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1

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

2

Networking in the Vancouver Hospitals: An Incremental Management Approach  

PubMed Central

This paper describes a multi-site network application involving electronic transmission of video, audio and data among five teaching hospitals in Vancouver, B.C. The rationale behind a network approach is explained and the system design is outlined. The network includes both long-haul cable based network technolgies (LHN) and Local Area Network technologies (LAN) that currently integrate 2 mainframes and 11 mini computers operating in the five sites. Philosophical and strategical approaches to implementation of the network are explained. Particular attention is drawn to the notion of the incremental management of change and the role of product champions. It is suggested that the use of network technology enables a wide variety of semi-autonomous departments and computer applications to “touch without intrusion.” It is emphasized the implementation of such change requires sophisticated technical and human engineering skills.

Cassidy, Paul A.; Morrison, J. Ian; Hardwick, David F.

1985-01-01

3

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

PubMed

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

Zuberi, Daniyal M; Ptashnick, Melita B

2011-03-01

4

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

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

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

5

Massachusetts General Hospital - Psychiatry Program  

NSDL National Science Digital Library

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

2007-07-02

6

General hospital psychiatry in the 1980's  

Microsoft Academic Search

There has been an increasing amount of attention being given to the role of community hospital based inpatient psychiatric\\u000a services in the face of changing utilization patterns, state hospital deinstitutionalization and cutbacks in community support\\u000a programs. These trends have converged over recent years to reshape the nature of psychiatric practice in the general hospital\\u000a setting. It is likely that these

Donald Seidemann

1984-01-01

7

Examining General Hospitals' Smoke-Free Policies  

ERIC Educational Resources Information Center

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

Whitman, Marilyn V.; Harbison, Phillip Adam

2010-01-01

8

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

9

Examining general hospitals' smoke-free policies  

Microsoft Academic Search

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 faced when implementing such a policy or the barriers to implementing one.

Marilyn V. Whitman; Phillip Adam Harbison

2010-01-01

10

Addiction treatment in Vancouver  

Microsoft Academic Search

In a context of escalating, addiction-related epidemics and a disorganized system of addiction services, Vancouver Coastal Health and its partners worked toward a comprehensive continuum of services that meets the range of needs of the population in Vancouver. The health authority delivers an array of services tailored to a set of outcomes. The majority of resources focus on eliminating impairment,

David C. Marsh; Benjamin R. Fair

2006-01-01

11

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

PubMed

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

Rees, Tom

2002-01-01

12

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

13

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

14

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.

15

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

16

Alternate Level of Care Patients in Public General Hospital Psychiatry.  

ERIC Educational Resources Information Center

Analyzes the interaction between psychiatric services in public general hospitals and in other institutional settings. A one-day census of patients in a New York general hospital showed the hospital was providing care to a large number of patients in need of other, less intensive institutional settings. (BH)

Marcos, Luis R.; Gil, Rosa M.

1984-01-01

17

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

18

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

19

Southern Vancouver Island  

NSDL National Science Digital Library

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

1999-01-01

20

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

21

Psychiatric disorder in hospital and general practice  

Microsoft Academic Search

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

Brian Cooper

1966-01-01

22

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

23

Immunohistochemistry in district general hospitals in England and Wales  

Microsoft Academic Search

The findings of a survey on the use of immunohistochemistry in district general hospitals in England and Wales are reported. Immunohistochemistry is used in most district hospitals, contributes to the accuracy and objectivity of some histopathological diagnoses, and is considered to be generally useful though not without drawbacks. Its expansion is being hindered by lack of funds for reagents and

P A Hall; P Domizio; G Slavin; D A Levison

1987-01-01

24

[Salmonella infection in a large general hospital].  

PubMed

In this work the results of the epidemiological survey of the epidemic of salmonellosis in a large hospital with diversified specialization are given. The detailed description of morbidity dynamics with the distribution of the described cases according to the severity of the course of the infectious process, the groups of the most affected patients and the mechanism of the transmission of infection under hospital conditions is presented. This epidemic of salmonellosis is considered from the viewpoint of the theory of the self-regulation of parasitic systems. The characteristic features of nosocomial salmonellosis, detected in the course of the epidemiological survey, make it possible to determine the main trends in the prophylaxis of this infection in a large hospital. PMID:9103074

Akimkin, V G; Beliakov, V D

1996-01-01

25

WSU Vancouver Historic Collection  

NSDL National Science Digital Library

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

26

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

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

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

27

Prescribing at the hospital-general practice interface. I: Hospital outpatient dispensing policies in England.  

PubMed Central

OBJECTIVE--To describe the outpatient dispensing policies of major acute hospitals in England. DESIGN--Postal questionnaire survey in November 1990. SETTING--All (278) major acute hospitals in England with more than 250 beds, excluding maternity, paediatric, or psychiatric hospitals; nine hospitals declined. PARTICIPANTS--Hospital chief pharmacists. MAIN OUTCOME MEASURES--Current dispensing policy and exceptions to it; when the policy was formed; and who was involved in its formation. RESULTS--Completed questionnaires were received from 200 (72%) of the hospitals approached. The quantities of drugs dispensed to outpatients ranged from zero in 12 hospitals to unlimited amounts in nine; nearly half (92) dispensed a 14 days' supply of drugs. The greater the restriction on outpatient dispensing, the more recently the policy had been introduced (chi 2 for trend = 7.15; df = 1; p less than 0.01). Permissible exceptions to the policy included the consultant's specific request (134 hospitals), difficulty in obtaining drugs in the community (102), urgent need for start of treatment (49), and certain types of patients (41) or drugs or their regimens (104). Groups who were neither represented on the hospital committee concerned with policy formation nor consulted before policy changes included regional health authorities in 122 hospitals, district health authorities in 101 hospitals, and general practitioners in 32 hospitals. CONCLUSIONS--Outpatient dispensing policies varied considerably among the hospitals surveyed, but they seemed to be moving towards greater restrictions on the supply of drugs given to outpatients.

Wilkie, P.; Sibbald, B.; Raftery, J.; Anderson, S.; Freeling, P.

1992-01-01

28

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

29

Nurses as psychiatric consultants in a general hospital emergency room  

Microsoft Academic Search

Psychiatric nurses' experience in milieu therapy, home treatment, community aftercare, and psychotherapy can be the basis for new roles in mental health. This study used psychiatric nurses as consultants to general physicians in a general hospital emergency room. Psychiatric nurses successfully managed 66% of the psychiatric referrals in the emergency room and required only telephone consultation in a majority of

Nelda K. Severin; Robert E. Becker

1974-01-01

30

Empirical assessment of the economic behaviour of Dutch general hospitals.  

PubMed

We study the cost structure and efficiency of Dutch general hospitals over the period 1985-1995. Several studies on the efficiency of hospitals now exist. Most of them start from the assumption that hospital management attempts to minimize cost. We went beyond this assumption by trying to collect empirical evidence on management behaviour with respect to patient selection. We did so by estimating both the direct cost function and the indirect cost function as proposed by Färe and Primont and compared the results. We found that acknowledging the possibility of output reallocation increases the validity of optimizing models in the hospital sector but a complete indirect optimizing model ignores that some output categories are less flexible especially in the short run. Endogenous shifts in the allocation of patients appear to be realized through time by increased specialization of hospitals. We suggest that a mixed direct-indirect cost model is probably preferable. PMID:14981651

Blank, J L T; Merkies, A H Q M

2004-03-01

31

Hospital-treated myocardial infarction and the general practitioner  

PubMed Central

Patients who had a myocardial infarction were interviewed with their spouses in hospital and after returning home. Advice about rehabilitation, such as that recently recommended by the Working Party of the Royal College of Physicians, was often not received. General practitioners have great opportunities for organising a graded programme of rehabilitation and may often communicate ideas more easily to their patients than hospital staff. However, some practitioners are reluctant to do this work.

Mayou, Richard; Foster, Ann; Williamson, Barbara

1976-01-01

32

Discharge against medical advice at a general hospital in Catalonia  

Microsoft Academic Search

Some studies on discharge against medical advice (AMA) in general hospitals report a prevalence between 0.7–7% with 11–42% of this population identified as psychiatric patients. To study the sociodemographic and psychopathological features of patients who leave AMA, we performed a retrospective case-control comparison study of length of hospitalization and presence of psychiatric disturbances on patients who left AMA from the

Rosó Duñó; Esther Pousa; Jordi Sans; Carles Tolosa; Ada Ruiz

2003-01-01

33

Immunohistochemistry in district general hospitals in England and Wales.  

PubMed Central

The findings of a survey on the use of immunohistochemistry in district general hospitals in England and Wales are reported. Immunohistochemistry is used in most district hospitals, contributes to the accuracy and objectivity of some histopathological diagnoses, and is considered to be generally useful though not without drawbacks. Its expansion is being hindered by lack of funds for reagents and staff. In a few regions attempts are being made to rationalise expenditure and coordinate development of the service. We believe that if this can be done at a regional or national level then the relatively small cost entailed will be justified by a resulting improvement in the quality of patient care.

Hall, P A; Domizio, P; Slavin, G; Levison, D A

1987-01-01

34

Development of a screening questionnaire for the general hospital and general practices.  

PubMed

The purpose of this study was to develop a sensitive as well as brief screening questionnaire by combining the well-known instruments CAGE and the Michigan Alcoholism Screening Test (MAST) in detecting patients with alcohol dependence or abuse in general hospitals and general practices. The number of items was reduced by means of logistic regression and item analysis based on data of 1,167 consecutive admissions of a general hospital who completed both questionnaires. Further data were derived from a sample of 774 patients from 10 randomly selected general practices. A solution with nine items was validated in a second sample of 436 hospital inpatients. In all three samples, cases screening positive were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry to provide ICD-10 and DSM-III-R or DSM-IV diagnosis. In addition, 103 subjects with negative screening results were interviewed in the second general hospital sample. On grounds of the data of all three samples, a solution of seven items was chosen. This instrument comprises two CAGE and five MAST questions (Leubeck Alcohol Dependence and Abuse Screening Test; LAST) and was significantly higher in sensitivity than CAGE and SMAST. Data were robust in all three samples. It is concluded that the LAST is an optimized instrument for use in general hospital and general practice. PMID:9267540

Rumpf, H J; Hapke, U; Hill, A; John, U

1997-08-01

35

HOSPITAL STAY OF IN-PATIENTS IN A GENERAL HOSPITAL PSYCHIATRY UNIT  

PubMed Central

SUMMARY This report examines the hospital stay of psychiatric in-patients in a general hospital psychiatric setting. The hospital stay days, psychiatric diagnosis, outcome, number of re-admission and some socio-demographic details of patients admitted during one year period were recorded and analysed. The mean hospital stay was 29.39 ± 20.43 days. 60% patients stayed less than 4 weeks. The mean hospital stay of various categories was calculated. Schizophrenics 29.62 ± 25.82 days, manic depressives 35.29 ± 33.04 days and neuroses 24.83±18.43 days. Chronic Schizophrenics stayed longest (43.64±22.56) days. Of the Affective Psychosis group, between manics and depressives no difference was noticed. Good prognosis and relatively benign conditions had a briefer stay. Patients with no improvement stayed for significantly shorter- period (p< .001). Readmission cases tend to stay longer than fresh admissions (p< .05). The implications and interpretations especially in a general hospital psychiatric setting are discussed.

Chaturvedi, S.K.; Varma, V.K.; Malhotra, Savita; Kumar, Pradeep

1983-01-01

36

Discharge against medical advice at a general hospital in Catalonia.  

PubMed

Some studies on discharge against medical advice (AMA) in general hospitals report a prevalence between 0.7-7% with 11-42% of this population identified as psychiatric patients. To study the sociodemographic and psychopathological features of patients who leave AMA, we performed a retrospective case-control comparison study of length of hospitalization and presence of psychiatric disturbances on patients who left AMA from the University General Hospital in Catalan Spain over a two-year period. An analysis of the hospital epidemiological discharge register and retrospective chart review for presence of psychiatric disturbances found that AMA prevalence was 0.34%, the total discharge number in the 2-year period being 41,648. AMA rates by medical department were 0.44% for the internal medicine department; 0.24% for surgery; 0.26% for orthopedic surgery, 0.32% for obstetrics-gynecology and 0.93% for rehabilitation. The mean age for AMA patients was 38.63 years, with a higher number of men (59.9%). A total of 45.8% AMA discharges were from the internal medicine department. No significant differences were found in the average length of hospitalization between the AMA and control groups. The presence of psychiatric pathology was significantly higher among the AMA group (P<.05). The prevalence of AMA at our hospital was low in comparison to the rates reported in the literature. The patient at high risk for AMA discharge is a young man with a history of psychiatric pathology, mainly narcotic dependence. PMID:12583928

Duñó, Rosó; Pousa, Esther; Sans, Jordi; Tolosa, Carles; Ruiz, Ada

2003-01-01

37

Diagnosis of malignant melanoma by general practitioners and hospital specialists  

PubMed Central

The aim of this study was to audit all malignant melanomas confirmed histologically in the Scarborough Health District over six years, prompted by the continuing rise in incidence rate nationally and relatively high number of malignant melanomas excised by general practitioners (GPs) in this area. A total of 157 malignant melanomas were diagnosed (60% from females and 40% from males) over the six years; primary excisions being carried out by GPs (37%) and hospital specialists (63%). The clinical diagnosis of malignant melanoma was made in 9% of GP cases and 35% of the hospital specialist cases. However another 45.5% of GP cases, and 38% of hospital specialist cases were regarded as suspicious pigmented lesions clinically. The histological diagnosis was of superficial spreading malignant melanoma in 72% of the GP and 69% of the hospital specialist cases. Most of the GP melanomas were excised with a lateral margin of 2 mm or less (71%); around half of the hospital excisions had a margin of over 2 mm (49%). Most melanomas were 2 mm or less in depth (Breslow depth) in both the GP (81%) and hospital specialist (75%) series. Over the six year period (1993-98) the incidence of malignant melanomas has continued to rise, but Breslow depth at diagnosis has not changed significantly. It is therefore important to continue with early recognition of this condition by GPs in the first instance, reduction in its incidence being the long term goal. During five years of the study there were only 67 lesions thought clinically to be malignant melanoma (26 GP and 41 hospital specialist cases), but which proved to be benign histologically.???Keywords: malignant melanoma; histology; pigmented lesion

Jackson, A; Morgan, D; Ellison, R

2000-01-01

38

General internal medicine reappears in the teaching hospital: the experience of the Royal Victoria Hospital.  

PubMed Central

The internal medicine unit of the Royal Victoria Hospital in Montreal was created in 1979 to improve the training of residents and the care of patients. The practices of four internists were brought together in one part of the institution, and within 2 years there were 10 attending staff and 6 residents. The unit now provides continuing care for 2500 patients, many of whom have multisystem or potentially lethal problems. Residents and attending staff share the responsibility of providing 24-hour coverage. The group handles 5000 outpatient visits per year (20% of them being consultations) and provides a general medical consulting service for other hospital departments, with about 300 consultations per year. The creation of the unit, with highly visible role models, appears to have given new prestige to general internists in the hospital. The unit has served as a model for the reorganization of the other medical clinics and provides a base for research in health care delivery.

Kong, H. H.; Flegel, K. M.; Coke, W.; Hoey, J. R.

1982-01-01

39

[Pancreatic resections at general hospitals in Torreon, Coahuila].  

PubMed

A retrospective study of nine patients with pancreato-biliary neoplasias were operated in several general hospitals in Torreon, Mexico. Six had pancreatic adenocarcinoma, two ampullary carcinoma and one with common bile duct benign adenoma. We had a morbidity of 55% (5/9); three cases with pancreatic fistula (resolved with nutritional support and general measures) two had obstruction of gastricyeyuno anastomosis (one required surgical management). One patient (11%) died of massive pulmonary embolism. We have now the possibility to perform an earlier diagnosis with update invasive and non invasive diagnostic studies such ERCP, computed tomography and angiography. We are proud to have in our hospitals, intensive care units and well trained surgeons that allow us to perform such kind of specialized surgery. PMID:1308308

Bernal Gómez, R; de la Peña Carrizales, V; Noyola Cedillo, S; Orozco Flores, A; Herrera, L

1992-01-01

40

Alcohol-related diseases in general hospital patients.  

PubMed

To determine the prevalence and spectrum of alcohol-related diseases in a general hospital inpatient population, data of 1288 patients newly admitted to a city general hospital, who had been examined with regards to alcoholism, were surveyed. The sample consisted of 625 medical and 663 surgical patients aged 18-64 years. In 21% (29.3% of the men and 9.4% of the women), inpatient treatment was due to an alcohol-related disorder. The highest occurrence was found in the 35-55 year-olds. Frequently diagnosed disorders in alcohol-dependent patients included delirium tremens (12.8%), seizures (11.4%), head injuries (9.4%) and cirrhosis of the liver (8.1%), whereas alcohol abusers had often been injured. Excluding patients with alcohol-related diseases decreases the proportion of men in the sample by 6.2%. The prevalence of physically-damaged alcoholic patients in general hospitals suggests that preventative measures, such as consultation services, could be applied efficiently in this setting. PMID:9105512

Gerke, P; Hapke, U; Rumpf, H J; John, U

1997-01-01

41

Use of Short-term General Hospitals by Patients with Psychiatric Diagnoses. Hospital Cost and Utilization Project Research Note 8.  

National Technical Information Service (NTIS)

The report describes the case mix and hospital experience of patients with psychiatric diagnoses in a national sample of community hospitals. It is based on 1977 American Hospital Association Survey data for a national sample of 327 short-term general, no...

J. Wallen

1985-01-01

42

MUMPS (Massachusetts General Hospital Utility Multi-Programming System) Programming Documentation Standards.  

National Technical Information Service (NTIS)

The Massachusetts General Hospital Utility Multi-Programming System (MUMPS) was developed at the Laboratory of Computer Science at Massachusetts General Hospital. MUMPS is a high-level language which also functions as an operating system and data base man...

D. M. Pearsall W. M. Pugh

1986-01-01

43

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

44

Evolution of the Whipple procedure at the Massachusetts General Hospital  

PubMed Central

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

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

45

Incidence of nephrogenic systemic fibrosis at Chinese PLA General Hospital.  

PubMed

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

Zou, Zhitong; Ma, Lin; Li, Hengjin

2009-12-01

46

[Crisis intervention in the emergency service of a general hospital].  

PubMed

Two general hospitals of Brussels tapped, in 1977, 47% of all the emergency ambulance traffic. More than 50,000 patients were examined there in one year. A randomized sample of 12,000 records were analyzed. From this file, 1707 psychosocial cases were carried out. The study will follow the progression of the patients during this crisis situation. Statistic tests pinpoint that the most determining variable is the symptoms. Seven symptoms cover more than 95% of the interventions. These symptoms are: alcoholism, suicide attempts, abnormal behavior, psychologic complaints, somatic complaints, violence, drug-addiction. Statistical analysis reveals that the two most important variables to draws crisis interventions at the emergency room were the time used by patient and the frequency of call of the psychiatrist. Other variables used to draw up the progression of the patients were: way of arrival, diagnosis and final destination. PMID:2577947

Corten, P; Pelc, I

1989-01-01

47

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.

48

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

49

Discharge, Water Temperature, and Selected Meteorological Data for Vancouver Lake, Vancouver, Washington, Water Years 2011-13.  

National Technical Information Service (NTIS)

The U.S. Geological Survey partnered with the Vancouver Lake Watershed Partnership in a 2-year intensive study to quantify the movement of water and nutrients through Vancouver Lake in Vancouver, Washington. This report is intended to assist the Vancouver...

C. A. Marshall J. R. Foreman R. W. Sheibley

2014-01-01

50

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

PubMed

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 (RCQ) in two representative samples: 118 alcohol-dependent subjects admitted to a general hospital (sample 1) and 50 alcohol-dependent individuals in the general population (sample 2). In sample 1, alcohol-dependent persons were identified in 1167 consecutive admissions using screening questionnaires and a diagnostic interview (SCAN). In sample 2, alcohol dependence was assessed in 4075 individuals using a German version of CIDI. The distribution of stages of change differed significantly (p < 0.0001) between the groups, revealing a shift towards higher stages in the hospital subjects. Logistic regression analysis revealed that the stages of readiness to change and age contributed in predicting whether subjects belonged to the general hospital or the general population sample. Findings suggest that the general hospital is a suitable site to initiate interventions for alcohol-dependent individuals. PMID:10572776

Rumpf, H J; Hapke, U; Meyer, C; John, U

1999-01-01

51

Impediments to Screening for Hazardous Alcohol Use and Dependence in General Hospital Psychiatric Inpatients  

Microsoft Academic Search

Objective: The Alcohol Use Disorders Identification Test (AUDIT) has been developed to screen for hazardous and harmful alcohol consumption. It has been used among a variety of primary care, general population and general hospital populations. However, with the exception of one study undertaken by the author and colleagues, the use of the AUDIT in general hospital psychiatric patients has not

Gary K. Hulse

2001-01-01

52

Hybrid-dimension association rules for diseases track record analysis at Dr. Soetomo General Hospital  

Microsoft Academic Search

Dr. Soetomo General Hospital already has a Hospital Information System which has been computerized for data storage of each recapitulated patient's disease. Since data recapitulated the patient's disease is increasing, Dr. Soetomo Hospital needed an application which can provide information for decision makers. One application that can help in decision making is data mining. Data mining with hybrid-dimension association rules

Silvia Rostianingsih; Gregorius Satia Budhi; Ni Wayan Yessy Dwijayanti

2011-01-01

53

Asthma at the interface: bridging the gap between general practice and a district general hospital.  

PubMed Central

A clinic supervised by a nurse, using principles originally developed in general practice, was established in the paediatric department of a district general hospital. A randomised controlled study was conducted comparing children admitted with asthma or attending outpatients who were given a patient education programme and self management plan (intervention group) with a control group. The study comprised 91 patients aged 3-14 years admitted for asthma or attending a hospital outpatient department from November 1989 to November 1990. Seventy seven patients completed the study and kept diaries for a median of 283 days. Patients in the intervention group had significantly less restriction of activity (95% confidence interval (CI) -0.27 to -0.01) and fewer episodes of peak flow below 30% of best (95% CI 0.03 to 1.17). Patients in the intervention group were more likely to make the correct response to an acute exacerbation of their asthma than the control group (71% v 47%, 95% CI 9.51 to 39.1). The intervention group had fewer school absences and fewer home visits by a general practitioner. There was an increase in the readmission rate for the intervention group. A subgroup of patients who self managed by doubling their use of inhaled steroids during an exacerbation performed better than those patients who only increased their bronchodilator or were managed on salbutamol or sodium cromoglycate alone. Improvements in patient follow up and the structure of the self management plans used, particularly changing the peak flow level at which inhaled steroids are doubled, may further improve the outcome of patients attending the asthma clinic. Images

Charlton, I; Antoniou, A G; Atkinson, J; Campbell, M J; Chapman, E; Mackintosh, T; Schapira, D

1994-01-01

54

Homeless mentally ill patients in the community: Results of a general hospital emergency room study  

Microsoft Academic Search

Previous inattention to the specific circumstances of homeless mentally ill individuals in general hospital settings is discussed. Homeless mentally ill individuals who presented for emergency psychiatric care in a public general hospital setting exhibited distinctive patterns of service utilization and showed evidence of being a uniquely disabled, rootless, and impoverished subgroup of mentally ill individuals. The characteristics of homeless users

Leona L. Bachrach; Jose M. Santiago; Michael R. Berren

1990-01-01

55

Success of Referral for Alcohol Dependent Patients from a General Hospital  

Microsoft Academic Search

To assess the effectiveness of a multidisciplinary evaluation and referral process in a prospective cohort of general hospital patients with alcohol dependence, alcohol-dependent patients were identified in the wards of the general hospital and its primary care center. They were evaluated and then referred to treatment by a multidisciplinary team; those patients who accepted to participate in this cohort study

Stephane Rochat; Vincent Wietlisbach; Bernard Burnand; Ulrika Landry; Bertrand Yersin

2004-01-01

56

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

57

[Profile of psychiatric emergencies in general hospital wards].  

PubMed

Statistical study, using objective variables, was carried out to draw the profile of psycho-social cases at the emergency unit of Publics hospitals. The study analyses the attitude of the nursing and medical staff. This paper looks the problem throw three parameters: the symptoms, the diagnosis and the final destination. The most important conclusion is: staff seems to see his work with emergencies cases like a shunting problem and not like a beginning of therapeutical work. PMID:6524416

Corten, P; Pelc, I

1984-01-01

58

Geoscape Vancouver: Living with our Geological Landscape  

NSDL National Science Digital Library

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

59

Homeless mentally ill patients in the community: results of a general hospital emergency room study.  

PubMed

Previous inattention to the specific circumstances of homeless mentally ill individuals in general hospital settings is discussed. Homeless mentally ill individuals who presented for emergency psychiatric care in a public general hospital setting exhibited distinctive patterns of service utilization and showed evidence of being a uniquely disabled, rootless, and impoverished subgroup of mentally ill individuals. The characteristics of homeless users of general hospital psychiatric services may provide some important clues to system-wide deficits in community-based care for the members of this population. PMID:2257725

Bachrach, L L; Santiago, J M; Berren, M R

1990-10-01

60

33 CFR 165.1308 - Columbia River, Vancouver, WA.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Columbia River, Vancouver, WA. 165.1308 Section...Guard District § 165.1308 Columbia River, Vancouver, WA. (a) Location...safety zone: All waters of the Columbia River at Vancouver, Washington, bounded by a line...

2013-07-01

61

Klebsiella pneumoniae bacteraemia at an urban general hospital.  

