetic death, including: low preoperative total protein, high temperature and severe dehydration on presentation, prolonged dystocia, intraoperative hypotension, and drugs used during recovery. Type of delivery and day of the week the surgery was performed were significantly associated with length of hospitalization in the multivariable mixed effects model. The study identified some risk factors that may allow clinicians to better estimate the probability of mortality and morbidity in these mares. PMID:23115362

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

    ERIC Educational Resources Information Center

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

    2008-01-01

    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…

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

    PubMed Central

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

    2003-01-01

    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

  7. 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

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

    2001-01-01

    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

  8. Inguinal hernia repair: are the results from a general hospital comparable to those from dedicated hernia centres?

    PubMed Central

    Cheong, Kai Xiong; Lo, Hong Yee; Neo, Jun Xiang Andy; Appasamy, Vijayan; Chiu, Ming Terk

    2014-01-01

    INTRODUCTION We aimed to report the outcomes of inguinal hernia repair performed at Tan Tock Seng Hospital and compare them with those performed at dedicated hernia centres. METHODS We retrospectively analysed the medical records and telephone interviews of 520 patients who underwent inguinal hernia repair in 2010. RESULTS The majority of the patients were male (498 [95.8%] men vs. 22 [4.2%] women). The mean age was 59.9 ± 15.7 years. Most patients (n = 445, 85.6%) had unilateral hernias (25.8% direct, 64.3% indirect, 9.9% pantaloon). The overall recurrence rate was 3.8%, with a mean time to recurrence of 12.0 ± 8.6 months. Risk factors for recurrence included contaminated wounds (odds ratio [OR] 50.325; p = 0.004), female gender (OR 8.757; p = 0.003) and pantaloon hernias (OR 5.059; p = 0.013). Complication rates were as follows: chronic pain syndrome (1.2%), hypoaesthesia (5.2%), wound dehiscence (0.4%), infection (0.6%), haematoma/seroma (4.8%), urinary retention (1.3%) and intraoperative visceral injury (0.6%). Most procedures were open repairs (67.7%), and laparoscopic repair constituted 32.3% of all the inguinal hernia repairs. Open repairs resulted in longer operating times than laparoscopic repairs (86.6 mins vs. 71.6 mins; p < 0.001), longer hospital stays (2.7 days vs. 0.7 days; p = 0.020) and a higher incidence of post-repair hypoaesthesia (6.8% vs. 1.8%; p = 0.018). However, there were no significant differences in recurrence or other complications between open and laparoscopic repair. CONCLUSION A general hospital with strict protocols and teaching methodologies can achieve inguinal hernia repair outcomes comparable to those of dedicated hernia centres. PMID:24763834

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-07-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  12. Water quality improvement plan for Greater Vancouver

    SciTech Connect

    Foellmi, S.N. (Black and Veatch, Irvine, CA (United States). Environmental Div.); Neden, D.G. (Greater Vancouver Regional District, Burnaby, British Columbia (Canada)); Dawson, R.N. (Stanley Associates Engineering Ltd., Surrey, British Columbia (Canada))

    1993-10-01

    The Greater Vancouver Regional District commissioned an 18-month planning and predesign study to define the components in a comprehensive water and predesign study to define the components in a comprehensive water quality improvement plan for its 2,500-ML/d (660-mgd) system. The study included three primary tasks: (1) predesign of disinfection and corrosion control facilities, (2) a 12-month pilot testing program using parallel pilot plants at the Seymour and Capilano water supply reservoirs, and (3) planning for future filtration plants. The results of the study identified chlorine, ammonia, sulfur dioxide, soda ash, and carbon dioxide in a two-stage treatment approach as the recommended disinfection and corrosion control scheme for the low-pH, low-alkalinity water supplies. The pilot-plant studies confirmed that direct filtration using deep-bed monomedium filters operating at a loading rate of 22.5 m/h provided excellent treatment performance and productivity over a wide range of raw-water quality. Ozonation was studied extensively and found not to be beneficial in the overall treatment performance. The phased improvement plan for the disinfection, corrosion control, and filtration facilities has an estimated capital cost of about Can$459 million.

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

    PubMed

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

    2014-08-01

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

  14. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society, they will go to Victoria. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER be sponsorship. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student

  15. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society away, around #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS

  16. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society 6138 #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society

  17. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society about the Athletics fees. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

  18. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society in person.] #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society 6138 SUB

  19. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society 6138 SUB

  20. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society time. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Kyle: #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student

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

    E-print Network

    Collins, Gary S.

    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

  2. The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan

    PubMed Central

    Shimizu, Taro; Tsugawa, Yusuke; Tanoue, Yusuke; Konishi, Ryota; Nishizaki, Yuji; Kishimoto, Mitsumasa; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2013-01-01

    Background It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven. Objective We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals. Methods To assess the knowledge base of medicine, we conducted the General Medicine InTraining Examination (GM-ITE) for second-year residents in the last month of their residency. The items of the exam were developed based on the outcomes designated by the Japanese Ministry of Health, Labor, and Welfare. The educational environment was evaluated using the Postgraduate Hospital Educational Environment Measure (PHEEM) score, which was assessed by a mailed survey 2 years prior to the exam. A mixed-effects linear regression model was employed for the analysis of variables associated with a higher score. Results Twenty-one teaching hospitals participated in the study and a total of 206 residents (67 women) participated and completed the exam. There were no residents who declined to participate in the exam. The mean GM-ITE score was 58 (standard deviation 8.4). The mixed-effects linear regression analysis showed that a higher PHEEM score was associated with a higher GM-ITE score (P = 0.02). Having a department of general medicine, and hospital location in a provincial community (versus an urban setting), were also shown to have a significant relationship with the higher score (P = 0.03, and P = 0.02, respectively). Conclusion We found that the performance of the medical knowledge base of resident physicians was significantly associated with the educational environment of their hospitals. Improvement of the educational environment in teaching hospitals might be crucial for enhancing the performance of resident physicians in Japan. PMID:23930077

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

    E-print Network

    Paris-Sud XI, Université de

    2007-01-01

    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

  4. Hazard-evaluation and technical-assistance report HETA 90-122-l2073, technical assistance to San Francisco General Hospital and Medical Center, San Francisco, California

    Microsoft Academic Search

    C. E. Moss; T. Seitz

    1990-01-01

    In response to a request from the Director of the Environmental Health and Safety Department of the San Francisco General Hospital and Medical Center, located in San Francisco, California, an evaluation was undertaken of possible hazardous working conditions at that site. Concern existed about exposures to hazards while operating the germicidal lamp at the facility. Germicidal lamps were used to

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    Microsoft Academic Search

    Dave Lewis

    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

  8. Materialities, moving images and the Vancouver 2010 Winter Olympic Games

    Microsoft Academic Search

    Angela A. Piccini

    2012-01-01

    This paper discusses the circulation of archaeological heritage through moving image practices associated with the Olympic Games. From the Athens Games of 1896 to the Vancouver 2010 Winter Olympic Games, Olympic ‘mega-events’ (Roche 2000, 2003) continue to produce media narratives of place grounded in archaeological practices. I discuss the performativity of varied and distributed screen practices that extend and modify

  9. 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

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

    ERIC Educational Resources Information Center

    Yoon, Ee-Seul

    2011-01-01

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

  11. HIV\\/AIDS in Vancouver, British Columbia: a growing epidemic

    Microsoft Academic Search

    Colin W McInnes; Eric Druyts; Stephanie S Harvard; Mark Gilbert; Mark W Tyndall; Viviane D Lima; Evan Wood; Julio SG Montaner; Robert S Hogg

    2009-01-01

    The prevalence of HIV in Vancouver, British Columbia was subject to two distinct periods of rapid increase. The first occurred in the 1980s due to high incidence among men who have sex with men (MSM), and the second occurred in the 1990s due to high incidence among injection drug users (IDU). The purpose of this study was to estimate and

  12. Estimating the burden of hospitalization for pneumococcal pneumonia in a general population aged 50 years or older and implications for vaccination strategies.

    PubMed

    Amodio, Emanuele; Costantino, Claudio; Boccalini, Sara; Tramuto, Fabio; Maida, Carmelo M; Vitale, Francesco

    2014-05-01

    Streptococcus pneumoniae is a major cause of human infectious diseases worldwide. Despite this documented evidence, data on pneumococcal disease rates among general populations are scant because of the frequent lack of cultural identification. In this study we propose a model for estimating the burden of pneumococcal pneumonia on hospitalizations. The study was performed by analyzing administrative and clinical data of patients aged 50 years or older, resident in Sicily, and hospitalized, from 2005 to 2012. Demographic information, admission/discharge dates, discharge status, and up to 6 discharge diagnoses coded according to ICD-9 CM were collected for each hospitalized patient. During the 8-year study period, a total of 72,372 hospitalizations with at least one ICD-9 CM diagnosis code suggestive of all-cause pneumonia were recorded. Of these, 1943 (2.7%) hospitalizations had specific ICD-9 CM diagnosis codes for pneumococcal pneumonia. According to the proposed model, 16,541 (22.9%) pneumonia out of all-cause pneumonia was estimated to be attributable to S. pneumoniae. Pneumococcal pneumonia and model-estimated pneumococcal pneumonia had mean hospitalization rates of 13.4 and 113.3/100,000, respectively, with a decreasing temporal trend. The risk of hospitalization for pneumococcal pneumonia was strongly correlated with age (P<0.001). Our model provides data usable to construct suitable decisional models for the decision-makers and could allow to the responsibles of healthcare facilities to assess the budget impact if they hypothesize to offer vaccination for pneumococcal disease to certain cohorts of subjects aged 50 years or older. In our area, the high estimated hospitalization rates among adults aged ?65 years suggest the need to implement effective preventive strategies (e.g., vaccination) tailored for these groups. PMID:24577505

  13. 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.

  14. 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.

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

    Microsoft Academic Search

    Jesús Alberdi-Sudupe; Salvador Pita-Fernández; Sonia M Gómez-Pardińas; Fernando Iglesias-Gil-de-Bernabé; Jorge García-Fernández; Gonzalo Martínez-Sande; Sara Lantes-Louzao; Sonia Pértega-Díaz

    2011-01-01

    Background  Suicide and suicide attempts represent a severe problem for public health services. The aim of this study is to determine\\u000a the socio-demographic and psychopathological variables associated with suicide attempts in the population admitted to a General\\u000a Hospital.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  An observational-descriptive study of patients admitted to the A Coruńa University Hospital (Spain) during the period 1997-2007,\\u000a assessed by the Consultation and Liaison

  16. Estimating the Effectiveness of Isolation and Decolonization Measures in Reducing Transmission of Methicillin-resistant Staphylococcus aureus in Hospital General Wards

    PubMed Central

    Worby, Colin J.; Jeyaratnam, Dakshika; Robotham, Julie V.; Kypraios, Theodore; O'Neill, Philip D.; De Angelis, Daniela; French, Gary; Cooper, Ben S.

    2013-01-01

    Infection control for hospital pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) often takes the form of a package of interventions, including the use of patient isolation and decolonization treatment. Such interventions, though widely used, have generated controversy because of their significant resource implications and the lack of robust evidence with regard to their effectiveness at reducing transmission. The aim of this study was to estimate the effectiveness of isolation and decolonization measures in reducing MRSA transmission in hospital general wards. Prospectively collected MRSA surveillance data from 10 general wards at Guy's and St. Thomas' hospitals, London, United Kingdom, in 2006–2007 were used, comprising 14,035 patient episodes. Data were analyzed with a Markov chain Monte Carlo algorithm to model transmission dynamics. The combined effect of isolation and decolonization was estimated to reduce transmission by 64% (95% confidence interval: 37, 79). Undetected MRSA-positive patients were estimated to be the source of 75% (95% confidence interval: 67, 86) of total transmission events. Isolation measures combined with decolonization treatment were strongly associated with a reduction in MRSA transmission in hospital general wards. These findings provide support for active methods of MRSA control, but further research is needed to determine the relative importance of isolation and decolonization in preventing transmission. PMID:23592544

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

    PubMed Central

    Krsti?, Goran

    2011-01-01

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

  18. Investigating Elastic Anisotropy of the Leech River Complex, Vancouver Island using finite-frequency sensitivity kernels

    NASA Astrophysics Data System (ADS)

    Matharu, G.; Bostock, M. G.; Christensen, N. I.; Tromp, J.; Peter, D. B.

    2012-12-01

    The Leech River Complex (LRC) of southern Vancouver Island is part of a once continuous belt of Cretaceous sandstone, mudstone and volcanics that formed an accretionary wedge along the northwestern margin of North America. Metamorphism at 50 Ma to prehnite-pumpellyite, greenschist, amphibolite and blueschist facies produced pervasive foliations with strong phyllosilicate lattice preferred orientations. Laboratory measurements and in-situ S-wave splitting analysis of tectonic tremor wavetrains indicate that this fabric produces substantial S-wave anisotropy of up to 30%. In this study we seek to gain further understanding on the nature of anisotropy within the LRC using high signal to noise ratio low frequency earthquake (LFE) templates and 3-D simulations from the spectral element method (SEM). The LFEs are characterized by impulsive, double couple, point sources and lie along a surface between 27 and 37 km depth that is inferred to be the plate boundary, immediately underlying the LRC. The SEM modelling employs a regional mesh that incorporates realistic topography, bathymetry and a 3-D tomographic P-wave velocity model of southern Vancouver Island. It allows us to readily simulate wave propagation in general anisotropic media with up to 21 independent elastic constants. We will investigate the orientation and distribution of anisotropy within the LRC by employing sensitivity kernels determined using adjoint methods in conjunction with SEM.

  19. Prostitution in Vancouver: violence and the colonization of First Nations women.

    PubMed

    Farley, Melissa; Lynne, Jacqueline; Cotton, Ann J

    2005-06-01

    We interviewed 100 women prostituting in Vancouver, Canada. We found an extremely high prevalence of lifetime violence and post-traumatic stress disorder (PTSD). Fifty-two percent of our interviewees were women from Canada's First Nations, a significant overrepresentation in prostitution compared with their representation in Vancouver generally (1.7-7%). Eighty-two percent reported a history of childhood sexual abuse, by an average of four perpetrators. Seventy-two percent reported childhood physical abuse, 90% had been physically assaulted in prostitution, 78% had been raped in prostitution. Seventy-two percent met DSM-IV criteria for PTSD. Ninety-five percent said that they wanted to leave prostitution. Eighty-six percent reported current or past homelessness with housing as one of their most urgent needs. Eighty-two percent expressed a need for treatment for drug or alcohol addictions. Findings are discussed in terms of the legacy of colonialism, the intrinsically traumatizing nature of prostitution and prostitution's violations of basic human rights. PMID:16114585

  20. Serotypes and extended spectrum beta-lactam resistance in aminoglycoside resistant Pseudomonas aeruginosa isolates from two Belgian general hospitals: a seven year study.

    PubMed

    Vanhoof, R; Godard, C; Nulens, E; Nyssen, H J; Wildemauwe, C; Hubrechts, J M; Maes, P; Hannecart-Pokorni, E

    1993-06-01

    A total of 1896 isolates of Pseudomonas aeruginosa resistant to aminoglycosides and isolated during the period 1983-1989 in two Belgian general hospitals were included in this study. The most frequently encountered O serotypes were O4, O11, O12 and non-typable isolates. The majority of the isolates showed resistance to extended spectrum beta-lactam antibiotics (cefotaxime, ceftriaxone and cefepime). However, a low degree of resistance was found for ceftazidime. By contrast, amikacin and isepamicin, remained active on a significant number of aminoglycoside resistant isolates. In both hospitals, impermeability and AAC(3)II enzyme production were the most prevalent aminoglycoside resistance mechanisms. There were marked differences between the two hospitals with regard to the distribution of the O-serotypes and resistance profiles. PMID:8104976

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

    E-print Network

    Seroude, Laurent

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

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

    Microsoft Academic Search

    VANESSA J. CRAIG; STEVEN F. WILSON

    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

  3. Hospitality in hospitals?

    Microsoft Academic Search

    Denver Severt; Taryn Aiello; Shannon Elswick; Cheryl Cyr

    2008-01-01

    Purpose – The purpose of this paper is to explore an organization-wide philosophy of hospitality in a hospital setting. Design\\/methodology\\/approach – An exploratory case study method approach matched the research purpose. First, a hospitality centric philosophy (HCP) was defined from the literature review. Next, a triangulation of unstructured visits, structured visits and key informant interviews is used to further explore

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

    PubMed

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

    2004-10-01

    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

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

    PubMed Central

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

    2013-01-01

    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

  6. 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.

  7. The Alma Mater Society of U.B.C. Vancouver November 7, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver November 7, 2012 PLACE: Council Chambers SUB Room 206) Committee Motions: #12;The Alma Mater Society of U.B.C. Vancouver November 7, 2012 PLACE: Council Chambers

  8. Clinical Pathways - An Evaluation of its Impact on the Quality of Care in an Acute Care General Hospital in Singapore

    Microsoft Academic Search

    J Cheah

    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

  9. Differences in care between general medicine and respiratory specialists in the management of patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease

    PubMed Central

    Wijayaratne, Kurugamage; Wilson, Jessica; Sivakumaran, Pathmanathan; Sriram, Krishna B.

    2013-01-01

    CONTEXT: Hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) may be managed by either respiratory specialists (RS) or general medicine physicians (GMP). While previous studies have audited the hospital AECOPD management of RS, only a small number of studies have evaluated the management of GMP. AIMS: The aims of this study were to firstly examine the differences in AECOPD management of GMP and RS and secondly compare their care to national COPD guidelines. METHODS: A retrospective review was undertaken of consecutive AECOPD patients admitted to two hospitals (one hospital where all AECOPD patients were managed by RS and another where all AECOPD patients were managed by GMP) over a 3-month period. Electronic medical records, medical case notes, pathology and radiology data for the admission were reviewed. RESULTS: There were 201 COPD exacerbations in 169 patients (49.7% male, mean age 72.3). GMP managed 84 (41.7%) exacerbations. In comparison to RS, GMP performed fewer spirometry tests, blood gas analysis and less frequently treated patients with guideline-recommended medications. Referral to pulmonary rehabilitation was poor for both groups of clinicians. Median length of stay was shorter in GMP patients versus RS patients (3 days vs. 5 days, P = 0.001). There were no differences in the 12-month re-admission (41.7% vs. 38.5%, P = 0.664) and mortality rates (10.7% vs. 6%, P = 0.292) between both groups of patients. CONCLUSION: Our study found differences in the hospital AECOPD management of GMP and RS, but these did not translate into different clinical outcomes between their patients. We also found suboptimal adherence to national COPD guidelines, suggesting that there is scope for improvement in the AECOPD management of both groups of clinicians. PMID:24250732

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

    PubMed

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

    2010-01-01

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

  11. The Alma Mater Society of U.B.C. Vancouver March 21, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver March 21, 2012 PLACE: Council Chambers SUB Room 206 Page Committee #12;The Alma Mater Society of U.B.C. Vancouver March 21, 2012 PLACE: Council Chambers SUB Room 206;The Alma Mater Society of U.B.C. Vancouver March 21, 2012 PLACE: Council Chambers SUB Room 206 Page 3

  12. The Alma Mater Society of U.B.C. Vancouver July 11, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver July 11, 2012 PLACE: Council Chambers SUB Room 206 Page Alma Mater Society of U.B.C. Vancouver July 11, 2012 PLACE: Council Chambers SUB Room 206 Page 2 of 3 b, Reports and Motions: #12;The Alma Mater Society of U.B.C. Vancouver July 11, 2012 PLACE: Council Chambers

  13. The Alma Mater Society of U.B.C. Vancouver May 2, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver May 2, 2012 PLACE: Council Chambers SUB Room 206 Page 1) Committee Motions: #12;The Alma Mater Society of U.B.C. Vancouver May 2, 2012 PLACE: Council Chambers SUB as recommended." #12;The Alma Mater Society of U.B.C. Vancouver May 2, 2012 PLACE: Council Chambers SUB Room 206

  14. The Alma Mater Society of U.B.C. Vancouver June 20, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver June 20, 2012 PLACE: Council Chambers SUB Room 206 Page Mater Society of U.B.C. Vancouver June 20, 2012 PLACE: Council Chambers SUB Room 206 Page 2 of 7 J Mater Society of U.B.C. Vancouver June 20, 2012 PLACE: Council Chambers SUB Room 206 Page 3 of 7 *The

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

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver February 15, 2012 PLACE: Council Chambers SUB Room 206) Constituency and Caucus Motions: L) Committee Motions: #12;The Alma Mater Society of U.B.C. Vancouver February of the SSF is $429,414 10. MOVED , SECONDED #12;The Alma Mater Society of U.B.C. Vancouver February 15, 2012

  16. The Alma Mater Society of U.B.C. Vancouver May 22, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver May 22, 2012 PLACE: Council Chambers SUB Room 206 Page 1, 2012 #12;The Alma Mater Society of U.B.C. Vancouver May 22, 2012 PLACE: Council Chambers SUB Room 206 employees be changed to be in #12;The Alma Mater Society of U.B.C. Vancouver May 22, 2012 PLACE: Council

  17. The Alma Mater Society of U.B.C. Vancouver April 4, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver April 4, 2012 PLACE: Council Chambers SUB Room 206 Page as recommended." #12;The Alma Mater Society of U.B.C. Vancouver April 4, 2012 PLACE: Council Chambers SUB Room." #12;The Alma Mater Society of U.B.C. Vancouver April 4, 2012 PLACE: Council Chambers SUB Room 206 Page

  18. The Alma Mater Society of U.B.C. Vancouver August 29, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver August 29, 2012 PLACE: Council Chambers SUB Room 206 on the AMS 2011/2012 Financial Statements as presented." #12;The Alma Mater Society of U.B.C. Vancouver and thus amend the Code as recommended." #12;The Alma Mater Society of U.B.C. Vancouver August 29, 2012

