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How does increasing the binding energy per nucleon release energy | Nuclear Binding energy | Profile changes in Q&A are not pushed to Area 51 | eng_Latn | 27,000 |
How does the Higgs boson work? | How does the Higgs mechanism work? | Why Bobbi and Hunter can no longer work for S.H.I.E.L.D.? | eng_Latn | 27,001 |
Do neutrinos get their mass via interacting with the Higgs Boson? | Do neutrinos not couple to the Higgs field? | Do neutrinos not couple to the Higgs field? | eng_Latn | 27,002 |
What are the consequences of LHC results for supersymmetry? | Which SUSY models are affected by the recent LHCb result? | Supersymmetry in Quantum Field Theory | eng_Latn | 27,003 |
Fermilab's results and a fifth force | Could someone explain the muon $g-2$ experiment problem? | Why isn't Higgs coupling considered a fifth fundamental force? | eng_Latn | 27,004 |
Quantum Field interaction transferred via "exchanging fermions" | Is there some special case where a fermion can mediate a force? | Why cannot fermions have non-zero vacuum expectation value? | eng_Latn | 27,005 |
Is muon a point particle? | What is spin as it relates to subatomic particles? | Why is the decay of a neutral rho meson into two neutral pions forbidden? | eng_Latn | 27,006 |
March 2021 CERN discovery? What would be the properties of the new particle/force from decaying bottom (beauty) quarks? | Breakthrough at the Large Hadron Collider -Leptoquarks skepticism? | Indiscernible to create descending chain of elementary models | eng_Latn | 27,007 |
Defending champion Lewis Hamilton says the technical problems afflicting him are making him fear for his hopes of winning a fourth world title. | The Englishman is 24 points adrift of Mercedes team-mate Nico Rosberg after finishing fifth in the Grand Prix of Europe, which the German won.
"I am definitely not feeling confident for the future, but I have a lot of races ahead," said Hamilton.
"It's looking like a good year for Nico, but I never give up."
Hamilton arrived in Baku having cut Rosberg's lead from 43 points to nine with two victories.
But he made life difficult for himself on F1's newest track with a mistake-ridden performance in qualifying, which left him 10th on the grid.
His race was then hampered by a problem with the car's engine settings, which the team could not tell him how to change because of restrictions on help drivers can be given over team radio.
"I am just glad I got some points and am hoping from now on I will have some better races," said Hamilton.
"But I have been hoping that for some time and still have these engine problems here and there so we have work to do."
The team said they had programmed one of the engine's modes incorrectly, so it was giving less power when it was intended to give more.
The same problem afflicted Rosberg in the race, but he was able to change out of it faster than Hamilton.
That's because he had changed the setting himself during the race.
When that change subsequently caused a drop in power, it was a relatively simple leap of understanding to change it back again.
By contrast, Hamilton had been in the mode from the start of the race because he was going to have to pass people.
When he noticed a problem first occur on lap four, it took a while for the team to work out what it was and it was not obvious to Hamilton what to do.
He said he felt the team radio rules should be revisited.
"It was dangerous," he said. "Just looking at my steering wheel a large proportion of the lap, all the way down the straight just looking at my wheel and all they can tell me is it's a wrong switch position.
"So I am looking at every single switch thinking: 'Am I being an idiot here? Have I done something wrong?' And I hadn't.
"The radio ban was supposed to stop driver aids and this wasn't a driver aid it was a technical issue.
"F1 is so technical that it is far too technical almost.
"To have that many switch positions it is something you should be able to rectify because everyone can see it in the garage.
"It would have added to the spectacle if I had had full power. I would have been more in the race."
Asked if he felt F1 should be "less computer and more man", he said: "Definitely. But it isn't and it won't be so there is no point talking about it.
"It is what it is. Maybe the rule needs to be looked at again."
Subscribe to the BBC Sport newsletter to get our pick of news, features and video sent to your inbox. | The particle has been the subject of a 45-year hunt to explain how matter attains its mass.
Both of the Higgs boson-hunting experiments at the LHC (Atlas and CMS) see a level of certainty in their data worthy of a "discovery".
More work will be needed to be certain that what they see is a Higgs, however.
The results announced at Cern (European Organization for Nuclear Research), home of the LHC in Geneva, were met with loud applause and cheering.
Prof Peter Higgs, after whom the particle is named, wiped a tear from his eye as the teams finished their presentations in the Cern auditorium.
"I would like to add my congratulations to everyone involved in this achievement," he added later.
"It's really an incredible thing that it's happened in my lifetime."
Prof Stephen Hawking joined in with an opinion on a topic often discussed in hushed tones.
"This is an important result and should earn Peter Higgs the Nobel Prize," he told BBC News.
"But it is a pity in a way because the great advances in physics have come from experiments that gave results we didn't expect."
The CMS experiment team claimed they had seen a "bump" in their data corresponding to a particle weighing in at 125.3 gigaelectronvolts (GeV) - about 133 times heavier than the protons that lie at the heart of every atom.
They claimed that by combining two data sets, they had attained a confidence level just at the "five-sigma" point - about a one-in-3.5 million chance that the signal they see would appear if there were no Higgs particle.
However, a full combination of the CMS data brings that number just back to 4.9 sigma - a one-in-two million chance.
Prof Joe Incandela, spokesman for CMS, was unequivocal: "The results are preliminary but the five-sigma signal at around 125 GeV we're seeing is dramatic. This is indeed a new particle," he told the Geneva meeting.
The Atlas experiment results were even more promising, at a slightly higher mass: "We observe in our data clear signs of a new particle, at the level of five sigma, in the mass region around 126 GeV," said Dr Fabiola Gianotti, spokeswoman for the Atlas experiment at the LHC.
Prof Rolf Heuer, director-general of Cern, commented: "As a layman I would now say I think we have it."
"We have a discovery - we have observed a new particle consistent with a Higgs boson. But which one? That remains open.
"It is a historic milestone but it is only the beginning."
Commenting on the emotions of the scientists involved in the discovery, Prof Incandela said: "It didn't really hit me emotionally until today because we have to be so focussed… but I'm super-proud."
Dr Gianotti echoed Prof Incandela's thoughts, adding: "The last few days have been extremely intense, full of work, lots of emotions."
A confirmation that this is the Higgs boson would be one of the biggest scientific discoveries of the century; the hunt for the Higgs has been compared by some physicists to the Apollo programme that reached the Moon in the 1960s.
Scientists would then have to assess whether the particle they see behaves like the version of the Higgs particle predicted by the Standard Model, the current best theory to explain how the Universe works. However, it might also be something more exotic.
All the matter we can see appears to comprise just 4% of the Universe, the rest being made up by mysterious dark matter and dark energy.
A more exotic version of the Higgs could be a bridge to understanding the 96% of the Universe that remains obscure.
Scientists will have to look at how the Higgs decays - or transforms - into other, more stable particles after being produced in collisions at the LHC.
Dr Pippa Wells, a member of the Atlas experiment, said that several of the decay paths already showed deviations from what one would expect of the Standard Model Higgs.
For example, a decay path where the Higgs transforms into two photon particles was "a bit on the high side", she explained.
These could get back into line as more statistics are added, but on the other hand, they may not.
"We're reaching into the fabric of the Universe at a level we've never done before," said Prof Incandela.
"We're on the frontier now, on the edge of a new exploration. This could be the only part of the story that's left, or we could open a whole new realm of discovery."
• The Standard Model is the simplest set of ingredients - elementary particles - needed to make up the world we see in the heavens and in the laboratory
• Quarks combine together to make, for example, the proton and neutron - which make up the nuclei of atoms today - though more exotic combinations were around in the Universe's early days
• Leptons come in charged and uncharged versions; electrons - the most familiar charged lepton - together with quarks make up all the matter we can see; the uncharged leptons are neutrinos, which rarely interact with matter
• The "force carriers" are particles whose movements are observed as familiar forces such as those behind electricity and light (electromagnetism) and radioactive decay (the weak nuclear force)
• The Higgs boson came about because although the Standard Model holds together neatly, nothing requires the particles to have mass; for a fuller theory, the Higgs - or something else - must fill in that gap
[email protected] and follow me on Twitter | eng_Latn | 27,008 |
How to include number of not-yet-decayed radioactive atoms in MLE? | How to model this odd-shaped distribution (almost a reverse-J) | Why is the decay of a neutral rho meson into two neutral pions forbidden? | eng_Latn | 27,009 |
Why is rho to two pions not allowed? | Why is the decay of a neutral rho meson into two neutral pions forbidden? | every rank 2 oriented matroid is realizable | eng_Latn | 27,010 |
Cuba returned to the United States an inert Hellfire missile that had been wrongly shipped to Havana in June 2014. | The missile, which did not contain explosives, had been shipped to Spain for a Nato training exercise, the Wall Street Journal said.
It was then taken to Germany and eventually to Charles de Gaulle Airport in Paris for onward delivery to Florida.
It was instead loaded on to an Air France flight to Havana.
The incident could have led to a serious loss of military technology, officials told the Wall Street Journal.
The whole affair has been embarrassing for the Americans, who have had to ask the Cubans if they could have their highly sensitive missile back, says the BBC's Will Grant in Havana.
The missile arrived on a flight from Paris "by mistake or mishandling in the country of origin," said a Cuban Foreign Ministry statement.
"Cuba acted with seriousness and transparency and co-operated to find a satisfactory solution to this issue," it added.
The AGM 114 Hellfire is a laser-guided missile that can be deployed from an attack helicopter or an unmanned drone.
US officials were worried that Cuba could share the advanced technology inside the missile with countries such as North Korea, China or Russia, sources close to the investigation told the Wall Street Journal.
The US and Cuba, old Cold War enemies, restored diplomatic relations in July last year after more than 50 years.
The two countries have been working to rebuild their economic and trade ties.
An announcement is expected on Tuesday about the reinstatement of scores of commercial flights between US cities and Havana. | Anti-matter is rare today; it can be produced in "atom smashers", in nuclear reactions or by cosmic rays.
But physicists think the Big Bang should have produced equal amounts of matter and its opposite.
New results from the DZero experiment at Fermilab in Illinois provide a clue to what happened to all the anti-matter.
This is regarded by many researchers as one of the biggest mysteries in cosmology.
The data even offer hints of new physics beyond what can be explained by current theories.
For each basic particle of matter, there exists an anti-particle with the same mass but the opposite electric charge.
For example, the negatively charged electron has a positively charged anti-particle called the positron.
But when a particle and its anti-particle collide, they are "annihilated" in a flash of energy, yielding new particles and anti-particles.
Similar processes occurring at the beginning of the Universe should have left us with equal amounts of matter and anti-matter.
Yet, paradoxically, today we live in a Universe made up overwhelmingly of matter.
Researchers working on the DZero experiment observed collisions of protons and anti-protons in Fermilab's Tevatron particle accelerator.
They found that these collisions produced pairs of matter particles slightly more often than they yielded anti-matter particles.
The results show a 1% difference in the production of pairs of muon (matter) particles and pairs of anti-muons (anti-matter particles) in these high-energy collisions.
"Many of us felt goose bumps when we saw the result," said Stefan Soldner-Rembold, one of the spokespeople for DZero.
"We knew we were seeing something beyond what we have seen before and beyond what current theories can explain."
Dr Guennadi Borissov, from Lancaster University in the UK, who is co-leader of the project, said: "This beautiful result provides important input to understanding the matter dominance in the Universe.
"The DZero experiment is still collecting data and so, as long as funding for our work continues, we can expect to make even more precise measurements of this effect in the future."
The dominance of matter in the Universe is possible only if there are differences in the behaviour of particles and anti-particles.
Physicists had already seen such differences - known as called "CP violation". But these known differences are much too small to explain why the Universe appears to prefer matter over anti-matter.
Indeed, these previous observations were fully consistent with the current theory, known as the Standard Model. This is the framework drawn up in the 1970s to explain the interactions of sub-atomic particles.
Researchers say the new findings, submitted for publication in the journal Physical Review D, show much more significant "asymmetry" of matter and anti-matter - beyond what can be explained by the Standard Model.
If the results are confirmed by other experiments, such as the Collider Detector (CDF) at Fermilab, the effect seen by the DZero team could move researchers along in their efforts to understand the dominance of matter in today's Universe.
The data presage results expected from another experiment, called LHCb, which is based at the Large Hadron Collider near Geneva.
LHCb was specifically designed to shed light on this central question in particle physics.
