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1

Listeriosis at Vancouver General Hospital, 1965-79.  

PubMed Central

The records were reviewed of all patients treated at the Vancouver General Hospital over the 15 years from 1965 through 1979 for infections proved by culture to have been caused by Listeria monocytogenes. Although listeriosis is not common in humans, certain groups seem to be susceptible - immunocompromised patients, pregnant women, neonates and the elderly. All these groups were represented among the 22 cases reviewed. There were 17 adults, 3 of whom were pregnant women who had only a mild influenza-like illness. Of the remaining 14 adults 9 were immunocompromised and 5 apparently immunocompetent; 7 presented with meningitis and 7 with bacteremia only. Of the five infants with neonatal listeriosis, two had early-onset disease (bacteremia) and three had the late-onset form (meningitis). Seven patients were treated with penicillin alone, seven with ampicillin alone and eight with penicillin or ampicillin combined with kanamycin, gentamicin or chloramphenicol. There were eight deaths: several were directly attributable to the listeriosis, but in others the severity of the underlying illness was an important factor. Serotypes 1 and 4b were equally common among the 16 specimens of L. monocytogenes that were typed.

Skidmore, A. G.

1981-01-01

2

Hemoglobinopathies in a hospital population in Vancouver.  

PubMed Central

A number of varieties of thalassemia were found to be common in the Vancouver area and in other parts of British Columbia. Of 3117 patients whose blood samples were studied by hemoglobin electrophoresis at the Vancouver General Hospital between Jan 1, 1965 and June 30,1977, 813 had the beta-thalassemia trait, 18 had homozygous beta-thalassemia, 97 had alpha-thalassemia trait, 24 had hemoglobin H disease and 14 had miscellaneous variants. Eight patients had interactions of beta-thalassemia with hemoglobin S,C, D, O arab or Vancouver, and one patient had alpha thalassemia associated with hemoglobin Constant Spring. Twelve other variants were noted. They included hemoglobins B2, E, Q, GHsi Tsou, J Bangkok, British Columbia, KOLN, Lepore, Rampa, Tacoma, St. Claude and an unidentified alpha-chain variant.

Gray, G. R.; Marion, R. B.

1978-01-01

3

Expo '86, Vancouver: impact on British Columbia's Children's Hospital.  

PubMed Central

Over 22 million visitors attended the 1986 world exposition in Vancouver, and this had a significant impact on the local pediatric facility. A total of 559 children visited the emergency department of British Columbia's Children's Hospital with injuries or illnesses resulting from the fair. Of these, 193 (34%) had come directly from the site. The children's ages ranged from 1 1/2 months to 18 years, 4 months (mean 6.99 years). Of the 559 children 31% were not covered by medical insurance. Twenty-four of the children were admitted to the hospital, and one died at the Expo site. Most of the illnesses were upper respiratory tract infections and gastroenteritis. The proportion of visits for trauma was 50%, compared with the yearly average of 25%. There was a 6% increase in the workload in the emergency department during the fair; the percentage was even higher during July and August, particularly after 1800 hours. Recommendations are made to aid with the planning of medical care for similar events.

Hlady, L J; Macnab, A J; Smith, D F; Wensley, D F

1987-01-01

4

GENERAL HOSPITAL PSYCHOLOGY  

Microsoft Academic Search

The practice of psychology in general hospitals has evolved from a few isolated practitioners operating primarily within psychiatry to several thousand psychologists, organized administratively and providing a wide range of services to various hospital departments. This article reviews major developments in the practice of hospital psychology. Four current influences on hospital psychologists are particularly noted: the deinstitutionalization of chronic mental

ROBERT J. DUNN

1986-01-01

5

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

SciTech Connect

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

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

1990-02-01

6

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

PubMed

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

Zuberi, Daniyal M; Ptashnick, Melita B

2011-01-27

7

[General coordination of hospital activity].  

PubMed

The present article describes the organizational and general coordination measures taken by the hospital management to attend the 325 victims who arrived at our hospital after the terrorist attack on the morning of 11 March. Firstly, we summarize the activity performed by the extra-hospital emergency services and the distribution of the victims in centers. Secondly, we describe in greater detail the interventions performed to initiate the External Emergency Action Plan in our hospital, the triage system and identification of patients who used it, as well as the resources in terms of beds, operating rooms and personnel that were used on that day. Lastly, by way of discussion, we provide a critical analysis of our interventions. PMID:15771833

Rodríguez, Paz; Serra, José Antonio

2005-03-01

8

Psychology and the general hospital  

Microsoft Academic Search

Several basic issues that affect the establishment of psychological services in the General Hospital are considered. Historically, because of mutual avoidance, employment relationships infrequently have been developed. Recently, however psychiatric services have been instituted in these settings. The primary choice for psychology currently is one of assuming traditional roles and functions, within the realm of mental health, and\\/or the provision

Marvin Goodman

1967-01-01

9

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.

2007-07-02

10

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

11

Splenectomy in a general hospital.  

PubMed Central

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%).

Glass, J M; Gilbert, J M

1996-01-01

12

Bleomycin and subsequent anaesthesia: A retrospective study at Vancouver General Hospital  

Microsoft Academic Search

A retrospective review was made of 20 surgical procedures in 14 patients with testicular carcinoma, previously treated with\\u000a bleomycin chemotherapy, to evaluate the incidence of postoperative pulmonary complications. Other studies have suggested an\\u000a increased rate of pulmonary complications, including fatal respiratory failure, when inspired oxygen fraction (Fio2) exceeds 0.3 during or after operation. There is a suggestion that bleomycin may

M. J. Douglas; C. M. L. Coppin

1980-01-01

13

Examining General Hospitals' Smoke-Free Policies  

ERIC Educational Resources Information Center

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

Whitman, Marilyn V.; Harbison, Phillip Adam

2010-01-01

14

7. Hospital Point, general view from steps of the Portsmouth ...  

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

7. Hospital Point, general view from steps of the Portsmouth Naval Hospital Building showing radiating walks, view to northeast - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

15

Clinical training experience in district general hospitals  

Microsoft Academic Search

AIMSTo 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

Roderick MacFaul; Stephen Jones; Ursula Werneke

2000-01-01

16

Appropriateness of hospital admissions in general hospitals in Egypt.  

PubMed

We measured the rate of inappropriate admissions, and associated factors, in 3 general hospitals in Egypt. A total of 1191 admissions were reviewed using the Appropriateness Evaluation Protocol for adult patients and the Pediatric Appropriateness Evaluation Protocol for paediatric patients. Inappropriate admissions were 66.3% and 78.9% of admissions in the surgery departments of 2 hospitals compared with 1.9% in the 3rd hospital that followed a specific admission protocol for elective surgery. The paediatrics department had the lowest rates of inappropriate admissions in all hospitals (0%, 1.0% and 1.9%). On logistic regression analysis, the route of admission was the only factor significantly associated with inappropriate admissions in the departments of surgery, obstetrics/gynaecology and internal medicine. PMID:20214126

Al-Tehewy, M; Shehad, E; Al Gaafary, M; Al-Houssiny, M; Nabih, D; Salem, B

17

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.

18

Methadone prescribing in the general hospital  

Microsoft Academic Search

Purpose – The purpose of this paper is to evaluate the clinical practice for management of opiate dependence in a general hospital in-patient population based on agreed standards and changes of clinical practice after the introduction of a guideline. Design\\/methodology\\/approach – A complete cycle of audit was carried out based on the agreed guideline, which was introduced after the first

Jennifer Anderson; Kit Wa Chan; Cathy Walsh; Mervyn London

2010-01-01

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

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

Hern, Matt

2009-01-01

20

GENERAL VIEW OF WARD BUILDINGS, B11, B10, B9, AND NORTH ...  

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

GENERAL VIEW OF WARD BUILDINGS, B11, B10, B9, AND NORTH ELEVATION OF CONNECTING HALLWAY OF WARD C BUILDINGS, LOOKING WEST - Barnes General Hospital, East Fourth Plain Boulevard & O Street, Vancouver, Clark County, WA

21

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

Code of Federal Regulations, 2010 CFR

...2009-10-01 2009-10-01 false Excluded hospitals and hospital units: General rules. 412.22 Section 412...PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Hospital Services Subject to and...

2009-10-01

22

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

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Excluded hospitals and hospital units: General rules. 412.22 Section 412...PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Hospital Services Subject to and...

2010-10-01

23

PSYCHIATRIC INPATIENT SERVICES IN GENERAL HOSPITALS  

PubMed Central

Traditional asylum care of psychiatric patients leads to the isolation, confinement, and restraint of the patients, and to isolation of psychiatric practice from the rest of medicine. Modern psychiatric advances have demonstrated the disadvantages to both patients and their families of such isolation, confinement and restraint. It is in the best interests of patients and professional workers that inpatient psychiatric services be continuous with, and contiguous to, other medical services and to rehabilitation services of all kinds. Examination of currently available information reveals a shortage of psychiatric beds in California, particularly for diagnosis and brief treatment. Thus, not only is there a need to develop psychiatric inpatient facilities, but also an opportunity to develop them along several different lines. Since both the Hill-Burton Act (federal) and the Short-Doyle Act (state) give financial assistance to only those psychiatric services established in general hospitals or affiliated with general hospitals, this requirement calls for examination in the light of experience with services so operated. At first, the Short-Doyle Act was perceived as a panacea for the psychiatric ills of the state. Now it is beginning to be recognized as one method of providing additional mental health resources, rather than the exclusive method. As more short-term cases are treated in local, tax-supported, psychiatric units in general hospitals, an impact can be expected on the state hospital program. In its administration of the Short-Doyle Act, the Department of Mental Hygiene attempts to respond to community needs as locally determined. It tries to insure local option and encourage local responsibility while furthering high standards of staffing and of service.

Hume, Portia Bell; Rudin, Edward

1960-01-01

24

2010 Meeting Materials of the General Hospital and Personal ...  

Center for Biologics Evaluation and Research (CBER)

... Roster of the General Hospital and Personal Use Devices Panel. -. 2010 Meeting Materials of the General Hospital and Personal Use Devices Panel ... More results from www.fda.gov/advisorycommittees/committeesmeetingmaterials/medicaldevices

25

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

Code of Federal Regulations, 2013 CFR

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

2013-07-01

26

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

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

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

27

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

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

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

28

Breast reconstruction at a district general hospital.  

PubMed Central

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.

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

1993-01-01

29

Infective endocarditis in a district general hospital.  

PubMed Central

Thirty-three cases of infective endocarditis presenting during a 6.5 year period to a district general hospital were analysed retrospectively. The annual incidence was 22 cases per million population. Twenty-two cases had pre-existing cardiac disease, mainly valvular disease-usually rheumatic (nine cases) and prosthetic valves (10 cases). Recognizable precipitants such as recent surgery were uncommon. Two cases presented after deliberate drug overdose possibly due to depression exacerbated by systemic disease. Symptoms were usually non-specific. All but two cases had murmurs and most were pyrexial. Splinter haemorrhages and clubbing were seen in about 20% of cases. Viridans-type streptococci were the commonest infecting organisms (14 cases). Staphylococcal infection (six cases) was confined to intravenous drug abusers and patients with prosthetic valves. Five cases were culture negative. Cardiac failure was present in 13 cases at presentation and developed in seven others during treatment. Acute valve replacement was necessary in eight cases, and late replacement in three. Renal impairment (plasma urea > 8 mmol/l and/or plasma creatinine > 120 mumol/l) occurred in 19 cases during the course of their illness. Embolic phenomena occurred in 12 patients and mostly involved the central nervous system. In the 8 fatal cases, the cause of death was cardiac failure in six, cerebrovascular accident in one, and myocardial infarction in one. Four of the six patients who subsequently died of cardiac failure had been referred for surgery. Both those who were not referred had coexisting medical problems. Factors associated with increased mortality were age, male sex, cardiac failure (P < 0.01), renal impairment (P < 0.05), and embolic phenomena (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Manford, M; Matharu, J; Farrington, K

1992-01-01

30

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

31

Hospital Waste Treatment and Disposal in the General University Hospital - Current Situation and Future Challenges  

Microsoft Academic Search

The General Hospital of Prague, together with a maternity home, foundling hospital and hospice was established in 1790 under the so called “directive rules” issued by Josef II in 1781. At the time of its opening there were 300 beds and now the number varies from 1800 to 2000 beds.The present General University Hospital (GUH) is inevitably a producer of

V. Bencko; J. Kapek; O. Vinš

2003-01-01

32

General medical care external hospitalizations for patients in Texas state mental health hospitals.  

PubMed

We explored the characteristics of general medical hospital admissions for patients in state mental health hospitals. Data were extracted from a statewide database of all hospital discharges for 5 years identified as general medical hospital admissions that occurred during the stay of patients at state mental health hospitals. Across the 9 mental health hospitals in the state system, rates of admission to general medical hospitals varied significantly from 0.7% to 3.7%. On average, of the 1.9% of all state mental health inpatients who had a general hospital admission, 25% occurred within 4 days of admission to the mental hospital. The average general hospitalization lasted 5.7 days. The reported total charge for all stays was $34 million. Dehydration (15%), hypertension (10%), and diabetes (10%) were the most frequent diagnoses. Thirteen percent of diagnoses met preventable hospitalization criteria. Given the variability among hospitals in admission rates and the number of preventable conditions, improvements in patient care and health as well as reduced admissions to general medical hospitals may be possible. PMID:23479290

Shafer, Alan B; Ray, Ryan Kumar; Becker, Emilie A

2013-03-01

33

Changes in General Hospital Psychiatric Care, 1980–1985  

Microsoft Academic Search

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

Charles A. Kiesler

1991-01-01

34

[Long-term care elderly residents in general hospitals].  

PubMed

Long-term care facilities for the elderly have regularly to work together with general hospitals to provide care to acutely ill residents or when they require all together more complex diagnostic procedures and multi-specialty care. The decision to hospitalize a nursing home elderly resident is multifactorial and it is based on factors such as illness severity and care facility infrastructure. Hospitalizations have benefits and risks such developing iatrogenic diseases, delirium, and functional decline, which may deteriorate patients' general condition and their quality of life during and/or after hospitalization. This study aimed at addressing specific aspects of assessment, treatment and management of nursing home elderly who require to be hospitalized, especially focusing on their effective care. Common conditions such delirium, iatrogenic diseases, poor nutrition, functional decline, hospice care and special characteristics of nursing home elderly during their admission to general hospitals are discussed. PMID:17173173

Gorzoni, Milton Luiz; Pires, Sueli Luciano

2006-12-01

35

Maribor General Hospital from its foundation until World War II  

Microsoft Academic Search

Summary  The author describes the history of Maribor General Hospital from its foundation in 1799 until the beginning of World War\\u000a II. In 1799 the magistrate of the town of Maribor issued a memorandum regarding the establishment of a town hospital in the\\u000a renovated building of the town hospice, providing space for 24 patients. The work of the hospital was carried

Gregor Pivec

2006-01-01

36

Energy Management Study for General Leonard Wood Army Community Hospital.  

National Technical Information Service (NTIS)

William Tao Associates, Inc. (WTA) was commissioned by the United States Army Corps of Engineers (COE) to perform an Energy Management Study of the General Leonard Wood Army Community Hospital (GLWACH). The Hospital is a 366,000 SF facility, with schedule...

1986-01-01

37

Clinical significance of anaerobic bacteremias in a general hospital  

Microsoft Academic Search

A prospective study was designed to investigate anaerobic bacteremias and evaluate their incidence and significance in a general hospital. One or more blood cultures positive for anaerobic microorganisms were analyzed from each of a total of 61 patients hospitalized between January 1988 and April 1992, in accordance with an established protocol. The clinical repercussions of bacteremia were also analyzed. Two

J. Gómez; V. Baños; J. Ruiz; F. Herrero; M. Pérez; L. Pretel; M. Canteras; M. Valdés

1993-01-01

38

Past Meeting Materials for the General Hospital and Personal ...  

Center for Biologics Evaluation and Research (CBER)

... Meeting Materials. -. Summaries of Past Meetings. Summary of the General Hospital and Personal Use Devices Panel Meeting - May 4, 2007 ... More results from www.fda.gov/advisorycommittees/committeesmeetingmaterials/medicaldevices

39

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

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

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

40

Alpha-Antitrypsin Reference Laboratory, Massachusetts General Hospital, Boston.  

National Technical Information Service (NTIS)

An Alpha1-Antitrypsin Reference Laboratory has been established in the Immunology Unit of the Children's Service at the Massachusetts General Hospital. Facilities are now available and methods now working for the storage of serum samples in the frozen sta...

R. C. Talamo

1972-01-01

41

Do psychiatric units at general hospitals attract less stigmatizing attitudes compared with psychiatric hospitals?  

PubMed

Aims. It is often assumed that psychiatric units at general hospitals attract less stigma than do specialized psychiatric hospitals, but so far this has not been examined empirically. Methods. We conducted a representative population survey in Germany (n = 2410) in order to compare attitudes towards psychiatric units and attitudes towards psychiatric hospitals. Two subsamples were presented with identical items concerning either psychiatric units or hospitals. We conducted multinomial logit analyses of answer categories to detect any differences in attitudes. Results. A majority of respondents held favourable opinions of psychiatric in-patient care at both psychiatric units and psychiatric hospitals. Attitudes towards units and hospitals did not differ meaningfully. Conclusions. The influence of location on the image of psychiatric care has been over-estimated. We discuss other implications of locating psychiatric care at general hospitals. PMID:22995060

Schomerus, G; Matschinger, H; Angermeyer, M C

2012-09-21

42

A STUDY OF PROBLEM DRINKERS IN A GENERAL HOSPITAL  

PubMed Central

349 new admissions in the wards of Medicine, General Surgery & Orthopedics in a general hospital were screened with MAST & AUDIT for problem use of alcohol. Problem drinking was present in 14.6% of the inpatients. The severity and the need for additional treatment were measured with Addiction Severity Index (ASI). Majority of the patients had problems in more than one ar?a. Nevertheless, only one fourth of the patients were referred for psychiatric treatment. The findings indicate the need to develop services towards the recognition and referrals of the problem drinkers in general hospitals

Babu, R. Sateesh; Sengupta, S.N.

1997-01-01

43

Innovation in Hospital Podiatric Residencies: Waldo General Hospital--A Model Program.  

ERIC Educational Resources Information Center

The Waldo General Hospital Podiatric Residency Program, designed to be an intense, "well-rounded," multifaceted, single year of postgraduate practical training for the podiatric physician, is described. Surgical training, internal medicine, "outside rotations," in-hospital rotations, and meetings and lectures are discussed. A podiatric lecture…

Miller, Stephen J.

1980-01-01

44

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

ERIC Educational Resources Information Center

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

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

2006-01-01

45

The American General Hospital as a Complex Social System  

PubMed Central

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

Georgopoulos, Basil S.; Matejko, Aleksander

1967-01-01

46

Recognition of alcoholic liver disease in a district general hospital  

Microsoft Academic Search

Two-hundred-and-two patients with alcoholic liver disease whose investigations included a liver biopsy were seen in a district general hospital over a seven year period. Thirty-five percent presented with general gastrointestinal symptoms rather than with overt liver disease or previously recognised excess consumption of alcohol. Recognition of the alcohol problem was assisted by the finding of a raised mean corpuscular volume

A J Levi; D M Chalmers

1978-01-01

47

Hospitalization After Open Colectomy: Expectations and Practice in General Surgery  

Microsoft Academic Search

Purpose. There is increasing pressure to reduce the length of stay (LOS) in hospital after colectomy. To assess the impact of unintended variations on LOS, actual discharge management was compared with the expectations expressed by general surgeons. Methods. We retrospectively examined 262 patients who underwent elective open colectomy. The effects of patient demographics, surgical variables, and functional recovery on postoperative

Riccardo Nascimbeni; Rita Cadoni; Francesco Di Fabio; Claudio Casella; Bruno Salerni

2005-01-01

48

Bedside haemodynamic monitoring: experience in a general hospital  

Microsoft Academic Search

Bedside right heart haemodynamic monitoring was carried out on 55 occasions over 18 months in the cardiac care unit of a district general hospital. The technique was used to assist in the management of 27 patients with acute heart failure by helping to select appropriate treatment. Although the catheters were flow guided, insertion and positioning were facilitated by fluoroscopy. The

J Bayliss; M Norell; A Ryan; M Thurston; G C Sutton

1983-01-01

49

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.

50

How people die in hospital general wards: a descriptive study.  

PubMed

To describe how patients die in hospital, 370 patients (age >18 years; in hospital for>24 hours) who died on the general wards of 40 Italian hospitals were assessed. Differences between patients whose death was expected and patients whose death was unexpected were evaluated. Data on treatments and care in proximity of death were collected after interviewing the nurse responsible for the patient within 72 hours of the patient's death, and from clinical and nursing records. For 58% of patients, death was highly expected. Symptom control was inadequate for the most severely ill patients: 75% experienced at least one "severe" symptom (42% pain and 45% dyspnea). Nurses tended to judge patients' global care as "good" or "very good" (76%), in spite of the persistence of symptoms and the scant use of analgesics. Despite some encouraging signs of sensitivity to end-of-life problems, acute inpatient institutions in Italy still deal inadequately with the needs of dying persons. PMID:16043005

Toscani, Franco; Di Giulio, Paola; Brunelli, Cinzia; Miccinesi, Guido; Laquintana, Dario

2005-07-01

51

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

PubMed Central

Background Critics have raised concerns that specialty cardiac hospitals exacerbate racial disparities in cardiovascular care, but empirical data are limited. Methods and Results We used administrative data from the Medicare Provider and Analysis Review (MEDPAR) Part A and Provider-of-Service (POS) files from 2002 to 2005. Multivariable logistic regression models were constructed to examine the likelihood of black Medicare patients being admitted to a cardiac hospital for coronary revascularization when compared with white patients within the same healthcare referral region (HRR) after accounting for geographic proximity to the nearest hospitals, procedural acuity and co-morbidities. We identified 35,309 patients who underwent coronary artery bypass grafting (CABG) in 18 HRRs and 94,525 patients who underwent percutaneous coronary intervention (PCI) in 20 HRRs with cardiac hospitals performing these procedures. Patients at cardiac hospitals were more likely to be men and white, and to have less co-morbidity than those at general hospitals. The likelihood of black patients undergoing coronary revascularization at a cardiac hospital was significantly lower for CABG (adjusted odds ratio [OR], 0.67; P=0.01) and PCI (adjusted OR, 0.63; P<0.0001). However, this relationship was substantially attenuated in black patients living in close proximity (i.e., within 10 miles) to cardiac hospitals (adjusted OR for CABG, 0.95; p=0.75; adjusted OR for PCI, 0.78; P=0.01). Conclusions Black patients were significantly less likely to be admitted at cardiac hospitals for coronary revascularization. Precise reasons for these findings are unclear, but suggest complex associations between race and geography in decisions about where to receive care.

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

2009-01-01

52

Salvage prostatectomy post-definitive radiation therapy: The Vancouver experience  

PubMed Central

Introduction: Prostate cancer recurrence following primary radiation is common. If the recurrence remains localized to the prostate gland, surgical removal may result in long-term local control or cure. Despite the well-established oncological outcomes, salvage prostatectomy is infrequently performed or reported. We present our experience with salvage prostatectomy at a Canadian centre. Methods: We identified all patients undergoing salvage prostatectomy at the Vancouver General Hospital between 1995 and 2010 from a prospectively recorded and maintained prostate cancer database. Details regarding initial presentation, delivery of radiotherapy, clinical features at the time of recurrence, as well as oncological and functional outcomes, were collected. Information regarding postoperative morbidity was collected prospectively and confirmed by retrospective chart review. Results: Over a 15-year period, salvage prostatectomy was successfully completed in 21 patients. With a median follow-up period of 68 months (range: 2–122), 9 (43%) patients experienced a biochemical recurrence, with most failing within the first 2 years of surgery. There were 3 deaths in the cohort, all from prostate cancer, giving a prostate cancer specific and overall survival of 86%. The main postoperative morbidity was bladder neck contracture, occurring in 40%. One patient each developed a recto-urethral fistula and osteitis pubis. Physician-recorded data regarding continence was available in 13 (62%). Of these 13 patients, 10 (85%) men were recorded as dry or using 1 pad per day. Conclusions: This is the first Canadian centre to report that salvage prostatectomy can be performed with favourable oncological and functional outcomes.

Corcoran, Niall M.; Godoy, Guilherme; Studd, Rodney C.; Casey, Rowan G.; Hurtado-Coll, Antonio; Tyldesley, Scott; Goldenberg, S. Larry; Gleave, Martin E.

2013-01-01

53

Tampa General Hospital "blows the whistle on violence".  

PubMed

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

54

Neurologic consultations in a general hospital. Spectrum of latrogenic disease.  

PubMed

In a prospective study of 1,500 neurologic consultations during 1978 and 1984 within the Johns Hopkins Hospital, iatrogenic neurologic conditions were found in 14 percent of patients. The most common antecedents were angiography, cardiac surgery, and immunosuppression. Neurologists found previously unsuspected significant neurologic conditions in 27 percent of patients. Determining the underlying causes of delirium posed a special diagnostic problem. The accuracy of general physicians and surgeons in the application of criteria for brain death was low. Consultations for solely medical-legal reasons are increasing. These findings indicate the need for improved surveillance of neurological injury in hospitals, earlier recognition of delirium and research into its mechanisms, and additional education about criteria for brain death. PMID:3799655

Moses, H; Kaden, I

1986-12-01

55

Access Improvements and Land Bridge Construction, Fort Vancouver National Historic Site Environmental Assessment, May 2005.  

National Technical Information Service (NTIS)

Fort Vancouver National Historic Site (Fort Vancouver NHS) is located along the north shore of the Columbia River adjacent to the City of Vancouver (City of Vancouver) in Clark County, Washington. The authorized boundary of Fort Vancouver NHS is approxima...

2005-01-01

56

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.

57

Analysis of two strategies for structuring Medicare reimbursement to maximize profitability in acute care general hospitals  

Microsoft Academic Search

The healthcare literature sometimes cites Medicare as a negative determinant of hospital profitability. However, a review of Florida acute care short-term general hospital data revealed a subset of profitable hospitals with high percentages of their revenue structure comprised of Medicare reimbursements. Some investigators might contend that these hospitals are just better managed; that hospital profitability is not related to patient

James D Barrington

2010-01-01

58

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

Microsoft Academic Search

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

Shane Reti

59

The role of psychology and psychiatry in general hospital settings in Alabama  

Microsoft Academic Search

Investigated the availability of psychiatric units in general hospitals, the variety of staff personnel employed, and the range of treatment methods utilized in Alabama. 36% of the responding hospitals provided inpatient psychiatric services. Larger hospitals were more apt to provide these services. The type of staff employed and treatment utilized were similar for both psychiatric institutions and general community hospitals.

J. Kevin Thompson; Frank L. Collins; Chester W. Jenkins

1979-01-01

60

Ophthalmic emergencies in a district general hospital casualty department.  

PubMed Central

A survey of ophthalmic emergencies attending the casualty department of a district general hospital over a 12-month period is presented. The total number of new casualty attendances was 30,649 of which 1870 (6.1%) presented with an ophthalmic problem. There was a 3 to 1 male to female preponderance and a peak age of presentation between 20 and 30 years. The main aetiological factors were trauma 65.6% and inflammation 21.7%. Of the trauma patients 80% had sustained minor trauma (abrasions or foreign material to the cornea or conjunctiva) and of the patients with inflammation 71% had either conjunctivitis or blepharitis. There was a trend towards increased numbers in the summer months. The percentage of patients with inflammatory disease was higher in the early summer and the winter months. Nine of the 11 patients with acute angle closure glaucoma presented between November and February. All patients were initially seen by the accident and emergency medical staff, who were able to treat 69% without further consultation. No serious pathology was overlooked. It is suggested that, in the district general hospital setting, co-operation between the eye and the accident and emergency departments can be to their mutual benefit.

Edwards, R S

1987-01-01

61

Financial management challenges for general hospital psychiatry 2001.  

PubMed

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

Goldberg, R J

62

Comparison of improvement process of addict and general coma patients hospitalized in Taleghani hospital  

PubMed Central

Abstract: Background: Substance and other relative compounds prevents of physiological Adernocorticotropin secretion from pituitary gland and lead to mental exciting and arousal. Present study investigated impact of addiction on improvement process of coma in addiction and general patients. Methods: 170 coma patients hospitalized in Taleghani hospital in 1390 were investigated, that 10 persons of them were addict, therefore 10 addict patients and 10 general patients with GCS 5/6 were selected as control group with access able sampling way. Ti data collection used of patient folders. To data analysis used of T test with spss19. Results: finding showed that addict patients improvement process is faster than general patients. Cortizol level in addiction patients is lower than general patients and this lead to mental and physiological arousal in addicts. Therefore to control of problems resulting of substance using incision, kind and dose of drug and substance and harmonic conditions is change. And this mater leads to faster improvement in addictions. Conclusions: addict patients are dangerous patients. And have to special notes to coma problems and recovery because adrenal gland weakness and default. Keywords: Addiction, Coma, ICU, GCS 5/6

Akbari, Mostafa; Soleimani, Pezhman; Kohi, Farzaneh; Kahrizi, Somayeh

2012-01-01

63

Motivation to change drinking behavior: comparison of alcohol-dependent individuals in a general hospital and a general population sample  

Microsoft Academic Search

The general hospital would be especially suited to initiate interventions if hospitalized alcohol-dependent individuals were particularly motivated to change their drinking behavior. This study compares the readiness to change of alcohol-dependent persons in the general hospital and the general population. Stages of change according to the model of Prochaska and DiClemente [6] are assessed using the Readiness to Change Questionnaire

Hans-Jürgen Rumpf; Ulfert Hapke; Christian Meyer; Ulrich John

1999-01-01

64

Management of perforated peptic ulcer in a district general hospital  

PubMed Central

INTRODUCTION Laparoscopic surgery has become increasingly popular for elective surgery but it has gained slow transference to emergency surgery. The management of perforated peptic ulcers (PPU) laparoscopically is an accepted strategy yet it still remains infrequently used. The purpose of this study was to analyse the utility and outcomes of laparoscopy versus open repair for PPU in a district general hospital. In addition, we evaluated whether the subspecialty of the on-call consultant affected the method of repair performed and the training opportunities for trainee surgeons. METHODS Between 2003 and 2009, 53 patients underwent laparoscopic repair, 89 patients underwent open repair and a further 20 patients had laparoscopic repair that was converted to open repair for PPU. The results from a prospectively compiled database were analysed with primary outcome measures including operative time, length of hospital stay and mortality. RESULTS The median operating time in the laparoscopic group was 60.0 minutes compared with 50.5 minutes in the open group. Hospital stay in surviving patients was significantly shorter in patients treated completely laparoscopically (5 days) when compared with the open group (6 days) (p<0.01). There were six deaths in the laparoscopic group (11%) compared with 13 in the open group (15%) and one in the converted group (5%). Trainees performed 53% (47/89) of open repairs and 13% (7/54) of laparoscopic repairs. CONCLUSIONS Both laparoscopic and open repair are equally safe in the management of PPU. Our findings support the view that this procedure can be successfully used as a training operation.

Critchley, AC; Phillips, AW; Bawa, SM; Gallagher, PV

2011-01-01

65

Evolution of the Whipple procedure at the Massachusetts General Hospital  

PubMed Central

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

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

2013-01-01

66

Stem cell transplantation programme at Singapore General Hospital.  

PubMed

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

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

67

Prevalence of Potential Drug Interactions in an Iranian General Hospital  

PubMed Central

The hazards of prescribing many drugs, including side-effects, drug-drug interactions and difficulties of compliance have long been recognized as particular problems when prescribing. This study estimates the rate and factors associated with potential drug-drug interactions in prescriptions from wards of An Iranian General Hospital. Data were retrieved from the pharmacy of a general hospital (200 beds) during one year period 2010. Potential drug-drug interaction were identified using a computerized drug-drug interaction database system (Prescription Analyzer 2000, Sara Rayane Co., Iran). Patients of both genders and 15 years-old or more were included in this study. Prescriptions with two or more drugs prescribed were selected during one year period 2010. Gender number of drugs and therapeutic drug classes on prescriptions were explored as associated factors to drug-drug interaction. The overall prevalence of potential drug-drug interaction was 20.3%. The risks of severe potential drug interactions were relatively high and the rate of potential drug-drug interaction was significantly higher in women (60.6%) and the patients aged over 60 years old (57.1%). The frequency of the potentially severe drug-drug interaction was 10.8% with digoxin-furosemide as the most common interacting pair (5.91%). A positive correlation was found between drug-drug interaction, patient's age, number of drugs and drugs acting on cardiovascular system. So cardiology women inpatients, age more then 60 years old, and patients prescribed digoxin and angiotensin-converting enzyme inhibitors should be closely monitored for adverse outcomes from drug-drug interaction.

Sepehri, G.; Khazaelli, P.; Dahooie, F. Arabpour; Sepehri, E.; Dehghani, M. R.

