Forging a partnership in information systems. The case of Vancouver Hospital.
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British Columbia↗
Biomedical subjects
M Martin
Publications and source records attributed to M Martin.
[Occupational accidents in Barcelona (Spain), from 1992 to 1993].
INTRODUCTION: The statistics related to labor accidents as with any other notification system ought to be the basis for programs and policies with a view to the adoption of preventive measures. In order to establish preventive norms, however, the health system needs data from researchers focussing on the dynamics of and the pitfalls revealed by specific events. Within this context the main objective of this study is to proceed with an in-depth analysis of the labor accidents verified in Barcelona (Spain) using for this purpose a descriptive statistics model to test variables such as type of accident, economic sector, economic enterprise and type of labor contract. METHOD: The data source utilized was the notification system for labor accidents with grave consequences such as death of the victim registered in Barcelona during the period 1992-1993. Labor accidents registered for male workers numbered 848. A log-linear model was applied to this data base. RESULTS AND CONCLUSIONS: The results show a positive association between traumatic accidents with the construction, traffic and services sectors. A positive association was also found between traumatic accidents and the size of the company concerved the small ones being the worse type in terms of worker's injuries. Regarding the nontraumatic accidents, the study showed a positive correlation between large-sized enterprises and type of temporary worker and the civil construction sector as compared to workers with long term work contracts within industry and services. There was some evidence, also, of a positive association between small and medium sized companies and temporary work and the occurrence of work accidents.
Accidents, Occupational↗
Generalizing everyday memory: signs and handedness.
Memory for frequently encountered road signs was investigated. In Experiment 1, the average level of recall of road sign features was found to be only 47%. In Experiment 2, more left-handed than right-handed people recalled that a walking figure faces right on one sign, whereas more right-handed than left-handed people recalled that a digging figure faces left on another sign. Performance thus reflected not a difference in level of mnemonic ability between left-handed and right-handed groups but instead the compatibility between group and task. In Experiment 3, participants were asked to draw any figure walking and any figure digging, with a pattern of results similar to that of Experiment 2. It is suggested that handedness effects in recall are mediated by motor imagery.
Adolescent↗
Considerations and contemplation on reflective practice.
In thinking through practice reflections Margi uses images and text to contemplate the form of conversation when spiritual/ elemental experience enables a person or family to reconnect the layers of their everyday world with the heart or centre of their being.
Communication↗
[Institutionalisation and professionalisation of (occupational) medicine in Germany].
In the first tierce of XIX century the necessity of steps for the health care of working people on the side of medicine and also of the state was perceived. The claims for the producing of the appropriate structural and coneptional conditions led to the creation of work medicine as a sphere, that developed in Germany in relation to political values, social-political programs and medical models. An acknowledgement gained such conception of work medicine and less on the medical work prevention. The notion of work medicine was related with the insurance system from 1883/84 against the unlucky accidents and diseases. The process of institutionalisation and professionalisation of medicine in Germany from the beginning was formed by coexistence of different sociological sciences and mixture of various groups of interest, intending an influence on the form of both processes. This constelation caused a sluggish and slow progress. For example astonishing is the time needed by the work medicine for its stabilisation as a knowledge at the universities. We may go out from presupposition, that the broadening of the industrial production brings chances to this part of medicine having interest in negative consequences of this progress for the human health. However the university teachers regarded the work medicine existed on the edge of medical sciences till the time after the second world war. The progress came thanks to the impulses of single physicians, who beginning in 7-years of the XVIII century published increasing amounts of papers on the work medicine (handicraft and industrial hygiene). Some organizations were created whose interests concerned the work health damaging aspects. A special role had the German Society of Handicraft-Industrial Hygiene, founded in 1922.
Germany↗
The Use of Nonprescription Weight Loss Products Among Female Basketball, Softball, and Volleyball Athletes from NCAA Division I Institutions: Issues and Concerns.