Commenting on the latest findings, Dr Tara Shears, a particle physicist at the University of Liverpool who works on LHCb and CDF, said: "It's not yet at the stage of a discovery or an explanation, but it is a very tantalising hint of what might be."
Dr Shears, who is not a member of the DZero team, added: "It certainly means that LHCb will be eager to look for the same effect, to confirm whether it exists and if it does, to make a more precise measurement."
[email protected] | eng_Latn | 27,011 |
A US-based physics experiment has found a clue as to why the world around us is composed of normal matter and not its shadowy opposite: anti-matter. | Anti-matter is rare today; it can be produced in "atom smashers", in nuclear reactions or by cosmic rays.
But physicists think the Big Bang should have produced equal amounts of matter and its opposite.
New results from the DZero experiment at Fermilab in Illinois provide a clue to what happened to all the anti-matter.
This is regarded by many researchers as one of the biggest mysteries in cosmology.
The data even offer hints of new physics beyond what can be explained by current theories.
For each basic particle of matter, there exists an anti-particle with the same mass but the opposite electric charge.
For example, the negatively charged electron has a positively charged anti-particle called the positron.
But when a particle and its anti-particle collide, they are "annihilated" in a flash of energy, yielding new particles and anti-particles.
Similar processes occurring at the beginning of the Universe should have left us with equal amounts of matter and anti-matter.
Yet, paradoxically, today we live in a Universe made up overwhelmingly of matter.
Researchers working on the DZero experiment observed collisions of protons and anti-protons in Fermilab's Tevatron particle accelerator.
They found that these collisions produced pairs of matter particles slightly more often than they yielded anti-matter particles.
The results show a 1% difference in the production of pairs of muon (matter) particles and pairs of anti-muons (anti-matter particles) in these high-energy collisions.
"Many of us felt goose bumps when we saw the result," said Stefan Soldner-Rembold, one of the spokespeople for DZero.
"We knew we were seeing something beyond what we have seen before and beyond what current theories can explain."
Dr Guennadi Borissov, from Lancaster University in the UK, who is co-leader of the project, said: "This beautiful result provides important input to understanding the matter dominance in the Universe.
"The DZero experiment is still collecting data and so, as long as funding for our work continues, we can expect to make even more precise measurements of this effect in the future."
The dominance of matter in the Universe is possible only if there are differences in the behaviour of particles and anti-particles.
Physicists had already seen such differences - known as called "CP violation". But these known differences are much too small to explain why the Universe appears to prefer matter over anti-matter.
Indeed, these previous observations were fully consistent with the current theory, known as the Standard Model. This is the framework drawn up in the 1970s to explain the interactions of sub-atomic particles.
Researchers say the new findings, submitted for publication in the journal Physical Review D, show much more significant "asymmetry" of matter and anti-matter - beyond what can be explained by the Standard Model.
If the results are confirmed by other experiments, such as the Collider Detector (CDF) at Fermilab, the effect seen by the DZero team could move researchers along in their efforts to understand the dominance of matter in today's Universe.
The data presage results expected from another experiment, called LHCb, which is based at the Large Hadron Collider near Geneva.
LHCb was specifically designed to shed light on this central question in particle physics.
Commenting on the latest findings, Dr Tara Shears, a particle physicist at the University of Liverpool who works on LHCb and CDF, said: "It's not yet at the stage of a discovery or an explanation, but it is a very tantalising hint of what might be."
Dr Shears, who is not a member of the DZero team, added: "It certainly means that LHCb will be eager to look for the same effect, to confirm whether it exists and if it does, to make a more precise measurement."
[email protected] | Armed officers were sent to the supermarket in Blackheath, West Midlands, on Saturday and several roads were closed.
A teenager has been charged with making an explosive substance and maliciously causing an explosive substance to endanger life.
The boy has also been charged with possession of a bladed article.
West Midlands Police confirmed the teenager was remanded in custody on Monday.
"No members of the public were hurt during the incident and road closures have now been lifted in the area," police added. | eng_Latn | 27,012 |
Is it true that the cast of X-Men has signed on for a total of 7 films? | Unfortunately, it's just a rumor. The actors have only been in talks recently to sign on for a 4th. Therefore, the only conclusion you can come to, is that it's not true. Even though it hasn't happened yet--I see nothing wrong with having four more movies..! =) | Good question. It depends on whether you count exchange particles (ie particles associated with the fundemental forces of nature), if you count antiparticles, and which particle physics model you are using.\n\nIn the "Standard Model" of particle physics there are the follwing fundemental particles (the word's in CAPTIALS are the type of particle):\n\nLEPTONS:\nelectron, muon, tau.\nelectron neutrino, muon neutrino, tau neutrino.\n\nQUARKS:\nup, charmed, top.\ndown, strange, bottom.\n\nGAUGE BOSONS:\nphoton, W+, W-, Z0 (note the +, - and 0 are superscripts)\n8 different gluons.\n\nand finally... the Higgs Boson (still undiscovered).\n\nThis doesn't count antiparticles, of which there are 12 (6 anti-leptons and 6 anti-quarks).\n\n\nSome theories introduce a whole host of new particles, but none of these extra particles have been discovered either. | eng_Latn | 27,013 |
positron electron pairs? | What you're asking about are called "virtual particles" which are constantly and spontaneously generated in the near-vacuum of space. It's a quantum mechanical effect that occurs at spatial sizes smaller than about 1.6^ minus 35 meters (..some 10^ 20 times smaller than a proton) It's there that space becomes a kind of seething foam filled with energy. Virtual particles are formed in pairs, each the anti-particle of the other so that they almost instantaneously self-annihilate.\n\nThis website provides more on this subject ==>http://www.sciam.com/askexpert_question.cfm?articleID=0004D0F8-772A-1526-B72A83414B7F0000 | got it........he's spelling out "happy birthday neopets", so it's PTP\n\n\nh b n \na i e \np r o \nP T P \ny h e \nd t \na s \ny | eng_Latn | 27,014 |
Is de Broglie's subquantic medium the strongly interacting dark matter which fills 'empty' space? Is it the DM that waves in a double slit experiment? | Is de Broglie's subquantic medium a strongly interacting dark matter? Is there evidence of the dark matter when a double slit experiment is performed? | What state of matter does dark matter have? | eng_Latn | 27,015 |
what is a bottom quark | Bottom quarks are one of the easiest ways to observe quark flow in a quark gluon plasma. For this reason, it is advantageous in a detector to have superb capabilities at detecting bottom quarks through their decay products and interactions. This paper will provide an overview of bottom quark behavior in a quark gluon plasma, as well as methods used to detect this behavior. Once | The first quartile (also called the lower quartile) is the number below which lies the 25 percent of the bottom data. The second quartile (the median) divides the range in the middle and has 50 percent of the data below it. | eng_Latn | 27,016 |
how many up quarks in a neutron | For example, the hadron constituents of atomic nuclei, neutrons and protons, have charges of 0 e and +1 e respectively; the neutron is composed of two down quarks and one up quark, and the proton of two up quarks and one down quark. | This is again third generation quark like top quark. The mass of bottom quark is in range 4100 to 4400 MeV/c 2 and ISO-spin value is -1/2. They have charge up to -1/3. It is first observed in the formation of upsilon meson which is the combination of bottom-anti bottom quark pair.he proton is made by combination of two up and one down quark while neutron is made by the pairing of two down quarks and an up quark.. Thus the complete nature of bosons is explained by all six types of quarks. Gluons are the exchange particles in the interaction of quarks. | eng_Latn | 27,017 |
who is in the generating force? | The Generating Force consists of those Army organizations whose primary mission is to generate and sustain the Operational Armyâs capabilities for employment by Joint Force commanders. | However, it is not an inverse square force like the electromagnetic force and it has a very short range. Yukawa modeled the strong force as an exchange force in which the exchange particles are pions and other heavier particles. The range of a particle exchange force is limited by the uncertainty principle. It is the strongest of the four fundamental forces. Since the protons and neutrons which make up the nucleus are themselves considered to be made up of quarks, and the quarks are considered to be held together by the color force, the strong force between nucleons may be considered to be a residual color force. | eng_Latn | 27,018 |
What evidence is there of the existence of quarks? | Can quarks be considered real and elementary? | A fiber bundle over Euclidean space is trivial. | eng_Latn | 27,019 |
The universal covering group of a symmetry group | Why exactly do sometimes universal covers, and sometimes central extensions feature in the application of a symmetry group to quantum physics? | Why exactly do sometimes universal covers, and sometimes central extensions feature in the application of a symmetry group to quantum physics? | eng_Latn | 27,020 |
BackgroundInjury severity measures are based either on the Abbreviated Injury Scale (AIS) or the International Classification of diseases (ICD). The latter is more convenient because routinely collected by clinicians for administrative reasons. To exploit this advantage, a proprietary program that maps ICD-9-CM into AIS codes has been used for many years. Recently, a program called ICDPIC trauma and developed in the USA has become available free of charge for registered STATA® users. We compared the ICDPIC calculated Injury Severity Score (ISS) with the one from direct, prospective AIS coding by expert trauma registrars (dAIS).MethodsThe administrative records of the 289 major trauma cases admitted to the hospital of Udine-Italy from 1 July 2004 to 30 June 2005 and enrolled in the Italian Trauma Registry were retrieved and ICDPIC-ISS was calculated. The agreement between ICDPIC-ISS and dAIS-ISS was assessed by Cohen's Kappa and Bland-Altman charts. We then plotted the differences between the 2 scores against the ratio between the number of traumatic ICD-9-CM codes and the number of dAIS codes for each patient (DIARATIO). We also compared the absolute differences in ISS among 3 groups identified by DIARATIO. The discriminative power for survival of both scores was finally calculated by ROC curves.ResultsThe scores matched in 33/272 patients (12.1%, k 0.07) and, when categorized, in 80/272 (22.4%, k 0.09). The Bland-Altman average difference was 6.36 (limits: minus 22.0 to plus 34.7). ICDPIC-ISS of 75 was particularly unreliable. The differences increased (p < 0.01) as DIARATIO increased indicating incomplete administrative coding as a cause of the differences. The area under the curve of ICDPIC-ISS was lower (0.63 vs. 0.76, p = 0.02).ConclusionsDespite its great potential convenience, ICPIC-ISS agreed poorly with its conventionally calculated counterpart. Its discriminative power for survival was also significantly lower. Incomplete ICD-9-CM coding was a main cause of these findings. Because this quality of coding is standard in Italy and probably in other European countries, its effects on the performances of other trauma scores based on ICD administrative data deserve further research. Mapping ICD-9-CM code 862.8 to AIS of 6 is an overestimation. | To determine accurately the number of serious injuries at EU level and to compare serious injury rates between different countries it is essential to use a common definition. In January 2013, the High Level Group on Road Safety established the definition of serious injuries as patients with an injury level of MAIS3+(Maximum Abbreviated Injury Scale). Whatever the method used for estimating the number or serious injuries, at some point it is always necessary to use hospital records. The aim of this paper is to understand the implications for (1) in/exclusion criteria applied to case selection and (2) a methodological approach for converting ICD (International Classification of Diseases/Injuries) to MAIS codes, when estimating the number of road traffic serious injuries from hospital data. A descriptive analysis with hospital data from Spain and the Netherlands was carried out to examine the effect of certain choices concerning in- and exclusion criteria based on codes of the ICD9-CM and ICD10. The main parameters explored were: deaths before and after 30 days, readmissions, and external injury causes. Additionally, an analysis was done to explore the impact of using different conversion tools to derive MAIS3 + using data from Austria, Belgium, France, Germany, Netherlands, and Spain. Recommendations are given regarding the in/exclusion criteria and when there is incomplete data to ascertain a road injury, weighting factors could be used to correct data deviations and make more real estimations. | We prove that groups acting geometrically on delta-quasiconvex spaces contain no essential Baumslag-Solitar quotients as subgroups. This implies that they are translation discrete, meaning that the translation numbers of their nontorsion elements are bounded away from zero. | eng_Latn | 27,021 |
