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A 20-year study of an adolescent psychiatric clientele, with special reference to the age of onset.

https://arctichealth.org/en/permalink/ahliterature31748
Source
Nord J Psychiatry. 2001;55(1):5-10
Publication Type
Article
Date
2001
Author
J. Pedersen
T. Aarkrog
Author Affiliation
Department of Child Psychiatry, Centralsygehuset i Holbaek, Gl. Ringstedvej 1, DK-4300 Holbaek, Denmark.
Source
Nord J Psychiatry. 2001;55(1):5-10
Date
2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Borderline Personality Disorder - diagnosis - epidemiology - psychology
Child
Cross-Sectional Studies
Denmark - epidemiology
Hospitals, Urban
Humans
Patient Admission - statistics & numerical data
Psychiatric Department, Hospital - statistics & numerical data
Research Support, Non-U.S. Gov't
Retrospective Studies
Schizophrenia, Childhood - diagnosis - epidemiology - psychology
Schizotypal Personality Disorder - diagnosis - epidemiology - psychology
Suicide, Attempted - psychology - statistics & numerical data
Abstract
During a period of 20 years (1968-1988) all inpatients admitted for the first time to the adolescent psychiatric unit in Copenhagen (n = 841) were classified in accordance with social and psychiatric variables, to describe the clientele as a group and, furthermore, to investigate changes occurring during that period. The total clientele had a broad age range (12-21 years), with as many as 36% less than 15 years old. Eleven percent of the patients had attempted suicide before admission. Fifty-six percent of the total group were diagnosed as psychotic or as borderline cases. The patients came predominantly from lower social levels, and almost half the group had a child debut defined as symptoms that had resulted in referral for further investigation during childhood. Moreover, among the schizophrenic patients 35% had an early onset. The age of onset may have some clinical significance, as this item was related to several sociodemographic variables. Finally, an increase in the rate of psychoses and lower social class was recorded during the period.
PubMed ID
11827600 View in PubMed
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Academic and nonacademic laboratories perform equally on CIQC immunohistochemistry proficiency testing.

https://arctichealth.org/en/permalink/ahliterature113089
Source
Am J Clin Pathol. 2013 Jul;140(1):55-60
Publication Type
Article
Date
Jul-2013
Author
Zhongchuan Will Chen
Heather Neufeld
Maria A Copete
John Garratt
C Blake Gilks
Emina E Torlakovic
Author Affiliation
Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
Source
Am J Clin Pathol. 2013 Jul;140(1):55-60
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Academic Medical Centers
Breast Neoplasms - diagnosis
Canada
Data Collection
Female
Hospitals, Rural
Hospitals, Urban
Humans
Immunohistochemistry - standards
Laboratories - standards
Laboratory Proficiency Testing - standards
Paraffin Embedding
Pathology - standards
Quality Assurance, Health Care
Reproducibility of Results
Tissue Array Analysis
Tumor Markers, Biological - analysis
Workload
Abstract
To test whether academic centers (ACs) are more successful than nonacademic centers (NACs) in immunohistochemistry (IHC) external quality assessment challenges in the Canadian Immunohistochemistry Quality Control (CIQC) program.
Results of 9 CIQC challenges for breast cancer marker (BM) and various non-breast cancer marker (NBM) tests were examined. Success rates were compared between AC/NAC laboratories and those located in small or large cities. Performance was also correlated with annual IHC case volumes.
There was no statistically significant difference in performance in any of the comparisons. However, overall performance on BM was significantly better (P
PubMed ID
23765534 View in PubMed
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Access to palliative care services in hospital: a matter of being in the right hospital. Hospital charts study in a Canadian city.

https://arctichealth.org/en/permalink/ahliterature133654
Source
Palliat Med. 2012 Jan;26(1):89-94
Publication Type
Article
Date
Jan-2012
Author
Joachim Cohen
Donna M Wilson
Amy Thurston
Rod MacLeod
Luc Deliens
Author Affiliation
Ghent University & Vrije Universiteit Brussel, End-of-Life Care Research Group, Brussels, Belgium. jcohen@vub.ac.be
Source
Palliat Med. 2012 Jan;26(1):89-94
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Canada
Child
Child, Preschool
Female
Health Services Accessibility - standards
Health Services Research
Hospital Planning
Hospitals, Urban - organization & administration
Humans
Infant
Male
Medical Records
Middle Aged
Palliative Care - organization & administration - standards
Referral and Consultation - standards
Young Adult
Abstract
Access to palliative care (PC) is a major need worldwide. Using hospital charts of all patients who died over one year (April 2008-March 2009) in two mid-sized hospitals of a large Canadian city, similar in size and function and operated by the same administrative group, this study examined which patients who could benefit from PC services actually received these services and which ones did not, and compared their care characteristics. A significantly lower proportion (29%) of patients dying in hospital 2 (without a PC unit and reliant on a visiting PC team) was referred to PC services as compared to in hospital 1 (with a PC unit; 68%). This lower referral likelihood was found for all patient groups, even among cancer patients, and remained after controlling for patient mix. Referral was strongly associated with having cancer and younger age. Referral to PC thus seems to depend, at least in part, on the coincidence of being admitted to the right hospital. This finding suggests that establishing PC units or a team of committed PC providers in every hospital could increase referral rates and equity of access to PC services. The relatively lower access for older and non-cancer patients and technology use in hospital PC services require further attention.
PubMed ID
21680750 View in PubMed
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Achieving clinical improvement: an interdisciplinary intervention.