2012-01-01

68

Causes and predictors of mortality in hospitalized lupus patient in Sarawak General Hospital, Malaysia.  

PubMed

Systemic lupus erythematosus (SLE) is a serious autoimmune disease that can be life threatening and fatal if left untreated. Causes and prognostic indicators of death in SLE have been well studied in developed countries but lacking in developing countries. We aimed to investigate the causes of mortality in hospitalized patients with SLE and determine the prognostic indicators of mortality during hospitalization in our center. All SLE patients who were admitted to Sarawak General Hospital from January 1, 2006 to December 31, 2010, were followed up in a prospective study using a standard protocol. Demographic data, clinical features, disease activities and damage indices were collected. Logistic regression and Cox regression analysis were used to determine the prognostic indicators of mortality in our patients. There were a total of 251 patients in our study, with the female to male ratio 10 to 1. Our study patients were of multiethnic origins. They had a mean age of 30.5?±?12.2 years and a mean duration of illness of 36.5?±?51.6 months. The main involvements were hematologic (73.3%), renal (70.9%) and mucocutaneous (67.3%). There were 26 deaths (10.4%), with the main causes being: infection and flare (50%), infection alone (19%), flare alone (19%) and others (12%). Independent predictors of mortality in our cohort of SLE patients were the presence of both infection and flare of disease (hazard ratio (HR) 5.56) and high damage indices at the time of admission (HR 1.91). Infection and flare were the main causes of death in hospitalized Asian patients with SLE. The presence of infection with flare and high damage indices at the time of admission were independent prognostic indicators of mortality. PMID:23112253

Teh, C L; Ling, G R

2012-10-30

69

Vancouver Sun APEC 97 news archive  

NSDL National Science Digital Library

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

70

Pediatric Services in General Hospitals. Minimal Criteria and Guidelines.  

National Technical Information Service (NTIS)

Minimal criteria and guidelines for pediatric services in hospitals, as presented by the Michigan Department of Public Health, are intended to assist in the operation of hospitals or the development and operation of pediatric services. Proposed minimal re...

1971-01-01

71

Vancouver’s promise of the world’s first sustainable Olympic Games  

Microsoft Academic Search

Vancouver has committed to host the world’s first sustainable Olympic Games in 2010. This promise is in keeping with local policy trends in the Vancouver region toward visions of sustainability and with growing attention by the International Olympic Committee (IOC) to environmental sustainability concerns. We demonstrate that interests in sustainability at local and international scales may differ markedly, however, resulting

Meg Holden; Julia MacKenzie; Robert VanWynsberghe

2008-01-01

72

Connection: Schwartz Center Rounds at Massachusetts General Hospital Cancer Center  

PubMed Central

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital, founded the Kenneth B. Schwartz Center®, a nonprofit organization dedicated to supporting and advancing compassionate health care. The Center sponsors Schwartz Rounds®, a multidisciplinary forum in which doctors, nurses, chaplains, social workers, and other staff reflect on important psychosocial issues that arise in caring for patients. Attendees participate in an interactive discussion about issues anchored in a case presentation and share their experiences, thoughts, and feelings. The patient narratives may center on wonderful events and transcendent experiences or tragic stories, during which staff can only bear witness to the suffering. The Rounds focus on caregivers' experiences, and encourage staff to share insights, own their vulnerabilities, and support each other. The primary objective is to foster healing relationships and provide support to professional caregivers, enhance communication among caregivers, and improve the connection between patients and caregivers. Currently, >50,000 clinicians attend monthly Schwartz Rounds at 195 sites in 31 states, numbers that are rapidly growing. In this article we explore the reasons that contribute to the success of this model of multidisciplinary reflection.

Schapira, Lidia; Mack, Sally; Stanzler, Marjorie; Lynch, Thomas J.

2010-01-01

73

Mortality in children admitted to Port Moresby General Hospital: how can we improve our hospital outcomes?  

PubMed

A detailed audit, part retrospective and part prospective, of deaths occurring in children admitted to the children's wards of the Port Moresby General Hospital over a 12-month period was made. 238 children died out of the 4898 admitted, an overall case fatality rate of 4.9%, with a monthly range of 3.7%-9.6%. The proportion of deaths approximated the proportion of admissions in each age group. 92% of the children had a weight of less than 80% of the standard weight for age and 30% weighed less than 60% of the standard weight for age. 24 (11%) of the deaths occurred within the first 6 hours of admission, 39 (17%) within the first 12 hours and 58 (26%) within the first 24 hours. 89 children (40%) died more than one week after admission. Pneumonia, meningitis, measles and septicaemia were the four leading certified causes of death and paediatric AIDS was the fifth. Less than half of the deceased children were appropriately immunized for their age. 27 deaths (12%) were assessed as preventable. 150 (67%) were classified as from treatable causes but unavoidable, 18 (8%) from untreatable causes, 22 (10%) of undetermined cause and 34 (15%) avoidable. The factors associated with avoidable deaths were delayed treatment (20 children), inadequate treatment (8 children), incorrect treatment (1 child) and others (5 children). Infant and child mortality could be reduced by general measures such as improving community nutrition and immunization status and improving care-seeking behaviour. Hospital-related measures to reduce mortality include improving the accuracy and effectiveness of triage and provision of adequate staffing levels and bed space. Periodic in-depth audit is necessary to assess quality of patient care, to identify problems and to point towards their solution. Accurate recordkeeping is essential for appropriate audit and planning. PMID:16454393

Nasi, Titus; Vince, John D; Mokela, David

74

A psychiatric unit in a general hospital in Brazil: predictors of length of stay  

Microsoft Academic Search

The planning and organization of mental health care in developing countries frequently lacks empirical data. The World Health Organization recommended psychiatric brief inpatient programms in general hospitals for these countries as a cost-effective alternative to the traditional mental hospital. Length of hospital stay is a crucial factor in a cost-effective mental health care organization. In a newly organized psychiatric inpatient

P. Dalgalarrondol; W. F. Gattaz

1992-01-01

75

Use of Short-Term General Hospitals by Patients with Psychiatric Disorders.  

National Technical Information Service (NTIS)

The paper analyzes the hospital experience of patients with psychiatric diagnoses in a national sample of short-term non-federal general hospitals. The analyses will use a data base compiled by the Hospital Cost and Utilization Project (HCUP) at the Natio...

J. Wallen

1984-01-01

76

The need for acute, subacute and nonacute care at 105 general hospital sites in Ontario  

Microsoft Academic Search

Background: Previous studies of hospital utilization have not taken into account the use of acute care beds for subacute care. The authors determined the proportion of patients who required acute, subacute and nonacute care on admission and during their hospital stay in general hospitals in Ontario. From this analysis, they identified areas where the efficiency of care delivery might be

Virginia F. Flintoft; J. Ivan Williams; Robert C. Williams; Antoni S. H. Basinski; Paula Blackstien-Hirsch; C. David Naylor

1998-01-01

77

A COMPARISON OF PSYCHIATRIC REFERRALS WITHIN THE TEACHING HOSPITAL WITH THOSE FROM PRIMARY CARE AND GENERAL HOSPITALS IN SAUDI ARABIA  

PubMed Central

Objective: This study aims at examining the pattern of psychiatric referrals with particular reference to (1) age and gender (2) source of referrals and (3) diagnosis of referred patients within a teaching hospital Method: Four hundred and twenty seven referrals (n=427) for psychiatric consultation within KKUH were selected prospectively by systematic randomization over a period of one year, and were compared with a general hospital (n=138) and primary health care (n=402) psychiatric referrals to a mental health facility. Results: The age of referred patients across the three settings differed significantly and the male patients were slightly over-represented in the teaching hospital referrals. Pediatric clinics in the teaching hospital constituted significant sources of psychiatric referrals as compared to the general hospitals. Schizophrenic disorders and acute psychoses were significantly less among teaching hospital referred patients, whereas anxiety and mood disorders were much more common among teaching hospital and primary care patients. The number of personality disorders diagnosed in teaching hospital settings was significant. Conclusions: In Saudi Arabia, sources of psychiatric referrals and diagnostic patterns of mental disorders differ across the three levels, and this is comparable to international research on psychiatric referrals. Besides exploring other aspects of referral process, researchers at the three settings should carry out follow-up studies to assess the impact of psychiatric consultations on the global outcome of referred consultees.

Al-Habeeb, Tariq A.

2002-01-01

78

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

Federal Register 2010, 2011, 2012, 2013

...No. FDA-2013-M-0042] Medical Devices; General Hospital and Personal...the date of enactment of the Medical Device Amendments of 1976), generally...of Subjects in 21 CFR Part 880 Medical devices. Therefore, under the...

2013-05-16

79

Predicting Specialty Psychiatric Inpatient Care in General Hospitals: Agreement Between Two Independent Methods  

Microsoft Academic Search

In a follow up to previous work (Kiesler, Simpkins, & Morton, 1989), we predicted where in a general hospital a psychiatric patient would be treated: psychiatric unit, chemical dependency unit, or scatter bed. Independent a priori clinical assumptions and multiple-discriminant function predictions were compared for 5,033 patients receiving psychiatric inpatient treatment in general hospitals with specialized units in the 1980

Charles A. Kiesler; Celeste G. Simpkins; Teru L. Morton

1991-01-01

80

Previous Help Seeking and Motivation to Change Drinking Behavior in Alcohol-Dependent General Hospital Patients  

Microsoft Academic Search

To assess the suitability of implementing secondary prevention approaches for alcohol abuse and dependence in the general hospital, it is worth examining how many problem drinkers are detected in this setting for the first time and whether these individuals are motivated to change their drinking behavior. In a representative general hospital sample (N = 1167), subjects were detected by a

Hans-Jürgen Rumpf; Ulfert Hapke; Ulrich John

1998-01-01

81

Improving analgesic prescribing in a general teaching hospital  

Microsoft Academic Search

Patients suffering from cancer and human immunodeficiency virus (HIV) disease at a teaching hospital were found to have poorly controlled pain. Many were prescribed inappropriate analgesia. A palliative care service was established to provide symptom control for patients and education for staff. Educational materials were developed, didactic teaching organized, and one-to-one education by case discussion provided to improve patient management.

Regina McQuillan; Ilora Finlay; Cleopatra Branch; Dave Roberts; Mike Spencer

1996-01-01

82

Clinical Psychology in General Hospital Settings: Issues in Interprofessional Relationships  

Microsoft Academic Search

We suggest that the involvement of clinical psychologists in health care teams may not necessarily improve health care. The position of clinical psychology with regard to medical theory and practice is examined. Then issues arising from multidisciplinary teamwork, with particular emphasis on consultation–liaison work, are discussed. We conclude that professional power structures in hospital settings have a profound influence on

Tracey Miller; Leslie Swartz

1990-01-01

83

Wildlife Risk Management at Vancouver International Airport  

Microsoft Academic Search

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

Gary F. Searing

2005-01-01

84

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...

85

Program Evaluation at Vancouver Community College.  

ERIC Educational Resources Information Center

Developing instructional programing priorities and planning program improvements require an understanding of how effectively program objectives are being met. A formalized process for evaluating programs has been developed at Vancouver Community College as an aid in these and other aspects of instructional planning. (SSH)

Cousineau, John G.

1983-01-01

86

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

PubMed Central

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

Kearley, K

1990-01-01

87

Staff attitudes toward violence in the general hospital. A comparison between Amsterdam and Tel Aviv.  

PubMed

This study reports the results of a cross-cultural comparative investigation of violent behavior of patients, relatives, and visitors toward the medical staff in two general hospitals. The situation in an Israeli community general hospital in Tel Aviv was compared to that of a Dutch university hospital. General impressions existed that violence appeared to be a serious problem in the hospital in Tel Aviv, whereas there are scarcely any reports of violence in general hospitals in the Netherlands. Semistructured interviews with members of the medical and nursing staff confirmed these impressions. In Israel, the "aggressor" would be described as a young male without any specific traits, whereas in the Netherlands, he would be associated with alcohol abuse, drug addiction, and would possibly belong to street gangs or be a member of a minority group. Circumstances that may lead to violence are mentioned and situational, and social and cultural influences are discussed. PMID:2376325

van Londen, L; Hes, J P; Ameling, E H; Hengeveld, M W

1990-07-01

88

Tumor marker requests in a general teaching Turkish hospital  

Microsoft Academic Search

Serum tumor markers may be requested inappropriately by clinicians. In this retrospective study, we aimed to investigate the\\u000a appropriateness of TM requests in our hospital. Patients in the study were identified from the TM requests for 3 months between\\u000a June–August 2004, using the laboratory database. A total of 2249 patients (1351 men, 898 women) were included in the study\\u000a and

Gülsen Yilmaz; Fatma Meriç Yilmaz; Mehmet Senes; Dogan Yucel

2007-01-01

89

Effective clinical policies in a district general hospital  

Microsoft Academic Search

Effective clinical practice in a hospital needs current knowledge together with the skills and right attitude; these should\\u000a be applied continuously. Failure of this system can be due to ignorance or arrogance. We attempted to correct these deficiencies\\u000a by formulating a set of policies which were enforced from 1962 to 1983. The policies related to the following: intensive care\\u000a (including

Ian Jonathan Gordon; Eric Sherwood Jones

1998-01-01

90

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

Microsoft Academic Search

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

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

2006-01-01

91

Hospital psychiatric units. Nonsmoking policies.  

PubMed

Establishing nonsmoking policies in hospitals--even on acute psychiatric units--requires patience, planning, and a bit of nerve. The benefits of such a move, however, can be significant for patients and staff. When Vancouver General Hospital implemented a complete indoor nonsmoking policy on its psychiatric assessment and inpatient psychiatry units, workplace conditions noticeably improved, and some long-standing beliefs about psychiatric patients were disproved. Several conditions provided the impetus to change to a nonsmoking policy. With a few exceptions (palliative care, the burn unit) the indoor areas were nonsmoking; nevertheless, the hospital environmental committee considered a site-wide (indoor and outdoor) ban on smoking. One reason was that the community funding that had provided psychiatric patients with cigarettes would soon be cut off. Another reason was that all psychiatry units were anticipating moving into the new hospital tower--a facility slated to be smoke-free--on its completion. PMID:8487222

Beemer, B R

1993-04-01

92

The development of an infection control link-nurse programme in a district general hospital  

Microsoft Academic Search

Management of hospital-acquired infection is costly, and a vital part of risk management. It is also closely linked with the quality of patient care. Information regarding hospital-acquired infection is increasingly being sought by both purchasers and providers. This paper describes the setting up and development of an infection control link-nurse system over a fouryear period in a district general hospital.

E. L. Teare; A. Peacock

1996-01-01

93

Tending the Army: Women and the British General Hospital in North America, 1754-1763  

Microsoft Academic Search

This essay argues that the British Army's North American general hospital and an increasingly large and diverse group of army women became not only connected but dependent on one another during the Seven Years' War. This relationship derived from the army's reorganization of its medical services in a way that intentionally predicated the hospital's operation and success on army women

Sarah Fatherly

2012-01-01

94

Comparing the Characteristics of Prison Inmates Who Require Psychiatric Hospitalization with the General Prison Population  

Microsoft Academic Search

This research profiles the 472 patients hospitalized during an an-nual period at Central New York Psychiatric Center, which is the sole provider of hospitalization for any of New York State's 40,000 sentenced inmates who require acute inpatient psychiatric care. Patient characteristics are compared with those of the State's general prison population. Application of this form of analysis may prove useful

Leta D. Smith

1988-01-01

95

Contributions to a panel on issues raised by psychology in the general hospital  

Microsoft Academic Search

The position taken is that psychology suffers an identity problem in general hospital practice. A number of potential solutions are discussed. One is the extraction of the psychotherapy role from both psychiatry and psychology and its reinvestment in a distinct professional group. The effect would be to create a more obvious hiatus between the hospital roles of psychiatry and psychology,

J. J. Sigal

1967-01-01

96

Manual on radiation protection in hospital and general practice. Volume 1. Basic protection requirements  

Microsoft Academic Search

A general review of the radiation protection requirements common to all medical applications of ionizing radiation and radionuclides is presented in the first volume of a three-part series dealing with the radiation protection of patients, occupationally exposed persons, and the public. The series is directed to national authorities, hospital administrators, supervisors, hospital workers, teachers, and others who have responsibility in

C. B. Braestrup; K. J. Vikterlof

1974-01-01

97

Implementation of a Prototype Generalized Network Technology for Hospitals *  

PubMed Central

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

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

1981-01-01

98

Comprehensive Study of the Incentive Award Program at General Leonard Wood Army Community Hospital.  

National Technical Information Service (NTIS)

General Leonard Wood Army Community Hospital's (GLWACH) Partnership Forum, a collection of supervisors, employees, and union representatives, feel the current incentive award program is a major source of worker discontent. Therefore, they commissioned thi...

M. L. Cox

2001-01-01

99

Our Experience with Integrated Patient Care Audit at Kansas City General Hospital and Medical Center.  

National Technical Information Service (NTIS)

The experience of the Kansas City (Mo.) General Hospital and Medical Center in developing and implementing an integrated patient care audit is documented. The prerequisites for successful implementation of an integrated patient care audit are outlined, as...

1974-01-01

100

Bisalbuminemia. A new molecular variant, albumin Vancouver.  

PubMed

Of 18 members of a Fiji Indian family investigated, eight of the 12 males and two of the six females had an electrophoretically slow-type bisalbuminemia (alloalbuminemia). The albumin was characterized by the hiterto unique ratio of the two bands (Al A 35%: variant 65%), and by dye-binding studies and electrophoretic mobility in different media. The data suggest that this is a new variant, which we propose to call albumin Vancouver (Al Va). PMID:709819

Frohlich, J; Kozier, J; Campbell, D J; Curnow, J V; Tárnoky, A L

1978-11-01

101

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.

2011-06-06

102

Lithium treatment: prescribing and monitoring habits in hospital and general practice  

Microsoft Academic Search

OBJECTIVES--To define current clinical practice of lithium prescribing and monitoring and to compare hospital based practice with general practice. DESIGN--Prospective study of doctors' practice. SETTING--Psychiatric hospital day and outpatient facilities and general practices in Edinburgh and Midlothian district (population 600,000). SUBJECTS--458 patients taking lithium who had been stabilised and who remained as outpatients during the year of study. 219 were

R. F. Kehoe; A. J. Mander

1992-01-01

103

A STUDY OF ALCOHOL RELATED PHYSICAL DISEASES IN GENERAL HOSPITAL PATIENTS  

PubMed Central

We studied the prevalence of harmful use of alcohol and alcohol related diseases in newly admitted patients in a general hospital. Two hundred and ninety seven patients were screened for alcohol use with Alcohol Use Disorders Identification Test (AUDIT). Sixty one subjects (21%) had harmful pattern of alcohol consumption. Of these twenty eight patients (9.4%) had alcohol-related diseases, while in 33 patients (11.1%) we did not find any association between alcohol use and hospital diagnoses. Physicians? referral rate for problem drinking was low. The findings indicate the need for an active consultation service to address the specific issue of harmful drinking among patients admitted in general hospitals.

Srinivasan, K.; Augustine, Mary Kutty

2000-01-01

104

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

Microsoft Academic Search

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

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

2010-01-01

105

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

PubMed Central

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.

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

1988-01-01

106

The Quality and Characteristics of Leading General Hospitals’ Websites in China  

Microsoft Academic Search

This paper focuses on the evaluation of quality of hospital websites in China. Leading general hospitals’ websites in China\\u000a are increasingly used by the public, but research on the quality of these websites in China is few and far between. In this\\u000a article, we conducted a cross-sectional descriptive infodemiology study to assess the quality and to describe the characteristics\\u000a of

Xiaolei Liu; Zhen Bao; Haitao Liu; Zhenghong Wang

107

Deliberate Self-Harm Patients Who Discharge Themselves from the General Hospital Without Adequate Psychosocial Assessment  

Microsoft Academic Search

Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more

Rachel Crowder; Rohan Van Der Putt; Ceri-Anne Ashby; Andrew Blewett

2004-01-01

108

General surgery contributes to the financial health of rural hospitals and communities.  

PubMed

Rural hospitals and communities often profit from the ability to provide surgical services. There can also be substantial financial costs for individuals, hospitals, and communities associated with not having access to surgical care in rural areas. Despite these advantages, limitations that include a shortage of rural general surgeons and other surgical staff and financial constraints prevent some rural institutions from offering surgical services. Few concrete data are available on this subject, and more research is needed to confirm anecdotal reports regarding the positive economic impact derived from general surgical services. It is especially important to examine and quantify the direct and indirect financial contribution that a general surgeon makes to a rural hospital and community. PMID:19944821

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

2009-12-01

109

School Choice in the "Stratilingual" City of Vancouver  

ERIC Educational Resources Information Center

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

Yoon, Ee-Seul; Gulson, Kalervo N.

2010-01-01

110

Lithium treatment: prescribing and monitoring habits in hospital and general practice.  

PubMed Central

OBJECTIVES--To define current clinical practice of lithium prescribing and monitoring and to compare hospital based practice with general practice. DESIGN--Prospective study of doctors' practice. SETTING--Psychiatric hospital day and outpatient facilities and general practices in Edinburgh and Midlothian district (population 600,000). SUBJECTS--458 patients taking lithium who had been stabilised and who remained as outpatients during the year of study. 219 were treated by their general practitioner and 190 by the hospital; 49 had shared care or care transferred during the study. MAIN OUTCOME MEASURES--Daily dose, duration of treatment, psychiatric diagnosis, mean annual serum lithium concentration, frequency of occurrence of and response to raised serum concentrations. RESULTS--Compared with hospital doctors general practitioners were more likely to prescribe lithium three or more times daily (43/219 (general practice) v 10/190 (hospital); chi 2 = 18.6, p = 0.001) and to estimate serum concentrations less frequently (4.5 v 5.3 measurements/year; t = 3.04, p = 0.003), and their patients were more likely to experience raised lithium concentrations (39/219 v 17/190; chi 2 = 6.8, p = 0.01). One third of doctors made no response to raised lithium concentrations in the next six weeks. CONCLUSIONS--General practitioners and hospital doctors care for similar types of patients and the stringency of lithium surveillance varies greatly among doctors. Certain aspects of practice give cause for concern and could be improved by following more uniform guidelines.

Kehoe, R. F.; Mander, A. J.

1992-01-01

111

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

SciTech Connect

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.

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

1985-08-01

112

Same Day Surgery at the 121st General Hospital Seoul, South Korea.  

National Technical Information Service (NTIS)

The 121st General Hospital, Seoul, South Korea, is the only Army Medical Treatment Facility for all United States armed forces assigned to the Republic of Korea. The 121st currently lacks a same-day surgery program and likely has never had such a program....

A. R. Mathisen

2006-01-01

113

Factors influencing mortality from infective endocarditis in two district general hospitals  

Microsoft Academic Search

Factors influencing mortality were studied in 92 consecutive cases of infective endocarditis admitted to two district general hospitals between January 1975 and April 1982. Thirty two patients died, an overall mortality of 35%, 13 patients died before diagnosis and 19 despite aggressive antimicrobial therapy. Bactericidal antibiotic levels were monitored in 39 cases but these did not appear to influence outcome.

D. McGivern; P. Ispahani; D. Banks

1987-01-01

114

Treatment of epilepsy in general hospitals: do patients and neurologists agree on success or failure?  

Microsoft Academic Search

Objective: Opinions of patients and neurologists about aspects of their epilepsy and their treatment were compared.Method: Thirty-two neurologists, working in general hospitals, included 198 patients aged 16 years or more. Both neurologist and patient independently completed a questionnaire consisting of simple open questions about the epilepsy and the drug treatment. The average characteristics for this group are very similar to

A. P ALDENKAMP; C VAN DONSELAAR

2003-01-01

115

Associations between malnutrition, poor general health and oral dryness in hospitalized elderly patients  

Microsoft Academic Search

Objective: to obtain information about the possible relationship between symptoms and signs of oral dryness and malnutrition\\/poor general health in hospitalized older people. Design: a cross-sectional clinical investigation with measurements of unstimulated salivary flow rates (USFR), stimulated salivary flow rates (SSFR), nutritional status, serum albumin concentration and an evaluation of symptoms of oral dryness and loss of appetite by a

VALERIE DORMENVAL; EJVIND BUDTZ-JORGENSEN; PHIUPPE MOJON; ANDRE BRUYERE; CHARLES-HENRI RAPIN

116

Use of the Mental Health Act and Mental Capacity Act in the general Hospital  

Microsoft Academic Search

This article highlights the most important principles of the Mental Capacity Act 2005 and some of the amendments to the Mental Health Act 1983 that are relevant to the general hospital setting. The article focuses on how capacity should be assessed and how best interest decisions for someone lacking capacity should be made. It also discusses the role of independent

Afia Ali; Ian Hall

2009-01-01

117

Use of the Mental Health Act and common law in the general hospital  

Microsoft Academic Search

This updates a contribution published in 2003 that aimed to give clinicians a framework for understanding the medico-legal aspects of treatment refusal in general hospital practice with respect to adults in England and Wales. The update discusses recent advice from the Mental Health Act Commission, the NICE guideline on self-harm, the Bournewood ruling by the European Court of Human Rights,

Eleanor Feldman

2006-01-01

118

ORIGINAL ARTICLES Knowledge about the Scottish Mental Health Act in a General Hospital Setting  

Microsoft Academic Search

Background Clinical experience suggests that non-psychiatrists' knowledge of mental health legislation in relation to emergency detention is inadequate. However, most non- psychiatrists will use this legislation at some point in their career. Methodology A questionnaire about emergency detention legislation wascirculatedtonon-psychiatricmedicalstafftotesttheir knowledge of the provisions relevant to the general hospital. Results Two hundred and seventy four medical staff replied (a response

BJ Baig; J Walker; ES Crowe; SM MacHale; H Aditya; SG Potts

2008-01-01

119

Researches regarding the morton ether inhaler at massachusetts general hospital, Boston.  

PubMed

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

Haridas, Rajesh P; Mifflin, Jeffrey A

2013-11-01

120

Managing pain in opioid-dependent patients in general hospital settings.  

PubMed

Opioid-dependent patients have unique pain management and psychosocial needs. Inadequate staff training, the absence of addiction screening and intervention protocols, and stigma related to opioid use can impact outcomes negatively for these patients in general hospital settings. PMID:23469497

Liberto, Lindsay A; Fornili, Katherine S

121

Recent HIV Testing Among General Hospital Inpatients with Schizophrenia: Findings from Four New York City Sites  

Microsoft Academic Search

Background: While widely acknowledged to be an important clinical and public health issue, HIV assessment, counseling, and testing for the seriously mentally ill has not been well studied. Objective: To determine what proportion and which inpatients with schizophrenia have been recently tested for HIV. Method: A sample of 300 inpatients with schizophrenia were recruited from four general hospitals in New

James Walkup; Donna D. McAlpine; Mark Olfson; Carol Boyer; Steve Hansell

2000-01-01

122

Value of routine preoperative tests: a multicentre study in four general hospitals  

Microsoft Academic Search

Summary We have assessed the value of routine preoperative tests in asymptomatic patients and their influence on anaesthetic and surgical decisions. We studied 3131 ASA I and II patients from four general hospitals undergoing elective surgical procedures. A retrospective review of the medical records revealed that 853 (27%) patients had some ab- normal test result, of which 465 (15%) were

A. PEREZ; J. PLANELL; C. BACARDAZ; A. HOUNIE; J. FRANCI; C. BROTONS; L. CONGOST; I. BOLIBAR

1995-01-01

123

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

ERIC Educational Resources Information Center

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

Sugue-Castillo, Mariella

2009-01-01

124

Effectiveness of opportunistic brief interventions for problem drinking in a general hospital setting : systematic review  

Microsoft Academic Search

OBJECTIVE: To determine the effectiveness of opportunistic brief interventions for problem drinking in a general hospital setting. DESIGN: Systematic review. DATA SOURCES: Medline, PsychInfo, Cochrane Library, reference lists from identified studies and review articles, and contact with experts. MAIN OUTCOME MEASURE: Change in alcohol consumption. RESULTS: Eight studies were retrieved. Most had methodological weaknesses. Only one study, with a relatively

Maria J Emmen; Gerard M Schippers; Gijs Bleijenberg; H. C. H. Wollersheim

2004-01-01

125

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

PubMed Central

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

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

2012-01-01

126

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

PubMed

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

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

2004-05-01

127

The Vancouver Obsessional Compulsive Inventory (VOCI).  

PubMed

The original Maudsley Obsessional Compulsive Inventory (MOCI) has been widely used and is considered to be one of the best available self-report instruments for measuring observable obsessive-compulsive problems such as washing and checking. However, it has several limitations and requires updating. Our revision of the MOCI, the Vancouver Obsessional Compulsive Inventory (VOCI), was designed to provide assessment of a range of obsessions, compulsions, avoidance behaviour, and personality characteristics of known or theoretical importance in obsessive-compulsive disorder (OCD). The development of the VOCI is described, and we provide evidence of its reliability and validity. Our findings in samples of people with OCD, people with other anxiety disorders or depression, community adults, and undergraduate students suggest that the VOCI is a promising new measure. We anticipate that, like its predecessor, the VOCI will have widespread use in both research and clinical settings. PMID:15381439

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

2004-11-01

128

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

EPA Science Inventory

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

129

Awareness and utilization of peer support programs in Singapore public general hospitals.  

PubMed

To address the effects of acute, chronic and cumulative stress in the healthcare environment in Singapore, the Ministry of Health provided funding to develop a comprehensive crisis response management system (peer support programs/PSPs) that increases mental health awareness, provides emotional support to affected staff during work-related critical incidents and assists hospital management to better understand the emotional needs of the employees. This paper reports the awareness and utilization of PSPs in Singapore public general hospitals about one year after they were set up. PMID:23894802

Chan, Angelina O M; Kee, Jass P C; Chan, Yiong Huak

2012-01-01

130

An analysis of OSHA inspections assessing contaminant exposures in general medical and surgical hospitals.  

PubMed

This study analyzed data from the Occupational Safety and Health Administration's (OSHA) Chemical Exposure Health Database to assess contaminant exposures in general medical and surgical hospitals. Seventy-five inspections conducted in these hospitals from 2005 through 2009 were identified. Five categories of inspections were conducted, the three most common being complaint-based, planned, and referral-based inspections. Complaint-based inspections comprised the majority of inspections-55 (73%) of the 75 conducted. The overall violation rate for all inspection types was 68%. This finding was compared to the violation rates of planned inspections (100%), referral-based inspections (83%), and complaint-based inspections (62%). Asbestos was the hazardous substance most commonly sampled and cited by OSHA in hospitals, with 127 samples collected during 24 inspections; 31% of the total 75 inspections resulting in one or more violations were due to asbestos. PMID:23521143

Knight, Jordan L; Sleeth, Darrah K; Larson, Rodney R; Pahler, Leon F

2013-03-25

131

[The activity of psychiatric consultancy within a general hospital. The relationship and institutional implications].  

PubMed

The consultancy activity performed by Biella Ward of the local general hospital in 1979-1987 is described. After presenting data regarding the quantity and nature of consultancy requests, the medico-hospital cultural background relating to mental suffering is analysed. The hospital often tends to address only the patient's bidimensional aspects, excluding his internal being. Because of a mutual, tacit contact between physician and patient, the moment of admission is seen as a "somatic repair service". The psychological crisis usually arises in the form of the breakdown of the contract when the possible uncertainty of diagnosis and the prolongation of clinical examination affects the personality. In the specific case of Biella Psychiatry, the forced closure of the Psychiatric Diagnosis and Care Service about six years ago helped push the Psychiatrist towards a "liaison" role. PMID:2325864

Merra, S; Bosusco, G; Campisi, P; Lomonaco, E; Gioeli, A

1990-03-01

132

[Analysis of a complex health division at the Modena General Hospital by means of DRG indicators].  