PubMed

Of 47 patients with Klebsiella pneumoniae bacteraemia admitted to the Hillbrow Hospital, Johannesburg during a period of 18 months, 31 were males and 16 were females. Features predisposing to illness were found in 89.4% patients, chronic alcoholism, neoplastic disease and diabetes mellitus being the most common. Twenty-five infections were acquired in hospital and 22 in the community. Most patients (59.6%) had pneumonia. All isolates of K. pneumoniae were resistant to ampicillin (100%); several (42.6%) were resistant to other antibiotics also. The overall mortality rate was 55.3%. A higher mean initial blood pressure and lower concentrations of serum urea and bilirubin were found in survivors. None of the 28 patients, surviving more than 48 h who received combined therapy with an aminoglycoside and a beta-lactam antibiotic (to which the organism was susceptible) died. Among the remaining patients treated with either an appropriate beta-lactam agent alone, an appropriate aminoglycoside alone or ciprofloxacin the combined mortality rate was 83.3% (P = 0.007). PMID:2405058

Feldman, C; Smith, C; Levy, H; Ginsburg, P; Miller, S D; Koornhof, H J

1990-01-01

62

Utilization of local jails and general hospitals by state psychiatric center patients  

Microsoft Academic Search

The idea that the deinstitutionalization of state psychiatric centers has resulted in increased utilization of general hospitals and correctional facilities by people with severe and persistent mental illness is widely held. This hypothesis of transinstitutionalization was tested by examining hospitalization and incarceration rates of people who had been or would be institutionalized in state psychiatric centers in 16 upstate New

Steven M. Banks; James L. Stone; John A. Pandiani; Judith F. Cox; Pamela C. Morschauser

2000-01-01

63

Radiological Practice and Medical Records in a Large General Hospital in Hiroshima.  

National Technical Information Service (NTIS)

The analysis of the records of the Radiology Department of a large general hospital in Hiroshima is reported. This analysis demonstrated that: over the years since the end of World War II, the activity of radiologic practice in this hospital has gradually...

K. Matsuura S. Sawada W. J. Russell H. Yoshinaga

1965-01-01

64

PSYCHIATRIC SERVICES IN GENERAL HOSPITALS--A Report of the Northern California Psychiatric Society's Committee on the Need for Psychiatric Services in General Hospitals  

PubMed Central

A study made by a special committee appointed for the purpose by the Northern California Psychiatric Society found that a real need exists for local psychiatric services in general hospitals of the Northern California area. Such services can be provided readily—and in some communities are already available. A broad segment of the population looks to the general hospital to provide diagnosis and care and so enable the patient's prompt recovery from psychiatric disorders. The study further emphasizes the importance of such factors as a competent psychiatric chief, adequate staff and personnel and good planning in organizing inpatient and outpatient facilities and integrating treatment so that all the functions of the hospital are available to psychiatric patients. Granted these special considerations, the services can be provided more easily than many physicians, including some psychiatrists and administrators, suppose.

Juul, Clement O.

1957-01-01

65

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

66

Legal outcomes of sexually abused children evaluated at the Philippine General Hospital Child Protection Unit  

Microsoft Academic Search

ObjectivesTo 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.

Mariella Sugue-Castillo

2009-01-01

67

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

Microsoft Academic Search

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

Simon J. Williams; Michael Calnan

1991-01-01

68

Postnatal depression and psychosis--a mother and baby unit in a general hospital.  

PubMed

The experience of a Mother and Baby Unit in a General Hospital Psychiatry Department in managing postnatal depression and puerperal psychosis over a 2-year period is reviewed. In our community severe depressive illness will more often be referred to a Public General Hospital with a psychiatric service. The mean admission duration of 26 days for depressive illness was significantly lower than that previously reported by a Psychiatric Hospital. A significant delay in presentation appeared in half the cases, which could be reduced by attention to the family and past psychiatric history, especially the patient's relationship to her own mother indicating risk of puerperal mental disturbance. PMID:3233082

Kissane, D; Ball, J R

1988-08-01

69

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

PubMed Central

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

Chambers, Catharine; MacDougall, Laura; Li, Min

2008-01-01

70

Histoplasmosis: twenty years experience in a general hospital.  

PubMed Central

This report summarizes the clinical and laboratory data on 57 patients with histoplasmosis, including 13 with progressive disseminated disease. The experience in general is supportive of that of others in that although infection with Histoplasma capsulatum is prevalent, clinical disease is uncommon and disseminated disease actually rare. The data again emphasize the limitations of diagnostic methods, and in particular point up the need to obtain cultures of biopsy material from mucocutaneous lesions. Images Fig. 1

Tompsett, R.; Portera, L. A.

1976-01-01

71

Attitudes to cancer of medical and surgical nurses in a district general hospital  

Microsoft Academic Search

The personal beliefs and attitudes of nurses can have serious implications for their practice. Yet there are a lack of studies on nurses' attitudes to cancer in the UK in general, and in Northern Ireland specifically. The need for such studies is further emphasized by the importance of nurses' role in the Cancer Units of district general hospitals, as proposed

Eilis McCaughan; Kader Parahoo

2000-01-01

72

Specific psychiatric morbidity in liver cirrhosis in a Nigerian general hospital setting  

Microsoft Academic Search

The purpose of this investigation was to explore the psychiatric complications of liver cirrhosis in a Nigerian general hospital setting. The mental state of 31 consecutive patients with liver cirrhosis seen in a gastroenterology unit, from July 1996 to August 1998, was assessed using the 30-item General Health Questionnaire (GHQ-30) and Present State Examination (PSE) and compared with those of

Henry S Aghanwa; Dennis Ndububa

2002-01-01

73

Ohio's Parma Community General Hospital celebrates 40 years. Independence, growth featured as themes.  

PubMed

Parma Community General Hospital in Parma, Ohio, is called "the only successful independent community hospital in Cuyahoga County." It celebrated its 40th anniversary in 2001 by touting impressive statistics, such as growing to 339 beds now from 200 beds in 1962. Events to celebrate the anniversary included an employee celebration, the opening of a residential hospice center and a community prayer breakfast. PMID:12238235

Botvin, Judith D

2002-01-01

74

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

75

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

76

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

PubMed Central

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

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

2013-01-01

77

Intermediate care at a community hospital as an alternative to prolonged general hospital care for elderly patients: a randomised controlled trial  

PubMed Central

Background Demographic changes together with an increasing demand among older people for hospital beds and other health services make allocation of resources to the most efficient care level a vital issue. The aim of this trial was to study the efficacy of intermediate care at a community hospital compared to standard prolonged care at a general hospital. Methods In a randomised controlled trial 142 patients aged 60 or more admitted to a general hospital due to acute illness or exacerbation of a chronic disease 72 (intervention group) were randomised to intermediate care at a community hospital and 70 (general hospital group) to further general hospital care. Results In the intervention group 14 patients (19.4%) were readmitted for the same disease compared to 25 patients (35.7%) in the general hospital group (p = 0.03). After 26 weeks 18 (25.0%) patients in the intervention group were independent of community care compared to seven (10.0%) in the general hospital group (p = 0.02). There were an insignificant reduction in the number of deaths and an insignificant increase in the number of days with inward care in the intervention group. The number of patients admitted to long-term nursing homes from the intervention group was insignificantly higher than from the general hospital group. Conclusion Intermediate care at a community hospital significantly decreased the number of readmissions for the same disease to general hospital, and a significantly higher number of patients were independent of community care after 26 weeks of follow-up, without any increase in mortality and number of days in institutions.

Garasen, Helge; Windspoll, Rolf; Johnsen, Roar

2007-01-01

78

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

PubMed Central

Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356) gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298). Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented through survey method is required to support these conclusions.

2011-01-01

79

Effects of Medicare BBA spending reductions on the profitability of general acute care hospitals.  

PubMed

The Balanced Budget Act of 1997 was intended to reduce spending by about $115 billion from the Medicare Hospital Insurance trust fund over a five-year period. Several studies were funded by the hospital industry that indicated that the actual reductions would be far greater than $115 billion and that these reductions would have a devastating effect on U.S. hospital finances. In 1999, Congress passed the Balanced Budget Refinement Act, which added back about $11 billion in spending for fiscal years 2000 through 2002. In 2000, Congress passed the Benefits Improvement and Protection Act, which restored another $37 billion in spending over a five-year period. These cutbacks were going into effect at the same time as a cyclical decline in hospital operating margins occurred. This study was designed to determine if any separate effect of the Balanced Budget Act could be detected in the operating margins of general acute care hospitals in Tampa Bay, Florida. Operating margins were analyzed for 25 hospitals for a 12-year period (1990 through 2001), and a regression model was tested in which the dependent variable was the difference in mean operating margins for each hospital between the 1990 through 1997 period and the 1998 through 2001 period. The mean percentage of hospital revenue derived from Medicare, five other revenue source variables, and three hospital structural variables were used as the predictor variables. A statistically significant decline in operating margins was seen between these two periods, but Medicare revenue did not account for a significant amount of the variance. Thus, it was concluded that the Balanced Budget Act of 1997 did not significantly affect the operating margins of the study hospitals. Implications for Medicare policy are addressed. PMID:15074120

Sear, Alan M

2004-01-01

80

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

PubMed Central

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

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

2013-01-01

81

Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals.  

PubMed

Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments. PMID:20144031

Hanrahan, Nancy P; Aiken, Linda H; McClaine, Lakeetra; Hanlon, Alexandra L

2010-03-01

82

Relationship between Psychiatric Nurse Work Environments and Nurse Burnout in Acute Care General Hospitals  

PubMed Central

Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses’ capacity to sustain safe and effective patient care environments.

Hanrahan, Nancy P.; Aiken, Linda H.; McClaine, Lakeetra; Hanlon, Alexandra L

2010-01-01

83

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

USGS Publications Warehouse

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

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

2014-01-01

84

Adverse Events Associated With Organizational Factors of General Hospital Inpatient Psychiatric Care Environments  

PubMed Central

Objective Although general hospitals receive nearly 60% of all inpatient psychiatric admissions, little is known about the care environment and related adverse events. The purpose of this study was to determine the occurrence of adverse events and examine the extent to which organizing factors of inpatient psychiatric care environments were associated with the occurrence of these events. The events examined were wrong medication, patient falls with injuries, complaints from patients and families, work-related staff injuries, and verbal abuse directed toward nurses. Methods This cross-sectional study used data from a 1999 nurse survey linked with hospital data. Nurse surveys from 353 psychiatric registered nurses working in 67 Pennsylvania general hospitals provided information on nurse characteristics, organizational factors, and the occurrence of adverse events. Linear regression models and robust clustering methods at the hospital level were used to study the relationship of organizational factors of psychiatric care environments and adverse event outcomes. Results Verbal abuse toward registered nurses (79%), complaints (61%), patient falls with injuries (44%), and work-related injuries (39%) were frequent occurrences. Better management skill was associated with fewer patient falls and fewer work-related injuries to staff. In addition, fewer occurrences of staff injuries were associated with better nurse-physician relationship and lower patient-to-nurse staffing ratios. Conclusions Adverse events are frequent for inpatient psychiatric care in general hospitals, and organizational factors of care environments are associated with adverse event outcomes. Further development of evidence-based quality and safety monitoring of inpatient psychiatric care in general hospitals is imperative.

Kumar, Aparna; Aiken, Linda H.

2010-01-01

85

Variables correlated with elderly referral from nursing homes to general hospitals  

PubMed Central

Background Referring patients from nursing homes to general hospitals exposes them to nosocomial diseases, and may result in the development of a broad spectrum of physical, mental and social damages. Therefore, minimizing the referring of nursing home patients to hospitals is an important factor for keeping the elderly healthy and minimizing health expenditures. In this study we examined the variables related to the referral rates from nursing homes to general hospitals and the relationship between the referral and the mortality rates among the elderly who live in nursing homes in the Haifa Sub-district. Methods Thirty-two nursing homes were included in a cross-sectional study. All medical directors and head nurses were interviewed using a structured questionnaire between November 2006 and October 2007. Statistical analysis, including the ANOVA and the nonparametric Spearman tests, were employed to determine the factors that influence referral rates and the correlation between referral rates and mortality rates. Results The referral rate ranged between 18 and 222 per 100 financed elderly in a single year. In the multivariate analysis, the absence of a physician from the nursing home at the time of the referral to general hospitals was the only significant variable related to referral rates. No significant relationships were found between referral rates and mortality rates. Conclusions Absence of a significant relationship between referral rates and mortality rates may indicate that high referral rates do not necessarily protect the elderly from death. Therefore, any recommendations issued by the Ministry of Health (MOH) should emphasize in-house treatment rather than hospitalization. Clear instructions on referral from nursing homes to general hospitals need to be constructed by the MOH. The MOH should increase the presence of physicians in the nursing homes, especially, when the need to refer a patient arises. Further quantitative and epidemiologic studies should be conducted in order to, more fully and reliably, create guidelines for policy recommendations.

2014-01-01

86

A review of 50 consecutive cytology cell block preparations in a large general hospital  

Microsoft Academic Search

AIMS: To review consecutive cell block preparations of cytological specimens in a large general hospital. METHODS: 50 cell blocks were made over an 18 month period in which about 1900 fine needle aspirations (FNAs) were performed. The aspirator was a cytologist or, for image guided FNAs, a radiologist with a cytologist at hand to collect the specimen. Forty eight cell

F Mayall; B Chang; A Darlington

1997-01-01

87

A 9-year experience of laparoscopic hysterectomy in a UK district general hospital  

Microsoft Academic Search

Hysterectomy is the commonest major gynaecological operation. Laparoscopic hysterectomy now offers a means of converting an otherwise abdominal approach into a vaginal procedure. A UK district general hospital has evaluated its experience in laparoscopic hysterectomy over 9 years, starting at a point when abdominal hysterectomy was a norm in the UK. Three hundred and sixty-three women underwent laparoscopic hysterectomy from January

Anil Gudi; Al Samarrai

2005-01-01

88

Reliability and Validity of the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire  

Microsoft Academic Search

Background: We have recently developed the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ), a brief scale to measure cognitive and executive dysfunction in mood and anxiety disorders, and we here report on its reliability and validity. Methods: The internal consistency of the CPFQ was assessed by computing Cronbach’s coefficient ? based upon the average intercorrelation of the 7

Maurizio Fava; Dan V. Iosifescu; Paola Pedrelli; Lee Baer

2009-01-01

89

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

90

Should we continue oesophageal surgery in a district general hospital? A review of 200 consecutive cases.  

PubMed Central

A series of 200 oesophageal resections is presented. The results show that acceptable standards are obtainable in a district general hospital (DGH) thus favouring the suggestion that such services could be organised by 'networking' rather than centralisation. This avoids the disadvantages to many DGH patients which follow centralisation.

Dickson, G. H.; Waters, R.; Bull, J.; Kaul, V.; Sitzia, J.

2001-01-01

91

Job satisfaction and occupational stress in UK general hospital nursing staff  

Microsoft Academic Search

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

Andrew Guppy; Tim Gutteridge

1991-01-01

92

Patient, hospital, and general practitioner characteristics associated with non-attendance: a cohort study.  

PubMed

Studies examining characteristics of non-attendance at hospital outpatients have given inconsistent results. We examined a cohort of 1972 referrals from 26 general practitioners, with complete follow-up. Five factors were found to be significantly associated with non-attendance: male sex, younger age, longer interval between referral and appointment, higher Jarman score and patients of a high-referring general practitioner. Targeting of strategies to reduce non-attendance is possible using these results. PMID:11942451

Hamilton, William; Round, Alison; Sharp, Deborah

2002-04-01

93

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

PubMed

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

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

2008-08-01

94

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

95

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

Microsoft Academic Search

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

LYNN OWENS; IAN T. GILMORE; MUNIR PIRMOHAMED

96

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

97

Abdominal wound dehiscence. A 10-year survey from a district general hospital.  

PubMed Central

The incidence of abdominal wound dehiscence at a district general hospital was found to be about 1.5%. Analysis of a group of 123 patients with dehiscence in 3 separate years during a 10-year period confirmed that disruption most commonly occurs during the second postoperative week. The suture material used for primary closure appeared to have no influence on subsequent dehiscence. After resuture the recorded incidence of incisional herniation was 19% and the mortality was 24%. Patients who survived resuture remained in hospital for a prolonged period.

White, H.; Cook, J.; Ward, M.

1977-01-01

98

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

99

Acute generalized weakness in patients referred to Amirkola Children's Hospital from 2005 to 2010  

PubMed Central

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

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

2012-01-01

100

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

2013-04-01

101

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

PubMed Central

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

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

2013-01-01

102

[General information system through whole hospital and electronic medical record system].  

PubMed

A new system has been introduced and implemented at the Nagoya City University Hospital since January 2004 in order to improve services for patients and general operation for management of the hospital. General Information System has been consisted with Electronic Medical Record System (EMRS), which is the core of all system and divisional system such as Clinical Laboratory Tests, Images, Medical Accounting and so on. A new system has been built and operated to work with the EMRS at the Department of Central Clinical Laboratory (CCL). To cooperate with the new system, we have constructed and operated directly the EMRS such as automatic registration the latest information on infectious diseases and blood transfusions, clinical reports on laboratory test through the hospital news and/or e-mail, introducing laboratory pre test before the consultation, rapid reports of panic values to the doctor in charge of the patients directly, the new system build up a closer cooperation between division of blood transfusion division and that of immuno-chemistry in CCL through EMRS. The new system has been brought not only efficiency and strengthen of function in CCL but also strengthen the service to patients in the hospital. PMID:16548236

Goto, Takaaki

2006-02-01

103

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

PubMed

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

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

1985-10-01

104

Massachusetts general hospital: improving patient access to the breast oncology clinic.  

PubMed

As part of Massachusetts General Hospital's overall quality improvement program, the Massachusetts General Hospital Breast Oncology Program participated in the NCCN Breast Cancer Outcomes Database Opportunities for Improvement Program. A review of concordance to breast oncology quality measures revealed that a small proportion of patients with breast cancer started chemotherapy more than 120 days after diagnosis. Therefore, the research team designed a quality improvement project to increase the percentage of concordance with the ASCO quality measure that requires time to treatment of less than 120 days and to decrease the number weeks from last definitive surgery to first adjuvant chemotherapy by 2014. A multipronged approach of improvements was used: to systems and infrastructure, communication among providers, and recruitment of additional staff as needed. This article describes the project and future initiatives to further improve the quality of breast cancer care at the institution. PMID:24614048

Lennes, Inga T; Bloom, Mara; Bohlen, Nie; Moy, Beverly

2014-02-01

105

Case control study of epidural catheter infections in a district general hospital.  

PubMed

Ten infections associated with the use of epidural catheters for post-operative pain relief were identified in patients of a district general hospital in 1997 and 1998. A case control study showed that the infections were commoner in the summer months and associated with analgesia infused by syringes rather than pumps. Infection rates and risk factors can be analysed regularly if pain teams maintain a database of epidural catheters inserted, which includes information about infections. PMID:11280266

Dawson, S J; Small, H; Logan, M N; Geringer, S

2000-12-01

106

Introducing fetal fibronectin testing to a district general hospital in women with symptoms of preterm labour  

Microsoft Academic Search

AimsTo evaluate the use of fetal fibronectin (fFN) testing within a District General Hospital and to review the fFN predictive values in women presenting with symptoms of preterm labour.MethodsRetrospective case note review of all women having a fFN test at East Sussex NHS Trust from April 2009 to April 2010 (n=123). Data collected included risk factors for preterm labour, signs

H Myint; V Singh; N J Roberts

2011-01-01

107

Predictors of frequent attenders of emergency department at an acute general hospital in Singapore  

Microsoft Academic Search

ObjectiveTo determine factors associated with frequent emergency department (ED) attendance at an acute general hospital in Singapore.MethodPatients who attended the ED from 1 January to 31 December 2006 without prior attendance in the preceding 12 months (index attendance) were tracked for 12 months. Variables included in the analysis were age, gender, race, date and time of attendance, patient acuity category

P. Paul; B. H. Heng; E. Seow; J. Molina; S. Y. Tay

2010-01-01

108

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

109

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

110

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

111

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

112

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

113

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

PubMed Central

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

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

2008-01-01

114

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

PubMed

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

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

2014-01-01

115

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

PubMed Central

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

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

2010-01-01

116

The impact of a 10-year audit cycle on blood usage in a district general hospital.  

PubMed

As clinical governance moves from concept to practice, it is emerging as a realistic strategy to promote and improve quality within the National Health Service, as well as satisfying the demand for external accountability. In the context of blood transfusion, the area of responsibility encompasses product liability, as well as efficient use of blood as a resource and transfusion as an appropriate clinical response. Clinical governance may be a modern catch phrase, but the principles it enshrines have long been established within blood transfusion, and in other aspects of haematology. Here, an audit cycle comprising four audits over a 10-year period to monitor the use of cross-matched blood in a large district general hospital is described. Initially, blood use was considered by hospital site, and by the surgical procedure for which it was requested. Later, the scope of the audit was expanded to consider usage by individual consultant. A standard of efficient use of cross-matched blood was taken to be a cross-match to transfusion ratio of < 1.5. The information was reviewed by the hospital transfusion committee, who have a key role in co-ordinating and assessing the practice of transfusion within a hospital. In this hospital, audit has been one of the main tools for improving practice, in particular by enabling the implementation and continuous revision of a maximum blood order schedule. Further, as the process of audit has developed, problem areas have been highlighted, and strategies to improve usage have been brought in with encouraging results. The audit is now being expanded again to include a greater focus on usage of cross-matched blood in the nonsurgical setting. PMID:11696230

James, R M; Brown, S; Parapia, L A; Williams, A T

2001-10-01

117

Historical review: First facial pain patient admitted to Massachusetts General Hospital, February 1823 and first case series.  

PubMed

Founded in 1811, the Massachusetts General Hospital recently celebrated its bicentennial. The War of 1812 delayed construction of the building so the first patient actually was admitted to the hospital 10 years later, on September 3, 1821. By 1823, the 60 hospital beds were full. Patient 66 was admitted on February 28, 1823, and his hospital course, as described in the admissions book, was transcribed for the Massachusetts General Hospital bicentennial celebration. That case history is reproduced and a case series of 6 similar patients published in 1828 by Dr John Warren, surgeon-in-chief and a founder of the hospital, is presented. In this report, the authors comment on the diagnosis, treatment, and outcome of these patients in the context of the contemporaneous health care environment and in light of the current knowledge of facial pain disorders. This article was adapted from the authors' commentary for the bicentennial celebration. PMID:23866949

Keith, David A; Dodson, Thomas B; Kaban, Leonard B

2013-08-01

118

Variable Lengths of Stay among Ischemic Stroke Subtypes in Chinese General Teaching Hospitals  

PubMed Central

Background Length of stay (LOS) is one of the most important quantitative indexes that measures health service utilization within a hospital. Many studies have examined the association of three major stroke categories with LOS. Our aim is to investigate the differences of LOS among ischemic stroke subtypes, results from which are helpful to healthcare providers and government agencies to improve health care delivery efficiency. Methodology/Principal Findings Using the Beijing Municipal Health Bureau’s hospitalization summary reports, we performed a retrospective study among first-ever in-hospital patients with ischemic stroke (ICD-10 I63) in three general teaching hospitals in Beijing, China, from 2006 to 2010 with generalized linear model. In our study, 5,559 patients (female, 36.0%; age, 64.4±12.9 years) were included. The estimated mean LOS of ischemic stroke was 17.4±1.8 days. After adjusting for confounders, LOS of lacunar infarction (14.7 days; p<0.001) and LOS of small cerebral infarction (17.0 days; p?=?0.393) were shorter than that of single cerebral infarction (17.9 days, p<0.001). LOS of multi-infarct (19.0 days; p?=?0.028), brainstem infarction (19.3 days; p?=?0.045), basal ganglia infarction (18.5 days; p?=?0.452) and other subtypes of ischemic stroke (18.9 days; p?=?0.327) were longer than that of single cerebral infarction. Conclusions LOS of ischemic stroke patient differes across single cerebral infarction, lacunar infarction, multi-infarct and brainstem infarction patients. The ascending order of LOS was lacunar infarction, small cerebral infarction, single cerebral infarction, basal ganglia infarction, other subtypes of ischemic stroke, multi-infarct and brainstem infarction.

Li, Yi; Liu, Hui; Wang, Jing; Li, Yan; Yu, Guo-Pei; Ma, Xie-Min; Liang, Ming-Hui; Zhang, Jun; Zhao, Lue Ping

2012-01-01

119

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

PubMed

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

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

2010-01-01

120

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

PubMed Central

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

2013-01-01

121

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

PubMed

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

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

2011-02-01

122

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

123

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

PubMed Central

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

Ross, Colin; Jensen, Brian

1980-01-01

124

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

PubMed Central

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

Emmanuel, J.; Walter, N.

1989-01-01

125

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

126

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

127

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

Microsoft Academic Search

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

T M Hayes; J Harries

1984-01-01

128

Outcome of major trauma patients in a Hong Kong general hospital.  

PubMed

This is a retrospective study on the outcome using the TRISS methodology of 94 significantly injured patients over a 24-month period, managed by the Hospital Trauma Team in a general hospital since the formation of the Team in August 1994. There were 37 deaths and nine (24.3%) of these were 'potentially preventable' according to TRISS methodology. Seven of these nine 'potentially preventable or unexpected deaths' were transferred from a nearby district hospital where there was no acute operative facilities. There was no significant difference between the sex, age, mode of injury or Injury Severity Score between the direct admission and transfer-in cases and the M-statistic values of the two groups were similar. Five of the nine deaths happened in the first 4 months after the formation of the Trauma Team and the other four were scattered in the subsequent 20 months. The rate of preventable deaths was 50% (five out of 10 deaths) in the first 4 months, and was 15% (four out of 26) in the subsequent period. The probable causes for the 'potentially preventable trauma deaths' were delay owing to interhospital transfer, delay in activation of the trauma team, unidentified intra-peritoneal haemorrhage, failure to control haemorrhage and delayed or inadequate definitive operation. The evident improvement in the reduction of unexpected trauma deaths were likely associated with the success factors of the improvement of the multi-disciplinary cooperation including mutual understanding, simultaneous patient assessment, higher readiness to use diagnostic peritoneal lavage or ultrasonography to evaluate blunt abdominal trauma, earlier senior participation in patient care, shortening in response time of supportive facilities and a gradual cultural change towards dedicated trauma patient care. Further reduction in unexpected deaths can be expected if better prehospital triage by ambulance staff is attained to transfer trauma patients to the most appropriate instead of the nearest hospital. PMID:9827831

Kam, C W; Kitchell, A K; Yau, H H; Kan, C H

1998-09-01

129

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

PubMed

Little is known about the effect of human immunodeficiency virus (HIV) infection on the Central American healthcare system. We describe HIV-related admissions in a Guatemalan medical service. The study was conducted at Guatemala City's largest public hospital. Data were derived from standardized data collection sheets maintained by the HIV testing service and by HIV clinic physicians. Data were collected for 295 medicine admissions of 257 HIV-infected adults during an 18-month period in 1999 and 2000; 30% of the patients were women. Average age was 33 years. Only 12.5% of the patients had been diagnosed with HIV infection prior to 1999 and nearly all had symptomatic AIDS. 60.3% of the patients were diagnosed with HIV infection during their hospitalization. The most common discharge diagnoses were tuberculosis (13.9%), toxoplasmosis, diarrhoea, candida and other fungal infections, and meningitis. Mean length of stay for HIV-positive patients was 17 days. 23.7% of the patients died during their hospitalization; this was double the mortality of non-HIV patients. HIV-infected patients represented 5.8% of the total admissions of the general medical wards. In a country where HIV prevalence is thought to be less than 1%, AIDS is now responsible for over 5% of admissions to a large medical service at a cost of $500,000 per year. These findings underline the importance of HIV infection in Central America and demonstrate the utility of tracking hospital admission data as a method of surveillance. PMID:14678588

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

2003-12-01

130

Water quality improvement plan for Greater Vancouver  

SciTech Connect

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

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

1993-10-01

131

The first four years' experience of day case orthopaedic surgery in a district general hospital.  