https://arctichealth.org/en/permalink/ahliterature187771
Source
Health Care Manage Rev. 2002;27(4):42-56
Publication Type
Article
Date
2002
Author
Diane M Irvine Doran
G Ross Baker
Michael Murray
John Bohnen
Catherine Zahn
Souraya Sidani
Jennifer Carryer
Author Affiliation
Faculty of Nursing, University of Toronto, Ontario.
Source
Health Care Manage Rev. 2002;27(4):42-56
Date
2002
Language
English
Publication Type
Article
Keywords
Clinical Competence
Group Processes
Health Services Research
Hospitals, Urban - organization & administration - standards
Humans
Interprofessional Relations
Ontario
Outcome and Process Assessment (Health Care)
Patient Care Team - standards
Problem Solving
Staff Development
Total Quality Management
Abstract
This study evaluates whether training health care teams in continuous quality improvement methods results in improvements in the care of and outcomes for patients. Nine of the 25 teams who participated in the study were successful in improving the care/outcomes for patients. Successful teams were more effective at problem solving, engaged in more functional group interactions, and were more likely to have physician participation.
PubMed ID
12433246 View in PubMed
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Adoption of an innovation to repair aortic aneurysms at a Canadian hospital: a qualitative case study and evaluation.

https://arctichealth.org/en/permalink/ahliterature160317
Source
BMC Health Serv Res. 2007;7:182
Publication Type
Article
Date
2007
Author
Nathalie M Danjoux
Douglas K Martin
Pascale N Lehoux
Julie L Harnish
Randi Zlotnik Shaul
Mark Bernstein
David R Urbach
Author Affiliation
Department of Health, Policy, Management and Evaluation, University of Toronto, Toronto, Canada. nathalie.danjoux@utoronto.ca
Source
BMC Health Serv Res. 2007;7:182
Date
2007
Language
English
Publication Type
Article
Keywords
Academic Medical Centers - organization & administration
Aortic Aneurysm, Abdominal - surgery
Blood Vessel Prosthesis Implantation - methods - utilization
Decision Making, Organizational
Diffusion of Innovation
Hospitals, Urban - organization & administration
Humans
Ontario
Organizational Case Studies
Organizational Innovation
Qualitative Research
Vascular Surgical Procedures - methods - utilization
Abstract
Priority setting in health care is a challenge because demand for services exceeds available resources. The increasing demand for less invasive surgical procedures by patients, health care institutions and industry, places added pressure on surgeons to acquire the appropriate skills to adopt innovative procedures. Such innovations are often initiated and introduced by surgeons in the hospital setting. Decision-making processes for the adoption of surgical innovations in hospitals have not been well studied and a standard process for their introduction does not exist. The purpose of this study is to describe and evaluate the decision-making process for the adoption of a new technology for repair of abdominal aortic aneurysms (endovascular aneurysm repair [EVAR]) in an academic health sciences centre to better understand how decisions are made for the introduction of surgical innovations at the hospital level.
A qualitative case study of the decision to adopt EVAR was conducted using a modified thematic analysis of documents and semi-structured interviews. Accountability for Reasonableness was used as a conceptual framework for fairness in priority setting processes in health care organizations.
There were two key decisions regarding EVAR: the decision to adopt the new technology in the hospital and the decision to stop hospital funding. The decision to adopt EVAR was based on perceived improved patient outcomes, safety, and the surgeons' desire to innovate. This decision involved very few stakeholders. The decision to stop funding of EVAR involved all key players and was based on criteria apparent to all those involved, including cost, evidence and hospital priorities. Limited internal communications were made prior to adopting the technology. There was no formal means to appeal the decisions made.
The analysis yielded recommendations for improving future decisions about the adoption of surgical innovations. ese empirical findings will be used with other case studies to help develop guidelines to help decision-makers adopt surgical innovations in Canadian hospitals.
Notes
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PubMed ID
18005409 View in PubMed
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Advanced life support vs basic life support field care: an outcome study.