  19. The Alma Mater Society of U.B.C. Vancouver March 6, 2013 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver March 6, 2013 PLACE: Council Chambers SUB Room 206 Page;The Alma Mater Society of U.B.C. Vancouver March 6, 2013 PLACE: Council Chambers SUB Room 206 Page 2 wellbeing; #12;The Alma Mater Society of U.B.C. Vancouver March 6, 2013 PLACE: Council Chambers SUB Room 206

  20. The Alma Mater Society of U.B.C. Vancouver January 25, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver January 25, 2012 PLACE: Council Chambers SUB Room 206: L) Committee Motions: 4. MOVED , SECONDED #12;The Alma Mater Society of U.B.C. Vancouver January 25 , SECONDED #12;The Alma Mater Society of U.B.C. Vancouver January 25, 2012 PLACE: Council Chambers SUB Room

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

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver February 8, 2012 PLACE: Council Chambers SUB Room 206 and Caucus Motions: L) Committee Motions: 4. MOVED , SECONDED #12;The Alma Mater Society of U.B.C. Vancouver Alma Mater Society of U.B.C. Vancouver February 8, 2012 PLACE: Council Chambers SUB Room 206 Page 3

  2. The Alma Mater Society of U.B.C. Vancouver September 12, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver September 12, 2012 PLACE: Council Chambers SUB Room 206: This requires a 2/3rds vote 5. MOVED , SECONDED #12;The Alma Mater Society of U.B.C. Vancouver September 12 to the exclusive service. #12;The Alma Mater Society of U.B.C. Vancouver September 12, 2012 PLACE: Council Chambers

  3. The Alma Mater Society of U.B.C. Vancouver February 27, 2013 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver February 27, 2013 PLACE: Council Chambers SUB Room 206 the end of February until the second week in March." #12;The Alma Mater Society of U.B.C. Vancouver Alma Mater Society of U.B.C. Vancouver February 27, 2013 PLACE: Council Chambers SUB Room 206 Page 3

  4. The Alma Mater Society of U.B.C. Vancouver January 9, 2013 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver January 9, 2013 PLACE: Council Chambers SUB Room 206 Alma Mater Society of U.B.C. Vancouver January 9, 2013 PLACE: Council Chambers SUB Room 206 Page 2 of 5: Other Substantive Changes" and #12;The Alma Mater Society of U.B.C. Vancouver January 9, 2013 PLACE

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

    E-print Network

    Pedersen, Tom

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

  6. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER CONSTITUTION SECTION 1: NAME The name of the Society is the Alma Mater Society of the University of British Columbia Vancouver. SECTION such other things as may be incidental or conducive to the above objects. #12;Alma Mater Society of UBC

  7. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society and the Executive Director. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS staff wouldn't take the towels to the recycling area. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY

  8. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society 6138 SUB specific for AMS staff or together with UBC people. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH? There are lots of businesses. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS

  9. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society). #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society with Pierre to make sure we have something. The recent federal budget increases #12;THE ALMA MATER SOCIETY

  10. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society 6138 SUB. · UNA does this. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student on August feasibility. And to have Chelsea (his assistant) map out what needs to be done. #12;THE ALMA MATER

  11. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society International. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student to integrate this with the HR Department. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA

  12. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society,000. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society: Matt, Tracey, and Justin to speak to CiTR. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY

  13. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society on Wednesday. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student if the brewery made sense. The next step now is to find funding. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY

  14. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society Coordinators, along with the Project Manager. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH choose to use. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS

  15. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society, and then it would be January or February before we had a new person. #12;THE ALMA MATER SOCIETY of two. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS

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

    ERIC Educational Resources Information Center

    Culhane, Dara

    2003-01-01

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

  17. Acute referral of patients from general practitioners: should the hospital doctor or a nurse receive the call?

    PubMed Central

    2011-01-01

    Background Surprisingly little is known about the most efficient organization of admissions to an emergency hospital. It is important to know, who should be in front when the GP requests an acute admission. The aim of the study was to analyse how experienced ED nurses perform when assessing requests for admissions, compared with hospital physicians. Methods Before- and after ED nurse assessment study, in which two cohorts of patients were followed from the time of request for admission until one month later. The first cohort of patients was included by the physicians on duty in October 2008. The admitting physicians were employed in the one of the specialized departments and only received request for admission within their speciality. The second cohort of patients was included by the ED in May 2009. They received all request from the GPs for admission, independent of the speciality in question. Results A total of 944 requests for admission were recorded. There was a non-significant trend towards the nurses admitting a smaller fraction of patients than the physicians (68 versus 74%). While the nurses almost never rejected an admission, the physicians did this in 7% of the requests. The nurses redirected 8% of the patients to another hospital, significantly more than the physicians with only 1%. (p < 0.0001). The nurses referred significantly more patients to the correct hospital than the doctors (78% vs. 70% p: 0.03). There were no differences in the frequency of unnecessary admissions between the groups. The self-reported use of time for assessment was twice as long for the physicians as for the nurses. (p < 0.0001). Conclusions We found no differences in the frequency of admitted patients or unnecessary admissions, but the nurses redirected significantly more patients to the right hospital according to the catchment area, and used only half the time for the assessment. We find, that nurses, trained for the assignment, are able to handle referrals for emergency admissions, but also advise the subject to be explored in further studies including other assessment models and GP satisfaction. PMID:21831325

  18. 4. Hospital Point, Saunders Monument, view to northeast Portsmouth ...

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

    4. Hospital Point, Saunders Monument, view to northeast - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

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

    PubMed

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

    2013-07-30

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

  20. Salmon poisoning disease in dogs on southern vancouver island.

    PubMed

    Booth, A J; Stogdale, L; Grigor, J A

    1984-01-01

    Salmon poisoning disease in dogs has previously been reported in North America only along the western coast of the U.S.A. This paper presents the findings from eight affected dogs recently diagnosed on Vancouver Island, Canada. The clinical signs shown by these dogs were lethargy, anorexia, pyrexia and lymph node enlargement. The causative agent, Neorickettsia helminthoeca was observed in macrophages obtained from lymph node aspirates. This organism is transmitted to dogs in cysts of the fluke Nanophyetus salmincola salmincola within the tissues of the salmon or trout. The presence of fluke eggs in the feces of dogs showing typical signs is very suggestive of a diagnosis of salmon poisoning disease. Appropriate treatment, including chloramphenicol or oxytetracycline and fluid therapy, resulted in recovery. Prevention of salmon poisoning disease in endemic areas can be achieved by advising owners against allowing their dogs to eat raw salmon or trout. We suggest, based on the diagnoses made in these eight dogs, that Vancouver Island now be considered an endemic area for salmon poisoning disease. PMID:17422349

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

    PubMed Central

    2013-01-01

    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

  2. Rate of Pressure Ulcers in Intensive Units and General Wards of Iranian Hospitals and Methods for Their Detection

    PubMed Central

    AKBARI SARI, Ali; DOSHMANGHIR, Leila; NEGHAHBAN, Zahra; GHIASIPOUR, Maryam; BEHESHTIZAVAREH, Zeinab

    2014-01-01

    Abstract Background This study aimed to estimate the rate of pressure ulcers in intensive care units (ICUs) and medical and surgical wards of Iranian hospitals and compare the performance of methods of medical record review as well as direct observation for their detection. Methods The research team visited 308 patients in medical and surgical wards of hospitals affiliated with Tehran University of Medical Sciences and a further 90 patients in their ICUs between March 2009 and April 2010. In addition 310 patient records were randomly selected from patients discharged from the ICUs between March 2009 and April 2010. And a further 600 patient records were randomly selected from the patients that were discharged from medical and surgical wards between March 2010 and April 2011. These 910 selected records were retrospectively reviewed to identify pressure ulcers. Data were collected by a structured checklist. Results In ICUs 24 of 90 patients (26.7%, 95% CI: 17.56 to 35.84) that were directly observed and 59 of 310 patients (19.0%, 95% CI: 14.63 to 23.37) that were studied by retrospective review of medical records had pressure ulcers. In medical and surgical wards, 5 of 308 patients (1.6%, 95% CI: 0.20 to 3.00) that were directly observed had pressure ulcers, but no pressure ulcer was detected by review of 600 medical records. Conclusion Pressure ulcers are significantly more frequent in ICUs than in medical and surgical wards and a significant proportion of pressure ulcers are not reported.

  3. TOURISM AND HOSPITALITY MANAGEMENT (TOUR)

    E-print Network

    Calgary, University of

    TOURISM AND HOSPITALITY MANAGEMENT (TOUR) Bachelor of Commerce Degree The tourism industry & conferences, adventure tourism, travel trade, and tourism services. The Tourism and Hospitality concentration integrates general management concepts with the professional knowledge that is required by the tourism

  4. Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2014-01-01

    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

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

    SciTech Connect

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

    1984-01-01

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

  7. A Survey of Services to Learning Disabled Students in the Vancouver School District.

    ERIC Educational Resources Information Center

    Hooker, Veronica; Foster, Ann

    1986-01-01

    Elementary and secondary education services available to learning disabled students in the Vancouver school system are described, including teaching and evaluation centers and an extended skills development center. (CL)

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

    PubMed

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

    2006-01-01

    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

  9. The Monitoring Network of the Vancouver 2010 Olympics

    NASA Astrophysics Data System (ADS)

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

    2014-01-01

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

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

    PubMed

    Turner, N J; Hebda, R J

    1990-04-01

    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

  11. Measuring Adverse Drug Events on Hospital Medicine Units with the Institute for Healthcare Improvement Trigger Tool: A Chart Review

    PubMed Central

    Lau, Iris; Kirkwood, Allison

    2014-01-01

    Background: An adverse drug event (ADE) is a noxious, unintended response to a drug, occurring at doses used in humans for prophylaxis, diagnosis, or treatment of disease or for modification of physiological function. ADEs account for about one-quarter of all adverse events in Canadian hospitals. Canadian data on specific types of ADEs and commonly implicated drugs are lacking. In particular, there is a paucity of data on ADEs that occur during hospital admissions. Objectives: The primary objective was to identify the incidence of ADEs in a sample of adult general medicine inpatients over a 1-year period. The secondary objective was to identify the 5 drugs most frequently responsible for ADEs in this setting. Methods: A retrospective chart analysis was conducted for general medicine patients discharged from St Paul’s Hospital in Vancouver, British Columbia, from January to December 2011. ADEs were identified using the Institute for Healthcare Improvement (IHI) Trigger Tool for Measuring Adverse Drug Events. The Naranjo criteria were applied to assess causality, and a physician independently authenticated the ADEs for preventability and harm using the categories of harm set out by the US National Coordinating Council for Medication Error Reporting and Prevention. Results: Of the 204 patient encounters reviewed, 15 involved ADEs, which represented an incidence of 7% over the 1-year study period. The 5 drugs most frequently implicated in ADEs were vancomycin, ciprofloxacin, ceftriaxone, piperacillin–tazobactam, and moxifloxacin. Conclusions: The rate of ADEs during hospital admissions was substantial. These events may necessitate additional investigations and interventions and may prolong the hospital stay. The authors do not recommend the IHI Trigger Tool for Measuring Adverse Drug Events for efficient prospective detection of ADEs in manual chart reviews. Possible modifications to improve the utility of this tool might include incorporating it into a compatible electronic health record system with automated trigger detection. PMID:25548399

  12. UBC Robson Square 800 Robson Street, Vancouver, BC V6Z 3B7

    E-print Network

    Michelson, David G.

    UBC Robson Square 800 Robson Street, Vancouver, BC V6Z 3B7 phone: 604.827.5444 email: robson.bookings@ubc.ca Page 1 CATERING MENU EXCLUSIVE CATERING PROVIDED BY CATERING MENU CATERING PROVIDED BY: #12;UBC Robson Square 800 Robson Street, Vancouver, BC V6Z 3B7 phone: 604.827.5444 email: robson.bookings@ubc.ca Page 2

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

    PubMed

    Cheah, J

    2000-07-01

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

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

    PubMed Central

    Shamim, Faisal; Asghar, Ali; Karam, Karima

    2015-01-01

    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

  15. American Hospital Association

    NSDL National Science Digital Library

    2005-01-01

    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.

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

    PubMed Central

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

    2014-01-01

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

  17. Tuberculous meningitis: presentation, diagnosis and outcome in hiv-infected patients at the douala general hospital, cameroon: a cross sectional study

    PubMed Central

    2013-01-01

    Introduction Tuberculous meningitis (TBM) the most fatal presentation of tuberculosis (TB) especially in HIV-infected patients is a real diagnostic and therapeutic challenge worldwide. In Cameroon where HIV and TB are amongst the leading public health problems, the magnitude of TBM has not been defined. Therefore, the objective of this cross sectional study was to describe the presentation and in-hospital outcome of TBM among HIV patients in Douala as well as its diagnostic difficulties. Methods We did a clinical case note analysis of all HIV-1 infected patients treated for TBM in the Internal medicine unit of the Douala General Hospital, between January 1st 2004 and December 31st 2009. The diagnosis of TBM was made using clinical, laboratory [cerebrospinal fluid (CSF) analysis] and/or brain computerised tomographic (CT) scan features. Results During the study period, 8% (54/672) of HIV-infected patients had TBM. Their mean age was 40.3 ± 12.7 years. The main presenting complaint was headache in 74.1% (40/54) of patients. Their median CD4 cell count was 16 cells/mm3 (IQR: 10 – 34). CSF analysis showed median protein levels of 1.7 g/l (IQR: 1.3 – 2.2), median glucose level of 0.4 g/l (IQR: 0.3 – 0.5) and median white cell count (WCC) count of 21 cells/ml (IQR: 12 – 45) of which mononuclear cells were predominant in 74% of CSF. Acid fast bacilli were found in 1.9% (1/54) of CSF samples. On CT scan hydrocephalus was the main finding in 70.6% (24/34) of patients. In hospital case fatality was 79.6% (43/54). Conclusion TBM is a common complication in HIV-infected patients in Douala with high case fatality. Its presumptive diagnosis reposes mostly on CSF analysis, so clinicians caring for HIV patients should not hesitate to do lumbar taps in the presence of symptoms of central nervous system disease. PMID:23758832

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

    PubMed Central

    2011-01-01

    Background Suicide and suicide attempts represent a severe problem for public health services. The aim of this study is to determine the socio-demographic and psychopathological variables associated with suicide attempts in the population admitted to a General Hospital. Methods An observational-descriptive study of patients admitted to the A 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

  19. 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

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

    2015-01-01

    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. PMID:25767358

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

    NASA Astrophysics Data System (ADS)

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

    2015-06-01

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

  1. WSU Vancouver 2013 Mini-Grant Guidelines and Application Form | Page 1 of 4 WSU Vancouver Internal Research Mini-Grant

    E-print Network

    Collins, Gary S.

    Research Mini-Grant Guidelines and Application Spring 2013 Application deadline: 5:00 p.m. on Friday, April (WSUV) Research Mini-Grant is to stimulate faculty research productivity by providing "seed" funds., following completion of your research mini-grant project. #12;WSU Vancouver 2013 Mini-Grant Guidelines

  2. Rural hospitals

    PubMed Central

    Radford, Andrea; Slifkin, Rebecca; Schur, Claudia; Cheung, Karen; Baernholdt, Marianne

    2013-01-01

    The 340B Drug Pricing Program has the potential to reduce outpatient pharmaceutical costs for qualifying hospitals—hut many rural hospital administrators are unaware of their organization’s eligibility. PMID:18637547

  3. Validation of Ottawa ankle rules protocol in Greek athletes: study in the emergency departments of a district general hospital and a sports injuries clinic

    PubMed Central

    Papacostas, E; Malliaropoulos, N; Papadopoulos, A; Liouliakis, C

    2001-01-01

    Objective—To validate the Ottawa ankle rules protocol for predicting ankle and midfoot fractures in Greek athletes. Method—A prospective survey in the emergency departments of a district general hospital and a sports injury clinic in Greece over nine months. A clinical evaluation was made of 122 patients with acute ankle and/or midfoot injury, and then radiographs were taken. Results—Nine ankle and eight midfoot fractures were detected. The sensitivity of the Ottawa ankle rules protocol in predicting fractures in both the malleolar and midfoot zones was 100%. The negative predictive value for each of these areas was also 1.0. Specificity was estimated to be 0.3 for ankle fractures and 0.4 for midfoot fractures. Positive predictive values were 0.16 and 0.28 respectively. A possible reduction of up to 28.7% was found in the need for radiography. Conclusions—Use of the Ottawa ankle rules protocol in evaluating injured Greek athletes resulted in 100% sensitivity when performed by orthopaedic residents or sports medicine doctors, and had the potential to reduce the use of radiography. Key Words: ankle sprains; radiographs; injuries PMID:11726486

  4. Hazard-evaluation and technical-assistance report HETA 90-122-l2073, technical assistance to San Francisco General Hospital and Medical Center, San Francisco, California

    SciTech Connect

    Moss, C.E.; Seitz, T.

    1990-10-01

    In response to a request from the Director of the Environmental Health and Safety Department of the San Francisco General Hospital and Medical Center, located in San Francisco, California, an evaluation was undertaken of possible hazardous working conditions at that site. Concern existed about exposures to hazards while operating the germicidal lamp at the facility. Germicidal lamps were used to disinfect the air in tuberculosis and aerosolized pentamidine clinics. The workers wore no protective eye wear. All rooms used a 30 watt germicidal lamp. Lower wattage bulbs in the smaller rooms would have reduced occupational ultraviolet (UV) exposure. Reflectance levels of UV radiation were quite high and varied. Worker exposure to germicidal lamp UV levels was dependent on many factors, some of the most important ones being the position of the bulb in the room, age of the bulb, obstruction of the UV radiation by objects near the bulb, and the height of the worker. While there are no consensus guidelines available on ventilation systems designed for areas where germicidal lamps are used, the provision of good room air distribution and mixing is recommended to prevent stagnant air conditions or short circuiting of supply air within the room. Bulb changers need to be aware of the need for protective clothing and gloves for protection from both the UV radiation levels as well as possible glass breakage.

  5. Comparison of two prophylactic single-dose intravenous antibiotic regimes in the treatment of patients undergoing elective colorectal surgery in a district general hospital.

    PubMed

    Kingston, R D; Kiff, R S; Duthie, J S; Walsh, S; Spicer, A; Jeacock, J

    1989-08-01

    Two hundred and twenty-nine patients were entered into a study to compare the effectiveness and safety of two single-shot antibiotic regimes in patients undergoing elective colorectal surgery in two district general hospitals. A single shot of intravenous (IV) latamoxef disodium was as effective as an IV combination of cefuroxime and metronidazole in control of wound infection following elective large bowel surgery when given as a bolus at the time of anaesthetic induction. The incidence of major wound infection was 6% and was evenly distributed in the two treatment groups. Half the major wound infections were associated with faecal fistulae. A single shot of IV antibiotic at the time of anaesthetic induction was safe, simple and an effective prophylaxis against major wound infection. There was a low incidence (1.3%) of serious postoperative bleeding and no serious adverse reactions were noted. The overall mortality was 9%. Death was significantly related to elderly patients, a poor performance status, operative contamination and wound infections. PMID:2810183

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

    PubMed Central

    2005-01-01

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

  7. 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

  8. The Alma Mater Society of U.B.C. Vancouver August 1, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver August 1, 2012 PLACE: Council Chambers SUB Room 206 Page July 17, 2012 Legislative Procedures Committee minutes dated July 24, 2012 #12;The Alma Mater Society Alma Mater Society of U.B.C. Vancouver August 1, 2012 PLACE: Council Chambers SUB Room 206 Page 3 of 5

  9. The Alma Mater Society of U.B.C. Vancouver February 6, 2013 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver February 6, 2013 PLACE: Council Chambers SUB Room 206 Committee minutes dated August 29, 2012 #12;The Alma Mater Society of U.B.C. Vancouver February 6, 2013, research and professional training and opportunities provided to graduate students. #12;The Alma Mater

  10. The Alma Mater Society of U.B.C. Vancouver October 10, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver October 10, 2012 PLACE: Council Chambers SUB Room 206 Council meeting in September; and Whereas negotiations are still ongoing, #12;The Alma Mater Society of U Mater Society of U.B.C. Vancouver October 10, 2012 PLACE: Council Chambers SUB Room 206 Page 3 of 5 7

  11. The Alma Mater Society of U.B.C. Vancouver March 7, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver March 7, 2012 PLACE: Council Chambers SUB Room 206 Page the revised Internal Policy on Expulsion from the Student Union Building as presented." #12;The Alma Mater Mater Society of U.B.C. Vancouver March 7, 2012 PLACE: Council Chambers SUB Room 206 Page 3 of 3 12

  12. The Alma Mater Society of U.B.C. Vancouver October 24, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver October 24, 2012 PLACE: Council Chambers SUB Room 206 minutes dated October 11, 2012 J) Executive Committee Motions: 4. MOVED , SECONDED #12;The Alma Mater at ." #12;The Alma Mater Society of U.B.C. Vancouver October 24, 2012 PLACE: Council Chambers SUB Room 206

  13. The Alma Mater Society of U.B.C. Vancouver January 11, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver January 11, 2012 PLACE: Council Chambers SUB Room 206 Mater Society of U.B.C. Vancouver January 11, 2012 PLACE: Council Chambers SUB Room 206 Page 2 of 4 K: Fee Waiver for UBCO' and thus amend the Code as recommended." Note: Requires 2/3rds #12;The Alma Mater

  14. First Contemporary Case of Human Infection with Cryptococcus gattii in Puget Sound: Evidence for Spread of the Vancouver Island Outbreak?

    PubMed Central

    Upton, Arlo; Fraser, James A.; Kidd, Sarah E.; Bretz, Camille; Bartlett, Karen H.; Heitman, Joseph; Marr, Kieren A.