PubMed Central

Clinical data were obtained for 2838 consecutive patients admitted to a new day case unit in a district general hospital by four consultant surgeons between 1 October 1981 and 30 September 1985. Surgical procedures under general anaesthesia: on 2581 patients were analysed in detail. Intra-articular arthroscopic surgery was performed on 60% of knees. A fifth of patients had manipulation and intra-articular infection of a joint. Surgical operations involving the hands and forearm were required by 17%. Toe surgery was performed on 11% of patients of whom 21% had a distal metatarsal osteotomy. Overnight admission was necessary for 6% of patients because of postanaesthetic difficulties, the operation occurring too late in the day or proving more extensive. The use of day case facilities was an economic saving, pleased 98% of patients and reduced waiting list time significantly, except for patients with serious chronic joint disorders. The waiting list for total hip and knee replacements increased in the four year period.

Older, J.

1988-01-01

132

Predictors of hospital discharge to an extended care facility after major general thoracic surgery.  

PubMed

Failure to anticipate the need to discharge patients to rehabilitation centers and skilled nursing facilities results in expensive delays in the discharge of patients after surgery. Early identification of patients at high risk for discharge to these extended care facilities could mitigate these delays and expenditures. The purpose of this study was to identify preoperative patient factors associated with discharge to extended care facilities after major general thoracic surgery. Discharge records were identified for all patients undergoing major general thoracic surgery admitted to a university hospital between January 2006 and May 2009 who had a stay of longer than one day. The following risk factors were selected a priori based on clinical judgment: age, preoperative albumin, preoperative Zubrod score, history of peripheral vascular disease, and use of home oxygen. Multiple logistic regression analysis was used to estimate the statistical significance and magnitude of risk associated with each predictor of patient discharge to extended care facilities. Of the 1646 patients identified, 68 (4.1%) were discharged to extended care facilities. Hospital length of stay was on average six days longer for patients discharged to these facilities than for patients discharged home (P < 0.0001). Multivariate analysis demonstrated that advanced age, lower preoperative albumin, and increased preoperative Zubrod score were statistically significant predictors of discharge to extended care facilities. Age, preoperative nutritional status, and functional status are strong predictors of patient discharge to extended care facilities. Early identification of these patients may improve patient discharge planning and reduce hospital length of stay after major thoracic surgery. PMID:24666870

Walters, Dustin M; Nagji, Alykhan S; Stukenborg, George J; Peluso, Melissa R; Taylor, Matthew D; Kozower, Benjamin D; Lau, Christine L; Jones, David R

2014-03-01

133

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

PubMed Central

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

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

2014-01-01

134

D. Campbell Meyers, M.D., L.R.C.P., M.R.C.S. (Eng.) 1863-1927, pioneer of Canadian general hospital psychiatry.  

PubMed

The paper describes the pioneering contributions of Dr. D. Campbell Meyers (1863--1927) to general hospital psychiatry during the first decade of this century at the Toronto General Hospital where, between 1906 - 1911, he operated the first public general hospital psychiatric unit in Canada. His conflict with Dr. C. K. Clarke who opposed his efforts is documented. To honour Meyers' contributions the Department of Psychiatry, Toronto General Hospital, has been named "The D. Campbell Meyers Memorial Department of Psychiatry". PMID:1102081

Pos, R; Walters, J A; Sommers, F G

1975-08-01

135

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

PubMed Central

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

Al-juboori, Ahmad Nasrat

2013-01-01

136

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

PubMed

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

Al-Juboori, Ahmad Nasrat

2013-01-01

137

Primary epithelial submandibular salivary gland tumours--review of management in a district general hospital setting.  

PubMed

Primary epithelial submandibular gland (SMG) tumours are uncommon, accounting for 8-12% of all salivary gland neoplasms, and most studies come from large specialised centres. There is little published about the relative frequency and outcome of SMG tumours treated in general hospitals. A retrospective study from two district general hospitals over a 10 year period (1996-2005). Seventeen benign (68%) and eight malignant (32%) tumours were included. A painless mass was the most common presentation. Pain and paraesthesia were not pathognomonic of malignancy. Pleomorphic adenoma accounted for all 17 benign tumours and adenoid cystic carcinoma was the commonest malignant tumour. Fine needle aspiration cytology (FNAC) accurately identified 78% of the benign tumours but none of the malignant tumours. Pre-operative imaging was also unable to distinguish malignant from benign tumours. Incomplete excision was reported in 20% of cases and was more common for malignant tumours. It may be difficult to distinguish benign from malignant SMG tumours on clinical examination and pre-operative investigations. Any suspected submandibular tumour should be considered for early treatment even when FNAC is suggestive of a benign tumour. PMID:18676173

Ethunandan, M; Davies, B; Pratt, C A; Puxeddu, R; Brennan, P A

2009-02-01

138

[Current status and needs of the department of neurology as a specialized department of a general hospital].  

PubMed

In this report, I have summarized the current situation surrounding diagnosis, treatment and related needs in the department of neurology in relation to postgraduate neurology training considered from the standpoint of a specialized department within a general hospital. This summary is based on the responses to a questionnaire that was sent to the persons in charge of education and training at 180 institutions affiliated with the Japanese Society of Neurology and 478 education and training institutions among Japanese city hospitals, excluding university hospitals and special research institutions. Replies were received from 305 hospitals, amounting to a response rate of 63.8%. The number of doctors working in the department of neurology was found to be low at 2 in 84 hospitals and 3 in 65 hospitals. The majority of neurologists at general hospitals are fully engaged in examining outpatients as well as inpatients, and they do not have adequate time for research, education and training and participation in the activities of academic associations. Of the 10 items cited in the questionnaire relating to the types of postgraduate neurology training desired by neurologists employed in general hospitals, the most common selections in order of decreasing frequency were improvement in the capacity to manage common disorders (such as headache, dizziness, numbness, etc.) diagnosed in the outpatient clinic, improvement in the capacity to diagnose the acute phase of cerebral apoplexy, further education about EEG (electroencephalogram) and EMG (electromyogram), and medical ethical issues such as informed consent. The views about postgraduate neurological education and training described in detail in writing by the respondents were as follows. 1) Neurologists required by a city general hospital Numerous respondents commented that the capacity to diagnose medical neurological diseases associated with internal (systemic) medical disorders is needed since there are remarkably few doctors in general hospitals whose interest is confined only to neurological diseases ranging from rare to common complaints. In contrast, neurologists whose knowledge and training derives from a wide clinical base of internal medicine are in great demand. 2) Points of disparity between postgraduate neurology training in a university hospital and neurologists required by a city general hospital In addition, many respondents expressed the view that under the medical school system, neuroscience and research are given a higher priority than the cultivation of clinical medical skills and although there may be keen academic interest in the clinical diagnosis and treatment of rare diseases, there is not necessarily the same level of keen interest in common diseases, hence the universities may be educating researchers effectively, but are not necessarily producing capable clinicians. 3) Measures that should be taken to address this difference in postgraduate neurology training between university and city general hospitals The university hospital is separated into research and clinical groups and the time has now come for a system of management under which a professor leads the research group and another professor leads the clinical group. There should be a clear-cut clarification of the responsible roles of university and city general hospitals in the postgraduate education and training of neurologists. Furthermore, the professional staff and facilities of general hospitals that are affiliated with universities should be upgraded and expanded to enable them to serve more effectively as sites of clinical education and training. The position and status of neurologists at city general hospitals should be raised to the same level as that of university professors and institutions affiliated with the Japanese Society of Neurology. PMID:11464485

Yamane, K

2000-12-01

139

Continuing education among Chinese nurses: A general hospital-based study  

PubMed Central

SUMMARY Background Continuing education (CE) is increasingly critical for nurses to keep abreast of rapid changes in patient care due to advancements in knowledge and technology. Objective The objective of this study was to explore Chinese nurses’ perceptions on continuing education, how best CE practices meet their learning needs, and the motivation and barriers nurses face in completing CE. Methods A cross-sectional study of 2727 hospital-employed Chinese nurses from ten general hospitals was conducted from September to October 2010. Nurses’ perceptions on CE, as well as motivational and preventive factors in CE were assessed. Results The majority of nurses (97.3%) attended CE activities in the last twelve months. More than 92.2% of the nurses were familiar with the value of CE. Nurses expected CE activities to take place within a five-day period and to consist of 2 h per activity. The major factors that motivate nurses to participate in CE are the desire to gain and update their knowledge of the newest nursing development and procedures, to improve their practical skills and comprehensive qualities, to maintain professional status and to receive an academic degree. Factors that hindered nurses’ participation in CE included time constraints, work commitments, a lack of opportunity, cost of the courses and previous negative experiences with CE programs. Conclusion Chinese nurses considered CE an extremely important measure to further develop their professional competency. Nurses’ actual expectations for CE and the motivation and barriers for participation in CE from nurses’ individual, family and hospital perspective must be taken into the account in order to make CE programs more effective.

Ni, Chunping; Hua, Yan; Shao, Pei; Wallen, Gwenyth R.; Xu, Shasha; Li, Lu

2014-01-01

140

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

PubMed Central

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

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

2012-01-01

141

Child abuse and neglect as seen in General Hospital, Kuala Lumpur--a two year study.  

PubMed

Eighty-six children diagnosed as child abuse and/or neglect were admitted to the Paediatric wards of the General Hospital, Kuala Lumpur during 1985 and 1986. Of these cases, 62 were of physical abuse, six of sexual abuse, one case of both physical and sexual abuse and 17 of neglect. There were 25 boys and 61 girls. Thirty-four of these children were Malays, 16 Chinese, 26 Indians, three mixed and seven illegal immigrants. Twenty-one were below the age of one year, 24 from one to four years, 25 from five to nine years and 16 were ten years and above. The abusers were mainly close members of the family. Of these children, 24 were sent back to their parents and 11 to their relatives home. Twenty-seven were taken into care by the Ministry of Social Welfare and the remaining seven children who were illegal immigrants, were deported with their parents. Only one child was successfully fostered. Eleven children were taken away from the hospital by their parents or guardians without the knowledge of the health staff. There were five deaths in the series. PMID:2626119

Kassim, M S; George, R; Kassim, K; Begum, M; Cherian, M P; Tajudin, A K; Chandran, V; Anan, A; Reddy, R; Singh, J

1989-06-01

142

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

2013-01-01

143

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

PubMed Central

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

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

2013-01-01

144

Community support of patients with a left ventricular assist device: The Toronto General Hospital experience  

PubMed Central

BACKGROUND: Implantation of a left ventricular assist device (LVAD) is an acceptable therapy for patients with advanced heart failure. LVADs may be used as a bridge to recovery, a bridge to transplantation or as destination therapy. Although the morbidity rate of individuals on device support remains high, experience suggests that patients who are discharged home have satisfactory outcomes during support and following heart transplantation. METHODS: A retrospective review of 24 patients implanted with an LVAD between October 2001 and December 2006 was performed. Nineteen patients received a device as a bridge to transplantation and five received a device as destination therapy. Postoperative follow-up was performed routinely in the heart function/LVAD clinic at the Toronto General Hospital (Toronto, Ontario) and all adverse events were recorded. RESULTS: The majority of patients were men, with a mean age of 44 years and a diagnosis of dilated cardiomyopathy (62%). Seventeen patients (71%) were discharged home on support; one died, 14 were transplanted, one was explanted and one patient remains on support in the community. Post-transplant survival was 93% in patients discharged home compared with 40% transplanted during their hospital stay. Outpatients spent 56% of their overall support time at home, with only 12 readmissions totalling 120 patient days. CONCLUSIONS: LVAD patients can be safely managed in the community. Patients who are discharged home experience better outcomes in both pre- and post-transplant survival. Successful outpatient management provides a strong foundation for the establishment of destination therapy within mechanical circulatory support programs in Canada.

MacIver, Jane; Ross, Heather J; Delgado, Diego H; Cusimano, Robert J; Yau, Terrence M; Rodger, Marnie; Harwood, Stephen; Rao, Vivek

2009-01-01

145

[Administration of human performance: a case study in a General Hospital of Fortaleza, Ceará State].  

PubMed

The thematic of this work presents questions on the practice of the Evaluation of functional performance in an organization of public health. This axle of analysis gains importance from the difficulties of developing evaluation systems with alliances between policies of concession of financial incentives, in a specific cultural context. In this direction, it is necessary to admit the limits of this management tool. From a qualitative research, a semi-structured questionnaire was applied to the staff (public servers) of a public general hospital of Ceará State. It was observed the characterization of the performance evaluation system used in the institution, being able to verify its adequacy to the models proposed in the literature and the relevancy of its intentions with the perceptions and expectations of the searched servers. PMID:20640290

Fontenele, Maria de Fátima Marrocos

2010-06-01

146

Causes for cancellation of elective surgical procedures in a Spanish general hospital.  

PubMed

Cancellation of scheduled surgery is undesirable for patients and an inefficient use of resources. We prospectively collected data for 52 consecutive months in a public general hospital to estimate the prevalence and causes. The overall cancellation rate was 6.5% (2559 of 39 115 scheduled operations). Cancellation by broad category was for 'medical reasons' in 50%, 'patient-related factors' in 23%, and due to 'administrative/logistic problems' in 25%. The commonest specific causes within these categories were respectively: infections/fever (18%), patient did not attend (20%) and lack of theatre time (23%). This data will help direct resources to target prevention of cancellations as a result of these main problems. PMID:19413817

González-Arévalo, A; Gómez-Arnau, J I; delaCruz, F J; Marzal, J M; Ramírez, S; Corral, E M; García-del-Valle, S

2009-05-01

147

[Motivational profile of nurses working in a general hospital in the state of São Paulo].  

PubMed

The present study aimed at identifying the motivational profile of nurses who work in a public general hospital as well as at finding out the motivations that lead nurse in their work and correlating attitudes and beliefs verified in the responses of the subjects to work and their motivations. Data were collected through three instruments, two of them were scales of Likert type (MOSE e ACTRA) and one questionnaire with data to characterize the sample that was formed by 184 nurses. Results enabled the author to delineate a motivational profile based on the three social motivations and conclude that the majority of nurses studied are working in order to overcome the underdevelopment. PMID:10876547

Pasti, M J; Gir, E; Dela Coleta, J A

1999-12-01

148

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

149

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

PubMed

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

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

2013-05-01

150

Cryptosporidiosis among children with acute gastroenteritis in the pediatric ward in the General Hospital, Penang.  

PubMed

Stool samples from 836 cases with diarrhea and acute gastroenteritis from the Pediatric ward, Penang General Hospital, were examined for Cryptosporidium oocysts. A dimethyl sulfoxide modified acid fast technique was used for the identification of the parasites. 36 samples or 4.3% were found to be positive for Cryptosporidium. The prevalence of infection was higher (2.39%) in children with diarrhea and vomiting than in children with acute gastroenteritis alone (0.8%). Stool examination and cultures from the Cryptosporidium positive samples revealed no other parasites, rotavirus or enteropathogenic bacteria. This suggests that Cryptosporidium may be an important agent in the causation of diarrhea in young children. A routine laboratory examination for the detection of Cryptosporidium in the search for causal agents of childhood diarrhea in our environment may, therefore, be significant. PMID:1948280

Ludin, C M; Afifi, S A; Hasenan, N; Maimunah, A; Anuar, A K

1991-06-01

151

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

Microsoft Academic Search

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

Helge Garåsen; Roar Johnsen

2007-01-01

152

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

2012-07-01

153

Louisiana hospital's wellness center popular for health maintenance. East Jefferson General focuses on those 50 and over.  

PubMed

East Jefferson General Hospital in Metairie, La., conducted comprehensive research prior to developing its new Wellness Center. Newspaper, direct mail and internal publications advertising boosted interest, as did employees wearing "Ask Me About The Wellness Center" buttons. Through satellite sales offices in the hospital and at a local shopping mall, more than 900 people purchased memberships before the center opened, and now an average of 600 to 700 people visit the center daily. PMID:11467196

Rees, T

2001-01-01

154

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

PubMed

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

Aryankhesal, Aidin; Sheldon, Trevor

2010-08-01

155

[Ambulatory surgery clinic in a public general hospital. Organization and results].  

PubMed

In surgery a day care clinic is defined as an institution in which patients undergo elective operations the day of their admission and are discharged within 24 h after surgery. An important goal of day care surgery is to avoid unnecessary hospitalisations however providing the patient with the same quality of treatment and personal satisfaction. This presentation describes the patients selection, information and follow-up, the organization of the day care system, the computerized quality control and the medical outcome. Our experience is based on a 2-year period of day care surgery in a general community hospital. The results of 581 consecutively operated, not selected, patients are presented. Quality control was performed for all patients during their stay at the day care unit, and for 98.5% as follow-up control by the General Practitioners. The most frequent operations were: arthroscopies, meniscectomies, removals of implants after osteosynthesis, decompressions of peripheral nerves, large excisions of skin-tumors, bursectomies, reconstructions of torn ligaments, hernial repairs, strippings of varicose veins, hemorrhoidectomies and operations of the anal and genital region. We present the patients age, the type of anesthesia, the type of operation, eventual complications (in clinic, 24 hours after discharge and at the end of the treatment), the medical results as well as the costs of the after-treatment. PMID:9312395

Scheidegger, A; Biaggi, J

1996-01-01

156

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

157

[Characteristics of human immunodeficiency virus infection in the San Juan de Dios General Hospital].  

PubMed

A prospective clinical study was conducted between January 1991 and June 1992 of 92 HIV seropositive patients attending the Adult Outpatient Clinic of the San Juan de Dios General Hospital in Guatemala City. 52 of the patients met the US Centers for Disease Control clinical criteria for AIDS. Limitations in the diagnostic and laboratory facilities of the hospital hampered identification of some opportunistic infections. 74 of the 92 patients were male. 3 of the 18 infected women gave birth during the study period; the status of their children is not yet known. 87% of the cases were in adults aged 18-40. 25 of the patients died during the 18-month study period and 9 were lost to follow-up. 57 of the 92 had lived in the US or Mexico. 43 of the 74 men reported homosexual relations. 6 reported use of intravenous drugs. 3 had received blood transfusions as the only known risk factor. 56 had histories of sexually transmitted diseases. 3 patients reported always using condoms, 57 never did so, and the rest did so occasionally. 52 of the patients had opportunistic infections. 18 had proven and 5 had presumptive extrapulmonary mycobacteria, probably tuberculosis. 2 had salmonella in the blood. 4 had presumptive cytomegalovirus, 6 had chronic mucocutaneous herpes, and 3 had presumptive HIV encephalopathy. 12 had esophageal candidiasis, 6 had extrapulmonary cryptococcosis, and 14 had pneumocystis carinii pneumonia. 13 had proven intestinal cryptosporidiosis, and 1 each had presumptive cerebral toxoplasmosis and extraintestinal strongyloidiasis. 3 had proven Kaposi's sarcoma and 1 had proven immunoblastic lymphoma. 10 had HIV-related weight loss. PMID:12290621

Estrada Y Martin, R M; Molina, H; Samayoa, B; Carlos, R; Velazquez, S; Behrens, E; Melgar, N; Arathoon, E

1992-01-01

158

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

PubMed

To celebrate the bicentennial of the 1811 charter to establish the Massachusetts General Hospital, we tell the stories of the physicians and surgeons of the hospital who practiced pathology until the discipline was more firmly established with the recruitment of James Homer Wright who became the first full-time pathologist at the hospital in 1896. One of the two co-founders of the hospital, John Collins Warren (famed primarily for being the surgeon at the first public demonstration of ether anesthesia) had a major interest in pathology; he published a book focused on gross pathology (1837) and began the important specimen collection subsequently known as the Warren Anatomical Museum at Harvard Medical School (HMS). An early physician, John Barnard Swett Jackson, became the first professor of pathology in the United States (1847) and was a noted collector whose specimens were added to the Warren Museum. Dr Jackson showed no interest in microscopy when it became available, but microscopy was promoted from circa the late 1840s at Harvard and likely at the hospital by Oliver Wendell Holmes, the famed essayist who was on the staff of the hospital and faculty at the medical school. Microscopy was probably first used at the Hospital with any frequency on examination of fluids by the first officially designated 'Microscopist,' John Bacon Jr, in 1851, and after the mid-1850s by Calvin Ellis on anatomic specimens; Ellis went on to pioneering reform of the HMS curriculum. Reginald Heber Fitz succeeded Ellis in 1871 and was the first to be officially designated as 'Pathologist' at the hospital. Fitz is remembered for two major contributions: his paper showing the nature of, and potential surgical cure for, the disease that he termed 'appendicitis'; and his description of acute pancreatitis. With the microscope now firmly entrenched and with the increase in surgery after Fitz's work on appendicitis, surgical pathology grew quickly. J Collins Warren, the grandson of the co-founder, had a major interest in pathology and in 1895 published an impressive volume entitled 'Surgical Pathology and Therapeutics.' Dr Warren had a major interest in breast disease and was a pioneer of needle biopsy in the evaluation of breast masses. In 1888, William Fiske Whitney joined the staff of the hospital and spent his nearly 30-year career practicing primarily as a surgical pathologist, making particular innovations in intraoperative consultation. The contributions of these individuals brought the field from a gross pathology-oriented discipline mostly oriented around teaching to a microscopy-dependent practice integral to patient care, and hence set the stage for the formal founding of the Pathology department in 1896. PMID:21926958

Young, Robert H; Louis, David N

2011-10-01

159

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

160

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

161

Reception Classes for Immigrant Students in Vancouver, Canada.  

ERIC Educational Resources Information Center

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

Gunderson, Lee

2002-01-01

162

Urban travel time models: a case study of Vancouver (BC)  

Microsoft Academic Search

Travel time survey data obtained from the City of Vancouver's Engineering Department show that travel times in the city have remained fairly constant over the past three decades, although traffic volumes and the number of traffic control devices have increased. This constant travel time pattern is contrary to that predicted by traditional travel time models. The traditional travel time models

Chris Nutakor; Frank Navin

1994-01-01

163

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

ERIC Educational Resources Information Center

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

Ellis, E. N.; And Others

164

Vancouver Community College Educational Plan, 1988-1993.  

ERIC Educational Resources Information Center

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

Gallagher, Paul

165

A participant observation study of power relations between nurses and doctors in a general hospital.  

PubMed

The problem addressed in this paper is how nurse-doctor power relations are manifested in a hospital setting. A review of the literature identified four major ideal types of interaction between nurses and doctors in decision-making processes. These were unproblematic subordination, informal covert decision making, informal overt decision making and formal overt decision making on the part of nurses. Each of these types was tested against empirical data gained from participant observation of interactions between the nurses and doctors working in an intensive care unit and a general medical ward. It was concluded that while both the unproblematic subordination and the informal covert decision-making types of interaction appeared superficially to be used frequently, closer examination revealed that, with the exception of nurse-consultant interactions, nurses were less dependent on these subordinate modes of interaction than much of the literature suggested. Formal overt decision making, despite official encouragement, was also infrequently utilized. However, it was noticed that senior nurses especially used informal overt strategies to involve themselves in decision-making sequences. Use of such strategies had the effect of reducing though not eliminating the power differential between doctors and nurses. PMID:1869721

Porter, S

1991-06-01

166

Undiagnosed hepatitis C on the general medicine and trauma services of two urban hospitals?  

PubMed Central

Summary The inpatient medical service may be an important location to identify undiagnosed hepatitis C virus (HCV) infection. We conducted a cross-sectional HCV prevalence study in consecutive patients aged 18–65 admitted in a three-month period to two urban hospitalsgeneral internal medicine and trauma services. Patient sera were anonymously screened for anti-HCV antibody with an enzyme-linked immunoassay and, when anti-HCV positive (+), for HIV. Health system records were examined for prior HCV testing or diagnosis or an HIV diagnosis then linked anonymously to test results. Multivariate logistic regression was used to examine associations of patient and health care factors with unknown HCV+ status. Of 786 unique patients tested (60.3% of all admitted patients), 62 (7.9%) were HCV+ without a prior HCV+ test or diagnosis while 61 patients (7.8%) tested HCV+ but had prior HCV+ test or diagnosis. Of 62 patients with unknown HCV+, 6 (9.7%) were HIV+ but only 3 had a prior HIV diagnosis; of 61 patients with known HCV+, all 9 (14.8%) HIV+ had been diagnosed. Among the 640 patients with prior unknown HCV status, an HCV+ test was strongly associated with age: 50–65 (adjusted odds ratio [AOR] 5.44, CI 2.20–13.48) and age 36–49 (AOR 4.65, CI 1.91–11.32) versus. 18–35. In this anonymous study, we could not obtain HCV risk factor data but the positive and negative predictive values of HCV testing all inpatients with an unknown HCV status were 99.3% and 99.0%, respectively. In similar urban general medicine and trauma services, broader efforts to test for HCV in inpatients aged 36–65 may be warranted.

Brady, Kathleen A.; Weiner, Mark; Turner, Barbara J.