PubMed

The authors have assessed the activity of a complex division (three wards) at the Modena General Hospital. The parameters used were DRG indicators: Case-Mix Index; Performance Index and Resources Index. It is a in-house hospital analysis, since the benchmark is based on the three units average figures. The analysis covers 1479 patients hospitalized during the first 6 months of the year 2000. The authors have taken into account overall DGRs, surgical DGRs and recurrent DGRs. Making allowance for the limits of such comparison, the study shows some differences as regards efficiency and cost-curbing policies, with the surgical unit having the largest and most diversified number of cases. PMID:14981549

Vecchi, Elena; Righi, Elena; Cavazzuti, Lucia; Bicocchi, Marco; Aggazzotti, Gabriella

133

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

PubMed Central

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

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

1985-01-01

134

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

Microsoft Academic Search

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

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

2001-01-01

135

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

PubMed Central

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

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

1999-01-01

136

A Retrospective Study of Malaria Infections in an Intensive Care Unit of a General Hospital in Malaysia  

Microsoft Academic Search

Aims: To study the clinical and demographic aspects as well as the outcomes of severe cases of malaria infections managed in the intensive care unit of the Sarawak General Hospital, Kuching from January 1996 to December 2001. Methods: All cases of malaria admitted to the intensive care unit of the Sarawak General Hospital from January 1996 to December 2001 were

K H Koh; P H Chew; A Kiyu

137

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

Microsoft Academic Search

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

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

2007-01-01

138

Substance Use Disorders Among Inpatients with Bipolar Disorder and Major Depressive Disorder in a General Hospital  

Microsoft Academic Search

The prevalence and type of substance abuse and dependence were determined for 49 patients with mood disorders on a general hospital psychiatric unit. A standardized diagnostic interview was conducted with a high value of interrater reliability. This study found that 18.4% of mood disorder inpatients met the diagnostic criteria for psychoactive substance use disorders by DSM-III-R. Sedatives-hypnotics-anxiolytics was the most

Chao-Cheng Lin; Ya-Mei Bai; Pei-Gi Hu; Hong-Shiow Yeh

1998-01-01

139

Antibacterial Resistance and Molecular Typing of Methicillin-Resistant Staphylococcus aureus in a Kuwaiti General Hospital  

Microsoft Academic Search

Objective: To investigate antibiotic resistance and genetic relatedness of methicillin-resistant Staphylococcus aureus (MRSA) isolated in a general hospital in Kuwait over a period from 1996 to 1998 and 2001. Material and Methods: The isolates were characterized by antibacterial susceptibility testing, coagulase serotyping, coagulase gene polymorphism (coag-RFLP) and pulsed-field gel electrophoresis (PFGE). Results: The MRSA isolates were highly resistant to gentamicin,

E. E. Udo; N. Al-Sweih; S. Mohanakrishnan; P. W. J. West

2006-01-01

140

The psychiatric inpatient treatment of children and youth in general hospitals  

Microsoft Academic Search

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) irk short-term, non-Federal general hospitals in 1980. Nationally, 128,300 children were treated for

Charles A. Kiesler; Celeste Simpkins; Teru Morton

1989-01-01

141

Air Pollution and Emergency Department Visits for Suicide Attempts in Vancouver, Canada  

PubMed Central

Background: Comorbidity of depression, heart disease, and migraine has been observed in clinical practice, while ambient air pollution has been identified among different risk factors for these health conditions. Suicide attempts and ideations as the result of depression may be linked to air pollution exposure. Therefore the effects of ambient air pollution on emergency department (ED) visits for suicide attempts were investigated. Methods: Emergency visit data were collected in a hospital in Vancouver, Canada. The generalized linear mixed models technique was applied in the analysis of these data. A natural hierarchical structure of the data was used to define the clusters, with days nested in a 3-level structure (day of week, month, year). Poisson models were fitted to the clustered counts of ED visits with a single air pollutant, temperature and relative humidity. In addition, the case-crossover methodology was used with the same data for comparison. The analysis was performed by gender (all, males, females) and month (all: January–December, warm: April–September, cold: October–March). Results: Both hierarchical and case-crossover methods confirmed positive and statistically significant associations among carbon monoxide (CO), nitrogen dioxide (NO2), sulphur dioxide (SO2), and particulate matter (PM10) for all suicide attempts in the cold period. The largest increase was observed for males in the cold period for a 1-day lagged exposure to NO2, with an excess risk of 23.9% (95% CI: 7.8, 42.4) and odds ratio of 1.21 (95% CI: 1.03, 1.41). In warm months the associations were not statistically significant, and the highest positive value was obtained for ozone lagged by 1 day. Conclusion: The results indicate a potential association between air pollution and emergency department visits for suicide attempts.

Szyszkowicz, Mieczyslaw; Willey, Jeff B.; Grafstein, Eric; Rowe, Brian H.; Colman, Ian

2010-01-01

142

Cost control of out-of-hours laboratory services in district general hospitals.  

PubMed Central

AIMS--To survey methods for cost control of out-of-hours laboratory services in district general hospitals in England and Wales. METHODS--A questionnaire was distributed to 66 district general hospital laboratories in England and Wales. RESULTS--The response rate was 61%. Most laboratories for which budgetary information was provided had on-call costs ranging between 10-21% of staff costs. Ninety five per cent of respondents had attempted to reduce workload by the use of various strategies. Seventy two per cent of responding laboratories had negotiated a wide variety of on-call agreements outside Whitley Council arrangements. Seventy two per cent were not satisfied with their on-call arrangements, the main desired objective being the introduction of the extended working day. CONCLUSIONS--From this study it seems that Whitley Council agreements for out-of-hours work are no longer appropriate for the average district general hospital laboratory. Workload reduction strategies should include the use of a limited list, audit of the use of the on-call service, and continued education of medical staff. Consideration may also be given to the introduction of fixed payments, extension of the working day, increased multidisciplinary on-call and increased bedside testing.

Allen, K D

1994-01-01

143

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

PubMed Central

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

2012-01-01

144

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

PubMed Central

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

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

2005-01-01

145

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

PubMed Central

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

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

2012-01-01

146

Low frequency earthquakes below southern Vancouver Island  

NASA Astrophysics Data System (ADS)

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

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

2012-11-01

147

Increasing hospitalizations and general practice prescriptions for community-onset staphylococcal disease, England.  

PubMed

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

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

2008-05-01

148

Barriers to the Operation of Patient Safety Incident Reporting Systems in Korean General Hospitals  

PubMed Central

Objectives This study aimed to explore the barriers to and factors facilitating the operation of patient safety incident reporting systems. Methods A qualitative study that used a methodological triangulation method was conducted. Participants were those who were involved in or responsible for managing incident reporting at hospitals, and they were recruited via a snowballing sampling method. Data were collected via interviews or emails from 42 nurses at 42 general hospitals. A qualitative content analysis was performed to derive the major themes related to barriers to and factors facilitating incident reporting. Results Participants suggested 96 barriers to incident reporting in their hospitals at the organizational and individual levels. Low reporting rates, especially for near misses, were the most commonly reported issue, followed by poorly designed incident reporting systems and a lack of adequate patient safety leadership by mid-level managers. To resolve and overcome these barriers, 104 recommendations were suggested. The high-priority recommendations included introducing reward systems; improving incident reporting systems, by for instance implementing a variety of reporting channels and ensuring reporter anonymity; and creating a strong safety culture. Conclusions The barriers to and factors facilitating incident reporting include various organizational and individual factors. As an important way to address these challenging issues and to improve the incident reporting systems in hospitals, we suggest several feasible methods of doing so.

Hwang, Jee-In; Lee, Sang-IL

2012-01-01

149

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

PubMed Central

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

2012-01-01

150

Use of a General Level Framework to Facilitate Performance Improvement in Hospital Pharmacists in Singapore  

PubMed Central

Objective. To evaluate the acceptability and validity of an adapted version of the General Level Framework (GLF) as a tool to facilitate and evaluate performance development in general pharmacist practitioners (those with less than 3 years of experience) in a Singapore hospital. Method. Observational evaluations during daily clinical activities were prospectively recorded for 35 pharmacists using the GLF at 2 time points over an average of 9 months. Feedback was provided to the pharmacists and then individualized learning plans were formulated. Results. Pharmacists’ mean competency cluster scores improved in all 3 clusters, and significant improvement was seen in all but 8 of the 63 behavioral descriptors (p ? 0.05). Nonsignificant improvements were attributed to the highest level of performance having been attained upon initial evaluation. Feedback indicated that the GLF process was a positive experience, prompting reflection on practice and culminating in needs-based learning and ultimately improved patient care. Conclusions. The General Level Framework was an acceptable tool for the facilitation and evaluation of performance development in general pharmacist practitioners in a Singapore hospital.

Wong, Camilla; Coombes, Ian; Cardiff, Lynda; Duggan, Catherine; Yee, Mei-Ling; Wee Lim, Kiat; Bates, Ian

2012-01-01

151

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

PubMed Central

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

Binks, Katherine; Dunkley, Mia; Coates, Christopher

2008-01-01

152

Students' Corner Sleep Deprivation and its associated factors among general ward patients at a Tertiary Care Hospital in Pakistan  

Microsoft Academic Search

Objective: To estimate the occurrence rate of sleep deprivation and to identify the environmental, staff-related and patient-related factors associated with SD among general ward patients of a tertiary care hospital in Pakistan. Methods: In a cross-sectional study, a pre-tested questionnaire was administered to 108 patients admitted into the general medical and general surgical wards of Aga Khan University Hospital, Karachi.

Majid Shafiq; Farah F. Salahuddin; Maham Siddiqi; Zaman Shah; Rehmat Ali; Rizwan A. Siwani; Ayesha Saleem; Kashif Shakoor Shaikh; Ali Khan Khuwaja

153

General hospital resources consumed by an elderly population awaiting long-term care.  

PubMed

The provision of extended care facilities in urban Ireland has lagged behind the growth in the numbers of older people. A final pathway for placement is often through the general hospital and the attendant delay results in a diversion of resources. We developed a database of the long-term care waiting lists for the years 1994-present and this was analysed for the six years 1994-1999. We calculated the number of bed-days consumed by elderly patients awaiting placement in long-term care facilities and thus the hospital resources consumed during these periods. The total number of bed-days consumed over the study period was 51,923, the mean being 8653.8 days. Approximately 23.9% of patients die in hospital while awaiting long-term placement. Translating these bed-days into opportunity cost losses in areas relevant to the general hospital we found that 560 extra elective orthopaedic procedures and 1,212 extra transurethral prostatectomies could have been performed per year. The problem of overnight stays in casualty could have been totally abolished if only 65% of these beds were free. Elective theatre is often cancelled with one of the primary reasons being lack of beds. If even a proportion of these beds could be freed up few if any theatre sessions would have to be cancelled, assuming bed availability to be the only factor. This study confirms that the lack of appropriate accommodation for older people requiring extended care is consuming a significant proportion of health care resources. An accelerated program of building of publicly funded long-term placement facilities is urgently required to ameliorate this problem, especially in the greater Dublin area. Further study is required to determine whether this problem exists in other health board areas and if so whether it exists to the same extent. PMID:11693210

Coughlan, T; O'Neill, D

154

A STUDY OF EMERGENCY PSYCHIATRIC REFERRALS IN A TEACHING GENERAL HOSPITAL1  

PubMed Central

SUMMARY The socio-demographic and clinical characteristics of one hundred consecutive referrals from emergency O.P.D. of a teaching general hospital were studied. The referral rate was 5.4%. The source, reason and purpose of the referrals were studied. Half of the patients had presented with somatic symptoms. Altered sensorium, suicidal attempt and excitements together constituted one third of all emergency referrals. The diagnosis of neurosis was given in half of the patients and one third of all patients were labelled as suffering from hysterical neurosis. The nature of the presenting complaints and psychiatric diagnoses were comparable to that of the other studies.

Kelkar, D.K.; Chaturvedi, S.K.; Malhotra, S.

1982-01-01

155

Introducing an annualised contract for a consultant team in a district general hospital.  

PubMed

The majority of physicians work a weekly timetable consisting of programmed activities (PAs) defined by the consultant contract. This paper describes the implementation of an annualised contract within a gastroenterology department, which is located across two district general hospital sites within the same trust. The perceived benefits of the system include the introduction of a new out-of-hours emergency endoscopy service, more efficient backfilling of vacant endoscopy lists and greater transparency of work patterns and workload between colleagues and within the trust. PMID:23760692

Ayres, Lachlan; Hughes, Rebecca; Brooklyn, Trevor; Shaw, Ian; Valori, Roland

2013-06-01

156

Road traffic accidents before and after seatbelt legislation--study in a district general hospital.  

PubMed Central

Injuries among samples of car accident cases attending the Accident & Emergency (A & E) department of a District General Hospital (DGH) in the year before and after the introduction of seat belt legislation were classified applying the Abbreviated Injury Scale using information recorded in the patient case notes. Those who died or did not attend an A & E department were not included in the sampling frame. The number of those who escaped injury increased by 40% and those with mild and moderate injuries decreased by 35% after seatbelt legislation. There was a significant reduction in soft tissue injuries to the head. Only whiplash injuries to the neck showed a significant increase.

Thomas, J

1990-01-01

157

A prospective study of patients absconding from a general hospital psychiatry unit in a developing country.  

PubMed

Characteristics of patients absconding from an open psychiatry ward in a developing country may be different from both those in developed countries and a mental hospital setting. The aim of this paper is to study the incidence and characteristics of patients absconding from an open psychiatric ward in a general hospital-based psychiatric unit in India. We studied patients consecutively admitted to an open psychiatric ward over a 2-month period. We compared those who absconded with those who did not. Out of 231 patients admitted, 33 absconded. Among those who absconded, 15 had bipolar disorder, 11 had schizophrenia and five had substance-related disorders. Nine had indicated their intention to do so at admission. Ten patients had absconded by the second day. The treatment cost was the likely influencing factor for seven patients who absconded after deemed fit for discharge on clinical grounds. Only 10 patients were readmitted to the hospital within 2 weeks of absconding. The risk of absconding is highest in the early days following. Absconding patients did not differ significantly from others in many socio-demographic and clinical features. Treatment costs are an important consideration in India. PMID:18638205

Khisty, N; Raval, N; Dhadphale, M; Kale, K; Javadekar, A

2008-08-01

158

Nosocomial infections in the general pediatric wards of a hospital in Turkey.  

PubMed

The aims of this study were to determine the prevalence, type, and clinical features of nosocomial infections (NIs), their etiological distribution, and the antibiotic resistance patterns of causative organisms in the general pediatric wards of a hospital in Turkey over a 3-year period. The Hospital Infection Control Committee NI surveillance reports were used as a database. NIs were detected in 171 (2.25%) of the 7,594 hospitalized patients. Some of these patients experienced more than 1 episode, and thus, the total NI episodes were 229. Patients' age varied from 1 to 144 months (mean ± standard deviation, 14.5 ± 23.6 months). The NI rate was 3.02%, and the NI density was 3.17/1,000 patient days. The most frequent NIs were lower respiratory system infections, blood stream infections, and urinary tract infections. Gram-negative organisms were the most frequently isolated agents. Of the 171 patients with NIs, 47 (27.5%) died. PMID:22814155

Balaban, Ismail; Tan?r, Gönül; Metin Timur, Ozge; Oz, Fatma Nur; Ayd?n Teke, Türkan; Bayhan, Gülsüm Iclal; Sözak, Nejla; Göl, Ne?e

2012-07-01

159

Ben Taub General Hospital & LifeGift: Strengthening a Partnership to Save Lives and Improve Healthcare Delivery.  

National Technical Information Service (NTIS)

Ben Taub General Hospital, working closely with LifeGift, consistently ranks at or near the top of the list of hospitals in the United States that receive informed consent for organ donation from patients' families. Presently, organs are procured from the...

D. G. Philpot

2007-01-01

160

Prevalence of Current DSM-IV Alcohol Use Disorders in Short-Stay, General Hospital Admissions, United States, 1994  

Microsoft Academic Search

Background: This study provides, to our knowledge, thefirstnationalprevalenceestimatesofDiagnosticandSta- tistical Manual of Mental Disorders, Fourth Edition (DSM- IV), alcohol use disorders based on a structured, diagnos- tic instrument for inpatient admissions to US general hospitals. Existing prevalence estimates for inpatient ad- missions came from studies conducted in 1 or 2 hospitals and therefore do not support national inference. Methods: A multistage

Barbara A. Smothers; Harold T. Yahr; Michael D. Sinclair

2003-01-01

161

The influence of the opinion of an infectious disease consultant on the appropriateness of antibiotic treatment in a general hospital  

Microsoft Academic Search

The antibiotics chosen in hospitals are not always the most appropriate. A comparative prospective study with sequential analysis was designed to assess how the opinion of an infectious disease consultant affected the clinical efficacy of antimicrobial treatment in a general hospital. We studied 250 patients who had microbiologically documented infections according to Center for Disease Control criteria. The patients were

J. Gomez; S. J. Conde Cavero; J. L. Hernandez Cardona; M. L. Nunez; M. Cantera; M. Vales

162

Analysis of the Effectiveness of the Retail Pharmacy Utilization Intervention at General Leonard Wood Army Community Hospital.  

National Technical Information Service (NTIS)

In September 2008, the General Leonard Wood Army Community Hospital (GLWACH) Pharmacy Department executed an initiative to reduce the utilization of retail pharmacy services. This initiative was implemented due to the increase in retail prescription drug ...

S. A. Moore-Velbis

2009-01-01

163

Health Hazard Evaluation Report No. HHE-80-98-790, San Francisco General Hospital, San Francisco, California.  

National Technical Information Service (NTIS)

Worker exposures to dimethyl-sulfoxide (67685) (DMSO) were evaluated at San Francisco General Hospital (SIC-8060) in San Francisco, California on April 30, 1980. The evaluation was requested by an unspecified individual on behalf of approximately 36 affec...

M. Coye P. L. Belanger

1981-01-01

164

Measuring outcomes in acute neurorehabilitation in General Hospital setting - our experience.  

PubMed

In General Hospital setting, where varieties of patients are included in neurorehabilitation process, set of multidisciplinary functional tests were established, as a routine in daily work. Tests were done by physiotherapists and occupational therapists who were members of rehabilitation team. Our aim was to select the tests which can be used as a routine and are applicable for different neurological impairments in daily work. Tests were applied to inpatients admitted to the Medical, Trauma, Neurology and Neurosurgery wards in the Rashid Hospital, DOHMS, Dubai. Fifty inpatients with different neurological impairments admitted to totally 8 wards, were tested in the beginning of rehabilitation process and on discharge from the hospital. Nine tests were used as standardized tests for measuring motor, cognitive, focal impairment, ADL activities and disability: Motricity Index, Trunk Control Test, Standing Balance score, Functional Ambulation Categories test, Mini Mental State Examination, Canadian Neurological Scale, Action Research Arm test, Bartel Index and Functional Independent Measurements. FIM, Motricity Index and Trunk Control Test were applicable for all tested patients, with required adaptation for different neurological conditions within the same score. Other tests were not applicable for all patients as routine, but there were very useful for certain number of patients as a measurement of functional improvement. It is very important to have proper setup of tests, which are simple, reliable and valid for measuring impairment, disability and handicap and which can be used as standardized part of assessment protocol. Also, they must be applicable for different neurological impairments to monitor treatment progress. Combination of tests performed by different professionals and comprehensive approach of all team members is very important for measuring outcomes in rehabilitation and evaluating patient's impairment and disability. Proper hospital setup, optimal number of staff, good communication and team work are leading to better outcome in neurorehabilitation process. PMID:16995851

Muji?-Skiki?, Emela; Trebinjac, Suad; Avdi?, Dijana; Dzumhur-Sari?, Amra

2006-08-01

165

Developing an endoscopic mucosal resection service in a district general hospital  

PubMed Central

Objective To describe the implementation of a formal single-operator led endoscopic mucosal resection (EMR) service in a district general hospital, and the effect on patient outcome of this service development. Design Prospective audit during initiation and subsequent development of EMR service. Setting District general hospital. Patients All patients referred to EMR service between 1 January 2008 and 31 December 2011. Interventions Nil in addition to clinical care. Main outcomes measured The number of EMRs per year including polyp size and histology, recurrence of polyp tissue at 3?months following EMR, and complications including early/delayed bleeding and perforation. Results Following service implementation, the number of EMRs rose from 11 in 2008 to 35 in 2011, with the number of large polyps (>30?mm) rising from four in 2008 to 24 in 2011. Recurrent or residual adenomatous tissue fell from 75% in 2008 to 4.76% in 2011. Only one perforation occurred over the 4?years (0.8% perforation rate: 1 in 120 polypectomies). A reduction in surgical intervention for adenomatous polyp removal was observed during the audit period. Conclusions Professional engagement and support by medical, surgical and nursing members of the endoscopy team promoted development of skill and confidence in EMR. Exposure to higher volumes of EMR procedures allowed successful removal of larger lesions, while maintained patient safety and reduced the need for surgical removal of benign polyps.

Lamb, Chris A; Barbour, Jamie A

2012-01-01

166

[General practice consultation in a hospital emergency department. History, evaluation and prospects].  

PubMed

INSTALLATION OF A GENERAL MEDICINE CONSULTATION: In 1995, in reaction to an increase of more than 35% over three years, related essentially to out-patient consultations, the installation of a general medicine consultation (GMC) near the emergency unit reception area (EUR) was envisaged. The project, developed over 5 years and based on an epidemiological study, was finally set-up in January 2000. The aims of the GMC are to supply information to the patients, help them in their administrative rights, and their subsequent follow-up by an external physician; the benefits expected by the EUR is the re-concentration on heavier and more urgent pathologies. THE FUNCTION OF THE GMC: Exclusively reserved for CCMU 1 patients (level 1 of the clinical classification of emergency unit patients), the GMC relies on general practice, with the presence of general practitioners installed in the SAU (emergency unit) sector, a double admission method (either via the emergency unit, or directly), a means of payment for the consultation and the absence of priority access to the technical network of the hospital. A social services worker is present. RECRUITMENT: After 18 months of activity, the GMC had managed more than 4500 patients and the method of referral via the SAU, almost exclusive at the beginning, has been reduced to a minority. The patients are generally young; socially close to the underprivileged population surrounding the SAU, but not in a situation of precariousness. The four principle motives for consultation are benign traumas, ENT infections, dermatological affections and pain. A DYNAMIC STRUCTURE: The rapid progress in the context of general medicine, and the observations of the physicians and non-physicians participating in this experience, has progressively modified the aim and mission of this GMC, which is gradually becoming a real structure of permanent care. Its originality is its close link between the town and the hospital, whilst permitting the various actors to remain free and independent. The traditional system of permanent care is no longer adapted to our society, and we must rapidly find solutions. The vocation of the GMC is not to become a universal model, but this new experience opens new horizons for the future. PMID:12448329

Lafay, Vincent; Giraud, Christiane; Bel, Corinne; Giovannetti, Olivier

2002-10-26

167

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

SciTech Connect

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

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

2012-07-15

168

[Liaison child psychiatry and the interpersonal relationships in the context of the general child hospital].  

PubMed

The staff of a big general hospital is a community of people with all the alliances and conflicts developing within it. The child psychiatrist works primarily with the pediatricians and the nurses but also with other specialized people of this community. Pediatricians require a prompt answer to their call, clarity of communication and effectiveness. Child psychiatrists complain among other things that they are often invited a little before the discharge of the child, that their instructions are frequently not followed and that they are not informed about the discharge of the patient so to make adequate planning. At the hospital prejudices may exist about child psychiatry which have to be overcome by the specialist. Meetings between child psychiatrists and pediatricians regarding their common patients are helpful in the development of alliances as well as for the appreciation of the knowledge and the understanding of patients which a child psychiatrist can communicated. Teaching pediatric residents knowledge regarding child development elements of psychopathology and of the function of families helps them to become acquainted with child psychiatry. The same possibility is offered through the daily clinical work of a child psychiatrist. Contact with the nursing staff is necessary in order to improve patient care and staff cooperation. Relationships developed in the context of consultation liaison child psychiatry are frequently modified and under review but can also help to the establishment of respect for the work offered by a child psychiatrist. PMID:22466522

Liakopoulou, M

2007-04-01

169

FOLFIRINOX in locally advanced pancreatic cancer: the Massachusetts General Hospital Cancer Center experience.  

PubMed

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

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

2013-05-08

170

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

PubMed Central

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

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

2000-01-01

171

Biomedical waste generation in Puducherry Government General Hospital and its management implications.  

PubMed

In India, not much attention has been paid to the management of biomedical waste (BMW). The present paper describes the collection and disposal of BMW in the Government General Hospital (GH) of Puducherry, India. The authors document (a) the lack of segregation between infections and noninfectious BMW as well as a failure to implement the prescribed rules for proper management of BMW; (b) improper treatment and transportation and the final disposal of BMW along with municipal garbage; and (c) an inadequate training of personnel, insufficient personal protective equipment, and a lack of knowledge regarding the proper use of such equipment. The authors recommend the establishment of standards and periodic monitoring along with effective training of personnel. PMID:19452838

Boss, U Jagadeesh Chandira; Moli, G Poyya; Roy, Goutam; Prasad, K V Devi

2009-05-01

172

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

PubMed Central

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

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

2013-01-01

173

The use of cross-sectional echocardiography in a general hospital.  

PubMed Central

Three hundred and five patients routinely referred to a general hospital were surveyed to assess the advantages of cross-sectional echocardiography (CSE) over the conventional M mode method. CSE provided a dynamic display of the movement of the heart, particularly left ventricular function, and facilitated the location of cardiac structures. It was valuable in assessing the degree of mitral stenosis and the type of left ventricular outflow obstruction. Mitral valve prolapse, pericardial effusion, intracardiac tumours and congential heart disease were more easily diagnosed than by M mode techniques, but the origin of the basal systolic murmur still remained a problem. It was concluded that the 2 systems were complementary, and that CSE provided important additional information which improved the diagnostic capability of echocardiography. Images Fig. 1 Fig. 2 Fig. 3

Brown, A. K.; Anderson, V.

1980-01-01

174

Mini schools: the new global city communities of Vancouver  

Microsoft Academic Search

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 schools – small and selective public schools within larger urban public secondary schools

Ee-Seul Yoon

2011-01-01

175

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

ERIC Educational Resources Information Center

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

Yoon, Ee-Seul

2011-01-01

176

WILDLIFE CONTROL AT VANCOUVER INTERNATIONAL AIRPORT: INTRODUCING BORDER COLLIES  

Microsoft Academic Search

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

Dave Ball

2000-01-01

177

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

ERIC Educational Resources Information Center

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

Gilsdorf, Rie Algeo

2004-01-01

178

Improving surgical access: the Vancouver experience  

PubMed Central

The University of British Columbia Hospital program was designed to augment existing provincial capacity for hip and knee replacement. The patient–surgeon relationship was maintained throughout the entire care pathway and “ring-fenced” capacity (i.e., designated hospital ward bed and operating room capacity that is geographically remote from the emergency intake of patients) minimized the risk of cancellations. Analysis of the results revealed a mean patient satisfaction score of 4.7 out of 5, a complication rate of 4.4%, a mean operating room time of 1 hour and 45 minutes and a mean postoperative length of stay in hospital of 3.4 days. More than 1600 joint replacements — an additional 16% provincial capacity — were performed within budget during each of the first 2 years of operation. A high standard of care was maintained, with high rates of patient satisfaction and a low complication rate.

Williams, Daniel H.; Iker, Carolyn; Leith, Laurie; Masri, Bassam A.

2011-01-01

179

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

PubMed

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. PMID:22365264

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

2012-02-24

180

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

ERIC Educational Resources Information Center

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

Kronenberg, J.; And Others

1994-01-01

181

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

ERIC Educational Resources Information Center

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

Kronenberg, J.; And Others

1994-01-01

182

Nonformulary drug requests at an academic hospital in Germany – the role of general practitioners' long-term medication  

Microsoft Academic Search

Objective: To determine the influence of general practitioners' outpatient medication on nonformulary drug requests in university hospitals.\\u000a \\u000a \\u000a \\u000a Methods: During a period of 1 year every nonformulary drug request at the Göttingen University Hospital was analysed (reason for request,\\u000a drug class). A second analysis examined whether the introduction of a new order form that allowed the prescribing physician\\u000a to mark a

W. Himmel; B. Lönker; M. M. Kochen

1998-01-01

183

Medical Psychology Services in Dutch General Hospitals: State of the Art Developments and Recommendations for the Future  

Microsoft Academic Search

In this article an overview is presented of the emergence of medical psychology in the care of somatically ill patients. The\\u000a situation in the Netherlands can be considered as prototypical. For 60 years, clinical psychologists have been working in\\u000a general, teaching and academic hospitals. Nowadays, they are an integrated non-medical specialism working in the medical setting\\u000a of hospitals in the Netherlands,

P. H. G. M. Soons; Johan Denollet

2009-01-01

184

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

National Technical Information Service (NTIS)

Papers on library services to hospital personnel, hospital patients, and housebound or handicapped persons, which were presented at the 1983 International Federation of Library Associations (IFLA) conference, include: (1) 'Education and Training for Healt...

1983-01-01

185

Etiology and Antibiotic Susceptibility Patterns of Community and Hospital-Acquired Urinary Tract Infections in a General Hospital in Kuwait  

Microsoft Academic Search

Objective: Our purpose was to determine the bacterial profile and prevalence of antibiotic resistance patterns of uropathogens, as well as evaluate the problem with extended-spectrum ?-lactamase (ESBL) producing isolates, causing urinary tract infections (UTIs) in Al-Amiri Hospital, Kuwait, over a 3-year period. Materials and Methods: Isolates (56,505) from symptomatic UTI cases from January 2005 to December 2007 were identified by

Khalifa Al Benwan; Noura Al Sweih; Vincent O. Rotimi

2010-01-01

186

The incidence of stroke at Department of Neurology, Dubrovnik General Hospital in 2008.  

PubMed

Data on all patients admitted in 2008 to the Department of Neurology, Dubrovnik General Hospital, were retrospectively analyzed. In a total of 663 patients, there were 247 (37.25%) stroke patients. Ischemic stroke was diagnosed in 217 (87.85%) and hemorrhagic stroke in 30 (12.15%) patients. In the cohort of stroke patients, there were 136 (55.00%) women and 111 (45.00%) men. The group of patients with ischemic stroke consisted of 124 (57.15%) women and 93 (42.85%) men, and the group of those with hemorrhagic stroke of 12 (40%) women and 18 (60%) men. The majority of patients with ischemic stroke (89.86%) and hemorrhagic stroke (76.66%) were over 60 years of age. Only 9 (4.14%) patients with ischemic stroke and 5 (16.66%) patients with hemorrhagic stroke were employed. The mortality rate was 20.24% in the overall stroke group and 19.35% in the ischemic stroke group. In the group of patients with hemorrhagic stroke, 26.66% of patients died at our Department, however, additional 20% of patients with this type of stroke were transferred to the Hospital Intensive Care Unit or to Departments of Neurosurgery in Split and Zagreb, so precise data on the disease outcome in these patients were missing. Eighteen (7.29%) patients were from other countries, mostly from Bosnia and Herzegovina. The majority of them had ischemic stroke (83.33%) and 12 (66.66%) patients were over 60 years of age. PMID:22649881

Ivankovi?, Mira; Drobac, Marina; Gverovi?-Antunica, Antonela; Demarin, Vida

2011-12-01

187

Ultrasound-guided liver resection: Early experience in a district general hospital  

PubMed Central

Introduction Intraoperative ultrasonography (IOUS) is the gold standard for tumor staging and operative decision making in liver surgery. Providing dynamic information on tumor–vessel relationships and distribution of intrahepatic veins, IOUS is also an important support for guiding the resection. Few authors report an extensive use of IOUS-guidance as a safe and effective approach. The aim of this study is to investigate the short-term results of an early experience of ultrasound (US) guided liver resection. Methods From December 2005 to December 2007 an extensive use of IOUS-guided resection was applied in 11 consecutive patients (8 males and 3 females; median age 74 years). Perioperative data were collected prospectively to assess the influence of this approach on mortality, morbidity and early recurrence. Results Four patients had hepatocellular carcinoma, 4 liver metastases, 1 peripheral cholangiocarcinoma, 1 hemangioma and 1 inflammatory pseudotumor. A median of 1 (range: 1–4) nodule per patient was resected. Median lesion size was 44 mm. Liver procedures included: 3 wedge resections, 3 subsegmentectomies, 4 segmentectomies and 3 bisegmentectomies. Median blood loss was 235 ml. Median surgical margin in cancer patients was 5 mm (range: 1–12). An average of 1 unit of blood transfusion was administered in 5 patients. Median postoperative hospital stay was 9 days. There was no mortality. Major complications occurred in 1 patient and minor complications in 5 patients. During a median follow-up of 14 months no recurrences were observed. Conclusions In this study, use of IOUS-guided liver resection performed in a district general hospital proved to be a safe and effective approach in terms of short-term outcome.

Grondona, P.; Meola, C.; Floris, F.; Masini, R.; Brignole, E.; Quidaciolu, F.

2008-01-01

188

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

PubMed Central

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

2010-01-01

189

Postpartum prevention of pertussis in a French maternity hospital: Impact on general practitioners.  