    2007-01-01

    We report a case of cryptococcosis due to C. gattii which appears to have been acquired in the Puget Sound region, Washington State. Genotyping confirmed identity to the predominant Vancouver Island genotype. This is the first documented case of human disease by the major Vancouver Island emergence strain acquired within the United States. PMID:17596366

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

    PubMed Central

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

    2014-01-01

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

  16. Accessing Patient Electronic Records Larry Lookup, RN, works on a busy general Medical unit as an inpatient RN in ABC hospital. He also has

    E-print Network

    Oliver, Douglas L.

    as an inpatient RN in ABC hospital. He also has experience working in the Emergency Department at another hospital prior to his employment at ABC. Larry has a personal interest in the care and treatment of cancer their surgery and post operative course for his own education. When he works on the oncology unit, he has found

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

    PubMed Central

    2012-01-01

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

  18. Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient departments of two tertiary care hospitals of Lahore

    PubMed Central

    Humayun, Ayesha; Fatima, Noor; Naqqash, Shahid; Hussain, Salwa; Rasheed, Almas; Imtiaz, Huma; Imam, Sardar Zakariya

    2008-01-01

    Background The principles of informed consent, confidentiality and privacy are often neglected during patient care in developing countries. We assessed the degree to which doctors in Lahore adhere to these principles during outpatient consultations. Material & Method The study was conducted at medical out-patient departments (OPDs) of two tertiary care hospitals (one public and one private hospital) of Lahore, selected using multi-stage sampling. 93 patients were selected from each hospital. Doctors' adherence to the principles of informed consent, privacy and confidentiality was observed through client flow analysis performed by trained personnel. Overall patient perception was also assessed regarding these practices and was compared with the assessment made by our data collectors. Results Some degree of informed consent was obtained from only 9.7% patients in the public hospital and 47.8% in the private hospital. 81.4% of patients in the public hospital and 88.4% in the private hospital were accorded at least some degree of privacy. Complete informational confidentiality was maintained only in 10.8% and 35.5% of cases in public & private hospitals respectively. Informed consent and confidentiality were better practiced in the private compared to the public hospital (two-sample t-test > 2, p value < 0.05). There was marked disparity between the patients' perspective of these ethical practices and the assessment of our trained data collectors. Conclusion Observance of medical ethics is inadequate in hospitals of Lahore. Doctors should be imparted formal training in medical ethics and national legislation on medical ethics is needed. Patients should be made aware of their rights to medical ethics. PMID:18816413

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

    E-print Network

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

  20. Radiation Dose in the Thyroid and the Thyroid Cancer Risk Attributable to CT Scans for Pediatric Patients in One General Hospital of China

    PubMed Central

    Su, Yin-Ping; Niu, Hao-Wei; Chen, Jun-Bo; Fu, Ying-Hua; Xiao, Guo-Bing; Sun, Quan-Fu

    2014-01-01

    Objective: To quantify the radiation dose in the thyroid attributable to different CT scans and to estimate the thyroid cancer risk in pediatric patients. Methods: The information about pediatric patients who underwent CT scans was abstracted from the radiology information system in one general hospital between 1 January 2012 and 31 December 2012. The radiation doses were calculated using the ImPACT Patient Dosimetry Calculator and the lifetime attributable risk (LAR) of thyroid cancer incidence was estimated based on the National Academies Biologic Effects of Ionizing Radiation VII model. Results: The subjects comprised 922 children, 68% were males, and received 971 CT scans. The range of typical radiation dose to the thyroid was estimated to be 0.61–0.92 mGy for paranasal sinus CT scans, 1.10–2.45 mGy for head CT scans, and 2.63–5.76 mGy for chest CT scans. The LAR of thyroid cancer were as follows: for head CT, 1.1 per 100,000 for boys and 8.7 per 100,000 for girls; for paranasal sinus CT scans, 0.4 per 100,000 for boys and 2.7 per 100,000 for girls; for chest CT scans, 2.1 per 100,000 for boys and 14.1 per 100,000 for girls. The risk of thyroid cancer was substantially higher for girls than for the boys, and from chest CT scans was higher than that from head or paransal sinus CT scans. Conclusions: Chest CT scans caused higher thyroid dose and the LAR of thyroid cancer incidence, compared with paransal sinus or head CT scans. Therefore, physicians should pay more attention to protect the thyroid when children underwent CT scans, especially chest CT scans. PMID:24608902

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

    PubMed Central

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

    2013-01-01

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

  2. 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

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

    2013-10-15

    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

  3. Anxiety Status and its Relationship with General Health Related Quality of Life among Prostate Cancer Patients in Two University Hospitals in Kuala Lumpur, Malaysia

    PubMed Central

    ISA, Mohamad Rodi; MOY, Foong Ming; ABDUL RAZACK, Azad Hassan; MD ZAINUDDIN, Zulkifli; ZAINAL, Nur Zuraida

    2013-01-01

    Background This study aimed to determine the prevalence of anxiety among prostate cancer patients, and to ascertain the association between stress status, socio-demographic, medical and surgical illness, current urinary problem and cancer status with general health-related quality of life (HRQOL) among these patients. Methods: A hospital based, cross sectional study was conducted at Surgical Clinic, University Malaya Medical Centre (UMMC) and Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using universal sampling. Result: A total of 193 patients were recruited. The prevalence of anxiety was 25.4% (95%CI: 19.2 – 31.6). The anxiety ratings were mild anxiety (10.4%), moderate anxiety (13.6%) and severe anxiety (1.6%). The total quality of life among stress group was 59.2 ± 14.7 and among non-stress group was 73.9 ± 12.7. There was a significant negative weak correlation between anxiety score and total quality of life (rs=?0.534, P<0.001). In multivariable analysis, there was a significant difference in the total quality of life (QOL) among anxiety status [adj. mean diff. = ?9.1 (95%CI: ?15.2, ?4.7)]. The adjusted mean difference was associated by age category of the patients (P<0.001); living partner (P<0.001); intermittency (P=0.035) and problem of hematuria during micturition (P=0.005). Conclusion: The prevalence of anxiety among prostate cancer was moderately high. Treating the urination problem as well as encouraging living with spouse/family may improve the quality of life among anxiety condition of these patients. PMID:23641401

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    Microsoft Academic Search

    Dave Lewis; Dan Smith

    2004-01-01

    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

  7. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society asked about Executive orientations. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA Derek Moore send out the timeline for discussing proposed names for the new SUB. #12;THE ALMA MATER

  8. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society) and the 2008 Lighter Footprint Strategy that came out of it. #12;THE ALMA MATER SOCIETY to the Compass card, fraud will plummet. #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH

  9. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society Endowment Fund (entrenching in bylaws) o Changing quorum (bylaw amendment) #12;THE ALMA MATER SOCIETY for the individual Execs to move turnover, for academic reasons, so they don't forfeit #12;THE ALMA MATER SOCIETY

  10. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society minutes. The main event will be the opening of the building in 2014. SCD028-13 #12;THE ALMA MATER the temperature on it; people will want to make it their home page. #12;THE ALMA MATER SOCIETY

  11. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER AMS Student Society came only because their group came. Matt: This should be our niche. #12;THE ALMA MATER SOCIETY't know what's going on, I'll vote no." #12;THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH

  12. #59-2357 Main Mall Vancouver, BC V6T 1Z4

    E-print Network

    Farrell, Anthony P.

    Agora Café #59-2357 Main Mall Vancouver, BC V6T 1Z4 Web: http://blogs.landfood.ubc.ca/agora Phone for the last two years, and it is with bittersweet emotions that I part from Agora Café at the end of this month. To the dedicated and wonderful volunteers ­ you are what makes Agora happen, day in and day out

  13. Protecting wetland habitat in the Cypre Watershed Planning Unit, Clayoquot Sound, Vancouver Island, British Columbia

    Microsoft Academic Search

    Kate McNutt; Barbara Beasley; Margret Moeges

    Harvesting old-growth forest is one of the activities that has strongly shaped the economic, social, and ecological landscapes of Clayoquot Sound on the west coast of Vancouver Island in British Columbia. Clearcutting, which has been the dominant harvesting method, has changed the distribution and natural age classes of forests, altered drainage systems, and affected the visual appearance of the landscape.

  14. Quad Conference, Vancouver B.C. April 9, 20051 Community and School Traffic Safety

    E-print Network

    Bertini, Robert L.

    Quad Conference, Vancouver B.C. April 9, 20051 Community and School Traffic Safety Partnership (CSTSP) ­ Measuring Traffic Safety Performance In Portland, Oregon Quad Conference April 9, 2005 Chris Oregon DOT · July 2003 - Portland City Council approved the Portland Traffic Safety Coordination Council

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

    Microsoft Academic Search

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

    2004-01-01

    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

  16. CCCG 2009, Vancouver, BC, August 17--19, 2009 Open Problems from CCCG 2008

    E-print Network

    Demaine, Erik

    mirrors can trap the light from any one point source. It seems most natural to treat the mirrors as openCCCG 2009, Vancouver, BC, August 17--19, 2009 Open Problems from CCCG 2008 Erik D. Demaine # Joseph O'Rourke + The following is a list of the problems presented on August 14, 2008 at the open

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

    Microsoft Academic Search

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

    2002-01-01

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

  18. Clandestine Operations: The Vancouver Womens Caucus, the Abortion Caravan, and the RCMP

    Microsoft Academic Search

    Christabelle Sethna; Steve Hewitt

    2009-01-01

    In 1969, the reform of the Criminal Code legalized contraception, abortion, and homosexual acts between consenting adults. Yet the conditions under which legal abortion was now permissible were so restrictive that the new abortion law provoked widespread discontent. One women’s liberation group, the fledging Vancouver Women’s Caucus (VWC), outlined a plan to travel to Ottawa between February and May 1970

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

    ERIC Educational Resources Information Center

    Leckie, Gloria J.; Hopkins, Jeffrey

    2002-01-01

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

  20. 149th Meeting of the Acoustical Society of America, Vancouver, May 2005 Oldenburg University, acoustics group

    E-print Network

    Vormann, Matthias

    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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

    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…

  2. Appears in the 2000 International Symposium on Computer Architecture, Vancouver. HLS: Combining Statistical and Symbolic Simulation

    E-print Network

    Chong, Frederic T.

    Appears in the 2000 International Symposium on Computer Architecture, Vancouver. HLS: Combining continue to evolve, many optimizations reach a point of diminishing returns. We introduce HLS, a hybrid spanned by design parameters. We validate the accuracy of HLS through correlation with existing cycle

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

    ERIC Educational Resources Information Center

    Vessey, Rachelle

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Guo, Shibao

    2014-01-01

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

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

    Microsoft Academic Search

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

    2009-01-01

    BACKGROUND: Street-involved youth are a population at risk of adopting injection as a route of administration, and preventing the transition to injection drug use among street youth represents a public health priority. In order to inform epidemiological research and prevention efforts, we conducted a qualitative study to investigate the initiation of injection drug use among street-involved youth in Vancouver, Canada.

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

    ERIC Educational Resources Information Center

    Gosselin, Viviane

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Guardado, Martin

    2006-01-01

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

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

    E-print Network

    California at Davis, University of

    1 The City of Vancouver's Approach to Electric Vehicles: 7 Pillars Malcolm Shield, Climate 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

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

    E-print Network

    Invited Presentation, EdMedia '94 Vancouver, Canada page 1 Issues and Obstacles with Multimedia, multimedia authoring involves making hard choices, forecasting technological evolution and adapting of the common threads shared by three dissimilar cases of multimedia authoring which we have experimented with

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

    E-print Network

    Michelson, David G.

    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

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

    E-print Network

    Blumstein, Daniel T.

    . To identify whether predator discrimination abilities of the critically endangered Vancouver Island marmots-stimulus control). Regardless of specific predator discrimination abilities, for some species overall `personality reactivity in the presence of a predator, we also conducted a mirror-image stimulus (MIS) presentation

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

    E-print Network

    Pulfrey, David L.

    the right mix. Erik MacKinnon: A lot of us get nothing out of our investment of $200 a year in Athletics. I of U.B.C. Vancouver PLACE: Council Chambers August 29, 2012 SUB Room 206 Page 2 of 20 o Hoping to come get zero. Louise Cowin: That's the challenge: what might it take to get you involved? Erik Mac

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

    Microsoft Academic Search

    Adrian Weber; Benjamin Gilbert; C. E. Prescott

    2003-01-01

    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

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

    Microsoft Academic Search

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

    1995-01-01

    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

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

    ERIC Educational Resources Information Center

    Kayaalp, Dilek

    2014-01-01

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

  16. Biomarkers of Holocene buried conifer logs from Bella Coola and north Vancouver, British Columbia, Canada

    Microsoft Academic Search

    Angelika Otto; Bernd R. T Simoneit

    2002-01-01

    The biomarker compositions of a Holocene seep oil (liquefied resin) originating from a buried log of Douglas fir (Pseudotsuga menziesii) from Bella Coola, BC, Canada, and a Holocene pine wood (Pinus sp.) sample from north Vancouver, BC, Canada, were analyzed using gas chromatography–mass spectrometry (GC–MS). The total extract of the Bella Coola sample contains the sesquiterpenoid derivative calamenene and diterpenoids

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

    USGS Publications Warehouse

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

    2010-01-01

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

  18. A comparison of Canadian general pediatric dosing publications.

    PubMed

    Dayneka, Natalie

    2003-01-01

    A comparison of the general pediatric dosing guidelines published in Canada was conducted. Institutions that publish pediatric dosing guidelines as a separate publication or as part of the hospital formulary were mailed a survey of questions to describe their publication. Publications that met the inclusion criteria were evaluated using 12 assessment criteria: approval or submissions by medical specialty groups, drug inclusion, dosing guidelines, dosing in organ failure, pharmacokinetic/pharmacodynamic parameters, therapeutic guidelines, intravenous and oral administration guidelines, adverse drug reactions/drug interactions, referencing, drug acquisition costs, organization and readability. Four Canadian pediatric centres satisfied the criteria for publishing general pediatric dosing guidelines. These were reviewed by the process of formulary selection (in alphabetical order by city): Formulary of Drugs and Dosing Manual (Halifax), Formulary of Drugs (Toronto), Drug Dosage Guidelines and Formulary (Vancouver), and Pediatric Drug Dosage Handbook (Winnipeg). Dosing guidelines from published pediatric drug trials have been collated with institutional experience and historical practice to produce a practical source of pediatric dosing information. PMID:14506508

  19. Quantitation of Serum Free Light Chains in Combination with Protein Electrophoresis and Clinical Information for Diagnosing Multiple Myeloma in a General Hospital Population

    Microsoft Academic Search

    Armin P. Piehler; Nina Gulbrandsen; Peter Kierulf; Petter Urdal

    BACKGROUND: Serum free light chain (SFLC) measure- ments have recently come into use as an aid for diag- nosing monoclonal gammopathy. We evaluated SFLC measurements in combination with serum protein electrophoresis (SPE) and clinical information for di- agnosing multiple myeloma (MM) in a hospital population.

  20. Hospital Patients and Handicapped Readers Section and Round Table of Libraries for the Blind. Libraries Serving the General Public Division. Papers.

    ERIC Educational Resources Information Center

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

    Papers on hospital and health libraries and library services to the blind and deaf which were presented at the 1982 International Federation of Library Associations conference include: (1) "Leisure Pursuits of the Blind" by Antun Lastric (Yugoslavia); (2) "Library Services for the Handicapped in Canada: An Overview" by Francoise Hebert (Canada);…

  1. TIEMPO DE ESPERA Y SU RELACIÓN CON LA SATISFACCIÓN DE LOS USUARIOS EN LA FARMACIA CENTRAL DE UN HOSPITAL GENERAL DE LIMA

    Microsoft Academic Search

    Ericson Gutierrez; Willy Ramos; Alex G. Ortega-Loayza; Christian Torres; Daniel Montesinos; Oscar León; Carlos Galarza

    2009-01-01

    To determine the influence of waiting time on customers satisfaction in the central pharmacy of the Hospital Nacional Dos de Mayo (HNDM), we conducted a cross-sectional study which recorded the times of each sub process of care (billing, payment in cash and delivery of drugs) through direct observation of users. We evaluated the level of user's satisfaction using a Likert

  2. Failed hospital mergers.

    PubMed

    Blackstone, Erwin A; Fuhr, Joseph P

    2003-01-01

    The spate of hospital mergers in recent years has yielded both substantial increases in market power and many divestitures. These seemingly contradictory results stem from the pressures imposed by stakeholders of merging hospitals and the inability of those stakeholders to exert control over nonprofit institutions prior to the effectuation of a merger. This Article examines several recent mergers, analyses their failures, and recommends that the judiciary and state attorneys general look carefully at merging nonprofits so as to fill the void left by the lack of market control mechanisms. PMID:12940679

  3. A comparative study of anxiety and depression in patients with bronchial asthma, chronic obstructive pulmonary disease and tuberculosis in a general hospital of chest diseases

    PubMed Central

    Moussas, Georgios; Tselebis, Athanasios; Karkanias, Athanasios; Stamouli, Dimitra; Ilias, Ioannis; Bratis, Dionisios; Vassila-Demi, Kalliopi

    2008-01-01

    Background Depression necessitating assistance from health professionals has a lifetime prevalence of 10%. Chronic disease increases comorbidity with mood and/or anxiety disorders. Patients with chronic pulmonary disease present with severely impaired functionality, chronic somatic and psychogenic pain, require frequent hospitalizations and have a dependency upon medical and nursing personnel. In the present study we assessed anxiety and depression in patients hospitalized for pulmonary disease in a pulmonary disease hospital. Methods We assessed anxiety, using the Spielberger state-trait anxiety scale, and depression, using the Beck Depression Inventory, in 132 patients with pulmonary disease. Results A total of 49.2% of the sample had moderate or severe depression and 26.5% had anxiety. Women had higher depression and anxiety scores than men (t test, p < 0.05). Depression was positively correlated with anxiety, age and time from diagnosis. Anxiety was positively correlated with depression and time from diagnosis (Pearson r = 0.62 and 0.29, p < 0.01). Patients with chronic obstructive pulmonary disease and bronchial asthma had higher depression scores than patients with tuberculosis (t test, p < 0.01). Conclusion Depression and anxiety are very prevalent in patients with pulmonary disease, especially chronic disease. This may be a very important negative factor in patients' adaptation to the chronic course of their disease. PMID:18495038

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

    Microsoft Academic Search

    Dave H. Lewis; Dan J. Smith

    2004-01-01

    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

  5. CCCG 2009, Vancouver, BC, August 1719, 2009 Open Problems from CCCG 2008

    E-print Network

    Demaine, Erik

    the light from any one point source. It seems most natural to treat the mirrors as open segments, to avoidCCCG 2009, Vancouver, BC, August 17­19, 2009 Open Problems from CCCG 2008 Erik D. Demaine Joseph O'Rourke The following is a list of the problems presented on August 14, 2008 at the open-problem session of the 20th

  6. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

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

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

    E-print Network

    Mukhopadhyay, Asish

    . Shafiul Alam Asish Mukhopadhyay* Animesh Sarker* Abstract The point placement problem is to determine depending on those queried in the previous rounds. School of Computer Science, University of Windsor, {alam9 first principal reference is [2], where it was shown that the jewel (Fig. 4) and K2,3 are both line

  8. General anesthesia

    MedlinePLUS

    General anesthesia is a treatment with certain medicines that puts you into a deep sleep so you do not ... You will receive general anesthesia in a hospital or outpatient office. Most times, a doctor called an anesthesiologist will put you to sleep. Sometimes, a ...

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

    PubMed Central

    Stitt, Tyler; Mountifield, Julie; Stephen, Craig

    2007-01-01

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

  10. 33 CFR 165.1308 - Columbia River, Vancouver, WA.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Datum: NAD 83]. (b) Effective dates. This section is effective annually on July fourth from 9 p.m. to 11 p.m. (PDT) unless otherwise specified by Federal Register notice. (c) Regulation. In accordance with the general...

  11. Characteristics of etiological diagnostic workup across the past 10 years in patients with spontaneous intracerebral hemorrhage in a large general hospital.

    PubMed

    Wang, Qiuxiao; Lin, Sen; Dong, Wei; Liu, Ming

    2014-01-31

    Abstract Objective: A swift and accurate diagnosis of etiology would lay the foundation of targeted management for patients with spontaneous intracerebral hemorrhage (SICH). It is unclear what the status of diagnostic workup related to etiology is in Chinese hospitals which treat the majority of the hemorrhagic patients in the world. We aim to demonstrate characteristics on diagnostic workup implemented routinely in both departments of Neurology and Neurosurgery in patients with SICH. Methods: We enrolled patients with SICH from March 2002 to December 2011 from Chengdu stroke registry. Data on diagnostic workup were extracted. Results: A total of 2264 patients diagnosed as SICH with rapid neuroimaging (computed tomography (CT) or magnetic resonance imaging (MRI)) scan were included. Patients in the department of Neurosurgery had a lower median Glasgow Coma Scale (GCS) score and a longer median length of stay. They had a significantly lower proportion of hyperlipidemia and heart disease, but a higher proportion of hypertension, alcohol consumption and history of stroke (all p?hospitalized in (all p?hospitalized in recent years had undertaken more examinations on intracranial vascular. It is an urgency to explore a practical scheme of diagnostic workup for the etiology of SICH. PMID:24483215

  12. 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.

  13. [Historical exploration of Acapulco hospitals, Guerrero, Mexico].