https://arctichealth.org/en/permalink/ahliterature205160
Source
Acad Emerg Med. 1998 Jun;5(6):592-8
Publication Type
Article
Date
Jun-1998
Author
J S Eisen
I. Dubinsky
Author Affiliation
Queen's University Faculty of Medicine, Kingston, Ontario, Canada.
Source
Acad Emerg Med. 1998 Jun;5(6):592-8
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Adult
Aged
Cohort Studies
Emergency medical services
Female
Hospital Bed Capacity, 300 to 499
Hospitalization - statistics & numerical data
Hospitals, Teaching
Hospitals, Urban
Humans
Life Support Care - classification
Male
Middle Aged
Ontario
Outcome and Process Assessment (Health Care)
Urban Population
Abstract
To determine whether the provision of advanced life support (ALS) field care has any impact on patient outcome in the urban Canadian environment.
A convenience cohort study was conducted of all emergent ambulance transfers of adults to an urban Canadian hospital from May 22 to July 31, 1996. Data were collected from ambulance call reports regarding presenting complaint and field interventions applied, and from hospital records regarding time in the ED, hospital length of stay (LOS), and discharge disposition. Patient outcomes were compared within 7 presenting complaint groups (chest pain, altered level of consciousness, shortness of breath, abdominal pain, motor vehicle crash, falls, and other) by field care level: level 1--BLS (basic life support) vs levels 2 and 3--ALS.
The study population consisted of 1,397 patients. No significant differences were seen between BLS and ALS patients on baseline demographics. ED triage score did not depend on field care level for any group, implying that those in the ALS group were not inherently sicker. Outcome measures (ED LOS, admission rates, and hospital LOS) showed no significant differences between BLS and ALS for each presenting complaint group. Discharge dispositions were analyzed by chi2 but were not varied enough to allow reliable analysis. Observation of trends suggested no difference between BLS and ALS.
There was no beneficial impact on the measured patient outcomes found in association with the provision of ALS vs BLS field care in Metropolitan Toronto for patients who were brought to a nontrauma center.
PubMed ID
9660286 View in PubMed
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The Advanced Trauma Life Support Program in Manitoba: a 5-year review.

https://arctichealth.org/en/permalink/ahliterature221346
Source
Can J Surg. 1993 Apr;36(2):181-3
Publication Type
Article
Date
Apr-1993
Author
J. Ali
M. Howard
Author Affiliation
Department of Surgery, University of Manitoba, Winnipeg.
Source
Can J Surg. 1993 Apr;36(2):181-3
Date
Apr-1993
Language
English
Publication Type
Article
Keywords
Education, Medical, Continuing
Emergency Service, Hospital
Family Practice - education
General Surgery - education
Hospitals, Rural
Hospitals, Urban
Humans
Life Support Care
Manitoba
Program Evaluation
Questionnaires
Time Factors
Abstract
Twenty Advanced Trauma Life Support (ATLS) courses were conducted at the University of Manitoba between 1982 and 1987. There were 302 registrants, 95 of whom were from rural communities. Twelve registrants failed the course. The impact of the program was assessed by questionnaire (68.8% response overall). The response from department heads of surgery in urban hospitals was 87.5% and from surgeons in rural areas 50%. Fifty-eight percent of rural surgeons, 62.5% of urban surgeons and 75% of urban emergency-department directors claimed they could identify those who had attended an ATLS course by the increased confidence demonstrated and the use of more timely and appropriate consultation and treatment. Thirty percent of rural surgeons, 37% of urban surgeons and 42% of emergency-department directors claimed that mortality and morbidity were decreased when care was provided by ATLS-trained physicians. The remainder were undecided because of lack of information. Ninety-three percent of respondents indicated that the course increased their confidence, trauma capability and ability to communicate with consultant trauma surgeons. Fifty-two percent thought the course should be mandatory for all physicians, and 100% thought it should be mandatory for all emergency-department physicians. The data suggest that although most physicians treat fewer trauma patients 5 years after their ATLS training, the course is still highly recommended, and it has improved trauma care. Although the ATLS program was intended primarily for rural physicians, more urban-based physicians registered for it.
PubMed ID
8472232 View in PubMed
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AIDS management: five hospitals compared.

https://arctichealth.org/en/permalink/ahliterature230659
Source
Dimens Health Serv. 1989 Jun;66(5):14-7, 28-30
Publication Type
Article
Date
Jun-1989

255 records – page 1 of 26.