Congestive Heart failure (CHF) is a growing public health problem that affects nearly 6.5 million individuals nationwide. Access to quality outpatient care and disease management programs has been shown to improve disease treatment and prognosis. Rural populations face unique challenges in the availability and accessibility of quality cardiovascular care. In 2018, we conducted a pooled cross-sectional analysis of the Nationwide Inpatient Sample (NIS) for 2009-2014 to examine recent trends in CHF-related hospital deaths in the United States, highlighting urban-rural differences within each census region. identify CHF-related hospital deaths. We performed a multivariable logistic regression analysis to compare the odds of CHF-related hospital death, by levels of rurality and within each census region. Most CHF-related hospital deaths occurred in the South and Midwest census regions and in large central metropolitan areas. Findings from census region stratified models revealed that non-core residents living within the West (OR 1.47, CI 1.26, 1.71), Midwest (OR 1.30, CI 1.17, 1.44), and South (OR=1.21, 95% C.I.=1.12 – 1.32) had a higher relative risk (but not higher absolute numbers) of experiencing death during a CHF-related hospitalization, compared to patients in large central metropolitan areas. Within each census region, there were also differences in odds of a CHF-related hospital death depending on patient sex, comorbidities, insurance type, median annual income, and year. As efforts to reduce rural health disparities in CHF morbidity continue, more work is needed to understand and test interventions to reduce the risk of death from CHF in noncore areas of the West, Midwest, and South. | OBJECTIVES ::: To examine the association between hospital type and mortality and length of stay using hospitalized Medicare beneficiaries for a 10-year period. ::: ::: ::: METHODS ::: The retrospective cohort study included 16.9 million hospitalized Medicare beneficiaries > or = 65 years of age admitted for 10 common medical conditions and 10 common surgical procedures from 1984 to 1993. A total of 5,127 acute-care hospitals in the United States were grouped into 6 mutually exclusive hospital types based on teaching status and financial structure (for-profit [FP], not-for-profit [NFP], osteopathic [OSTEO], public [PUB], teaching not-for-profit [TNFP], and teaching public [TPUB]) as reported in the 1988 American Hospital Association database. Logistic and linear regression methods were used to examine risk-adjusted 30-day and 6-month mortality and length of stay. ::: ::: ::: RESULTS ::: During the 10-year study period, 10.6 million patients were admitted with 1 of the 10 selected medical conditions, and 6.3 million patients were hospitalized for 1 of the 10 selected surgical procedures. Patients at TNFP hospitals had significantly lower risk-adjusted 30-day mortality rates than patients at other hospital types when all diagnoses or procedures were combined (combined diagnoses: RR(TNFP) = 1.00 [reference], RR(TPUB) = 1.40, RR(OSTEO) = 1.14, RR(PUB) = 1.07, RR(FP) = 1.03, RR(NFP) = 1.02; combined procedures: RR(TNFP) = 1.00 [reference], RR(OSTEO) = 1.36, RR(TPUB) = 1.30, RR(PUB) = 1.16, RR(FP) = 1.13, RR(NFP) = 1.08). The results were mostly consistent when diagnoses and procedures were examined separately. After adjustment for patient characteristics, patients at other hospital types had 10% to 20% shorter lengths of stay (LOS) than patients at TNFP hospitals for most diagnoses and procedures studied. ::: ::: ::: CONCLUSION ::: As measured by the risk-adjusted 30-day mortality, TNFP hospitals had an overall better performance than other hospital types. However, patients at TNFP hospitals had relatively longer LOS than patients at other hospital types, perhaps reflecting the medical education and research activities found at teaching institutions. Future research should examine the empirical evidence to help elucidate the adequate LOS for a given condition or procedure while maintaining the quality of care. | Blunt trauma abdomen rarely leads to gastrointestinal injury in children and isolated gastric rupture is even rarer presentation. We are reporting a case of isolated gastric rupture after fall from height in a three year old male child. | eng_Latn | 27,022 |
Partial adjustment without apology | Shock absorption: A Markov-chain measurement using micro-panel data | Comparison of outcome from intensive care admission after adjustment for case mix by the APACHE III prognostic system. | eng_Latn | 27,023 |
We undertook this study to determine the use of transthoracic and transesophageal echocardiography in detecting valvular perforation and the clinical impact of the latter on the outcome of left-sided infective endocarditis. Transthoracic echocardiography was performed in 58 consecutive patients with infective endocarditis. According to the study protocol, a subgroup of 42 patients also underwent transesophageal echocardiography. At referral, 20 (34%) of 58 patients had echocardiographic evidence of valvular perforation (group A). No valvular perforations were found in the remaining 38 patients (group B). During a follow-up period of 27 ± 16 months, a major complication occurred in 18 of 20 patients in group A and in 11 of 38 patients in group B ( p p | Guidelines and Expert Consensus documents aim to present all the relevant evidence on a particular issue in order to help physicians to weigh the benefits and risks of a particular diagnostic or therapeutic procedure. They should be helpful in everyday clinical decision-making. ::: ::: A great number of Guidelines and Expert Consensus Documents have been issued in recent years by different organizations, the European Society of Cardiology (ESC) and by other related societies. By means of links to web sites of National Societies several hundred guidelines are available. This profusion can put at stake the authority and validity of guidelines, which can only be guaranteed if they have been developed by an unquestionable decision-making process. This is one of the reasons why the ESC and others have issued recommendations for formulating and issuing Guidelines and Expert Consensus Documents. ::: ::: In spite of the fact that standards for issuing good quality Guidelines and Expert Consensus Documents are well defined, recent surveys of Guidelines and Expert Consensus Documents published in peer-reviewed journals between 1985 and 1998 have shown that methodological standards were not complied within the vast majority of cases. It is therefore of great importance that guidelines and recommendations are presented in formats that are easily interpreted. Subsequently, their implementation programmes must also be well conducted. Attempts have been made to determine whether guidelines improve the quality of clinical practice and the utilisation of health resources. ::: ::: The ESC … | We prove that groups acting geometrically on delta-quasiconvex spaces contain no essential Baumslag-Solitar quotients as subgroups. This implies that they are translation discrete, meaning that the translation numbers of their nontorsion elements are bounded away from zero. | eng_Latn | 27,024 |
Podologists are nurses who care for the diabetic foot (orthotics, offloading devices, blisters, calluses, treatment of fungus infection and patient education). In contrast to podiatrists, they are not qualified to perform any surgical treatment or wound care. We analysed whether there is an association between the decrease in major amputations and the number of podologic foot care (PFC) visits prescribed in Germany. Detailed list of all major lower limb amputations (OPS 5-864) performed from 2007 to 2011 was provided by the Federal Statistical Office. Data were separated for the 16 federal states in Germany. Detailed lists of the number of PFC treatments for each of the 5 years were derived from the federal report of the statutory health insurance. The total numbers of hospitalised cases per year having diabetes mellitus documented as an additional diagnosis were used to adjust for the different rates of people with diabetes in each federal state. Within a 5-year time period, population-based major amputations per 100 000 people dropped from 21·7 in 2007 to 17·5 in 2011 (-18·5%); whereas the number of PFC treatments per 1000 insured increased from 22 in 2007 to 60 in 2011 (+172·7%). The total number of major amputations divided by the total number of hospitalised cases with the additional diagnosis of diabetes mellitus (DM) shows an inverse correlation with the number of PFC treatments per 1000 insured (Pearson's correlation factor is -0·52049). The five countries with the highest increase in PFC compared with the five countries with the lowest increase (35·6 versus 15·4 per 1000 insured) will have only small differences in the decrease in major amputation rates in this period (-5·1 versus -3·4 per 100.000). There is a strong association between increasing utilisation PFC and decreasing major amputations in Germany. Further study is required to document the cost-effectiveness of this service. | Multidisciplinary team (MDT) approach has been shown to reduce diabetic foot ulcerations (DFUs) and lower extremity amputations (LEAs), but there is heterogeneity between team members and interventions. Podiatrists have been suggested as "gatekeepers" for the prevention and management of DFUs. The purpose of our study is to review the effect of podiatric interventions in MDTs on DFUs and LEAs. We conducted a systematic review of available literature. Data's heterogeneity about DFU outcomes made it impossible for us to include it in a meta-analysis, but we identified 12 studies fulfilling inclusion criteria that allowed for them to be included for LEA outcomes. With the exception of one study, all reported favourable outcomes for MDTs that include podiatry. We found statistical significance in favour of an MDT approach including podiatrists for our primary outcome (total LEAs (RR: 0.69, 95% CI 0.54-0.89, I2 = 64%, P = 0.002)) and major LEAs (RR: 0.45, 95% CI 0.23-0.90, I2 = 67%, P < 0.02). Our systematic review, with a standard search strategy, is the first to specifically address the relevant role of podiatrists and their interventions in an MDT approach for DFU management. Our observations support the literature that MDTs including podiatrists have a positive effect on patient outcomes but there is insufficient evidence that MDTs with podiatry management can reduce the risk of LEAs. Our study highlights the necessity for intervention descriptions and role definition in team approach in daily practice and in published literature. | This memo specifies CPIM Presence Information Data Format (PIDF) as a ::: common presence data format for CPIM-compliant IM/Presence protocols. | eng_Latn | 27,025 |
BACKGROUND ::: Little has been published regarding outcomes subsequent to complications after thoracic surgery. The present study investigated outcomes and risk factors associated with mortality in patients admitted to an intensive care unit (ICU) after initial recovery from thoracic oncology surgery. ::: ::: ::: METHODS ::: From March 2001 to August 2005, 1,087 patients underwent major resection for lung or esophageal cancer. Ninety-four (8.6%) of those patients required ICU care after initial recovery, and were the subject of the present retrospective review. ::: ::: ::: RESULTS ::: The patient group included 85 males (90.4%), of mean age 66 years. Patients were classified as either survivors (n = 63, 67%) or nonsurvivors (n = 31, 33%). The most common reason for ICU readmission was pulmonary complication (n = 73, 77.7%). Sixty-four patients (68.1%) required mechanical ventilation and 42 (43.3%) required renal support. Multivariate analysis showed that the initial acute physiological assessment and chronic health evaluation (APACHE) III score at readmission to ICU, duration of mechanical ventilation, and renal support were risk factors for in-hospital mortality. The overall three-year survival was 50.6%. Cox analysis showed that survivors who underwent tracheostomy had a poor prognosis (p = 0.011). Of 12 late mortalities in survivors who underwent tracheostomy, 9 (75%) were due to cancer-unrelated causes. ::: ::: ::: CONCLUSIONS ::: The ICU readmission after thoracic oncology surgery was associated with high in-hospital mortality. Identification of patients with a high APACHE score and (or) prolonged ventilation at readmission may help predict the risk of mortality. Preemptive strategies designed to optimize treatment of such high-risk patients may improve outcomes. Survivors from ICU readmission after thoracic oncology surgery require meticulous and frequent follow-up due to a high risk of deterioration after discharge. | INTRODUCTION ::: We sought to derive literature-based summary estimates of readmission to the ICU and hospital mortality among patients discharged alive from the ICU. ::: ::: ::: METHODS ::: We searched MEDLINE, Embase, CINAHL and the Cochrane Central Register of Controlled Trials from inception to March 2013, as well as the reference lists in the publications of the included studies. We selected cohort studies of ICU discharge prognostic factors that in which readmission to the ICU or hospital mortality among patients discharged alive from the ICU was reported. Two reviewers independently abstracted the number of patients readmitted to the ICU and hospital deaths among patients discharged alive from the ICU. Fixed effects and random effects models were used to estimate the pooled cumulative incidence of ICU readmission and the pooled cumulative incidence of hospital mortality. ::: ::: ::: RESULTS ::: The analysis included 58 studies (n = 2,073,170 patients). The majority of studies followed patients until hospital discharge (n = 46 studies) and reported readmission to the ICU (n = 46 studies) or hospital mortality (n = 49 studies). The cumulative incidence of ICU readmission was 4.0 readmissions (95% confidence interval (CI), 3.9 to 4.0) per 100 patient discharges using fixed effects pooling and 6.3 readmissions (95% CI, 5.6 to 6.9) per 100 patient discharges using random effects pooling. The cumulative incidence of hospital mortality was 3.3 deaths (95% CI, 3.3 to 3.3) per 100 patient discharges using fixed effects pooling and 6.8 deaths (95% CI, 6.1 to 7.6) per 100 patient discharges using random effects pooling. There was significant heterogeneity for the pooled estimates, which was partially explained by patient, institution and study methodological characteristics. ::: ::: ::: CONCLUSIONS ::: Using current literature estimates, for every 100 patients discharged alive from the ICU, between 4 and 6 patients on average will be readmitted to the ICU and between 3 and 7 patients on average will die prior to hospital discharge. These estimates can inform the selection of benchmarks for quality metrics of transitions of patient care between the ICU and the hospital ward. | We prove that groups acting geometrically on delta-quasiconvex spaces contain no essential Baumslag-Solitar quotients as subgroups. This implies that they are translation discrete, meaning that the translation numbers of their nontorsion elements are bounded away from zero. | eng_Latn | 27,026 |