    PubMed

    Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo

    2006-01-01

    This study attempts to recount the history of the main hospitals of the port of Acapulco from colonial times until the end of the 20th century. The Augustine friars began hospital care at the end of the first part of the 16th century. Later, Bernardino Alvarez (1514?-1584), with the support of the Spanish crown, founded the first formal hospital in Acapulco called Hospital de Nuestra Seńora de la Consolación (Our Lady of Consolation Hospital). During the 16th and 17th centuries, the sick were attended by friars, and by the end of the 19th century there were physicians and surgeons. From the end of the Independence War until the end of the 19th century, the port did not have any true hospital. The first degreed physicians and surgeons arrived and resided in Acapulco in 1920. In 1938, the Hospital Civil Morelos (Morelos Civil Hospital) began providing services. It was replaced by the Hospital General de Acapulco (General Hospital of Acapulco). At the fourth decade of the past century the Cruz Roja (Red Cross) was created. In 1957 the hospital services of the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute of Social Security), which was founded in 1963, was inaugurated with the Unidad Medico/Social (Medical and Social Unit) of the IMSS in Acapulco. This began the journey of modernity in Acapulco. In 1992, Hospital Regional Vicente Guerrero (Regional Hospital Vicente Guerrero) of the IMSS, initiated its services. In 1960, medical services for civil workers and their families were housed in the Hospital Civil Morelos (Morelos Civil Hospital). Shortly afterwards, the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE, Security and Social Services Institute for State Employees) had their own hospital. During the 20th century, Acapulco has added other hospital services to care for members of the navy and armed forces, as well as for those persons with financial resources for private care. PMID:17244509

  14. 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

  15. Cost characteristics of hospitals.

    PubMed

    Smet, Mike

    2002-09-01

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

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

    PubMed

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

    2013-04-01

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

  17. Prevalence of nosocomial infections in representative German hospitals

    Microsoft Academic Search

    P. Gastmeier; G. Kampf; N. Wischnewski; T. Hauer; G. Schulgen; M. Schumacher; F. Daschner; H. Rüden

    1998-01-01

    The nosocomial infection (NI) rate in German hospitals was studied in order to create reference data for comparison in hospitals where ongoing surveillance is impossible. The study was designed as a one-day prevalence study. Patients in 72 selected hospitals (inclusion criteria: acute care hospitals with departments for general medicine, surgery, obstetrics\\/ gynaecology) were examined by four external investigators (physicians trained

  18. 42 CFR 412.200 - General provisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...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,...

  19. Massachusetts law gives hospitals energy incentives

    SciTech Connect

    Cohn, L.

    1982-08-30

    A new law allowing hospitals to retain the difference between pre-paid insurer's rates over actual costs reverses a cost-cutting disincentive into a financial incentive for the Massachusetts General Hospital and the American Hospital Association. If hospital costs exceed the insurer's preset reimbursements, however, hospitals must make up the difference. The new law creates incentives for energy management and could serve as a model for other states if it proves effective. The federal government may apply the concept to the Medicare-Medicaid reimbursement formula. (DCK)

  20. MAPUniversity Hospital Directions from University Hospital to

    E-print Network

    Pharmacy Lobby Visitor Elevators Escalator Patient Elevators University Hospital Information ElevatorVERSION 1 MAPUniversity Hospital VERSION 5 Directions from University Hospital to: Huntsman Cancer on the sixth floor of the Huntsman Cancer Hospital. Open Mon.­Fri. 7 a.m.­8:30 p.m., Sat.­Sun. 11 a.m.­7 p

  1. An external evaluation of a peer-run outreach-based syringe exchange in Vancouver, Canada

    PubMed Central

    Hayashi, Kanna; Wood, Evan; Wiebe, Lee; Qi, Jiezhi; Kerr, Thomas

    2010-01-01

    Objective Vancouver, Canada has been the site of an epidemic of human immunodeficiency virus (HIV) among injection drug users (IDU). In response, the Vancouver Area Network of Drug Users (VANDU) initiated a peer-run outreach-based syringe exchange programme (SEP) called the Alley Patrol. We conducted an external evaluation of this programme, using data obtained from the Vancouver Injection Drug Users Study (VIDUS). Methods Using generalised estimating equations (GEE) we examined the prevalence and correlates of use of the SEP among VIDUS participants followed from 1 December 2000 to 30 November 2003. Results Of 854 IDU, 233 (27.3%) participants reported use of the SEP during the study period. In multivariate GEE analyses, service use was positively associated with living in unstable housing (Adjusted Odds Ratio [AOR] = 1.83, 95% Confidence Interval [CI]: 1.39 – 2.40), daily heroin injection (AOR = 1.31, 95% CI: 1.01 – 1.70), daily cocaine injection (AOR = 1.34, 95% CI: 1.03 – 1.73), injecting in public (AOR = 3.07, 95% CI: 2.32 – 4.06), and negatively associated with needle reuse (AOR = 0.65, 95% CI: 0.46 – 0.92). Conclusion The VANDU Alley Patrol SEP succeeded in reaching a group of IDU at heightened risk for adverse health outcomes. Importantly, access to this service was associated with lower levels of needle reuse. This form of peer-based SEP may extend the reach of HIV prevention programmes by contacting IDU traditionally underserved by conventional syringe exchange programmes. PMID:20359877

  2. The Vancouver Lymphadenopathy-AIDS Study: 2. Seroepidemiology of HTLV-III antibody.

    PubMed

    Jeffries, E; Willoughby, B; Boyko, W J; Schechter, M T; Wiggs, B; Fay, S; O'Shaughnessy, M

    1985-06-15

    Testing for antibody to human T-lymphotropic retrovirus (HTLV-III) was carried out in 448 participants in the Vancouver Lymphadenopathy-AIDS (acquired immune deficiency syndrome) Study. The overall prevalence rate of seropositivity was 34%. Of 130 seronegative subjects followed for an average of 8.5 months, 14 became seropositive; thus, the approximate annual seroconversion rate was 15%. More than 100 male sexual partners in one's lifetime, frequent receptive anal intercourse, fisting, a history of gonorrhea or hepatitis, and frequent sexual contact in clubs were found to be independent risk factors for HTLV-III seropositivity. PMID:2988729

  3. 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

    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

    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

  4. Hospitals for sale.

    PubMed

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

    2011-01-01

    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

  5. Evaluation of the effectiveness of postgraduate general medicine training by objective structured clinical examination---pilot study and reflection on the experiences of Kaohsiung Medical University Hospital.

    PubMed

    Tsai, Jer-Chia; Liu, Keh-Min; Lee, Kun-Tai; Yen, Jo-Chu; Yen, Jeng-Hsien; Liu, Ching-Kuan; Lai, Chung-Sheng

    2008-12-01

    Objective structured clinical examination (OSCE) is an effective assessment method to evaluate medical students' clinical competencies performance. Postgraduate year 1 (PGY1) residents have been initiated in a general medicine training program in Taiwan since 2003. However, little is known about the learning effectiveness of trainees from this program. This pilot study aimed to evaluate the clinical core competencies of PGY1 residents using OSCE, and to reflect on the strengths and weaknesses of this pilot assessment project. OSCE was conducted for five PGY1 examinees (4 men, 1 woman) with five stations covering core themes, including history taking, physical examination, clinical procedure of airway intubation, clinical reasoning, and communication skills for informing bad news. Itemized checklists and five-point Likert scale global ratings were used for evaluating performance. The results showed that the performance of our PGY1 residents on history taking was significantly better after about 2 months of postgraduate training on general internal medicine. Self-evaluation on performance by examinees revealed significantly lower global ratings on post-course OSCE (4.14 +/- 0.80 vs. 3.68 +/- 0.66; p < 0.02). Surveys from tutors and standardized patients (SPs) completed at pre- and post-course OSCEs showed consistently favorable responses on the purposes, content, process, and environment of this assessment (4.0 +/- 0.17 vs. 4.0 +/- 0.12, nonsignificant). However, a survey of the examinees completed at pre- and post-course OSCEs showed relatively unfavorable responses to the same aspects, and to tutors and SPs (4.1 +/- 0.09 vs. 3.7 +/- 0.18; p < 0.05). Qualitative information revealed that tutors and SPs remarked that PGY1 residents' medical knowledge performance was satisfactory but their clinical reasoning performance, communication skills (giving bad news) and self-confidence were unsatisfactory. In conclusion, this pilot study has demonstrated that OSCE is a rational and feasible assessment method for evaluating the effectiveness of our PGY general medicine training program. The quantitative data and qualitative information provide a foundation to improve the quality of the program design and evaluation in implementing postgraduate general medicine training. PMID:19251557

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

    PubMed Central

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

    2010-01-01

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

  7. Hospitals for Sale

    Microsoft Academic Search

    Michael M. Costello; Daniel J. West Jr; Bernardo Ramirez

    2011-01-01

    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

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

    PubMed Central

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

    2014-01-01

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

  9. West Penn Hospital /Allegheny General Hospital Medical Education Consortium

    E-print Network

    Juola, Patrick

    Disciplinary Action 54 Appeal Process 62 RESIDENT FATIGUE 62 MOONLIGHTING POLICY 64 HIPPAA POLICY 64 months Ambulatory 1 month Sports Medicine 1 month Neurology ˝ month Elective ˝ month EM/IM R3 Categorical

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

    Microsoft Academic Search

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

    2003-01-01

    Analyses of pollen, macrofossils and charcoal from subalpine lakes provide insight into past climatic changes as well as local factors affecting the sites, especially since steep precipitation and temperature gradients typify mountainous regions. Lake and bog cores collected from three sites on southern and central Vancouver Island (Porphyry and Walker lakes and Harris Lake Ridge Bog) were analysed for pollen,

  11. The Alma Mater Society of U.B.C. Vancouver November 28, 2012 PLACE: Council Chambers SUB Room 206

    E-print Network

    Pulfrey, David L.

    The Alma Mater Society of U.B.C. Vancouver November 28, 2012 PLACE: Council Chambers SUB Room 206) Executive Committee Motions: 4. MOVED , SECONDED From the Executive Committee #12;The Alma Mater Society Governance Board for a one year term commencing January 1, 2013. #12;The Alma Mater Society of U

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

    Microsoft Academic Search

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

    2004-01-01

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

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

    Microsoft Academic Search

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

    1996-01-01

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

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

    Microsoft Academic Search

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

    2000-01-01

    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

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

    ERIC Educational Resources Information Center

    Henry, Elizabeth Ruth

    2014-01-01

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

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

    Microsoft Academic Search

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

    1995-01-01

    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

  17. Educational Toward a cardiovascular pathology training Report on the forum held in Vancouver, March 6, 2004, Society for Cardiovascular Pathology

    Microsoft Academic Search

    Gaetano Thienea; Anton E. Beckerb; L. Maximilian Bujac; John T. Fallond; Bruce M. McManuse; Frederick J. Schoenf; Gayle L. Wintersf

    Cardiovascular pathology is a subspecialty of anatomic pathology that requires both clinical education and expertise in contemporary physiopathology. The Society for Cardiovascular Pathology sponsored a special workshop within the frame of the USCAP Annual Meeting, held in Vancouver, March 6-12, 2004, to address the present and future role of cardiovascular pathology in research, clinical care, and education. Clearly, the recruitment

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

    Microsoft Academic Search

    Michael G. G. Foreman; Richard E. Thomson

    1997-01-01

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

  19. Bibliography for the Hospitality Industry.

    ERIC Educational Resources Information Center

    Nelson, Elizabeth A.

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

  20. Financial Performance of Academic Medical Center Hospitals.

    ERIC Educational Resources Information Center

    Whitcomb, Michael E.; Cleverly, William O.

    1993-01-01

    A study of major academic medical center hospitals analyzed their financial performance for a five-year period. Results indicate the hospitals have stabilized their short-term financial performance in recent years. However, in general, their financial position is not strong and is threatened by the growing percentage of Medicaid discharges.…

  1. Hospital diversification and financial management.

    PubMed

    Eastaugh, S R

    1984-08-01

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

  2. Radiobiological intercomparison of the 160 MeV and 230 MeV proton therapy beams at the Harvard Cyclotron Laboratory and at Massachusetts General Hospital.

    PubMed

    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

    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

  3. Technical Report TR-014 May 2001 Research Section, Vancouver Forest Region, BCMOF Research Disciplines: Ecology ~ Geology ~ Geomorphology ~ Hydrology ~ Pedology ~ Silviculture ~ Wildlife

    E-print Network

    Disciplines: Ecology ~ Geology ~ Geomorphology ~ Hydrology ~ Pedology ~ Silviculture ~ Wildlife TR-014 Tools ~ Silviculture ~ Wildlife #12;Technical Report TR-014 May 2001 Research Section, Vancouver Forest Region, BCMOF Research Disciplines: Ecology ~ Geology ~ Geomorphology ~ Hydrology ~ Pedology ~ Silviculture ~ Wildlife

  4. 2014 consensus statement from the first Economics of Physical Inactivity Consensus (EPIC) conference (Vancouver).

    PubMed

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

    2014-06-01

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

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

    PubMed Central

    Sandberg, Dan

    2015-01-01

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

  6. The process of safer crack use among women in Vancouver's Downtown Eastside.

    PubMed

    Handlovsky, Ingrid E; Bungay, Vicky; Johnson, Joy; Phillips, J Craig

    2013-04-01

    In this article we discuss the findings from a grounded theory study in which we explored how women residing in Vancouver's Downtown Eastside (DTES) minimized some of the physical, psychological, and interpersonal harms associated with crack cocaine use, and identify the social, economic, and political factors that influence safer use. Data were collected over a 3-month period and involved group interviews with 27 women at an agency run by drug users in the DTES. A preliminary theory of safer crack use is discussed, consisting of the central phenomenon of caring for self and others. In addition, four thematic processes are described: (a) establishing a safe physical space, (b) building trusting relationships, (c) learning about safer crack use, and (d) accessing safer equipment. Implications of the findings are discussed in relation to supporting women's efforts and improving health outcomes. PMID:23258112

  7. Reversed Contralateral LISS Plate for Vancouver B1 Periprosthetic Femoral Shaft Fractures.

    PubMed

    Russo, Matthew; Malekzadeh, A Stephen; Hampton, Chadwick; Hymes, Robert; Schwartzbach, Cary; Schulman, Jeffrey

    2015-06-01

    The authors reviewed all patients treated for periprosthetic femur fractures between March 1, 2007, and January 31, 2010 at the senior author's institution. Demographic features, mechanism of injury, radiographs, and computed tomography scans were reviewed to determine the type and stability of the femoral implant at the time of injury. All Vancouver B1 fractures were treated with a novel technique that used a contoured distal femoral locking plate intended for the contralateral femur and reversed to accommodate the ipsilateral femoral bow and contour of the proximal femur. Fixation was achieved around the implant with percutaneously placed unicortical and/or bicortical screws. Radiographs were reviewed for fracture healing, malunion, implant failure, and prosthetic loosening. Fifteen patients were identified and underwent the procedure as described. One patient died soon after surgery of complications from a ruptured preexisting esophageal ulcer. Of the remaining 14 patients, the average duration of follow-up was 25 months (range, 6-31 months). Two patients did not achieve union; however, repeat interpretation of the presenting radiographs showed likely misdiagnosed Vancouver B2 fractures. The first patient had late aseptic loosening and underwent revision surgery 22 weeks postoperatively. The other had early loss of fixation that required revision with a long stem prosthesis. Other complications included 1 deep venous thrombosis and 2 superficial wound infections. The infections were successfully treated with a single formal irrigation and debridement, primary closure, and a short course of oral antibiotics. Ultimately, in 86% of patients (12/14), fracture healing occurred with this biologically friendly technique. [Orthopedics. 2015; 38(6):e467-e472.]. PMID:26091218

  8. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  9. Hospitalization of Children with Down Syndrome

    PubMed Central

    Tenenbaum, Ariel; Hanna, Rana N.; Averbuch, Diana; Wexler, Isaiah D.; Chavkin, Maor; Merrick, Joav

    2014-01-01

    Introduction: Children with Down syndrome present with multiple medical problems in a higher prevalence compared with the general population, which may lead to hospitalizations. Methods: Analysis of 560 hospitalizations of 162 children aged 0–16?years with Down syndrome at Hadassah Medical Center during the years 1988–2007 compared with data on children in the general population, hospitalized at the same period. Data was collected from patient files and statistical data from the Ministry of Health. Results: Respiratory infections were the leading cause for hospitalization of children with Down syndrome. The number of hospitalizations of children with Down syndrome compared to the number of all children, who were hospitalized was surprisingly similar to their proportion in the general population. Eleven children died during their hospitalization (five heart failure, three sepsis, one respiratory tract infection, and one due to complication after surgery). Nine of the 11 had a congenital heart anomaly. Conclusion: Children with Down syndrome can present with complex medical issues and we support the concept of a multidisciplinary team that has experience and knowledge to serve as a “one stop shop” for these individuals and their families, with timely visits in which a comprehensive evaluation is performed, problems attended to and prevention plans applied. In this way, we may prevent morbidity, hospitalizations, and mortality. PMID:24688981

  10. Research on hospital administrators' ethics: an agenda.

    PubMed

    Williamson, S; Jauch, L R

    1995-03-01

    This discussion argues that whereas ethically questionable practices have been identified in many industries, the moral consequences of many hospital management decisions make this industry particularly worthy of ethics studies. Because health care, the hospital's product, typically represents more immediate, intimate, and possibly irreversible benefit or harm to its customer, the patient, than does the typical product of general industry, hospital executives should be held to higher ethical standards in their decision making. Yet little is known about the ethical thinking of hospital managers. Kohlberg's moral reasoning development theory and Rest's Defining Issues Test offer the theoretical base and the means to compare the ethical reasoning of hospital executives to that of their nonhospital counterparts in general industry. This research agenda can offer important clues regarding the need to emphasize ethics in health care industry educational programs. PMID:10143574

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  12. 21 CFR 880.6890 - General purpose disinfectants.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 2010-04-01 2010-04-01 false General purpose disinfectants. 880.6890 Section...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous...

  13. 21 CFR 880.6890 - General purpose disinfectants.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 2013-04-01 2013-04-01 false General purpose disinfectants. 880.6890 Section...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous...

  14. 21 CFR 880.6890 - General purpose disinfectants.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 2014-04-01 2014-04-01 false General purpose disinfectants. 880.6890 Section...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous...

  15. 21 CFR 880.6890 - General purpose disinfectants.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 2012-04-01 2012-04-01 false General purpose disinfectants. 880.6890 Section...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous...

  16. 21 CFR 880.6890 - General purpose disinfectants.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 2011-04-01 2011-04-01 false General purpose disinfectants. 880.6890 Section...HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Miscellaneous...

  17. The MASSACHUSETTS GENERAL HOSPITAL SURGICAL SOCIETY

    E-print Network

    Mootha, Vamsi K.

    as an artificial lung. Sarah Thayer then spoke on developmental path- ways in pancreatic cancer. An update as a pediatric surgeon in developing pharmacologic treatments for ovarian cancer. Mark Katlic dis- cussed his longstanding interest in the surgical treatment of geriatric patients. The last talk of the morning sessions

  18. Blood Transfusion Service Massachusetts General Hospital

    E-print Network

    Mootha, Vamsi K.

    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

  19. Blood Transfusion Service Massachusetts General Hospital

    E-print Network

    Mootha, Vamsi K.

    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

  20. Regional Hospital Input Price Indexes

    PubMed Central

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

    1981-01-01

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

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

    Microsoft Academic Search

    Colin P. Laroque; Dan J. Smith

    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.

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

    Microsoft Academic Search

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

    1995-01-01

    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

  3. Six-Stage Hospital Beds Arrangement Management System

    Microsoft Academic Search

    Guan-Dao Yang; Lu Sun; Xiao Liu

    2010-01-01

    In recent years, the arrangement of hospital beds, utilizing the rule of First Come, First Serve (FCFS), reveals the common poor management of hospitals. Importantly, our proposed Six-stage Hospital Beds Arrangement Management System (Six-stage HBAMS) uses General Utility Function (utilizing Gray Correlation Analysis) to determine the hospitalization orders of patients. To verify Six-stage HBAMS, we use our proposed History Repeating

  4. Hospital-based intensive monitoring of antibiotic-induced adverse events in a university hospital

    Microsoft Academic Search

    Filomena Mazzeo; Annalisa Capuano; Amalia Avolio; Amelia Filippelli; Francesco Rossi

    2005-01-01

    Hospital-based monitoring is one of the methods used to collect data about drug prescriptions and adverse events. The aim of this 20-day observational prospective study was to evaluate the frequency and type of adverse reaction to antibiotics, and predisposing risk factors in inpatients in six departments of a university hospital (ophthalmology, paediatrics, internal medicine, general surgery, infectious diseases, anaesthesiology and

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

    NASA Astrophysics Data System (ADS)

    Leithead, A.; Li, S.

    2002-12-01

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

  6. 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

    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

    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

  7. 38 CFR 3.157 - Report of examination or hospitalization as claim for increase or to reopen.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...reopen. (a) General. Effective...of outpatient or hospital examination or date...uniformed services hospital will be accepted...former member of the Armed Forces on the temporary...admission to a non-VA hospital where a...

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

    PubMed

    Becker, Scott; Koch, Elissa

    2006-01-01

    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

  9. Help prevent hospital errors

    MedlinePLUS

    ... prevent medical errors when you are in the hospital. ... Share your health information with health care providers in the hospital. DO NOT think they already know it. Know what tests are being done. Ask what the test is for, ...

  10. HOSPITAL RADIOLOGIC DECONTAMINATION CENTER

    Microsoft Academic Search

    J. R. Karel; S. Ketyer

    1962-01-01

    In 1961 the Medical Division of the Union County Civil Defense and ; Disastor Control organization in cooperation with the Radiology Department of St. ; Elizabeth Hospital in Elizabeth, N. J., developed a Hospital Decontamination ; Center. In addition to being a decontamination center, St. Elizabeth Hospital ; has become a fallout monitor station for Union County. According to the

  11. HOSPITALS FOR RURAL PEOPLE.

    ERIC Educational Resources Information Center

    MANNY, ELSIE S.; ROGERS, CHARLES E.