OBJECTIVE: To identify and describe the use of nonprescription weight loss products among female basketball, softball, and volleyball players from NCAA Division I institutions and to address health and sports performance issues concerning the use of weight loss products by female athletes. DESIGN AND SETTING: Mailed self-reporting questionnaire, sample of convenience. The Department of Physical Education at the University of South Carolina sponsored this study. SUBJECTS: The researchers sent 371 questionnaires to NCAA Division I athletic trainers of ten basketball teams, ten softball teams, and eleven volleyball teams. The recipients returned all of the questionnaires. Of the subjects, 106 played basketball, 138 played softball, and 127 played volleyball. MEASUREMENTS: A survey consisting of nine questions related to the use of weight loss products by NCAA Division I female athletes. RESULTS: Approximately 29% of the subjects reported using nonprescription weight loss products, which included general weight-reducing products, diuretics, and laxatives. More volleyball players (71%) used all types of these products than did softball (32%) or basketball (11.3%) players. More white athletes (32.3%) reported using the products than did African American athletes (6.7%). More volleyball players (23.6%) used diuretics than did softball (3.6%) or basketball (1.0%) players. Laxative use was greatest among volleyball players (18.8%), followed by basketball (1.8%) and softball (2.9%) players. Subjects typically reported purchasing nonprescription weight loss products over the counter (96.4%). The mean age of initial use was 16.2 years. Frequency of use increased during the out-of-sport season. The number one reason for using nonprescription weight loss products was for appearance enhancement (79.6%). CONCLUSIONS: Based upon the results of this study, the use of nonprescription weight loss products is particularly common among volleyball players, but softball and basketball players also use them. Most subjects used these products during the out-of-sport season; therefore, information and intervention programs should target out-of-season use patterns. These programs should address the effects weight loss products have on sports performance and general health and should address issues relating to physical appearance.
Journal Article↗
The Use of Alcohol Among NCAA Division I Female College Basketball, Softball, and Volleyball Athletes.
OBJECTIVE: To identify and describe alcohol use among NCAA Division I female college basketball, softball, and volleyball players and to determine to what extent the players have been exposed to alcohol or other drug education programs. DESIGN AND SETTING: Mailed self-reporting questionnaire, sample of convenience. The study was conducted in the Department of Physical Education at the University of South Carolina. SUBJECTS: NCAA Division I athletic trainers of ten female basketball teams, ten female softball teams, and eleven female volleyball teams received questionnaires. A total of 371 participants returned questionnaires: 106 basketball players, 138 softball players, and 127 volleyball players. MEASUREMENTS: After reviewing the related literature, I developed a questionnaire and pilot tested it with a group of female swimmers and track and field athletes. The questionnaire consisted of three sections: demographic information, alcohol use, and alcohol education. I analyzed the questionnaires descriptively (frequencies, percentages, and means) and collectively, on the total population, and separately, on all teams. To validate and further understand information gained from the questionnaires, I conducted multiple face-to-face interviews with forty (11%) of the participants. RESULTS: Almost 79% of the subjects consumed alcohol, with light beers being the most popular beverage. Most started using alcohol before 18 years of age. More softball (89.1%) and volleyball (88.9%) athletes reported drinking than did basketball (63.2%) athletes. Quantity and frequency of alcohol use decreased during the competitive sport season but increased out of season. Almost 60% (55.9%) of the participants engaged in binge drinking (defined as four or more drinks per drinking episode) out of season and 35% in season. Female athletes who lived off campus drank more frequently than those who lived in residence halls, but athletes living in residence halls reported drinking in larger quantities. The most common reasons subjects chose not to use alcohol included the effects alcohol has on health and sports performance, coaches' rules, dislike of the taste of alcohol, and concerns about weight gain. Those who chose to use alcohol did so mostly for social purposes. Most subjects received 4 to 8 hours of alcohol education in lecture sessions during their college careers. The majority wanted additional education, especially with regard to the effects of alcohol on sports performance. CONCLUSIONS: Based upon the results of this study, alcohol education has little impact on alcohol use among NCAA Division I female basketball, softball, and volleyball players, particularly out of season. Most choose to use alcohol simply to have fun. Because alcohol affects athletic performance, female athletes tend to use less alcohol in season. Future studies should address the types of alcohol prevention and intervention methods used during out-of-season and in-season periods. Correlation studies should investigate relationships between these programs and alcohol use among female athletes. A broader population of athletes from various sports (eg, field hockey, golf, gymnastics, tennis, soccer, and swimming) should also be investigated.