INTRODUCTION ::: Data evaluating trends in hospital volume are lacking. The current study sought to examine trends in outcomes relative to hospital volume following liver surgery. ::: ::: ::: METHODS ::: A total of 14,296 patients >18 years undergoing an elective liver resection (LR) for cancer were identified using the National Inpatient Sample from 2001 to 2011. Multivariable logistic regression analysis was performed to compare postoperative morbidity and mortality relative to hospital volume over time. ::: ::: ::: RESULTS ::: Over time, the proportion of patients undergoing a LR at a high-volume hospital (HVH) increased from 24.4 to 45.0 %, while the proportion of patients undergoing a LR at a low-volume hospital (LVH) decreased from 40.4 to 22.7 %. On multivariable analysis, patients undergoing a LR at high-volume hospitals demonstrated a 29 % lower odds of mortality (OR = 0.71, 95 % CI = 0.59-0.86, p < 0.001) compared with patients undergoing a LR at a LVH. The rate of regionalization, however, was not equal among all patients as older patients, patients belonging to a racial minority, and those presenting with substantial comorbidity were less likely to undergo a LR at a HVH. ::: ::: ::: CONCLUSION ::: An increase in the regionalization of liver surgery was observed over time. Trends in regionalization were, however, associated with discrepancies in access to HVH among specific patient populations. | OBJECTIVE ::: To determine whether the relationship between hospital volume and mortality has changed over time. ::: ::: ::: BACKGROUND ::: It is generally accepted that hospital volume is associated with mortality in high-risk procedures. However, as surgical safety has improved over the last decade, recent evidence has suggested that the inverse relationship has diminished or been eliminated. ::: ::: ::: METHODS ::: Using national Medicare claims data from 2000 through 2009, we examined mortality among 3,282,127 patients who underwent 1 of 8 gastrointestinal, cardiac, or vascular procedures. Hospitals were stratified into quintiles of operative volume. Using multivariable logistic regression models to adjust for patient characteristics, we examined the relationship between hospital volume and mortality, and assessed for changes over time. We performed sensitivity analyses using hierarchical logistic regression modeling with hospital-level random effects to confirm our results. ::: ::: ::: RESULTS ::: Throughout the 10-year period, a significant inverse relationship was observed in all procedures. In 5 of the 8 procedures studied, the strength of the volume-outcome relationship increased over time. In esophagectomy, for example, the adjusted odds ratio of mortality in very low volume hospitals compared to very high volume hospitals increased from 2.25 [95% confidence interval (CI): 1.57-3.23] in 2000-2001 to 3.68 (95% CI: 2.66-5.11) in 2008-2009. Only pancreatectomy showed a notable decrease in strength of the relationship over time, from 5.83 (95% CI: 3.64-9.36) in 2000-2001, to 3.08 (95% CI: 2.07-4.57) in 2008-2009. ::: ::: ::: CONCLUSIONS ::: For all procedures examined, higher volume hospitals had significantly lower mortality rates than lower volume hospitals. Despite recent improvements in surgical safety, the strong inverse relationship between hospital volume and mortality persists in the modern era. | Background ::: Laparoscopic liver resection (LLR) remains to be established as a safe and effective alternative to open liver resection (OLR) for hepatocellular carcinoma (HCC). | eng_Latn | 27,027 |
BACKGROUND ::: Despite widespread guidelines recommending the use of lung-protective ventilation (LPV) in patients with acute lung injury (ALI), many patients do not receive this lifesaving therapy. We sought to estimate the incremental clinical and economic outcomes associated with LPV and determined the maximum cost of a hypothetical intervention to improve adherence with LPV that remained cost-effective. ::: ::: ::: METHODS ::: Adopting a societal perspective, we developed a theoretical decision model to determine the cost-effectiveness of LPV compared to non-LPV care. Model inputs were derived from the literature and a large population-based cohort of patients with ALI. Cost-effectiveness was determined as the cost per life saved and the cost per quality-adjusted life-years (QALYs) gained. ::: ::: ::: RESULTS ::: Application of LPV resulted in an increase in QALYs gained by 15% (4.21 years for non-LPV vs 4.83 years for LPV), and an increase in lifetime costs of $7,233 per patient with ALI ($99,588 for non-LPV vs $106,821 for LPV). The incremental cost-effectiveness ratios for LPV were $22,566 per life saved at hospital discharge and $11,690 per QALY gained. The maximum, cost-effective, per patient investment in a hypothetical program to improve LPV adherence from 50 to 90% was $9,482. Results were robust to a wide range of economic and patient parameter assumptions. ::: ::: ::: CONCLUSIONS ::: Even a costly intervention to improve adherence with low-tidal volume ventilation in patients with ALI reduces death and is cost-effective by current societal standards. | Intensive care survivors continue to experience significant morbidity following acute hospital discharge, but healthcare costs associated with this ongoing morbidity are poorly described. As the demand for intensive care increases, understanding the magnitude of postacute hospital healthcare costs is of increasing relevance to clinicians and healthcare planners. We undertook a systematic review of the literature reporting major healthcare resource use by intensive care survivors following discharge from the hospital and identified factors associated with increased resource use. ::: Seven electronic databases (1990 to August 2012), conference proceedings, and reference lists were searched. ::: Studies published in English were included that reported postacute hospital discharge healthcare resource use at the individual level for survivors of intensive care. ::: Two reviewers screened abstracts and one abstracted data using standardized templates. Study quality was assessed using recognized appraisal methods specific to economic evaluation, epidemiological studies, and randomized trials. ::: From 4,909 articles, 18 articles representing 14 cohorts fulfilled inclusion criteria. There was substantial variation in methodology, especially the resource categories included in the studies. Following standardization to a common currency and year, variation in cost of resource use was evident (range 2011 US $18,847–$148,454 for year 1 postdischarge). Studies undertaken within the United States reported the highest costs; those in the United Kingdom reported substantially lower costs. Factors associated with increased resource use included increasing age, comorbidities, organ dysfunction score, and previous resource use. ::: Wide variation in methodological approaches limited study comparability and external validity of findings. We found substantial variation in the cost of resource use, especially among countries. Careful description of patient cohorts and healthcare systems is required to maximize generalizability. We give recommendations for a more standardized approach to improve design and reporting of future studies. | In this paper we prove that every nonlinear ∗ -Lie derivation from a factor von Neumann algebra into itself is an additive ∗ -derivation. | eng_Latn | 27,028 |
Last week, the Department of Health announced its plans for reforming regulation of doctors. The BMJ asked some of those affected for their opinions | The White Paper also outlines robust revalidatory mechanisms for all statutorily regulated health professionals who will periodically be required to demonstrate their fitness to practise. There are two core components to the proposed revalidation – relicensure and recertification. ::: ::: ::: For relicensure, all doctors will have a licence to practise to remain on the medical register, to be renewed every five years. This will be based on annual appraisal system which will be modified to have a summative (judgemental) element in addition to the current formative (developmental) structure. A 360° feedback system will also be piloted in England. ::: ::: ::: Specialist re-certification will apply to specialist doctors, including general practitioners requiring them to meet the standards set and assessed by the medical Royal colleges and respective specialist societies. | Berzelius failed to make use of Faraday's electrochemical laws in his laborious determination of equivalent weights. | eng_Latn | 27,029 |
An independent NHS? Why it really is time to separate from direct government involvement. | EDITOR—I received 21 items of correspondence about my personal view on separating the NHS from direct government involvement, mostly supporting the idea and many urging me to take it further.1 I have worked in the NHS for 28 years and my conclusions are based on first hand experience of the waste associated with massive bureaucracy to support edicts from the top, short term solutions to … | OBJECTIVE: This article aims at presenting the existing patient classifications systems. METHODS: a literature review. RESULTS: Instruments found out are: that by Garrard et al, Home Health Care Classification System, Katz Scale, the utilized tables by the Brazilian Medical Enterprises in Home Care and by Home Care National Enterprises Center, the Therapeutic Intervention Scoring System (TISS) for non-ICU patients, adapted by Dal Ben, and the catalog for services delivery of the Assistance and Home Care Services Foundation (Fondation des services d'aide et des soins a domicile). From these instruments, the last two mentioned measure the workload and others present indicators for obtaining human and financial resources. FINAL CONSIDERATIONS: In relation to the time spent in caring patients, it is of 24 hours when dependence is total; of 12 hours when it is partial and moderated dependence 6 hours caring/per day, per patient. | eng_Latn | 27,030 |
Health care quality in a new Emergency Department based on the Danish Stroke register data | Background One of the intentions to develop the concept of an ED in Denmark is to increase health care quality in the treatment of acute patients. However, it is a massive reorganization including other workflows and competency profiles. At present, there are not established any general quality indicators for the acute treatment, but hospitals have reported to the Danish Stroke Register (DAP) for selected diseases. We have chosen “Stroke” as case to evaluate quality during a 3 years period under implementation of the ED concept, since these patients are among the 20 most common illnesses in our department. | Thousands turned out last weekend to protest at cuts, deficits, and increasing private sector involvement in the NHS. ::: ::: The “Day of Action” was organised by NHS Together, a collaboration of health service unions, NHS staff … | eng_Latn | 27,031 |
'Not for resuscitation': guidelines for decision making and documentation. | In 1991, the government's Chief Medical Officer made it clear that the responsibility for resuscitation policy lay with consultants, and that they should ensure this policy was understood by all staff caring for a patient, in particular junior medical staff. Since then, many hospitals and trusts have provided members of the multidisciplinary team with guidance on how to ensure that adequate and satisfactory communication is in place to record a patient's resuscitation status. However, as is common in the NHS, poor documentation is still evident. Guy's & St Thomas' Hospital Trust has been using a document since April 1998 which is clearly written, user friendly and does not contain ambiguous statements. With ongoing audit of this policy document we hope to reduce the incidence of inappropriate resuscitation attempts which are costly, both emotionally and financially, for all concerned. | Example of a tarpaulin lean to used as an operating theatre by the New Zealand Field Ambulance Units, and which is said to be used exclusively by the New Zealand Medical Corps. Shows lean to at the 6 New Zealand Field Ambulance in the Cassino area, Italy, during World War II. Photograph taken on 25 April 1944 by George Robert Bull. ::: Quantity: 1 b&w original negative(s). ::: Physical Description: Cellulosic film negative | eng_Latn | 27,032 |
[Consensus on nursing diagnoses, interventions and outcomes for home care of patients with heart failure]. | Abstract This was a consensus study with six cardiology nurses with the objective of selecting nursing diagnoses, outcomes and interventions described by NANDA International (NANDA-I), Nursing Outcomes Classification (NOC), Nursing Intervention Classification (NIC), for home care of patients with heart failure (HF). Eight nursing diagnoses (NDs) were pre-selected and a consensus was achieved in three stages, during which interventions/activities and outcomes/indicators of each NDs were validated and those considered valid obtained 70% to 100% consensus. From the eight pre-selected NDs, two were excluded due to the lack of consensus on appropriate interventions for the clinical home care scenario. Eleven interventions were selected from a total of 96 pre-selected ones and seven outcomes were validated out of 71. The practice of consensus among expert nurses provides assistance to the qualifications of the care process and deepens the knowledge about the use of tazonomies in nursing clinical practice. | NHS managers have called for a major overhaul of plans to reform the NHS in their response to the government’s listening exercise. ::: ::: The NHS Confederation, which represents health service managers, said in its submission to the NHS Future Forum, which is conducting the listening exercise, that reform of the NHS was needed. It added, however, that the government had not made the case for such major change and that reforms were not sufficiently focused on the difficulties facing the NHS such as the financial squeeze, variability in standards of care, … | eng_Latn | 27,033 |
A Three Year Journey to Organizational and Financial Health Using the Balanced Scorecard: A Case Study at a Yale New Haven Health System Hospital | The use and design of the BSC in the health care sector: A systematic literature review for Italy, Spain, and Portugal | Fifty Years and Going Strong: What Makes Behaviorally Anchored Rating Scales So Perennial as an Appraisal Method? | eng_Latn | 27,034 |
Are Patient-reported Outcomes Correlated With Clinical Outcomes After Surgery? -based Study A Population | Assessing Quality Using Administrative Data | Path collective variables without paths | eng_Latn | 27,035 |
PROBLEM ::: Policymakers and clinicians are concerned that initiatives to improve the quality of care for some conditions may have unintended negative consequences for quality in other conditions. ::: ::: ::: OBJECTIVE ::: We sought to determine whether a practice redesign intervention that improved care for falls, incontinence, and cognitive impairment by an absolute 15% change also affected quality of care for masked conditions (conditions not targeted by the intervention). ::: ::: ::: DESIGN, SETTING, AND PARTICIPANTS ::: Controlled trial in 2 community medical groups, with 357 intervention and 287 control patients age 75 years or older who had difficulty with falls, incontinence, or cognitive impairment. ::: ::: ::: INTERVENTION ::: Both intervention and control practices implemented case-finding for target conditions, but only intervention practices received a multicomponent practice-change intervention. Quality of care in the intervention practices improved for 2 of the target conditions (falls and incontinence). ::: ::: ::: MAIN OUTCOME MEASURES ::: Percent of quality indicators satisfied for a set of 9 masked conditions measured by abstraction of medical records. ::: ::: ::: RESULTS ::: Before the intervention, the overall percent of masked indicators satisfied was 69% in the intervention group and 67% in the control group. During the intervention period, these percentages did not change, and there was no difference between intervention and control groups for the change in quality between the 2 periods (P=0.86). The intervention minus control difference-in-change for the percent of masked indicators satisfied was 0.2% (bootstrapped 95% confidence interval, -2.7% to 2.9%). Subgroup analyses by clinical condition and by type of care process performed by the clinician did not show consistent results favoring either the intervention or the control group. ::: ::: ::: CONCLUSION ::: A practice-based intervention that improved quality of care for targeted conditions by an absolute 15% change did not affect measurable aspects of care on a broad set of masked quality measures encompassing 9 other conditions. | Objective: The new contract for primary care in the UK offers fee-for-service (FFS) payments for a wide range of activities in a quality outcomes framework (QOF), with payments designed to reflect likely workload. This study aims to explore the link between these financial incentives and the likely population health gains. Methods: The study examines a subset of eight preventive interventions covering 38 of the 81 clinical indicators in the quality framework. The maximum payment for each service was calculated and compared with the likely population health gain in terms of lives saved per 100,000 population based on evidence from McColl et al. (1998). Results: Maximum payments for the eight interventions examined make up 57% of the total maximum payment for all clinical interventions in the (QOF). There appears to be no relationship between pay and health gain across these eight interventions. Two of the eight interventions (warfarin in atrial fibrillation and statins in primary prevention) receive no incentive. Conclusions: Payments in the new contract do not reflect likely population health gain. There is a danger that clinical activity may be skewed towards high-workload activities that are only marginally effective, to the detriment of more cost-effective activities. If improving population health is the primary goal of the NHS, then FFS incentives should be designed to reflect likely health gain rather than likely workload. | We prove that groups acting geometrically on delta-quasiconvex spaces contain no essential Baumslag-Solitar quotients as subgroups. This implies that they are translation discrete, meaning that the translation numbers of their nontorsion elements are bounded away from zero. | eng_Latn | 27,036 |