PubMed

A protocol which combined giving parents' information and issuing them with a pertussis vaccine prescription was introduced in 2008 in the maternity ward of the Angers University Hospital, France. As a result, a vaccine coverage rate of 69% among mothers and 63% among fathers was achieved. The aim of this study was to assess the impact of this protocol on general practitioners in the county for which Angers is the main specialist maternity unit, in terms of their opinions on it and any changes they made to their practices. An anonymous, descriptive survey was carried out in 2009, via a questionnaire sent out to the 655 general practitioners (GPs). The response rate among the GPs was 77% (508/655). Of the respondents, 97.8% (497/508) were familiar with the vaccination recommendations and of these, 30.4% (150/495; missing data n=2) knew of them through the information letter given out by the maternity unit and 97.6% (482/494; missing data n=3) stated that they had informed their patients of them. Of the GPs who replied, 97.5% (476/488; missing data n=9) approved of the strategy, while 60.4% of them (285/472; missing data n=4) said they had changed their information practices since 2008 and 67.2% (307/457; missing data n=19) said they had changed their vaccination practices over the same period. Most of the GPs (53% (241/454); missing data n=43) approved of the maternity unit giving parents the vaccine. The pertussis prevention protocol introduced by the maternity unit was clearly understood by the general practitioners and led them to significantly change their information and vaccination practices. PMID:23973244

Leboucher, Bertrand; Abbou, Fatma; Gascoin, Géraldine; Cipierre, Cécile; Descamps, Philippe; Sentilhes, Loïc

2013-08-22

190

Epidemiology and surgical management of breast cancer in gynecological department of Douala General Hospital  

PubMed Central

Introduction Breast cancer is one of the most common gynecological cancers in our environment. Douala General Hospital (DGH) is one of the two main centers in Cameroon, where the cancerous patient can receive multidisciplinary management including radiotherapy. Methods The aim of our study was to describe the epidemiological, clinical profile and surgical management of patients with breast cancer in gynecological department of DGH. Results A total of 42 patients were recruited in our department within a period of 3 years (from November 2006 to October 2009). The mean age was 46 years (range: 29-73 years). Characteristics of our study group were as followed: female sex (100%); breast feeding (95.245%); familial history of breast cancer (7.14%); 14.29% of patients were nulliparous and 19.05% primiparous. The main mode of discovering the disease was auto examination (92.86%). The clinical tumor size ranges from 2cm to 20cm with a mean of 6.83cm. Patients were then mostly diagnosed at stage III (54.76%) of the WHO classification. Only 2.38% were diagnosed at stage I. The main method of diagnosis was breast fine needle aspiration. Neo adjuvant treatment was administered in 78.57% of patients and the main surgical treatment was mastectomy (92.86%). Many patients are still followed up (59.52%), but we already had a mortality rate of 14.29% at the end of December 2010. We had no feedback for 26.19% of the study group. Conclusion Breast cancer is generally diagnosed in advanced stage in our milieu; there is therefore a need for generalized sensitization of the population.

Nguefack, Charlotte Tchente; Biwole, Martin Essomba; Massom, Annie; Kamgaing, Jacques Tsingaing; Njamen, Theophile Nana; Ekane, Gregory Halle; Obinchemti, Thomas Egbe; Priso, Eugene Belley

2012-01-01

191

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

PubMed

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

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

2009-05-27

192

Pancreatic debridement in a district general hospital--viable or vulnerable?  

PubMed Central

Little is known about the outcome after pancreatic debridement in the district general hospital (DGH) setting and the debate about centralisation of pancreatic surgical services continues. We retrospectively reviewed our experience over 2 years, looking particularly at mortality, morbidity and cost. Of 12 cases treated during this period, 8 were women and 7 were gallstone induced. The mean pre-operative age was 56.5 years and pre-operative Apache II score was 15. The rates for postoperative morbidity and mortality were 67% and 25%, respectively In half, digital necrosectomy was performed and in half a regional pancreatic resection. These figures are similar to others found in the literature (comparison with 15 contemporary series). The median cost per patient was 21,487 pounds, mainly due to ITU accommodation (57.4% of total costs). This is similar to other previously published rates and the rate from our local tertiary centre. It is concluded that acceptable results for pancreatic debridement are producible in the DGH at economically viable levels. Images Figure 1 Figure 2

Catto, J. W. F.; Alexander, D. J.

2002-01-01

193

Birthing experience of adolescents at the Ottawa General Hospital Perinatal Centre.  

PubMed Central

OBJECTIVE: To study the experiences of prenatal care, prenatal classes and birthing among adolescents. DESIGN: Anonymous self-report questionnaire survey. SETTING: Ottawa General Hospital Perinatal Centre. PATIENTS: A total of 100 adolescents (aged less than 20 years) and 100 control subjects (aged over 19 years) who gave birth at the Perinatal Centre from June 1989 to August 1990. MAIN OUTCOME MEASURES: Prenatal experiences, attendance at prenatal classes, experiences in labour and delivery, postpartum care. RESULTS: Only 26% of the adolescent patients sought prenatal care in the first trimester, and only 27% attended prenatal classes, as compared with 87% and 91% of the control subjects (p < 0.001). Most of the adolescents felt uncomfortable in the same waiting room as adult women. During labour and delivery 50% of the adolescents had their mothers with them for support, whereas 83% of the adults had their husbands with them (p < 0.001). Over half (59%) of the adolescents stated that they were not prepared for labour and delivery, as compared with 26% of the adults (p < 0.001). Of the adolescents 85% opted to care for their babies after birth. CONCLUSION: Pregnant adolescents do not avail themselves adequately of the medical and psychosocial services available to them through the health care system. Our findings suggest features of prenatal clinics that would make them attractive and accessible to such patients.

Lena, S M; Marko, E; Nimrod, C; Merritt, L; Poirier, G; Shein, E

1993-01-01

194

Family-centered care in Ontario general hospitals: the views of pediatric nurses.  

PubMed

Registered nurses and registered practical nurses working on pediatric units in 35 Ontario general hospitals participated in a study that examined their perceptions and practices of family-centered care (FCC). The Family-Centered Care Questionnaire-Revised (FCCQ-R) was used to collect the data. The participants were asked to rate their level of agreement regarding necessary elements (perceptions) of family-centered care and whether these elements are part of their current work (practice). The participants had a reasonable knowledge of the necessary elements of family-centered care, but were not consistently including these in their every day work. A number of barriers to the implementation of family-centered care were also identified. Perception and practice scores were higher among those who had participated in continuing education on family-centered care than those who had not. The findings suggest that some nurses may be having difficulties shifting from a medical helping model of care to an enabling helping model of care, which is considered the foundation of family-centered care. Difficulties in implementing family-centered care appear to be systemic, both at the unit and organizational level. Based on the findings, implications for practice, education and research are suggested. PMID:15487299

Caty, S; Larocque, S; Koren, I

195

Forensic medicine in the Rivers State of Nigeria: experience in four rural general hospitals.  

PubMed

A retrospective study of 375 consecutive medicolegal cases seen in four peripheral general hospitals in the Rivers State of Nigeria over a five-year period (March 1984 to February 1989) was undertaken. The most common indications for forensic medical consultation were assaults (78.6%) using clubs, sticks, fists and machetes as weapons, road traffic accidents (9.1%) and sexual offences (7.7%). The proportions of accidental deaths (4.3%), homicidal deaths (2.9%), sudden natural deaths (0.5%), maternal deaths (0.5%) and suicidal deaths (0.3%) were much lower. The male-to-female ratio was 1.4 to 1. The patients' ages ranged from 10 months to 75 years, with a mean of 31.6 years. Twenty-three cases (6.1%) were children, while the remaining 352 cases (93.9%) were adults. The study showed that for those cases which do come to the pathologist's attention, forensic personnel and laboratory services are inadequate in the peripheral parts of Nigeria. The study also highlighted the possible range of medicolegal problems of which the medical practitioner should be aware, even if he is practising in the rural non-urbanized areas of Nigeria. The study shows that not all deaths are registered in Nigeria. PMID:10689865

Amakiri, C N

2000-01-01

196

Routine Use of the "ADE Scorecards", an Application for Automated ADE Detection in a General Hospital.  

PubMed

Retrospective detection of Adverse Drug Events (ADEs) is challenging, notably because ADEs result from complex interactions between many factors. Data mining techniques have recently emerged in the field of automated retrospective ADE detection. The "ADE Scorecards" are a research application based on data-mining that has been built in the framework of the PSIP European Project, and potentially enables automated ADE retrospective detection. The objective of this paper is to evaluate the use of the ADE Scorecards in a real-life healthcare situation. For that purpose, the ADE Scorecards have been implemented in a French general hospital and have been used by the physicians and pharmacists for three years (corresponding to 73,000 inpatient stays). According to the results, 2% of the analyzed inpatient stays have a potential ADE with hyperkalemia, and 1% of them have a potential ADE with vitamin K antagonist overdose. In practice, the application, which was first designed to be a standalone web-based application for the physicians, has been used as a part of a more global quality improvement approach led by the pharmacists. PMID:23920566

Chazard, Emmanuel; Luyckx, Michel; Beuscart, Jean-Baptiste; Ferret, Laurie; Beuscart, Régis

2013-01-01

197

A comparison of the attitudes shown by general practitioners, hospital doctors and medical students towards alternative medicine.  

PubMed Central

The aim of this study was to compare and contrast the views of general practitioners (GPs), hospital doctors and medical students to alternative medicine. A questionnaire was sent to a random sample of 100 GPs and 100 hospital doctors in the South West Thames Regional Health Authority (SWTRHA). A convenience sample of 237 pre-clinical medical students at St George's Hospital Medical School was also given a questionnaire. Eighty-seven GPs and 81 hospital doctors replied. Five therapies were investigated: acupuncture; chiropractice; homeopathy; naturopathy; and osteopathy. All respondents were asked about their attitude towards and knowledge of these therapies. Doctors were asked how often they referred patients for such treatment and whether they practised it themselves. GPs and hospital doctors had similar levels of knowledge of the therapies. Medical students were the least informed but the most enthusiastic respondents. Seventy per cent of hospital doctors and 93% of GPs had, on at least one occasion, suggested a referral for alternative treatment. GPs were making these referrals more frequently and earlier. Twelve per cent of hospital doctors and 20% of GPs were practising alternative medicine. The majority of the respondents felt that alternative medicine should be available on the National Health Service (NHS) and that medical students should receive some tuition about alternative therapies. A considerable proportion of those doctors referring patients to alternative practitioners were ignorant of their official qualifications.

Perkin, M R; Pearcy, R M; Fraser, J S

1994-01-01

198

His own private hospital  

PubMed Central

Dr. Brian Day had a simple solution when it became increasingly difficult to book operating room time in Vancouver. He built his own hospital. The Cambie Surgical Centre, which treats patients from BC and around the world, has 2 main operating rooms, 10 recovery beds and 5 private rooms for extended stays. "What I've done," says Day, "is say that if there are no operating rooms at UBC, I'll build my own."

Jones, D

1997-01-01

199

Vancouver ­ A Century of Self-organized Rain  

NASA Astrophysics Data System (ADS)

Vancouver in British Columbia is a young city. It borders on steep mountainous terrain where landslides are relatively frequent. As the city expands onto hazardous terrain more is at risk. The landslides usually follow periods of prolonged rainfall culminating in short periods of high intensity. The frequency of heavy rainfall is therefore important in knowing when to expect and prepare for landlides and in issuing warnings. Vancouver has about a century of rainfall records for the airport station on the Fraser River delta where the incoming weather from the Pacific Ocean is relatively unaffected by orographic effects. Precipitation data is presented in both annual and monthly totals. The cumulative departure from the mean shows a drying trend for the first part of the last century, more or less average conditions for the middle part and finally a pronounced increase in wetness in the last part of the century. Two very wet periods in the early eighties and mid-nineties caused more landslide damage than at any time since settlement began in this part of Canada. Individual storm events on the North Shore mountains of Vancouver are also examined as power law distributions. Despite the complexity of precipitation, both annual and monthly values follow power law distributions. This remarkable finding allows estimates to be made of the probability of occurrence of damaging amounts of precipitation which is useful for risk management and engineering purposes. The probability of even more extreme events is predictable and is of interest to insurance companies.

Skermer, Nigel; Skermer, Nycolas; Barber, Tony; Olive, Ken

200

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.

201

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

ERIC Educational Resources Information Center

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

Lewis, Sharna; Stenfert-Kroese, Biza

2010-01-01

202

Clinical Care Provided on Postgraduate Dental Clinical Training Course at Tokyo Dental College Chiba Hospital, Department of General Dentistry  

Microsoft Academic Search

Number of patients assigned to dental residents, course of treatment and number of various technical tasks performed as described in the Reports on Clinical Training of Dentists published by the Department of General Dentistry, Tokyo Dental College Chiba Hospital since its establishment in 2002 were compared between before (2003-2005) and after (2006-2007) clinical training was made mandatory, and the state

Toshiyuki Takahashi; Masatake Tsunoda; Toshiko Sugiyama; Daiki Yamakura; Yoshihiro Kondo; Akio Noro

2009-01-01

203

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

Microsoft Academic Search

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

Catherine Moore; Janet Leathem

204

Percutaneous endoscopic gastrostomy in a general hospital: prospective evaluation of indications, outcome, and randomised comparison of two tube designs  

Microsoft Academic Search

The indications for percutaneous endoscopic gastrostomy (PEG) and patient outcome, were examined prospectively in the setting of a general hospital. In the course of 26 months, 76 patients underwent PEG (median age 62 years (range 18-99)) and were followed up for 6887 patient days. The median (range) duration of PEG feeding was 93 (3-785) days. The procedure was carried out

M Z Panos; H Reilly; A Moran; T Reilly; P J Wallis; R Wears; I M Chesner

1994-01-01

205

A Comparison of Japanese and American Psychiatrists’ Attitudes towards Patients Wishing to Die in the General Hospital  

Microsoft Academic Search

Background: The attitudes of the psychiatrists in Japan and the US were compared in order to investigate their ideas on whether patients in general medical hospitals who have a desire to die should be allowed to do so or be assisted in this regard, and whether they require psychiatric evaluation and intervention, and the cultural influences on these attitudes. Methods:

Douglas Berger; Isao Fukunishi; Mary Alice O’Dowd; Takashi Hosaka; Tomifusa Kuboki; Yoshihiro Ishikawa

1997-01-01

206

Long-term follow-up of kidney transplant recipients: comparison of hospitalization rates to the general population  

PubMed Central

Background Kidney transplant recipients are recognized as a vulnerable population that is at increased risk of adverse health outcomes. However, there have been few studies that have compared hospital-related morbidity of these patients to the general population, and how this differs with respect to time since transplantation. Such analyses are useful in estimating the health burden in this patient population. Methods We assembled a population-based Canadian cohort (excluding Quebec) of 6,116 kidney transplant recipients who underwent transplantation between 1 April 2001 and 31 December 2008. Record linkage was used to identify hospital discharge records of these patients from 1 April 2001 through 31 March 2009. Hospital discharges were tabulated across the main disease chapters of the ICD10, and person-years of follow-up were calculated across age and sex strata. Comparisons of hospital-related morbidity to the general population were made by using a standardized hospitalization ratio (SHR). For those who underwent transplantation in 2004, stratified analyses were performed to explore differences in hospital discharge rates both before and after transplantation. Results After excluding hospitalizations due to complications from transplantation, when compared to the general population, transplant recipients were approximately 6.4 (95% CI: 6.3, 6.5) times more likely to be hospitalized during follow-up. The SHRs were highest during the time periods proximate to transplantation, and then decreased to approximately a five-fold increase from 3 years post transplantation onwards. The largest disease-specific excesses were observed with infectious diseases and diseases of the endocrine system. Among those who underwent transplantation in 2004, the SHR decreased from 11.2 to 5.0 in the periods before and after surgery, respectively. Conclusions Our results indicate that, even more than 5-years post transplantation, there remains a more than six-fold difference in hospitalization rates relative to the general population. Additional work is needed to confirm these findings, and to develop strategies to reduce long-term morbidity in this patient population.

2013-01-01

207

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

ERIC Educational Resources Information Center

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

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

208

Medical Data Mining for Early Deterioration Warning in General Hospital Wards  

Microsoft Academic Search

Data mining on medical data has great potential to improve the treatment quality of hospitals and increase the survival rate of patients. Every year, $4$ -- $17\\\\%$ of patients undergo cardiopulmonary or respiratory arrest while in hospitals. Early prediction techniques have become an apparent need in many clinical area. Clinical study has found early detection and intervention to be essential

Yi Mao; Yixin Chen; Gregory Hackmann; Minmin Chen; Chenyang Lu; Marin Kollef; Thomas C. Bailey

2011-01-01

209

Resident research training conducted in a community hospital general surgery residency program  

Microsoft Academic Search

PurposeResearch is educationally important for surgical residents. However, little information exists regarding effective methods for teaching residents scientific methodology in a community hospital. This effort describes an effective program conducted in a community hospital for enhancing scientific opportunities of surgical residents.

Richard M Lampman; Seth W Wolk; Jennifer Fowler; Robert Cleary; Richard A Pomerantz; William J Fry; Walter M Whitehouse; Verne L Hoshal

2003-01-01

210

Specialised Chronic Compartment Measurement Clinic in a District General Hospital: Is it Worthwhile?  

PubMed Central

INTRODUCTION Chronic compartment syndrome is one of the conditions that cause exertional pain in the young. In this condition, a careful history taking is usually the key for making the correct diagnosis, but intracompartmental pressure measurement that has high sensitivity and specificity rates can add invaluable confirmation, especially when surgical decompression is indicated. In a district general hospital there is usually a logistical problem in performing compartmental pressure measurement. In this study, we describe our experience in dealing with such a problem by setting up a quarterly specialised clinic for intracompartmental pressure measurement that, according to our knowledge, is unique in the UK. PATIENTS AND METHODS We retrospectively reviewed the medical records of 42 patients referred to our specialised clinic and documented the referral patterns, clinical picture, additional investigations, pressure measurement results, final diagnosis and outcome of treatment. The intracompartmental measurement was recorded pre- and post-exercise on the treadmill for 1 min or 5 min and results were interpreted according to published criteria. RESULTS The mean age of the referred 42 patients was 33.1 years (range, 15–78 years). There were 16 positive results (38%) confirming the diagnosis of chronic compartment syndrome and four clinically characteristic cases of this condition with negative results. There were 22 negative results (53%), one borderline, and three patients were not tested for different reasons. All of the 10 patients who were treated surgically had positive pre-operative test results. CONCLUSIONS An inappropriate referral rate of approximately 52% was encountered that had a significant impact on the waiting time for the proposed test (5.7 months), which is far longer than the 18-week target for treatment in the NHS. We found that a positive test is a strong predictor of a successful outcome of surgical treatment. Such a specialised clinic, therefore, should only receive carefully assessed patients.

Zeineh, Nedal; Ardolino, Antonella; O'Connor, David

2009-01-01

211

The additional impact of liaison psychiatry on the future funding of general hospital services.  

PubMed

Accurate coding system is fundamental in determining Casemix, which is likely to become a major determinant of future funding of health care services. Our aim was to determine whether the Hospital Inpatient Enquiry (HIPE) system assigned codes for psychiatric disorders were accurate and reflective of Liaison psychiatric input into patients' care. The HIPE system's coding for psychiatric disorders were compared with psychiatrists' coding for the same patients over a prospective 6 months period, using ICD-10 diagnostic criteria. A total of 262 cases were reviewed of which 135 (51%) were male and 127 (49%) were female. The mean age was 49 years, ranging from 16 years to 87 years (SD 17.3). Our findings show a significant disparity between HIPE and psychiatrists' coding. Only 94 (36%) of the HIPE coded cases were compatible with the psychiatrists' coding. The commonest cause of incompatibility was the coding personnel's failure to code for a psychiatric disorder in the present of one 117 (69.9%), others were coding for a different diagnosis 36 (21%), coding for a psychiatric disorder in the absent of one 11 (6.6%), different sub-type and others 2 (1.2%) respectively. HIPE data coded depression 30 (11.5%) as the commonest diagnosis and general examination 1 (0.4%) as least but failed to code for dementia, illicit drug use and somatoform disorder despite their being coded for by the psychiatrists. In contrast, the psychiatrists coded delirium 46 (18%) and dementia 1 (0.4%) as the commonest and the least diagnosed disorders respectively. Given the marked increase in case complexity associated with psychiatric co-morbidities, future funding streams are at risk of inadequate payment for services rendered. PMID:23495543

Udoh, G; Afif, M; MacHale, S

212

Parallel rapid HIV testing in pregnant women at Tijuana General Hospital, Baja California, Mexico.  

PubMed

The objectives of this study were to evaluate the performance of parallel rapid HIV testing and the presence of HIV-associated risk factors in pregnant women with unknown HIV status in Baja California, Mexico. Pregnant women attending the delivery unit or the prenatal clinic at Tijuana General Hospital had blood drawn for parallel rapid HIV testing with Determine™ HIV-1/2 and Uni-Gold™ Recombigen(®) HIV. The parallel rapid HIV test performance was compared to the enzyme immunoassay (EIA) and western blot. From September 2007 to July 2008, 1,383 (94%) of 1,464 women in labor and 1,992 (96%) of 2,075 women in prenatal care were enrolled. The HIV seroprevalence among women screened during labor (19/1,383, 1.37%, 95% CI: 0.85-2.18%) was significantly higher compared to those seeking prenatal care (5/1,992, 0.25%, 95% CI: 0.09-0.62%; p<0.001). Of 25 pregnant women testing positive by parallel rapid HIV testing 24 had a positive confirmatory western blot and one (0.03%) was confirmed as false positive. Additionally, two (0.06%) women had parallel rapid HIV discordant testing results; both tested negative by western blot. All women who tested negative by rapid testing had negative results on pooled EIA antibody testing. The overall sensitivity, specificity, and positive and negative predictive values of parallel rapid HIV testing were 100%, 99.9%, 96%, and 100%, respectively. These findings document a very high acceptance rate and an excellent performance of the parallel rapid HIV testing strategy during pregnancy. PMID:23050550

Viani, Rolando M; Araneta, Maria Rosario G; Spector, Stephen A

2012-11-19

213

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

PubMed Central

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

Joypaul, Vickram B.

2012-01-01

214

What benefits do general practitioners see in electronic links to hospitals, family practitioner committees and community services?  

PubMed

A postal questionnaire concerning attitudes towards, and uses for electronic links was sent to 136 Nottinghamshire general practitioners (GPs) in November 1988 and yielded 128 responses (94%). While electronic links to Family Practitioner Committees (FPCs) and local hospitals were viewed positively by 90% of the responders, such links to community services were not so welcome. Overall most doctors rated 'very useful' the transmission of laboratory and x-ray results, the receipt of interim hospital discharge letters, and the booking of open access appointments. Computer users, who made up 35% of the sample, were statistically more likely to be positive towards links to FPCs and hospitals, and most of them rated 'very useful' examples of electronic information transfer, compared to non-users. This survey encourages plans to electronically link together disparate sections of the health service. Practices already computerised, of which there are surprisingly large numbers, are the obvious first sites and were the most enthusiastic about such links. PMID:10296856

Pringle, M

1989-12-01

215

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

PubMed Central

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

2012-01-01

216

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

PubMed Central

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

2012-01-01

217

AB 23. Anxiety and depression in a COPD population sample from the general hospital of serres  

PubMed Central

Background The study of the frequency of anxiety and depression in patients suffering from Chronic Obstructive Pulmonary Disease and their correlation with the severity and management of the disease, the somatometric parameters, subjective dyspnea and the pulmonary function tests. Patients and methods Twenty-five consecutive patients with diagnosed COPD who visited the outpatient pulmonology clinic of General Hospital of Serres during 07-09/2012 were studied. The patients underwent spirometry, arterial blood gases analysis, 6 minute walking test (6MWD) and filled validated questionnaires for the detection of anxiety (State-Trait Anxiety Inventory - STAI-Gr X-2), depression (Beck Depression Inventory - BDI-II), subjective dyspnea (MRC) and level of COPD control (COPD Assessment Test - CAT). The correlation analysis was performed using Spearman’s correlation test and the SPSS v15 software. Results The Body Mass Index (BMI) correlated negatively with BDI (r=–0.4, P<0.05). Dyspnea (MRC score) positively correlated with the presence of depression (r=0.61, P=0.001) and anxiety (r=0.6, P=0.001), with CAT score (r=0.8, P<0.001) and negatively with 6MWD (r=–0.55, P<0.007). CAT presented a positive correlation with BDI (r=0.71, P<0.001), STAI (r=0.73, P<0.001) and negative with 6MWD (r=–0.44, P=0.036). Arterial PO2 had a negative correlation with BDI (r=–0.57, P=0.003) and STAI (r=-0.41, P=0.039), whilst BDI had a positive correlation with STAI (r=0.55, P<0.001) and negative with 6MWD (r=–0.43, P=0.039). Finally, STAI score correlated negatively with 6MWD (r=–0.43, P=0.039). Conclusions Patients with a lower BMI had higher rates of depression, possibly due to the increased percentage of patients presenting an emphysematic phenotype (as derived by the data analysis from the study population). Both the subjective dyspnea feeling and the poor COPD control showed correlation with high rates of anxiety and depression, as well as with smaller walking distances in the 6 minute tests. Hypoxemia alone significantly correlated with depression and anxiety, whereas these two correlated with each other and with lower exercise capacity.

Mitka, Aikaterini; Kaimakamis, Evangelos; Katsavouni, Charoula; Bobotas, Dimitrios; Antoniadis, Antonios

2012-01-01

218

Randomised controlled trial to compare GP-run orthopaedic clinics based in hospital outpatient departments and general practices  

PubMed Central

Background To reduce outpatient waiting times, a growing number of outpatient clinics for selected groups of patients are being provided by GPs with special interests (GPwSIs). Aim To determine whether there are differences in patient satisfaction or clinical outcome among patients attending orthopaedic clinics provided by GPwSIs in hospital or community settings. Design of study Randomised controlled trial. Setting Hospital outpatient departments or general practices. Method Three hundred and twenty-one patients with minor orthopaedic problems were referred by GPs to the orthopaedic surgery department of the University Hospitals of Leicester NHS Trust; 168 patients were randomised to care by GPwSIs in practices, and 153 were randomised to care by the same GPwSIs in clinics held at hospital outpatient departments. Patients completed the SF-36v2 and satisfaction questionnaires at their first appointment, and again 3 months later. Results There was no significant difference between the sites in changes in health. After the first clinic attendance, patients attending practice-based clinics were more satisfied with access to appointments and information received. Conclusion For selected orthopaedic referrals seen by GPwSIs, there were no significant differences in clinical outcomes between practice-based and hospital-based clinics, but some features of practice-based clinics tend to be preferred by patients.

Baker, Richard; Sanderson-Mann, Jo; Longworth, Stephen; Cox, Rachel; Gillies, Clare

2005-01-01

219

Surgical management of pneumothorax: significance of effective admission or communication strategies between the district general hospitals and specialized unit.  

PubMed

A preoperative delay in emergency surgery for spontaneous pneumothorax is associated with a poor outcome after surgery and a prolonged hospital stay. To reduce preoperative delays, all tertiary referrals from district general hospitals to our thoracic surgery unit were processed through a 'clinical decisions unit' (CDU). Prior to the establishment of the CDU, these patients were added to a waiting list for a surgical bed. This study has reviewed the effect of this change in admission policy on the efficiency of treatment for non-elective spontaneous pneumothorax. An intergroup comparison (pre-CDU group vs. post-CDU group) was made of the following parameters: referral to transfer time, transfer to surgery time and length of inpatient stay in the referring and tertiary hospitals. There were no significant differences in gender, diagnosis, treatment in the referring hospitals, postoperative clinical outcome, or indications for or type of surgery. The total length of inpatient stay in the referring and tertiary hospitals was significantly reduced for the post-CDU group (12 vs. 15 days; P<0.001), which was attributed to the earlier transfer of patients (18 vs. 78 hours; P<0.001) hours. Allowing surgical access to a traditional medical admission unit is therefore, cost-effective and significantly improves the efficiency of non-elective pneumothorax surgery. PMID:21873367

Aslam, Muhammad I; Martin-Ucar, Antonio E; Nakas, Apostolos; Waller, David A

2011-08-26

220

[The program for the promotion of breast feeding in the Hospital General de México: an evaluation study].  

PubMed

The malnutrition and infection seen in the infant population can be reduced with correct breast feeding practice. In 1988 and 1989, La Leche League of Mexico and the Mexico City General Hospital, Secretary of Health, carried out a breast feeding promotion program in the same hospital. The program had three components: 1) in-service training for health care personnel in the pediatric and obstetric services; 2) changes in perinatal care procedures aimed at improving the start of maternal nursing during the hospital stay; and 3) classes concerning breast feeding advantages and techniques for primiparas. As a result of the program, 110 hospital workers received lactation management training and there was improvement in several breast feeding related indicators measured during the post-partum hospital stay (reduction in the mean time between the arrival of the newborn to the rooming-in area and first maternal nursing, greater proportion of infants observed receiving the breast, and a better interaction between mothers and newborns when offering the breast) and the primiparas who participated in the program breast fed their infants for longer periods than did a program control group (median of 17 and 12 weeks, respectively; the difference in the proportion of infants still being nursed at 16 weeks was statistically significant). PMID:1549788

Vandale-Toney, S; Reyes-Vázquez, H; Montaño-Uscanga, A; López-Marroquín, E; Vega-Castillo, N E

221

General anesthesia for cesarean section at a tertiary care hospital 1990–1995: indications and implications  

Microsoft Academic Search

Complications of general anesthesia for cesarean section remain the leading cause of anesthesia-related maternal mortality. General anesthesia, however, is becoming less popular for obstetric anesthesia, and thus fewer cesarean sections are conducted using this technique. As the number of general anesthesia cases decrease, the number of difficult intubations witnessed and managed by residents decreases. In addition, patients who undergo general

L. C. Tsen; R. Pitner; W. R. Camann

1998-01-01

222

[A multicenter study of emergencies in basic general hospitals in Catalonia].  

PubMed

The demand of the hospital emergency services was evaluated by the analysis of 11650 emergencies seen during one week in 22 county hospitals. A modified ICHPPC-2 was used for the codification of diagnoses. The mean age of the patients was 30.6 years. The distribution through the days of the week was homogeneous and the duration of the hospital stay was lower than 2 hours in 85%. 80% of the patients went to the hospital by their own decision. The emergency cases were considered as non-justified in 22.4%, mild emergencies in 56.5%, and severe emergencies in 17%. 75.9% of patients were sent back to their homes, and 11.8% were admitted to the hospital. The predominant groups of emergencies were trauma (33.9%), respiratory diseases (11.8%), ill-defined signs and symptoms (9.3%), and osteomuscular (6.7%), digestive (5.8%) and infective (4.7%) diseases. The indispensable requirements to be collected for a better knowledge of emergency services are evaluated. PMID:2651818

Balanzó Fernández, X; Pujol Farriols, R

1989-01-28

223

Radiation dose measurements for optimisation of chest X-ray examinations of children in general radiography hospitals.  

PubMed

This study was performed to measure the entrance surface air kerma (ESAK) for optimisation of chest X-ray examination of children in general radiography hospitals in Khartoum. ESAK was estimated using the X-ray tube output exposure and patient-specific exposure parameters collected during routine examinations. The estimated ESAK values per radiography ranged from 17 to 89 ?Gy, 32 to 161, 67 to 242, 77 to 278; and from 95 to 389 ?Gy for Newborn, 1, 5, 10 and 15 y children, respectively. Doses are comparable with a previous study and are somewhat higher than the UK reference dose levels. The study demonstrated the necessity to follow guidelines for quality radiograph as a key element in the optimisation of X-ray examination of children. Frequent dose measurements are of particular importance for the optimisation of X-ray examination of children in general radiography hospitals. PMID:23542763

Suliman, Ibrahim I; Elawed, Sahar O

2013-03-29

224

Cost-Benefit Analysis on the Feasibility of Implementing A Same-Day Surgery Program at the 121ST General Hospital, Seoul, Korea.  

National Technical Information Service (NTIS)

This retrospective study analyzed the factors and variables that would impact on the implementation of a same-day surgery (SDS) program at the 121st General Hospital. The 121st General Hospital serves as the primary, definitive-care medical treatment faci...

2000-01-01

225

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

PubMed Central

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

2013-01-01

226

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

Microsoft Academic Search

AbstractObjective: To see whether there is a difference in outcome between patients treated with oral and intravenous antibiotics for lower respiratory tract infection.Design: Open controlled trial in patients admitted consecutively and randomised to treatment with either oral co-amoxiclav, intravenous followed by oral co-amoxiclav, or intravenous followed by oral cephalosporins.Setting: Large general hospital in Dublin.Patients: 541 patients admitted for lower respiratory

Robert Chan; Linda Hemeryck; Myra ORegan; Luke Clancy; John Feely

1995-01-01

227

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

PubMed

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

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

2011-07-26

228

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

ERIC Educational Resources Information Center

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

Culhane, Dara

2003-01-01

229

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

Microsoft Academic Search

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

Brian Calkins; Eric Anderson; Paul Ashley

1995-01-01

230

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

ERIC Educational Resources Information Center

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

Culhane, Dara

2003-01-01

231

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

ERIC Educational Resources Information Center

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

Cahill, Kay

2011-01-01

232

Waiting lists, waiting times and admissions: an empirical analysis at hospital and general practice level  

Microsoft Academic Search

We report an empirical analysis of the responses of the supply and demand for secondary care to waiting list size and waiting times. Whereas previous empirical analyses have used data aggregated to area level, our analysis is novel in that it focuses on the supply responses of a single hospital and the demand responses of the GP practices it serves,

Frank Windmeijer; Hugh Gravell; Pierre Hoonhout

2004-01-01

233

Waiting lists, waiting times and admissions: an empirical analysis at hospital and general practice level  

Microsoft Academic Search

We report an empirical analysis of the responses of the supply and demand for secondary care to waiting list size and waiting times. Whereas previous empirical analyses have used data aggregated to area level, our analysis focuses on the supply responses of a single hospital and the demand responses of the GP practices it serves, and distinguishes between first outpatient

Frank Windmeijer; Hugh Gravelle; Pierre Hoonhout

2005-01-01

234

Audit of Diagnostic and Interventional Craniocervical Catheter Angiographic Procedures at the Singapore General Hospital  

Microsoft Academic Search

Introduction: Catheter angiography is an established imaging modality of evaluating cerebral and head and neck vascular diseases. It is, however, an invasive procedure with a small risk of complications. The aim of our study was to evaluate the prevalence of peri-procedural compli- cations in a local hospital setting. Materials and Methods: A total of 88 patients underwent diagnostic and interventional

ASC Low; FRCR MBBS; KP Tan

235

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

PubMed

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

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

2006-02-17

236

Negative illness perceptions associated with low mental and physical health status in general hospital outpatients in China.  