2014-01-01

167

Incidence of nosocomial pneumonia in a medical intensive care unit and general medical ward patients in a public hospital in Bombay, India  

Microsoft Academic Search

We prospectively studied the incidence of hospital-acquired pneumonia in 1886 consecutive admissions to an 1800 bed hospital in Bombay; 991 of them to general medical wards and 895 to a 17-bed medical intensive care unit (ICU). The average bed occupancy in the general wards was 56 patients in a ward with 40 beds. Staffing in the general ward was two

M. Merchant; D. R. Karnad; A. A. Kanbur

1998-01-01

168

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

Microsoft Academic Search

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

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

1996-01-01

169

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

Microsoft Academic Search

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

Dylan Harris; Rachel Davies

2007-01-01

170

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

171

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

Microsoft Academic Search

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,

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

2011-01-01

172

An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy  

PubMed Central

Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs). Information was focused on diagnosis (DSM-IV), reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS), the Modified Overt Aggression Scale (MOAS) and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs) completed both admission and discharge visits. A severe psychotic episode with (19.1%) or without (47.7%) aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge) and depression (12.9% at admission and 14.7% at discharge) were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD) total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0%) patients had episodes of aggressiveness at admission and 8 (1.7%) at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%), 686 (94.2%) and 676 (92.9%). The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%), typical anti-psychotics (48.3%, 57.0%, 49.6%), atypical anti-psychotics (35.6%, 41.8%, 39.8%) and antidepressants (40.9%, 48.8%, 43.2%). Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20.6% and 26.6% with two drugs, and 53.2%, 57.8% and 59.0% with > two drugs. Benzodiazepines were the most common drugs both at admission (60.0%) and during hospitalisation (85.7%), and 69.5% were prescribed at discharge. Conclusion patients with psychiatric diseases in acute phase experienced a satisfactory outcome following intensified therapeutic interventions during hospitalisation.

Ballerini, Andrea; Boccalon, Roberto; Boncompagni, Giancarlo; Casacchia, Massimo; Margari, Francesco; Minervini, Lina; Righi, Roberto; Russo, Federico; Salteri, Andrea

2007-01-01

173

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).

174

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

PubMed

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

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

2013-04-01

175

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

PubMed Central

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

2014-01-01

176

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

PubMed Central

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

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

2013-01-01

177

Treatment Results of a Periprosthetic Femoral Fracture Case Series: Treatment Method for Vancouver Type B2 Fractures Can Be Customized  

PubMed Central

Background Currently, an algorithmic approach for deciding treatment options according to the Vancouver classification is widely used for treatment of periprosthetic femoral fractures after hip arthroplasty. However, this treatment algorithm based on the Vancouver classification lacks consideration of patient physiology and surgeon's experience (judgment), which are also important for deciding treatment options. The purpose of this study was to assess the treatment results and discuss the treatment options using a case series. Methods Eighteen consecutive cases with periprosthetic femoral fractures after total hip arthroplasty and hemiarthroplasty were retrospectively reviewed. A locking compression plate system was used for osteosynthesis during the study period. The fracture type was determined by the Vancouver classification. The treatment algorithm based on the Vancouver classification was generally applied, but was modified in some cases according to the surgeon's judgment. The reasons for modification of the treatment algorithm were investigated. Mobility status, ambulatory status, and social status were assessed before the fracture and at the latest follow-up. Radiological results including bony union and stem stability were also evaluated. Results Thirteen cases were treated by osteosynthesis, two by revision arthroplasty and three by conservative treatment. Four cases of type B2 fractures with a loose stem, in which revision arthroplasty is recommended according to the Vancouver classification, were treated by other options. Of these, three were treated by osteosynthesis and one was treated conservatively. The reasons why the three cases were treated by osteosynthesis were technical difficulty associated with performance of revision arthroplasty owing to severe central migration of an Austin-Moore implant in one case and subsequent severe hip contracture and low activity in two cases. The reasons for the conservative treatment in the remaining case were low activity, low-grade pain, previous wiring around the fracture and light weight. All patients obtained primary bony union and almost fully regained their prior activities. Conclusions We suggest reaching a decision regarding treatment methods of periprosthetic femoral fractures by following the algorithmic approach of the Vancouver classification in addition to the assessment of each patient's hip joint pathology, physical status and activity, especially for type B2 fractures. The customized treatments demonstrated favorable overall results.

Lee, Sang Yang; Sakai, Yoshitada; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro

2014-01-01

178

Current Status of Prescription in Type 2 Diabetic Patients from General Hospitals in Busan  

PubMed Central

Background Data regarding the prescription status of individuals with diabetes are limited. This study was an analysis of participants from the relationship between cardiovascular disease and brachial-ankle pulse wave velocity in patients with type 2 diabetes (REBOUND) Study, which was a prospective multicenter cohort study recruited from eight general hospitals in Busan, Korea. We performed this study to investigate the current status of prescription in Korean type 2 diabetic patients. Methods Type 2 diabetic patients aged 30 years or more were recruited and data were collected for demographics, medical history, medications, blood pressure, and laboratory tests. Results Three thousands and fifty-eight type 2 diabetic patients were recruited. Mean age, duration of diabetes, and HbA1c were 59 years, 7.6 years, and 7.2%, respectively. Prevalence of hypertension was 66%. Overall, 7.3% of patients were treated with diet and exercise only, 68.2% with oral hypoglycemic agents (OHAs) only, 5.3% with insulin only, and 19.2% with both insulin and OHA. The percentage of patients using antihypertensive, antidyslipidemic, antiplatelet agents was similar as about 60%. The prevalence of statins and aspirin users was 52% and 32%, respectively. Conclusion In our study, two thirds of type 2 diabetic patients were treated with OHA only, and one fifth with insulin plus OHA, and 5% with insulin only. More than half of the patients were using each of antihypertensive, antidyslipidemic, or antiplatelet agents. About a half of the patients were treated with statins and one third were treated with aspirin.

Suk, Ji Hye; Lee, Chang Won; Son, Sung Pyo; Kim, Min Cheol; Ahn, Jun Hyeob; Lee, Kwang Jae; Park, Ja Young; Shin, Sun Hye; Kwon, Min Jeong; Kim, Sang Soo; Kim, Bo Hyun; Lee, Soon Hee; Park, Jeong Hyun

2014-01-01

179

Ear, Nose and Throat Day-Case Surgery at a District General Hospital  

PubMed Central

INTRODUCTION In 2000, The NHS Plan in the UK set a target of 75% for all surgical activity to be performed as day-cases. We aim to assess day-case turnover for ENT procedures and, in particular, day-case rates for adult and paediatric otological procedures together with re-admissions within 72 h as a proxy measure of safety. PATIENTS AND METHODS Retrospective collection of data (procedure and length of stay) from the computerised theatre system (Galaxy) and Patient Information Management System (PIMS) of all elective patients operated over one calendar year. The setting was a district general hospital ENT department in South East England. All ENT operations are performed with the exception of oncological head and neck procedures and complex skull-base surgery. RESULTS Overall, 2538 elective operations were performed during the study period. A total of 1535 elective adult procedures were performed with 74% (1137 of 1535) performed as day-cases. Of 1003 paediatric operations, 73% (730 of 1003) were day-cases. Concerning otological procedures, 93.4% (311 of 333) of paediatric procedures were day-cases. For adults, we divided the procedures into major and minor, achieving day-case rates of 88% (93 of 101) and 91% (85 of 93), respectively. The overall day-case rate for otological procedures was 91% (528 of 580). Re-admission rates overall were 0.7% (11 of 1535) for adults and 0.9% (9 of 1003) for paediatric procedures. The most common procedure for re-admission was tonsillectomy accounting for 56% of all adult re-admissions and 78% of paediatric re-admissions. The were no deaths following day-case procedures. DISCUSSION ENT surgery is well-suited to a day-case approach. UK Government targets are attainable when considering routine ENT surgery. Day-case rates for otology in excess of targets are possible even when considering major ear surgery.

Pezier, T; Stimpson, P; Kanegaonkar, RG; Bowdler, DA

2009-01-01

180

Pathologic findings of Whipple pancreaticoduodenectomy: a 5-year review on 51 cases at Taleghani general hospital  

PubMed Central

Aim The aim of this study was to comprehensively analyze histopathologic parameters of Whipple pancreaticoduodenectomy specimens at Taleghani general hospital pathology department. Background The Whipple procedure is performed for variety of tumors involving the head of the pancreas, ampulla of Vater, common bile duct, or duodenum. Patients and methods Records of all cases of Whipple pancreaticoduodenectomy between 2007 and 2011were retrospectively reviewed and pathological details of diagnosis and staging were extracted. Results A total of 51 patients underwent Whipple procedure during a 5-year period, including 37 males and 14 females. The average age was 57 years (18-82 years). The most frequent presenting symptoms were jaundice and weight loss. Forty-four patients (86.3%) had malignant and 7 (13.7%) had benign lesions. Among malignant lesions, 27 (61.4%) were ampullary carcinomas, 12 (27.3%) were pancreatic carcinomas and 5 (11.4%) were cholangiocarcinomas. The pathological stage of most of the tumors was T3 (50%); followed by T2 (29.5%), and T1 (15.9%); only 4.5% were T4. Mean tumor size was 2.8 cm (0.2-7 cm). Duodenal and common bile duct margins were tumor-free in most cases (95.5 %). The pancreatic margin was free in 81.8% of patients; this margin had not been evaluated in 5 patients. Nearly 38.6% of all tumors showed vascular invasion while 68.2% showed perineural invasion. The average number of dissected lymph nodes was 4 (range 1-15); although in 25% of specimens, no lymph nodes had been found. Twelve specimens (35.3%) had lymph node metastases. Conclusion The present study demonstrates that most of our patients are diagnosed with malignancy, at advanced stage, and further research is needed to develop practical methods for earlier diagnosis. The fact that 25% of specimens had no lymph nodes needs more consideration.

Mohsenifar, Zhaleh; Ahmadvand, Alireza; Zare, Khandan

2012-01-01

181

[Role of general hospitals in health services to population of a large city].  

PubMed

Parameters characterizing public health activities in Chelyabinsk are analyzed. Time course of volume parameters characterizing the activities of multi-discipline hospitals and analogous parameters for the whole city demonstrate their relationships and necessitate optimization of management of primarily large multi-discipline institutions. Among the elements of this optimization are planning of volume parameters of the treatment-and-prophylaxis institutions in accordance with the municipal order, revision of indications for hospitalization, control of validity of hospitalization, and improvement of managing technologies in outpatient clinics. PMID:11763766

Alekseev, N A

2001-01-01

182

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

PubMed

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

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

2005-06-01

183

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

PubMed Central

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

Krstic, Goran

2011-01-01

184

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

NASA Astrophysics Data System (ADS)

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

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

2012-12-01

185

Erasing English Language Competency: African Migrants in Vancouver, Canada  

Microsoft Academic Search

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

Gillian Creese

2010-01-01

186

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

187

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

188

Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England  

PubMed Central

Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES) in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK), general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82]) between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22), stroke, both overall (I60-64) and by subtype, and pulmonary embolism (I26), HES records appeared to be both reliable and complete. Conclusion Hospital admission data in England provide diagnostic information for vascular disease of sufficient reliability for epidemiological analyses.

2012-01-01

189

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

PubMed

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

Choi, Mankyu; Lee, Keon-Hyung

2008-01-01

190

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

191

Molar apicectomy with amalgam root-end filling: results of a prospective study in two district general hospitals  

Microsoft Academic Search

Aim To determine the five-year success rates, site or sites of failure, prognostic indicators and lower lip morbidity associated with molar apicectomy using amalgam root-end filling.Design Multicentre, prospective study.Setting The departments of oral and maxillo-facial surgery in two district general hospitals.Method One thousand and seven molar apicectomy procedures, combined with amalgam root-end filling were expedited during the period 1974–1995. A

T M Gale; C M Wesson

2003-01-01

192

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

Microsoft Academic Search

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

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

2001-01-01

193

[Evaluation of ergonomic conditions of video display terminal operators in a general hospital].  

PubMed

Operating a computer terminal is currently an integral part of daily work of both administrative and medical personnel in every hospital. Extended work with video display terminals (VDTs) is often characterized by typical symptomatology termed as cumulative trauma disorders (CTD) or repetitive strain injuries (RSI). We have demonstrated that about 80% of the hospital VDT operators had complaints compatible with CTD/RSI and 16% were treated for these conditions. These findings indicate the need to incorporate ergonomists in planning or modifying current VDT work stations in order to minimize the development of such symptoms. PMID:18814515

Idilbi, Nasra; Karakis, Isabella; Linn, Shai; Carel, Rafael

2008-07-01

194

Development of Peer-Group-Classification Criteria for the Comparison of Cost Efficiency among General Hospitals under the Korean NHI Program  

PubMed Central

Objectives To classify general hospitals into homogeneous systematic-risk groups in order to compare cost efficiency and propose peer-group-classification criteria. Data Sources Health care institution registration data and inpatient-episode-based claims data submitted by the Korea National Health Insurance system to the Health Insurance Review and Assessment Service from July 2007 to December 2009. Study Design Cluster analysis was performed to classify general hospitals into peer groups based on similarities in hospital characteristics, case mix complexity, and service-distribution characteristics. Classification criteria reflecting clustering were developed. To test whether the new peer groups better adjusted for differences in systematic risks among peer groups, we compared the R2 statistics of the current and proposed peer groups according to total variations in medical costs per episode and case mix indices influencing the cost efficiency. Data Collection A total of 1,236,471 inpatient episodes were constructed for 222 general hospitals in 2008. Principal Findings New criteria were developed to classify general hospitals into three peer groups (large general hospitals, small and medium general hospitals treating severe cases, and small and medium general hospitals) according to size and case mix index. Conclusions This study provides information about using peer grouping to enhance fairness in the performance assessment of health care providers.

Kang, Hee-Chung; Hong, Jae-Seok; Park, Heon-Jin

2012-01-01

195

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

PubMed Central

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

Scott, Alex; Grewal, Navdeep; Guy, Pierre

2014-01-01

196

Preventing Suicidal Behaviour in a General Hospital Psychiatric Service: Priorities for Programming  

Microsoft Academic Search

with suicidal behaviour, 14 articles on the treatment of major psychiatric disorders, 1 article and 1 published abstract on discharge from hospital, and 2 articles on reducing access to means. Conclusions: Based on a review of each category, we make several program and policy recommendations, including regularly updating clinical assessment skills, using guidelines for assessment of patients following a suicide

Paul S Links; Brian Hoffman

2005-01-01

197

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

Microsoft Academic Search

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

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

2003-01-01

198

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

PubMed Central

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

2012-01-01

199

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

PubMed

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 visits, inpatient admissions, day-case treatment and emergency admissions. The results are plausible and in line with the theoretical model. For example: the demand from practices for first outpatient visits is negatively affected by waiting times and distance to the hospital. Increases in waiting times and waiting lists lead to increases in supply; the supply of elective inpatient admissions is affected negatively by current emergency admissions and positively by lagged waiting list and waiting time. We use the empirical results to investigate the dynamic responses to one off policy measures to reduce waiting times and lists by increasing supply. PMID:16127673

Windmeijer, Frank; Gravelle, Hugh; Hoonhout, Pierre

2005-09-01

200

Establishing a General Medical Outpatient Clinic for Cancer Survivors in a Public City Hospital Setting  

Microsoft Academic Search

INTRODUCTION  Many cancer centers and community hospitals are developing novel models of survivorship care. However, few are specifically\\u000a focused on services for socio-economically disadvantaged cancer survivors.\\u000a \\u000a \\u000a \\u000a AIMS  To describe a new model of survivorship care serving culturally diverse, urban adult cancer patients and to present findings\\u000a from a feasibility evaluation.\\u000a \\u000a \\u000a \\u000a SETTING  Adult cancer patients treated at a public city hospital cancer center.\\u000a \\u000a \\u000a \\u000a PROGRAM

Elliott J. Goytia; David W. Lounsbury; Mary S. McCabe; Elisa Weiss; Meghan Newcomer; Deena J. Nelson; Debra Brennessel; Bruce D. Rapkin; M. Margaret Kemeny

2009-01-01

201

An audit of a medical anticoagulant clinic in a District General Hospital.  

PubMed Central

The working and costs of the anticoagulant clinic at the Royal Gwent Hospital was reviewed over the period July 1980-June 1981. The hospital notes of the patients were reviewed and a questionnaire distributed to each patient. The majority of patients have cardiac valve problems or deep vein thrombosis, the latter sometimes being associated with pulmonary emboli. No major complications were reported during the year, but 9.7% reported rectal bleeding or haematuria. The annual cost of running the clinic is approximately 20,000 pounds and, if this is representative of Britain as a whole, about 3.75 million pounds is spent annually on anti-coagulation clinics. Several recommendations are made for improving the anticoagulant clinic service, which includes making sure that the doctor at the clinic and the patient are made aware of the reason for anticoagulation, its duration, and possible side effects and interactions with other drugs.

Shafi, M.; Mayberry, J.; Calcraft, B.

1983-01-01

202

Study of an outbreak of cefoxitin-resistant Klebsiella pneumoniae in a general hospital.  

PubMed Central

During a 3-month period, six Klebsiella pneumoniae isolates resistant to cefoxitin and penicillin-inhibitor combinations were derived from patients in the intensive care unit of a hospital in Athens, Greece. Enterobacterial repetitive intergenic consensus PCR and pulsed-field gel electrophoresis provided evidence of the clonal origin of the isolates. Conventional techniques and ribotyping were inadequate in proving that the isolates were related. Resistance was due to a plasmidic class C beta-lactamase.

Gazouli, M; Kaufmann, M E; Tzelepi, E; Dimopoulou, H; Paniara, O; Tzouvelekis, L S

1997-01-01

203

Affective disorders, social support, and health status in geriatric patients in a general hospital  

Microsoft Academic Search

A randomized-sample taken from all elderly patients aged 70 years and over hospitalized for medical\\/surgical disorders was studied (N = 108) to determine the influence of health problems and social support on depression. According to DSM-III-R diagnostic criteria, 50.9% had psychiatric disorders and 15.7% had affective disorders. In the total sample, depressive symptoms significantly correlated with the existence of health

Luisa Lázaro; Teodor Marcos; Manuel Valdés

1995-01-01

204

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

PubMed Central

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

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

2013-01-01

205

Estimating prevalence of alcohol abuse and dependence in one general hospital: an approach to reduce sample selection bias.  

PubMed

Prevalence estimates of alcohol abuse or dependence in general hospitals are often limited to single wards, small data collecting periods or insufficient diagnostic procedures. Therefore, the present study aimed to ascertain alcohol abuse or dependence in one general hospital, to compare prevalence data for all the 11 wards and 6 intake months, to establish if screening is sufficient or if a two-step diagnostic procedure is needed, and to determine whether information for an alcohol diagnosis on suspicion is available. A sample of 1309 medical or surgical in-patients were screened by questionnaires or medication for withdrawal, and, if screening-positive, were interviewed with the alcohol section of a standardized psychiatric interview. In screening-negative patients, a diagnosis on suspicion was given if medication to treat withdrawal had been used, or if there was evidence of single criteria of alcohol dependence, somatic disorders from alcohol drinking, raised laboratory parameters on grounds of alcohol drinking or of self-reported high alcohol consumption. Of the medical and surgical in-patients, 20.7 and 16.0% respectively were alcohol abusers or dependents, with a range of prevalence rates of alcohol abuse or dependence among wards of 11.1-32.9% and among intake months between 11.3 and 28.7%. Of the medical department in-patients, 1.9%, and of the surgical in-patients, 2.1%, were screened as false-positive cases. In addition, 5.5% of the medical and 12.0% of the surgical patients were given a diagnosis on suspicion. It is concluded that all general wards and different intake months should be taken into account when estimating prevalence of alcohol abuse or dependence in a general hospital. PMID:10528822

John, U; Rumpf, H J; Hapke, U

1999-01-01

206

Morphine and the "lytic cocktail" for terminally ill patients in a French general hospital: evidence for an inverse relationship.  

PubMed

Undertreatment of cancer pain with analgesic drugs is still a frequent problem in French hospitals. In the absence of good analgesic practices, the use of a so-called lytic cocktail, which combines a neuroleptic (chlorpromazine), an opioid (meperidine), and an antihistamine (promethazine) has become common during the terminal phase of the disease. The lytic cocktail (LC) has been subsequently denounced as a type of disguised euthanasia. The aim of our study was to examine the prescription of morphine and lytic cocktail for terminally ill patients in a 427-bed French general hospital during a 3-year period (1989-1991) that coincided with the beginning of a pain relief service. The study was performed in two steps: a chart review of the 841 deceased patients during the observation period and an examination of morphine and parenteral promethazine consumption from the hospital pharmacy. Data from both the charts and the pharmacy showed an inverse relationship between these treatments. Morphine consumption increased while LC consumption decreased. The number of deceased patients who received LC were 24.4% in 1989, 19.9% in 1990, and 6.6% in 1991 (P < 0.001 between 1990 and 1991). The number of deceased who received morphine were 13.6% in 1989, 20.6% in 1990, and 23.9% in 1991 (P < 0.01 between 1989 and 1990). During the same period, the annual hospital morphine consumption increased by 191%, and the annual hospital parenteral promethazine consumption decreased by 62.5%. Our results suggest that, when pain is more correctly treated, the use of an inappropriate method of symptom control decreases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7541434

Meunier-Cartal, J; Souberbielle, J C; Boureau, F

1995-05-01

207

[Comparative survey on current status and the differences of treatment using modified FOLFOX6 regimen in patients with colorectal cancer in two general hospitals].  

PubMed

We surveyed the current status and the differences of treatment of colorectal cancer using modified FOLFOX6 regimen, in two general hospitals, Sakai City Hospital (A hospital) and Takarazuka Municipal Hospital (B hospital) between April 2005 and November 2006, retrospectively. The numbers of examined patients were 33 and 17 in A and B hospitals, respectively. The grade of myelosuppression and peripheral neuropathy were evaluated according to Common Terminology Criteria for Adverse Events v 3.0(CTCAE v 3.0)and Neurotoxicity Criteria of DEBIOPHARM(DEB-NTC). The setting of dosage was differed in two hospitals. In A hospital, the dosages of oxaliplatin, 5-FU bolus and 5-FU continuous infusion were more than 90% of the standard one at first time, and were reduced with almost same degree in the appearance of adverse effects. On the other hand, in B hospital, the dosages of these drugs were reduced about 20% even at first administration and, especially, the dose of 5-FU bolus tended to be remarkable reduction. Of adverse events, the rates of the appearance of neutropenia more than grade 3 was 21.2% and 47.1%, in A and B hospitals, respectively. No difference in peripheral neuropathy was detected at both hospitals. In conclusion, the differences in these two hospitals were detected in the dosage setting and myelosuppression, not in non-hematological adverse effects. PMID:18633257

Kitada, Noriaki; Morita, Satoko; Morimoto, Shigefumi; Yamasaki, Hajime; Fujii, Chika; Anami, Setsuko; Fukunaga, Mutsumi; Furukawa, Hiroshi; Takara, Kohji; Yokoyama, Teruyoshi; Watari, Masakatsu

2008-07-01

208

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

209

[Surveillance cultures after high-level disinfection of flexible endoscopes in a general hospital].  

PubMed

Introduction: Flexible endoscopes are instruments with a complex structure which are used in invasive gastroenterological procedures, therefore high-level disinfection (HLD) is recommended as an appropriate reprocessing method. However, most hospitals do not perform a quality control to assess the compliance and results of the disinfection process. Objectives: To evaluate the effectiveness of the flexible endoscopes’ decontamination after high-level disinfection by surveillance cultures and to assess the compliance with the reprocessing guidelines. Material and methods: Descriptive study conducted in January 2013 in the Gastroenterological Unit of a tertiary hospital. 30 endoscopic procedures were randomly selected. Compliance with guidelines was evaluated and surveillance cultures for common bacteria were performed after the disinfection process. Results: On the observational assessment, compliance with the guidelines was as follows: pre-cleaning 9 (30%), cleaning 5 (16.7%), rinse 3 (10%), first drying 30 (100%), disinfection 30 (100%), final rinse 0 (0%) and final drying 30 (100%), demonstrating that only 3 of 7 stages of the disinfection process were optimally performed. In the microbiological evaluation, 2 (6.7%) of the 30 procedures had a positive culture obtained from the surface of the endoscope. Furthermore, 1 (4.2%) of the 24 biopsy forcepsgave a positive culture. The organisms isolated were different Pseudomonas species. Conclusion: High-level disinfection procedures were not optimally performed, finding in 6.7% positive cultures of Pseudomonas species. PMID:25028900

Robles, Christian; Turín, Christie; Villar, Alicia; Huerta-Mercado, Jorge; Samalvides, Frine

2014-01-01

210

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

211

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

212

Successful laparoscopic management of ectopic pregnancy in a district general hospital.  

PubMed

A retrospective analysis of the management of ectopic pregnancy was undertaken at Billinge Hospital, Wigan from June 1999 to June 2002. A total of 114 cases of ectopic pregnancy were identified. Diagnosis was usually confirmed by laparoscopy (89.4%) and 102 cases (82.4%) were managed by laparoscopic salpingectomy. A total of 7.08% of patients needed a laparotomy after the initial laparoscopy and two (1.75%) had laparotomy performed as the primary approach. Medical treatment was given to eight women (7.0%). All the consultants were competent in performing laparoscopic surgery and 71.3% of cases were performed laparoscopically by a consultant. The diagnostic accuracy was high using a combination of urine pregnancy tests, serum beta-hCG and transvaginal scan. PMID:16368582

Karri, K; Harris, C P

2005-11-01

213

[Guideline for febrile children in the hospital setting; relevance for general practitioners and paediatricians].  

PubMed

- Febrile children pose the diagnostic dilemma of distinguishing those with serious infections from the vast majority with self-limiting diseases at an early stage.- Alarm symptoms can aid in assessing the probability of serious infections in febrile children.- The combined absence of alarm symptoms is useful in ruling out serious infections.- CRP and PCT values are important diagnostic markers in febrile children in hospital settings.- Children without any alarm symptoms and low inflammatory markers can be treated conservatively, provided there are good instructions on reassessment.- Children with amber alarm symptoms or mildly elevated inflammatory markers in whom a serious infection cannot be ruled out require clinical observation or ambulant follow-up; empirical parenteral antibiotic treatment should also be considered and easily accessible.- Children with red alarm symptoms or highly elevated inflammatory markers deserve clinical observation. In children < 3 months, empirical parenteral antibiotic treatment is also indicated. PMID:25027213

Nijman, R G; Oteman, N; Oostenbrink, R

2014-01-01

214

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

215

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

PubMed Central

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 the SIF. We used generalized estimating equations (GEE) to prospectively identify the prevalence and correlates of being referred by local police to Vancouver's SIF among IDU participating in the Scientific Evaluation of Supervised Injecting (SEOSI) cohort during the period of December 2003 to November 2005. Among 1090 SIF clients enrolled in SEOSI, 182 (16.7%) individuals reported having ever been referred to the SIF by local police. At baseline, 22 (2.0%) participants reported that they first learned of the SIF via police. In multivariate analyses, factors positively associated with being referred to the SIF by local police when injecting in public include: sex work (Adjusted Odds Ratio [AOR] = 1.80, 95%CI 1.28 – 2.53); daily cocaine injection (AOR = 1.54, 95%CI 1.14 – 2.08); and unsafe syringe disposal (AOR = 1.46, 95%CI 1.00 – 2.11). These findings indicate that local police are facilitating use of the SIF by IDU at high risk for various adverse health outcomes. We further found that police may be helping to address public order concerns by referring IDU who are more likely to discard used syringes in public spaces. Our study suggests that the SIF provides an opportunity to coordinate policing and public health efforts and thereby resolve some of the existing tensions between public order and health initiatives.