This study assessed the quality of written information about abortion methods provided by clinics in England and Wales. Forty-four sets of leaflets were collected. The average leaflet was found to provide only half the possible information about benefits, risks and general procedures. Only half of the leaflets were of standard readability and accessible by 83% of the British population. Therefore, it seems unlikely that most women in England and Wales are in a position to make an informed decision about abortion method. | Readability formulas are being increasingly used to measure the understandability of written information in clinical and health settings. This paper examines the most commonly used formulas (Dale-Chall Formula, Flesch Reading Ease, Flesch-Kincaid Formula, Fog Index, Fry Readability Graph, and SMOG Grading). Their reliability and validity when used in health-related areas are discussed, and findings resulting from their use are described. These findings show that much of the material written for patients and clients, in the areas of informed consent, illnesses and their investigation and treatment, and lifestyle advice, is too difficult for many of them to understand. It is also concluded that increasing readability usually leads to improvement in understanding and occasionally in co-operation with treatment. Finally, methods for supplementing the information gained from readability formulas are described. | This second edition is throughly revised and corrected to take account of the many changes in the subject over the last 6 years, and has been enlarged by over 20per cent. | eng_Latn | 27,037 |
BACKGROUND ::: Composite scores that combine several performance measures into a single ranking are becoming the accepted metric for assessing hospital performance. In particular, the Centers for Medicare & Medicaid Services Hospital Quality Incentive Demonstration (HQID) project bases financial rewards and penalties on these scores. Although the HQID composite calculation is straightforward and easily understood, its method of combining process and outcome measures has not been validated. ::: ::: ::: METHODS AND RESULTS ::: Using data on 530 hospitals from the Society of Thoracic Surgeons National Cardiac Database, we replicated the HQID methodology with 6 nationally endorsed performance measures (5 process measures plus survival) for coronary artery bypass surgery. Composite scores were essentially determined by process measure performance alone; the survival component explained only 4% of the composite score's total variance. This result persisted even when the survival component was allowed a 5-fold greater weighting in the composite summary. The popular "all-or-none" measurement approach was also dominated by the process component. Substantial disagreement was found among hospital rankings when several alternative methods were used; up to 60% of hospitals eligible for the top financial reward under HQID would change designation depending on the composite methodology used. The application of a simple statistical adjustment (standardization) to each method would provide more consistent results and a more balanced assessment of performance based on both process and outcomes. ::: ::: ::: CONCLUSIONS ::: Existing methods used to create composite performance measures have remarkably different weighting of process versus outcomes metrics and lead to highly divergent provider rankings. Simple alternative methods can create more balanced process-outcome performance assessments. | OBJECTIVE ::: To determine the impact on hospital ranking of different aggregation methods when creating a composite score from a set of quality indicators relating to a single clinical condition. ::: ::: ::: DESIGN ::: The analysis was based on 14966 medical records taken from all French hospitals that treated over 30 patients with acute myocardial infarction in 2008 (n=275). Five quality indicators measuring the quality of care delivered to patients with acute myocardial infarction at hospital discharge were aggregated by 5 methods issued from a variety of activity sectors (indicator average, all-or-none, budget allocation process, benefit of the doubt, and unobserved component model). ::: ::: ::: MAIN OUTCOME MEASURES ::: Each aggregation method was used to rank hospitals into 3 categories depending on the position of the 95% confidence interval of the composite score relative to the overall mean. Variations in rank according to method were estimated using weighted κ coefficients. ::: ::: ::: RESULTS ::: Agreement between methods ranged from poor (κ=0.20) to almost perfect (κ=0.84). A change of method led to a change in rank for 71% (196 of 275) of hospitals. Only 14 of 121 hospitals which were ranked top and 20 of 118 which were ranked bottom, by at least 1 of the 5 methods, held their rank on a switch to the 4 other methods. ::: ::: ::: CONCLUSION ::: Hospital ranking varied widely according to 5 aggregation methods. If one method has to be chosen, for instance for reporting to governments, regulatory agencies, payers, health care professionals, and the public, it is necessary to provide its rationale and characteristics, and information on score uncertainty. | Perfect Quantum Cloning Machines (QCM) would allow to use quantum nonlocality for arbitrary fast signaling. However perfect QCM cannot exist. We derive a bound on the fidelity of QCM compatible with the no-signaling constraint. This bound equals the fidelity of the Bu\v{z}ek-Hillery QCM. | eng_Latn | 27,038 |
Maternal mortality in high income countries has become low in recent years and therefore analysis of severe acute maternal morbidity has been added to confidential enquiries into the causes of maternal deaths. The major drawback at the moment is the lack of universal definitions of severe acute maternal morbidity. The prevalence of severe acute maternal morbidity in high income countries is between 3.8 and 12 per 1,000 births. Case fatality rates may reflect the quality of maternal health care. Audit is the instrument to analyse whether substandard care factors are present. Guidelines and protocols to provide obstetric critical care may be improved from audit findings and skills and drills training put in place. | Aims: This study aims to determine the frequency of near-miss obstetric events and analyze its nature such as reasons for near-miss, organ dysfunction associated and critical management required among pregnant women managed over a 3-year period in a Tertiary Care Teaching Hospital in Nepal. Methods: This hospital based prospective, descriptive study was done from August 2011 to February 2015. Case eligibility was defined by WHO Near-Miss Guidelines. Medical records of the patients and the interview with the patient, accompanying family members and health workers from referral centres were used to generate the data which were filled in the pre-designed questionnaire. The data generated and analyzed included age and gestation weeks, parity, mode of intervention, associated organ dysfunctions, reasons for near-miss and critical intervention accompanied to manage the near-miss cases. Results were presented in mean ± SD and percentages, wherever applicable. Results: There were 4617 deliveries with 28 near-miss cases. The major factors contributing near-miss events were obstetric haemorrhage followed by hypertensive disorder. Three fourth (n=21) of cases required blood transfusion and almost all cases (n=26) required ICU management. Coagulation disorder was observed in majority of cases (n=23) followed by cardiovascular, respiratory and uterine atony. Conclusions: In this study, maternal near-miss event was mainly attributable to obstetric haemorrhage followed by hypertension and sepsis. Major organ-system disorders observed were coagulation disorder, cardiovascular, respiratory and uterine disorders. Almost all the cases were managed in ICU and majority of them required blood transfusion. | Objective Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Design Nationwide facility-based retrospective cohort study. Settings All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. Population 987 audited cases of maternal death. Main outcome measures Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. Results 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. Conclusions The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other strategies, in particular confidential enquiries and near-miss audits, so as to inform corrective measures. | eng_Latn | 27,039 |
BACKGROUND: There is considerable variation in prescribing, and existing standards against which primary care prescribing is routinely judged consist largely of local or national averages. There is thus a need for more sophisticated standards, which must be widely applicable and have credibility among the general practice profession. AIM: A study aimed to develop a range of criteria of prescribing quality, to set standards of performance for these criteria, and apply these standards to practices. METHOD: A consensus group consisting of eight general practitioners and a resource team was convened to develop and define criteria and set standards of prescribing performance using prescribing analyses and cost (PACT) data. The standards were applied to 1992-93 prescribing data from all 518 practices in the former Northern Regional Health Authority. RESULTS: The group developed criteria and set numeric standards for 13 aspects of prescribing performance in four areas: generic prescribing, prescribing within specific therapeutic groups, drugs of limited clinical value and standards based on prescribing volume. Except for generic prescribing, standards for individual criteria were achieved by between 9% and 34% of practices. For each criterion, a score was allocated based on whether the standard was achieved or not. Total scores showed considerable variation between practices. The distribution of scores was similar between fundholding and non-fundholding practices, and also between dispensing and non-dispensing practices. CONCLUSION: Using a consensus group of general practitioners it is possible to agree criteria and standards of prescribing performance. This novel approach offers a professionally driven method for assessing the quality of prescribing in primary care. | Measuring quality of primary health care is a focus of attention within New Zealand and internationally as health care providers and funders recognise the need for objective measures. 1 One method of demonstrating quality is through maintenance of membership of professional colleges and participating in continuing medical education or ‘maintenance of professional standards’ (MOPS) programmes. Quality may also be measured at a practice level. Tools have been proposed for this purpose by colleges of general practice in New Zealand, Australia and UK, and by other organisations eg, Australian Community Health Accreditation and Standards Programme (CHASP) and Health Plan Employer and Data Set (HEDIS) from the USA National Committee on Quality Assurance. 2 There is increasing emphasis on delivering and purchasing primary care at a population level. 3 The measurement of outcomes, for example mortality and morbidity rates, remains the gold standard for measuring population health. However, crude rates are insensitive measures of the quality of health care since they may take a long time to reflect changes in quality of care and are heavily confounded by environmental determinants. Process measures can provide more timely indicators of quality and reduce confounding effects of environmental variables on assessments of the quality of care. 4 This paper proposes a set of process measures for quality of primary care that may be easily calculated from data collected by computerised queries of practice databases. | Berzelius failed to make use of Faraday's electrochemical laws in his laborious determination of equivalent weights. | eng_Latn | 27,040 |
Patient-rePorted outcome measures (Proms), or patient reported outcomes (Pros) as they are known in the united States, are questionnaires that seek to measure health status or health-related quality of life from the patient’s perspective. the questions ask patients specifically about their health and quality of life. they should not be confused with other types of questionnaire that ask patients about their opinion, satisfaction or view about treatments. Proms have gained increasing prominence since the publication of the darzi report during the last government (darzi 2008). the report recommended that Proms should be used routinely to provide data on the quality of care. Since 2009 nHS hospitals have been required to ask patients to complete a Prom questionnaire before and after four surgical procedures: hip replacement, knee replacement, hernia repair and varicose vein treatments. the data from these Proms are now published on a monthly basis and can be accessed on the nHS information centre website (www.ic.nhs.uk). the amount of data available is increasing, with pre-operative data published in april 2010 and post-operative data available since october 2010. the change of government has not decreased the importance of Proms. indeed, the nHS white paper said that the use and scope of PromS is likely to increase (department of Health (dH) 2010): ‘Proms are currently collected for some specific elective procedures, and could be applied to a broader array of other procedures, or more generally, in the future.’ Proms have been used in a number of different settings to provide data in clinical trials, audits, registers, manage individual care and to evaluate the performance of healthcare providers (dawson et al 2010). although Proms have not necessarily been developed specifically for older people (Fitzsimmons et al 2009), they can provide valuable data on the quality and effect of care directly from the patient’s perspective. it is therefore imperative that nursing staff have an understanding of their benefits and limitations. | This paper explores the concept of patient-centred care as a dimension of quality as applied to dentistry and provides a systematic review of the literature. The new NHS dental contract, which is currently being piloted in England, is committed to delivering improvements in quality. The Dental Quality and Outcomes Framework has been developed as a tool to measure quality and focuses on three key dimensions: clinical effectiveness, safety and patient experience. A systematic review of the literature reveals a lack of information pertaining to patient-centred care within dentistry, and in particular general dental practice. It would also suggest that there is currently a poor evidence base to support the use of the current patient reported outcome measures as indicators of patient centredness. | Berzelius failed to make use of Faraday's electrochemical laws in his laborious determination of equivalent weights. | eng_Latn | 27,041 |