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

  12. Defining rural hospital markets.

    PubMed Central

    Goody, B

    1993-01-01

    OBJECTIVE. The purpose of this study is to examine the geographic scope of rural hospital markets. DATA SOURCES. The study uses 1988 Medicare patient discharge records (MedPAR) and hospital financial information (HCRIS) for all rural hospitals participating in the Medicare Program. STUDY DESIGN. Hospital-specific market areas are compared to county-based market areas using a series of geographic and socioeconomic-demographic dimensions as well as indicators of market competitiveness. The potential impact of alternative market configurations on health services research is explored by estimating a model of rural hospital closure. DATA COLLECTION/EXTRACTION METHODS. Hospital-specific market areas were defined using the zip code of patient origin. Zip code-level data were subsequently aggregated to the market level. FINDINGS. Using the county as the hospital market area results not only in the inclusion of areas from which the hospital does not draw patients but also in the exclusion of areas from which it does draw patients. The empirical estimation of a model of rural hospital closure shows that the definition of a hospital market area does not jeopardize the ability to identify major risk factors for closure. CONCLUSIONS. Market area definition may be key to identifying and monitoring populations at risk from rural hospital decisions to downsize or close their facilities. Further research into the market areas of rural hospitals that have closed would help to develop alternative, and perhaps more relevant, definitions of the population at risk. PMID:8514499

  13. 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

  14. Hospital ownership and community benefit: looking beyond uncompensated care.

    PubMed

    Song, Paula H; Lee, Shoou-Yih D; Alexander, Jeffrey A; Seiber, Eric E

    2013-01-01

    Not-for-profit (NFP) hospitals have come under increased public scrutiny for management practices that are inconsistent with their charitable focus. Of particular concern is the amount of community benefit provided by NFP hospitals compared to for-profit (FP) hospitals given the substantial tax benefits afforded to NFP hospitals. This study examines hospital ownership and community benefit provision beyond the traditional uncompensated care comparison by using broader measures of community benefit that capture charitable services, community assessment and partnership, and community-oriented health services. The study sample includes 3,317 nongovernment, general, acute care, community hospitals that were in operation in 2006. Data for this study came from the 2006 American Hospital Association Hospital Survey and the 2006 Area Resource File. We used multivariate regression analyses to examine the relationship between hospital ownership and five indicators of community benefit, controlling for hospital characteristics, market demand, hospital competition, and state regulations for community benefit. We found that NFP hospitals report more community benefit activities than do FP hospitals that extend beyond uncompensated care. Our findings underscore the importance of defining and including activities beyond uncompensated care when evaluating community benefit provided by NFP hospitals. PMID:23650697

  15. Patients' Perceptions of Care Are Associated With Quality of Hospital Care: A Survey of 4605 Hospitals.

    PubMed

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

    2015-07-01

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

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

    PubMed Central

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

    2008-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Brown, Kendrick J.; Schoups, Gerrit

    2015-05-01

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

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

    PubMed Central

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

    2008-01-01

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

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

    SciTech Connect

    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

    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.

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

    PubMed Central

    2014-01-01

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

  2. Evaluation of a Medical and Mental Health Unit compared with standard care for older people whose emergency admission to an acute general hospital is complicated by concurrent 'confusion': a controlled clinical trial. Acronym: TEAM: Trial of an Elderly Acute care Medical and mental health unit

    Microsoft Academic Search

    Rowan H Harwood; Sarah E Goldberg; Kathy H Whittamore; Catherine Russell; John RF Gladman; Rob G Jones; Davina Porock; Sarah A Lewis; Lucy E Bradshaw; Rachel A Elliot

    2011-01-01

    Background  Patients with delirium and dementia admitted to general hospitals have poor outcomes, and their carers report poor experiences.\\u000a We developed an acute geriatric medical ward into a specialist Medical and Mental Health Unit over an eighteen month period.\\u000a Additional specialist mental health staff were employed, other staff were trained in the 'person-centred' dementia care approach,\\u000a a programme of meaningful activity

  3. Doctors' use of electronic medical records systems in hospitals: cross sectional survey

    Microsoft Academic Search

    H. Larum; G. Ellingsen; A. Faxvaag

    2001-01-01

    Objectives To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. Design Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. Setting 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. Participants 227

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

    PubMed Central

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

    2015-01-01

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

  5. Hospital diversification strategy.

    PubMed

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger. PMID:25223156

  6. [Minor emergency cases in big hospitals].

    PubMed

    Streuli, Rolf A

    2015-01-01

    Our hospitals are suffering from an increasing run of "minor emergency cases". Those are simple medical or surgical ailments that could be taken care of by a general practitioner's office in a competent and cost efficient way. Because of the ever growing problem of a shortage of general practitioners, those patients are directly going to the emergency room of our hospitals, where they are usually seen by a young and yet unexperienced doctor, who is ordering an expensive battery of tests even for minor troubles of his or her wellbeing. It was shown that emergency room crowding has a negative impact on the quality of patient care. The establishment of an office run by a general practitioner within the hospital emergency room may result in a certain relief of the situation. PMID:25533247

  7. [Maternal perception regarding hospitalized newborns].

    PubMed

    Carmona, Elenice Valentim; Vale, Ianę Nogueira do; Ohara, Conceiçăo Vieira da Silva; Abrăo, Ana Cristina Freitas de Vilhena

    2014-01-01

    Cross-sectional descriptive study conducted in the neonatal unit of a public teaching hospital in the state of Săo Paulo, Brazil, which aimed to determine the perceptions of mothers about their newborns hospitalized children. The sample consisted of 100 women questioned, through the Neonatal Perception Inventory Broussard, about how much trouble was expected to be presented by babies of the general unit, on behaviors such as crying; feeding; regurgitate or vomit; evacuate; sleep and have a routine. Then, the same questions were repeated about their own babies. Ninety mothers considered their children with fewer difficulties than other babies at the unit. Younger women and mothers of infants with higher weights tended to consider their children with more difficulty. The Inventory is easy to apply and may be useful in the evaluation of mother-child interaction, although its result cannot be considered in isolation. PMID:25517674

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

    PubMed Central

    2010-01-01

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

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

    PubMed Central

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

    1995-01-01

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

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

    E-print Network

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

    2011-06-20

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

  11. Landslide Sediment Flux and Forest Management in Northeastern Vancouver Island, Coastal British Columbia

    NASA Astrophysics Data System (ADS)

    Brardinoni, F.; Maynard, D.; Rollerson, T.

    2012-04-01

    To evaluate landslide response of mountain drainage basins to forest management we examine a historical inventory in northeastern Vancouver Island. The study area is underlain by extrusive (upper Triassic Karmutsen Formation) and intrusive rocks (Jurassic Island Intrusions). The dataset, compiled via interpretation of sequential aerial photosets, helicopter traverses, and extensive fieldwork, comprises a total of 1961 sediment sources, including 798 field-measured events. Field- and photo-based data cover a time window of approximately 70 years. The effects of forest management on landslide activity are assessed in terms of landslide density, sediment production, landslide geometry, landslide magnitude-frequency relations, topographic conditions of landslide initiation and deposition, and sediment redistribution across landscape components. Results indicate that forest management alters natural landslide dynamics in many respects. Logging-related debris avalanches are typically smaller. Consequently, the magnitude-frequency relation in logged terrain occupies the small-medium magnitude spectrum (< 6000 m3), with frequencies increasing by over an order of magnitude. Lithologic effects on sediment production appear amplified, in that terrain underlain by extrusive rocks become increasingly more unstable than intrusive ones. Analysis of landslide initiation and deposition zones reveals that forest management promotes colluvial aggradation on mid and lower hillslopes and in gullies. This pattern, which accelerates sediment recharge of gully systems, has the potential of increasing the frequency of channelized debris-flows, hence cause an extended period of disturbance, before sediment dynamics recover to pre-logging conditions. The effects of forest clearing on hillslope-channel coupling are composite: in cutblocks the percentage of sediment delivered to streams is reduced by 20-60% whereas road-related landslides are associated with highest connectivity to streams.

  12. Architecture and evolution of a fjord-head delta, western Vancouver Island, British Columbia

    NASA Astrophysics Data System (ADS)

    Gutsell, Jeffrey E.; Clague, John J.; Best, Melvyn E.; Bobrowsky, Peter T.; Hutchinson, Ian

    2004-07-01

    The architectural framework and Holocene evolution of the Zeballos fjord-head delta on west-central Vancouver Island was established through a multidisciplinary field-based study. The Zeballos delta is a composite feature, consisting of an elevated, incised, late Pleistocene delta and an inset Holocene delta graded to present sea level. Both deltas have a classic Gilbert-type tripartite architecture, with nearly flat topset and bottomset units and an inclined foreset unit. Time domain electromagnetic (TDEM) and ground-penetrating radar (GPR) surveys, borehole data, and gravel pit exposures provided information on the internal form, lithologies and substrate of both deltas. Both sets of deltaic deposits coarsen upward from silt in the bottomset unit to gravel in the topset unit. The TDEM survey revealed a highly irregular, buried bedrock surface, ranging from 20 m to 190 m in depth, and it delineated saltwater intrusion into the deltaic sediments.Late Quaternary sea-level change at Zeballos was inferred from delta morphology and the GPR survey. The elevated, late Pleistocene delta was constructed when the sea was about 21 m higher relative to the land than it is today. It was dissected when sea-level fell rapidly as a result of glacio-isostatic rebound. Relative sea-level reached a position about 20 m below the present datum during the early Holocene. Foreset beds that overlap and progressively climb in a seaward direction and topset beds that thicken to 26 m landward imply that the delta aggraded and prograded into Zeballos Inlet during the middle and late Holocene transgression. Sea-level may have risen above the present datum during the middle Holocene, creating a delta plain at about 4 m a.s.l. Remnants of this surface are preserved along the valley margins. Copyright

  13. The seasonal cycle in sinking particle fluxes off Vancouver Island, British Columbia

    NASA Astrophysics Data System (ADS)

    Peńa, M. A.; Denman, K. L.; Calvert, S. E.; Thomson, R. E.; Forbes, J. R.

    1999-11-01

    We have made year-long observations of sinking particle fluxes with sequential sediment traps moored at a depth of 200 m at three sites proceeding offshore from Vancouver Island, Canada in water depths of 500-2500 m. Total particle flux and biogenic silica decreased offshore as expected in an eastern boundary current regime. No obvious gradient was observed in POC, and CaCO 3 was proportionally greater offshore. Even there POC dominated over particulate inorganic carbon (as CaCO 3) indicating a net removal of CO 2 from surface water by biological activity. Common to all three sites, we observed an annual cycle in total particle flux, with highest fluxes during spring/summer, reflecting the higher primary production during these seasons. In spite of changes in total fluxes, the ratios between organic C, CaCO 3 and biogenic silica of the sedimented material did not change over the annual cycle. Atomic C organic/N total ratios were highest in the summer and lowest in the winter, possibly reflecting an increase in the relative contribution of lithogenic particles during winter. The isotopic composition of sinking particulate nitrogen ( ? 15Ntotal) tended to be lighter during periods of higher fluxes, most likely reflecting variation in relative nutrient utilization and length of the food chain. The ? 13Corganic composition of sinking particles varied among sites, probably reflecting differences in planktonic species composition; contributions of terrestrial organic matter appear unlikely. Currents at 50 m depth were higher and more variable at the inshore site, and temperature and salinity were also more variable, consistent with the tendency for dominance of diatoms (silica shells) in more energetic environments.

  14. Indoor sources of poly- and perfluorinated compounds (PFCS) in Vancouver, Canada: implications for human exposure.

    PubMed

    Shoeib, Mahiba; Harner, Tom; M Webster, Glenys; Lee, Sum Chi

    2011-10-01

    Perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) are widely detected in human blood and serum and are of concern due to their potential toxicity. This study investigated the indoor sources of these compounds and their neutral precursors through a survey of 152 homes in Vancouver, Canada. Samples were collected of indoor air, outdoor air, indoor dust, and clothes dryer lint and analyzed for neutral [i.e., fluorotelomer alcohols (FTOHs), perfluorooctane sulfonamide (FOSA), and perfluorooctane sulfonamidoethanol (FOSE)] and ionic [i.e., PFOS and perfluoroalkyl carboxylates (PFCAs)] poly- and perfluorinated compounds (PFCs). Indoor air was dominated by 8:2 FTOH with a geometric mean concentration (pg/m(3)) of 2900. Among the FOSAs and FOSEs, MeFOSE exhibited the highest air concentration with a geometric mean of 380 pg/m(3). PFOA was the major ionic PFC and was detected in all indoor air samples with a geometric mean of 28 pg/m(3), whereas PFOS was below the detection limit. The results for the ionic PFCs in indoor air are the first for North America. The pattern of the neutral PFCs in house dust was also dominated by 8:2 FTOH, with a geometric mean of 88 ng/g. Dusts were enriched (relative to air) with sulfonamidoethanol (FOSE) which comprised ?22% of the total neutral PFC content compared to only ?3% in air. PFOS and PFOA were the most prominent compounds detected in dust samples. Levels of neutral PFCs in clothes dryer lint were an order of magnitude lower compared to house dust. Human exposure estimates to PFCs for adults and children showed that inhalation was the main exposure route for neutral and ionic PFCs in adults. For toddlers, ingestion of PFCs via dust was more relevant and was on the order of a few mg/day. Results from this study contribute to our understanding of exposure pathways of PFCs to humans. This will facilitate investigations of related health effects and human monitoring data. PMID:21332198

  15. More efficient hospitals are closing.

    PubMed

    Cleverly, W O

    1993-04-01

    An examination of factors related to hospital closures reveals a disconcerting trend. Hospitals that closed in 1991 appear to have been more efficient than hospitals that closed in 1990, and hospitals that closed in 1990 appear to have been more efficient than hospitals that closed in 1989. This trend suggests that future hospital closures may pull relatively efficient hospitals out of the healthcare system. The end result may be increases, not decreases, in total healthcare costs. PMID:10145793

  16. The Veterinary Teaching Hospital at Colorado State University has an opening for a position as an Equine Field Service Veterinarian. Equine Field Service provides general medical care, preventive health, herd

    E-print Network

    The Veterinary Teaching Hospital at Colorado State University has an opening for a position to provide a hands-on learning experience for 4th year veterinary students while providing excellent equine appointments with clients in the Northern Colorado region Teach 4th year veterinary students about

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

    PubMed

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

    2014-11-13

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

  18. Dutch hospitals provide reliable "one click" patient information using a Quality Window.

    PubMed

    Van Rooy, Yvonne

    2014-01-01

    In 2014, the Dutch Association of Hospitals (Nederlandse Vereniging van Ziekenhuizen, NVZ) launched the "Quality Window" at general hospitals across the Netherlands. The Quality Window is an online platform for patients which shares a hospital's current and previous scores on ten quality indicators, from patient experience to employee satisfaction. The Quality Window therefore responds to the growing demand for information and transparency when it comes to hospital care and performance. Not only can patients access helpful information about a hospital's quality through the Quality Window, they can also compare results with other hospitals, the national average, and more. Many hospitals also take the opportunity to expand on how indicators work in practice and the actions being taken towards improvement. The Quality Window was developed with the help of hospitals and patients. Over the coming years it will be expanded to university hospitals across the country. General hospitals will also begin developing Quality Windows for specific patient groups, such as cancer patients. PMID:25985551

  19. Management of medical waste in Tanzanian hospitals.

    PubMed

    Manyele, S V; Anicetus, H

    2006-09-01

    A survey was conducted to study the existing medical waste management (MWM) systems in Tanzanian hospitals during a nationwide health-care waste management-training programme conducted from 2003 to 2005. The aim of the programme was to enable health workers to establish MWM systems in their health facilities aimed at improving infection prevention and control and occupational health aspects. During the training sessions, a questionnaire was prepared and circulated to collect information on the MWM practices existing in hospitals in eight regions of the Tanzania. The analysis showed that increased population and poor MWM systems as well as expanded use of disposables were the main reasons for increased medical wastes in hospitals. The main disposal methods comprised of open pit burning (50%) and burying (30%) of the waste. A large proportion (71%) of the hospitals used dust bins for transporting waste from generation points to incinerator without plastic bags. Most hospitals had low incineration capacity, with few of them having fire brick incinerators. Most of the respondents preferred on-site versus off-site waste incineration. Some hospitals were using untrained casual labourers in medical waste management and general cleanliness. The knowledge level in MWM issues was low among the health workers. It is concluded that hospital waste management in Tanzania is poor. There is need for proper training and management regarding awareness and practices of medical waste management to cover all carders of health workers in the country. PMID:18254511

  20. Effect of Hospital–SNF Referral Linkages on Rehospitalization

    PubMed Central

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

    2013-01-01

    Objective. To determine whether the rate of rehospitalization is lower among patients discharged to skilled nursing facilities (SNFs) with which a hospital has a strong linkage. Data Sources/Collection. We used national Medicare enrollment, claims, and the Minimum Data Set to examine 2.8 million newly discharged patients to 15,063 SNFs from 2,477 general hospitals between 2004 and 2006. Study Design. We examined the relationship between the proportion of discharges from a hospital and alternative SNFs on the rehospitalization of patients treated by that hospital–SNF pair using an instrumental variable approach. We used distances to alternative SNFs from residence of the patients of the originating hospital as the instrument. Principal Findings. Our estimates suggest that if the proportion of a hospital's discharges to an SNF was to increase by 10 percentage points, the likelihood of patients treated by that hospital–SNF pair to be rehospitalized within 30 days would decline by 1.2 percentage points, largely driven by fewer rehospitalizations within a week of hospital discharge. Conclusions. Stronger hospital–SNF linkages, independent of hospital ownership, were found to reduce rehospitalization rates. As hospitals are held accountable for patients' outcomes postdischarge under the Affordable Care Act, hospitals may steer their patients preferentially to fewer SNFs. PMID:24134773

  1. Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, (617) 732-6570 Externship in Hospital Dentistry and Oral Medicine

    E-print Network

    Dorf, Martin E.

    will be exposed to the ambulatory and in-patient activities of the hospital's Oral Medicine and General Practice information on the General Practice Residency: http://www.hsdm.harvard.edu/index.php/academics/programs/general_practice

  2. Changes in service availability in california hospitals, 1995 to 2002.

    PubMed

    Kirby, Paul B; Spetz, Joanne; Maiuro, Lisa; Scheffler, Richard M

    2006-01-01

    Hospitals face serious financial challenges in the current healthcare marketplace. In response to these challenges, they may alter their service offerings, eliminating services that are perceived as money-losing or adding new services in areas where profitability is expected to be greater. Although research has examined hospital closures, the more subtle phenomenon of hospital service changes has not been systematically studied. This issue is important because different types of hospital service changes could have different effects on hospital financial viability: extensive service closures could contribute to a downward spiral leading to hospital closure, whereas adding new services might help improve a hospital's finances. This article' examines changes in hospital service availability in California general acute care hospitals between 1995 and 2002. Our major findings indicate that many California hospitals made changes in their service offerings during the study period, although few made extensive changes. Altogether, about half of the hospitals in our study population either closed or opened at least one service. Nearly one-fourth of the hospitals in our study population closed one or more services, whereas just under one-third opened one or more new services. However, the vast majority of the hospitals that closed or added a service made only one or two such changes. In addition, few hospitals both closed and opened services. The service closed most frequently was normal newborn labor and delivery (obstetrics), whereas inpatient rehabilitation was the most frequently opened service. Hospitals that made the most service changes tended to be small, rural, and financially troubled at the start of the study period. Among this group of hospitals, service closures were associated with continued financial deterioration, whereas new service openings were associated with improvements in key financial ratios. PMID:16479748

  3. [Music in the hospital].

    PubMed

    Bouteloup, Philippe

    2010-01-01

    Occasional events, regular workshops, concerts, shows, artists in residence, cultural outings...Hospital does not necessarily have to be a place of silence and sadness. But this situation has not always been so straightforward as on the face of it, nothing is more incompatible with a hospital environment than music, which, by definition, is festive and noisy. PMID:20684389

  4. Hospitality, Tourism, and Recreation.

    ERIC Educational Resources Information Center

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  5. Handbook on Hospital Television.

    ERIC Educational Resources Information Center

    Prynne, T. A.

    Designed for both hospital personnel interested in television and audiovisual personnel entering the medical field, this handbook is a verbal and pictorial survey of what is being done with TV within the medical profession. After an introduction which answers technical questions about medical TV posed during the American Hospital Association's…

  6. Hospitality Occupations. Curriculum Guide.

    ERIC Educational Resources Information Center

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

    This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

  7. Characteristics of hospitals that outsource information system functions.

    PubMed

    Menachemi, Nir; Burke, Darrell; Diana, Mark; Brooks, Robert

    2005-01-01

    Despite the increasing trend among hospitals to outsource information system functions, little is known about these decisions in the acute-care setting. This study examined the outsourcing behavior of hospitals in Florida to determine the characteristics of hospitals that are most likely to outsource IS functions. In addition, the results provide an overview of which IS functions are most commonly outsourced in hospitals. Overall, survey responses from 98 hospitals indicate that the outsourcing of IS functions is more common in small hospitals and those in rural areas. Another important predictor of IS outsourcing behavior was the degree to which an organization placed a strategic importance on IS in its operations. Outsourcing behavior did not seem to be systematically related to the CIO reporting structure. However, having a physician in a senior level IT position did seem to correlate. Lastly, the data indicate that a hospital's profit status is not generally related to IS outsourcing. PMID:15682678

  8. The impact of critical total quality management practices on hospital performance in the ministry of health hospitals in saudi arabia.