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

2008-01-01

216

An audit of aspects of informed consent and pain relief in general surgical units of korle bu teaching hospital.  

PubMed

SummaryThere is the need to adequately inform patients about their disease, treatment options, surgery and post-operative complications. Adequate pain relief after surgery leads to less morbidity. Two important aspects of surgical practice are being addressed in this paper, the need for informed consent and post operative pain relief.A questionnaire survey was carried out in 100 patients on the four general surgical wards of the Korle Bu Teaching Hospital, just before they were discharged from hospital. They were asked what they knew or had been informed about their diagnosis, operation and complications of surgery. On pain relief, patients were asked about their experiences on the first post-operative day and what relief they had from analgesics.Twenty four did not know the diagnosis and 36 were not told what operation they were going to have before surgery. Although 75 were eventually told what operation they had, only 64 said they knew the operation. Sixty eight did not know what to expect after surgery; 87 did not know about possible complications. On the first post-operative day there was significant pain (scores 4 and 5) felt by 24 patients at rest and 46 on movement. The most frequently prescribed analgesic was pethidine.Patient information in General surgery at the Korle Bu Teaching Hospital is unsatisfactory. Post-operative analgesia is also poor. There is the need for surgeons to either train doctors to administer consent or administer it themselves. Anaesthetists should assume a leading role in managing post-operative pain. PMID:17299545

Clegg-Lamptey, Jna; Hodasi, Wm

2005-06-01

217

Method for Rating the Proficiency of the Hospital General Staff Nurse. Manual of Directions.  

National Technical Information Service (NTIS)

A method is described in this manual for rating the proficiency of general staff nurses. It employs behavioral descriptions of nursing care. The instrument or rating device consists of a booklet that is used as a workbook for accumulating behavioral descr...

1964-01-01

218

Recent trends in clinically significant nontuberculous Mycobacteria isolates at a Korean general hospital.  

PubMed

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

Kim, Hyun Soo; Lee, Yangsoon; Lee, Sangsun; Kim, Young Ah; Sun, Young-Kyu

2014-01-01

219

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

PubMed Central

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

Tesfaye, Solomon H.; Bune, Girma T.

2014-01-01

220

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

PubMed Central

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

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

2014-01-01

221

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

PubMed Central

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

Giunta, Diego; Briatore, Agustina; Baum, Analia; Luna, Daniel; Waisman, Gabriel; de Quiros, Fernan Gonzalez Bernaldo

2013-01-01

222

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

223

Prevalence of hepatitis B virus in patients with diabetes mellitus: a comparative cross sectional study at Woldiya General Hospital, Ethiopia  

PubMed Central

Introduction The overall prevalence of HBV in Ethiopia varies from 4.7-16.8% for Hepatitis B surface antigen (HBsAg) and 70-76.38% for at least one marker positive. Patients suffering from type I Diabetes Mellitus (DM) incur high risk of infection with hepatotropic viruses because of frequent hospitalization and blood tests. Methods A comparative cross sectional study was conducted at Woldiya General Hospital using 108 consented study populations from Diabetes and 108 non diabetes control groups during the period November 2010 - January 2011. VISITECT HBsAg rapid test kit and Humastat 80 chemistry analyzer were used. Multivariate logistic regression was used to see the association of HBV with clinical history of participants and Sociodemographic variables. All tests were two-sided with ?-level of 0.05 and 80% power. Results Prevalence of HBsAg was equal between diabetic and non diabetic individuals, 3.7% indicating that there was no difference between the two groups. Only history of invasive procedures and chronic liver disease showed association with HBsAg seropositivity. Conclusion In this study a positive relation was not indicated between HBV and Diabetes and the prevalence of HBsAg was equal between diabetic and non diabetic individuals.

Mekonnen, Daniel; Gebre-Selassie, Solomon; Fantaw, Surafel; Hunegnaw, Andualem; Mihret, Adane

2014-01-01

224

Coal-bed methane potential of Vancouver Island coalfields  

SciTech Connect

Commercially attractive quantities of coal-bed methane gas on Vancouver Island, British Columbia, are indicated from recent studies by the provincial Geological Survey Branch and independent consultants. Coal mining activity began in 1847, which provides large amount of data concerning drilling, mining, quality, and reserves. Presence of methane is corroborated by documented accounts of coal mine disasters. Coal measures are part of the Upper Cretaceous Nanaimo Group, which covers approximately 800 mi{sup 2} and are divided into two subbasins. Cretaceous strata rest unconformably on predominantly volcanic basement rocks and are controlled in their distribution by paleotopography. Maximum aggregate coal thickness in the Nanaimo subbasin is 30-60 ft in the Comox subbasin, greater than 40 ft. Post-Cretaceous faulting strongly influences the area. Tertiary intrusives have effected coal quality to some extent. Sampling of coal seams is currently underway to determine levels of thermal maturation. Vitrinite reflectance ranges from 0.59 to 3.21 (R{sub o} max). The majority of coals are of high-volatile B to A bituminous rank, with local variations near Tertiary intrusions. Test-well desorption data have indicated that coals can contain as much as 380 ft{sup 3} of methane per ton of coal. Gas samples taken were pipeline quality, about 95% methane, 4.5% heavier hydrocarbons, and 0.5% carbon dioxide. A conservative estimate of in-place methane resource is 800 bcf. Plans are currently underway to construct a natural gas pipeline from the mainland to service Vancouver Island. This would provide the necessary infrastructure to make extraction of the methane resource economic.

Kenyon, C. (Ministry of Energy, Mines, Petroleum Resources, Victoria, British Columbia (Canada)); Murray, D.K. (D. Keith Murray and Associates, Inc., Golden, CO (USA))

1990-05-01

225

The cost-effectiveness of Vancouver's supervised injection facility  

PubMed Central

Background The cost-effectiveness of Canada's only supervised injection facility has not been rigorously evaluated. We estimated the impact of the facility on survival, rates of HIV and hepatitis C virus infection, referral to methadone maintenance treatment and associated costs. Methods We simulated the population of Vancouver, British Columbia, including injection drug users and persons infected with HIV and hepatitis C virus. The model used a time horizon of 10 years and the perspective of the health care system. We compared the situation of the supervised injection facility with one that had no facility but that had other interventions, such as needle-exchange programs. The effects considered were decreased needle sharing, increased use of safe injection practices and increased referral to methadone maintenance treatment. Outcomes included life-years gained, costs, and incremental cost-effectiveness ratios discounted at 5% per year. Results Focusing on the base assumption of decreased needle sharing as the only effect of the supervised injection facility, we found that the facility was associated with an incremental net savings of almost $14 million and 920 life-years gained over 10 years. When we also considered the health effect of increased use of safe injection practices, the incremental net savings increased to more than $20 million and the number of life-years gained to 1070. Further increases were estimated when we considered all 3 health benefits: the incremental net savings was more than $18 million and the number of life-years gained 1175. Results were sensitive to assumptions related to injection frequency, the risk of HIV transmission through needle sharing, the frequency of safe injection practices among users of the facility, the costs of HIV-related care and of operating the facility, and the proportion of users who inject in the facility. Interpretation Vancouver's supervised injection site is associated with improved health and cost savings, even with conservative estimates of efficacy.

Bayoumi, Ahmed M.; Zaric, Gregory S.

2008-01-01

226

Adaptation and validation of a questionnaire assessing patient satisfaction with pharmacy services in general hospitals  

PubMed Central

Objective The aim of this study was to cross-culturally adapt the Armando Patient Satisfaction Questionnaire into Arabic and validate its use in the general population. Methods The translation was conducted based on the principles of the most widely used model in questionnaire translation, namely Brisling’s back-translation model. A written authorization allowing translation into Arabic was obtained from the original author. The Arabic version of the questionnaire was distributed to 480 participants to evaluate construct validity. Statistical Package for Social Sciences version 17.0 for Windows was used for the statistical analysis. Results The response rate of this study was 96%; most of the respondents (52.5%) were female. Internal consistency was assessed using Cronbach’s ?, which showed that this questionnaire provides a high reliability coefficient (reaching 0.9299) and a high degree of consistency and thus can be relied upon in future patient satisfaction research.

Al-Jumah, Khalaf Ali; Hassali, Mohamed Azmi; Al-Zaagi, Ibrahem

2014-01-01

227

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

PubMed Central

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 9 health facilities. Whereas the clinicians diagnosed a mental disorder in only 2.5% of the sample studied, 41.3% had CDI scores that suggested mild to moderate depression. The highest proportion of children with depressive symptomatology was found at the Kenyatta National and Teaching Referral Hospital. Conclusion Although prevalence rate for depression among children is high, detection rates remain low. This finding has clinical practice and policy implications within and outside Kenya.

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

2009-01-01

228

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

PubMed Central

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

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

2014-01-01

229

[A check list for working conditions and work satisfaction of nurses in general hospitals--report on results].  

PubMed

During a training on continuing education the nursing staff of the "Klinikum Bamberg" decided to start systematic research into career patterns, working conditions and work satisfaction. A checklist was developed. The study reports findings from 543 nurses in 4 german general hospitals. Leaving aside details about specific clinical areas it emerged a high agreement in positively evaluated working conditions and in negatively evaluated as well. Particularly positively evaluated areas are work-content, colleague in the wards, relationships with the immediate superiors. There was little homogeneity concerning working hours and range of duties. What was generally thought to need improvement was staffing level, workload, bed occupancy, hospital management/organization and salar. These findings are consistent with mostly all newer publications on this topic. They too are consistent with the professional self-awareness of the nursing staff inferrable from the career expectations: The most important object only rarely were in keeping with the traditional image of "service to humanity". Personal aims, such as money, were much more prevalent, but also to be able to give the best possible and dignific care. With respect to these findings we propose to do the following strategy: It no longer serves a useful purpose to continue research with variing methods of data collection and to confirm the already well known facts. It rather seems politically necessary to take the next steps: Using a standardized method of data collection, to get comparable data, based on this to establish the actual state of working conditions from the sight of the nursing staff. Finally to demand the changing of these conditions which need to be improved as the necessary framework for modern nursing practice. Our experience suggests that the check list is a suitable tool for the collection of these data. PMID:7548630

Meyer, H

1995-09-01

230

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

PubMed

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

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

2014-08-01

231

Cost of a cardiac surgical and a general thoracic surgical patient to the National Health Service in a London teaching hospital.  

PubMed Central

The cost of the inpatient stay for a typical aortic valve replacement and for an oesophagectomy were determined by recording and costing every aspect of the patients' care from admission until discharge. This method of cost calculation was found to be satisfactory and could be used by other centres to allow comparisons between hospitals or countries. At St Thomas's Hospital in 1977 the cost of a cardiac operation was 2755 pounds, an oesophagectomy 1870 pounds, and a general surgical operation 564 pounds.

Morgan, K D; Disbury, F C; Braimbridge, M V

1979-01-01

232

Modification of Visual Approach Slope Indicator Baffles at Pearson Field Airpark, Vancouver, WA.  

National Technical Information Service (NTIS)

This technical note describes a research effort that was accomplished to correct a safety deficiency with a Visual Approach Slope Indicator (VASI) system at the Pearson Field Airpark in Vancouver, Washington. During a recent inspection flight, the VASI sy...

J. W. Patterson

2007-01-01

233

77 FR 10618 - 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 Junction Railroad, LLC Eric Temple (applicant), a noncarrier individual...CWA. \\2\\ See Nicholas B. Temple, Eric Temple, Columbia Basin R.R.,...

2012-02-22

234

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

Federal Register 2010, 2011, 2012, 2013

...TRANSPORTATION Surface Transportation Board [Docket No. FD 35594] Eric Temple--Control Exemption--Portland Vancouver Junction...On February 6, 2012, Eric Temple (applicant), a noncarrier individual, filed with...

2012-06-05

235

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...

236

46. Photocopy of photograph (Modjeski report, The VancouverPortland Bridges, 1910, ...  

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

46. Photocopy of photograph (Modjeski report, The Vancouver-Portland Bridges, 1910, frontispiece) WILLAMETTE BRIDGE LOOKING UPRIVER TO PORTLAND - Burlington Northern Railroad Bridge, Spanning Willamette River at River Mile 6.9, Portland, Multnomah County, OR

237

Hip resurfacing in a district general hospital: 6-year clinical results using the ReCap hip resurfacing system  

PubMed Central

Background The purpose of our study was to prospectively report the clinical results of 280 consecutive hips (240 patients) who received a ReCap Hip Resurfacing System implant (Biomet Inc., Warsaw, USA) in a single district general hospital. Literature reports a large variation in clinical results between different resurfacing designs and published results using this particular design are scarce. Methods Mean follow up was 3.3 years (1.0 to 6.3) and four patients were lost to follow-up. All patients were diagnosed with end-stage hip osteoarthritis, their mean age was 54 years and 76.4% of all patients were male. Results There were 16 revisions and four patients reported a Harris Hip Score <70 points at their latest follow up. There were no pending revisions. Kaplan-Meier implant survival probability, with revision for any reason as endpoint, was 93.5% at six years follow-up (95%-CI: 88.8-95.3). There were no revisions for Adverse Reactions to Metal Debris (ARMD) and no indications of ARMD in symptomatic non-revised patients, although diagnostics were limited to ultrasound scans. Conclusions This independent series confirms that hip resurfacing is a demanding procedure, and that implant survival of the ReCap hip resurfacing system is on a critical level in our series. In non-revised patients, reported outcomes are generally excellent. Trial registration ClinicalTrials.gov Identifier: NCT00603395

2012-01-01

238

Tracking Ecosystem Loss on East Vancouver Island and the Gulf Islands: Recent Research and Application  

Microsoft Academic Search

The Sensitive Ecosystems Inventory 2003-2004 disturbance mapping project for east Vancouver Island and the Gulf Islands, British Columbia, measured changes to the landscape over approximately a ten-year period. In 1993-1997, the Sensitive Ecosystems Inventory mapped seven different natural ecosystem types that were considered to be rare and sensitive on east Vancouver Island and the Gulf Islands, plus two other ecosystem

JAN KIRKBY; DAVID CAKE

239

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

PubMed Central

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

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

2013-01-01

240

Massachusetts General Hospital  

Cancer.gov

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

241

Massachusetts General Hospital  

Cancer.gov

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

242

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

243

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

PubMed

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

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

2014-04-01

244

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

245

Condom use among people living with HIV/AIDS attending Abejukolo General Hospital in Kogi State, North Central Nigeria.  

PubMed

Background: Condom programming is an integral component in a range of HIV/AIDS prevention strategies and with repeated sexual contact among HIV-discordant couples, 98-100% of those who used latex condoms correctly and consistently did not become infected. The objective of this study is to determine condom use among people living with HIV/AIDS (PLWHA). Methods: This is a cross-sectional survey carried out among 231 PLWHA and receiving care and treatment at General Hospital Abejukolo in Kogi State, Nigeria. The research instrument was interviewer-administered questionnaire. The data obtained were analysed using EPI-INFO version 3.4.1 software and P-value of < 0.05 was significant for the study. Results: About three-quarters (70.6%) of the respondents had ever used condom. Reasons given by respondents who did not use condom were: Desire for children (39.7%), and reduction of sexual pleasure (17.7%) and partner preference. More than half (56.0%) of the respondents with multiple partners did not use condom. About half 119 (51.5%) have used condom in the last sexual encounter. Gender, literacy level and disclosure of HIV status to partners significantly influence condom use during sexual intercourse. Conclusion: The poor uptake of condom among PLWHA underscores the need for government and other stakeholders in the management of HIV/AIDS to provide more enlightenment opportunities to address the gaps in condom use and disclosure of HIV status to partners. PMID:24923368

Salaudeen, Adekunle G; Musa, Omotosho I; Ojotule, Austin; Yusuf, Ayodeji S; Durowade, Kabir A; Omokanye, Lukman O

2014-01-01

246

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

247

Analysis of the Clonality of Candida tropicalis Strains from a General Hospital in Beijing Using Multilocus Sequence Typing  

PubMed Central

Multilocus sequence typing (MLST) based on six loci was used to analyze the relationship of 58 Candida tropicalis isolates from individual patients in a general hospital in Beijing, China. A total of 52 diploid sequence types (DSTs) were generated by the MLST, all of which were new to the central database. Unweighted Pair Group Method with Arithmetic Mean (UPGMA) dendrograms were constructed, which showed that the 58 isolates were distributed robustly and 6 main groups were clustered regardless of the specimen source and medical department. The minimum spanning tree (MST) of the 58 isolates (52 DSTs) and all 401 isolates (268 DSTs) in the C. tropicalis central database (http://pubmlst.org/ctropicalis/) indicated that the isolates in this study clustered in three relative pure clonal complexes, and 2 clustered with isolates from Taiwan, Belgium, Brazil, and the US. This study presents the first MLST analysis of C. tropicalis isolates from Mainland China, which may be useful for further studies on the similarity, genetic relationship, and molecular epidemiology of C. tropicalis strains worldwide.

Wu, Yuan; Zhou, Haijian; Wang, Jing; Li, Lianqing; Li, Wenge; Cui, Zhigang; Chen, Xia; Cen, Ruiqi; Lu, Jinxing; Cheng, Ying

2012-01-01

248

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

249

Changing frequency of parotid gland neoplasms--analysis of 560 tumours treated in a district general hospital.  

PubMed

An analysis of all parotidectomies performed for neoplastic lesions in the maxillofacial unit at a district general hospital during a 26-year period between 1974-1999 was undertaken. The details analysed were age, sex, histology and temporal variations in the frequency of specific tumour types during the study period. A total of 538 parotidectomies performed on 529 patients in whom 560 tumours were present, formed the basis of this study. Marked variations were present in the age and sex distribution and relative frequency of specific tumour types in this study, when compared to previous reports. There were also differences in the age and sex distribution of pleomorphic adenoma and adenolymphoma (P <0.0001) in this study. The relative frequency of benign tumours and adenolymphoma increased, whereas that of pleomorphic adenoma decreased during the study period. In addition, there was a statistically significant decrease in the relative frequency of pleomorphic adenoma (P <0.0001) and an increase in adenolymphoma (P <0.0001) when comparisons were made with previous studies. This study from a defined population may be more representative of the true proportion of specific tumours in this population. The potential implications of the results on the investigation and treatment of parotid neoplasms is highlighted. PMID:11890618

Ethunandan, M; Pratt, C A; Macpherson, D W

2002-01-01

250

Changing frequency of parotid gland neoplasms--analysis of 560 tumours treated in a district general hospital.  

PubMed Central

An analysis of all parotidectomies performed for neoplastic lesions in the maxillofacial unit at a district general hospital during a 26-year period between 1974-1999 was undertaken. The details analysed were age, sex, histology and temporal variations in the frequency of specific tumour types during the study period. A total of 538 parotidectomies performed on 529 patients in whom 560 tumours were present, formed the basis of this study. Marked variations were present in the age and sex distribution and relative frequency of specific tumour types in this study, when compared to previous reports. There were also differences in the age and sex distribution of pleomorphic adenoma and adenolymphoma (P <0.0001) in this study. The relative frequency of benign tumours and adenolymphoma increased, whereas that of pleomorphic adenoma decreased during the study period. In addition, there was a statistically significant decrease in the relative frequency of pleomorphic adenoma (P <0.0001) and an increase in adenolymphoma (P <0.0001) when comparisons were made with previous studies. This study from a defined population may be more representative of the true proportion of specific tumours in this population. The potential implications of the results on the investigation and treatment of parotid neoplasms is highlighted.

Ethunandan, M.; Pratt, C. A.; Macpherson, D. W.

2002-01-01

251

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

252

The Vancouver Elementary Schools Area Counsellor Services and the Area Counsellor Training Program. A Study Prepared for the Vancouver School Board. Research Report No. 75-03.  

ERIC Educational Resources Information Center

This study is concerned with an examination of the area counsellor services in Vancouver elementary schools and the support program of training for area counsellors. Information, opinions and suggestions were sought from a wide number of individuals and agencies having some connection with or interest in the services. It is recognized first of all…

Kitley, Philip J.

253

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

NASA Astrophysics Data System (ADS)

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

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

2014-01-01

254

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

255

An Examination and Analysis of the Dynamics of the Human Behavior in the Fire Incident at the Anne Arundel General Hospital on November 14, 1978.  

National Technical Information Service (NTIS)

The fire incident at the Anne Arundel General Hospital on November 14, 1978 was detected by a nursing assistant at approximately 2015 hours. The nursing assistant entered room 412 of 'A' building to prepare the patient for sleeping. The nurses assistant i...

J. L. Bryan P. J. DiNenno

1978-01-01

256

Changes in patterns of psychiatric referral in a German general hospital: results of a comparison of two 1-year surveys 8 years apart  

Microsoft Academic Search

The aim of this study was to investigate the issues of changes in patterns of referral and interventions and of consistency of psychiatric diagnoses assigned by a psychiatric consultation-liaison service in a general hospital over an 8-year period. We compared two 1-year surveys 8 years apart. Survey A comprised 713 referrals in 1990, and Survey B included 1025 consecutive new

Hans-Bernd Rothenhäusler; Sigrid Ehrentraut; Hans-Peter Kapfhammer

2001-01-01

257

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

Microsoft Academic Search

As part of its policy of constant quality improvement, Établissement français du sang (EFS) des pays de la Loire (Pays de la Loire Regional Blood Transfusion Centre) carried out a satisfaction survey among the hospital personnel involved in prescribing and using immunohaematological tests and labile blood products (LBP). The polling tool selected by agreement between the Saint Nazaire’s hospital management

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

2004-01-01

258

Retrospective identification of episodes of deliberate self-harm from emergency room registers in general hospitals: an example from Shanghai.  

PubMed

The objective of this study was to assess the feasibility of using currently available emergency department (ED) records to retrospectively ascertain the prevalence and characteristics of episodes of medically treated deliberate self-harm (DSH). Discussions with ED staff identified 10 ED diagnoses in persons 12 years of age or older that were commonly used for episodes of DSH and another 7 injury-related diagnoses that could, under specific conditions, be acts of DSH. A retrospective analysis of the ED registry of one large general hospital in Shanghai for 2007 to 2010 identified all cases with one of these diagnoses. Diagnosis-specific algorithms based on the characteristics of each case were applied to classify cases as "probable DSH," "possible DSH" or "probably not DSH." The 1,495 cases of DSH identified accounted for 0.2% of all ED admissions over the 4 years; only 6 of them (0.4%) had an ED diagnosis of "suicide attempt." Three ED diagnoses-overdose of medication, fall from height, and pesticide ingestion-accounted for 1,275 (85.3%) of the DSH cases. There were substantial differences in the characteristics of male and female cases of DSH and a 43% drop in the proportion of ED admissions for DSH over the 4 years. In locations where it is not feasible to develop prospective registries of suicide attempts treated in EDs, retrospective analysis of ED records that use algorithms to classify the intentionality of injuries can provide estimates of the prevalence and characteristics of medically treated episodes of DSH. PMID:24224669

Xu, Yeqing; Phillips, Michael R; Wang, Liwei; Chen, Qiuhong; Li, Chunbo; Wu, Xiao

2013-01-01

259

Building Better Healthcare Facilities through Evidence-Based Design: Breaking New Ground at Vancouver Island Health Authority.  

PubMed

Many of today's healthcare facilities were constructed at least 50 years ago, and a growing number have outlived their useful lives. Despite renovations and renewals, they often fall short of providing an appropriate care setting. Clinicians and staff develop a mixture of compromises and workarounds simply to make things function. Evidence-based design principles are often absent from new healthcare facilities, perhaps because of lack of awareness of the principles or because implementing them may fall foul of short-term and short-sighted budgetary decisions. In planning a new healthcare facility in 2008, the executive team at Vancouver Island Health Authority decided to adopt the evidence-based design approach. They conducted site visits to newly constructed hospitals across North America and beyond, to determine best practices in terms of design and construction. These engagements resulted in the implementation of 102 evidence-based design principles and attributes in Victoria's Royal Jubilee hospital, a 500-bed Patient Care Centre. This $350M project was completed on time and on budget, showing that using evidence need not result in delays or higher costs. To date, the results of the evidence-based design are promising, with accolades coming from patients, staff and clinical partners, and a number of immediate and practical benefits for patients, families and care teams alike. PMID:24863125

Waldner, Howard; Johnson, Bart; Sadler, Blair

2012-12-01

260

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

PubMed

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

Heggie, Travis W

2009-07-01

261

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

2014-06-01

262

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

PubMed

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

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

2004-10-01

263

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

PubMed Central

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

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

2013-01-01

264

Adherence of surgeons to antimicrobial prophylaxis guidelines in a tertiary general hospital in a rapidly developing country.  