Journal Article↗
Paclitaxel plus vinorelbine in metastatic breast Ca patients with contraindications to receive anthracyclines.
Thirty-three metastatic breast cancer patients with prior chemotherapy (adjuvant alone, 9 patients; chemotherapy for metastatic disease alone, 13 patients; chemotherapy for both, 11 patients) received paclitaxel (Taxol) 135 mg/m2 over 1 h followed by vinorelbine (Navelbine) 30 mg/m2 over 10 minutes on day 1 every 3 weeks. All patients had contraindications to receive anthracycline therapy (primary resistance, 10 patients; dose reaching the maximum recommended dose and/or myocardiopathy, 23 patients). Twenty-eight patients had previously received anthracyclines, and the remaining 5 had received prior CMF (cyclophosphamide, methotrexate, fluorouracil). The combination of paclitaxel plus vinorelbine was given as first-line chemotherapy for metastatic disease to 9 patients and as second- or third-line to the remaining 24 patients. The mean number of metastatic sites was 2 (range 1-5). Twenty-two patients had visceral involvement. Overall, 3 complete and 13 partial responses were observed among the 33 patients (objective response rate 48.5%, 95% confidence interval 31% to 66.5%). The response rate in patients receiving the regimen as first-line chemotherapy was 67% (6/9 patients), compared to 42% (10/24) in those receiving the regimen as second- or third-line chemotherapy. Primary anthracycline-resistant patients showed a response rate of 60% (6/10), whereas the remaining patients had a response rate of 43.5% (10/23). The main toxicities were grade 3 alopecia (92%), grade 3-4 neutropenia (28%), neutropenic fever (16%), grade 1-2 peripheral neuropathy (44%), arthralgias-myalgias (32%), and hypersensitivity reactions (8%). Phlebitis was a significant clinical problem in patients receiving the drugs through a peripheral vein.
Adult↗
An investigation of antibiotic prescribing by general dental practitioners: a pilot study.
PURPOSE OF STUDY: This pilot study was designed to investigate how general dental practitioners prescribe antibiotics. METHODS: A total of 200 prescriptions were selected at random from 1775 prescriptions dispensed in 55 pharmacies across a Liverpool district. The type of antibiotic prescribed, the duration, frequency and dose were analysed. The legibility and any other errors or omissions were also noted. RESULTS: The legibility of the prescriptions was good with very few errors or omissions from the patient details. Seven different types of antibiotics were used with amoxycillin being the most frequently prescribed (64.5%), followed by metronidazole (21.5%). Penicillin, erythromycin, clindamycin, tetracycline and cephradine were the other antibiotics prescribed. There was a wide variation in the duration, frequency and doses prescribed. CONCLUSION: The results of this pilot study show that many practitioners prescribe antibiotics for inappropriately long periods and with inconsistent frequency and duration.
Anti-Bacterial Agents↗
A model to examine the validity of the 6-month abstinence criterion for liver transplantation.