    PubMed

    Alaraki, Mohammad Shamsuddin

    2014-01-01

    Total Quality Management (TQM) offers a method for solving quality and patient safety problems and bringing significant improvement to hospital performance. However, only few studies have been conducted in this area in developing countries, particularly in Saudi Arabia. This research is carried out in an attempt to address this gap, exploring the impact of applying TQM practices on hospital performance in the Saudi Ministry of Health hospitals. The study has included 4 hospitals in Tabuk Region, namely, King Khaled Hospital, King Fahad Hospital, Maternity and Children Hospital, and Hagel General Hospital. The data collection was done by the researcher when 400 questionnaires were distributed using a convenient sampling technique to access the required data. The response rate was 67.25% of the total questionnaires distributed. The TQM practices used in the study were as follows: leadership, employee management, information analysis, training, customer focus, continuous improvement, process management, and supplier management. The findings of the research show a significant positive correlation between the 8 practices of TQM and hospital performance with a correlation coefficient r value of 0.9 (P = .0001). The study also reveals that Saudi hospitals are facing difficulties in engaging the clinical staff in their quality initiative. Moreover, our findings show that accredited hospitals have significantly applied TQM practices more than unaccredited hospitals. PMID:24368721

  9. 21 CFR 20.112 - Voluntary drug experience reports submitted by physicians and hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...experience reports submitted by physicians and hospitals. 20.112 Section 20.112 Food...AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Availability of Specific Categories...experience reports submitted by physicians and hospitals. (a) A voluntary drug...

  10. 21 CFR 20.112 - Voluntary drug experience reports submitted by physicians and hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...experience reports submitted by physicians and hospitals. 20.112 Section 20.112 Food...AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Availability of Specific Categories...experience reports submitted by physicians and hospitals. (a) A voluntary drug...

  11. 21 CFR 20.112 - Voluntary drug experience reports submitted by physicians and hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...experience reports submitted by physicians and hospitals. 20.112 Section 20.112 Food...AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Availability of Specific Categories...experience reports submitted by physicians and hospitals. (a) A voluntary drug...

  12. 21 CFR 20.112 - Voluntary drug experience reports submitted by physicians and hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...experience reports submitted by physicians and hospitals. 20.112 Section 20.112 Food...AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Availability of Specific Categories...experience reports submitted by physicians and hospitals. (a) A voluntary drug...

  13. 21 CFR 20.112 - Voluntary drug experience reports submitted by physicians and hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...experience reports submitted by physicians and hospitals. 20.112 Section 20.112 Food...AND HUMAN SERVICES GENERAL PUBLIC INFORMATION Availability of Specific Categories...experience reports submitted by physicians and hospitals. (a) A voluntary drug...

  14. Trends in Out-of-Hospital Births in the United States, 1990-2012

    MedlinePLUS

    ... Trends in Out-of-Hospital Births in the United States, 1990–2012 On This Page Key findings In ... hospital births was generally higher in the northwestern United States and lower in the southeastern United States. More ...

  15. Children's experiences of hospitalization.

    PubMed

    Coyne, Imelda

    2006-12-01

    This article reports on children's experiences of hospitalization. Data were collected via semi-structured interviews with 11 children aged between seven and 14 years from four paediatric units in England. The children identified a range of fears and concerns, which included: separation from parents and family; unfamiliar environment; investigations and treatments; and loss of self-determination. The children's loss of self-determination over personal needs exacerbated their fears and concerns. It needs to be recognized that compliance with hospital routines is a variable, which influences children's reaction to hospitalization. The findings clearly indicate that children need adequate information tailored to their needs, that their views are sought in the planning and delivery of their care and that hospital environments need to be made more child-centred. Interventions designed to reduce children's stress during hospitalization are not only likely to decrease their stress at the time, but also likely to influence how future experiences are appraised and managed. PMID:17101624

  16. Innovation in Australian hospitals.

    PubMed

    Dwyer, Judith; Leggat, Sandra G

    2002-01-01

    This paper examines the challenge of innovation, and reports on innovation in the Australian hospital sector. Through review of both published and 'grey' literature, the analysis of the innovative record of Australian hospitals is focused on two key questions: How has the hospital sector made use of opportunities for renewal and improved effectiveness in its ongoing response to the challenges it faces? And are the conditions for effective innovation in place? To be truly innovative, the Australian hospital sector requires greater supporting mechanisms including: a consistent policy and funding framework, greater ability to harness the power of information, and development of innovation skills. The government has an important role to play in stimulating the creative capacities of hospitals and their staff. PMID:12474499

  17. 34. Photographic copy of historic drawing, "Naval Hospital and Battery ...

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

    34. Photographic copy of historic drawing, "Naval Hospital and Battery at Portsmouth, VA.," ca. 1862. (From Paul F. Moteelay and T. Campbell-Copeland's The Soldier in Our Civil War: A Pictorial History of the Conflict, 1861-1865. New York: Stanley Bradley Publishing Company, 1890, vol. 1, p. 320.) - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  18. This working paper is made available by the Fisheries Centre, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada.

    E-print Network

    Pauly, Daniel

    Working Paper #2014 - 07 Fishing in Easter Island, a Recent History (1950-2010) La (2014) Fishing in Easter Island, a recent history (1950-2010). Fisheries Centre Working Paper #2014 - 07, Fisheries Centre, University of British Columbia, Vancouver. 19 p. #12;Fishing in Easter Island: recent

  19. Image: A.J. Diamond and Barton Myers; Wolf House, 1974; Toronto, Ontario, Canada; designed by Barton Myers. Photo Credit: John Fulker, Courtesy of the West Vancouver Museum.

    E-print Network

    Sideris, Thomas C.

    Image: A.J. Diamond and Barton Myers; Wolf House, 1974; Toronto, Ontario, Canada; designed by Barton Myers. Photo Credit: John Fulker, Courtesy of the West Vancouver Museum. August 18, 2014- The Art of architecture. Barton Myers first attracted attention in the late 1960s for his civic buildings and urban

  20. The Centre for Blood Research John R. Hess, MD, MPH, FACP, FAAAS

    E-print Network

    Strynadka, Natalie

    The Centre for Blood Research John R. Hess, MD, MPH, FACP, FAAAS University of Maryland School of these circumstances. * Dr. Hess will be presenting a seminar at Vancouver General Hospital in the Taylor Fidler

  1. Hospital diversification: evaluating alternatives.

    PubMed

    Hammer, L

    1987-05-01

    The appropriateness of diversification as a growth strategy for hospitals is discussed, and planning for diversification is described. Because new forms of health-care delivery are now in direct competition with hospitals, many hospitals are confronting environmental pressures and preparing for future survival through diversification. To explore the potential risks and benefits of diversification, the hospital must identify opportunities for new business ventures. Diversification can be "related," through an expansion of the primary product line (health care), or "unrelated," into areas not directly associated with health care. The hospital must establish specific criteria for evaluating each diversification alternative, and the two or three most attractive options should be analyzed further through a financial feasibility study. The hospital should also seek legal advice to determine the implications of diversification for maintenance of tax status, antitrust limitations, and applicability of certificate of need. Although diversification may not be appropriate for every institution, hospitals should consider it as a strategy for increasing their revenue base, confronting environmental pressures, and securing future survival. PMID:3300300

  2. Experience of Adults and Children in Hospitals

    ERIC Educational Resources Information Center

    Rokach, Ami; Parvini, Maneli

    2011-01-01

    This review article examines the experience, in general but especially, of hospitalised children. The technical, environmental and social aspects of a hospital are described. Being hospitalised, especially for a child, could be a terrifying and painful experience. This experience has been described and closely examined with the aim of helping…

  3. Panel: Physicians Use Small Microcomputers for Hospital Patient Care

    PubMed Central

    Splitstone, Dale; Hartney, Thomas C.; Kaplan, Robert; Keene, Beverly; Masencup, Bonnie; Trotter, John

    1984-01-01

    “Physician's Use Small Microcomputers for Hospital Patient Care - A Panel Presentation” advances the view-points of the participants. Physician, Nurse, Pharmacist, Records Librarian, Computer Services and the Administrator present perspectives on small microcomputer use by Physicians. The Panelists have inaugurated a program of such nature in their four hundred beds, private, general hospital and discuss salient features.

  4. Small hospitality enterprises and local produce: a case study

    Microsoft Academic Search

    Abel Duarte Alonso; Martin ONeill

    2010-01-01

    Purpose – Contemporary academic research generally discusses positive spillovers that consumption and purchase of local foods\\/produce may have for consumers, farmers and local economies from which these products come. In a hospitality industry context, local produce can enhance culinary experiences as well as benefit regions and businesses that promote it. However, to what extent are hospitality businesses aware and receptive

  5. Photograph of model projected new hospital building and new landscaping ...

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

    Photograph of model projected new hospital building and new landscaping for area north of building 500. Model displayed on the mezzanine level of building 500. - Fitzsimons General Hospital, Bounded by East Colfax to south, Peoria Street to west, Denver City/County & Adams County Line to north, & U.S. Route 255 to east, Aurora, Adams County, CO

  6. The private management of public hospitals.

    PubMed Central

    Rundall, T G; Lambert, W K

    1984-01-01

    Since the public sector traditionally has provided the public goods viewed as unprofitable by the private sector, the growing trend to manage public hospitals under outside private contract raises some fundamental issues of concern. It is hypothesized here that the system maintenance and output goals of privately managed public hospitals become increasingly similar to those of investor-owned hospitals. The thesis is empirically tested using documented effects of private contract management on the operative goals of short-term, general hospitals owned by local governmental bodies. Traditionally managed public hospitals matched with the study hospitals on important characteristics serve as the control group. Costs do appear to be reduced under private contract management, but the service structure becomes somewhat altered. It is the task of public health policymakers to reconcile the cost-control and efficiency mechanisms brought about by private management with the community's right of access to comprehensive medical care. Carefully structured regionalization plans--a possible means of providing both--will require the stimulation of more government involvement during an era of cutbacks. PMID:6490379

  7. Hospital Records Database

    NSDL National Science Digital Library

    This new joint project from the Wellcome Trust and the UK Public Record Office helps researchers locate records of hospitals all over the UK. The database currently contains over 2,800 entries and may be searched by hospital or town name. Information contained in the database includes administrative details of the hospitals, location and covering dates of administrative and clinical records, and the existence of lists, catalogs or other finding aids. A sample search for "royal" under hospital name returned 210 records, and one for "Manchester" under town name produced 124 returns. While the target audience of this database -- researchers in British medical history -- is rather specialized, this new resource will prove extremely useful for these scholars and their students.

  8. Christiana Hospital, Newark, Delaware

    Cancer.gov

    Christiana Hospital, Newark, Delaware Helen F. Graham Cancer Center at Christiana Care 4755 Ogletown-Stanton Rd. Newark, DE 19718 (302) 733-1000 www.christianacare.org www.christianacare.org/hfgcc • Robert Laskowski, MD, President and CEO, Christiana

  9. Hospital free cash flow.

    PubMed

    Kauer, R T; Silvers, J B

    1991-01-01

    Hospital managers may find it difficult to admit their investments have been suboptimal, but such investments often lead to poor returns and less future cash. Inappropriate use of free cash flow produces large transaction costs of exit. The relative efficiency of investor-owned and tax-exempt hospitals in the product market for hospital services is examined as the free cash flow theory is used to explore capital-market conditions of hospitals. Hypotheses concerning the current competitive conditions in the industry are set forth, and the implications of free cash flow for risk, capital-market efficiency, and the cost of capital to tax-exempt institution is compared to capital-market norms. PMID:1743965

  10. [Hospital gangrene (Gangraena nosocomialis)].

    PubMed

    Laval R, Enrique

    2012-02-01

    Hospital gangrene refers to a historical presentation of septic wounds, which was associated to situation with a multitude of wounded patients. Later, it was proven that hospital overcrowding together with inadequate wound treatment options aggravated the spread of the infection by nurses and surgeons as well as contaminated wound dressings resulting in high morbidity and mortality in the affected hospitals and lazarettos. This article, which reviews the historical situation of this disease in Chile, mainly bases on reports of the physicians Rafael Wormald and Jacinto Ugarte, who reported on this topic in 1852 and 1873, respectively, and on outbreak occurring between 1860 and 1870 at Hospital San Juan de Dios in Santiago. PMID:22552521

  11. Drug Overdose Deaths, Hospitalizations,

    E-print Network

    MacAdam, Keith

    Drug Overdose Deaths, Hospitalizations, and Emergency Department Visits in Kentucky, 2000 - 2012 #12; Kentucky Injury Preven on and Research Center Drug Overdose Deaths, Hospitaliza ons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Drug overdose deaths, 20002012

  12. Cornell Hospitality Quarterly

    NSDL National Science Digital Library

    Created by the Cornell University Center for Hospitality Research and managed by Sage Publications, this e-journal provides â??applied research theories about important industry trends and timely topics in lodging, restaurant, and tourism management.â?ť Though most articles are only available through a paid subscription, each quarter editors select a featured article, all of which are available on this site after a brief, free registration. Article topics include wine selection, revenue management, customer satisfaction measurement, hotel pricing, and computer simulation in hospitality education. This is an excellent resource for soon-to-be hospitality managers and administrators as well as for educators to keep informed of current trends in hospitality education.

  13. Fast tracking hospital construction.

    PubMed

    Quirk, Andrew

    2013-03-01

    Hospital leaders should consider four factors in determining whether to fast track a hospital construction project: Expectations of project length, quality, and cost. Whether decisions can be made quickly as issues arise. Their own time commitment to the project, as well as that of architects, engineers, construction managers, and others. The extent to which they are willing to share with the design and construction teams how and why decisions are being made. PMID:23513759

  14. Hospital air is sick.

    PubMed

    Brownson, K

    2000-11-01

    Indoor air quality has deteriorated so much since the 1970s oil shortage and subsequent energy-efficient construction of buildings that people are becoming seriously ill by just breathing the indoor air. This is a problem with all industrial buildings and hospital staff are at particular risk. There are various things that hospital managers from different departments can do to make the air safe for staff and patients to breathe. PMID:11185833

  15. Team-based Care for Patients Hospitalized with Heart Failure.

    PubMed

    Larsen, Paul M; Teerlink, John R

    2015-07-01

    Hospitalizations for acute heart failure (HF) and subsequent readmissions have received increased attention because of the burden they place on patients, providers, and the health care system. These hospitalizations represent a significant portion of the total cost of HF care and health care in general. Although much of the care of the patient with HF occurs outside of the hospital, the genesis of the programs that attempt to limit repeat hospitalizations begin in the impatient setting. By using evidence-based guidelines, interdisciplinary teams, and comprehensive discharge planning, costly readmissions can be reduced and outcomes improved. PMID:26142635

  16. Impacts of Hospitals' Innovativeness on Information System Outsourcing Decisions

    PubMed Central

    2014-01-01

    Objectives The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. Methods Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. Results Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. Conclusions Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management. PMID:24872912

  17. The Effect of Cuts in Medicare Reimbursement on Hospital Mortality

    PubMed Central

    Seshamani, Meena; Schwartz, J Sanford; Volpp, Kevin G

    2006-01-01

    Objective To determine if patients treated at hospitals under different levels of financial strain from the Balanced Budget Act (BBA) of 1997 had differential changes in 30-day mortality, and whether vulnerable patient populations such as the uninsured were disproportionately affected. Data Source Hospital discharge data from all general acute care hospitals in Pennsylvania from 1997 to 2001. Study Design A multivariate regression analysis was performed retrospectively on 30-day mortality rates, using hospital discharge data, hospital financial data, and death certificate information from Pennsylvania. Data Collection We used 370,017 hospital episodes with one of four conditions identified by the Agency for Healthcare Research and Quality as inpatient quality indicators were extracted. Principal Findings The average magnitude of Medicare payment reduction on overall net revenues was estimated at 1.8 percent for hospitals with low BBA impact and 3.6 percent for hospitals with a high impact in 1998, worsening to 2 and 4.8 percent, respectively, by 2001. Operating margins decreased significantly over the time period for all hospitals (p<.05). While unadjusted mortality rates demonstrated a disproportionate rise in mortality for patients from high impact hospitals from 1997 to 2000, adjusted analyses show no consistent, significant difference in the rate of change in mortality between high-impact and low-impact hospitals (p = .04–.94). Similarly, uninsured patients did not experience greater increases in mortality in high-impact hospitals relative to low-impact hospitals. Conclusions An analysis of hospitalizations in the Commonwealth of Pennsylvania did not find an adverse impact of increased financial strain from the BBA on patient mortality either among all patients or among the uninsured. PMID:16704507

  18. Decentralization and Hospital Pharmacy Services: The Case of Iranian University Affilliated Hospitals

    PubMed Central

    Ashna Delkhosh, Reza; Ardama, Ali; Salamzadeh, Jamshid

    2013-01-01

    The aim of this study was to evaluate the satisfaction rate of hospital managerial/clinical teams (HMCTs) including principles (chief executives), managers, supervisor pharmacists and head nurses from services presented by private sectors directing 10 pharmacy departments in hospitals affiliated to Shahid Beheshti University of Medical Sciences. This study is an observational and descriptive study in which a questionnaire containing 16 questions evaluating the satisfaction of the HMCTs from private sectors, and questions about demography of the responders was used for data collection. Collected data was applied to assign a satisfaction score (maximum 64) for each respondent. SPSS 17.0 and Microsoft Office Excel 2007 were used for statistical description and analysis of these information (where applicable). Overall, 97 people in charge of the hospitals (HMCTs) entered the study. The average satisfaction score was 26.38 ± 6.81 with the lowest satisfaction rate observed in Mofid children specialty hospital (19.5%) and the highest rate obtained for Imam Hussein (p.b.u.h) general hospital (65.3%). Generally, 59% of the HMCTs believed that the function of the private sector in the pharmacy of hospitals is satisfactory. Assuming that the satisfaction scores under 75% of the total obtainable score (i.e. 48 out of 64) could not be considered as an indicator of desired pharmacy services, our results revealed that the status of the services offered by private sectors are far behind the desired satisfactory level. PMID:24250687

  19. Is Hospital Competition Socially Wasteful?

    Microsoft Academic Search

    Daniel P. Kessler; Mark B. McClellan

    2000-01-01

    We study the consequences of hospital competition for Medicare beneficiaries' heart attack care from 1985 to 1994. We examine how relatively exogenous determinants of hospital choice such as travel distances influence the competitiveness of hospital markets, and how hospital competition interacts with the influence of managed-care organizations to affect the key determinants of social welfare-expenditures on treatment and patient health

  20. Rhodes Hall Ross Heart Hospital

    E-print Network

    Howat, Ian M.

    Emergency 315 315 26 Rhodes Hall Ross Heart Hospital James Cancer Hospital Martha Morehouse holidays. Information current as of 8/8/14. Subject to change without notice. Updates posted at ttm.m. James Cancer Hospital 7:10 a.m. Rhodes Hall 7:13 a.m. Ross Heart Hospital 7:15 a.m. Martha Morehouse

  1. 1. Oblique view of east portion of Portsmouth Naval Hospital ...

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

    1. Oblique view of east portion of Portsmouth Naval Hospital Complex showing in middle ground, from left to right, Medical Ward A (HABS No. VA01287-G), Medical Ward B (HABS No. VA-1287-H), Medical Ward C (HABS No. VA-1287-I, Portsmouth Naval Hospital Building (HABS No. VA-1287-A), Hospital Point; and in foreground, from left to right, gardener's tool shed (HABS No. VA-1287-C), Service Building (HABS No. VA01287-D), garage (HABS No. VA-1287-F), Medical Officer's Quarters C (HABS No. VA-1287-B), and Medical Officer's Quarters B (HAQBS No. VA-1287-E), view to north from roof of 1960 high-rise hospital - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  2. The effect of selective contracting on hospital costs and revenues.