CONTEXT ::: Many patients and their families have difficulty making decisions when confronted with complex medical problems. Often their expectations and hopes are beyond what medical science can deliver, and at times their desires seem to conflict with their treatment plans. Additionally, costly tests and treatments with little or no benefit are often explored. Inpatient palliative care consultation services for end-of-life-care planning can help patients navigate this complexity, arrive at a care plan consistent with their personal values, and be good stewards of precious medical resources. ::: ::: ::: OBJECTIVE ::: We conducted a study to assess the effect that one function of our organization's Inpatient Palliative Care Service-consultation regarding end-of-life-care planning-has on readmission rates. We believed that our study would show that interdisciplinary end-of-life-care planning improves resource use by reducing the probability and rate of hospital readmission. ::: ::: ::: METHODS ::: We retrospectively reviewed electronic records for Kaiser Permanente HealthConnect at Kaiser Permanente South Bay Medical Center in Harbor City, CA, for 200 consecutive patients referred to our Inpatient Palliative Care Service between November 2006 and February 2010, comparing hospital readmissions between two groups of patients. Members of both groups (100 patients in each) all had an Inpatient Palliative Care consult ordered for end-of-life-care planning; members of group A were seen solely by an inpatient palliative care registered nurse (RN), whereas members of group B were seen by an interdisciplinary team consisting of a physician, a bioethicist, a social worker, an RN, and a hospital chaplain. ::: ::: ::: RESULTS ::: We found that with the post-team consultation, readmissions to the hospital per patient per six months after consultation decreased from 1.15 to 0.7 admissions per patient. | BACKGROUND AND OBJECTIVE ::: Code status discussions may fail to address patients' treatment-related goals and their knowledge of cardiopulmonary resuscitation (CPR). This study aimed to investigate patients' resuscitation preferences, knowledge of CPR and goals of care. Design, setting, patients and measurements: 135 adults were interviewed within 48 h of admission to a general medical service in an academic medical centre, querying code status preferences, knowledge about CPR and its outcome probabilities and goals of care. Medical records were reviewed for clinical information and code status documentation. ::: ::: ::: RESULTS ::: 41 (30.4%) patients had discussed CPR with their doctor, 116 (85.9%) patients preferred full code status and 11 (8.1%) patients expressed code status preferences different from the code status documented in their medical record. When queried about seven possible goals of care, patients affirmed an average of 4.9 goals; their single most important goals were broadly distributed, ranging from being cured (n = 36; 26.7%) to being comfortable (n = 8; 5.9%). Patients' mean estimate of survival to discharge after CPR was 60.4%. Most patients believed it was helpful to discuss goals of care (n = 95; 70.4%) and the chances of surviving in hospital CPR (n = 112; 83.0%). Some patients expressed a desire to change their code status after receiving information about survival following in hospital CPR (n = 11; 8.1%) or after discussing goals of care (n = 2; 1.5%). ::: ::: ::: CONCLUSIONS ::: Doctors need to address patients' knowledge about CPR and take steps to avoid discrepancies between treatment orders and patients' preferences. Addressing CPR outcome probabilities and goals of care during code status discussions may improve patients' knowledge and influence their preferences. | Blunt trauma abdomen rarely leads to gastrointestinal injury in children and isolated gastric rupture is even rarer presentation. We are reporting a case of isolated gastric rupture after fall from height in a three year old male child. | eng_Latn | 27,042 |
BACKGROUND ::: Safety improvements are sometimes based on the premise that introducing measures to combat minor or no-harm incidents proportionately reduces the incidence of major incidents involving harm. This is in line with the principle of the Heinrich ratio, which asserts that there is a relatively fixed ratio between the incidence of no-harm incidents, minor incidents and major incidents. This principle has been advocated as a means of targeting and evaluating new safety initiatives. ::: ::: ::: RESEARCH METHODOLOGY ::: Both thought experimentation and analysis of empirical data were used to examine the plausibility of this principle. A descriptive statistical analysis was carried out using triangle plots to display the relative frequencies of the occurrence of safety incidents classified as minor, moderate or severe. ::: ::: ::: FINDINGS ::: Thought experiments indicated that the principle of a fixed Heinrich ratio has a dubious logical foundation. Analysis of emergency department attendance and studies of medication errors demonstrated marked variation in the relative ratios of different outcomes. Triangle plots of UK road traffic accident data revealed a hitherto unrecognized systematic pattern of change that contradicts the principle of the Heinrich ratio. ::: ::: ::: INTERPRETATION ::: This study of the principle of a fixed Heinrich ratio invalidates it: introducing measures to reduce the incidence of minor incidents will not inevitably reduce the incidence of major incidents pro rata. Any safety policies based on the assumption that the Heinrich ratio is true need to be rethought. | In contemporary healthcare settings, ensuring patient safety must be an underlying principal through which systems, teams, individuals and environments work in tandem to strive for. The adoption of a culture in the NHS where patient safety is given greater priority is key to improvement. Recent events at Mid-Staffordshire hospitals among others have brought patient safety into the minds of the public and it increasingly demands attention from clinicians, the press and governments. However, much of the work into patient safety has been completed in the secondary care field with very little work completed in primary care settings. In primary care dentistry, improving patient safety is a relatively new concept with a distinct lack of evidence base. In this article, we discuss what patient safety is and debate its relevance to primary care dentistry. We also look at previous work completed in this field and make recommendations for future work to address the current lack of research. | Distillation at an infinite reflux ratio in combination with an infinite number of trays has been investigated. | eng_Latn | 27,043 |
Memoriam of Acknowledgements:Comments on FENG Zhi's Sonnets Collection | Not only has FENG Zhi's Sonnets Collection helped achieve the author's artistic breakthrough,but also demonstrated its distinctive artistic charm on the part of contemporaneous war-resistance parnassus. Therefore,ever since its advent it has received great concern and much speculation on its theme. So,what is the theme on earth? By reading Sonnets Collection through and relating it to the contemporary social surroundings,the paper finds out that the theme is the memoriam of acknowledgements,including acknowledgements for natural images,for great men and even for daily lives. It is these acknowledgements that make Sonnets Collection a work of psychic meditation. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,044 |
The Swot Analysis of The Çorum Tourism | Tourism sector in Turkey has shown great progress since 1980. Contribution of foreign money acquired from tourism while the country was having economic problems helped to decrease foreign debt and unemployment. The data showing the number of tourists coming to the country, income earned from tourists, amount of expenditure per tourist and the share of tourism from GDP, investment and exports, indicate that tourism is one of the most leading sectors in Turkish Economy from 1980's onward. It will be possible for Turkey to have a great share from international tourism sector earnings if more competitive and sustainable policies are implemented in the future; and this will increase social welfare in the possible shortest period. The aim of this study is to determine the general situation of tourism in Corum province of Turkey and to analyze its tourism possibilities and facilities. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,045 |
ResearchGuides. Research and Scholarship: A Faculty Guide. Empirical Research. | This guide is designed to assist in choosing research topics, involving yourself in conferences, submitting your work for publication and protecting and understanding your rights as an author. It also provides examples of colleagues' scholarship. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,046 |
Is it time to stop talking about services being ‘nurse-led’? | Over the past 20 years, several changes to the UK's health-care system has led to a significant transition of power from medicine to nursing roles in renal medicine. However, as services continue to evolve, Peter Ellis and Karen Jenkins ask whether kidney care services should be focusing their efforts on promoting ‘person-centred’ care rather than ‘nurse-led’ services. | Aims This study aimed to identify how di ierent trusts in England were utilising lay involvement through their clinical governance committees. Method It considered the perspectives of both the trust and the lay members. Twenty-three clinical governance chairs and lay participants returned a questionnaire. Results This study found that the lay participants were far from representative of the local population in terms of socio-demographics and special interests, and highlighted dee ciencies in their recruitment and training. Conclusions The conclusions point to successful approaches that could be applied by trusts. | eng_Latn | 27,047 |
Interventions for treating influenza: an overview of Cochrane systematic reviews | Reason for Withdrawal ::: ::: ::: This protocol was withdrawn from The Cochrane Library issue 10, 2014 as the authors were unable to complete the overview. To view the published versions of this article, please click the 'Other versions' tab. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,048 |
Reform, malpractice sour younger doctors' outlook | Young physicians think the outlook for their profession is bleak, according to a recent survey by the Physicians Foundation, a nonprofit organization that advocates for doctors. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,049 |
Health Companion Project: A community-based participatory research model for health promotion in Iran: | A 4-year (2008–2011) community-based participatory research was implemented in the Kohgiloyeh and Boyerahmad province, Iran. A steering committee was established from academics, policy makers, health officials, and representatives of health sectors. This committee selected six regions within Boyerahmad and Dena counties based on administrative divisions. Health companions consisting of stakeholders, academics, local leaders, health providers, and public representatives were established to guide the project in each region. The health companion groups were enabled by attending workshops dealing with need assessment, priority setting, and research methodology. Health companion groups adopted a Planned Approach to Community Health (PATCH) methodology including community mobilization for data collection, health priority setting, developing of a comprehensive intervention plan, and evaluation. A list of main health issues and their priorities for each region was provided. Subsequently, research topics were dete... | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,050 |
OUTBREAK OF INFLUENZA IN A NEONATAL INTENSIVE CARE UNIT | An outbreak of influenza A/Victoria/3/75 (H3N2) involving five infants in a neonatal intensive care unit is described. The clinical signs and symptoms were indistinguishable from those seen in bacterial sepsis. There was no evidence of meningoencephalitis. All infants recovered without any sequelae. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | yue_Hant | 27,051 |
Sleep on the wards: an ongoing battle | As a junior doctor, aside from the predictable daily tasks, I found an all too familiar request from many patients. “Doctor, I had a terrible night’s sleep, you couldn’t prescribe me something could you?” My colleagues were surprised at the frequency of this request—patients’ sleep not being a subject covered in detail when we were medical students. But, whether it’s a nurse thrusting a drug chart in front of us to request sleeping tablets or a … | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,052 |
Knowledge ofand reportedasthma management among SouthAustraliangeneralpractitioners | SUMMARY Aim.Thisstudy, carried outin1989, setouttoassess general practitioners' knowledge ofasthmamanagement and their reported management practices. Method. Of153randomly selected SouthAustralian generalpractitioners 127(83%)completed aquestionnaire designed toexplore issues relating tothemanagement of asthma. Results. Thesurveyrevealed substantial differences between general practitioners intheir knowledge andmanagementpractices including theassessment oftheseverity ofasthma, theneedforobjective monitoring, that isbythe useofspirometry andpeakflowmeters, andtheuseof medication. Overall, thesampledgeneral practitioners believed thatpatient-related factors werethemainbarriers toeffective treatment ofasthma. Conclusion. Thefindings ofthis study suggest thatideal asthmamanagementwas notbeingattained. More research isrequired toascertain whysuchvariability amongpractitioners exists andhowbesttoremedythese differences. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,053 |