Six months of abstinence from alcohol is a commonly used criterion for liver transplantation eligibility for patients with alcoholic cirrhosis. There is limited evidence to document the validity of this criterion with regard to risk of alcoholism relapse. Ninety-one patients with alcoholic cirrhosis were interviewed for relapse risk using the High Risk Alcoholism Relapse (HRAR) Scale. The HRAR model can be used to predict relapse risk independent of duration of sobriety and therefore can be used to examine the validity of the 6 months of abstinence criteria in this clinical population. The two methods demonstrated poor to fair agreement. Agreement was highest with a cutoff allowing a 5% 6-month relapse risk when 79% agreement (c = 0.56) was demonstrated between the two methods. Using the 6-month abstinence criterion alone disallows a significant number of candidates who have a low relapse risk based on their HRAR score. The validity of the 6-month abstinence criterion is supported somewhat by comparison with the HRAR model. However, use of the 6-month abstinence criterion alone forces a significant number of patients with a low relapse risk by HRAR to wait for transplant listing. A relapse risk model based on an estimate of alcoholism severity in addition to duration of sobriety may more accurately select patients who are most likely to benefit from liver transplantation.
Adult↗
Beliefs about diabetes and diabetic complications.
A study of people with non-insulin dependent diabetes found that, generally, they had a good understanding of its complications although over half believed they personally were not vulnerable. Non-diabetic subjects had limited knowledge in this area.
Adult↗
Competency-based instruction in critical invasive skills improves both resident performance and patient safety.
BACKGROUND: Correct performance of invasive skills is essential, but residents often undertake such procedures after no or minimal instruction. METHODS: We instructed eight postgraduate year 1 (PGY1) residents in the cadaver laboratory using a competency-based approach (CBI). Each resident had been evaluated before the laboratory during patient encounters. Group instruction in endotracheal tube insertion (ET), venous cutdown (VC), and chest tube insertion (CT) was followed by individual pretesting and hands-on teaching, with 100% competency the goal. Failure was considered an inability to perform the task correctly or within 120 seconds. After the laboratory, residents were evaluated for correctness and rapidity of performance. RESULTS: Prelaboratory failures consisted of ET, 7; CT, 5; VC, 7. Postlaboratory failures were 0 for all. Prelaboratory complications consisted of ET, 3.3 +/- 1.1; CT, 1.9 +/- 1.0; VC, 3 +/- 1.0. Postlaboratory complications were 0 for all. Prelaboratory times (seconds) were ET, 66.5 +/- 30.8; CT, 104 +/- 4.1; VC, 116.3 +/- 0.7. Postlaboratory times were ET, 25 +/- 7; CT, 65.5 +/- 10.7; VC, 81.3 +/- 2.5. Changes were statistically significant for all (P < .03, nonparametric). Residents performed 20 CTs with 1 pneumothorax, 80 ETs with 2 failures, and 20 VCs with no complications. Initial trauma resuscitation time decreased from 25 to 10 minutes. CONCLUSIONS: (1) Residents' skills rapidly improve with CBI; (2) skills learned through CBI in the laboratory can be translated to and sustained in the clinical setting; (3) CBI produces competent residents who perform skills rapidly and with minimal complications.
Cadaver↗
Body composition and biochemical profile as affected by diet and renal transplantation among renal patients.
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Adult↗
Achieving the right balance with strategic planning.
Nurse executives must be involved with their organization's strategic management and marketing process, keep abreast of business trends and shifts, and at the same time find a good balance between nursing and business administration. An overview of the strategic planning models helps managers apply the process to health care, and in particular, nursing administration.
Decision Making, Organizational↗
Techniques for quantification of cytokine mRNAs.
Various methods are currently used to monitor cytokine mRNA expression levels in clinical samples. In instances where sample size is limited (e.g. biopsies), amplification procedures such as reverse transcription followed by polymerase chain reaction amplification appear to be the only ones that are currently useful. This paper provides a review of such techniques for the detection and quantitation of cytokine message in clinical samples, and compares semiquantitative and competitive techniques in terms of sensitivity, reproducibility, feasibility and costs.
Animals↗
Delivery of therapeutic doses of radioiodine using bispecific antibody-targeted bivalent haptens.