PubMed

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

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

2013-01-01

265

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

266

Workload Due to Aspergillus fumigatus and Significance of the Organism in the Microbiology Laboratory of a General Hospital  

Microsoft Academic Search

The increase in the immunocompromised population and the incidence of invasive aspergillosis (IA) are leading to an overinterpretation of the potential clinical significance of many isolates of Aspergillus fumigatus. Our work prospectively assesses the workload of the isolation of A. fumigatus and its clinical significance in the microbiology laboratory of a large teaching hospital. During a 3-year period, all patients

E. Bouza; J. Guinea; T. Pelaez; J. Perez-Molina; L. Alcala; P. Munoz

2005-01-01

267

Seroprevalence of HIV, Hepatitis B, and Syphilis Among Pregnant Women at the General Hospital, Guatemala City, 2005-2009  

Microsoft Academic Search

Background: Sexually transmitted infection (STI) screening in pregnancy provides an excellent opportunity for secondary prevention. Objective: To document the epidemiology of HIV, hepatitis B, and syphilis among pregnant women at a Guatemalan national hospital. Results: From 2004 to 2009, 118 (0.76%) of 15 563 of women tested in the prenatal clinic had HIV infection, 29 (0.22%) of 13 028 women

Blanca Samayoa; Matthew Robert Anderson; Karla Patricia Alonso Pacheco; Carol Lee; Alicia Pittard; Alex Soltren; Ingrid Barrios Matos; Eduardo Arathoon

2010-01-01

268

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

Microsoft Academic Search

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

Margaret E Slade

1992-01-01

269

Downscaling of Precipitation over Vancouver Island using a Synoptic Typing Approach  

Microsoft Academic Search

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

Stephen R. Sobie; Andrew J. Weaver

2011-01-01

270

Downscaling of Precipitation over Vancouver Island using a Synoptic Typing Approach  

Microsoft Academic Search

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

Stephen R. Sobie; Andrew J. Weaver

2012-01-01

271

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

Microsoft Academic Search

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

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

2002-01-01

272

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

Microsoft Academic Search

The Plate Boundary Observatory installed six Gladwin Tensor Strainmeters (GTSMs) on the Olympic peninsula in June and July 2005. Four boreholes are currently being drilled on Vancouver Island, Canada, with strainmeter installation planned for autumn 2005. Initial results from the strainmeters on the Olympic Peninsula indicate that all are measuring an accumulation of strain and that the phase and amplitudes

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

2005-01-01

273

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

274

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

275

Habitus, rules of the labour market and employment strategies of immigrants in Vancouver, Canada  

Microsoft Academic Search

Workplace conventions and hiring practices are barriers confronted by immigrants in the Canadian labour market. This paper considers these barriers in the context of Bourdieu's concept of habitus. The empirical research presented examines immigrants from South Asia and the former Yugoslavia in the labour market of Greater Vancouver. A statistical analysis of census data and immigrant landing records is supplemented

Harald Bauder

2005-01-01

276

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

Microsoft Academic Search

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

H. A. Cleugh; T. R. Oke

1986-01-01

277

‘British Columbia Is Open for Business’: Environmental Justice and Working Forest News in the Vancouver Sun  

Microsoft Academic Search

This paper analyses the Vancouver Sun's coverage of the Working Forest Initiative, which the provincial government of British Columbia (BC), Canada, introduced in 2002. The Working Forest originally defined forestry as the primary use of all forested Crown land in BC that was not within protected areas. By 2003, this policy initiative was transformed into a largely symbolic recognition of

Mark C. J. Stoddart

2007-01-01

278

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

279

Collaboration in Workplace Literacy: The Vancouver Municipal Workplace Language Training Program.  

ERIC Educational Resources Information Center

Ways that workplace literacy programs can be made to work and the circumstances or forces that promote or hinder them are discussed, based on experiences in Vancouver, British Columbia, where 26 percent of the population is minority and 20 percent of the 8,000 city employees speak English as a Second Language. The story documented in this report…

Darville, Richard

280

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

Microsoft Academic Search

Effects of deforestation upon slopes in limestones and in volcanic rocks in the Benson River valley, northern Vancouver Island, have been investigated quantitatively. Postlogging soil erosion and vegetal regeneration success were assessed by measuring soil depth, percent bare rock and moss cover, and the numbers and diversity of trees, shrubs, and plants on 25 sampling sites, each containing ten measuring

K. A. Harding; D. C. Ford

1993-01-01

281

Proglacial Sedimentation in the Loss Creek Valley, Southwestern Vancouver Island, British Columbia  

Microsoft Academic Search

A stratigraphic study was conducted on an exposure lo- cated in the lower reaches of Loss Creek on Vancouver Island. Four areas were identified in the 72 m high expo- sure. The lowest unit is composed of 17 m of laminated clays (Unit 1). The next exposure is a 3 m bed of poorly- sorted sand and gravel with a-b

Jacqueline J. Denton; Colin P. Laroque; Adria E. Williams; Paul J. Wilson

282

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

ERIC Educational Resources Information Center

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

Petersen, Leah; Park-Saltzman, Jeeseon

2010-01-01

283

What's The Gendered Story? Vancouver's Prime Time Olympic Glory on NBC  

Microsoft Academic Search

Previous Olympic media studies have shown that NBC's Winter Olympic telecast is far more likely to promote and advance men athletes and sports than women athletes and sports (see Billings, 2008b), and this study of the 2010 Vancouver Winter Olympic telecast again reveals gender divisions. Analysis of all 64 hours of NBC's prime time telecast revealed that (a) when excluding

James R. Angelini; Paul J. MacArthur; Andrew C. Billings

2012-01-01

284

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

285

Rockfish (Scorpaenidae) Assemblages of Trawlable and Untrawlable Habitats off Vancouver Island, British Columbia  

Microsoft Academic Search

We compared assemblages of demersal rockfishes (Scorpaenidae) associated with two areas of the continental slope off northern Vancouver Island, British Columbia, Canada. Twenty and 21 sets of sunken gill nets were completed on trawlable and untrawlable areas, respectively. The species assemblages on the two areas were markedly different, as demonstrated by their diversity, evenness, and percent similarity and by cluster

Kathleen R. Matthews; Laura J. Richards

1991-01-01

286

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

ERIC Educational Resources Information Center

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

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

2008-01-01

287

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

ERIC Educational Resources Information Center

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

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

2006-01-01

288

Interstate Highway 5(SR 5), Columbia River Bridge to Burnt Bridge Creek (Vancouver Freeway), Washington.  

National Technical Information Service (NTIS)

The project proposes six-laning a section of an existing four-lane freeway, updating the interchanges and providing for a wider median. Directly effected is the City of Vancouver in Clark County, Washington. The environmental impact of this project on the...

1972-01-01

289

National Hospital Discharge Survey  

Cancer.gov

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

290

[Evidence-based medicine in internal guideline development in a general hospital--the Park-Clinic EbM-Project].  

PubMed

Evidence-based medicine (EbM) is despite its historical roots still a young concept that is quite relevant in everyday work, but yet little used. The first hospital specific approach to implement EbM into the health care system and daily clinical practice in Germany is recorded in the project of the Park-Klinik Weissensee (Berlin). Implementation and execution of EbM into daily routine should be reached through five steps which should result in better quality of treatment of the patients: 1. EbM-Training for hospital staff; 2. EbM-Search (= access to electronic databases and EbM-information); 3. Guideline-Committee (= hospital committee for the development of clinical practice guidelines); 4. EbM-Recommendation (= use of EbM-information in discharge letters) and, finally 5. EbM-Events (= vocational trainings for hospital physicians and general practitioners). Although project duration is yet quiet short, first results allow to look into the future with confidence. At the same time it can be recognized how long and difficult the way for all participants will be to reach evidence-based information and communication. The "Park-Klinik EbM-Project" can make an important contribution to health care services research in Germany. PMID:11503560

Zielinski, W; Goldstein, M; König, U

2001-07-01

291

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

292

Transgenic oilseed rape along transportation routes and port of Vancouver in western Canada.  

PubMed

The occurrence of transgenic herbicide-resistant oilseed rape (Brassica napus) in ruderal (non-crop disturbed) areas has not been investigated previously in Canada. The primary objective of this study was to document their occurrence in two main ruderal areas (along railways and roads) in the province of Saskatchewan, where half of all oilseed rape is grown, and at the port of Vancouver, British Columbia on the west coast of Canada, where most oilseed rape destined for export is transported by rail. During the 2005 growing season, leaf samples of oilseed rape plants were collected at randomly-selected sites along railways and roads across Saskatchewan ecoregions and at Vancouver; infestation area, density, and plant height of oilseed rape were measured at each site. The presence of the glyphosate and glufosinate resistance traits was determined using test strips. The infestation area of oilseed rape, averaged across 155 sampled sites in the Saskatchewan survey, was markedly smaller in populations along railways than roads; in contrast, infestation area averaged across 54 sites in the Vancouver survey was greater for populations along railways than roads. In both surveys, mean plant density was greater for populations found along railways than roads. Two-thirds of oilseed rape plants sampled across Saskatchewan ecoregions and at Vancouver were transgenic, although the relative proportion of plants with the glyphosate or glufosinate resistance trait varied between surveys. Frequency of occurrence of transgenic plants in ruderal areas was similar to the proportion of the oilseed rape area planted with transgenic cultivars in the recent preceding years. A single transgenic B. rapa x B. napus hybrid was found along a road in Vancouver, confirming the relatively high probability of hybridization between these two Brassica species. With current control measures, transgenic oilseed rape populations may persist and spread in these ruderal areas. PMID:17328853

Yoshimura, Yasuyuki; Beckie, Hugh J; Matsuo, Kazuhito

2006-01-01

293

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

Microsoft Academic Search

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

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

2010-01-01

294

Community-based medical systems advancement in a hospital-primary health care centre in Crete, Greece: concepts, methods, and the new role of the general practitioner.  

PubMed

Modern health systems research and development emphasize the transition from hospital to primary health care. Importantly, this transition is projected to be coordinated and interactive, as facilitated, e.g., by improved information systems and collaboration between the involved parties, including Universities and health authorities. An ideal combination of this might accordingly be offered by a synthesis of a basic hospital and primary health care center in an area of suitable site, size, and structure. We believe that our institution, Nosokomion Neapolis, in; the moderate-size Cretan township of Neapolis (New-city) offers an interesting model example of this, because of its affiliation with the University of Heraklion and its international and EU-supported project status. In the present report we want to emphasize the elements that are particularly well suited and manageable and in many ways both opportunistic and conscientious "back to the future" instances of a successful Hospital/Primary Health Care integration. Specifically, we think that the advantages in local area epidemiology, prevention, and quality assurance are apparent, and nurture a--rather renewed that new-role of the general practitioner as both a holistic population doctor and a health systems researcher for the year 2,000 and beyond. PMID:9604784

Chatziarsenis, M; Lionis, C; Faresjö, T; Fioretos, M; Trell, E

1998-06-01

295

Oxacilin-resistant Coagulase-negative staphylococci (CoNS) bacteremia in a general hospital at S?o Paulo city, Brasil  

PubMed Central

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

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

2008-01-01

296

Nocardiosis of the central nervous system: experience from a general hospital and review of 84 cases from the literature.  

PubMed

Central nervous system (CNS) nocardiosis is a rare disease entity caused by the filamentous bacteria Nocardia species. We present a case series of 5 patients from our hospital and a review of the cases of CNS nocardiosis reported in the literature from January 2000 to December 2011. Our results indicate that CNS nocardiosis can occur in both immunocompromised and immunocompetent individuals and can be the result of prior pulmonary infection or can exist on its own. The most common predisposing factors are corticosteroid use (54% of patients) and organ transplantation (25%). Presentation of the disease is widely variable, and available diagnostic tests are far from perfect, often leading to delayed detection and initiation of treatment. The optimal therapeutic approach is still undetermined and depends on speciation, but lower mortality and relapse rates have been reported with a combination of targeted antimicrobial treatment including trimethoprim/sulfomethoxazole (TMP-SMX) for more than 6 months and neurosurgical intervention. PMID:24378740

Anagnostou, Theodora; Arvanitis, Marios; Kourkoumpetis, Themistoklis K; Desalermos, Athanasios; Carneiro, Herman A; Mylonakis, Eleftherios

2014-01-01

297

[Improvement of therapeutic environment--effort to establish the medical center for GID in a general hospital].  

PubMed

Treatment for gender identity disorder (GID) should be done in cooperation with psychologist, gynecologist, urologist, plastic surgeon and extramural scholars as a team treatment. And if possible, it should be a comprehensive treatment with supports of a social worker, a coordinator and an expert nurse. The ethical committee for individual GID patient treatment has already dissolved according to the third edition of the guideline. We call the therapeutic team Okayama University Hospital Gender Center. It treats not only GID patients, but also gender associated diseases such as disorders of sex development (DSD). Unfortunately, there are not so many institutions which meet our conditions throughout the country. In the present circumstances we can't go along with their needs. So many GID patients go abroad and have Sex reassignment surgery (SRS). To solve this problem national insurance for SRS should be approved as soon as possible and many institutes should start GID treatment. PMID:22844817

Namba, Yuzaburo

2012-01-01

298

15-Year survival and retention of patients in a general hospital-affiliated methadone maintenance treatment (MMT) center in Israel.  

PubMed

We have extended our previous 10-year follow-up study of MMT retention for another 5 years and added data on survival of all patients ever admitted to our MMT clinic (6/1993 to 6/2007). Data were calculated from admission to MMT until leaving, death, or study closure (6/2008). Ninety-four of a total of 613 patients (4711.6 person-years [py]) died. Cancer was the primary cause of death for those who remained in treatment, and overdose for those who left MMT. Longer survival (p=0.051) with a trend for a lower mortality rate (p=0.08) was noted among the 464 patients who stayed in treatment > or =1 year (1.8/100 py), compared with the 149 patients who left MMT <1 year (2.6/100 py). Predictors of survival in multivariate analyses were younger age (<40 years) at admission, living with a spouse/partner, being hepatitis B sera-negative, not abusing benzodiazepines on admission (interaction effect), not being referred directly from hospitalization to MMT, and not leaving the MMT program for hospitalization. The two latter variables also predicted longer retention, as did a high methadone dose (> or =100mg/d), no opiate and, no benzodiazepine abuse after 1 year and either having any DSM-IV-TR Axis I, or no Axis I&II psychiatric diagnoses. Unlike retention, mortality was associated with pre-treatment severity and comorbidities thus only partially reflects MMT outcome (opiate abstinence and treatment success). Benzodiazepine abuse reduced both retention and survival, emphasizing the high priority that should be given to stopping it. PMID:19914783

Peles, Einat; Schreiber, Shaul; Adelson, Miriam

2010-03-01

299

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

PubMed Central

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

2013-01-01

300

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

PubMed Central

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

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

2013-01-01

301

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

302

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

303

A district general hospital's method of post-operative infection surveillance including post-discharge follow-up, developed over a five-year period.  

PubMed

We report on a post-operative infection surveillance system which includes post-discharge follow-up, developed over five years in a district general hospital in the West Midlands, UK. The methods used for following up 667 patients undergoing one of five representative surgical procedures are described. Emergency, elective and day-case procedures are included. A combination of healthcare worker questionnaire, telephone calls and patient questionnaire gave a follow-up rate of 92.7%. The system took infection control staff an average of 40 min per patient (30 min inpatient assessment, 10 min post-discharge). Almost half (48%) of surgical site infections were diagnosed after discharge from hospital. The system worked equally well when conducted as part of the UK Nosocomial Infection National Surveillance Scheme (NINSS), or as in-house projects. It is likely that the system could be used in other areas with similar population characteristics and support from local general practitioners working in the community. PMID:11516186

Stockley, J M; Allen, R M; Thomlinson, D F; Constantine, C E

2001-09-01

304

Development and Validation of a Novel Vancomycin Dosing Nomogram for Achieving High-Target Trough Levels at 2 Canadian Teaching Hospitals  

PubMed Central

Background: Recent guidelines recommend a vancomycin trough (predose) level between 15 and 20 mg/L in the treatment of invasive gram-positive infections, but most initial dosing nomograms are designed to achieve lower targets (5–15 mg/L). Clinicians need guidance about appropriate initial dosing to achieve the higher target. Objective: To develop and validate a high-target vancomycin dosing nomogram to achieve trough levels of 15–20 mg/L. Methods: A retrospective study was conducted at 2 teaching hospitals, St Paul’s Hospital and Vancouver General Hospital in Vancouver, British Columbia. Patients who were treated with vancomycin between January 2008 and June 2010 and who had achieved a trough level of 14.5–20.5 mg/L were identified. Demographic and clinical data were collected. Multiple linear regression was used to develop a vancomycin dosing nomogram for each hospital site. An integrated nomogram was constructed by merging the data from the 2 hospitals. A unique set of patients at each institution was used for validating their respective nomograms and a pooled group of patients for validating the integrated nomogram. Predictive success was evaluated, and a nomogram was deemed significantly different from another nomogram if p < 0.05 via “?2 testing. Results: Data from 78 patients at one hospital and 91 patients at the other were used in developing the respective institutional nomograms. For each hospital’s data set, both age and initial serum creatinine were significantly associated with the predicted dosing interval (p < 0.001). Validation in a total of 105 test patients showed that the integrated nomogram had a predictive success rate of 56%. Conclusions: A novel vancomycin dosing nomogram was developed and validated at 2 Canadian teaching hospitals. This integrated nomogram is a tool that clinicians can use in selecting appropriate initial vancomycin regimens on the basis of age and serum creatinine, to achieve high-target levels of 15–20 mg/L. The nomogram should not replace clinical judgment for patients with unstable and/or reduced renal function.

Thalakada, Rosanne; Legal, Michael; Lau, Tim T Y; Luey, Tiffany; Batterink, Josh; Ensom, Mary H H

2012-01-01

305

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

Microsoft Academic Search

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

Dave H. Lewis; Dan J. Smith

2004-01-01

306

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

ERIC Educational Resources Information Center

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

Hollander, Marcus J.; Macurdy, E. Ann

307

Tree-ring analysis of yellow-cedar ( Chamaecyparis nootkatensis ) on Vancouver Island, British Columbia  

Microsoft Academic Search

Yellow-cedar (Chamaecyparis nootkatensis(D. Don) Spach) are the oldest known coniferous trees in Canada. This paper reports on the first dendrochronological investigation of yellow-cedar trees at montane sites on Vancouver Island. Mature yellow-cedar trees were selected for study at four sites along a 200-km northwest-southeast transect. Trees older than 500 years were common at three of the four sites, with numerous

Colin P. Laroque; Dan J. Smith

1999-01-01

308

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

PubMed Central

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

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

2014-01-01

309

[Systematic controlled placenta birth: analysis of 200 cases recruited at the general hospital of Abobo (Abidjan, Côte d'Ivoire)].  

PubMed

Haemorrhage of placenta birth is one of the main reasons of maternal mortality in developing countries. The control of this third stage of delivery remains one of the means to stem the scourge. This survey shows that controlled placenta birth is a safe mean to reach this objective: 200 women who had normal vaginal deliveries at the Abobo North hospital were included in the survey. Among them, one hundred women had a controlled placenta birth whereas 100 had a normal one. The analysis of the results showed that: the haemorrhage rates during placenta birth slightly decrease in the group with controlled placenta birth and are clearly lower in the group of patients with risks factors of haemorrhage in 10% of the cases; the delay of placenta birth is twice shorter in the group having a controlled placenta birth than in the group with normal placenta birth; blood loss in the group with controlled placenta birth is three times less important than in the other group. This study speaks in favour of a systematic controlled placenta birth during the third stage of labour as it is already performed elsewhere. PMID:18432007

Ecra, A Touré; Horo, A; Fanny, M; Ouattara, H; Adjoussou, S; Koné, M

2008-02-01

310

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

SciTech Connect

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

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

1984-01-01

311

A review of Providencia bacteremia in a general hospital, with a comment on patterns of antimicrobial sensitivity and use.  

PubMed Central

Six cases of Providencia bacteremia occurring between 1969 and 1978 were reviewed. These cases represented 3% of the gram-negative bacteremias occurring at one hospital. All six cases of Providencia bacteremia were secondary to urinary tract infection with P. stuartii, and in most the infection developed only shortly before the onset of bacteremia; in three cases the bacteremia developed immediately following manipulation of the urinary tract. Patients with long-standing Providencia infections did not acquire bacteremia. The signs and symptoms of Providencia bacteremia were typical of those of septicemia except that vascular collapse was not a prominent feature, occurring in only one patient. The mortality was 33%. All the Providencia strains cultured from the bloodstream were susceptible to gentamicin, although the frequency of gentamicin resistance increased from roughly 10% to 50% during the period studied; the increase in gentamicin use over this period was more gradual. Also noted was a decrease in resistance to ampicillin that paralleled a decrease in ampicillin use. All the Providencia strains were susceptible to amikacin.

Prentice, B; Robinson, B L

1979-01-01

312

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

PubMed Central

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

1991-01-01

313

Tidal current energy assessment for Johnstone Strait, Vancouver Island  

Microsoft Academic Search

Abstract: The maximum tidal power potential of Johnstone Strait, BC, Canada is evaluated using a two-dimensional,finite element,model,(TIDE2D) with,turbines,simulated,in certain regions by increasing the drag. Initially, side channels are closed off so that the flow is forced through,one channel,to test the validity of a general analytic theory [1] with numerical,results. In this case, the modelled power potential of 886 MW agrees

G Sutherland; M Foreman; C Garrett

2007-01-01

314

Psychiatric consultations and therapy recommendations following a suicide attempt in a general hospital and their associations with selected parameters in a 1-year period.  

PubMed

Abstract Objective. Our study aims to determine the frequency and distribution of suicide attempts according to the patients' characteristics and type of suicide attempt as well as the method of treatment proposed by the consultation-liaison service in a general hospital. Methods. This retrospective naturalistic study covers a 1-year period (2012), during which 51 suicide attempters were hospitalised in the Charité Berlin, Campus Benjamin Franklin, Germany. The following data were analysed: method of suicide, account of prior psychiatric history and medication, as well as the acute psychiatric diagnosis and treatment - including pharmacotherapy. Results. Most of the patients were diagnosed with a psychiatric illness. Major depressive disorder was the most frequent diagnosis in consultation. Treatment recommendations more often entailed further psychiatric treatment than medication. In the cases where medication was indeed given, benzodiazepines were the most frequently prescribed. Conclusions. Most of the suicide attempters needed further therapy in psychiatric hospitals. A specialised pharmacotherapy (antidepressants, mood stabilisers) was rarely recommended by the psychiatric consultation service. The psychiatric consultation and therapy recommendations are important in guiding future acute treatment procedures. PMID:24236906

Tauch, Deborah; Winkel, Susanne; Quante, Arnim

2014-06-01

315

Day-case surgery in children under 2 years of age: experience in a district general hospital and survey of parental satisfaction.  

PubMed

One surgeon's experience of day-case paediatric surgery in a population aged less than 2 years at a district general hospital is reported. During a 6-year period from 1989 to 1994, 82 day-case operations were performed in 79 infants and young children. All children were managed by a multidisciplinary team including surgeon, paediatric anaesthetist and paediatric nurses. There was no mortality and minimal morbidity. A telephone survey of parents enquiring into satisfaction with all aspects of pre-, peri-, and post-operative care revealed that the procedures are well-accepted. The survey also showed that there was no increased utilization of primary health care professionals when day-case surgery is performed in this young age group. We conclude that paediatric day-case surgery is safe and well-tolerated by both infants and parents and is suitable for performance in non-specialist centres provided a team approach is adopted. PMID:8997032

Stiff, G; Haray, P N; Chilcott, M; Williams, I; Watkins, G; Foster, M E

1996-12-01

316

Elective abdominal aortic aneurysm operations--the results of a single surgeon series of 243 consecutive operations from a district general hospital.  

PubMed Central

BACKGROUND: There are few data on the morbidity and mortality of planned elective surgery for infrarenal abdominal aortic aneurysm (AAA) as a single surgeon series. This audit is of a consecutive series of AAA operations performed by one surgeon in one district general hospital over a 13-year period. METHODS: 243 patients were operated on for AAA between 1985 and 1998. Data were collected on the majority of patients prospectively. A reliable method was devised to identify all patients. Any missing complication and mortality data were then collected retrospectively. RESULTS: 13 patients died as a result of their operation (5.3%). In patients over the age of 80 years (36), five patients died (14%) and in the 207 patients under the age of 80 years, eight died (3.8%). Cardiac deaths were the most frequent cause (38%); 82 patients had recorded complications (34%). The operative mortality rate has increased in later years, (2.2% to 7.1%), largely due to an increase in the very elderly accepted for operation (12% to 16%), and a possible increase in co-morbidity. CONCLUSIONS: An acceptable and comparable mortality rate can be achieved in a district general hospital. The complication rate is high indicating the need for very intense medical and nursing care for these patients postoperatively. There is a considerable variance in mortality rates with age and risk even in the practice of one surgeon, indicating a need to be very knowledgeable and cautious in interpreting postoperative mortality data. This is the largest single surgeon series to date in the UK.

Humphreys, W. V.; Byrne, J.; James, W.

2000-01-01

317

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

318

PMM.06?Five-year experience of maternal cardiac disease in a district general hospital 2008-2012.  

PubMed

: CMACE 2008 has shown that the overall rate of mortality from cardiac disease has tripled over the last two decades being, the largest cause of indirect maternal death; mainly due to acquired heart disease. With the current increase in older mothers, obesity, immigration and survival of babies operated on for congenital heart disease, the need to identify women at risk of heart disease and to plan their careful management is crucial. Early identification of risk factors include hypertension, pre-eclampsia, diabetes, smoking, obesity and hyperlipidaemia and a multidisciplinary management improves maternal and foetal outcomes. General principles include a MDT approach with obstetrician, physician and regular monitoring. A 5-year retrospective survey of 31 women with cardiac disease was carried out in a Joint clinic. (3200 deliveries annually). Data included demographics, type of heart disease, medical, drug history, pregnancy management, delivery place, outcomes. 19 primigravida,14 multipara; all except one were all Caucasian. The most frequent reasons for referral were congenital heart disease or surgery for it, (n = 13) valve disease (n = 9) and arrhythmias (n = 8). Also, chemotherapy induced cardiomyopathy, pericarditis and neurocardiogenic syncope. All women were booked into the clinic by 12 weeks. 24 (73%) had ECG, 25 (76%) echocardiography. 10 women had foetal echocardiogram in pregnancy (all normal). 79% women had cardiology referral, 34% anaesthetic referral. 29 (93%) pregnancies were delivered locally while 4 delivered in a tertiary unit. 19 women delivered vaginally, 7 had emergency CS while 4 planned CS. 1 had a PPH and 1 admission to NNU. Maternal cardiac disease management in a joint clinic shows good outcomes. PMID:25021003

Old, A; Arya, R; Macleod, K; Verma, A; Chattington, P

2014-06-01

319

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

PubMed Central

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

Stitt, Tyler; Mountifield, Julie; Stephen, Craig

2007-01-01

320

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

PubMed Central

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

2011-01-01

321

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

USGS Publications Warehouse

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

Laenen, Antonius; Solin, Gary L.