Sudden death in the super obese – the forensic implications of obesity | The incidence of obesity in the general population is increasing and consequently those requiring post-mortem are of a consistently higher body mass index. Special consideration must be given to the approach to post-mortem in the obese. Aside from the manual handling and practical difficulties, obesity generates a unique pathophysiology which frequently underlies the cause of death, especially sudden death in these individuals. A thorough understanding of the pathophysiology and an awareness of the wide range of conditions associated with obesity is essential in forensic pathology. I will review obesity associated mortality, the patho-physiology of obesity and the range of possible conditions affecting various organ systems using select case examples and touching briefly on recent research findings within the ever increasing field of obesity literature. | BACKGROUND/OBJECTIVE ::: The goal of this update in hospice and palliative care is to summarize and critique research published between January 1 and December 31, 2014 that has a high potential for impact on clinical practice. ::: ::: ::: DESIGN ::: To identify articles we hand searched 22 leading journals, the Cochrane Database of Systematic Reviews, and Fast Article Critical Summaries for Clinicians in Palliative Care. We also performed a PubMed keyword search using the terms "hospice" and "palliative care." ::: ::: ::: MEASUREMENTS ::: We ranked candidate articles based on study quality, appeal to a breadth of palliative care clinicians, and potential for impact on clinical practice. ::: ::: ::: RESULTS ::: In this manuscript we have summarized the findings of eight articles with the highest ratings and make recommendations for clinical practice based on the strength of the resulting evidence. | eng_Latn | 27,054 |
Implementation of PACS and informatics in a community-sized hospital: making real-time radiology a reality | This paper describes the implementation experience in a community hospital setting to provide medical information at the point of decision instantaneously using digital and communication technologies. A unique partnership has been formed between the provider, the Saint John's Health Center, and the vendor to develop, design, and implement a hospital- wide PACS using a multi-phased approach.© (2001) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only. | BACKGROUND/OBJECTIVE ::: The goal of this update in hospice and palliative care is to summarize and critique research published between January 1 and December 31, 2014 that has a high potential for impact on clinical practice. ::: ::: ::: DESIGN ::: To identify articles we hand searched 22 leading journals, the Cochrane Database of Systematic Reviews, and Fast Article Critical Summaries for Clinicians in Palliative Care. We also performed a PubMed keyword search using the terms "hospice" and "palliative care." ::: ::: ::: MEASUREMENTS ::: We ranked candidate articles based on study quality, appeal to a breadth of palliative care clinicians, and potential for impact on clinical practice. ::: ::: ::: RESULTS ::: In this manuscript we have summarized the findings of eight articles with the highest ratings and make recommendations for clinical practice based on the strength of the resulting evidence. | eng_Latn | 27,055 |
National Institutes of Health Will Honor Clinton's Commitment to Increase Spinal Cord Injury Research | This Washington Fax report summarized the NIH plan, but also discussed the NIH's usual resistance to earmarking funds ::: for special diseases at legislators' requests, and noted why it was disruptive to make such demands, especially halfway ::: through a fiscal year. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,056 |
Patient and carer input and the NHS: a vital tool in improving care | In every other industry, ‘the customer is king’– so why should health care be any different? With reference to the Department of Health’s newly published legislation, Real Accountability: Guidance on the NHS duty to report on consultation, Alan Glasper examines the importance of patient and carer input into NHS services. | In this issue we carry a number of convergent papers on Theory and Methods that will contribute to the debate about “fit for purpose” academic support for practice. From the United States, Dr Roux provides a comprehensive glossary of terms for the increasingly important multilevel analysis, while Wardle and colleagues explore the use of a home affluence scale as an alternative means of assessing socioeconomic status in adolescence. ::: ::: See pages 588, 595 ::: ::: From Manchester come two complementary papers that propose the use of impact numbers in health policy decisions and in measuring the effects of interventions on population health, and McCarthy … | eng_Latn | 27,057 |
Photocopying permitted by license only dialogues of the heart: Norodom Sihanouk and Mahatma Ghandi as portrayed by Helene Cixous | In 1985, Helene Cixous’ eight‐hour play, L'Histoire terrible mais inachevee de Norodom Sihanouk, roi du Cambodge (The Terrible but Unfinished Story of Norodom Sihanouk, King of Cambodia), opened in Paris at the Theâtre du Soleil. Two years later, in 1987, Cixous presented a second major play based on recent history: L'Indiade, ou l'Inde de leurs reves (The Indiade, or India of their Dreams). Unlike Cixous’ earlier plays, which featured female protagonists and few characters, these two revolve around strong male figures, Sihanouk and Ghandi, and a cast of some fifty other personalities ranging from powerful men such as Chou‐Enlai, Jawaharlal Nehru, Henry Kissinger and Lord Mountbatten to simple peasants and ghosts. Cixous portrays Sihanouk and Ghandi at dramatic historical moments, when their countries are being torn asunder. She captures the essence of each man as the spiritual symbol of a people in crisis. Focusing on their “dialogues of the heart,” this article examines comparable elements in the portra... | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,058 |
Ratiometric fluorescence imaging of nuclear pH in living cells using Hoechst-tagged fluorescein. | Small-molecule fluorescent sensors that allow specific measurement of nuclear pH in living cells will be valuable for biological research. Here we report that Hoechst-tagged fluorescein (hoeFL), which we previously developed as a green fluorescent DNA-staining probe, can be used for this purpose. Upon excitation at 405nm, the hoeFL-DNA complex displayed two fluorescence bands around 460nm and 520nm corresponding to the Hoechst and fluorescein fluorescence, respectively. When pH was changed from 8.3 to 5.5, the fluorescence intensity ratio (F520/F460) significantly decreased, which allowed reliable pH measurement. Moreover, because hoeFL binds specifically to the genomic DNA in cells, it was applicable to visualize the intranuclear pH of nigericin-treated and intact living human cells by ratiometric fluorescence imaging. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,059 |
An Empirical Research in the Stock Market of Shanghai by GARCH Model | GARCH model is a kind of time series model developed after 1982. It reflects a special feature of (economic) variables-time-varying variances. So it plays the important role in the financial market. We introduce the form and classes of GARCH in this article in detail, then we establish the GARCH(1,1)-t and GARCH(1,1)-normal model to analyse the risk of stock market. The result indicates that GARCH(1,1)-t model is better than others. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,060 |
Health System Reform: The Case for a Single-Payer Approach-Reply | In Reply. —Since I submitted my article toTHE JOURNAL, developments in the marketplace have underscored the necessity of moving to a single-payer system to preserve the patient-physician relationship. Notably, on March 22, 1994, the Travelers Insurance Company and Metropolitan Life announced their intention to merge their health care operations. Where are the physicians and the patients in this merger? US Health, a large national managed care corporation, is reported to take 28% of its premium dollar for "administrative overhead." That is 28 cents of every dollar as the measure of care denied to patients. The evidence is overwhelming that "the market" is responding to health care cost pressures and that that response is to consolidate the control of the for-profit insurance companies over the health care delivery system. We are on the verge of becoming the only country in the world to hand over its health care system to | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | kor_Hang | 27,061 |
Are separate black and white MMPI norms needed?: An IQ-controlled comparison of accused murderers | Investigated racial differences in MMPI responding by comparing samples of black and white males charged with murder (N = 160). Mancova was used to control statistically for the effects of intelligence on racial differences. Prior to the use of Mancova blacks had significantly higher scores on F and MA. When the effects of intelligence were controlled F and MA were no longer significantly different for blacks and whites. However, with black and white SS equated on IQ, significant differences emerged on the K and SI scales. These results indicate that construction of separate black and white norms for violent offenders is premature. More research is needed on variables that affect individual differences on the MMPI. Language: en | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,062 |
The acquired immunodeficiency syndrome (AIDS): memorandum from a WHO meeting. | An International Conference on Acquired Immunodeficiency Syndrome (AIDS), sponsored by the United States Department of Health and Human Services and the World Health Organization, was held in Atlanta on 15-17 April 1985. More than 3000 participants from 50 countries attended. This conference was followed by a meeting organized by WHO on 18-19 April where the participants reviewed the information presented at the conference and assessed its international health implications, which are described in this Memorandum. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,063 |
A protocol for the investigation of pregnancy loss. | A protocol for the evaluation of pregnancy loss should include a maternal history, dysmorphic examination of the fetus or abortus, photographs, autopsy, chromosome studies (in most cases), and radiographic or xeroradiographic studies. Selected cases with suspected ascending or transplacental infection may require microbiologic investigation. Increasing specialized laboratory techniques may help in the diagnosis of inborn errors of metabolism or storage disorders. Coordination of studies requires the interaction of OB/GYN, pathology, genetics, cytogenetics, and nursing in order to assure delivery of this clinical service. Knowledge of the causes of pregnancy loss and their typical time and mode of presentation can facilitate a focused evaluation, with a high chance of achieving an accurate diagnosis. The goal of all investigations is to provide families with recurrence risk data on which to base future childbearing decisions, as well as information on potential prenatal monitoring. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,064 |
Research on Cardiopulmonary Function of the Undergraduates in Shanxi Agricultural University | We put into effect on the undergraduates in Shanxi Agricultural University by means of comparing experiment: 10-15 minute physical training in physical Education classes, 20-minute morning exercises and training of Cardiopudmonary function on body-building prescription. The results show the enforcement of experiment achieved the goal of improving cardiopulmonary function of the undergraduates. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,065 |
Early Parental Responses to Sudden Infant Death, Stillbirth or Neonatal Death | Objective: To examine the mental health of parents after stillbirth (SB), neonatal death (NND) or sudden infant death syndrome (SIDS). | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,066 |
On a computer-oriented approach to actuarial calculations | Abstract The literature about the use of electronic computers in life insurance companies is very extensive. But still there is not much written about the possibility to by-pass commutation functions in making actuarial calculations. Most actuaries seem to use basically the same methods nowadays as they used twenty years ago when they had to do all calculations by hand or with the aid of very simple mechanical devices. But as a consequence of the increasing speed of generally used data processing equipment there will probably be a change in this attitude because of the great flexibility that can be reached by more advanced methods. | In the number of the Journal for April, 1868, Herr Wilhelm Lazarus, of Hamburg, reported the recent establishment in Berlin of a German Life Assurance Institute, a society having generally the same object as the Institute of Actuaries. As the proceedings of such an association cannot fail to interest the members of the Institute of Actuaries and the readers of its Journal , we purpose laying before them some of the more interesting papers read before the German Institute; and as a fit introduction to these we now give the following translation of the laws of that Society, for which we are indebted to Mr. J. Hill Williams.—ED. J. I. A. | eng_Latn | 27,067 |
Demoralization: a precursor to physician burnout? | Demoralization is a state of hopelessness and helplessness that is akin to, but separable from, depression. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,068 |
RESEARCH ARTICLE Spread, volatility and monetary policy: empirical evidence from the Indian overnight money market | This study uses a GARCH model to estimate conditional volatility in the Indian overnight money market during the period 1999–2006. It finds that the bid-ask spread in the overnight market was positively related to conditional volatility during 1999–2002. This relationship, however, has undergone a structural break since 2002 and lagged spread, along with conditional variance of the call rate, played an important role in determining spread during 2002–2006, indicating the improvement in market microstructure in recent years. Regarding monetary policy measures and money market volatility, the empirical findings indicate that expansionary monetary policy reduces volatility of both the weighted average call rate and the bid-ask spread. Among individual policy instruments, announcement of cash reserve ratio changes have a negative impact on the volatility of both call rate and spread. The other policy variables like Bank Rate, repo and reverse repo rates have a mixed impact on volatility of call rate and spread. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,069 |
H.R.3163 - Affordability Is Access Act | Affordability Is Access Act This bill amends the Public Health Service Act to require health insurance and group health plans to cover, as preventive care for women, over-the-counter oral contraceptives for daily use, regardless of whether an enrollee has a prescription for the contraceptive. (Insurers and plans cannot impose cost sharing for preventive care.) | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,070 |
Reducing nosocomial infection in neonatal intensive care: an intervention study. | Nosocomial infection is a common cause of morbidity and mortality for hospitalized neonates. This report describes measures taken to reduce the prevalence of nosocomial infection within a 34-bed neonatal intensive care unit in Malaysia. Interventions included a one-to-one education programme for nursing staff (n = 30); the education of cleaners and health-care assistants allocated to work in the unit; and the introduction of routine (weekly) screening procedure for all infants with feedback given to staff. The education programme for nurses focused on the application of standard precautions to three common clinical procedures: hand washing, tracheobronchial suctioning and nasogastric tube feeding. These were evaluated using competency checklists. The prevalence of nosocomial blood and respiratory tract infections declined over the 7-month study period. This study highlights the importance of education in contributing to the control of nosocomial infection in the neonatal intensive care unit. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,071 |