UNLABELLED: Two-step pretargeting strategies have been designed to deliver radioisotopes to tumors more selectively than directly labeled antibodies or fragments. In this article, we compare quantitatively the potential of these strategies for the radioimmunotherapy of solid tumors. METHODS: Direct targeting was performed using iodine-labeled IgG and F(ab')2. As two-step strategies, we used the sequential injection of anti-CEA x anti-DTPA-In bispecific F(ab')2 (BsF(ab')2) and monovalent and bivalent DTPA derivatives labeled with iodine. The biodistribution of iodine in nude mice grafted with the LS174T human colorectal carcinoma was monitored in time and used for calculating radiation doses. RESULTS: In agreement with earlier studies, the IgG was more effective for delivering a radiation dose to the tumor than the F(ab')2 (7.8 versus 0.76 Gy/MBq, respectively) and both were moderately selective with respect to normal tissues (tumor:blood of 2.9 and 1.7, respectively). At their MTD, they should deliver 86 and 34 Gy, respectively, to the tumor. Using a nM-affinity DTPA-In bivalent hapten, the two-step protocol was optimized by varying the dosage of the BsF(ab')2, the stoichiometry of the reagents and the pretargeting time. The saturation of the tumor was obtained by injecting 5 nmol (500 microg) of BsF(ab')2. The pretargeted BsF(ab')2 was saturated by the injection of 0.5 mol of bivalent hapten per mole of antibody. With a 48-hr pretargeting time, the selectivity of the irradiation of the tumor was optimized (tumor:blood of 7.8) but only at the price of a lower efficiency (0.35 versus 0.86 Gy/MBq, 48-hr and 20-hr pretargeting time, respectively). Attempts to increase selectivity by using a microM-affinity DTPA-Y bivalent hapten or by chasing excess circulating radiolabeled hapten with an excess of unlabeled hapten also reduced tumor exposure. The use of a monovalent hapten resulted in both lower efficiency and selectivity. However, the two-step pretargeting of high-affinity bivalent hapten (Affinity Enhancement System, AES) should deliver 30-60 Gy to the tumor with less than 9 Gy to the blood in tumor-bearing mice. CONCLUSION: Radioimmunotherapy with AES is predicted to be as efficient and with lower hematological toxicity than direct targeting.
Animals↗
[Cardiac surgery in renal transplant patients. Apropos of 24 cases].
UNLABELLED: Results of cardiac surgery in renal transplant patients are not well documented. Immunosuppression as well as associated conditions in these patients, and the increased susceptibility of the renal allograft to the extracorporeal circulation (ECC) may alter the prognosis of renal transplant patients submitted to cardiac surgery. To evaluate this hypothesis, we reviewed the files of 24 patients (18 Male, 6 Female; age: 49 +/- 12 years) operated under ECC between 1978 and 1997. Twenty patients underwent coronary artery bypass surgery, 5 patients a valve replacement procedure (aortic and/or mitral), and one patient necessitated a Cabrol procedure for an ascending aorta aneurysm. Preoperatively, the majority of patients were in functional class (NYHA) IV (16 patients), and ejection fraction was > 50% in 18 patients. Two operative deaths secondary to cardiogenic shock were encountered. Five patients (23%) were reoperated for bleeding; 5 patients (23%) sustained a major infection (2 pneumonias, 2 mediastinitis and one wound infection) resulting in death in one patient; 5 patients (23%) were treated for arythmia; and 2 patients (9%) suffered a perioperative myocardial infarction. Serum creatinine levels did not increase significantly during hospitalization (p = 0.41 between extreme values). Mean follow-up (41 +/- 28 months) of the 20 survivors revealed recurrent angina in 5 patients and late death in 4 patients, cardiac-related in 3 cases. CONCLUSION: Cardiac surgery in renal transplant patients is subjected to a high morbidity and mortality. Mid-term prognosis is reserved especially in presence of associated conditions.
Angina Pectoris↗
[Effect of ionizing radiation on transforming growth factor-beta expression].
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Animals↗