PubMed

In western countries, negative illness perceptions are associated with poor health status and affect health outcomes in primary care populations. The aim of this study is to examine the relationship between illness perception and mental and physical health status in general hospital outpatients in China. This multicentre, cross-sectional study analysed a total of 281 consecutive patients from four general hospital outpatient departments of internal medicine and traditional Chinese medicine in Beijing and Kunming. The patients answered questionnaires concerning illness perception (Brief-IPQ), somatic symptom severity (Patient Health Questionnaire-15), illness behaviour (Scale for the Assessment of Illness Behaviour), emotional distress (Hospital Anxiety and Depression Scale) and health-related quality of life (Twelve-Item Short Form Health Survey). Negative illness perception, especially negative emotional reactions, perceived illness consequences, encumbering illness concerns, and strong illness identity were significantly associated with high emotional distress, impairing illness consequences, and a low mental and physical quality of life. Using a multiple linear regression model, five strongest correlates of negative illness perception were high anxiety, seeking diagnosis verification, low mental and physical quality of life and high somatic symptom severity. The variance explained by this model was 35%. Chinese general hospital outpatients showed associations between negative illness perceptions and poor mental and physical health status that were similar to those of primary care patients in western countries. The main difference was that no association with perceived illness control was found in Chinese patients. Chinese physicians should be sensitised to their patients' negative illness perceptions and should focus on helping patients cope with uncertainty and anxiety by providing an understandable illness model and increasing control beliefs. PMID:23721418

Wu, Heng; Zhao, Xudong; Fritzsche, Kurt; Salm, Florian; Leonhart, Rainer; Jing, Wei; Yang, Jianzhong; Schaefert, Rainer

2013-05-30

237

Study of the cost-benefit analysis of electronic medical record systems in general hospital in China.  

PubMed

Electronic medical record (EMR) systems have been proposed as technology to improve the quality of patient care, decrease medical errors, control and reduce medical expenditure, however the financial effects have not yet been as well documented in China. We presented a net financial cost-benefit analysis of implementing electronic medical record systems in general hospital in China. The data, which were obtained from studies of the general hospital and the published literature, collected from 15 consecutive fiscal months from May 1, 2009 to August 30, 2010. We performed a perspective cost-benefit study to analyze the financial effects of EMR system implementing. The reference strategy for comparisons was the traditional paper-based medical record. The net financial benefits or costs for a 6-year period were calculated. All data were adjusted for inflation. The totally assessed net benefit from implementing an EMR system for a 6-year period was $559,025 in the general hospital. Benefits accrue primarily from savings in new medical record creation, decreased full-time-equivalent (FTE) employees, saving of adverse drug events (ADEs) and dose errors, improved charge capture and decreased billing errors. In this model, the time of return on investment is 3.00 years. In one-way sensitivity analysis, the model was most sensitive in new medical record creation; the net benefit varied from $398,057 to $719,992. The five-way sensitivity analysis with the most pessimistic and optimistic assumptions showed results ranging from a $76,970 net cost to a $1,062,122 net benefit; the pessimistic time of return on investment is 5.38 years. An EMR system cost-benefit analysis can rapidly demonstrate a positive return on investment when implemented in hospitals. The magnitude of the return is sensitive to several key factors. PMID:22212632

Li, Kai; Naganawa, Shinji; Wang, Kai; Li, Ping; Kato, Ken; Li, Xiu; Zhang, Jie; Yamauchi, Kazunobu

2012-01-03

238

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

PubMed Central

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

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

2012-01-01

239

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

SciTech Connect

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

Calkins, Brian; Anderson, Eric; Ashley, Paul

1995-01-01

240

Diagnostic yield from barium enemas: a study among patients referred by general practitioners and hospital outpatient departments.  

PubMed Central

Although the double contrast barium enema is the standard radiological examination of the colon, it is not universally available to patients referred by their general practitioners. A retrospective survey of all double contrast barium enemas carried out over a two year period in one health district was undertaken to determine the diagnostic yield of pathological findings for patients referred by general practitioners and hospital outpatient departments and for patients who had rigid sigmoidoscopy prior to the enema and those who did not. A total of 530 patients were studied. The diagnostic yield for the hospital outpatients was 41.6% and in the general practitioner group 35.6%. In the patients who had rigid sigmoidoscopy the yield was 42.7% compared with 32.6% in those who had no prior sigmoidoscopy. It is concluded that the withdrawal of direct access for barium enemas to general practitioner patients in this district because of a low diagnostic yield cannot be justified. The lower diagnostic yield in the patients who did not have sigmoidoscopy supports the policy of requiring this examination prior to all barium enemas.

Wafula, J M

1992-01-01

241

Rectal Cancer Surgery in a District General Hospital: Controlled Follow-up Study  

Microsoft Academic Search

.   Local recurrence after curative surgery of rectal cancer indicates failure of the initial treatment. In recent years reported\\u000a local recurrence rates have steadily decreased. In this study 364 patients treated for rectal cancer were analyzed retrospectively\\u000a to determine if it is still justified to treat this disease in small nonspecialized hospitals. An overall local recurrence\\u000a rate of 9.7% was

Gaston Schütz; Marko Aleksic; Bernward Ulrich

1999-01-01

242

Clinico-Pathological Discrepancies in a General University Hospital in S?o Paulo, Brazil  

PubMed Central

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

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

2008-01-01

243

Enhanced trabeculectomy in a UK district general hospital setting: is selective use of 5-fluorouracil all that is required?  

PubMed

To determine whether primary trabeculectomies performed in a UK district general hospital, specifically without making use of mitomycin-C augmentation but with selective use of the low potency anti-metabolite 5-fluorouracil, produce an acceptable long-term intraocular pressure (IOP)-lowering effect for an unselected patient group. Retrospective analysis of the outcomes of all the trabeculectomies (53 eyes) performed by a single surgeon in a UK district hospital with or without 5-fluorouracil enhancement. The mean follow-up period was 5.04 years. Mean IOP preoperatively was 26.4 mm Hg while postoperatively the mean was ?14.9 at all the time periods examined. Intraoperative complications occurred in two eyes (3.8 %) including one suprachoroidal haemorrhage and one hyphema. Postoperative complications that occurred during the follow-up period included choroidal effusions in seven patients (13 %), early postoperative bleb leak in four patients (8 %) and immediate postoperative hypotony not requiring intervention in 18 patients (34 %). Five patients (9 %) developed postoperative hyphema (all <30 % anterior chamber height) and one patient (1.9 %) developed blebitis and endophthalmitis. None of our patients developed hypotony maculopathy. When trabeculectomy is performed on unselected patients attending a UK district general hospital, selective 5-fluorouracil augmentation is probably all that is required to obtain acceptable surgical outcomes. PMID:23334661

de Klerk, T A; Chaudhry, N; Moriarty, A P

2013-01-20

244

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

PubMed Central

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.

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

2013-01-01

245

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

ERIC Educational Resources Information Center

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

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

2008-01-01

246

Patients presenting with acute myocardial infarction to a district general hospital: baseline results and effect of audit.  

PubMed

The Cardiovascular Health Strategy recommended that patients presenting with acute myocardial infarction receive thrombolysis within ninety minutes of alerting medical or ambulance services. The aim of this prospective study was to describe the management of patients with acute myocardial infarction (AMI) presenting to a district general hospital in Donegal. All patients with a confirmed diagnosis of acute myocardial infarction, excluding those from the Donegal Area Rapid Treatment Study (DARTS) practices, admitted to Letterkenny General Hospital (LGH) from 31.08.99 to 31.08.01 were included in the study. 349 patients were included in the study; average age of 68 ranging from 30 to 96 years and 69% were male. Of the 349 patients, 101 (29%) were located more than 30 miles from LGH at the time of onset of symptoms. The median time taken from the onset of symptoms to calling for help was 119 minutes. The median time from hospital arrival to patients being admitted to CCU was 90 minutes. Thrombolytic therapy was administered in 31% of patients; for these patients the median call to needle time was 200 minutes. Call to needle times differed significantly between rural (median 227.5 minutes n = 64) and urban patients (median 175 minutes n = 37, p < 0.05, Mann-Whitney). Hospital delay times decreased throughout the study period (p > 0.05, Mann-Whitney). The study extends the findings from previous research by investigating the individual time delay components from onset of symptoms to treatment in AMI patients. Delay times exceed the recommended call to needle and door to needle times suggesting the need for interventions to reduce these times. PMID:12722781

O'Neill, J; Dowling, J; Wright, P; Murphy, A W; Bury, G; Tedstone-Doherty, D; Bannan, L

2003-03-01

247

Who needs chaplain's visitation in general hospitals? Assessing patients with psychosocial and religious needs.  

PubMed

Owing to the declining length of patients' hospital stay in recent years, chaplains need evidence-based criteria to decide which patients are likely to have the greatest psychosocial and/or religious-spiritual needs. Therefore, the present pilot study aims at sorting out evidence-based criteria to assess patients with lack of coping resources. A total of 610 patients in the German-speaking part of Switzerland were surveyed with regard to their psychosocial health. The results suggest that lack of vitality (including health condition), lack of support and lack of faith (including spiritual struggle) are valid and reliable criteria for chaplains as internal triggers for pastoral visitation. PMID:21928495

Winter-Pfändler, Urs; Morgenthaler, Christoph

248

Iatrogenic and Non-Iatrogenic Vascular Trauma in a District General Hospital: A 21-year Review  

Microsoft Academic Search

Background  Vascular trauma is associated with significant mortality and severe complications. Vascular injuries in the UK are infrequent,\\u000a although the exact incidence remains unknown. The objective of this article is to describe patients presenting with vascular\\u000a trauma to one surgeon over 21 years in a British hospital.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective review of prospectively collected data was performed and supplemented by case notes retrieval.

Henry D. I. De' AthRobert; Robert B. Galland

2010-01-01

249

Setting up a service for people with functional disorders in a general hospital setting.  

PubMed

Following attendance at the Unexplained Neurological Symptoms course at the National Hospital for Neurology and Neurosurgery in Feb 2009, we have successfully developed a neurological physiotherapy service for functional neurological disorders at our local NHS Trust Hospital, serving both in-patients and out-patients. The development of this service was driven by a feeling within our neurological physiotherapy team that these often complex and challenging patients could be managed more effectively and efficiently on a seperate pathway to patients with chronic organic neurological disease. We were supported at all stages by consultant neurologists at our Trust. A protocol was written outlining the pathway of management for these patients including referral criteria. A patient information leaflet was produced and key points for management and treatment were drawn up. Education of all multidisciplinary team members was undertaken. The service was audited after one year. The most significant success of the service has been a 90% closure rate for episodes of neurological physiotherapy care. A patient information leaflet was produced and key points for management and treatment were drawn up. Education of all multidisciplinary team members was undertaken. The service was audited after one year. The most significant success of the service has been a 90% closure rate for episodes of neurological physiotherapy care. PMID:24109044

Sparkes, Christine; Jordan, Carmel; Graham, Andrew; Galton, Clare; Damien, Max; Pokorny, Petr; Manji, Hadi

2013-11-01

250

Research Paper: Computerized Physician Order Entry and Electronic Medical Record Systems in Korean Teaching and General Hospitals: Results of a 2004 Survey  

Microsoft Academic Search

ObjectiveTo determine the availability of computerized physician order entry (CPOE) and electronic medical record (EMR) systems in teaching and general hospitals in the Republic of Korea.DesignA combined mail and telephone survey of 283 hospitals.MeasurementsThe surveys assessed the availability of CPOE and EMRs in the hospitals, as well as inducement, participation, and saturation regarding CPOE use by physicians.ResultsA total of 122

Rae Woong Park; Seung Soo Shin; Young In Choi; Jae Ouk Ahn; Sung Chul Hwang

2005-01-01

251

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

PubMed Central

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.

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

2012-01-01

252

Iowa Diagnosis Study, January - June, 1974. An Analysis of the Average Length of Stay and Mortality Experience for Patients Discharged from Iowa's Short-Term General Hospitals.  

National Technical Information Service (NTIS)

A study was conducted to analyze the average length of stay and mortality experiences for patients discharged from short-term general hospitals in Iowa. The study was conducted between January and June 1974. Hospital records of 213,170 inpatients discharg...

1974-01-01

253

The Monitoring Network of the Vancouver 2010 Olympics  

NASA Astrophysics Data System (ADS)

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

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

2012-12-01

254

Repeated precise gravity measurements on Vancouver Island, British Columbia  

NASA Astrophysics Data System (ADS)

Over the past 3 years, repeated precise gravity measurements have been made on Vancouver Island, British Columbia, to test a practical field technique for precise gravimetric surveys and to monitor possible gravity changes associated with contemporary crustal deformation. In order to obtain a precision for measured gravity differences of a few microgals (1 ?Gal = 10 nm/s2), rigorous field survey procedures were followed and the operating characteristics and calibration nonlinearities of the LaCoste and Romberg model D gravimeters were taken into account. Instrument evaluations indicate that although the standard error of the mean of several gravity ties is 1.5-2.0 ?Gal for an individual instrument, the present achievable accuracy of the model D gravimeter for the measurement of temporal gravity changes is 3-4 ?Gal, provided the dial settings of previous surveys are recovered or both long and short wavelength nonlinearities in calibration can be specified. Semiannual surveys of the central Vancouver Island region indicate significant temporal variations over the past 3 years. Gravity changes as large as 60 ?Gal at sites adjacent to lake shorelines are caused by the mass effect of changing water levels and can be accounted for by simple model calculations. A gravity effect of seasonal changes in groundwater levels is not identifiable in the data, although easternmost network sites are underlain by porous sediments subject to seasonal water table fluctuations of 1 or 2 m which are expected to cause gravity variations of the order of 10?Gal. A spatially coherent pattern of longer-term gravity trends is indicated in the northern network after corrections have been made for known mass changes. These trends can be interpreted in terms of relative elevation changes of the order of 2 cm/a between Buttle Lake and the area to the northwest. Alternatively, a change in density caused by secular changes of water content in fracture zones or by compression through an accumulation of stress could also cause the observed gravity trends.

Dragert, H.; Lambert, A.; Liard, J.

1981-07-01

255

POST DISCHARGE DROPOUT OF ALCOHOLICS - A NATURALISTIC STUDY IN A GENERAL HOSPITAL SETTING  

PubMed Central

In a naturalistic longitudinal design 133 consecutive inpatients with alcohol dependence syndrome were followed up for one year following discharge from the hospital. 59 patients (group 1) paid follow up visit at regular intervals whereas 28 subjects (group 2)never returned despite three consecutive postal intimations. Rest of the patient were irregular in follow up. The individuals in group 1 were compared with those in group 2 on various sociodemographic and clinical variables with the aim of delineating the characteristics that could define the alcoholics who dropped out following discharge. It was found that such patient were relatively younger with lower level of education, less frequently married, had earlier onset of problem drinking with poor social support and higher rates of mental problems. It was concluded that post discharge attrition of alcoholics could be a social as well as a clinical problem in any setting rendering long treatment for alcoholism.

Sengupta, Somnath; Kar, N.; Sharma, P.S.V.N.; Rao, Gaunasagari

2001-01-01

256

Amputation in the diabetic: ten years experience in a district general hospital.  

PubMed Central

Over a period of 10 years, 149 amputations were performed for lower limb ischaemia in 119 diabetic patients. Thirty patients required amputation of the second limb. Ninety per cent of the patients were over the age of 60 years. Sixty four ischaemic limbs were treated by primary local amputation or debridement--29 healed successfully, 30 proceeded to a higher amputation. The incidence of multiple local operations was high. A below knee amputation was performed in 56 limbs--7 failed to heal and required a more proximal amputation. Seventy five patients in the series have died; 58 of these survived less than 3 years from their first amputation. The hospital stay for all patients was long; for an unsuccessful local amputation the average stay was 109 days. Conservative management with the Scotchcast boot has been shown to be satisfactory. This must be compared with the significant costs to the patient of early operative intervention.

Britton, J. P.; Barrie, W. W.

1987-01-01

257

AIDS and the small city: the cost at Kingston General Hospital.  

PubMed Central

Although AIDS is often thought of as a "big-city" disease, it is also becoming a serious health care issue for doctors and other health care workers in "small-city" Canada. Kingston, Ont., is one of those small cities, and of the facilities trying to come to grips with a disease about which much remains to be learned. In this article, Drs. Peter Ford and David Robertson outline their hospital's estimate of the cost, in manpower and money, of dealing with the AIDS crisis. The final estimate: roughly $700,000. Although most of the cost will involve one-time capital spending, they point out that there will likely be ongoing labour-related costs because of the special programs and increased manpower needed to deal with AIDS patients. Clearly, AIDS is no longer a big-city disease. Images p558-a p559-a

Ford, P; Robertson, D

1988-01-01

258

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

Microsoft Academic Search

Objectives  The aim of the project was to develop a plan to address a forecasted deficit of approximately $4.65 million for fiscal year\\u000a 2010\\/11 in the Vancouver Communities division of the Vancouver Coastal Health Authority. For disinvestment opportunities identified\\u000a beyond the forecasted deficit, a commitment was made to consider options for resource re-allocation within the Vancouver Communities\\u000a division.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A standard approach

Craig Mitton; Francois Dionne; Rizwan Damji; Duncan Campbell; Stirling Bryan

2011-01-01

259

La douleur en santementale : premiere enquete nationale aupres des PH chefs de service de psychiatrie generale et de pharmacie Pain management in mental health care: the first nationwide survey of hospital practitioners of general psychiatry and pharmacy in France  

Microsoft Academic Search

This is the first survey of pain management in the mental health system in France. Pain management related to psychiatric disorders must take place in psychiatric hospitals and the psychiatric units of general hospitals where pharmacists have a central responsibility and the facility's pain management committee (CLUD) plays a key role. Raising awareness about pain manage- ment (treatment, training, and

E. Serra; D. Saravane; I. De Beauchamp; J.-C. Pascal; C.-S. Peretti; E. Boccard

260

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

PubMed

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 partnership 1 year later. PMID:14577704

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

2003-10-01

261

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

ERIC Educational Resources Information Center

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

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

2011-01-01

262

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

Microsoft Academic Search

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

Hani Raoul Khouzam

2000-01-01

263

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

Microsoft Academic Search

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

HaniRaoul Khouzam

2000-01-01

264

Carriage of group B Streptococcus in pregnant women and newborns: a 2-year study at Perugia General Hospital.  

PubMed

OBJECTIVE: To study the prevalence of group B Streptococcus (GBS) colonization in pregnant women and their newborns at Perugia General Hospital. METHODS: The number of mother---child pairs examined was 2300. Vaginal swabs were collected from the mothers at delivery, and auricular and pharyngeal swabs and gastric aspirate from the newborns at birth. Maternal risk factors for GBS disease, including premature delivery, intrapartum fever, prolonged rupture of membranes and multiple births, were evaluated. RESULTS: Maternal and neonatal colonization rates were 11.3% and 4.6%, respectively. GBS was isolated in 41.5% of the neonates born to colonized mothers and in 0.1% of those born to non-colonized mothers. No significant difference was observed in vertical transmission rates in the presence or absence of maternal risk factors. The external auditory canal was the most frequent (93.5%) and heavily colonized body site. Type Ib was the most common serotype among GBS isolates from mothers and babies. C surface protein was not detected in serotype V and VIII isolates, but was frequent in all other serotypes. Early-onset disease was observed in 0.4/1000 live births. CONCLUSIONS: The prevalence of maternal and neonatal colonization at Perugia General Hospital was similar to that obtained in other studies performed in Italy. The external auditory canal was confirmed as the most reliable body site to be sampled for the detection of neonates exposed to maternal GBS colonization. PMID:11864128

Sensini, Alessandra; Tissi, Luciana; Verducci, Nadia; Orofino, Maristella; von Hunolstein, Christina; Brunelli, Bruno; Malà, Gian Luca; Perocchi, Fausto; Brunelli, Roberta; Lauro, Vincenzo; Ferrarese, Remo; Gilardi, Giovanni

1997-06-01

265

Risk factors of stroke patients admitted to a general hospital in Kuwait.  

PubMed

There are limited data on stroke incidence in the Middle East, and only one study from Kuwait. The aim of this study was to establish a baseline status of stroke in Kuwait. We performed a retrospective chart review of all patients admitted from January 1st to December 31st, 2008 to the Amiri Hospital, Kuwait, who either were discharged or passed away with a diagnosis of stroke. Documented risk factors for stroke were analyzed for the total cohort and for male and female subgroups. Stroke subtypes were defined in accordance with the Trial of Org 10172 in acute stroke treatment (TOAST) criteria. There were 151 cases of stroke, of which 90.1% were ischemic. Eighty-five (56.3%) of the patients had diabetes mellitus, 86 (57.0%) had hyperlipidemia, and 104 (68.9%) had hypertension. Statins were used by 42.4% of the 86 hyperlipidemic patients prior to their presentation, and only 66 hypertensive patients (63.5%) were receiving treatment for hypertension prior to their presentation. Atrial fibrillation was diagnosed in 4% of the patients prior to their presentation, and 4% more were diagnosed afterward. History of ischemic heart disease was present in 28.5% of the subjects. This study shows similar rates of risk factors to regionally published reports and provides an updated picture of stroke in Kuwait. PMID:23005700

Ashkanani, Abdulaziz; Hassan, Khalid Ali; Lamdhade, Shekhar

2012-10-26

266

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

PubMed

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

Lääperi, A L

1996-01-01

267

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

EPA Science Inventory

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

268

Isolated locked compression plating for Vancouver Type B1 periprosthetic femoral fractures  

Microsoft Academic Search

ObjectiveReport treatment results of periprosthetic femoral fractures adjacent or at the tip of a stable femoral stem (Vancouver Type B1) using a locked compression plate as the sole method of fracture stabilisation.

Ginger K. Bryant; Saam Morshed; Julie Agel; M. Bradford Henley; David P. Barei; Lisa A. Taitsman; Sean E. Nork

2009-01-01

269

Analysis of Governance and Management (GM) Approach Agility During the Vancouver 2010 Olympic Games.  

National Technical Information Service (NTIS)

The conduct of major operations, such as the Vancouver 2010 (V2010) Olympics, requires the interaction of various departments, organizations and actors. In order to deal with these complex endeavours effectively and efficiently, the collective of organisa...

B. M. Fraser D. Smith M. Jobidon P. S. Farrell

2011-01-01

270

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

Federal Register 2010, 2011, 2012, 2013

...Transportation Board [Docket No. FD 35594] Eric Temple--Control Exemption--Portland Vancouver...On February 6, 2012, Eric Temple (applicant), a noncarrier individual...controlled by applicant and Nicholas B. Temple, leases and operates its rail...

2012-06-05

271

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

PubMed

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

Turner, N J; Hebda, R J

1990-04-01

272

Drug Use Evaluation of Moxifloxacin (Avelox) Using a Hand-Held Electronic Device At a Canadian Teaching Hospital  

PubMed Central

Background: The use of moxifloxacin (Avelox) has increased at Vancouver General Hospital since its introduction onto the formulary in 2002. It is unclear, however, whether the use of the drug is optimal according to its indication. Hand-held electronic devices, such as personal digital assistants (PDAs), are novel tools that can be used during routine patient care to collect data for drug use evaluation (DUE) reviews. Objective: We hypothesized that moxifloxacin was over-utilized and that opportunities existed to optimize its use. This study was designed to characterize moxifloxacin use in concordance with evidence-based assessment criteria. The feasibility of using a PDA device as a data-collection tool was also evaluated. Design: An observational DUE was conducted over a 4-week period (from February 17 to March 16, 2007) at Vancouver General Hospital, a 955-bed tertiary care hospital. Inpatients who received at least one dose of moxifloxacin were enrolled. Evidence-based assessment criteria were developed to evaluate the appropriateness of moxifloxacin use, and a PDA database was developed for data collection. The primary endpoint was the proportion of moxifloxacin use for approved first-line indications. Results: A total of 132 patients were included. Eighty-nine patients (67%) received moxifloxacin for first-line indications, including community-acquired pneumonia (57%) and acute exacerbation of chronic bronchitis (10%). Forty-three patients (33%) had alternative indications, primarily hospital-acquired pneumonia (25%). In 129 evaluable patients, approximately half (51%) of the clinical outcomes were successful; 37% were indeterminate; and 12% were failures. General medicine and respiratory service clinicians prescribed moxifloxacin more appropriately compared with surgical service personnel. Most of the pharmacists supported the use of PDAs as DUE data-collection tools. Conclusion: Overall, moxifloxacin utilization at Vancouver General Hospital was appropriate according to evidence-based assessment criteria. Additional opportunities to improve its use exist through health care staff education. PDAs are ideal data-collection tools for DUEs, as they can be conveniently used during routine patient care.

Samilski, Jennifer A. E.; Lau, Tim T. Y.; Elbe, Dean H. T.; Aulakh, Amneet K.; Lun, Eric M. C.

2012-01-01

273

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

Microsoft Academic Search

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

H. J. Sixma; D. H. de Bakker

1996-01-01

274

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

Microsoft Academic Search

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

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

2001-01-01

275

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

PubMed Central

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

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

2007-01-01

276

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

NASA Astrophysics Data System (ADS)

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

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

2012-08-01

277

Harmful microinjecting practices among a cohort of injection drug users in Vancouver Canada  

PubMed Central

Objectives We sought to identify factors associated with harmful microinjecting practices in a longitudinal cohort of IDU. Methods Using data from the Vancouver Injection Drug Users Study (VIDUS) between January 2004 and December 2005, generalized estimating equations (GEE) logistic regression was performed to examine sociodemographic and behavioral factors associated with four harmful microinjecting practices (frequent rushed injecting, frequent syringe borrowing, frequently injecting with a used water capsule, frequently injecting alone). Results In total, 620 participants were included in the present analysis. Our study included 251 (40.5%) women and 203 (32.7%) self-identified Aboriginal participants. The median age was 31.9 (interquartile range: 23.4–39.3). GEE analyses found that each harmful microinjecting practice was associated with a unique profile of sociodemographic and behavioral factors. Discussion We observed high rates of harmful microinjecting practices among IDU. The present study describes the epidemiology of harmful microinjecting practices and points to the need for strategies that target higher risk individuals including the use of peer-driven programs and drug-specific approaches in an effort to promote safer injecting practices.

Rachlis, Beth; Lloyd-Smith, Elisa; Small, Will; Tobin, Diane; Stone, Dave; Li, Kathy; Wood, Evan; Kerr, Thomas

2013-01-01

278

Predictors of short-term deterioration and compliance in psychiatric emergency patients: a prospective study of 457 patients referred to the emergency room of a general hospital  

Microsoft Academic Search

The aim of this study was to identify predictors of (1) short-term outcome and (2) short-term compliance with treatment (for non-hospitalized patients) in psychiatric emergency patients. Subjects comprised 457 patients referred to the emergency ward of a French general hospital and requiring examination by a psychiatrist. Clinical and therapeutic assessments were carried out at baseline, using DSM-IV diagnoses and overall

Didier Cremniter; Christine Payan; Antoine Meidinger; Guillermo Batista; Jacques Fermanian

2001-01-01

279

An audit of the quality of operation notes in two district general hospitals. Are we following Royal College guidelines?  

PubMed

The quality of medical record keeping is being subjected to increasingly close scrutiny. The 1992 report of the National Confidential Enquiry into Perioperative Deaths (NCEPOD) noted a considerable variation in the quality of operation notes submitted by all contributing surgical specialties. This study has audited the quality of 264 general surgical operation notes written by 10 consultants and 16 trainees in two district general hospitals (DGH). Postoperative instructions were absent in nearly two-thirds of operation notes and serial numbers of prostheses were rarely recorded. On almost every criterion trainees scored higher than consultants and emergency operation notes scored better than elective notes. About 70 per cent of notes written by consultants were illegible or the procedure could not be understood from the description given, by the nurse or junior doctor collecting the data. Until word processor databases become more widespread in operating theatres, it is suggested that a specifically designed proforma be used, with prescribed headings to act as aides-mémoire for the surgeon. PMID:8017801

Baigrie, R J; Dowling, B L; Birch, D; Dehn, T C

1994-01-01

280

Caesarean or vaginal delivery for preterm very-low-birth weight (?1,250 g) infant: experience from a district general hospital in UK  

Microsoft Academic Search

Objective  To determine whether delivery by caesarean is associated with a better neuro-developmental outcome at two years for preterm\\u000a infants born weighing 1,250 g or less.\\u000a \\u000a \\u000a \\u000a Setting  District General Hospital, United Kingdom.\\u000a \\u000a \\u000a \\u000a Design  All inborn infants weighing <1,250 g born at St Helier University Hospital between January 1995 and December 2003 were identified\\u000a from contemporaneously collected computer database. All hospital records were retrieved.

Khalid N. Haque; Anne-Maria Hayes; Zeeshan Ahmed; Rachel Wilde; Choong Yi Fong

2008-01-01

281

Nutrient and phytoplankton dynamics off the west coast of Vancouver Island during the 1997/98 ENSO event  

NASA Astrophysics Data System (ADS)

Six research cruises were conducted off the west coast of Vancouver Island between April and October of 1997 and 1998 as part of the Canadian GLOBEC project to compare nutrient and phytoplankton dynamics between ENSO (1997) and non-ENSO (1998) years. Limited sampling also was conducted during three cruises in 1999. During the 1997 ENSO period, there was a shallow thermocline (˜10 m) that resulted in a shallower mixed layer, lower salinity and density, and stronger summer stratification. In general on the shelf, the 1997 growing season was characterized by higher nitrate (7.5 ?M) and silicic acid (17 ?M) concentrations, lower total chlorophyll (˜76 mg m -2), lower phytoplankton carbon biomass (0.2 mg C L -1), and lower diatom abundance and biomass than in 1998. Phytoplankton assemblages were dominated by nanoplankton in 1997 and by diatoms in 1998. These results suggest that the 1997 ENSO was responsible for a reduction in the growth and biomass of larger phytoplankton cells. In mid-1998, the hydrographic characteristics off the west coast of Vancouver Island changed suddenly. The 1997 poleward transport of warm water reversed to an equatorward transport of coastal water in July 1998, which was accompanied by normal summer upwelling. During 1998, a large diatom bloom (mainly dominated by Chaetoceros debilis, Leptocylindrus danicus and to a lesser extent by Skeletomema and Pseudo-nitzschia sp.) was observed in July over the continental shelf. This large bloom resulted in chlorophyll concentrations of up to 400 mg m -2, primary productivity of up to 11 g C m -2 d -1, and near undetectable dissolved nitrogen concentrations at some of the shelf stations in 1998. In contrast, during 1997, the sub-tropical waters that were advected over the slope, resulted in low chlorophyll a and primary productivity (generally <1 g C m -2 d -1). Therefore, there was a sharp contrast between the very high primary productivity on the shelf in July 1998, due to normal nutrient replenishment from summer upwelling and outflow from the Strait of Juan de Fuca, and the lower primary productivity during the 1997 ENSO year. During 1998, non-ENSO conditions resulted in phytoplankton biomass that was twice as high on the shelf as that measured in regions beyond the continental shelf of the west coast of Vancouver Island.

Harris, Shannon L.; Varela, Diana E.; Whitney, Frank W.; Harrison, Paul J.