    PubMed Central

    Zwanziger, J; Melnick, G A; Bamezai, A

    2000-01-01

    OBJECTIVE: To examine the effects of selective contracting on California hospital costs and revenues over the 1983-1997 period. DATA SOURCES/STUDY SETTING: Annual disclosure data and discharge data sets for 421 California general acute care hospitals from 1980 to 1997. ANALYSIS: Using measures of competition developed from patient-level discharge data, and financial and utilization measures from the disclosure data, we estimated a fixed effect multivariate regression model of hospital costs and revenues. FINDINGS: We found that hospitals in more competitive areas had a substantially lower rate of increase in both costs and revenues over this extended period of time. For-profit hospitals lowered their costs and revenues after selective contracting was initiated relative to the cost and revenue levels of not-for-profit hospitals. The Medicare PPS has also led high-cost hospitals to lower their costs. CONCLUSIONS: The more competitive the hospital's market, the greater degree to which it has had to lower the rate of increase in costs. A similar pattern exists with regard to hospital revenues. Both of these trends appear to result from the growth of selective contracting. It remains unclear to what extent these cost reductions were the result of increased efficiency or of reduced quality. Since hospital cost growth is sensitive to the competitiveness of its market, antitrust enforcement is a critical element in any cost containment policy. PMID:11055452

  3. Have the implementation of a new specialised emergency medical service influenced the pattern of general practitioners involvement in pre-hospital medical emergencies? A study of geographic variations in alerting, dispatch, and response

    PubMed Central

    Vaardal, B; Lossius, H; Steen, P; Johnsen, R

    2005-01-01

    Methods: This was a prospective, observational cohort study of 385 000 inhabitants covered by the two EMDCs of Rogaland county, Norway, including 1035 on scene missions of the EP manned EMS during the period 1998–99. Results: The proportion of emergency calls routed through 113 was significantly lower, the proportion of alerts to GPs significantly higher, and the proportions of GPs on scene significantly higher in rural than urban areas. Conclusion: We found geographical differences in the involvement of GPs in pre-hospital emergency medical situations, probably caused by a specialised emergency medical service system including an EMDC and an air and ground EP manned EMS. There were geographical differences in public use of the toll free 113, and alerts to GPs by the EMDCs, which is likely to result from geographical conditions and proximity to medical resources. Future organisation of the EMS has to reflect this to prevent unplanned and unwanted autonomously emerging EMS systems. PMID:15735277

  4. Profiling hospitals for length of stay for treatment of psychiatric disorders

    Microsoft Academic Search

    Jeffrey S. Harman; Brian J. Cuffel; Kelly J. Kelleher

    2004-01-01

    Managed behavioral health care organizations (MBHOs) often profile hospitals on length of stay (LOS) and other performance measures. However, previous research has suggested that most of the variation in utilization for general medical conditions is attributable to case-mix indicators and random sources rather than individual providers. Hospital discharge data are used to estimate hierarchical linear models, where hospitals and physicians

  5. Hazards of Hospitalization: Hospitalists and Geriatricians Educating Medical Students about Delirium and Falls in Geriatric Inpatients

    ERIC Educational Resources Information Center

    Lang, Valerie J.; Clark, Nancy S.; Medina-Walpole, Annette; McCann, Robert

    2008-01-01

    Geriatric patients are at increased risk for complications from delirium or falls during hospitalization. Medical education, however, generally places little emphasis on the hazards of hospitalization for older inpatients. Geriatricians conducted a faculty development workshop for hospitalists about the hazards of hospitalization for geriatric…

  6. ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2002

    Microsoft Academic Search

    CRAIG A. PEDERSEN; PHILIP J. SCHNEIDER; DOUGLAS J. SCHECKELHOFF

    Results of the 2002 ASHP nation- al survey of pharmacy practice in hospital settings that pertain to dispensing and ad- ministration are presented. A stratified random sample of pharmacy directors at 1101 general and children's medical-surgical hospitals in the United States were surveyed by mail. SMG Market- ing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn

  7. Lack of effective communication between communities and hospitals in Uganda: a qualitative exploration of missing links

    Microsoft Academic Search

    Elizeus Rutebemberwa; Elizabeth Ekirapa-Kiracho; Olico Okui; Damien Walker; Aloysius Mutebi; George Pariyo

    2009-01-01

    BACKGROUND: Community members are stakeholders in hospitals and have a right to participate in the improvement of quality of services rendered to them. Their views are important because they reflect the perspectives of the general public. This study explored how communities that live around hospitals pass on their views to and receive feedback from the hospitals' management and administration. METHODS:

  8. Sixteen Years of Croup in a Western Australian Teaching Hospital: Effects of Routine Steroid Treatment

    Microsoft Academic Search

    Gary C Geelhoed

    1996-01-01

    Study objective: To describe the experience of croup at Princess Margaret Hospital for Children (PMH), the only tertiary pediatric hospital in Western Australia, from 1980 through 1995 with reference to the introduction of routine steroid treatment in the ICU in 1989, in the general hospital wards from 1989 through 1993, and in the emergency department observation ward in 1993. Methods:

  9. [Marianne in hospital].

    PubMed

    Weium, Frode

    2003-12-23

    In 1948 Norwegian architect and author Odd Brochmann (1909-92) published his popular children's book Marianne in hospital (Marianne pĺ sykehus). Two years later the book was filmed on the initiative of the Ministry of Social Affairs. This article considers the question of what were the purposes of the film. Officially, it was presented as an attempt to teach children not to be afraid of hospitals. However, in internal notes and letters the health authorities stressed that the film should be an educational film about the social benefits and health services of the welfare state. Furthermore, I will argue that the film was the result of a wish to present the nation's modern hospital care and, by way of conclusion, discuss the characterisation of the film as educational. PMID:14691510

  10. Depressive Symptoms and Hospital Readmission in Older Adults

    PubMed Central

    Albrecht, Jennifer S.; Gruber-Baldini, Ann L.; Hirshon, Jon M.; Brown, Clayton H.; Goldberg, Richard; Rosenberg, Joseph H.; Comer, Angela C.; Furuno, Jon P.

    2014-01-01

    Background Identifying patients at high risk of hospital readmission may facilitate interventions to improve care. Depressive symptoms are prevalent among hospitalized older adults and may provide a target for these interventions if associated with readmission. The aim of this study was to quantify the risk of 30-day unplanned hospital readmission among adults age ?65 with depressive symptoms. Design and Setting Prospective cohort study of adults aged ?65 admitted to the University of Maryland Medical Center between 7/1/11 and 8/9/12. Participants 750 patients aged ?65 admitted to the general medical and surgical units and followed for 31 days following hospital discharge. Measurements Primary exposure was depressive symptoms at admission, defined as ?6 on the 15-item Geriatric Depression Scale. Primary outcome was unplanned 30-day hospital readmission, defined as an unscheduled overnight stay at any inpatient facility not occurring in the emergency department. Results Prevalence of depressive symptoms was 19% and incidence of 30-day unplanned hospital readmission was 19%. Depressive symptoms were not significantly associated with hospital readmission (Relative Risk (RR) 1.20; 95% Confidence Interval (CI) 0.83, 1.72). Age, Charlson Comorbidity Index score, and ?2 hospitalizations within the past 6 months were significant predictors of unplanned 30-day hospital readmission. Conclusion Although not associated with hospital readmission in our study, depressive symptoms are associated with other poor outcomes and may be under-diagnosed among hospitalized older adults. Hospitals interested in reducing readmission should focus on older patients with more comorbid illness and recent hospitalizations. PMID:24512099

  11. Dramatically changing rates and reasons for hospitalization in multiple sclerosis

    PubMed Central

    Elliott, Lawrence; Marriott, James; Cossoy, Michael; Blanchard, James; Tennakoon, Aruni; Yu, Nancy

    2014-01-01

    Objective: We aimed to describe hospitalizations in the multiple sclerosis (MS) population, and to evaluate temporal trends in hospitalizations in the MS population compared to the general population. Methods: Using population-based administrative data, we identified 5,797 persons with MS and a matched general population cohort of 28,769 persons. Using general linear models, we evaluated temporal trends in hospitalization rates and length of stay in the 2 populations over the period 1984–2011. Results: In 1984 the hospitalization rate was 35 per 100 person-years in the MS population and 10.5 in the matched population (relative risk [RR] 3.33; 95% confidence interval: 1.67–6.64). Over the study period hospitalizations declined 75% in the MS population but only 41% in the matched population. The proportion of hospitalizations due to MS declined substantially from 43.4% in 1984 to 7.8% in 2011. The 3 most common non–MS-related reasons for admission in the MS population were diseases of the digestive, genitourinary, and circulatory systems. Admissions for bacterial pneumonia, influenza, urinary tract infections, and pressure ulcers occurred more often in the MS population than in the general population, while admissions for circulatory system disease and neoplasms occurred less often. Older age, male sex, and lower socioeconomic status were associated with increased hospitalization rates for non–MS-related reasons. Conclusions: Although hospitalization rates have declined dramatically in the MS population over the last quarter century, they remain higher than in the general population. Admissions for MS-related reasons now constitute only a small proportion of the reasons for hospitalization. PMID:25085638

  12. [Smarter hospital care].

    PubMed

    Ubbink, Dirk T; Papadopoulos, Niki E; Legemate, Dink A

    2014-01-01

    The quality of hospital care is being questioned. This calls for decisions and innovations both in terms of care process and content. Innovations do not always have the desired effect and are often insufficiently supported by scientific evidence. The adoption and application of evidence-based principles in the organization as well as in the content of healthcare are therefore pivotal, not only for care professionals, but for hospital managers and decision makers as well. Implementation of these ideas appears most successful when conducted on different levels: national, strategic, tactical, and operational, and in educational as well as clinical settings. PMID:24893809

  13. Hospital mergers: a panacea?

    PubMed

    Weil, Thomas

    2010-10-01

    Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders. PMID:20660531

  14. General Education GENERAL EDUCATION

    E-print Network

    Bolding, M. Chad

    34 General Education 34 GENERAL EDUCATION An undergraduate student whose enrollment in a curriculum occurs after May 15, 2005, must fulfill the general education requirements in effect at that time in curricular or general education requirements shall be considered under the curriculum year change

  15. General Education GENERAL EDUCATION

    E-print Network

    Stuart, Steven J.

    35 General Education GENERAL EDUCATION An undergraduate student whose enrollment in a curriculum occurs after May 15, 2005, must fulfill the general education requirements in effect at that time in curricular or general education requirements shall be considered under the curriculum year change

  16. General Education GENERAL EDUCATION

    E-print Network

    Stuart, Steven J.

    36 General Education GENERAL EDUCATION An undergraduate student whose enrollment in a curriculum occurs after May 15, 2005, must fulfill the general education requirements in effect at that time in curricular or general education requirements shall be considered under the curriculum year change

  17. General Education GENERAL EDUCATION

    E-print Network

    Stuart, Steven J.

    37 General Education GENERAL EDUCATION An undergraduate student whose enrollment in a curriculum occurs after May 15, 2005, must fulfill the general education requirements in effect at that time in curricular or general education requirements shall be considered under the curriculum year change

  18. [Competition between hospitals--from a legal perspective].

    PubMed

    Bohle, Thomas

    2009-01-01

    Competition between hospitals exists in many different fields. In legal terms this competition is shaped by disputes over the status of "hospitals forming part of the Hospital Plan" (Plankrankenhaus). The German Federal Constitutional Court's ruling of January 14, 2004 granted hospital authorities the right of action for unfair competition. According to the Federal Administrative Court's ruling of September 25, 2008, however, third-party protection is limited to cases where the hospital filing the suit has itself unsuccessfully applied for inclusion in the state-level hospitals plan for the market segment served by the accepted hospital. In contrast, action that merely challenges an unfair preference of a competitor will remain inadmissible. Third-party protection between hospitals is also under way in the field of "Integrated Healthcare" (Integrierte Versorgung) (Sect. 140a et seqq. Book V of the German Social Security Code-SGB V): in the case of ECJ C-300/07 on December 16, 2008 (Oymanns/AOK Rheinland & Hamburg) the Advocate General in his final submissions not only expressed the opinion that the statutory health insurance funds are contract-placing authorities, but also argued that integration contracts are public orders. If the European Court of Justice (ECJ) takes the Advocate General's view, future integration contracts will become subject to the regulations governing public orders and thus also subject to the relevant verification procedure. PMID:20120194

  19. Noise levels in the hospital environment in Ibadan.

    PubMed

    Omokhodion, F O; Sridhar, M K C

    2003-06-01

    Noise levels were measured in 3 hospitals in Ibadan; a teaching hospital with approximately 800 beds and 2 general hospitals with about 200 beds each. A type 2 digital integrating sound level meter was used to measure noise levels in selected sites. Children's clinics and wards in the teaching hospital recorded the highest noise levels, 68-73db(A) and 55-77db(A) respectively, compared to similar facilities for adults. High noise levels 74-89dB(A) were also recorded in the operating rooms. Noise levels above 80db (A) were recorded in service areas such as the boiler room, and laundry and generator rooms in the teaching hospital. Corresponding sites in the general hospitals were less noisy as such services are provided at a minimum in these hospitals. Sleep interference is known to occur at noise levels recorded in this study. Staff conversation makes a large contribution to noise levels in patient care areas. The use of hospital equipment in patient care also contributes to the noise levels especially in operating room. This can be reduced if attention is drawn to this as an important part of patient care. Noise levels in service areas need to be monitored closely and workers in those areas may need hearing protection and regular audiometric assessment. PMID:15032459

  20. Interior of Damaged Hospital

    USGS Multimedia Gallery

    The interior of this masonry-built hospital in Cauquenes, Chile had severe fracturing and partially collapsed interior walls following the M 8.8 earthquake on Feb. 27, 2010. This building will be torn down and replaced with a reinforced concrete building....

  1. Damaged Hospital Wing

    USGS Multimedia Gallery

    This two story hospital wing in Cauquenes, Chile suffered severe damage to the wall of the first floor as a result of the M 8.8 earthquake on Feb. 27, 2010. This building must be torn down. All patients were successfully evacuated at 3:34 AM after the earthquake shaking started....

  2. Hospitality: How Woundedness Heals

    Microsoft Academic Search

    Andrew Metcalfe

    2010-01-01

    This article is based on the ethnography of a drop?in center for the destitute. Making a distinction between curing and healing, we argue that this center heals through its hospitality; its open acceptance of mutual woundedness. Rather than being the problem to be cured, woundedness heals the fantasies of perfection that alienate us from each other and from our whole

  3. Responsible Hospitality. Prevention Updates

    ERIC Educational Resources Information Center

    Colthurst, Tom

    2004-01-01

    Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

  4. UCSF Benioff Children's Hospitals is the new name of the affiliated hospitals, UCSF Benioff Children's Hospital and Children's Hospital & Research Center Oakland. Each

    E-print Network

    Klein, Ophir

    UCSF Benioff Children's Hospitals is the new name of the affiliated hospitals, UCSF Benioff Children's Hospital and Children's Hospital & Research Center Oakland. Each hospital also has a new name ­ UCSF Benioff Children's Hospital San Francisco, and UCSF Benioff Children's Hospital Oakland

  5. Guide to Choosing a Hospital

    MedlinePLUS

    ... How hospitals’ rates of readmission and 30-day mortality (death) rates for certain conditions compare with the national rate. • How each hospital uses outpatient medical imaging tests (like CT scans ...

  6. [Volgograd military hospital--70 years].

    PubMed

    Novikov, V Ia; Alborov, Z Ts

    2012-01-01

    History of the Volgograd military hospital dates back to July 24, 1941, when on the basis of the regional children's bone tuberculosis sanatorium in Krasnodar was transformed into 2150th military hospital consisted of 240 beds. Since May 1944 relocated in the city of Stalingrad became a garrison hospital. Today the hospital is a multidisciplinary health centre of the Russian Defense Ministry. Annually, the hospital performed at least 3000 surgical procedures, including more than 37%--are complex. In surgery, improved endovideosurgical direction, over 31% of emergency operations performed using this method. Since December 2009 the hospital became a structural division of the District Hospital in 1602 in Rostov on Don. The close connection between the branch and district hospital allows for complex diagnostic situations to consult leading experts, including consultation, thus ensuring the most effective treatment results. PMID:22545455

  7. How hospitals approach price transparency.

    PubMed

    Houk, Scott; Cleverley, James O

    2014-09-01

    A survey of finance leaders found that hospitals with lower charges were more likely than other hospitals to emphasize making prices defensible rather than simply transparent. Finance leaders of hospitals with higher charges were more likely to express concern that price transparency would cause a reduction in hospital revenue by forcing them to lower charges. Those respondents said commercial payers likely will have to agree to renegotiate contracts for price transparency to be a financially viable proposition. PMID:25647890

  8. Hospital waste management in Tehran

    Microsoft Academic Search

    M. A. Abduli

    1994-01-01

    The main objective of this paper is to analyse the present status of hospital waste management in Tehran and subsequently to draw up a policy regarding generation, collection, onsite handling, storage, processing, recycling, transportation and safe disposal of health care wastes in Tehran. Through field investigations of 133 hospitals, all steps of waste management inside and outside hospitals are surveyed.

  9. Childrens Hospital Inservice Education Curriculum.

    ERIC Educational Resources Information Center

    Lutz, Joan

    A description is provided of a 15-month, in-service nursing education program at Childrens Hospital (Los Angeles, California). The first sections of the paper describe Childrens Hospital and provide a rationale for the hospital-based program. A listing of program goals and objectives is also provided, indicating that the curriculum is designed to…

  10. Hospital Quality: A PRIDIT Approach

    PubMed Central

    Lieberthal, Robert D

    2008-01-01

    Background Access to high quality medical care is an important determinant of health outcomes, but the quality of care is difficult to determine. Objective To apply the PRIDIT methodology to determine an aggregate relative measure of hospital quality using individual process measures. Design Retrospective analysis of Medicare hospital data using the PRIDIT methodology. Subjects Four-thousand-two-hundred-seventeen acute care and critical access hospitals that report data to CMS' Hospital Compare database. Measures Twenty quality measures reported in four categories: heart attack care, heart failure care, pneumonia care, and surgical infection prevention and five structural measures of hospital type. Results Relative hospital quality is tightly distributed, with outliers of both very high and very low quality. The best indicators of hospital quality are patients given assessment of left ventricular function for heart failure and patients given ?-blocker at arrival and patients given ?-blocker at discharge for heart attack. Additionally, teaching status is an important indicator of higher quality of care. Conclusions PRIDIT allows us to rank hospitals with respect to quality of care using process measures and demographic attributes of the hospitals. This method is an alternative to the use of clinical outcome measures in measuring hospital quality. Hospital quality measures should take into account the differential value of different quality indicators, including hospital “demographic” variables. PMID:18454777

  11. [The birth of the hospital].

    PubMed

    Le Coz, R

    1998-01-01

    Hospitals were founded as early as the forth century, by the Church in the Byzantine Empire. However, it was not before the sixth century, with the Reform of Justinian, that the hospital got its definitive organization. In Bagdad, as soon as the eight century, the christian-nestorian doctors organized the first hospitals in the Arab-Muslim world. PMID:11637013

  12. Hospital Infection Control in Sweden

    Microsoft Academic Search

    Bertil Nyström

    1988-01-01

    In Sweden the 23 counties are responsible for the medical care of their inhabitants. They own and run virtually all hospitals. This system facilitates a county-based hospital infection control system. The infection control team is based in the county hospital department of clinical bacteriology. It is headed by an MD clinical bacteriologist or, in some counties, by an infectious disease

  13. St. Jude Children's Research Hospital

    Cancer.gov

    St. Jude Children’s Research Hospital was founded in 1962. The Cancer Center received its NCI designation in 1977 and was awarded status as a comprehensive cancer center by NCI in 2008. The hospital’s mission is to advance cures and means of prevention for pediatric catastrophic diseases through research and treatment.

  14. SECRETARA GENERAL Secretaria General

    E-print Network

    Escolano, Francisco

    SECRETARÍA GENERAL Secretaria General Aránzazu Calzada González Vicesecretario General Salvador #12;Juan Luis Nicolau, nuevo decano de la Facultad de Ciencias Económicas y Empresariales de la UA (Publicada 29/05/2014) El catedrático del departamento de Marketing de la Universidad de Alicante, Juan Luis

  15. Correlated Paleoseismic Interpretation of Turbidites from 3 Distinct Sedimentary Environments in the Cascadia Subduction Zone Off Vancouver Island Canada

    NASA Astrophysics Data System (ADS)

    Enkin, R. J.; Hamilton, T. S.; Rogers, G. C.

    2014-12-01

    Sedimentary sequences containing turbidites can provide important paleoseismic records. We present sedimentary records from 3 distinct sedimentary systems which provide a reliable well-dated paleseismic record. All 3 sites are subject to strong ground shaking in the event of a megathrust earthquake along the Cascadia Subduction Zone near Vancouver Island, Canada. Effingham Inlet is an anoxic fjord on the west coast of Vancouver Island with an age model based on radiocarbon dates from terrestrial plant material (no marine correction), the Mazama Ash, and sedimentation rates constrained by annual laminations [Dallimore et al. 2008, Enkin et al., 2013]. Barkley Canyon [Goldfinger et al., 2012], 150 km SW, has been sampled at the abyssal plain fan in front of a submarine canyon. Slipstream Slump [ms submitted], 40 km north of Barkley Canyon, is a well-preserved 3 km wide sedimentary failure from the frontal ridge of the Cascadia accretionary wedge. At Slipstream, given the 2300 m water depth and the thin weak crust at the outer edge of the accretionary wedge, megathrust earthquake shaking is the most likely trigger for the turbidity currents, with sediments sourced exclusively from the exposed slide scar. Correlations based on sedimentology and physical property logging are made between turbidites observed at Barkley Canyon and Slipstream Slump, and a mutually consistent age model is defined using only planktonic foraminiferal dates and Bayesian analysis with a Poisson-process sedimentation model. A young marine reservoir age of ?R=0 yr brings the top to the present and produces age correlations consistent with the thickest (>10 cm) Effingham Inlet turbidites. Correlations of physical property logs tie the Effingham Inlet record to the offshore, despite the extreme differences in the sedimentology. Having good marine geophysical data and well positioned core transects allows the facies analysis needed to interpret the turbidite record. This study provides a much needed link between the marine and terrestrial paleoseismic records. The combined paleoseismic record has 10 turbidites between 10.8 and 6.6 ka, after which the offshore sites became sediment-starved and only 2 or 3 more turbidites were deposited. The recurrence interval for the inferred Early Holocene megathrust earthquakes is 460 ± 140 years.

  16. Health care professional staffing, hospital characteristics, and hospital mortality rates.

    PubMed

    Bond, C A; Raehl, C L; Pitterle, M E; Franke, T

    1999-02-01

    To evaluate associations among hospital characteristics, staffing levels of health care professionals, and mortality rates in 3763 United States hospitals, a data base was constructed from the American Hospital Association's Abridged Guide to the Health Care Field and hospital Medicare mortality rates from the Health Care Financing Administration. A multivariate regression analysis controlling for severity of illness was employed to determine the associations. Hospital characteristics associated with lower mortality were occupancy rate and private nonprofit and private for-profit ownership. Mortality rates decreased as staffing level per occupied bed increased for medical residents, registered nurses, registered pharmacists, medical technologists, and total hospital personnel. Mortality rates increased as staffing level per occupied bed increased for hospital administrators and licensed practical-vocational nurses. To our knowledge, this is the first study to show that pharmacists were associated with lower mortality rates. PMID:10030762

  17. CCCG 2009, Vancouver, BC, August 1719, 2009 The Centervertex Theorem for Wedge Depth

    E-print Network

    Miller, Gary L.