1978-01-01

322

NICE guideline for the management of head injury: an audit demonstrating its impact on a district general hospital, with a cost analysis for England and Wales  

PubMed Central

Objectives To answer concerns related to implementation of the National Institute for Clinical Excellence (NICE) guideline on the management of head injury by determining the impact on the workload of a district general hospital. Increased computed tomography (CT) was of particular concern (cost, radiation risk, and delivery constraints). Method Retrospective audit of all patients attending the hospital's emergency department with a head injury over a three month period. Any reattendees for the same head injury episode were excluded but the need for CT was recorded. Case notes and electronic records were reviewed to determine whether the CT head or skull radiograph (SXR) was indicated in line with the NICE guideline. The workload was compared with an identical audit performed before the implementation of the NICE guideline. Results Of 17?472 patients attending the ED in 2004, 472 had a head injury. CT scan was indicated in 36, a significant increase from 2003 (p<0.001). No SXR was indicated but two were performed, a significant decrease (p<0.001). The admission rate was unaltered. The positive predictive value of NICE was 17.1% compared with 25% (p?=?not significant) for the authors' pre?NICE departmental guideline. Conclusions This department has seen an increase in CT head requests since the implementation of the NICE guideline. This costs an extra £15?000 per 100 head injuries annually for this department, with an estimated £51.7 million burden for England and Wales. Further evaluation is required as there were only nine brain injuries in this audit population.

Shravat, B P; Huseyin, T S; Hynes, K A

2006-01-01

323

The effect of electronic medical record application on the length of stay in a Chinese general hospital: a department- and disease-focused interrupted time-series study.  

PubMed

A key purpose of electronic medical records (EMR) introduced in medical institutions is to improve work efficiency. The average length of stay (LOS) is just an important indicator to evaluate work efficiency of medical care in hospitals. Recently, there have been reports about effects of EMR application on LOS in medical institutions, but they have been mostly based on the overall analysis of a region or a hospital and not of specific clinical departments and diseases or based on longer time periods. Therefore, in this study, we selected four clinical departments and four diseases with the largest number of inpatients from January 2004 to December 2012 in a Chinese 3A general hospital and used an interrupted time-series method by the departments and diseases to analyze the relationship of EMR application and LOS. Through our analyses, we concluded that, under unadjusted condition, LOS were all reduced (P?

Yang, Peng; Cao, Yi; Liu, Danhong; Bai, Yuxiang; Pan, Feng; Xu, Yongyong

2014-05-01

324

THE GREATER VANCOUVER WATER DISTRICT - AN ECOLOGICAL INVENTORY APPROACH TO FIRE HAZARD ASSESSMENT AND TREATMENT FOR PROTECTION OF WATER QUALITY AND OTHER SECONDARY VALUES  

Microsoft Academic Search

In 1992 the Greater Vancouver Water District began an extensive ecological inventory of its three water- sheds (53,600 ha) that serve as the drinking water source for the Greater Vancouver Region. The focus of the inventory, which integrates physical and eco- logical information, was to provide watershed manag- ers with a better understanding of the physical and ecological processes within

B. A. Blackwell; R. N. Green; Hedberg B. A. Blackwell; D. Ohlson

325

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

PubMed

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

Novak, Colin W; Goater, Timothy M

2013-02-01

326

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

327

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

328

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

329

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

PubMed

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

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

1989-08-01

330

Esthesioneuroblastoma: an update on the massachusetts eye and ear infirmary and massachusetts general hospital experience with craniofacial resection, proton beam radiation, and chemotherapy.  

PubMed

Objectives?To update the Massachusetts General Hospital (MGH) and Massachusetts Eye and Ear Infirmary (MEEI) experience in the management of esthesioneuroblastoma (ENB) with multimodality therapy and to reassess treatment outcomes and complications in a larger cohort with longer follow-up times. Design?A retrospective chart review. Setting?A tertiary referral center. Participants?All patients presenting with ENB and managed at the MGH and MEEI from 1997 to 2013. Main Outcome Measures?Disease-free and overall survival. Results?Twenty-two patients were identified with an average follow-up of 73 months. Ten patients presented with Kadish stage B disease and 12 with stage C disease. A total of six patients (27%) developed regional metastases. Treatment for all patients included craniofacial resection (CFR) followed by proton beam irradiation with or without chemotherapy. The 5-year disease-free and overall survival rates were 86.4% and 95.2%, respectively, by Kaplan-Meier analysis. Negative margins were a significant factor in disease-free survival. One patient experienced severe late-radiation toxicity. Conclusions?ENB is safely and effectively treated with CFR followed by proton beam irradiation. The high incidence of regional metastases warrants strong consideration for elective neck irradiation. Proton beam radiation is associated with lower rates of severe late-radiation toxicity than conventional radiotherapy. PMID:24498591

Herr, Marc W; Sethi, Rosh K V; Meier, Joshua C; Chambers, Kyle J; Remenschneider, Aaron; Chan, Annie; Curry, William T; Barker, Fred G; Deschler, Daniel G; Lin, Derrick T

2014-02-01

331

Comparative cost analysis of generalized anxiety disorder and major depressive disorder patients in secondary care from a national hospital registry in Finland.  

PubMed

Abstract Background: Major depressive disorder (MDD) has shown to cause high costs to society. Earlier research indicates that generalized anxiety disorder (GAD) also causes high costs, but only limited data is available in varying settings. Aims: To analyse the secondary care costs of GAD compared with those of MDD. Methods: Retrospective database analysis from Finnish Hospital Discharge Registers (FHDR). All GAD and MDD patients diagnosed between 1 January 2007 and 31 December 2007 in FHDR were recorded and individual-level secondary care costs during a 48-month follow-up period were measured. Results: The total mean cost of GAD with history of MDD or some other anxiety disorder was significantly higher than that of MDD with history of GAD or some other anxiety disorder during the 48-month follow-up period. The costs of pure GAD were comparable with those of pure MDD, but after adjusting for age and sex, the costs of pure MDD were higher than those of pure GAD. Conclusions: The economic burden of individual GAD patients is comparable with that of MDD patients in secondary care. PMID:23931684

Kujanpää, Tero; Ylisaukko-Oja, Tero; Jokelainen, Jari; Linna, Miika; Timonen, Markku

2014-07-01

332

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

PubMed Central

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

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

2014-01-01

333

A cohort study to analyze the risk of venous thromboembolism mortality in patients admitted to the general medicine department, tan tock seng hospital, singapore.  

PubMed

The purpose of this study was to assess the risk of venous thromboembolism (VTE) in patients admitted to the Tan Tock Seng Hospital (TTSH), Singapore during October and November 2009. The primary outcome assessed was mortality due to VTE, or development of deep vein thrombosis or pulmonary embolism (PE) within 3 months from the day of admission. Both univariate and multivariate analyses were performed for all-cause mortality and deaths associated with PE. Seven hundred twenty-one patients admitted to the 5th floor of the General Medicine Department, TTSH, during the 2 months were analyzed. There were 368 (51.04%) female patients and 353 (48.96%) male patients. As per race distribution, 566 (78.50%) patients were Chinese, 100 (13.86%) patients were Malaysians, 46 (6.38%) patients were Indians, and 9 (1.26%) were other races. Four hundred ninety-two (68.24%) were independent for activities of daily living (ADL) and 229 (31.76%) were dependent for all ADL. There were in all 42 deaths. There were definite PE deaths in 2 (4.76%) patients, probable PE deaths in 3 (7.14%) patients, and suspected PE deaths in 8 (19.05%) patients. Twenty (47.62%) deaths were due to pneumonia, 3 (7.14%) deaths were due to urinary tract infections, and 4 (9.52%) deaths were due to other infections. Two (4.76%) deaths were due to myocardial infarction. The risk of VTE was high in acutely ill patients admitted to the General Medicine Department, TTSH, Singapore. The factors that predispose patients to a very high risk are ADL dependence, acute heart failure, past history of VTE, or if they are clinically dehydrated and have acute renal failure. This warrants increased awareness and need for VTE prophylaxis. PMID:22654470

Sule, Ashish Anil; Chin, Tay Jam; Sinnathamby, Letchumi; Lee, Hwei Khien; Earnest, Arul

2011-06-01

334

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

2012-08-01

335

Three-dimensional travel time tomography of the gas hydrate area offshore Vancouver Island based on OBS data  

Microsoft Academic Search

This dissertation presents results from a complex seismic study using Ocean Bottom Seismometers (OBS) conducted at a site of deep sea gas hydrate occurrence. The site is located on the accretionary margin of the northern Cascadia subduction zone offshore Vancouver Island, Canada. The major objectives for this study were the construction of a 3-D velocity model around the Bullseye vent

Mikhail Mikhailovich Zykov

2006-01-01

336

Distribution of diatom surface sediment assemblages within Effingham Inlet, a temperate fjord on the west coast of Vancouver Island (Canada)  

Microsoft Academic Search

Twenty-nine surface sediment samples from Effingham Inlet, a small fjord on the west coast of Vancouver Island, British Columbia, were analyzed for diatoms. This fjord has been selected for paleoceanographic investigation due to the presence of laminated sediments resulting from the dysoxic to anoxic bottom water conditions in the inner and outer basins of the inlet. Distributional patterns of the

Murray B Hay; Reinhard Pienitz; Richard E Thomson

2003-01-01

337

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

338

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

Microsoft Academic Search

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

Ji-Yeon Shin

2010-01-01

339

Ethno-Cultural Differences in the Use of Alcohol and Other Drugs: Evidence from the Vancouver Youth Drug Reporting System  

Microsoft Academic Search

This article reports on ethno-cultural differences in the use of alcohol and other drugs by using data derived from the Vancouver Youth Drug Reporting System. Data were collected between May and August 2006 among a sample of 514 youth aged 16 to 25. Statistically significant ethno-cultural differences were reported for “lifetime” alcohol and other drugs prevalence; alcohol and other drugs

Cameron Duff; Ajay K. Puri; Clifton Chow

2011-01-01

340

Feeding rates and abundance of marine invertebrate planktonic larvae under harmful algal bloom conditions off Vancouver Island  

Microsoft Academic Search

The interactions between toxic phytoplankton and their potential grazers are poorly understood aspects of the ecology of harmful algal blooms. In this study, we determined the feeding rates, prey selection and trophic impact of different marine invertebrate planktonic larvae on the natural bloom of Heterosigma akashiwo and Prorocentrum triestinum which occurred on the west coast of Vancouver Island in July

Rodrigo Almeda; Amber M. Messmer; Nagore Sampedro; Louis A. Gosselin

2011-01-01

341

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

342

An Analysis of Certain Factors in the Diffusion of Innovations in Nursing Practice in the Public General Hospitals of the Province of British Columbia.  

ERIC Educational Resources Information Center

The study analyzed the process of diffusion as it functions in regard to changes in nursing practice in a selected segment of Canadian hospitals. Three aspects of diffusion were investigated: (1) the flow of new information in nursing through a newwork of hospitals; (2) factors affecting the adoption of new nursing practices; and (3) factors…

DuGas, Beverly Writter

343

Risk factors for elevated HIV incidence rates among female injection drug users in Vancouver  

PubMed Central

Background In 1997, we found a higher prevalence of HIV among female than among male injection drug users in Vancouver. Factors associated with HIV incidence among women in this setting were unknown. In the present study, we sought to compare HIV incidence rates among male and female injection drug users in Vancouver and to compare factors associated with HIV seroconversion. Methods This analysis was based on 939 participants recruited between May 1996 and December 2000 who were seronegative at enrolment with at least one follow-up visit completed, and who were studied prospectively until March 2001. 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. Results As of March 2001, seroconversion had occurred in 110 of 939 participants (64 men, 46 women), yielding a cumulative incidence rate of HIV at 48 months of 13.4% (95% confidence interval [CI] 11.0%–15.8%). Incidence was higher among women than among men (16.6% v. 11.7%, p = 0.074). Multivariate analysis of the female participants' practices revealed injecting cocaine once or more per day compared with injecting less than once per day (adjusted relative risk [RR] 2.6, 95% CI 1.4–4.8), requiring help injecting compared with not requiring such assistance (adjusted RR 2.1, 95% CI 1.1–3.8), having unsafe sex with a regular partner compared with not having unsafe sex with a regular partner (adjusted RR 2.9, 95% CI 0.9–9.5) and having an HIV-positive sex partner compared with not having an HIV-positive sex partner (adjusted RR 2.7, 95% CI 1.0–7.7) to be independent predictors of time to HIV seroconversion. Among male participants, injecting cocaine once or more per day compared with injecting less than once per day (adjusted RR 3.3, 95% CI 1.9–5.6), self-reporting identification as an Aboriginal compared with not self-reporting identification as an Aboriginal (adjusted RR 2.5, 95% CI 1.4–4.2) and borrowing needles compared with not borrowing needles (adjusted RR 2.0, 95% CI 1.1–3.4) were independent predictors of HIV infection. Interpretation HIV incidence rates among female injection drug users in Vancouver are about 40% higher than those of male injection drug users. Different risk factors for seroconversion for women as opposed to men suggest that sex-specific prevention initiatives are urgently required.

Spittal, Patricia M.; Craib, Kevin J.P.; Wood, Evan; Laliberte, Nancy; Li, Kathy; Tyndall, Mark W.; O'Shaughnessy, Michael V.; Schechter, Martin T.

2002-01-01

344

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

345

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

346

2014 Consensus Statement from the first Economics of Physical Inactivity Consensus (EPIC) Conference (Vancouver).  

PubMed

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

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

2014-06-01

347

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

PubMed Central

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

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

2014-01-01

348

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

PubMed Central

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

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

2013-01-01

349

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

PubMed Central

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

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

2014-01-01

350

Office of Inspector General; Medicare program; prospective payment system for hospital outpatient services. Health Care Financing Administration (HCFA), HHS, and Office of Inspector General (OIG), HHS. Final rule with comment period.  

PubMed

This final rule with comment period implements a prospective payment system for hospital outpatient services furnished to Medicare beneficiaries, as set forth in section 1833(t) of the Social Security Act. It also establishes requirements for provider departments and provider-based entities, and it implements section 9343(c) of the Omnibus Budget Reconciliation Act of 1986, which prohibits Medicare payment for nonphysician services furnished to a hospital outpatient by a provider or supplier other than a hospital, unless the services are furnished under an arrangement with the hospital. In addition, this rule establishes in regulations the extension of reductions in payment for costs of hospital outpatient services required by section 4522 of the Balanced Budget Act of 1997, as amended by section 201(k) of the Balanced Budget Refinement Act of 1999. PMID:11010643

2000-04-01

351

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

PubMed Central

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

2012-01-01

352

How accurate is the diagnosis of exercise induced asthma among Vancouver schoolchildren?  

PubMed Central

Background: Limited access to exercise testing facilities means that the diagnosis of exercise induced asthma (EIA) is mainly based on self-reported respiratory symptoms. This is open to error since the correlation between exercise related symptoms and subsequent exercise testing has been shown to be poor. Aim: To study the accuracy of clinically diagnosed EIA among Vancouver schoolchildren. Methods: Fifty two children referred for investigation of poorly controlled EIA were studied. Following a careful history and physical examination, children performed pulmonary function tests before, then 5 and 15 minutes after a standardised treadmill exercise test. Based on overall assessment, a diagnostic explanation for each child's respiratory complaints was provided as far as possible. Results: Only eight children (15.4%) fulfilled diagnostic criteria for EIA (fall in FEV1 ?10%). Of the remainder: 12 (23.1%) were unfit, 14 (26.9%) had vocal cord dysfunction/sigh dyspnoea, 7 (13.5%) had a habit cough, and 11 (21.1%) had no abnormalities on clinical or laboratory testing, so were given no diagnosis. Initial reported symptoms of wheeze or cough often changed significantly following a careful history, particularly among the eight elite athletes. The final complaint was sometimes not respiratory, and, in a few cases, was not even associated with exercise. Conclusions: The clinical diagnosis of EIA is inaccurate among Vancouver schoolchildren, principally due to the unreliability of their initial exercise related complaints. Symptom exaggeration, familiarity with medical jargon, and psychogenic complaints are all common. A careful history is essential in this population before basing any diagnosis on self-reported respiratory symptoms.

Seear, M; Wensley, D; West, N

2005-01-01

353

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

PubMed Central

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

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

2014-01-01

354

General anesthesia  

MedlinePLUS

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

355

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

PubMed

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

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

2014-01-01

356

Hospital structure and consumer satisfaction.  

PubMed Central

This study examines the relationship between hospital structural characteristics and patient satisfaction with hospital care. Teaching hospitals and private hospitals were expected to receive higher ratings of patient satisfaction than were nonteaching and government-controlled hospitals, because they generally are reputed to be technologically superior. Results show that, in general, most patients are satisfied with their hospital stays, but they are clearly more dissatisfied with their stays in teaching hospitals. Although a number of other correlates of patient satisfaction with the hospital stay are identified, no measure succeeds in reducing to insignificance the strong relationship between teaching status and dissatisfaction. Some suggestions are made as to why teaching hospital receive relatively poor evaluations from their patients.

Fleming, G V

1981-01-01

357

First-trimester pregnancy scanning as a screening tool for high-risk and abnormal pregnancies in a district general hospital setting.  

PubMed

This study set out to evaluate the feasibility and acceptability of routine early ultrasound (12-14 weeks) within a district general hospital (DGH) for identifying high-risk and abnormal pregnancies. This was a pilot study for screening by ultrasound examination all women who presented to their community midwife before 12 weeks' gestation. The study involved 991 women who presented clinically pregnant before 12 weeks' gestation between May 1998 and May 1999. Women were offered routinely two ultrasound examinations during their pregnancy, the first at 12-14 weeks' gestation and the second at 20-21 weeks' gestation. The main outcome measures were: range and number of abnormal/high-risk pregnancies identified during an ultrasound scan at 12-14 weeks' gestation; range and number of abnormalities diagnosed during scans at later gestations; outcomes of the pregnancies; questionnaires assessing how the women viewed early pregnancy ultrasound as a method of screening. Nine hundred and eighty-four (99%) women accepted the offer of an early ultrasound scan at 12-14 weeks' gestation; of these 840(85%) women accepted screening for trisomy 21 (T21) by fetal nuchal translucency thickness (NT) and maternal age (fetal medicine foundation risk assessment programme) and this was completed successfully in 797(80%) of cases. Twenty-four women (2%) had a failed pregnancy and where necessary an ERPC was performed following a planned admission. Thirty pregnancies (3%) were diagnosed as abnormal or having high risk of abnormality at the early scan. A major abnormality was confirmed before the expected anomaly scan at 20 weeks in five (17%) pregnancies; all of these patients opted for an elective termination. Twenty-six (3%) pregnancies had a diagnosis of abnormality at their anomaly scan. Of these, three pregnancies were diagnosed as major abnormalities with two resulting in termination of the affected pregnancy before 24 weeks' gestation. Eight hundred and thirty-seven women (85%) completed questionnaires, 833 women (84.5%) were satisfied with the counselling they received before the ultrasound scan and 827 women (84%) answered that they would accept an early pregnancy scan if offered during their next pregnancy. Early pregnancy ultrasound at 12-14 weeks' gestation can be used as an effective method of identifying and screening for major abnormalities of pregnancy within a DGH setting, but it is appropriate to use this in conjunction with an anomaly scan at around 20 weeks' gestation. Women found this method of screening acceptable. PMID:12521697

Drysdale, Karen; Ridley, D; Walker, Karry; Higgins, B; Dean, Taraneh

2002-03-01

358

Skin growths of the head and neck region in elderly patients--analysis of two five-year periods in General Hospital Karlovac, Croatia.  

PubMed

Skin lesions, benign and malignant, are more common in the older than younger people. Due to the aging of the skin and greater exposure to the impact of ultraviolet rays, their long-term cumulative negative effect, skin lesions are more common in the head and neck area than on other parts of the skin. This paper analyses the pathohistological diagnosis of material after the surgical excision of tumors of the skin on the head and neck of persons older than 60, at the General Hospital Karlovac through two five-year period. The first period is the period from 2006 to 2010 and the second one from 1996 to 2000. The aim was to determine for each period the type and variety of skin lesions, the prevalence of the disease, the age and gender structure, and finally to compare the two periods. The total number of excisions in the first period was 1200, and in the second 513. In both periods more excisions was done in women than men, if compared it comes to 1.4:1. The ratio of malignant (basocellular carcinoma, squamous cell carcinoma and melanomas), and benign tumors (seborrheic keratoses, moles and others) in the first period was 49.3 to 46.3%, and in the second 56.7 to 42.1%. Precancerous lesions (actinic keratoses and Mb Bowen's disease) accounted for 4.3% of lesions in the first and 1.2% in the second period. The total number of basocellular carcinoma was 481/232, which makes 81.3% of all malignant tumors in the first, or 79.7% in the second period. Our results showed that around half of all skin lesions removed in both periods consisted of malignant tumors, among which the most common were basal cell carcinomas. High prevalence of malignant non-melanoma skin cancers, 48.7 and 56%, indicate the importance of protection from UV radiation, and early detection and treatment of skin cancer and precancerous lesions. PMID:22220434

Aleri?, Zorica; Bauer, Vladimir

2011-09-01

359

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

360

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

361

Hospital Topics: The Hospital Consultant's Secretary  

PubMed Central

Analysis of work done by the secretaries attached to one medical unit in a general hospital showed that much was discretionary in character and entailed making decisions. Work in the unit was made easier and more efficient by this intelligent use of initiative by the secretaries. At present the pay given to medical secretaries in hospital is below a level that would be commensurate with their responsibility.

Gooch, J. H.; Harcourt, R. A. F.; Ibbetson, J. F. R.; Whitmore, D. A.

1972-01-01

362

[An epidemiological evaluation of the incidence of detecting markers of hepatitis B and C viral infection in the blood of the medical personnel of a large general hospital].  

PubMed

Virus hepatitis B and C are widespread human diseases of viral etiology, characterized by a common mechanism of the transmission of their etiological agents. The study of the routes of transmission of these infections in hospitals and the epidemiological characterization of the occurrence of the markers of hepatitis B and C among the medical personnel working in therapeutic and prophylactic institutions (TPI) are highly important problems. The data obtained in our investigations make it possible to determine the irregular character of the detection rate of the markers of virus infection among the medical personnel in different departments of a large hospital and to give explanation for such irregularity. A high morbidity rate in virus hepatitis B and C among the medical personnel continues to be one of serious problem facing TPI, and the improvement of the methods of their prevention is still a highly important task of hospital epidemiology. PMID:9304325

Akimkin, V G; Lytsar', B N; Skvortsov, S V; Samokhodskaia, L M; Aristarkhova, I V; Symakova, I A; D'iachuk, E K

1997-01-01

363

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

PubMed

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

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

2013-03-01

364

An autonomous multibeam, sidescan, and subbottom survey of a methane hydrate outcrop in Barkley Canyon, offshore Vancouver Island  

Microsoft Academic Search

We have used the MBARI Mapping AUV (autonomous underwater vehicle) to conduct a multibeam bathymetry, subbottom, and sidescan survey of a massive, partially exposed hydrate deposit found in Barkley Canyon, off-shore Vancouver Island. The Mapping AUV is a torpedo-shaped, 6000 m rated vehicle designed and constructed by MBARI. The vehicle is equipped with a 200 kHz multibeam sonar, 110 kHz

D. W. Caress; H. J. Thomas; W. J. Kirkwood; P. G. Brewer

2006-01-01

365

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

366

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

367

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

NASA Astrophysics Data System (ADS)

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

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

2002-12-01

368

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

ERIC Educational Resources Information Center

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

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

369

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

Microsoft Academic Search

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

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

2007-01-01

370

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

371

Treatment of Vancouver B3 periprosthetic femur fractures with a fluted tapered stem.  

PubMed

Periprosthetic femur fractures around a hip arthroplasty associated with a loose stem and severely deficient or comminuted bone typically have been treated with substitution for the proximal femur using an allograft prosthetic composite or a tumor prosthesis. Eight patients (mean age, 68 years; range, 34-80 years) with Vancouver Type B3 femur fractures were treated with revision using a long modular fluted tapered uncemented stem with retention of the proximal femur. Access to the failed prosthesis and joint was gained through the fracture or osteotomy and soft tissue attachments to the fracture fragments were maintained. One patient died within 1 week. The remaining patients were followed up 1 to 2 years (mean, 1.5 years). At final followup, all patients had stable implants and all acute fractures were healed. Marked reconstitution of proximal femoral bone stock was observed consistently. All surviving patients were ambulatory and none had more than mild pain. The preliminary results of this method show a high rate of stable implant fixation and fracture healing with preservation and reconstitution of the host femur. PMID:14646721

Berry, Daniel J

2003-12-01

372

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

PubMed Central

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

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

2013-01-01

373

Prevalence and antimicrobial susceptibility of extended-spectrum beta-lactamase-producing bacteria in intensive care units of Sanandaj general hospitals (Kurdistan, Iran).  

PubMed

This study focused on analyzing the spread of extended-spectrum beta-lactamase (ESBL) enzymes among Gram-negative bacteria at intensive care units (ICUs). Between January 2007 and January 2008, 301 consecutive clinical isolates of Gram-negative type were isolated. Of these, 66 strains were collected from patients in ICUs in two major hospitals in Sanandaj (Kurdistan, Iran). The isolates were identified, tested for antimicrobial susceptibility, and analyzed for the presence of ESBL using the double-disk synergy test. Isolates with a positive ESBL phenotype were subjected to PCR for SHV, TEM, OXA and CTX-M beta-lactamase gene families. Sixty-six Gram-negative bacteria were isolated from clinical samples of 66 ICU patients. These isolates included 16 Escherichia coli, 28 Enterobacter spp., 5 Pseudomonas spp., 10 Klebsiella pneumoniae, 3 Serratia marcescens and 1 Stenotrophomonas maltophilia. Twenty-three (34.85%) of these isolates were ESBL producing. The ESBL genes detected were SHV, TEM, OXA-1, OXA-2 and CTX-M. The results show the presence of ESBL genes among Gram-negative bacteria in the ICU setting of Sanandaj's hospitals. There is a need to institute a strict hospital infection control policy and regular surveillance of bacterial resistance to antimicrobial agents. PMID:19521074

Ramazanzadeh, Rashid; Chitsaz, Mohsen; Bahmani, Nasrin

2009-01-01

374

Globally dispersed mobile drug-resistance genes in Gram-negative bacterial isolates from patients with bloodstream infections in a US urban general hospital  

PubMed Central

Mobile drug-resistance genes with identical nucleic acid sequences carried by multidrug-resistant Escherichia coli strains that cause community-acquired infections are becomingly increasingly dispersed worldwide. Over a 2-year period, we analysed Gram-negative bacterial (GNB) pathogens from the blood of inpatients at an urban public hospital to determine what proportion of these isolates carried such globally dispersed drug-resistance genes. Of 376 GNB isolates, 167 (44?%) were Escherichia coli, 50 (13?%) were Klebsiella pneumoniae, 25 (7?%) were Pseudomonas aeruginosa, 25 (7?%) were Proteus mirabilis and 20 (5?%) were Enterobacter cloacae; the remainder (24?%) comprised 26 different GNB species. Among E. coli isolates, class 1 integrons were detected in 64 (38?%). The most common integron gene cassette configuration was dfrA17-aadA5, found in 30 (25?%) of 119 drug-resistant E. coli isolates and in one isolate of Moraxella morganii. Extended-spectrum ?-lactamase (ESBL) genes were found in 16 E. coli isolates (10?%). These genes with identical sequences were found in nearly 40?% of bloodstream E. coli isolates in the study hospital, as well as in a variety of bacterial species from clinical and non-clinical sources worldwide. Thus, a substantial proportion of bloodstream infections among hospitalized patients were caused by E. coli strains carrying drug-resistance genes that are dispersed globally in a wide variety of bacterial species.