2009-12-01

282

Major depressive disorder in the general hospital: adaptation of clinical practice guidelines ? ? This project has been supported by the Clinical Epidemiology Center whose funds are allocated by the University Hospital Department of Community Medicine and Community Health, Lausanne, Switzerland  

Microsoft Academic Search

Major Depressive Disorder is particularly frequent among physically ill inpatients. Despite the considerable human burden and financial costs, Major Depressive Disorder remains under-detected and under-treated. To improve this situation, clinical practice guidelines for the management of Major Depressive Disorder were developed for patients in the general hospital. They were adapted from existing good quality guidelines. A literature search has been

Rachel Voellinger; Alexandre Berney; Pierre Baumann; Jean-Marie Annoni; Christian Bryois; Thierry Buclin; Christophe Büla; Vincent Camus; Laurent Christin; Jacques Cornuz; Pierre de Goumoëns; Olivier Lamy; Jindrich Strnad; Bernard Burnand; Frederic Stiefel

2003-01-01

283

Perceptions of Receiving Bad News about Cancer among Bone Cancer Patients in Sarawak General Hospital - A Descriptive Study  

PubMed Central

Background: This study aimed to determine the perceptions and expectations of bone cancer patients with respect to their doctors and the breaking of bad news as well as the environment in which the news was delivered. Methods: A cross-sectional study using a pretested 41-item questionnaire was conducted using convenience sampling among bone cancer patients in Sarawak General Hospital. Face-to-face interviews were conducted after consent was obtained. Data were analysed using SPSS version 16 (SPSS Inc., IL, US). Results: A total of 30 patients were interviewed. The majority of the respondents were younger than 40-years-old, Malays, and female. All of the respondents perceived that they received news in a comfortable place, agreed that the doctor used simple language and appropriate words during the interaction, and believed that the way the doctor delivered the news might influence their life. The majority of the respondents reported that their news was received without interruption, that the doctor was sitting close but without making physical contact, and time was given for patient to ask questions and they were informed accordingly. Conclusion: Delivering bad news regarding cancer is an important communication skill and a complex task that can be learned and acquired. Specially tailored training is proposed to improve medical practice in this area.

Cheah, Whye Lian; Dollah, Nurul Bahariah; Chang, Ching Thon

2012-01-01

284

Non-operative management of blunt abdominal trauma. Is it safe and feasible in a district general hospital?  

PubMed Central

Background To evaluate the feasibility and safety of non-operative management (NOM) of blunt abdominal trauma in a district general hospital with middle volume trauma case load. Methods Prospective protocol-driven study including 30 consecutive patients who have been treated in our Department during a 30-month-period. Demographic, medical and trauma characteristics, type of treatment and outcome were examined. Patients were divided in 3 groups: those who underwent immediate laparotomy (OP group), those who had a successful NOM (NOM-S group) and those with a NOM failure (NOM-F group). Results NOM was applied in 73.3% (22 patients) of all blunt abdominal injuries with a failure rate of 13.6% (3 patients). Injury severity score (ISS), admission hematocrit, hemodynamic status and need for transfusion were significantly different between NOM and OP group. NOM failure occurred mainly in patients with splenic trauma. Conclusion According to our experience, the hemodynamically stable or easily stabilized trauma patient can be admitted in a non-ICU ward with the provision of close monitoring. Splenic injury, especially with multiple-site free intra-abdominal fluid in abdominal computed tomography, carries a high risk for NOM failure. In this series, the main criterion for a laparotomy in a NOM patient was hemodynamic deterioration after a second rapid fluid load.

Giannopoulos, George A; Katsoulis, Iraklis E; Tzanakis, Nikolaos E; Patsaouras, Panayotis A; Digalakis, Michalis K

2009-01-01

285

High resolution ultrasonography of the hand and wrist: three-year experience at a District General Hospital Trust.  

PubMed

A retrospective analysis of 227 patients undergoing ultrasonography (US) of the hand/wrist over a three-year period in a district general hospital trust was performed. The usefulness in each case was assessed by two independent reviewers using a qualitative rating system, as (A) Useful: determines management, (B) Useful: contributory, (C) Not useful: not misleading, or (D) Not useful: misleading/potentially harmful. US was useful in 74.8% of cases but misleading/potentially harmful in 13.1%. Misleading rates exceeding 10% in sub-categories including tendinopathy, carpal tunnel syndrome, foreign body and lumps, where US findings may influence the decision to operate or not, are particularly worrying. There were a number of cases where US led to unnecessary operations or suggested operating on the wrong structures, and also cases where US findings wrongly suggested that surgery was unnecessary. Various recommendations aimed to improve the usefulness of US in the Hand and Wrist, including mandatory/formal musculoskeletal US training, are made. PMID:21089192

Chan, J K K; Choa, R M; Chung, D; Sleat, G; Warwick, R; Smith, G D

2010-01-01

286

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

PubMed

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

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

2007-01-01

287

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

NASA Astrophysics Data System (ADS)

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

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

2011-09-01

288

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

PubMed Central

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.

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

2013-01-01

289

Real-time monitoring of currents and water level at second narrows to improve port efficiency in Vancouver harbour  

Microsoft Academic Search

A real-time monitoring system for currents and water levels was installed at Second Narrows in the Port of Vancouver in March 2001. Second Narrows restricts the movement of marine traffic into the upper harbour because of its strong tidal streams, limited depth and the presence of both a vehicular bridge and a rail bridge. The Port of Vancouver undertook a

D. D. Lemon; R. A. J. Chave; M. R. Clarke; T. A. Curran; A. Hinds; A. Thorn; A. Thomson; C. J. Badger

2003-01-01

290

Changes in drug therapy following hospital discharge for patients in a general practice: a German incident study  

Microsoft Academic Search

Objective  In primary care, clinically recommended drug medication is often modified after hospitalization. The aim of the study was\\u000a to examine the frequency and factors associated with GPs changing the hospital drug treatment in a sample of patients discharged\\u000a from the hospital.\\u000a \\u000a \\u000a \\u000a Methods  In a prospective study, the prehospital, hospital and posthospital diagnoses and drug treatment of 130 patients consecutively\\u000a recruited from

Uwe Müller-Bühl; Carolin Gerold; Peter Engeser; Joachim Szecsenyi

2009-01-01

291

Needle exchange and the HIV epidemic in Vancouver: lessons learned from 15 years of research.  

PubMed

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

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

2012-05-11

292

Improving Patient Recruitment to Multicentre Clinical Trials: The Case for Employing a Data Manager in a District General Hospital-Based Oncology Centre  

Microsoft Academic Search

One of the most frequently cited reasons for poor recruitment to multicentre randomized clinical trials is the additional workload placed on clinical staff. We report the effect on patient recruitment of employing a data manager to support clinical staff in an English district general hospital (DGH). In addition, we explore the effect data managers have on the quality of data

J. Strong; S. Karp

2001-01-01

293

Role of carotid sinus syndrome and neurocardiogenic syncope in recurrent syncope and falls in patients referred to an outpatient clinic in a district general hospital  

Microsoft Academic Search

Carotid sinus syndrome (CSS) and neurocardiogenic syncope (NCS) are recognised as important causes of recurrent syncope and falls in the elderly. In this study the role of CSS (diagnosed with carotid sinus massage) and NCS (diagnosed with prolonged head-up tilt) in a district general hospital were investigated.Over 27 consecutive months carotid sinus massage was performed in 139 patients. Of these

Abuzeid Eltrafi; Debra King; Joseph H Silas; Peter Currie; Michael Lye

2000-01-01

294

Anxiety, burnout and coping styles in general hospital staff exposed to workplace aggression: A cyclical model of burnout and vulnerability to aggression  

Microsoft Academic Search

Although an increasing problem, the aggression ( physical assault, threatening behaviour and verbal aggression) directed toward general hospital staff rather than staff in psychiatric institutions has not been widely investigated. The present study first compared anxiety, coping styles and burnout according to the frequency of aggressive experiences. Second, a sub-sample was examined to determine any immediate after-effects from aggressive encounters.

Sue Winstanley; Richard Whittington

2002-01-01

295

An Examination and Analysis of the Dynamics of the Human Behavior in the Fire Incident at the Maryland General Hospital on August 8, 1978.  

National Technical Information Service (NTIS)

The fire incident at the Maryland General Hospital on August 8, 1978 was detected by a nurses aide at approximately 0813 hours. The nurses aide detected an odor of smoke in the west corridor of the sixth floor central nursing unit. The nurses aide immedia...

J. L. Bryan P. J. DiNenno

1979-01-01

296

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

PubMed Central

Background Although the general association between socioeconomic status (SES) and hospitalization has been well established, few studies have considered the relationship between SES and hospital length of stay (LOS), and/or hospital re-admission. The primary objective of this study therefore, was to examine the relationship of SES to LOS and early re-admission among adult patients hospitalized with community-acquired pneumonia in a setting with universal health insurance. Methods Four hundred and thirty-four (434) individuals were included in this retrospective, longitudinal cohort analysis of adult patients less than 65 years old admitted to a large teaching hospital in Vancouver, British Columbia. Hospital chart review data were linked to population-based health plan administrative data. Chart review was used to gather data on demographics, illness severity, co-morbidity, functional status and other measures of case mix. Two different types of administrative data were used to determine hospital LOS and the occurrence of all-cause re-admission to any hospital within 30 days of discharge. SES was measured by individual-level financial hardship (receipt of income assistance or provincial disability pension) and neighbourhood-level income quintiles. Results Those with individual-level financial hardship had an estimated 15% (95% CI -0.4%, +32%, p = 0.057) longer adjusted LOS and greater risk of early re-admission (adjusted OR 2.65, 95% CI 1.38, 5.09). Neighbourhood-level income quintiles, showed no association with LOS or early re-admission. Conclusion Among hospitalized pneumonia patients less than 65 years, financial hardship derived from individual-level data, was associated with an over two-fold greater risk of early re-admission and a marginally significant longer hospital LOS. However, the same association was not apparent when an ecological measure of SES derived from neighbourhood income quintiles was examined. The ecological SES variable, while useful in many circumstances, may lack the sensitivity to detect the full range of SES effects in clinical studies.

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

2006-01-01

297

Almost Nine Years of Tremor Beneath Vancouver Island Monitored With a Two Station Tremor Detector  

NASA Astrophysics Data System (ADS)

The coherence which we find in the seismic signals of tremor beneath Vancouver Island allows the implementation of tremor detectors. Tremor is a double-couple source on the shallow dipping convergent plate interface, thus two stations positioned along strike receive optimum shear wave signals from tremor. With this favorable radiation pattern a pair of stations can monitor ~100 km of the subduction zone. The long duration of tremor events allows them to be distinguished from most other signals, regional surface waves being the greatest source of false detections. When tremor is detected the relative arrival time is determined and a plot of this is an analog for position of the tremor along strike. Two suitable stations are PGC (Sidney, BC) and VGZ (Gonzales, BC) , separation 28 km, with three component data available from the beginning of 2003 to the present. Application of the detector to these data finds the seven major episodes of tremor reported elsewhere and confirms the south to north migration of tremor generally observed in this portion of Cascadia. In addition at least 50 minor episodes of tremor are observed with approximately as much tremor in minor episodes as in major episodes. An alternative pair of stations are SIL and SSI with data from the beginning of 2003 to June 2006. The SIL-SSI and PGC-VGZ results are similar. The shorter separation of SIL-SSI (19 km) make them more sensitive, seeing approximately twice as many events. The most recent tremor was a strong burst north of PGC on June 27-28, 2011. The two station detector is an efficient monitor of tremor in Cascadia and we anticipate the next major episode of tremor in the fall of 2011.

Armbruster, J. G.

2011-12-01

298

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

Microsoft Academic Search

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 Coruña University Hospital (Spain) during the period 1997-2007,\\u000a assessed by the Consultation and Liaison

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

2011-01-01

299

The Hospital Incidence and Clinical Significance of Congenital Heart Malformations Resulting from Rubella Embryopathy  

PubMed Central

A retrospective study is reported of 75 children with rubella embryopathy syndrome, admitted to the Health Centre for Children, Vancouver General Hospital, during the four-year period from July 1, 1964 to July 1, 1968. Sixty-four of the 75 had cardiovascular malformations, 37 had ophthalmological defects, 31 had nerve deafness and three were mentally retarded. The most common cardiovascular defects were patent ductus arteriosus (36 patients), ventricular septal defect (22 patients) and pulmonary valvular stenosis (17 patients). Ninety-three per cent of the mothers had a history of exposure to rubella during their first trimester. The administration of gamma globulin to mothers exposed to rubella did not prevent fetal damage. Although this group of patients accounted for only 6% of children requiring open-heart surgery, it did account for 27% of the children having closed-heart surgical procedures and 10% of the case load of the cardiac catheterization laboratory.

Vince, Dennis J.

1970-01-01

300

Factors Influencing Reproduction in Captive Vancouver Island Marmots: Implications for Captive Breeding and Reintroduction Programs  

Microsoft Academic Search

Many factors important to reproduction are difficult to quantify for wild mammals, yet an understanding of them is often critical to species' recovery programs, particularly those involving captive breeding and reintroduction. We examined management variables employed by the Vancouver Island marmot captive breeding program during 1998-2005 to determine how such variables influenced production of young and litter sizes. We then

Diane L. Casimir; Axel Moehrenschlager; Robert M. R. Barclay

2007-01-01

301

Gender Differences in Vancouver Secondary Students''Interests Related to Information Technology Care  

Microsoft Academic Search

ABSTRACT This paper presents results from a survey ,of Vancouver ,secondary ,school students on their ,interests and perceived abilities in a range of subjects, the factors they felt would influence their career choices, and a number of issues related to computer ,use and perceptions of computer ,professionals. Females indicated substantially lower interest and perceived ability than males in three subjects,

V. Chan

2000-01-01

302

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

Microsoft Academic Search

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

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

2004-01-01

303

Anemia quatsinoensis sp. nov. (Schizaeaceae), a Permineralized Fern from the Lower Cretaceous of Vancouver Island  

Microsoft Academic Search

Anatomically preserved schizaeaceous vegetative and fertile organs have been identified from the Apple Bay locality (Lower Cretaceous) of Vancouver Island, British Columbia. Specimens are permineralized in calcareous nodules that contain numerous plants and marine invertebrates. Fertile pinnules are pinnately lobed, with abaxial sporangia and abaxially reflexed laminae. The pyriform sporangia have an apical annulus and occur in two rows on

Ruth A. Stockey; Gar W. Rothwell

2006-01-01

304

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

Microsoft Academic Search

Cryptococcus gattii causes life-threatening infection of the pulmonary and central nervous systems in hosts with normal immunity and traditionally has been considered to be restricted geographically to tropical and subtropical climates. The recent outbreak of C. gattii in the temperate climate of Vancouver Island, BC, Canada, led to a collaborative investigation. The objectives of the current study were to ascertain

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

2004-01-01

305

Police and public health partnerships: Evidence from the evaluation of Vancouver's supervised injection facility  

Microsoft Academic Search

In various settings, drug market policing strategies have been found to have unintended negative effects on health service use among injection drug users (IDU). This has prompted calls for more effective coordination of policing and public health efforts. In Vancouver, Canada, a supervised injection facility (SIF) was established in 2003. We sought to determine if local police impacted utilization of

Kora DeBeck; Evan Wood; Ruth Zhang; Mark Tyndall; Julio Montaner; Thomas Kerr

2008-01-01

306

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

Microsoft Academic Search

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

Kay Cahill

2011-01-01

307

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

Microsoft Academic Search

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

Christabelle Sethna; Steve Hewitt

2009-01-01

308

The genetic legacy of extirpation and re-colonization in Vancouver Island wolves  

Microsoft Academic Search

Hybridization between wild and domestic spe- cies is of conservation concern because it can result in the loss of adaptations and\\/or disappearance of a distinct taxon. Wolves from Vancouver Island, British Columbia (Canada), have been subject to several eradication campaigns during the twentieth century and were considered virtually extir- pated between 1950 and 1970. In this study, we use control

Violeta Munoz-Fuentes; Chris T. Darimont; Paul C. Paquet; Jennifer A. Leonard

2009-01-01

309

In back alleys near Vancouver's AIDS conference, the disease was gaining ground.  

PubMed Central

There was much more to this summer's international AIDS conference in Vancouver than reports by researchers. Richard Cairney says the $15-million conference attracted a mix of activists, demonstrators, physicians and business representatives, and they coexisted somewhat uneasily. Images p1161-a p1161-b p1163-a

Cairney, R

1996-01-01

310

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

ERIC Educational Resources Information Center

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

Cahill, Kay

2009-01-01

311

Electromagnetic induction in the San Juan Bay region of Vancouver Island  

Microsoft Academic Search

The response of the electric and magnetic field variations over the San Juan Bay region of Vancouver Island is studied using a scaled laboratory analogue model. The laboratory frequencies simulate periods of 10 and 100 s in the geophysical problem. The model results indicate that, for both E- and H-polarization of the source field, induced current in the ocean is

G. H. Chan; H. W. Dosso; L. K. Law

1981-01-01

312

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

Microsoft Academic Search

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

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

313

Complex context: Aboriginal participation in hosting the Vancouver 2010 Winter Olympic and Paralympic Games  

Microsoft Academic Search

In an effort to build understanding of diverse Indigenous experiences with the Olympics, we explore the relationship between the Vancouver Organizing Committee and the Four Host First Nations Society (FHFN). The research is grounded in theory that stresses the social influence and political nature of material–cultural landscapes. The article also connects important details from two disparate literatures: the politics and

Jennifer J. Silver; Zoë A. Meletis; Priya Vadi

2012-01-01

314

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

ERIC Educational Resources Information Center

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

Guardado, Martin

2006-01-01

315

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

Microsoft Academic Search

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

Susan C. Boyd; Joy L. Johnson; Barbara Moffat

2008-01-01

316

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

Microsoft Academic Search

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

Adrian Weber; Benjamin Gilbert; C. E. Prescott

2003-01-01

317

Psychometric properties of The Hospital Anxiety and Depression Scale and The General Health Questionnaire-20 in COPD inpatients.  

PubMed

Aim: To compare the psychometric properties between the Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire-version 20 (GHQ-20) in detecting psychological distress in COPD patients referred to pulmonary rehabilitation, and to examine the factor structure of GHQ-20. Methods: The study comprised 161 consecutive patients with mild to very severe COPD. For comparison of mean scores between the HADS and GHQ-20, one sample t-test was used. Potential differences in the detection of possible and normal cases were analysed using Pearson Chi square test. We report Pearson's correlations within and between the questionnaires, and internal consistency was assessed through Chronbach's alpha. The factor structure of the GHQ-20 was examined through principal axis factoring (PAF) with oblique rotation and eigenvalue >1. Results: There were no differences in mean scores of psychological distress between HADS and GHQ-20 (12.03 vs. 24.73, p = 0.000), as well as no differences in the prevalence of possible cases of psychological distress (34.6 vs. 36.9, p = 0.000) and normal cases (65.4 vs. 63.1, p = 0.000). The observed difference between HADS and GHQ-20 regarding internal consistency was marginal, with Chronbach's alpha coefficients of 0.91 and 0.94, respectively. The PAF analysis resulted in a three-factor solution for GHQ-20, notably with only two items loading on the third factor, giving an internal consistency <0.70. A two-factor solution, comprising anxiety/depression and coping, may therefore be more appropriate. Conclusions: This study demonstrates no significant differences between the HADS and GHQ-20 in their ability to detect possible cases of psychological distress in a rehabilitation setting for COPD patients. Although the HADS and GHQ-20 are measuring different concepts of psychological distress, both questionnaires can be recommended as screening tools for detection of psychological distress in COPD inpatients. The GHQ-20 appears to be two-dimensional, comprising anxiety/depression as one dimension, and coping as the other dimension. PMID:23713548

Bratås, Ola; Grønning, Kjersti; Forbord, Toril

2013-05-29

318

Planning for Hospital Pharmacies.  

National Technical Information Service (NTIS)

The publication presents guidelines for planning pharmacy facilities in short-term general hospitals. While the text refers specifically to hospitals of 100, 300, and 500 beds, the publication should prove useful to hospitals of any type or size. Planning...

1974-01-01

319

Changes in Outcome during Implementation of a Fast-Track Colonic Surgery Project in a University-Affiliated General Teaching Hospital  

Microsoft Academic Search

Background and Aims: The aim of this study was to investigate whether changes can be accomplished rapidly after implementing a fast-track colonic surgery project at a university-affiliated general teaching hospital. Methods: In 2004 and 2005 all colonic surgery patients were recorded for a number of pre-, per- and postoperative care elements. In 2006, during the implementation of a fast-track program,

K. J. C. Jottard; C. van Berlo; L. Jeuken; C. Dejong

2008-01-01

320

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

PubMed Central

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

Feng, Bin; Tan, Qingrong; Ji, Jianlin

2013-01-01

321

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

ERIC Educational Resources Information Center

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

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

2007-01-01

322

The majority of hospitalised patients have drug-related problems: results from a prospective study in general hospitals  

Microsoft Academic Search

Objective: To describe the frequency and types of drug-related problems (DRPs) in hospitalised patients, and to identify risk factors for DRPs and the drugs most frequently causing them.Methods From May to December 2002, 827 patients from six internal medicine and two rheumatology departments in five hospitals in Norway were included in this study. We recorded demographic data, drugs used, relevant

Hege Salvesen Blix; Kirsten K. Viktil; Åsmund Reikvam; Tron Anders Moger; Bodil Jahren Hjemaas; Piia Pretsch; Tine Flindt Vraalsen; Elspeth K. Walseth

2004-01-01

323

Psychiatric Morbidity and Burnout in the Medical Profession: An Italian Study of General Practitioners and Hospital Physicians  

Microsoft Academic Search

Background: Burnout and psychological stress symptoms represent a major problem among health care professionals. The aim of this study was to investigate the prevalence of and the relationship between psychiatric morbidity and burnout among a convenience sample of Italian primary care physicians (GPs) and hospital physicians (HPs). Method: The sample consisted of 328 physicians (182 GPs and 146 HPs) who

Luigi Grassi; Katia Magnani

2000-01-01

324

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

PubMed Central

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

2013-01-01

325

General hospital presentations of non-fatal hanging over a 28-year period: case-control study  

Microsoft Academic Search

Summary Suicide by hanging and self-strangulation ('hanging') has become more common. We studied people who presented to hospital during a 28-year study period after using these methods for non-fatal self-harm. Hanging increased greatly in frequency during this time. The male:female ratio was nearly 3:1. Females were distinguished from males by far higher rates of psychiatric care, personality disorder and previous

Keith Hawton; Helen Bergen; Deborah Casey; Sue Simkin

2008-01-01

326

Antibiotic use in 26 departments of internal medicine in 6 general hospitals in Israel: variability and contributing factors  

Microsoft Academic Search

Objectives: Increased antibiotic consumption is associated with increased bacterial resistance worldwide. We aimed to analyse antibiotic consumption and potential contributory factors in internal medicine departments in Israel. Methods: Data (2003-04) from 26 departments in 6 hospitals were retrieved. Defined daily doses (DDD)\\/100 bed-days were calculated for total antibiotic use and by antibiotic class. Patterns identified were correlated with 15 patients'

Itamar Shalit; Marcelo Low; Erez Levy; Michal Chowers; Oren Zimhony; Klaris Riesenberg; Jihad Bishara; Raul Raz

327

Founding an adverse drug reaction (ADR) network: A method for improving doctors spontaneous ADR reporting in a general hospital.  

PubMed

Adverse drug reactions (ADR) are underreported by doctors despite numerous efforts. We aimed to determine if establishing an "ADR reporting doctor's network" within a hospital would increase the quantity of ADRs reported by hospital doctors. One hundred hospital doctors joined the network. Email reminders were sent to network members during the 1 year study period, conveying information about ADRs reported, amusingly and pleasantly reminding them to report ADRs in minimal detail, by phone, email, text message or mail to the Clinical Pharmacology Unit, who would further complete the report. A total of 114 ADRs were reported during the study period in comparison to 48, 26, and 17 in the previous 3 years (2008, 2009, 2010, respectively). In the 3 years prior, doctors reported 41.7% of the reported ADRs whereas in the study period, doctors reported 74.3% of ADRs (P?

Goldstein, Lee Hilary; Berlin, Maya; Saliba, Walid; Elias, Mazen; Berkovitch, Matitiyahu

2013-08-19

328

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

PubMed Central

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.

2011-01-01

329

Parallel alternatives: Chinese-Canadian farmers and the Metro Vancouver local food movement  

Microsoft Academic Search

This article explores how food system localisation efforts in Metro Vancouver, Canada, intersect with tensions in the global agri-food system, including racial inequalities. Drawing on archival research, participant observation of local food marketing and policy-making, and interviews with local food movement participants, policy-makers, and Chinese-Canadian farmers, we explore factors that have influenced the emergence of a food system comprised of

Natalie Gibb; Hannah Wittman

2012-01-01

330

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

Microsoft Academic Search

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

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

2005-01-01

331

Revision hip arthroplasty as a treatment of Vancouver B3 periprosthetic femoral fractures without bone grafting  

PubMed Central

Background: It is conventionally considered that bone grafting is mandatory for Vancouver B3 periprosthetic femoral fractures (PFF) although few clinical studies have challenged the concept previously. The aim of the current study was to investigate the radiographic and functional results of Vancouver B3 PFF treated by revision total hip or hemiarthroplasty (HA) in combination with appropriate internal fixation without bone grafting. Materials and Methods: 12 patients with Vancouver B3 PFF were treated by revision THA/HA without bone grafting between March 2004 and May 2008. There were nine females and three males, with an average age of 76 years. PFFs were following primary THA/HA in nine patients and following revision THA/HA in three. Postoperative followup was 5.5 years on average (range, 3.5-6.5 years). At the final followup, radiographic results were evaluated with Beals and Tower's criteria and functional outcomes were evaluated using the Merle d’Aubigné scoring system. Results: All fractures healed within an average of 20 weeks (range, 12-28 weeks). There was no significant deformity and shortening of the affected limb and the implant was stable. The average Merle d’Aubigné score was 15.8. Walking ability was regained in 10 patients without additional assistance, while 2 patients had to use crutches. There were 2 patients with numbness of lateral thigh, possibly due to injury to the lateral femoral cutaneous nerve. There were no implant failures, dislocation and refractures. Conclusions: Revision THA/HA in combination with appropriate internal fixation without bone grafting is a good option for treatment of Vancouver B3 periprosthetic femoral fractures in the elderly.

Wang, Jia-Qi; Gao, You-Shui; Mei, Jiong; Rao, Zhi-Tao; Wang, Shu-Qing

2013-01-01

332

The genetic legacy of extirpation and re-colonization in Vancouver Island wolves  

Microsoft Academic Search

Hybridization between wild and domestic species is of conservation concern because it can result in the loss of adaptations\\u000a and\\/or disappearance of a distinct taxon. Wolves from Vancouver Island, British Columbia (Canada), have been subject to several\\u000a eradication campaigns during the twentieth century and were considered virtually extirpated between 1950 and 1970. In this\\u000a study, we use control region mitochondrial

Violeta Muñoz-Fuentes; Chris T. Darimont; Paul C. Paquet; Jennifer A. Leonard

2010-01-01

333

Fit for the fight? Illnesses in the Norwegian team in the Vancouver Olympic Games  

Microsoft Academic Search

BackgroundThe development of strategies to prevent illnesses before and during Olympic Games provides a basis for improved health and Olympic results.Objective(1) To document the efficacy of a prevention programme on illness in a national Olympic team before and during the 2010 Vancouver Olympic Winter Games (OWG), (2) to compare the illness incidence in the Norwegian team with Norwegian incidence data

Dag Vidar Hanstad; Ola Rønsen; Svein S Andersen; Kathrin Steffen; Lars Engebretsen

2011-01-01

334

Confronting the Cold War: The 1950 Vancouver Convention of the Cooperative Commonwealth Federation  

Microsoft Academic Search

: The 1950 Vancouver convention of the Co-operative Commonwealth Federation (ccf) opened against the backdrop of the Korean War and tense Cold War debates within Canada’s social democratic party. Providing a window into this moment of ideological tension, the gathering demonstrates how leftists sought to forge domestic and foreign policies amenable to the narrow public opinion of the McCarthy era.

Benjamin Isitt

2010-01-01

335

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

Microsoft Academic Search

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

Junichi Yoshida; Masahiro Shinohara; Mikimasa Ishikawa; Kenichi Matsuo

2006-01-01

336

Seismic structure of the Vancouver Island continental shelf using tomographic & waveform inversion of multichannel seismic refraction data  

NASA Astrophysics Data System (ADS)

The Tofino basin on the Vancouver Island continental shelf contains up to 4 km of sedimentary rocks, which lie above the accretionary wedge basement, the ocean basaltic Crescent terrane and the marine sedimentary Pacific Rim terrane. High resolution seismic velocity models from travel time tomography and full waveform inversion were used to determine the correlations between seismic velocities and structures interpreted from the multichannel seismic data. In particular, the study aims to illuminate deformation within accretionary wedge and Tofino basin sediments and the nature of basement structures. The MCS data used in this study were acquired in 1989 using a 144 channel streamer with maximum offset of 3783 m. First arrival offsets are observed out to maximum offset, with maximum apparent velocities typically near 2.2 km/s but locally as large as 4.8 km/s. A starting model was carefully constructed by first modeling a subset of the travel times using a ray-tracing approach in a block model with interfaces. The final model was obtained in a tomographic inversion of first arrival travel times within a uniform velocity grid with a grid spacing of 25 m. Modeled travel times and observed travel times agreed with a travel time residual of 6 ms, which was equivalent to the picking error. Based on formal corrugation tests, the model was able to resolve structures with a lateral resolution of ~1 km to depths of 0.5-1 km. The most prominent feature of the velocity model is a localized zone with a width of 6-8 km, in which seismic velocities rapidly increase sharply from 2.0 km/s to 2.4 km/s at 0.75 km depth and then uniformly to 4.8 km/s at 1.5 km depth. This is interpreted as the shallowest occurrence of volcanic Crescent terrane. An anticlinal fold or diapiric feature in the sediments is found ~2-3 km landward of the shallowest Crescent terrane, and is likely associated with a landward dipping fault (Tofino fault) that forms the top boundary of Crescent terrane. However, the maximum magnetic anomaly occurs ~5 km landward of the shallowest Crescent terrane, which may be highly fractured where it is shallow, or otherwise demagnetized. Within the shallow shelf sediments, velocities generally increase landwards. Sediments with velocities of 2 km/s are found at a depth of ~650 m near the shelf edge, and this depth decreases fairly uniformly to ~350 m at a distance of ~ 10 km from Vancouver Island. This increase in velocity may reflect the overall compaction of shelf sediments associated with the long-term and ongoing subduction of the Juan de Fuca plate. A sharp landward increase in shallow velocities near Vancouver Island likely indicates the transition to Pacific Rim terrane. The velocity model from the first-arrival tomographic inversion produces modeled travel times that are within ~ 1/4 period of observed travel times. It is thus suitable as a starting model for full waveform inversion. Results of the inversion, which is currently underway, should reveal even more details of structure and associated processes within sediments of Tofino basin.

Yelisetti, S.; Spence, G.

2010-12-01

337

The Vancouver Lymphadenopathy-AIDS Study: 7. Clinical and laboratory features of 87 cases of primary HIV infection.  

PubMed

In an ongoing prospective study of homosexual men conducted in Vancouver since November 1982, 87 cases of human immunodeficiency virus (HIV) seroconversion have been documented to date. Comparison of laboratory results obtained a mean of 4.9 months before and 5.4 months after the estimated date of seroconversion revealed that a significant increase in the serum IgG level (from 1149 to 1335 mg/dl on average) and in C1q binding (from 8.8% to 14.2% on average) was associated with early HIV infection (p less than 0.001). A marginally significant decrease in the ratio of helper to suppressor (CD4 to CD8) cells (from 1.55 to 1.29 on average) was also noted (p = 0.025). A marked decrease in absolute number of CD4 cells was not seen with seroconversion, which suggests that profound loss of these cells may be a long-term effect of HIV infection. The occurrence of symptoms (including fatigue, fever, night sweats, unintentional weight loss, diarrhea, joint pains, cough unrelated to smoking, shortness of breath, oral thrush, herpes zoster and rash) did not increase with seroconversion. This finding suggests that most cases of HIV seroconversion may be asymptomatic or associated with relatively minor symptoms. On the other hand, generalized lymphadenopathy was found to develop after HIV seroconversion in about 50% of cases. PMID:3647808

Boyko, W J; Schechter, M T; Craib, K J; Willoughby, B; Douglas, B; Sestak, P; McLeod, W A; O'Shaughnessey, M

1987-07-15

338

The Vancouver Lymphadenopathy-AIDS Study: 7. Clinical and laboratory features of 87 cases of primary HIV infection.  

PubMed Central

In an ongoing prospective study of homosexual men conducted in Vancouver since November 1982, 87 cases of human immunodeficiency virus (HIV) seroconversion have been documented to date. Comparison of laboratory results obtained a mean of 4.9 months before and 5.4 months after the estimated date of seroconversion revealed that a significant increase in the serum IgG level (from 1149 to 1335 mg/dl on average) and in C1q binding (from 8.8% to 14.2% on average) was associated with early HIV infection (p less than 0.001). A marginally significant decrease in the ratio of helper to suppressor (CD4 to CD8) cells (from 1.55 to 1.29 on average) was also noted (p = 0.025). A marked decrease in absolute number of CD4 cells was not seen with seroconversion, which suggests that profound loss of these cells may be a long-term effect of HIV infection. The occurrence of symptoms (including fatigue, fever, night sweats, unintentional weight loss, diarrhea, joint pains, cough unrelated to smoking, shortness of breath, oral thrush, herpes zoster and rash) did not increase with seroconversion. This finding suggests that most cases of HIV seroconversion may be asymptomatic or associated with relatively minor symptoms. On the other hand, generalized lymphadenopathy was found to develop after HIV seroconversion in about 50% of cases.