    . Miller Todd Phillips Donald R. Sheehy§ July 3, 2009 Abstract There are many depth measures on point sets generalization of halfspace depth that replaces halfspaces with wedges (cones or cocones) of angle . We introduce

  18. THE ALMA MATER SOCIETY OF THE UNIVERSITY OF BRITISH COLUMBIA VANCOUVER

    E-print Network

    Pulfrey, David L.

    to a discussion of the AMS brand. In general there should be style guides and operational consistency, using be passed on to HR. On the external side, there should be consolidation and consistency. o This led

  19. Hospital Variation in Survival After In?hospital Cardiac Arrest

    PubMed Central

    Merchant, Raina M.; Berg, Robert A.; Yang, Lin; Becker, Lance B.; Groeneveld, Peter W.; Chan, Paul S.

    2014-01-01

    Background In?hospital cardiac arrest (IHCA) is common and often fatal. However, the extent to which hospitals vary in survival outcomes and the degree to which this variation is explained by patient and hospital factors is unknown. Methods and Results Within Get with the Guidelines?Resuscitation, we identified 135 896 index IHCA events at 468 hospitals. Using hierarchical models, we adjusted for demographics comorbidities and arrest characteristics (eg, initial rhythm, etiology, arrest location) to generate risk?adjusted rates of in?hospital survival. To quantify the extent of hospital?level variation in risk?adjusted rates, we calculated the median odds ratio (OR). Among study hospitals, there was significant variation in unadjusted survival rates. The median unadjusted rate for the bottom decile was 8.3% (range: 0% to 10.7%) and for the top decile was 31.4% (28.6% to 51.7%). After adjusting for 36 predictors of in?hospital survival, there remained substantial variation in rates of in?hospital survival across sites: bottom decile (median rate, 12.4% [0% to 15.6%]) versus top decile (median rate, 22.7% [21.0% to 36.2%]). The median OR for risk?adjusted survival was 1.42 (95% CI: 1.37 to 1.46), which suggests a substantial 42% difference in the odds of survival for patients with similar case?mix at similar hospitals. Further, significant variation persisted within hospital subgroups (eg, bed size, academic). Conclusion Significant variability in IHCA survival exists across hospitals, and this variation persists despite adjustment for measured patient factors and within hospital subgroups. These findings suggest that other hospital factors may account for the observed site?level variations in IHCA survival. PMID:24487717

  20. Hospital mergers and market overlap.

    PubMed Central

    Brooks, G R; Jones, V G

    1997-01-01

    OBJECTIVE: To address two questions: What are the characteristics of hospitals that affect the likelihood of their being involved in a merger? What characteristics of particular pairs of hospitals affect the likelihood of the pair engaging in a merger? DATA SOURCES/STUDY SETTING: Hospitals in the 12 county region surrounding the San Francisco Bay during the period 1983 to 1992 were the focus of the study. Data were drawn from secondary sources, including the Lexis/Nexis database, the American Hospital Association, and the Office of Statewide Health Planning and Development of the State of California. STUDY DESIGN: Seventeen hospital mergers during the study period were identified. A random sample of pairs of hospitals that did not merge was drawn to establish a statistically efficient control set. Models constructed from hypotheses regarding hospital and market characteristics believed to be related to merger likelihood were tested using logistic regression analysis. DATA COLLECTION: See Data Sources/Study Setting. PRINCIPAL FINDINGS: The analysis shows that the likelihood of a merger between a particular pair of hospitals is positively related to the degree of market overlap that exists between them. Furthermore, market overlap and performance difference interact in their effect on merger likelihood. In an analysis of individual hospitals, conditions of rivalry, hospital market share, and hospital size were not found to influence the likelihood that a hospital will engage in a merger. CONCLUSIONS: Mergers between hospitals are not driven directly by considerations of market power or efficiency as much as by the existence of specific merger opportunities in the hospitals' local markets. Market overlap is a condition that enables a merger to occur, but other factors, such as the relative performance levels of the hospitals in question and their ownership and teaching status, also play a role in influencing the likelihood that a merger will in fact take place. PMID:9018212

  1. THE AFFILIATED TEACHING HOSPITALS AND DENTISTRY, SCHULICH SCHOOL OF MEDICINE & DENTISTRY OF

    E-print Network

    Sinnamon, Gordon J.

    to Canadian citizens and permanent residents of Canada only. DENTAL GENERAL PRACTICE RESIDENCY I hereby apply for a General Practice Residents. (Residents rotate through the two major teaching hospitals (three sites) PRE

  2. Rural Residents Who Are Hospitalized in Rural and Urban Hospitals: United States, 2010

    MedlinePLUS

    ... Who Are Hospitalized in Rural and Urban Hospitals: United States, 2010 On This Page Key findings Hospitalized rural ... distribution of hospitalized rural residents, by hospital location: United States, 2010 NOTE: Estimates may not add to totals ...

  3. Managerial socialization in short-term hospitals: some early evidence.

    PubMed

    Dworkin, Neil R; Goldstein, Joel

    2004-01-01

    In contrast to business corporations, little has been written about early managerial behavior in short-term, general hospitals. An executive transition into a new organization presents both risk and opportunity. This exploratory study into managerial socialization is aimed at identifying what healthcare executives actually do during the transition period from onset of recruitment to the end of their first 6 months in a new hospital position. The findings of this research should be useful in helping CEOs to plan for their transition into short-term, general hospitals. For these top management executives, the stakes are very high. In many instances, CEOs are expected to change the way their hospitals work. An understanding of the strategic, tactical, political, and cultural approaches they have used should help lead to more successful transition outcomes and effective organizational change. PMID:15559069

  4. Human Research Protection Office Barnes Jewish Hospital

    E-print Network

    Kornfeld, S. Kerry

    's Hospital. Information regarding the Washington University Federalwide Assurance (FWA) and registrationHuman Research Protection Office Barnes Jewish Hospital St. Louis Children's Hospital Washington for faculty, staff, and students at Washington University, Barnes Jewish Hospital, and St. Louis Children

  5. Virtual Pediatric Hospital

    MedlinePLUS

    ... Assistant? Last revised on January 21, 2015 Related Digital Libraries Pediatric GeneralPediatrics.com - the general pediatrician's view of the Internet PediatricEducation.org - a pediatric digital library and learning collaboratory intended to serve as a ...

  6. Hospitals, market share, and consolidation.

    PubMed

    Cutler, David M; Scott Morton, Fiona

    2013-11-13

    A large reduction in use of inpatient care combined with the incentives in the Affordable Care Act is leading to significant consolidation in the hospital industry. What was once a set of independent hospitals having arms-length relationships with physicians and clinicians who provide ambulatory care is becoming a small number of locally integrated health systems, generally built around large, prestigious academic medical centers. The typical region in the United States has 3 to 5 consolidated health systems, spanning a wide range of care settings, and a smaller fringe of health care centers outside those systems. Consolidated health systems have advantages and drawbacks. The advantages include the ability to coordinate care across different practitioners and sites of care. Offsetting this is the potential for higher prices resulting from greater market power. Market power increases because it is difficult for insurers to bargain successfully with one of only a few health systems. Antitrust authorities are examining these consolidated systems as they form, but broad conclusions are difficult to draw because typically the creation of a system will generate both benefit and harm and each set of facts will be different. Moreover, the remedies traditionally used (eg, blocking the transaction or requiring that the parties divest assets) by antitrust authorities in cases of net harm are limited. For this reason, local governments may want to introduce new policies that help ensure consumers gain protection in the event of consolidation, such as insurance products that charge consumers more for high-priced clinicians and health care centers, bundling payments to clinicians and health care organizations to eliminate the incentives of big institutions to simply provide more care, and establishing area-specific price or spending targets. PMID:24219952

  7. Assessing Alcohol Dependence in Hospitalized Patients

    PubMed Central

    Doering-Silveira, Juliana; Fidalgo, Thiago Marques; Nascimento, Carolina Lins E. Silva; Alves, Juliana Bernardo; Seito, Caroline Lumy; Saita, Maria Claudia; Belluzzi, Lorenza Oliveira; Silva, Laila Carolina; Silveira, Dartiu; Rosa-Oliveira, Leonardo

    2014-01-01

    Alcohol misuse is generally not detected in hospital settings. The goal of this study was to estimate the prevalence of alcohol abuse and dependence in hospitalized patients in a university hospital in Sao Paulo (Brazil). Patients were randomly selected from all hospital admissions. The final sample consisted of 169 adult inpatients. Two screening tools were used: the Short Alcohol Dependence Data (SADD) and the CAGE questionnaires. In this sample, 25.4% of patients could be considered alcohol dependent according to the CAGE questionnaire, whereas 32.9% of patients fulfilled the criteria according to the SADD. The only predictor of alcohol dependence was gender; male inpatients were 3.2 times more prone to alcohol dependence with female inpatients. All inpatients should be systematically screened for alcohol use disorders. The choice of the screening tool will depend on whether the goal is to identify inpatients with hazardous drinking behaviors or with established alcohol-related problems. To maximize proper case identification, the CAGE questionnaire should be used as a first-step screening tool, and patients who screen positive on this scale should be subsequently administered the SADD questionnaire to assess the severity of the condition. PMID:24879488

  8. Hospitals Productivity Measurement Using Data Envelopment Analysis Technique

    PubMed Central

    TORABIPOUR, Amin; NAJARZADEH, Maryam; ARAB, Mohammad; FARZIANPOUR, Freshteh; GHASEMZADEH, Roya

    2014-01-01

    Abstract Background This study aimed to measure the hospital productivity using data envelopment analysis (DEA) technique and Malmquist indices. Methods This is a cross sectional study in which the panel data were used in a 4 year period from 2007 to 2010. The research was implemented in 12 teaching and non-teaching hospitals of Ahvaz County. Data envelopment analysis technique and the Malmquist indices with an input-orientation approach, was used to analyze the data and estimation of productivity. Data were analyzed using the SPSS.18 and DEAP.2 software. Results Six hospitals (50%) had a value lower than 1, which represents an increase in total productivity and other hospitals were non-productive. the average of total productivity factor (TPF) was 1.024 for all hospitals, which represents a decrease in efficiency by 2.4% from 2007 to 2010. The average technical, technologic, scale and managerial efficiency change was 0.989, 1.008, 1.028, and 0.996 respectively. There was not a significant difference in mean productivity changes among teaching and non-teaching hospitals (P>0.05) (except in 2009 years). Conclusion Productivity rate of hospitals had an increasing trend generally. However, the total average of productivity was decreased in hospitals. Besides, between the several components of total productivity, variation of technological efficiency had the highest impact on reduce of total average of productivity.

  9. [Advantages and disadvantages of outsourcing hospital microbiological testings].

    PubMed

    Komatsu, Masaru

    2011-10-01

    In Japan, laws and ordinances were enforced to relax the regulation of the clinical laboratory setting in hospitals by revising the law of medical institutions in 2001. For this reason, outsourcing hospital microbiological testing, particularly by medium- or small-sized hospitals, was encouraged. The advantage of outsourcing microbiological testing is promotion of an efficient hospital management by cost saving. In contrast, the disadvantages are as follows: deterioration of specimen quality by extension of transportation time, delay in reporting by an independent laboratory compared with that by a hospital-based laboratory; this report is generally obtained within 1 or 2 days, difficulty and lack of communication between the laboratory staff and physician, and deterioration of the value of the microbiology report and the quality of the infection control system in a hospital. In addition to performing profit-related maintenance, independent laboratories should strive hard to maintain the same quality as that of a laboratory registered in a hospital. Furthermore, the new role of independent laboratories demands them to have a system allowing instant communication of information regarding the crisis control of infectious diseases to a hospital. PMID:22184876

  10. Tax aspects of outpatient drug transactions in nonprofit hospitals.

    PubMed

    McDaniel, P A; Fink, J L

    1985-02-01

    Tax issues related to sales of medications to outpatients by pharmacies in nonprofit hospitals are described. Hospitals are increasing their emphasis on development of ambulatory-care programs. Two aspects of the tax implications of such services are (1) whether revenue from sales of medications to ambulatory patients constitutes "unrelated business income" for the nonprofit hospital and thus is taxable and (2) whether engaging in dispensing of medications to ambulatory patients might jeopardize the tax-exempt status of the hospital. Various rulings from the Internal Revenue Service and court cases are reviewed. Sales of medications to members of the general public who are unrelated to the hospital are taxable. Sales of medications for the convenience of hospital patients, and irregular and intermittent sales to the public by a pharmacy that normally serves only "patients," are tax exempt. Sales of medications to the public probably do not jeopardize the tax-exempt status of a hospital so long as the primary purpose of the hospital is consistent with permissible tax-exempt purposes. PMID:3976684

  11. Evidence for the subducting lithosphere under Southern Vancouver Island and Western Oregon from teleseismic P wave conversions

    SciTech Connect

    Langston, C.A.

    1981-05-10

    Long-period teleseismic P waves recorded at VIC (Victoria, British Columbia) and COR (Corvallis, Orgeon) show anomalously large Ps conversions and later arriving P-to-S reverberations not observed from typical continental crustal sections or from previously proposed structures for these stations determined from refraction surveys. The timing and large amplitude of the Ps phase, relative to direct P, suggests a high velocity-contrast interface at 45 to 50 km depth under VIC and COR forming the base of a distinct low velocity zone. This interface is proposed to be the oceanic Moho which is being subducted under North America. Off azimuth Ps recorded at COR is consistent with a 20/sup 0/ eastward dip for the interface. Horizontal particle motion at both sites show evidence for lateral heterogeneity in local crustal structure. The distinct low velocity zone and its negative gradient with depth has important consequences for refraction interpretation in the region since the usual assumption of increasing velocity with depth is violated. Crustal thicknesses derived from such misinterpretation may be overestimated. In principle, this type of structure suggests a solution for the Vancouver Island crustal thickness problem in which the observed positive Bouguer gravity anomaly is inconsistent with the 50 km thick crustal thickness derived from previous refraction work.

  12. Injection drug users’ involvement in drug dealing in the downtown eastside of Vancouver: Social organization and systemic violence

    PubMed Central

    Small, Will; Maher, Lisa; Lawlor, Jeff; Wood, Evan; Shannon, Kate; Kerr, Thomas

    2014-01-01

    Background Illicit drug markets are a key component of the risk environment surrounding injection drug use. However, relatively few studies have explored how injection drug users’ (IDUs) involvement in drug dealing shapes their experiences of drug market-related harm. This exploratory qualitative study aims to understand IDUs’ dealing activities and roles, as well as the perceived benefits and risks related to participation in illicit drug markets, including experiences of drug market violence. Methods Ten IDUs with extensive involvement in drug dealing activities were recruited from the Vancouver Injection Drug User Study (VIDUS) and participated in semi-structured qualitative interviews, which elicited discussion of experiences dealing drugs, perceived benefits and hazards related to dealing, and understandings of drug market violence. Results Participant's involvement in drug market activities included corporate sales, freelance or independent sales, and opportunistic sales termed “middling” as well as drug market-related hustles entailing selling bogus drugs and robbing dealers. Participants primarily dealt drugs to support their own illicit drug use, and we found that arrest and criminal justice involvement, hazards stemming from drug debts, and drug market-related violence were key risks related to dealing activities. Conclusion The challenges of managing personal consumption while selling drugs exacerbates the hazards associated with drug dealing. Efforts to address drug dealing among IDUs should consider both drug dependency and the material conditions that propel drug users towards dealing activities. Interventions should explore the potential of combining enhanced drug treatment programs with low threshold employment and alternative income generation opportunities. PMID:23664788

  13. Setting the stage for chronic health problems: cumulative childhood adversity among homeless adults with mental illness in Vancouver, British Columbia

    PubMed Central

    2014-01-01

    Background It is well documented that childhood abuse, neglect and household dysfunction are disproportionately present in the backgrounds of homeless adults, and that these experiences adversely impact child development and a wide range of adult outcomes. However, few studies have examined the cumulative impact of adverse childhood experiences on homeless adults with mental illness. This study examines adverse events in childhood as predictors of duration of homelessness, psychiatric and substance use disorders, and physical health in a sample of homeless adults with mental illness. Methods This study was conducted using baseline data from a randomized controlled trial in Vancouver, British Columbia for participants who completed the Adverse Childhood Experiences (ACE) scale at 18 months follow-up (n?=?364). Primary outcomes included current mental disorders; substance use including type, frequency and severity; physical health; duration of homelessness; and vocational functioning. Results In multivariable regression models, ACE total score independently predicted a range of mental health, physical health, and substance use problems, and marginally predicted duration of homelessness. Conclusions Adverse childhood experiences are overrepresented among homeless adults with complex comorbidities and chronic homelessness. Our findings are consistent with a growing body of literature indicating that childhood traumas are potent risk factors for a number of adult health and psychiatric problems, particularly substance use problems. Results are discussed in the context of cumulative adversity and self-trauma theory. Trials registration This trial has been registered with the International Standard Randomized Control Trial Number Register and assigned ISRCTN42520374. PMID:24726046

  14. Fools rush in where angels fear to tread Playing God with Vancouver's Supervised Injection Facility in the political borderland.

    PubMed

    Small, Dan

    2007-01-01

    Healthcare does not exist in a social vacuum. Nowhere is this more obvious than in the case of people living with active addiction who are treated as social lepers: feared, despised and socially banished from the wider human family. People with addictions, and their families, fight for survival in the moral borderland between two competing understandings of their condition. According to one understanding, addiction is a concern for the criminal justice system while according to the other it is primarily a population health issue. In one orientation, addicts are troublesome offenders, while in the other they are wounded persons in need of medical attention. These competing values form a cultural web of belief that extends far beyond healthcare to the highest political office of Canadian society. This paper examines the politics of addiction over a 6-year period beginning at the municipal level in Vancouver and culminating with a confrontation between the Prime Minister of Canada and the tiny neighbourhood that provides a home for North America's only Supervised Injection Facility. Not wanting to let the medical facts get in the way of a political stand, Prime Minister Stephen Harper and his Health Minister, Tony Clement, played God this summer by playing politics with the lives of people in the shadows of Canadian society. PMID:17689340

  15. Dec.3-8, 2007NIPS2007, Vancouver, Canada Direct Importance Estimation with

    E-print Network

    Sugiyama, Masashi

    samples True function Learned function #12;10 Bias and VarianceBias and Variance : expectation over samples Bias Variance Generalization error (expected test error): Bias Variance #12;11 Model Specification)Ordinary Least-Squares (OLS) If model is correct: OLS minimizes bias asymptotically If model is misspecified: OLS

  16. Minimum-distance requirements could harm high-performing critical-access hospitals and rural communities.

    PubMed

    Casey, Michelle M; Moscovice, Ira; Holmes, G Mark; Pink, George H; Hung, Peiyin

    2015-04-01

    Since the inception of the Medicare Rural Hospital Flexibility Program in 1997, over 1,300 rural hospitals have converted to critical-access hospitals, which entitles them to Medicare cost-based reimbursement instead of reimbursement based on the hospital prospective payment system (PPS). Several changes to eligibility for critical-access status have recently been proposed. Most of the changes focus on mandating that hospitals be located a certain minimum distance from the nearest hospital. Our study found that critical-access hospitals located within fifteen miles of another hospital generally are larger, provide better quality, and are financially stronger compared to critical-access hospitals located farther from another hospital. Returning to the PPS would have considerable negative impacts on critical-access hospitals that are located near another hospital. We conclude that establishing a minimum-distance requirement would generate modest cost savings for Medicare but would likely be disruptive to the communities that depend on these hospitals for their health care. PMID:25847646

  17. Understanding differences between high- and low-price hospitals: implications for efforts to rein in costs.

    PubMed

    White, Chapin; Reschovsky, James D; Bond, Amelia M

    2014-02-01

    Private insurers pay widely varying prices for inpatient care across hospitals. Previous research indicates that certain hospitals use market clout to obtain higher payment rates, but there have been few in-depth examinations of the relationship between hospital characteristics and pricing power. This study used private insurance claims data to identify hospitals receiving inpatient prices significantly higher or lower than the median in their market. High-price hospitals, compared to other hospitals, tend to be larger; be major teaching hospitals; belong to systems with large market shares; and provide specialized services, such as heart transplants and Level I trauma care. High-price hospitals also receive significant revenues from nonpatient sources, such as state Medicaid disproportionate-share hospital funds, and they enjoy healthy total financial margins. Quality indicators for high-price hospitals were mixed: High-price hospitals fared much better than low-price hospitals did in U.S. News & World Report rankings, which are largely based on reputation, while generally scoring worse on objective measures of quality, such as postsurgical mortality rates. Thus, insurers may face resistance if they attempt to steer patients away from high-price hospitals because these facilities have good reputations and offer specialized services that may be unique in their markets. PMID:24476706

  18. Lower Mortality in Magnet Hospitals

    PubMed Central

    McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.

    2014-01-01

    Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082

  19. Cost inefficiency in Washington hospitals: a stochastic frontier approach using panel data.

    PubMed

    Li, T; Rosenman, R

    2001-06-01

    We analyze a sample of Washington State hospitals with a stochastic frontier panel data model, specifying the cost function as a generalized Leontief function which, according to a Hausman test, performs better in this case than the translog form. A one-stage FGLS estimation procedure which directly models the inefficiency effects improves the efficiency of our estimates. We find that hospitals with higher casemix indices or more beds are less efficient while for-profit hospitals and those with higher proportion of Medicare patient days are more efficient. Relative to the most efficient hospital, the average hospital is only about 67% efficient. PMID:11393744

  20. Hospital compliance with a state unfunded mandate: the case of California's Earthquake Safety Law.

    PubMed

    McCue, Michael J; Thompson, Jon M

    2012-01-01

    Abstract In recent years, community hospitals have experienced heightened regulation with many unfunded mandates. The authors assessed the market, organizational, operational, and financial characteristics of general acute care hospitals in California that have a main acute care hospital building that is noncompliant with state requirements and at risk of major structural collapse from earthquakes. Using California hospital data from 2007 to 2009, and employing logistic regression analysis, the authors found that hospitals having buildings that are at the highest risk of collapse are located in larger population markets, possess smaller market share, have a higher percentage of Medicaid patients, and have less liquidity. PMID:23216262