Adams-Sapper, S.; Sergeevna-Selezneva, J.; Tartof, S.; Raphael, E.; Diep, B. An; Perdreau-Remington, F.

2012-01-01

375

[The malaria epidemic in Antananarivo from 1983 to 1994 as seen through the Pediatric Service A in the Befelatanana General Hospital].  

PubMed

We report the symptoms of children affected by an epidemy of a serious form of malaria which raged in Tananarive from 1983 to 1994. These data are based on the hospital registers for the "Debré" room of the Pediatric Service "A" in the Befelatanana Hospital, and underline a few points as follows. In terms of morbidity, the epidemy started in 1984, reached a peak in 1988 (26.7% of the admitted), and started to spread in 1992. Boys and girls were equally affected, with the majority of children being 5 years old or more (51 to 58% of the cases). Most of the ill were coming from the suburbs (66.5%) in addition to those from the center (33.5%) of the city of Tananarive. At the peak of the epidemy, nearly half of the children had serious paludism (48.9%). Plasmodium falciparum was the causative parasite in 98.3% of the cases. Mortality did not seem to be influenced by the sex, age or residence of the children, but the two factors always encountered were malnutrition and late hospitalization. Treatment based on the use of quinine enabled the elimination of mortality by neuropaludism in 1991 to 1992. However, in 1993 and 1994, we are witnessing a reappearance of mortality apparently linked to the decline of the nutritional state of the ill. PMID:8784544

Razanamparany, M S; Randriamiharisoa, F A; Razanamparany, N J; Ramialimanana, V

1995-01-01

376

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

PubMed

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

Whiteside, A

1996-01-01

377

Compare Hospitals  

MedlinePLUS

... to making information about the safety, quality, and efficiency of their hospital available to the public. We ... Hospitals that implement these quality, safety, and/or efficiency practices have reported that their internal processes of ...

378

Multiple barriers against successful care provision for depressed patients in general internal medicine in a Japanese rural hospital: a cross-sectional study  

Microsoft Academic Search

BACKGROUND: A general internist has an important role in primary care, especially for the elderly in rural areas of Japan. Although effective intervention models for depressed patients in general practice and primary care settings have been developed in the US and UK medical systems, there is little information regarding even the recognition rate and prescription rate of psychotropic medication by

Tsuyuka Ohtsuki; Masatoshi Inagaki; Yuetsu Oikawa; Akiyoshi Saitoh; Mie Kurosawa; Kumiko Muramatsu; Mitsuhiko Yamada

2010-01-01

379

Cascadiacarpa spinosa gen. et sp. nov. (Fagaceae): castaneoid fruits from the Eocene of Vancouver Island, Canada.  

PubMed

Documenting the paleodiversity of well-studied angiosperm families serves to broaden their circumscription while also providing a time-specific reference point to mark the first occurrence of characters and appearance of lineages. More than 80 anatomically preserved specimens of spiny, cupulate fruits in various developmental stages have been studied from the Eocene Appian Way locality of Vancouver Island, British Columbia, Canada. Details of internal anatomy and external morphology are known for the cupules, fruits, and pedicels. Cupule spines branch and are often borne in clusters. Cupules lack clear sutures and are adnate to a single nut that is enclosed entirely with the exception of the apical stylar protrusion of the pistil. A central hollow cylinder of vascular tissue can be seen extending up the peduncle to the base of the fruit and along the inner wall of the cupule. The fruit has a sclerotic outer pericarp that grades into a parenchymatous mesocarp and a sclerotic endocarp lining the locules. Early in development, the two locules are divided by a thin septum to which the ovules are attached. Only one seed develops to maturity as evidenced by an embryo occupying the locule alongside an abortive apical ovule. Three-dimensional reconstructions of these fruits have allowed for comparisons to both extinct and extant fagaceous taxa. The Appian Way fruits are most similar to extant Castanopsis species (Fagaceae) but differ in having only two locules. Cascadiacarpa spinosa gen. et sp. nov. Mindell, Stockey et Beard is the first occurence of a bipartite gynoecium and earliest known occurrence of hypogeous fruits in Fagaceae. The appearance of Casacadiacarpa in the Eocene of British Columbia supports a Paleogene radiation of the family. The numerous derived characters of these fruits show that evalvate, spiny, single-fruited cupules of Fagaceae were present in the Paleogene of North America. PMID:21636406

Mindell, Randal A; Stockey, Ruth A; Beard, Graham

2007-03-01

380

Mental hospitals in India.  

PubMed

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

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

2000-04-01

381

[Day Hospital: history and conceptualization].  

PubMed

The appearance of Day Hospitals operated as a model to inspire the different ways of partial time psychiatric care (night hospitals, weekend hospitals, long hour activities in hospitalization services or general hospitals, etc.) and came to complement or replace complete hospitalization in classic psychiatric hospitals. This article presents the history and origins of Day Hospitals and their initial propagation in different countries, and especially in Argentina. Social and political conditions that set their emergence as a therapeutic resource in psychiatry, their models of functioning and variants of application according to the diagnoses of patients admitted, age groups, etc., the theories put into play to report their effects, several studies and technical results, and ideological views related to mental disorders and their treatment in the society are also being studied. PMID:23139920

Stagnaro, Juan C

2012-01-01

382

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

USGS Publications Warehouse

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

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

1995-01-01

383

[Mortality in the surgical unit of a general hospital. Study of 27 postoperative deaths among patients operated on during 1990-1492].  

PubMed

This study takes in account all post operative deaths during the year 1990 in one surgical Professorial unit of Lille academic hospital (France). During this year, 1492 consecutive patients underwent surgery. The mean age of deceased patients was 63.7 years. 15 died after emergency procedure and 12 after elective surgery. Lastly 2 patients died without any operation. The most common condition encountered in those cases was oesophageal carcinoma, thereafter gastric or duodenal complicated peptic ulcer, and finally colonic carcinoma and diverticular disease. 13 patients had neoplasia (45%). From a critical point of view, 14 patients died after surgical indication or procedure of questionable legitimacy. The comparison with a similar study conducted five years ago and the analysis of these charts allow us to reaffirm some basic principles of surgery. PMID:1761598

Proye, C; Martinot, J C; Triboulet, J P; Carnaille, B; Sautier, M; Dromer, D; Camp, D

1991-11-01

384

What doctors tell patients with breast cancer about diagnosis and treatment: findings from a study in general hospitals. GIVIO (Interdisciplinary Group for Cancer Care Evaluation) Italy.  

PubMed Central

In a study aimed at assessing whether and how patients with breast cancer are informed on their diagnosis and treatment a large group of physicians participating in a quality of care evaluation program were asked to report what they told patients about diagnosis and treatment. The completeness of such communication was then assessed using an explicit protocol designed to measure precision and lack of ambiguity of reported phrases. By this measure 39% patients received 'thorough' information on diagnosis and 11% 'detailed' information on surgery. These proportions become 48% and 14%, respectively, when only cases for whom answers were available are considered. Physicians, however, considered this communication 'thorough' for 69% of patients. Among patient-related characteristics, age, education and stage of disease were independent predictors of quality of information. Setting-dependent features more than individual provider attitudes seemed to account for at least part of the quality of information sharing behaviour as both hospital size (comparing centres larger than 500 beds and smaller ones) and degree of hospital organization (comparing centres adhering to the Italian Breast Cancer Task Force, FONCaM and those not) were - simultaneously - significant predictors of quality of communication, independently from patients' case-mix. Physicians' judgement - measured assuming the explicit protocol as standard - proved to be of acceptable sensitivity only when information was 'Thorough' by the protocol. However, its specificity and predictive values were consistently low in all three categories defined by the protocol, leading to high misclassification rates. The implications of these findings for studies aimed at assessing the quality of patients-providers communication are discussed.

1986-01-01

385

A 3D, finite element model for baroclinic circulation on the Vancouver Island continental shelf  

USGS Publications Warehouse

This paper describes the development and application of a 3-dimensional model of the barotropic and baroclinic circulation on the continental shelf west of Vancouver Island, Canada. A previous study with a 2D barotropic model and field data revealed that several tidal constituents have a significant baroclinic component (the K1 in particular). Thus we embarked on another study with a 3D model to study the baroclinic effects on the residual and several selected tidal constituents. The 3D model uses a harmonic expansion in time and a finite element discretization in space. All nonlinear terms are retained, including quadratic bottom stress, advection and wave transport (continuity nonlinearity). The equations are solved as a global and a local problem, where the global problem is the solution of the wave equation formulation of the shallow water equations, and the local problem is the solution of the momentum equation for the vertical velocity profile. These equations are coupled to the advection-diffusion equation for density so that density gradient forcing is included in the momentum equations. However, the study presented here describes diagnostic calculations for the baroclinic residual circulation only. The model is sufficiently efficient that it encourages sensitivity testing with a large number of model runs. In this sense, the model is akin to an extension of analytical solutions to the domain of irregular geometry and bottom topography where this parameter space can be explored in some detail. In particular, the consequences of the sigma coordinate system used by the model are explored. Test cases using an idealized representation of the continental shelf, shelf break and shelf slope, lead to an estimation of the velocity errors caused by interpolation errors inherent in the sigma coordinate system. On the basis of these estimates, the computational grid used in the 2D model is found to have inadequate resolution. Thus a new grid is generated with increased accuracy in the region of the shelf break. However, even with increased resolution, spurious baroclinic circulation seaward of the shelf break and in the vicinity of Juan de Fuca canyon remained a significant problem when the pressure gradient terms were evaluated using the ?? coordinate system and using a realistic density profile. With the new grid, diagnostic calculations of the barotropic and baroclinic residual circulation are performed using forcing from the observed ??t (density) field and from the gradient of this field. ?? 1992.

Walters, R. A.; Foreman, M. G. G.

1992-01-01

386

The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia.  

PubMed

The classification working group of the International Society of Urological Pathology consensus conference on renal neoplasia was in charge of making recommendations regarding additions and changes to the current World Health Organization Classification of Renal Tumors (2004). Members of the group performed an exhaustive literature review, assessed the results of the preconference survey and participated in the consensus conference discussion and polling activities. On the basis of the above inputs, there was consensus that 5 entities should be recognized as new distinct epithelial tumors within the classification system: tubulocystic renal cell carcinoma (RCC), acquired cystic disease-associated RCC, clear cell (tubulo) papillary RCC, the MiT family translocation RCCs (in particular t(6;11) RCC), and hereditary leiomyomatosis RCC syndrome-associated RCC. In addition, there are 3 rare carcinomas that were considered as emerging or provisional new entities: thyroid-like follicular RCC; succinate dehydrogenase B deficiency-associated RCC; and ALK translocation RCC. Further reports of these entities are required to better understand the nature and behavior of these highly unusual tumors. There were a number of new concepts and suggested modifications to the existing World Health Organization 2004 categories. Within the clear cell RCC group, it was agreed upon that multicystic clear cell RCC is best considered as a neoplasm of low malignant potential. There was agreement that subtyping of papillary RCC is of value and that the oncocytic variant of papillary RCC should not be considered as a distinct entity. The hybrid oncocytic chromophobe tumor, which is an indolent tumor that occurs in 3 settings, namely Birt-Hogg-Dubé Syndrome, renal oncocytosis, and as a sporadic neoplasm, was placed, for the time being, within the chromophobe RCC category. Recent advances related to collecting duct carcinoma, renal medullary carcinoma, and mucinous spindle cell and tubular RCC were elucidated. Outside of the epithelial category, advances in our understanding of angiomyolipoma, including the epithelioid and epithelial cystic variants, were considered. In addition, the apparent relationship between cystic nephroma and mixed epithelial and stromal tumor was discussed, with the consensus that these tumors form a spectrum of neoplasia. Finally, it was thought that the synovial sarcoma should be removed from the mixed epithelial and mesenchymal category and placed within the sarcoma group. The new classification is to be referred to as the International Society of Urological Pathology Vancouver Classification of Renal Neoplasia. PMID:24025519

Srigley, John R; Delahunt, Brett; Eble, John N; Egevad, Lars; Epstein, Jonathan I; Grignon, David; Hes, Ondrej; Moch, Holger; Montironi, Rodolfo; Tickoo, Satish K; Zhou, Ming; Argani, Pedram

2013-10-01

387

A Content Analysis of Media Coverage of the Introduction of a Smoke-Free Bylaw in Vancouver Parks and Beaches  

PubMed Central

The Board of Parks and Recreation in Vancouver, BC approved a smoke-free bylaw in the city’s parks, beaches and recreational facilities, effective 1 September 2010. We analyzed local news coverage and portrayal of the bylaw to understand the potential influence of news media on public perception of the bylaw in order to inform the media advocacy work of public health interest groups. We compiled a data set of newspaper articles (n = 90) and conducted a quantitative content analysis to examine content related to the outdoor smoke-free policy, including article slant, topics related to smoking and tobacco control, and any equity-related concerns raised. Newspaper coverage in Vancouver was largely supportive of the outdoor smoke-free bylaw. However, concerns over rights were frequently discussed in letters to the editor. Such equity concerns were rarely discussed in news articles, showing a potential disconnect between the concerns expressed in the media by members of the public and the coverage provided by print media.

Moshrefzadeh, Arezu; Rice, Wendy; Pederson, Ann; Okoli, Chizimuzo T. C.

2013-01-01

388

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

PubMed

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

Ross, Becki

2012-01-01

389

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

PubMed Central

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

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

2014-01-01

390

Hospital Preparedness and SARS  

PubMed Central

On May 23, 2003, Toronto experienced the second phase of a severe acute respiratory syndrome (SARS) outbreak. Ninety cases were confirmed, and >620 potential cases were managed. More than 9,000 persons had contact with confirmed or potential case-patients; many required quarantine. The main hospital involved during the second outbreak was North York General Hospital. We review this hospital’s response to, and management of, this outbreak, including such factors as building preparation and engineering, personnel, departmental workload, policies and documentation, infection control, personal protective equipment, training and education, public health, management and administration, follow-up of SARS patients, and psychological and psychosocial management and research. We also make recommendations for other institutions to prepare for future outbreaks, regardless of their origin.

Wallington, Tamara; Rutledge, Tim; Mederski, Barbara; Rose, Keith; Kwolek, Sue; McRitchie, Donna; Ali, Azra; Wolff, Bryan; White, Diane; Glassman, Edward; Ofner, Marianna; Low, Don E.; Berger, Lisa; McGeer, Allison; Wong, Tom; Baron, David; Berall, Glenn

2004-01-01

391

Predictors of early hospital readmission in HIV-infected patients with pneumonia  

Microsoft Academic Search

OBJECTIVE: Although hospitalization patterns have been studied, little is known about hospital readmission among HIV-infected patients\\u000a in the era of highly active antiretroviral therapy. We explored the risk factors for early readmission to a tertiary care\\u000a inner-city hospital among HIV-infected patients with pneumonia in Vancouver, Canada.\\u000a \\u000a \\u000a DESIGN: Case-control study.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Tertiary care, university-affiliated, inner-city hospital.\\u000a \\u000a \\u000a \\u000a \\u000a PARTICIPANTS: All HIV-infected patients who

Anita Palepu; Huiying Sun; Laura Kuyper; Martin T. Schechter; Michael V. O’Shaughnessy; Aslam H. Anis

2003-01-01

392

[Success factors in hospital management].  

PubMed

The hospital environment of most Western countries is currently undergoing dramatic changes. Competition among hospitals is increasing, and economic issues have become decisive factors for the allocation of medical care. Hospitals therefore require management tools to respond to these changes adequately. The balanced scorecard is a method of enabling development and implementation of a business strategy that equally respects the financial requirements, the needs of the customers, process development, and organizational learning. This method was used to derive generally valid success factors for hospital management based on an analysis of an academic hospital in Switzerland. Strategic management, the focus of medical services, customer orientation, and integration of professional groups across the hospital value chain were identified as success factors for hospital management. PMID:10023551

Heberer, M

1998-12-01

393

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

PubMed Central

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

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

2014-01-01

394

[Conscious survey of dental patients. 1. Questionnaire related to general dentistry (in the case of the new patients of the Nippon Dental University Hospital)].  

PubMed

Increased information on dentistry in the mass media in recent years may have caused changes in patients' attitudes toward dental care. To better understand patient' attitudes, we conducted a questionnaire survey of patients on the first visit to our hospital. Of 384 responses, 196 were eligible for statistical analysis. The following findings were obtained. 1. Among the motives for visiting a dental clinic, "Manifestation of pain or symptoms" was given by majority (85.7%) of respondents, followed by "detection of abnormality" (20.4%). The percentage of patients wanting treatment of "any part suggested by the dentist" was highest (35.7%), followed by those expecting "treatment including cleaning" (30.1%). The above results indicate that patients still tend to visit a clinical after subjective symptoms appear and leave the content of treatment to the dentist. However, an increasing number of patients appear to be concerned with their oral condition and visit a clinic before manifestation of symptoms. 2. Among factors in selecting their dentist, "expertise" obtained the highest percentage, 87.2%, followed by "providing prompt treatment" (38.8%) and "trying to avoid pain" (32.1%), in that order. Dissatisfaction with dentists was described as "no explanation of treatment" in 57.1%, "lack of sympathetic attitude" in 38.3% and "easily resorts to tooth extraction" in 35.4%. These results suggest that patients expect good human relations with their dentists, sufficient explanations of treatments and sympathetic consideration, as well as expertise. 3. The majority of patients (85.7%) hoped to receive instructions on oral hygiene and to be increased interest in information above prophylaxis. Meeting their needs will remain a future issue for dentists. PMID:2489300

Ozawa, Y; Kobayashi, T; Sato, M; Masaya, M; Uchikawa, Y; Tosaka, S; Uchikura, Y; Takahashi, K; Shibata, M; Noda, M

1989-08-01

395

Hospital Waste Management in theTeaching Hospitals of Karachi  

Microsoft Academic Search

Objective: To evaluate the current practices of segregation approaches, storage arrangements, collection and disposal systems in the teaching hospitals of Karachi. Methods: A cross-sectional survey was conducted in eight teaching hospitals of Karachi, using convenient sam- pling technique. The instrument of research was a self administered questionnaire, with four sections, relating to the general information of the institution, administrative information,

Shahida Rasheed; Saira Iqbal; Lubna A. Baig; Kehkashan Mufti

396

42 CFR 35.1 - Hospital and station rules.  

Code of Federal Regulations, 2012 CFR

...Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.1 Hospital and station rules. The officer in charge of a station or hospital of the Service is...

2012-10-01

397

42 CFR 35.2 - Compliance with hospital rules.  

Code of Federal Regulations, 2012 CFR

...Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.2 Compliance with hospital rules. All patients and visitors in stations and hospitals of the...

2012-10-01

398

15. Photographic copy of historic photograph, Portsmouth Naval Hospital Building, ...  

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

15. Photographic copy of historic photograph, Portsmouth Naval Hospital Building, view of southeast elevation, 1901. (Portsmouth Naval Shipyard Museum, Portsmouth, VA) - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

399

12. 1960 highrise hospital, front (south) facade, view to northwest ...  

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

12. 1960 high-rise hospital, front (south) facade, view to northwest - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

400

13. Photographic copy of historic photograph, Portsmouth Naval Hospital Building, ...  

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

13. Photographic copy of historic photograph, Portsmouth Naval Hospital Building, ca. 1875-1876. (Portsmouth Naval Shipyard Museum, Portsmouth, VA) - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

401

8. Hospital Point, pier and boat house (now Visiting Officer's ...  

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

8. Hospital Point, pier and boat house (now Visiting Officer's Quarters), view to east - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

402

6. Hospital Point, stairs at northwest bulkhead, view to north ...  

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

6. Hospital Point, stairs at northwest bulkhead, view to north - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

403

42 CFR 35.2 - Compliance with hospital rules.  

Code of Federal Regulations, 2013 CFR

... 2013-10-01 2013-10-01 false Compliance with hospital rules. 35.2 Section 35...STATION MANAGEMENT General § 35.2 Compliance with hospital rules. All patients and visitors in stations and hospitals of...

2013-10-01

404

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

PubMed Central

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

2013-01-01

405

Hospital fundamentals.  

PubMed

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

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

2014-07-01

406

Hospitality Management Education and Training.  

ERIC Educational Resources Information Center

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

Brotherton, Bob, Ed.; And Others

1995-01-01

407

Magmatic and tectonic history of the Leech River Complex, Vancouver Island, British Columbia: Evidence for ridge-trench intersection and accretion of the Crescent Terrane  

Microsoft Academic Search

The Leech River Complex, part of the Pacifi c Rim Terrane, is a Cretaceous metasedimentary and metaigneous assemblage on southern Vancouver Island. The Leech River Complex is fault-bounded between the Eocene Metchosin Igneous Com- plex to the south (part of the Crescent Terrane) and the Paleozoic to Jurassic Wrangel Terrane to the north and provides critical information on the evolution

Wesley G. Groome; Derek J. Thorkelson; Richard M. Friedman; James K. Mortensen; Nick W. D. Massey; Daniel D. Marshall; Paul W. Layer

408

Special report: highlights of the twenty-fifth annual summer meeting of the American Orthopaedic Foot and Ankle Society, Vancouver, Canada, July 16-18, 2009.  

PubMed

The Twenty-fifth Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society (AOFAS) was held 16-18 July 2009 at the Westin Bayshore Hotel in Vancouver, British Columbia, Canada. There were 521 registered attendees, including 339 (65%) individuals from 42 of the United States and 182 (35%) attendees from 32 countries outside the United States. PMID:21276565

Trepman, Elly; Thordarson, David B; Anderson, Robert B; Davis, W Hodges

2011-03-01

409

CART Decision-Tree Statistical Analysis and Prediction of Summer Season Maximum Surface Ozone for the Vancouver, Montreal, and Atlantic Regions of Canada  

Microsoft Academic Search

Prediction of daily maximum surface ozone (O3) concentration was begun by Environment Canada in the spring of 1993 for the Vancouver, Montreal, and Atlantic regions in order to advise the public of expected air quality. Forecasts have been issued for southern Ontario for many years by the province of Ontario, but this is a new undertaking in other parts of

William R. Burrows; Mario Benjamin; Stephen Beauchamp; Edward R. Lord; Douglas McCollor; Bruce Thomson

1995-01-01

410

Verification of an ENSO-Based Long-Range Prediction of Anomalous Weather Conditions During the Vancouver 2010 Olympics and Paralympics  

NASA Astrophysics Data System (ADS)

A brief review of the anomalous weather conditions during the Vancouver 2010 Winter Olympic and Paralympic Games and the efforts to predict these anomalies based on some preceding El Niño-Southern Oscillation (ENSO) signals are presented. It is shown that the Olympic Games were held under extraordinarily warm conditions in February 2010, with monthly mean temperature anomalies of +2.2 °C in Vancouver and +2.8 °C in Whistler, ranking respectively as the highest and the second highest in the past 30 years (1981-2010). The warm conditions continued, but became less anomalous, in March 2010 for the Paralympic Games. While the precipitation amounts in the area remained near normal through this winter, the lack of snow due to warm conditions created numerous media headlines and practical problems for the alpine competitions. A statistical model was developed on the premise that February and March temperatures in the Vancouver area could be predicted using an ENSO signal with considerable lead time. This model successfully predicted the warmer-than-normal, lower-snowfall conditions for the Vancouver 2010 Winter Olympics and Paralympics.

Mo, Ruping; Joe, Paul I.; Doyle, Chris; Whitfield, Paul H.

2014-01-01

411

Reflection on 10 Years of Community-Engaged Scholarship in the Faculty of Land and Food Systems at the University of British Columbia-Vancouver  

ERIC Educational Resources Information Center

In this article, the authors describe a cultural transformation to embrace community-engaged scholarship by faculty members in the Faculty of Land and Food Systems at the University of British Columbia-Vancouver. They describe a transition from community-inquiry faculty projects to community-engaged action research projects achieved through…

Rojas, Alejandro; Sipos, Yona; Valley, Will

2012-01-01

412

Welfare Checks, Drug Consumption, and Health: Evidence from Vancouver Injection Drug Users  

Microsoft Academic Search

This paper investigates the link between welfare payments and drug use among injection drug users. We find an increase in the likelihood of an overdose in the days following check arrival, and in the probability of leaving the hospital against medical advice (AMA) on check day. Using the check arrival date as an instrument, we estimate the Local Average Treatment

Chris Riddell; Rosemarie Riddell

2006-01-01

413

Welfare Checks, Drug Consumption, and Health: Evidence from Vancouver Injection Drug Users  

ERIC Educational Resources Information Center

This paper investigates the link between welfare payments and drug use among injection drug users. The authors find an increase in the likelihood of an overdose in the days following check arrival, and in the probability of leaving the hospital against medical advice (AMA) on check day. Using the check arrival date as an instrument, we estimate…

Riddell, Chris; Riddell, Rosemarie

2006-01-01

414

Economies of Scale and Scope: The Case of Specialty Hospitals  

Microsoft Academic Search

Research Objective: The recent growth of physician-owned hospitals specializing in cardiac, orthopedic, and surgical specialty services (specialty hospitals) in the U.S. has generated considerable controversy, yet there is little understanding of the economic logic of organizing hospital services around these single specialties. Because specialty hospitals are small relative to the general hospitals with which they compete, an important economic question

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

2010-01-01

415

Patient-related factors influencing satisfaction in the patient-doctor encounters at the general outpatient clinic of the university of calabar teaching hospital, calabar, Nigeria.  

PubMed

Medical consultation is at the centre of clinical practice. Satisfaction of a patient with this process is a major determinant of the clinical outcome. This study sought to determine the proportion of patients who were satisfied with their docto