Boyko, W J; Schechter, M T; Craib, K J; Willoughby, B; Douglas, B; Sestak, P; McLeod, W A; O'Shaughnessey, M

1987-01-01

339

Assessment of the implementation and knowledge of the UK National Guidelines for HIV Testing (2008) in key conditions at a UK district general hospital.  

PubMed

The objective of this study is to audit the implementation and knowledge of the British HIV Association (BHIVA) UK National guidelines for HIV testing (2008) in key conditions at Basildon & Thurrock University Hospital. Basildon Hospital is a district general hospital, serving over 400,000 patients in south-west Essex. A total of 348 patients were assessed through electronic to pathology data and patients' notes to investigate if they had been tested for HIV when diagnosed with the following conditions: tuberculosis (TB), hepatitis B and C, cervical intraepithelial neoplasia grade II/III, lymphoma, anal cancer, seminoma or Castleman's disease. The physicians involved were questioned as to their knowledge of the HIV testing guidelines. Of the 348 patients who were identified as having the above mentioned conditions, only 13.8% of those with any of the key conditions had received an HIV test. Only one non-HIV physician was aware of the guidelines. Knowledge of the 2008 BHIVA HIV testing guidelines is scanty among non-HIV-trained physicians. Health-care professionals in the field, irrespective of their role, should work harder to disseminate information and reduce prejudice that decreases testing of at-risk individuals. PMID:21427432

Gupta, N D; Lechelt, M

2011-02-01

340

Mortality and cost outcomes of elderly trauma patients admitted to intensive care and the general wards of an Australian tertiary referral hospital.  

PubMed

Mortality and cost outcomes of elderly intensive care unit (ICU) trauma patients were characterised in a retrospective cohort study from an Australian tertiary ICU Trauma patients admitted between January 2000 and December 2005 were grouped into three major age categories: aged > or =65 years admitted into ICU (n = 272); aged -65 years admitted into general ward (n = 610) and aged < 65 years admitted into ICU (n = 1617). Hospital mortality predictors were characterised as odds ratios (OR) using logistic regression. The impact of predictor variables on (log) total hospital-stay costs was determined using least squares regression. An alternate treatment-effects regression model estimated the mortality cost-effect as an endogenous variable. Mortality predictors (P < or = 0.0001, comparator: ICU > or = 65 years, ventilated) were: ICU < 65 not-ventilated (OR 0.014); ICU < 65 ventilated (OR 0.090); ICU age > or = 65 not-ventilated (OR 0.061) and ward > or = 65 (OR 0.086); increasing injury severity score and increased Charlson comorbidity index of 1 and 2, compared with zero (OR 2.21 [1.40 to 3.48] and OR 2.57 [1.45 to 4.55]). The raw mean daily ICU and hospital costs in A$ 2005 (US$) for age < 65 and > or = 65 to ICU, and > or = 65 to the ward were; for year 2000: ICU, $2717 (1462) and $2777 (1494); hospital, $1837 (988) and $1590 (855); ward $933 (502); for year 2005: ICU, $3202 (2393) and $3086 (2307); hospital, $1938 (1449) and $1914 (1431); ward $1180 (882). Cost increments were predicted by age < or = 65 and ICU admission, increasing injury severity score, mechanical ventilation, Charlson comorbidity index increments and hospital survival. Mortality cost-effect was estimated at -63% by least squares regression and -82% by treatment-effects regression model. Patient demographic factors, injury severity and its consequences predict both cost and survival in trauma. The cost mortality effect was biased upwards by conventional least squares regression estimation. PMID:19775042

Chan, L Y L; Moran, J L; Clarke, C; Martin, J; Solomon, P J

2009-09-01

341

[The concept of integrated internal medicine-psychosomatic patient management--experiences and results with its application in a general hospital].  

PubMed

Psychosomatic therapy has been realized by integration into general ward's therapeutic program in a general hospital. Within 3 1/2 years of development the medical staff has been qualified to perform basic elements of psychosomatic therapy, whilst the structure of the medical department has been changed in different aspects. During a period of 28 days the real extend of psychosomatic therapy now has been evaluated by questionnaire: 438 psychosomatic and psychosocial interventions were documented in this time, concerning 149 patients (= 53% of all patients treated in the department). Causes, trigger mechanic, settings, frequency, median duration, and different kinds of all these interventions are described. According to the clientèle of our medical department, with a lot of elderly and multi-handicapped persons, the main topics of interventions concerned--besides of specific psychosomatic treatment--addiction and problems of alcoholism, coping strategies and compliance, as well as further support of handicapped singles after discharge. PMID:1924669

Schmeling-Kludas, C; Niemann, B M; Jäger, K; Wedler, H

1991-07-01

342

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

PubMed Central

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

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

1996-01-01

343

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

PubMed Central

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

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

2013-01-01

344

Recognition of depression in children in general hospital-based paediatric units in Kenya: practice and policy implications  

Microsoft Academic Search

BACKGROUND: Physical disorders are commonly comorbid with depression in children attending general medical facilities. However, the depression component is rarely recognised. METHODS: A questionnaire on sociodemographics and history of presenting medical conditions was administered together with the Children's Depression Inventory (CDI) to all 11-year-old to 17-year-old children attending at nine medical facilities. RESULTS: In all, 408 children were recruited from

David M Ndetei; Lincoln I Khasakhala; Victoria N Mutiso; Anne W Mbwayo

2009-01-01

345

Relationship between hospital infection and long-term mortality in general surgery: a prospective follow-up study  

Microsoft Academic Search

A prospective study of 1431 patients admitted to a general surgery department were followed up for a median of 6.2 years after discharge (7679 person-years of follow-up). We collected information on underlying conditions, including severity of illness, and healthcare-related variables. Relative rates of death and their 95% confidence interval (CI) were estimated using person-years as the denominator. Multiple-risk factors adjusted

A Cosano; M. Á Mart??nez-González; M Medina-Cuadros; G Mart??nez-Gallego; S Palma; M Delgado-Rodr??guez

2002-01-01

346

Periprosthetic Vancouver type B1 and C fractures treated by locking-plate osteosynthesis  

PubMed Central

Background and purpose Historically, the treatment of periprosthetic femoral fractures (PFFs) has been associated with a high frequency of complications and reoperations. The preferred treatment is internal fixation, a revision of the femoral stem, or a combination of both. An improved understanding of plate use during internal fixation, and the introduction of locking-plate osteosynthesis may lead to improved outcome. We evaluated the outcome of Vancouver type B1 and C PFFs treated by locking-plate osteosynthesis, by assessing rates of fracture union and reoperations and by analyzing failure cases. Patients and methods From 2002 through 2011, 58 consecutive patients (60 fractures) with low-energy PFF around or below a stable femoral stem, i.e. Vancouver type B1 and C fractures, underwent osteosynthesis with a locking plate. All patients had a total hip replacement (THR). They were followed up clinically and radiographically, with 6 weeks between visits, until fracture union or until death. Fracture union was evaluated 6 months postoperatively. Results At a median follow-up time of 23 (0–121) months after PFF, 8 patients (8 fractures) had been reoperated due either to infection (n = 4), failure of fixation (n = 3), or loosening of the femoral stem (n = 1). All the patients who had been followed up for at least 6 months—and who did not undergo reoperation or die—went on to fracture union (n = 43). Interpretation Locking-plate osteosynthesis of periprosthetic Vancouver type B1 and C fractures gives good results regarding fracture union. It appears that spanning of the prosthesis to avoid stress-rising areas is important for successful treatment. Infection is the major cause of failure.

2012-01-01

347

Dr Robert McKechnie: Vancouver's pioneer surgeon and a patron of British Columbia sports & education.  

PubMed

Robert E. McKechnie, M.D.C.M. (1861-1944), was a distinguished graduate of McGill Medical School and a pioneer in the early days of surgery in Vancouver, Canada. He was a long-standing Canadian leader in both clinical and academic surgery. In addition, he played an important role in the founding of the University of British Columbia. He also commissioned an important challenge cup for the British Columbia rugby championship team in the same time and place as the establishment of hockey's Stanley Cup. PMID:22521046

Carter, Preston L

2012-05-01

348

Toxoplasma encephalitis in HIV/AIDS patients admitted to the Douala general hospital between 2004 and 2009: a cross sectional study.  

PubMed

BACKGROUND: It is estimated that about a third of the world's population is chronically infected with Toxoplasma gondii. Toxoplasma encephalitis (TE), which occurs as a reactivation of quiescent chronic infection, is one of the leading causes of central nervous system (CNS) infection in AIDS. Its diagnosis in most centres still remains difficult. We opted to describe the clinical and radiological features of TE as well as in-hospital outcome and its associated factors. METHODS: We carried out a cross sectional study on the clinical case notes of adult patients admitted and treated for TE at the Douala General Hospital, Cameroon between January 1st 2004 to December 31st 2009. RESULTS: Of 672 patients admitted during the study period, 14.4% (97/672) had TE. The mean age was 36.9 +/- 14.1 years and the median CD4 cell count was 68/mm3 (IQR): 43 -- 103). Headache and fever were the most common presenting symptoms in 92.8% (90/97) and 87.6% (85/97) of patients. Annular contrast enhanced lesions were the most common brain scan finding in 81.4% (79/97) of patients. In-hospital mortality was 29.9% (29/97). Altered sensorium, presence of focal signs, neck stiffness and low CD4 cell count were factors associated with mortality. Adjusting for low CD4 count, altered sensorium remained strongly associated with fatality, adjusted odd ratio (AOR) 3.5 (95%CI 1.2 -- 10.5). CONCLUSION: Toxoplasma encephalitis is common among AIDS patients in Douala. Its high case fatality warrants adequate and compliant prophylactic therapy in severely immune depressed patients as well early initiation of antiretroviral therapy in HIV-infected patients. PMID:23587093

Luma, Henry Namme; Tchaleu, Benjamin Clet; Mapoure, Yacouba Njankouo; Temfack, Elvis; Doualla, Marie Solange; Halle, Marie Patrice; Joko, Henry Achu; Koulla-Shiro, Sinata

2013-04-12

349

Intensification of the oxygen minimum zone in the northeast Pacific off Vancouver Island during the last deglaciation: Ventilation and\\/or export production?  

Microsoft Academic Search

The oxygen minimum zone (OMZ) off Vancouver Island was more oxygen depleted relative to modern conditions during the Allerød (~13.5 to 12.6 calendar kyr) and again from ~11 to 10 kyr. The timing of OMZ intensification is similar to that seen throughout the North Pacific, although the onset appears to have been delayed by ~1500 years off Vancouver Island. Radiocarbon

J. L. McKay; T. F. Pedersen; J. Southon

2005-01-01

350

Intensification of the oxygen minimum zone in the northeast Pacific off Vancouver Island during the last deglaciation: Ventilation and\\/or export production?  

Microsoft Academic Search

The oxygen minimum zone (OMZ) off Vancouver Island was more oxygen depleted relative to modern conditions during the Allerød (?13.5 to 12.6 calendar kyr) and again from ?11 to 10 kyr. The timing of OMZ intensification is similar to that seen throughout the North Pacific, although the onset appears to have been delayed by ?1500 years off Vancouver Island. Radiocarbon

J. L. McKay; T. F. Pedersen; J. Southon

2005-01-01

351

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

PubMed

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

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

2012-08-16

352

Breast Cancer Profile in a Group of Patients Followed up at the Radiation Therapy Unit of the Yaounde General Hospital, Cameroon  

PubMed Central

Objective. To describe the profile of breast cancer in the patients attending the radiation therapy unit of Yaounde General Hospital. Method. From 1989 to 2009, we conducted a descriptive retrospective study based on the register and medical records of patients. Results. During the study period, 531 breast cancer patients were recorded of which 0.75% were male. Age range was 18 to 82 years, with a mean of 45.17 years. Out of these, 66.1% were less than 50 years old and 31.9% less than 40. Self detection was the discovery method in most cases (95.34% of patients). Mean delay before presentation at hospital was 10.35 months, and 54.94% had used traditional medicine before medical evaluation. Metastasis and locally advanced breast cancer at diagnosis were present in 08.13% and 62.78%, respectively. Mastectomy was used in 88.08% of patients. Conclusion. The study reinforces the position occupied by late presentation and advanced stage at diagnosis of breast cancer profile in developing countries.

Kemfang Ngowa, J. D.; Yomi, J.; Kasia, J. M.; Mawamba, Y.; Ekortarh, A. C.; Vlastos, G.

2011-01-01

353

Repeat haematinic requests in patients with previous normal results: the scale of the problem in elderly patients at a district general hospital.  

PubMed

Repeating normal laboratory tests can waste resources. This study aimed to quantify unnecessary repeat haematinic tests taken from the elderly in a district general hospital. Haematinic tests (ferritin, B12, serum folate) from patients age ? 70 years were reviewed for repeat tests during an 8-week period. Questionnaires were given to doctors to establish when the considered repeating a 'borderline low normal' result to be clinically justifiable. 7.7% of all haematinic tests were repeat tests and of these, the majority (83%) was performed following a previously normal result. Thirteen of 24 doctors believed repeating a normal result at the bottom of the normal range ('borderline low normal') was justifiable. After excluding 'borderline low normal' results, 6.0% (at minimum) of repeat tests were done following a previous normal result and were unnecessary. This audit showed that there are a significant number of unnecessary repeat haematinic tests being performed. PMID:21692998

Ganiyu-Dada, Z; Bowcock, S

2011-06-22

354

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

PubMed Central

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

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

2011-01-01

355

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

PubMed Central

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

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

2012-01-01

356

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

PubMed Central

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

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

2004-01-01

357

Dental Treatment Needs in Vancouver Inner-City Elementary School-Aged Children  

PubMed Central

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

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

2013-01-01

358

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

PubMed Central

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

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

2010-01-01

359

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

NASA Astrophysics Data System (ADS)

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

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

2011-12-01

360

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

NASA Astrophysics Data System (ADS)

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

Shupe, Scott

2013-01-01

361

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

USGS Publications Warehouse

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

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

1997-01-01

362

A Re-interpreted Seismic Velocity Model Beneath Vancouver Island, Canada: a Shallower Subducting Slab?  

NASA Astrophysics Data System (ADS)

Seismic refraction data collected in 1980 across the Cascadia margin of Vancouver Island have been re-interpreted, since a recent re-evaluation of LITHOPROBE reflection profiles across the margin suggested that the subducting oceanic slab is much shallower than previously thought. Of primary interest on the reflection profiles is the regionally extensive E-reflection band in the lower continental crust. Recently, relocated seismicity, tomographic velocities and reflection images suggested that the E-reflection band lies directly above the subducting oceanic slab. This positions the subducting oceanic slab approximately 6 km shallower than previously interpreted from the refraction data. Using 2D traveltime inversion and synthetic seismograms, we have modeled high-amplitude secondary arrivals as wide-angle reflections from the Moho of the subducting plate, and not as continental Moho reflections. The reflection interface occurs at a depth of 35-37 km beneath central Vancouver Island, so that the top of the subducting slab is at ~30 km depth, just below the E-reflection band. Thus, the revised velocity model with a relocated oceanic slab fits the refraction observations as well as or better than former interpretations.

McNeill, A. F.; Spence, G. D.

2004-05-01

363

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

PubMed

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

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

2013-06-05

364

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

PubMed

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

Cheah, J

2000-07-01

365

Gold for ubiquitin in Vancouver: First Conference on Proteomics of Protein Degradation and Ubiquitin Pathways held June 6-8, 2010 in Vancouver, University of British Columbia, organized By Lan Huang, Thibault Mayor, and Peipei Ping.  

PubMed

The rise of proteomics has had tremendous influence on analysis and understanding of the role of post-translational modifications in biological processes. The covalent attachment of small proteins like ubiquitin, SUMO,(1) or other ubiquitin-like proteins (Ubls) is one class of post-translational modifications where proteomics has had notable impact. Various proteomics approaches, but in particular mass spectrometry-based analyses, have influenced the field and enabled significant advances over the past few years. The first meeting dedicated to proteomics of protein degradation and ubiquitin pathways showcased these advances and allowed a glimpse at future contributions of proteomics to this field. With its many attractive drug targets, the ubiquitin and proteasome system, as well as other proteolysis pathways, could offer new therapies for various human diseases including cancer and neurodegenerative disorders. The covalent linkage of ubiquitin to other proteins is catalyzed by the E1-E2-E3 cascade of enzymatic reactions whereby the many different E3 ubiquitin ligases provide substrate specificity to the process of protein ubiquitylation (1). Ubiquitylation is best known for targeting proteins for degradation by the proteasome, but other functions for ubiquitylation independent of proteolysis are also known. Likewise, modifications with SUMO or other Ubls generally do not regulate protein degradation but instead control subcellular localization, protein interactions, or change protein conformation and activity (2). The questions addressed by proteomics approaches to ubiquitylation and Ubl modifications are plentiful. They range from very specific, e.g. determination of the modified residue in a substrate protein, to complex, such as protein dynamics in proteome-wide ubiquitin (or Ubl) modification profiles (3). In either case, the rapid technological advancements (particularly in mass spectrometry instrumentation as well as quantitation and separation technologies) have allowed impressive progress, which was evident in the First Conference on Proteomics of Protein Degradation and Ubiquitin Pathways in Vancouver (http://ppdup.org/) (Fig. 1). PMID:20834021

Kaiser, Peter; Mayor, Thibault

2010-09-10

366

A comparison of Canadian general pediatric dosing publications.  

PubMed

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

Dayneka, Natalie

2003-01-01

367

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

PubMed

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

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

2012-06-14

368

Gender, Ethnicity, and Hybrid Forms of Community-Based Urban Activism in Vancouver, 1957–1978: The Strathcona story revisited  

Microsoft Academic Search

In the 1960s and early 1970s, residents of the neighbourhood of Strathcona in the city of Vancouver, Canada, successfully fought the grand designs of planners, engineers, politicians and developers to displace residents, demolish homes, clear lands, and rebuild the area. Against all odds, a relatively politically powerless group of residents and their supporters from diverse ethnic and class backgrounds formed

Jo-Anne Lee

2007-01-01

369

Margaretbarromyces dictyosporus gen. sp. nov.: a permineralized corticolous ascomycete from the Eocene of Vancouver Island, British Columbia  

Microsoft Academic Search

A single, permineralized ascoma resembling a pseudothecium assignable to the Pleosporales is described from the Eocene Appian Way fossil locality on Vancouver Island, British Columbia. The ascoma is globose, ostiolate, and erumpent on a fragment of the bark from an unidentified seed plant. Basally arranged asci contain large, multicelled, obovate ascospores within a single cavity or locule enclosed by a

Randal A. Mindell; Ruth A. Stockey; Graham Beard; Randolph S. Currah

2007-01-01

370

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

ERIC Educational Resources Information Center

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

Benjamin, Amanda

2009-01-01

371

Safety and danger in downtown Vancouver: Understandings of place among young people entrenched in an urban drug scene  

Microsoft Academic Search

We undertook this qualitative study to examine young people's understandings of the physical and social landscape of the downtown drug scene in Vancouver, Canada. In-depth interviews were conducted with 38 young people ranging from 16 to 26 years of age. Using the concept of symbolic violence, we describe how one downtown neighborhood in particular powerfully symbolizes ‘risk’ among local youth,

Danya Fast; Jean Shoveller; Kate Shannon; Thomas Kerr

2010-01-01

372

Coping with the Media at the Vancouver Winter Olympics: “We All Make a Living Out of This”  

Microsoft Academic Search

The purpose of this study was to examine the journalist-athlete relationship at a major competitive event to better understand how the media may be perceived as a source of strain and how elite athletes cope with the media demands. Ten participants were interviewed after the 2010 Vancouver Olympic Winter Games. Intrusive questioning may negatively affect and influence the athlete's preparation

Elsa Kristiansen; Dag Vidar Hanstad; Glyn C. Roberts

2011-01-01

373

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

ERIC Educational Resources Information Center

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

Benjamin, Amanda

2009-01-01

374

Fort Lewis, Yakima Firing Center, and Vancouver Barracks/Camp Bonneville basewide energy use plan; executive summary. Final report  

SciTech Connect

This Executive Summary presents an overview of a series of studies, mostly energy related, of Fort Lewis, Yakima Firing Center, Vancouver Barracks, and Camp Bonneville. Collectively, the work is known as the Basewide Energy Use Plan and is a part of the Energy Conservation Investment Program (ECIP).

Smiley, D.P.

1984-03-01

375

Improving Census-based Socioeconomic GIS for Public Policy: Recent Immigrants, Spatially Concentrated Poverty and Housing Need in Vancouver  

Microsoft Academic Search

There are a number of socioeconomic phenomena that are difficult to discern using only census data. We present an innovative approach developed to discern the spatial dimensions of risk for homelessness amongst recent immigrants in Vancouver, Canada. Dasymetric mapping and a postal survey are employed to improve the resolution and utility of census data. The results illustrate the potential for

Rob Fiedler; Nadine Schuurman; Jennifer Hyndman

376

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

Microsoft Academic Search

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

Roxanne Vingarzan; Bill Taylor

2003-01-01

377

Phosphorus forms and related soil chemistry of Podzolic soils on northern Vancouver Island. I. A comparison of two forest types  

Microsoft Academic Search

When cedar-hemlock (CH) and hemlock - amabalis fir (HA) forests of northern Vancouver Island are clearcut and replanted, growth of replanted trees is often poor on CH clearcuts but not adjacent HA clearcuts. This poor growth can be overcome with nitrogen (N) and phosphorus (P) fertilization, which suggests differences in nutrient cycling between CH and HA forests. The objective of

Barbara J. Cade-Menun; Shannon M. Berch; Caroline M. Preston; L. M. Lavkulich

2000-01-01

378

Anatomical distribution of colorectal cancer over a 10 year period in a district general hospital: is there a true "rightward shift"?  

PubMed Central

Introduction: Recent studies of patients with colorectal cancer have suggested a shift towards the proximal colon and an increase in the incidence of right sided colon cancer. This study aimed to determine the anatomical distribution of colorectal cancer over a 10 year period in a district general hospital. Methods: Records of patients diagnosed with primary colorectal cancer from 1993 to 2002 were reviewed for demographic data, histology subtype, and anatomical location of the tumour. Tumours located at and proximal to the splenic flexure were defined as right sided cancer and tumours arising distal to the splenic flexure were defined as left sided cancer. Results: A total of 763 patients were included in the study, of whom all had adenocarcinoma and 99% were white. Sixty nine percent of cancers were left sided and 31% were right sided. Although there was a 4% increase in the proportion of right sided cancers, there was no statistically significant increase using logistic regression analysis. Mann-Whitney U test revealed no significant difference in age at diagnosis between the right and left sided cancers. Although a higher proportion of females were diagnosed with right sided cancer compared with left sided cancer, this was not statistically significant. Conclusion: The anatomical distribution of colorectal cancer has been fairly stable at this hospital with no evidence of a shift towards the proximal colon. No differences were identified in the tumour distribution with respect to gender and age at diagnosis. Our findings support the initial application of flexible sigmoidoscopy for investigating patients with suspected colorectal malignancy and follow up colonoscopy for selected patients to exclude right sided pathology.

Gomez, D; Dalal, Z; Raw, E; Roberts, C; Lyndon, P

2004-01-01

379

Gravity Model Analysis of Hospital Patient Flows.  

National Technical Information Service (NTIS)

The effects of inner city hospital closure and the introduction of selected hospital financing reforms on patient flows in an urban hospital market are evaluated using a generalized gravity model. Closure of inner city hospitals is shown to increase patie...

J. M. Lowe

1993-01-01

380

24 CFR 242.4 - Eligible hospitals.  

Code of Federal Regulations, 2013 CFR

... 2013-04-01 false Eligible hospitals. 242.4 Section 242.4 Housing...AUTHORITIES MORTGAGE INSURANCE FOR HOSPITALS General Eligibility Requirements § 242.4 Eligible hospitals. (a) The hospital to be...

2013-04-01

381

Mopping up hospital infection  

Microsoft Academic Search

: Hospital cleaning is a neglected component of infection control. In the UK, financial constraints have forced managers to re-evaluate domestic services and general cleaning has been reduced to the bare minimum. Services have been contracted out in some hospitals, which has further lowered standards of hygiene. Control of infection personnel believe that cleaning is important in preventing hospital-acquired infections

S. J. Dancer

1999-01-01

382

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

PubMed

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

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

2012-12-20

383

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

NSDL National Science Digital Library

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

Grinnell, Max

2010-02-26

384

The ninth annual Ion Channel Retreat, Vancouver, Canada, June 27-29, 2011.  

PubMed

Nine years ago Aurora Biomed Inc. (Vancouver, Canada) committed to gathering the brightest minds and the most innovative research companies at one conference. The Ion Channel Retreat provides a podium for scientific discourse spanning a wide range of ion channel disciplines. This conference has consistently provided a venue for people to share knowledge, exchange ideas, and establish partnerships. This conference continues to expand and grow each year, demonstrating the value of such a conference. Attendees at the 2011 Ion Channel retreat presented ion channel research from 12 different countries, representing research groups located on 5 of the 7 continents. Aurora Biomed's 2011 Retreat covered a variety of topics including Ion Channels as Disease Targets, Ion Channels as Pain Targets, TRP-channels, Ion Channel Screening Technologies, Cardiac Function and Pharmacology, Cardiac Safety and Toxicology, and Structure and Function of Ion Channels. PMID:22149887

Brugger, Saranna; Garate, Marco; Papaianni, Gina; Volnoukhin, Maria; Zhan, Chris; Gill, Sikander; Liang, Sophia; Liang, Dong

2011-12-01

385

Difficulty accessing crack pipes and crack pipe sharing among people who use drugs in Vancouver, Canada  

PubMed Central

Background Crack pipe sharing can increase health risks among people who use drugs, yet the reasons for sharing these pipes have not been well described. Therefore, we sought to identify the prevalence and correlates of crack pipe sharing among a community-recruited sample of people who use illicit drugs in Vancouver, a setting where crack pipes are provided at low or no cost. Findings Data for this study were derived from two prospective cohorts of people who use drugs: the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS). Multivariate logistic regression was used to identify factors independently associated with crack pipe sharing. Among 503 crack users, 238 (47.3%) participants reported having shared a crack pipe in the previous six months. Having acquired a mouthpiece in the last six months (adjusted odds ratio [AOR] = 1.91; 95% confidence interval [CI]: 1.31 - 2.79) and difficulty finding new pipes (AOR = 2.19; 95%CI: 1.42 - 3.37) were positively associated with pipe sharing. Binge drug use (AOR = 1.39; 95%CI: 0.96 - 2.02) was marginally associated with sharing pipes. Discussion There was a high prevalence of crack pipe sharing in a setting where crack pipes are distributed at low or no cost. Difficulty accessing crack pipes was independently and positively associated with this behavior. These findings suggest that additional efforts are needed to discourage crack pipe sharing as well as increase access to crack pipes.

2011-01-01

386

Seismic Observations of a Possible Carbonate Mound on the Continental Slope off Vancouver Island  

NASA Astrophysics Data System (ADS)

A large carbonate or mud mound was identified about 5 km west of ODP Site 889 on the Vancouver Island continental slope. At its base, the mound is ~1 km wide perpendicular to the margin and ~2 km long parallel to the margin. In dives with the remotely-operated submersible ROPOS in May 2001, we observed widespread carbonate pavement was observed which made it impossible to collect sediment push cores. Piston coring also failed to penetrate the pavement or collect sediment samples. ROPOS also observed several biological communities of tubeworms and clams, indicating that venting of methane was likely active. To interpret the structure of this carbonate mound, a high resolution single channel seismic survey was carried out in summer 2001. The source was a 40 cu.in. sleeve airgun, fired by distance at an interval of 12.5 m. The grid consisted of 80 lines, each 3 km in length and separated by 25 m. The seismic lines, recording coherent reflectivity down to about 400 m beneath the seafloor, provide excellent images of this carbonate/mud mound and of the BSR beneath it. The single channel data form a pseudo-3D single channel seismic grid with 25 m,e 25 m square bins, and so we can use 3D migration techniques to image the complex structures. The mound is bounded on its landward and seaward sides by faults that dip toward Vancouver Island. The faults appear to connect to a particularly strong section of BSR, which may trap locally large concentrations of gas. The faults intersect the surface on either side of the mound, and may provide pathways for methane and other fluids from the gas reservoir to vents at the surface.

He, T.; Spence, G.; Hyndman, R.; Chapman, R. N.

2003-12-01

387

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

PubMed Central

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

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

2009-01-01

388

[Clinical and therapeutic aspects of trigeminal neuralgia. Apropos of 27 cases treated at the General Hospital of Grand-Yoffin Dakar].  

PubMed

The trigeminal neuralgia or "painful tic" of the face is an invalidating affection, which affects the quality of life of the patient. The odontologist must be able to diagnose it and take part in his good therapeutic assumption of responsibility. The diagnosis is sometimes difficult, being able to involve unsuited therapeutic methods prejudicial for the patient. The objective of our study was to analyse the clinical and therapeutic aspects of the trigeminal neuralgia. It was a transverse and descriptive study which 27 files of patients suffering of trigeminal neuralgia and treated in the odontology service of the General hospital of Grand-Yoff in Dakar between July 2002 and July 2008. We exploited the following parameters: the age, the sex, the oral state, duration of the symptoms, characteristics of the pain, the type of treatment. 22 patients of the 27 cases were female. The time of consultation was often late, the patients generally preferring begin with the traditional treatments. The neuralgia of V2 dominated the clinical picture, followed that neuralgia of V3. The pain was strictly unilateral, it was started by movement, speaking, eating or touching the trigger zone. The prescription of carbamazepine (Tegretol) was systematic, and constituted a true test diagnosis, it made possible to obtain an immediate sedation of the pains. In front of the medicamentous treatment failure, the alcoholization of the trigeminal branch has given good performances, indeed it made possible to obtain, a clear lull of more than 12 months for 9 patients out of the 10 who profited from it. The alcoholization of the trigeminal nerve remains an effective cure and constitutes an accessible alternative under our work conditions in Africa. PMID:20069961

Dia Tine, S; Tamba, B; Gassama, B B; Niang, P; Dia, L; Kébé Ndèye, F; Badiane, S; Diallo, B

2009-06-01

389

HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study  

PubMed Central

Background. Studies on HIV-associated central nervous system (CNS) diseases in Cameroon are rare. The aim of this study was to describe the clinical presentation, identify aetiological factors, and determine predictors of mortality in HIV patients with CNS disease. Methods. From January 1, 2004 and December 31, 2009, we did at the Douala General Hospital a clinical case note review of 672 admitted adult (age ? 18 years) HIV-1 patients, and 44.6% (300/672) of whom were diagnosed and treated for HIV-associated CNS disease. Results. The mean age of the study population was 38.1 ± 13.5 years, and median CD4 count was 49 cells/mm3 (interquartile range (QR): 17–90). The most common clinical presentations were headache (83%), focal signs (40.6%), and fever (37.7%). Toxoplasma encephalitis and cryptococcal meningitis were the leading aetiologies of HIV-associated CNS disease in 32.3% and 25% of patients, respectively. Overall mortality was 49%. Primary central nervous system lymphoma (PCNSL) and bacterial meningitis had the highest case fatality rates of 100% followed by tuberculous meningitis (79.8%). Low CD4 count was an independent predictor of fatality (AOR: 3.2, 95%CI: 2.0–5.2). Conclusions. HIV-associated CNS disease is common in Douala. CNS symptoms in HIV patients need urgent investigation because of their association with diseases of high case fatality.

Luma, Henry Namme; Tchaleu, Benjamin Clet Nguenkam; Temfack, Elvis; Doualla, Marie Solange; Ndenga, Daniela Pamela Ntchankam; Mapoure, Yacouba Njankouo; Njamnshi, Alfred Kinyuy; Djientcheu, Vincent-de-Paul

2013-01-01

390

A real-life experience using panitumumab in chemo-refractory metastatic colorectal cancer patients: a retrospective analysis at the Jewish General Hospital, 2009-2012  

PubMed Central

Background Panitumumab is a fully human monoclonal antibody, directed against the epidermal growth factor receptor, that was shown to be effective in third-line metastatic colorectal cancer. We performed a retrospective analysis of patients with chemo-refractory non-KRAS-mutated metastatic colorectal cancer, who received panitumumab at the Jewish General Hospital in Montreal, Canada, between 2009 and 2012. Methods This chart review included 44 patients (median age: 60 years; performance status: 0–3), of whom 50% had already received three lines of treatment. The primary endpoint was progression-free survival (pfs). Secondary endpoints were overall survival and safety. Tumour progression was determined by radiologic assessments performed once every 3 months per clinical guidelines or by clinical deterioration as determined by the clinician–investigator. Results In our sample, median pfs was 21.86 ± 5.23 weeks (95% confidence interval: 12.9 to 36.9 weeks) and overall survival was 35.14 ± 7.75 weeks (95% confidence interval: 25.6 to 73.4 weeks) with a median of 5 cycles of panitumumab treatment. The most frequently reported toxicities with panitumumab were skin toxicity (16.2% grade 3) and hypomagnesemia (10.8% grade 3). No infusion reactions were reported. Conclusions Despite a small sample size from a single institution, our survival and efficacy data are encouraging and comparable to results obtained from the registration panitumumab trial. Our findings suggest that panitumumab can be effective and tolerable in a real-world setting.

Mamo, A.; Nogueira, M. Cardoso; Batist, G.; Palumbo, M.; Panasci, L.; Ferrario, C.; Chaudhury, P.; Metrakos, P.; Kavan, P.

2013-01-01

391

A Suggested Program for the Achievement of Objectives for Josephine General Hospital, Grants Pass, Oregon. Final Report of Phase III of a Three-Phase Long-Range Development Study. Volume II.  

National Technical Information Service (NTIS)

The report presents results of the third phase of a long-range planning study designed to suggest how Josephine General Hospital, Josephine County, Oregon, could assume a new role and accomplish the primary objectives recommended in the first two phases. ...

1972-01-01

392

Intensification of the oxygen minimum zone in the northeast Pacific off Vancouver Island during the last deglaciation: Ventilation and/or export production?  

NASA Astrophysics Data System (ADS)

The oxygen minimum zone (OMZ) off Vancouver Island was more oxygen depleted relative to modern conditions during the Allerød (˜13.5 to 12.6 calendar kyr) and again from ˜11 to 10 kyr. The timing of OMZ intensification is similar to that seen throughout the North Pacific, although the onset appears to have been delayed by ˜1500 years off Vancouver Island. Radiocarbon dating of coeval benthic and planktonic foraminifera shows that between 16.0 and 12.6 kyr the age contrast between surface and intermediate waters (920 m depth) off Vancouver Island was similar to, or slightly less than, that today. There is no evidence of an increased age difference (i.e., decreased ventilation) during the deglaciation, particularly during the Allerød. However, sedimentary marine organic carbon concentration and mass accumulation rate increased substantially in the Allerød, suggesting that increased organic matter export was the principal cause of late Pleistocene OMZ intensification off Vancouver Island.

McKay, J. L.; Pedersen, T. F.; Southon, J.

2005-12-01

393

Fort Vancouver, 1829-1860. A Historical Archeological Investigation of the Goods Imported and Manufactured by the Hudson's Bay Company. Part 2.  

National Technical Information Service (NTIS)

Contents: Hudson's Bay Company material culture from 1823 to 1860 (Hudson's Bay Company importation, manufacturing and trade practices; Historical archaeological catalogue of the goods imported, manufactured and produced for Fort Vancouver); Domestic manu...

L. A. Ross

1978-01-01

394

Proceedings of the 1997 Particle Accelerator Conference Held in Vancouver, B.C., Canada on 12-16 May 1997. Volume 3: Subsystems, Technology and Applications.  

National Technical Information Service (NTIS)

The Proceedings contains 1261 papers presented at PAC'97, held in Vancouver in May, 1997. With one third of the 1221 delegates coming from 23 countries outside North America, these papers present a comprehensive picture of accelerator science, technology ...

J. Thomson M. Comyn M. Reiser M. K. Craddock

1997-01-01

395

Proceedings of the 1997 Particle Accelerator Conference Held in Vancouver, B.C., Canada on 12-16 May 1997. Volume 2: Beam Dynamics, Instrumentation and Controls.  

National Technical Information Service (NTIS)

The Proceedings contains 1261 papers presented at PAC'97, held in Vancouver in May, 1997. With one third of the 1221 delegates coming from 23 countries outside North America, these papers present a comprehensive picture of accelerator science, technology ...

J. Thomson M. Comyn M. Reiser M. K. Craddock

1997-01-01

396

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

Microsoft Academic Search

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

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

2008-01-01

397

Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population  

PubMed Central

The aim of the study was to determine the aetiology of large and symptomatic pericardial effusions and to review the management and subsequent outcome. A survey was done on a consecutive cases of patients who had undergone percutaneous pericardiocentesis over a 10 year period in a city centre general hospital serving a multiethnic catchment population. In all, 46 patients (24 male, 22 female; age range 16 to 90 years, mean 54 years) underwent a total of 51 pericardial drainage procedures (or attempted pericardiocentesis) between 1989 and 1998. Malignancy (44%), tuberculosis (26%), idiopathic (11%), and post-cardiac surgery (9%) were the most common causes of pericardial effusion. The most common presenting symptoms were breathlessness (90%), chest pain (74%), cough (70%), abdominal pain (61%) (presumed to be related to hepatic congestion), and unexplained fever (28%). In the 12 cases of tuberculous pericarditis, nine occurred in patients of Indo-Asian origin, and three in patients of Afro-Caribbean origin. Fever, night sweats, and weight loss were common among these patients, occurring in over 80% of cases of tuberculous pericarditis. Pulsus paradoxus was the most specific sign (100%) for the presence of echocardiographic features of tamponade, with strongest positive predictive value (100%). Although malignancy remains the most common cause in developed countries, tuberculous disease should be considered in patients from areas where tuberculosis is endemic. Percutaneous pericardiocentesis remains an effective measure for the immediate relief of symptoms in patients with cardiac tamponade, although its diagnostic yield in tuberculous pericarditis is relatively low.???Keywords: tuberculosis; pericardial effusions; percutaneous pericardiocentesis

Gibbs, C.; Watson, R.; Singh, S.; Lip, G.

2000-01-01

398

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

SciTech Connect

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

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

2006-04-01

399

Temporal Comparison of PBDEs, OH-PBDEs, PCBs, and OH-PCBs in the Serum of Second Trimester Pregnant Women Recruited from San Francisco General Hospital, California.  

PubMed

Prenatal exposures to polybrominated diphenyl ethers (PBDEs) can harm neurodevelopment in humans and animals. In 2003-2004, PentaBDE and OctaBDE were banned in California and phased-out of US production; resulting impacts on human exposures are unknown. We previously reported that median serum concentrations of PBDEs and their metabolites (OH-PBDEs) among second trimester pregnant women recruited from San Francisco General Hospital (2008-2009; n = 25) were the highest among pregnant women worldwide. We recruited another cohort from the same clinic in 2011-2012 (n = 36) and now compare serum concentrations of PBDEs, OH-PBDEs, polychlorinated biphenyl ethers (PCBs) (structurally similar compounds banned in 1979), and OH-PCBs between two demographically similar cohorts. Between 2008-2009 and 2011-2012, adjusted least-squares geometric mean (LSGM) concentrations of ?PBDEs decreased 65% (95% CI: 18, 130) from 90.0 ng/g lipid (95% CI: 64.7, 125.2) to 54.6 ng/g lipid (95% CI: 39.2, 76.2) (p = 0.004); ?OH-PBDEs decreased 6-fold (p < 0.0001); and BDE-47, -99, and -100 declined more than BDE-153. There was a modest, nonsignificant (p = 0.13) decline in LSGM concentrations of ?PCBs and minimal differences in ?OH-PCBs between 2008-2009 and 2011-2012. PBDE exposures are likely declining due to regulatory action, but the relative stability in PCB exposures suggests PBDE exposures may eventually plateau and persist for decades. PMID:24066858

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

2013-09-25

400

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

PubMed

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

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

2012-11-10

401

Slip Partitioning, Crustal Tectonics and Deformation of the Queen Charlotte Margin and Northern Vancouver Island  

NASA Astrophysics Data System (ADS)

Part I of this thesis investigates current deformation in western British Columbia from northern Vancouver Island in the south to Haida Gwaii in the north. The area is characterized by transition from the Cascadia subduction zone to the Queen Charlotte transform fault. The tectonic setting involves interactions between the Pacific, North America, Juan de Fuca, and Explorer plates, and the Winona block, involving a number of plate boundaries: the mainly strike-slip Queen Charlotte, Revere-Dellwood-Wilson and Nootka faults, the Explorer ridge, and the Cascadia subduction zone. Using GPS campaign data from 1993 to 2008 I derive a new crustal velocity field for Northern Vancouver Island and the adjacent mainland, and integrate it with previous velocity fields developed for Haida Gwaii, southern Vancouver Island and the adjacent mainland. The northern limit of the subduction zone is confirmed to be at Brooks Peninsula, where the direction of the crustal motion changes abruptly from ENE to NNE. I use viscoelastic models to explore what percentage of the observed deformation is transient, related to the earthquake cycle, and how much is permanent ongoing deformation, distributed off the continental margin. Previous authors have developed two competing end-member models that can each explain how the Pacific/North America plate convergence is accommodated off Haida Gwaii. These models assume either internal crustal shortening or underthrusting of the Pacific plate. These new GPS data allow me to conclude that underthrusting does occur, and that a small component (<15%) of the observed data reflects long-term deformation. South of Haida Gwaii the distinction between transient and long-term deformation is not as clear; however, I conclude that transient deformation alone cannot fully explain the observed velocities, and so long-term deformation likely must also occur. Part II of the thesis investigates the updip and downdip limits of the seismogenic zone of the Sumatra megathrust fault. Temperature and downdip changes in formation composition are controls proposed for these limits. To examine the thermal control I developed 2-D finite element models of the Sumatra subduction zone with smoothly varying subduction dip, variable thermal properties of the rock units, frictional heating along the rupture plane, and an appropriate thermal state for the incoming plate. The common updip thermal limit for seismic behaviour of 100-150°C occurs close to or at the trench in agreement with the rupture limit of the 2004 earthquake. Off central Sumatra the common downdip thermal limit range of 350-450°C occurs at 30-60 km depth. The 350°C isotherm location is in agreement with the earthquake limits but 450°C is deeper. North of Sumatra, 350°C occurs ˜14 km deeper than the earthquake rupture limit. The proposed composition control for the downdip limit, the intersection of the subduction thrust with the forearc mantle, is at a depth of ˜30 km, 140-200 km from the trench, in good agreement with the earthquake limits. These results support the conclusion that the Sumatra updip seismogenic limit is thermally controlled, but the downdip limit is governed by the intersection of the downgoing plate with the forearc Moho.

Hippchen, Sabine

402

[Development of a cooperative system for palliative care among a hospice ward, general ward, geriatric health services facility, and home in Japan Baptist Hospital-provision of home-based care by hospice physicians].  

PubMed

In November 2009, a home hospice palliative care clinic(clinic)was opened in addition to a hospice ward, general ward, and geriatric health services facility at our hospital. This marked the initiation of a health care system able to provide the palliative care desired by patients and families. We studied the characteristics and hospitalization status of 514 patients with cancer who died at the hospice ward, general ward, or their homes from November 2009 through December 2011. Overall, 373 patients died at the hospice ward, 11 at the general ward, and 130 at home. Hospice physicians participated in the home care of 20 patients. Hospice physicians provide home-based care in cooperation with clinic physicians, facilitating the palliative care of patients who initially do not have a place to receive terminal care and the prompt discharge of patients who want to live at home. PMID:23268903

Yamagiwa, Tetsuya; Nakayama, Shinya; Shiotani, Tomohiro; Fukuda, Akiko; Ito, Satoko; Watanabe, Go; Yamaoka, Yoshio

2012-12-01

403

13 C PMAS-NMR spectroscopy and chemical analysis of coarse woody debris in coastal forests of Vancouver Island  

Microsoft Academic Search

The coastal forests of British Columbia have large accumulations of coarse woody debris, and information on this pool is considered essential in developing sustainable management practices. We characterized coarse woody debris (7–12 and >12cm diameter) in forest chronosequences of four age classes located on the eastern and western sides of Vancouver Island. For three species (Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco),

C. M Preston; J. A Trofymow; J Niu; C. A Fyfe

1998-01-01

404

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

Microsoft Academic Search

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

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

2009-01-01

405

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

406

1. OVERVIEW OF MAIN HOSPITAL, NORTHEAST CORNER. Presidio of ...  

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

1. OVERVIEW OF MAIN HOSPITAL, NORTHEAST CORNER. - Presidio of San Francisco, Letterman General Hospital, Building No. 27, Letterman Hospital Complex, Edie Road, San Francisco, San Francisco County, CA

407

5. Hospital Point, northeast bulkhead (typical), view to northwest ...  

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

5. Hospital Point, northeast bulkhead (typical), view to northwest - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

408

Origin of igneous rocks associated with Mélanges of the Pacific Rim Complex, western Vancouver Island, Canada  

NASA Astrophysics Data System (ADS)

The Pacific Rim Complex (PRC) has previously been interpreted as a late Mesozoic subduction complex that formed along the western margin of Vancouver Island. This paper examines a specific aspect of this interpretation: that igneous rocks within the PRC are fault slices derived from the footwall or hanging wall of a subduction thrust. The footwall would have been an oceanic plate, and the hanging wall, Wrangellia, a large coherent terrane that underlies most of Vancouver Island. New mapping has shown that the PRC comprises a lower Mesozoic volcanic unit, herein named the Ucluth Formation, and a superjacent sequence, more than 2 km thick, of Lower Cretaceous sediment-rich mélanges. Within the mélanges are large blocks of volcanic and plutonic rocks, most of which were derived from the underlying Ucluth Formation. A minor fraction of these blocks cannot be assigned to Ucluth; they consist of Upper Jurassic pillow basalt and rare ultramafite. Fossil ages and chemical data indicate that the bulk of the igneous rocks in the PRC, as represented by the Ucluth Formation and blocks derived from the Ucluth, could not have come from Wrangellia nor from a subducting oceanic plate. The blocks of Upper Jurassic pillow basalt do represent fragments of oceanic crust, but field relations indicate that they are not fault slices. The mudstone matrix surrounding the blocks contains interbeds of "green tuff" which are shown to be scree deposits derived from the Ucluth and the Upper Jurassic pillow basalts. My interpretation is that the PRC mélanges formed by surficial mass wasting, and not by faulting along a subduction thrust. Furthermore, regional geologic relations indicate that the present location of the PRC, outboard of Wrangellia, is a result of strike slip faulting during the latest Cretaceous or early Tertiary. This event postdates the formational age of the mélanges by at least 45 m.y. An appendix of chemical analyses, locality descriptions, sample petrography, analytical methods, and estimated accuracy is available with the entire article on microfiche. Order from American Geophysical Union, 2000 Florida Avenue, N.W., Washington, DC 20009. Document T89-004; $2.50. Payment must accompany order.

Brandon, Mark T.

1989-12-01

409

Risk factors for elevated HIV incidence among Aboriginal injection drug users in Vancouver  

PubMed Central

Background Because of established links between entrenched poverty and risk of HIV infection, there have long been warnings that HIV/AIDS will disproportionately affect Aboriginal people in Canada. We compared HIV incidence rates among Aboriginal and non-Aboriginal injection drug users (IDUs) in Vancouver and studied factors associated with HIV seroconversion among Aboriginal participants. Methods This analysis was based on 941 participants (230 Aboriginal people) recruited between May 1996 and December 2000 who were seronegative at enrolment and had completed at least one follow-up visit. Incidence rates were calculated using the Kaplan–Meier method. The Cox proportional hazards regression model was used to identify independent predictors of time to HIV seroconversion among female and male Aboriginal IDUs. Results As of May 31, 2001, seroconversion had occurred in 112 (11.9%) of the participants, yielding a cumulative incidence of HIV infection at 42 months of 12.7% (95% confidence interval [CI] 10.3%–15.1%). The cumulative incidence at 42 months was significantly higher among the Aboriginal participants than among the non-Aboriginal participants (21.1% v. 10.7%, p < 0.001). This elevation in risk was present in both female and male Aboriginal IDUs. Among the female Aboriginal IDUs, frequent speedball (combined cocaine and heroin) injection (adjusted relative risk [RR] 3.1; 95% CI 1.4–7.1) and going on binges of injection drug use (adjusted RR 2.3; 95% CI 1.0–5.2) were found to be independent predictors of HIV seroconversion. Among the male Aboriginal IDUs, the independent predictors of seroconversion were frequent speedball injection (adjusted RR 2.9; 95% CI 1.0–8.5) and frequent cocaine injection (adjusted RR 2.5; 95% CI 1.0–6.5). Interpretation In Vancouver, Aboriginal IDUs are becoming HIV positive at twice the rate of non-Aboriginal IDUs. Our findings emphasize the urgent need for an appropriate and effective public health strategy — planned and implemented in partnership with Aboriginal AIDS service organizations and the Aboriginal community — to reduce the harms of injection drug use in this population.

Craib, Kevin J.P.; Spittal, Patricia M.; Wood, Evan; Laliberte, Nancy; Hogg, Robert S.; Li, Kathy; Heath, Katherine; Tyndall, Mark W.; O'Shaughnessy, Michael V.; Schechter, Martin T.

2003-01-01

410

Late Quaternary History of the Northeast Pacific Ocean off Vancouver Island, Canada  

NASA Astrophysics Data System (ADS)

Data for marine sediment cores collected from the continental margin off Western Canada indicate that dramatic changes in productivity and oxygen minimum zone intensity occurred during the last 16 kyr B.P. During the late glacial marine organic matter accumulation in sediments was greatly reduced off Vancouver Island. This reflected low primary and export production because glacial-mode atmospheric circulation (i.e., the dominance of the Aleutian Low) did not drive upwelling in the region. At start of the Bolling warm period (14.3 kyr B.P.), and coincident with the retreat of glaciers from the continental shelf, there was a substantial increase in the burial of organic matter. Much of this organic material was old terrestrial organic matter derived from the erosion of shelf sediments. However, the accumulation of marine organic matter also increased in the Bolling and peaked in the Allerod (13.5 to 12.6 kyr B.P.). At this time the marine organic carbon accumulation rate was an order of magnitude higher than in the late glacial and Holocene. Other paleoproductivity proxies (i.e., bio-barium, opal and alkenone abundances) also indicate increased marine productivity during the Allerod. Since productivity in the region is controlled by the upwelling of nutrient-rich subsurface waters the data suggest enhanced upwelling, which is also alluded to by radiocarbon data (i.e., a decrease in benthic-planktonic age differences). Redox-sensitive trace metal and benthic foraminifera data suggest that the intensity (i.e., degree of oxygen-depletion) of the oxygen minimum zone (OMZ) also fluctuated during the deglacial. Notably, there is a prominent increase in OMZ intensity during the Allerod. The corresponding increase in marine organic carbon accumulation at this time and lack of any evidence of decreased ventilation suggests that OMZ intensification was a response to increased primary productivity and carbon export. Intensification of the OMZ during the deglacial is documented along the length of the entire California Current System, but it appears to have been delayed by approximately 1500 years off Vancouver Island.

McKay, J. L.; Pedersen, T.

2003-12-01

411

The Vancouver Lymphadenopathy-AIDS Study: 6. HIV seroconversion in a cohort of homosexual men.  

PubMed Central

In an ongoing prospective study of homosexual men conducted since November 1982 in Vancouver, we identified 345 men who did not have antibody to human immunodeficiency virus (HIV) at the time of enrolment and for whom results of follow-up serologic testing were available. A total of 66 cases of seroconversion were documented among the 345 men between November 1982 and October 1985. Methods of survival data analysis that take into account the varying durations of follow-up were used to study the epidemiologic features of seroconversion in this group. The probability of seroconversion during the entire observation period was 23.1%. The seroconversion rates remained stable, at 10.5% and 10.0% during the last 2 years of the observation period. Cox regression analysis revealed the following variables to be independently associated with risk of seroconversion: frequent receptive anal intercourse, elevated number of male sexual partners in the year before enrolment, use of illicit drugs, a history of gonorrhea and age less than 30 years in November 1982. Multivariate analysis failed to reveal any role of oral sexual activity in the transmission of HIV. Oral ingestion of semen was not associated with seroconversion in either univariate or multivariate analysis. The observation that younger men were more likely to seroconvert suggests that young homosexual men were less likely than older men to modify their sexual behaviour.

Schechter, M T; Boyko, W J; Douglas, B; Willoughby, B; McLeod, A; Maynard, M; Craib, K J; O'Shaughnessy, M

1986-01-01

412

Urban Water Balance: 2. Results From a Suburb of Vancouver, British Columbia  

NASA Astrophysics Data System (ADS)

The paper demonstrates the use of the C. S. B. Grimmond et al. (this issue) water balance model. It is used to calculate the daily, monthly, and annual water balance components for a suburban catchment in Vancouver, British Columbia. The budget results for one complete year are presented and where possible are compared with those from other cities. The balance is also compared with that for a rural area in the region, thereby illustrating the effects of suburban development. In interpreting the results special consideration is directed toward elucidating the role of irrigation (mainly garden sprinkling) in the suburban water balance. The temporal pattern of external water use is related to prevailing weather conditions. In particular, it is shown to be closely related to evapotranspiration. The relationship is a complex feedback system involving human as well as biophysical controls. The model is run both with, and without, an irrigation input to gauge its impact on the water budget. Together the results provide both quantitative and qualitative support for the idea that irrigation is the source of water supporting the relatively large rates of suburban evapotranspiration reported in energy balance studies.

Grimmond, C. S. B.; Oke, T. R.

1986-09-01

413

A pilot study assessing the health status of the Hispanic American community living in Vancouver.  

PubMed

We undertook a pilot study in order to obtain baseline health information on the Hispanic American Community in Vancouver and to evaluate the feasibility of research in this community. We used the Interviewer Administered Questionnaire and the Lifestyle and Your Health Questionnaire from the Canada Health Survey [CHS]. Questionnaires were translated into Spanish and back into English. Descriptive analyses were similar to the CHS and focussed on health services utilization, lifestyle practices and psychological parameters. 43.3% of males and 12% of females did not have any medical consultation in the previous 12 months; 100% of respondents stated that high cost did not allow regular dental care; 23.3% of males and 28.6% of females experienced anxiety and depression; 26.2% of females did not known how to do breast self-examination. Significant potential health problems exist in this community particularly related to stress, lack of preventive behaviour and low utilization rates. Further research in this community is possible, but hampered primarily by a reluctance to participate because of concerns regarding privacy and immigration status. PMID:1473060

Palacios, C; Sheps, S

414

Vancouver AIDS conference: special report. Rwandan refugee camps: NGOs get rough treatment from both sides.  

PubMed

NGOs attempting to grapple with the thankless task of helping the Rwandan refugee camps have come in for some rough treatment from two directions over their HIV/AIDS efforts. At the policy level, an AMREF paper presented to the Vancouver conference charges bluntly that "There is no policy regarding HIV/STDs in refugee camps among international organizations specializing in refugee crises; thus there is absence of STD drugs and protocols, no privacy in open (tent) clinics, no means of protection (no condoms), and no information regarding STDs/HIV." AMREF bases its comments upon its experience among 700,000 Rwandan refugees in camps in West and North-West Tanzania, an area where (AMREF remarks pointedly) there was previously a low prevalence of HIV by Tanzanian standards, at 2-5%. At the operational level, CARE International, in a conference paper, reported rough treatment at the hands of the Rwandans themselves. It has been working under contract from AIDSCAP among the 400,000 Rwandans who fled to the Ngara district of Tanzania. Not surprisingly, it found that women and girls in the camps faced a higher risk than men. But more surprisingly at first sight, it found that after its HIV educational efforts "negative attitudes about condom use increased from 22% to 78%," which was possibly explained by "political ideology." "Young Hutu men in the camps boasted of their efforts to impregnate as many women and girls as possible to help replenish the population." PMID:12347376

Whiteside, A; Winsbury, R

415

Seismic investigations of a vent field associated with gas hydrates, offshore Vancouver Island  

NASA Astrophysics Data System (ADS)

A three-dimensional seismic reflection survey was carried out over a gas hydrate field offshore Vancouver Island in the area of Ocean Drilling Program Leg 146, Site 889/890. The area of investigation is located on the accretionary prism of the Cascadia margin in water depths of 1200-1500 m. Several seismic blank zones were observed in the seismic data over a frequency range from 30 Hz to 3.5 kHz, where the degree of blanking increases with seismic frequency. Time slices and selected horizon slices were used to define the spatial distribution of the blank zones. The zones range from 80 m to several hundred meters in width. One blank zone, almost circular with a diameter of ˜400 m, has a distinct seafloor expression. It shows the characteristics of a mud/carbonate mound and is probably associated with free gas expulsion. Hydrate was found at four sites with a piston corer within this blank zone at depths of 3-8 m below the seafloor. We present a tectonic model that explains the blank zones to be a result of differential uplift along thrust faults. The blank zones represent conduits for fluids and gas migrating upward. Blanking of the seismic energy is believed to be mainly the result of increased hydrate formation in lenses within the faults. The blanking effect is enhanced locally because of scattering at carbonates formed at the seafloor.

Riedel, M.; Spence, G. D.; Chapman, N. R.; Hyndman, R. D.

2002-09-01

416

Biomechanical Comparison of 2 Different Locking Plate Fixation Methods in Vancouver B1 Periprosthetic Femur Fractures  

PubMed Central

Locking plates are commonly used to treat fractures around a well-fixed femoral component. The optimal construct should provide sufficient fixation while minimizing soft-tissue dissection. The purpose of the current study was to determine whether plate length, working length, or bone mineral density affects survival of locking plate fixation for Vancouver type B1 periprosthetic hip fractures. A transverse osteotomy was created just distal to cemented femoral prostheses in 9 pairs of cadaveric femurs. Fractures were stabilized with long (20-hole) or short (12-hole) locking plates that were secured proximally with cables and screws and distally with screws only. Specimens were then cycled 10 000 times at 2500 N of axial force and 15 Nm of torque to simulate full weightbearing. A motion capture system was used to record fracture displacement during cycling. Failure occurred in 5 long and 3 short plates, with no significant differences found in the number of cycles to failure. For the specimens that survived, there were no significant differences found between long and short plates for displacement or rotation observed at the fracture site. A shorter working length was not associated with increased failure rate. Lower bone mineral density was significantly associated with failure (P = .02). We concluded that long locked plates do not appear to offer a biomechanical advantage over short locking plates in terms of fixation survival, and that bone mineral density was a better predictor of failure than was the fixation construct type.

Pletka, Joshua D.; Marsland, Daniel; Belkoff, Stephen M.; Mears, Simon C.; Kates, Stephen L.

2011-01-01

417

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

PubMed

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

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

2011-01-01

418

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

PubMed

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

Scherebnyj, Katrina; Hodgson, Murray

2007-10-01

419

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

PubMed Central

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

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

2008-01-01

420

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

NASA Astrophysics Data System (ADS)

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

Rottler, Joerg; Kennett, Malcolm; Stamp, Philip

2008-06-01

421

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

NASA Astrophysics Data System (ADS)

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

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

2010-07-01

422

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

PubMed Central

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

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

2013-01-01

423

Transitions of Care Consensus Policy Statement American College of Physicians-Society of General Internal Medicine-Society of Hospital Medicine-American Geriatrics Society-American College of Emergency Physicians-Society of Academic Emergency Medicine  

Microsoft Academic Search

The American College of Physicians (ACP), Society of Hospital Medicine (SHM), Society of General Internal Medicine (SGIM),\\u000a American Geriatric Society (AGS), American College of Emergency Physicians (ACEP) and the Society for Academic Emergency Medicine\\u000a (SAEM) developed consensus standards to address the quality gaps in the transitions between inpatient and outpatient settings.\\u000a The following summarized principles were established: 1.) Accountability; 2)

Vincenza Snow; Dennis Beck; Tina Budnitz; Doriane C. Miller; Jane Potter; Robert L. Wears; Kevin B. Weiss; Mark V. Williams

2009-01-01

424

Reduced in-hospital mortality from acute myocardial infarction with general adoption of thrombolytic treatment in the North West Thames health region 1979-1991  

Microsoft Academic Search

OBJECTIVE--To determine the impact of studies of thrombolytic treatment in acute myocardial infarction on inhospital mortality. DESIGN--Retrospective study. SETTING--All 21 major hospitals in the North West Thames health region. PATIENTS--63,903 patients with acute myocardial infarction. STUDY PERIOD--1979-1991. MAIN OUTCOME MEASURES--in-hospital mortality. RESULTS--Overall mortality decreased by 5.2% from 25.4% to 20.2% (P < 0.0001) (95% confidence interval (CI) 3.4 to 6.6).

R. A. Greenbaum; R. Morris; P. Sritara; D. Shanit; K. L. Chan

1995-01-01

425

A permission system for carbapenem use reduced incidence of drug-resistant bacteria and cost of antimicrobials at a general hospital in Japan.  

PubMed

Some drug management systems have been established in Japanese hospitals to reduce medical costs and regulate drug usage. Among the many available prescription drugs, antimicrobials should be given special attention because their inappropriate use often leads to sudden outbreaks of resistant bacteria. As drug specialists, pharmacists should monitor the use of all drugs, particularly antimicrobials. Carbapenems are a class of broad-spectrum antimicrobials that are widely used to treat infections worldwide. However, their inappropriate use has led to an increase in the incidence of drug-resistant bacteria and consequently, medical costs, at hospitals. To reduce inappropriate use and drug resistance, we have established a permission system to control the use of carbapenems at the Japanese Red Cross Nagoya Daiichi Hospital. In this study, we retrospectively evaluated the applicability of the new permission system compared to that of the notification system and the non control system for 14 months each. The two management systems were able to maintain total antibiotic use density and control the outbreak of drug-resistant bacteria (P. aeruginosa, E. coli, and K. pneumoniae). The number of carbapenem prescriptions was decreased dramatically when this permission system was enforced. Compared to the non control system, the cost of antimicrobials was reduced by $757,470 for the 14-month study period using the permission system. These results suggest that our system to control the use of antimicrobials can efficiently suppress the incidence of drug-resistant bacteria and medical costs at hospitals. PMID:22515115

Ikeda, Yoshiaki; Mamiya, Takayoshi; Nishiyama, Hideki; Narusawa, Shiho; Koseki, Takenao; Mouri, Akihiro; Nabeshima, Toshitaka

2012-02-01

426

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

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.

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

427

Ventilation grilles as a potential source of methicillin-resistant Staphylococcus aureus causing an outbreak in an orthopaedic ward at a district general hospital  

Microsoft Academic Search

The spread of methicillin-resistant Staphylococcus aureus (MRSA) in a hospital is thought to be mainly by direct contact. Environmental sources such as exhaust ducting systems have been increasingly recognized as a source for MRSA outbreaks in intensive therapy units. We describe an outbreak of MRSA related to ventilation grilles in an orthopaedic ward. Six patients and one nurse were involved

D. N. P. Kumari; T. C. Haji; V. Keer; P. M. Hawkey; V. Duncanson; E. Flower

1998-01-01

428

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

PubMed Central

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

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

1995-01-01

429

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

NASA Astrophysics Data System (ADS)

Submarine mud volcanoes are a common feature in margin environments, but few of them have been documented in the Northeast Pacific. However, during a Hydrosweep bathymetric survey in July, 2001, and a follow-on sub-surface seismic survey in August two mud volcanoes were imaged along the Nootka Fault, 16-18 km west of Vancouver Island at a water depth of 2500 m. The southern volcano, called Maquinna, lies directly along the southern expression of the left lateral, strike slip Nootka Fault. It is 1.5 km across, has a breached caldera and two small summit craters, and it stands about 30 m above the seafloor. The base is bounded by a narrow moat, partially filled by Holocene sediments that are flat lying; older, underlying sediments show steep downwarping towards the sides of the volcano. Subsurface imaging shows a dramatic loss of reflectivity beneath the volcano mound, which may indicate significant mobilization of material. However, a very bright reflector is seen at about 400 m depth below the volcano. This reflector is too deep for stability of methane clathrate, and is interpreted as a zone of high fluid content. A CTD vertical cast above the summit of the volcano showed strong, co-registered thermal, particulate, and oxygen anomalies that extend 50 m up into the overlying water column. These data indicate that the volcano is actively venting warm hydrothermal fluids. The fluids are depleted in CO2, contain background concentrations of CH4, but show elevated H2 concentrations above ocean background water. Microscopic examination of the Nootka hydrothermal samples shows that they contain dense and morphologically diverse microbial communities in comparison to background seawater with cell densities of 106 cells/ml. Enrichment culturing indicates that these communities include both anaerobic and aerobic organisms, some of which are thermophilic with optimal growth temperatures in excess of 50 deg C. Some of these cultures can use methane oxidation as an energy source. Additional culturing experiments and analysis of preserved samples are underway to further characterize the microbes. To further understand the biogeochemical cycles at these sites, samples recently taken from piston cores and CTD casts in this region, are being surveyed for stable and radio carbon isotope signatures of CH4, dissolved inorganic carbon, organic carbon and phospholipid b