A Slovakian Regional Court rules that the debt write-off under the “arrangement with creditors” does not constitute State aid within the meaning of the State Aid Act (Frucona) | Factual background: The defendant is a company active in production of beverages which was granted a debt write - off based on the concluded “arrangement with creditors” under the Act on… | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,072 |
Translation and validation of the German version of the foot and ankle outcome score | Purpose ::: Outcome assessment is critical in evaluating the efficacy of orthopaedic procedures. The Foot and Ankle Outcome Score (FAOS) is a 42-item questionnaire divided into five subscales, which has been validated in several languages. Germany has no validated outcome score for general foot and ankle pathology. The aim of this study was to develop a German version of the FAOS and to investigate its psychometric properties. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,073 |
Assessment of the Ki67 labeling index: a Japanese validation ring study | Background ::: A lack of consistent methods to evaluate Ki67 expression is problematic in terms of accurately predicting prognosis in breast cancer. Accordingly, this study aimed to identify the causes of discrepancies in Ki67 labeling index measurements by different observers under different conditions using breast cancer samples. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,074 |
Response to: ‘Comment on: standardisation of myositis-specific antibodies: where are we today?’ by Infantino et al | We agree with the notions made by Infantino et al 1 in their reply to our previously published report2 concerning the need for multicentre studies to obtain large enough number to validate new methods for detection of myositis-specific antibodies (MSA) and myositis-associated autoantibodies (MAA). We also … | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,075 |
Pragmatic Method to Assess Blood Pressure Control From Home Blood Pressure Diaries | The Annals of Family Medicine encourages readers to develop a learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care and then acting on those discussions.1 | BACKGROUND/OBJECTIVE ::: The goal of this update in hospice and palliative care is to summarize and critique research published between January 1 and December 31, 2014 that has a high potential for impact on clinical practice. ::: ::: ::: DESIGN ::: To identify articles we hand searched 22 leading journals, the Cochrane Database of Systematic Reviews, and Fast Article Critical Summaries for Clinicians in Palliative Care. We also performed a PubMed keyword search using the terms "hospice" and "palliative care." ::: ::: ::: MEASUREMENTS ::: We ranked candidate articles based on study quality, appeal to a breadth of palliative care clinicians, and potential for impact on clinical practice. ::: ::: ::: RESULTS ::: In this manuscript we have summarized the findings of eight articles with the highest ratings and make recommendations for clinical practice based on the strength of the resulting evidence. | eng_Latn | 27,076 |
Interactive case teaching method application in health law teaching | The value orientation of the case teaching was expound in this article:It is beneficial to train the creative and interpersonal communicative ability,all-round quality of health law of the students,and it is helpful to improve professional work of the teachers.The application measures of the case teaching were discussed mainly in this article:Giving the students more practical teaching time,choosing the appropriate cases and setting good examples,cases analysis and discussion,summarizing cases,composing case analysis reports.Finally,the questions were put in this article:case teaching differs from illustrating with example and speaking law with case,case teaching method should pay attention to combine other teaching methods. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,077 |
The Nobel Prize in 2005 for the discovery of Helicobacter pylori: implications for child health. | UNLABELLED ::: The Nobel Prize in Physiology or Medicine in 2005 has been awarded to B. Marshall and R. Warren for their discovery that peptic ulcer disease is caused by an infection with Helicobacter pylori. This infection, which affects about half of the world's population and is already extremely prevalent in adolescents in developing countries, starts as an asymptomatic gastritis which, under certain conditions, is followed by gastric or duodenal ulcer disease. ::: ::: ::: CONCLUSION ::: No proven benefit has yet been found by treating H. pylori-infected children with gastritis unless they have a peptic ulcer. Vaccination against H. pylori infection during early childhood is considered a means of preventing peptic ulcer disease and also possibly adenocarcinoma. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,078 |
Clinical Analysis of Hospital-acquied fungitoxicity infection pneumonia on 90 Cases | Objective:To inverstigate the basic circumstans and influence factor of hospital-acquired fungitoxicity infection pneumonia.Methods:To review analysis on 90 cases with hospital-acquired fungitoxicity infection pneumonia.Results:The rate of hospital-acquired fungitoxicity infection pneumonia is 18.5%.The main foundation diseases are Chronic Obstructive Pulminary Diseases(COPD),such as carcinoma,chronic renal failuer,systemic lupus erythematosus(SLE)and so on.For infection of fungi,one of the most commen dangerous is not reasonable usage antibacterial,another factor is malnutrition.Conclusion:The main dangerous factor of hospital-acquired fungitoxicity infection pneumonia is not reasonable usage antibacterial and exsit the foundation diseases.We must pay great attention to this question. | BACKGROUND/OBJECTIVE ::: The goal of this update in hospice and palliative care is to summarize and critique research published between January 1 and December 31, 2014 that has a high potential for impact on clinical practice. ::: ::: ::: DESIGN ::: To identify articles we hand searched 22 leading journals, the Cochrane Database of Systematic Reviews, and Fast Article Critical Summaries for Clinicians in Palliative Care. We also performed a PubMed keyword search using the terms "hospice" and "palliative care." ::: ::: ::: MEASUREMENTS ::: We ranked candidate articles based on study quality, appeal to a breadth of palliative care clinicians, and potential for impact on clinical practice. ::: ::: ::: RESULTS ::: In this manuscript we have summarized the findings of eight articles with the highest ratings and make recommendations for clinical practice based on the strength of the resulting evidence. | eng_Latn | 27,079 |
Methicillin-resistant Staphylococcus aureus: risk assessment and infection control policies. | The endemic state of methicillin-resistant Staphylococcus aureus (MRSA) occurs through a constant influx of MRSA into the healthcare setting from newly admitted MRSA-positive patients, followed by cross-transmission among inpatients and an efflux of MRSA from the hospital with discharged patients. To date, most MRSA prevention strategies have targeted cross-transmission among hospitalised patients. Intensive concerted interventions that include isolation can reduce the MRSA incidence substantially. However, debate continues about the cost-effectiveness of infection control policies, including screening protocols, to control the influx of MRSA into hospitals. The rationale and cost-effectiveness of wide screening, as compared to targeted screening, should be further studied using appropriate statistical approaches and economic modelling. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,080 |
STRUCTURAL HEALTH MONITORING VIA STIFFNESS UPDATE | The performance of an updated time-domain least-squares identification method for identifying a reduced-order linear system model in the case of limited response measurements and its use in structural health monitoring is evaluated. It is shown that the incorporation of a mass-invariability constraint enhances the robustness of the parametric identification procedure. The full structural stiffness and mass matrices are identified from the identified reduced-order model by using the condensed model identification and recovery method. The damage state is considered to be represented by an incremental stiffness degradation model. The degradation in stiffness is estimated through the minimization of an error function defined in terms of Rayleigh quotients. The performance of the proposed scheme is examined with reference to the simulated damage due to earthquake excitation in a 10-story building with rigid floor diaphragm. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | yue_Hant | 27,081 |
Management Of Male Infertility -- An Assay Used To Assess Sperm Membrane Integrity | Functional and morphological integrity of the sperm membrane was assessed by the ‘water test’, using distilled water as a hypoosmotic medium. Among 35 men with idiopathic infertility and 15 fertile men, good correlation between (b-g) type swollen sperm was observed for sperm concentration (r=0.63, p<0.001) and percent motility (r=0.53, p< 0.001). The percentage of swollen sperm was significantly different between fertile and infertile men. Thus ‘water test’ is simple and reliable to evaluate sperm membrane integrity. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | kor_Hang | 27,082 |
[Indications for the monitoring of aminoglycoside serum concentrations in internal medicine]. | Numerous factors in the human body can influence and cause variations in the pharmacokinetics of aminoglycoside antibiotics. As a result of these observations it has been demanded that all treatments with aminoglycosides be monitored. This would only appear to be justified for a limited number of indications, however, which involve very high dosages, long-term therapy and impaired renal function. The advantages of monitoring treatment are demonstrated in a patient with endocarditis. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,083 |
BELIEF-REVISION, THE RAMSEY TEST, MONOTONICITY, AND THE SO-CALLED IMPOSSIBILITY RESULTS | A cover at an end portion of a covered wire is incised by upper and lower cutting blades. The covered wire and the cutting blades are moved relatively in the longitudinal direction of the covered wire to thereby start the cover stripping operation at an end portion of the cover on the core. Thereafter, during this relative movement, the depth of incising the cover by the cutting blades is reduced step by step within a range where blade portions of the cutting blades can catch the cover. Even in the case where the cover of a covered wire is thin, it is made possible not only to strip the cover surely, but also to prevent a core from being injured. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | yue_Hant | 27,084 |
[A "good death" needs to be discussed. A study of patients with acute myeloid leukemia demonstrates the value of palliative care]. | The incidence of AML in Sweden is 5.4/100,000, i.e. 300 persons a year. About 70% of the patients die from their disease. In a retrospective study of medical journals of 106 patients with AML, who had died 1995-1997 in five selected hospitals in Sweden, the last week in life was studied. Sixty-six women and 40 men (age 19-84, mean 67) were included and 658 days of care were documented. The cause of death, the place of death, the type of care and clinical problems and symptoms were registered. We found bleeding (44%), infection (71%), pain (76%) and respiratory (59%) and psychological (64%) problems. Next of kin were often present and during the last week in life 3/4 of the patients had palliative care focusing on symptom relief and quality of life for the patients and his/her family. | This article examines the mid-twentieth-century transformation of U.K. pension fund investment policy known as the “cult of equity.” It focuses on the influence exercised by the Association of Superannuation and Pension Funds over actuarial and corporate governance standards, through actuaries who were members of its council. This intervention led to increasingly permissive actuarial valuations that reduced contributions for sponsors of pension funds investing in equities. Increased demand for equities required pension funds to adopt a more permissive approach to corporate governance than insurance companies and investment trusts, and contributed to declining standards of corporate governance. | eng_Latn | 27,085 |
Contributions of Living Labs in reducing market based risk | Traditionally, the gap between research and innovation has been covered by startups and entrepreneurs who take on the risk and the uncertainty associated with bringing to market novel products or services. Public intervention in innovation has indeed attempted to lower that risk, but his intervention has been commonly associated to increasing the availability of factors that could trigger innovation, such as capital or research potential, rather than reducing the risks associated with the market, such as product/service or business model inadequacy. However, experience shows that are these market risks the main culprits of the failure of new ventures. Recently a new kind of institution called Living Labs, aims to address this area, providing not only help in managing market risks but the kind of entrepreneurial spirit that could push innovation forward while helping in creating an initial demand that might foster its development. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,086 |
Search, Rescue, and Care of the Injured Following the 2003 Bam, Iran, Earthquake | Abstract Relief efforts started soon after the earthquake, but organized search and rescue missions were absent during the first 24 hours after the disaster. Once on their way, these missions were paralyzed by the chaos that ruled the first few days of the event, the harsh terrain, and the cold weather. Rubble removal and rescue of the trapped became secondary to transfer of the injured to hospitals. Most of the injured people were originally taken to Kerman city for stabilization before they were flown to other cities in Iran for further medical care. The hospitals in Kerman city were greatly burdened by this task. However, they performed heroically given scarce resources and staff, especially during the initial days of the disaster. By the second week of the disaster, field hospitals were operational in Bam and were able to provide care for people, relieving the pressure on Kerman city. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,087 |
Informed consent: a case for more education of the surgical team. | A questionnaire was given to 37 members of staff of the Department of Surgery, Addenbrooke's Hospital, Cambridge, in order to determine whether their knowledge was adequate to give accurate information to patients regarding operations and thus to obtain properly informed consent for that operation. Each participant was asked to estimate the 24-h and 30-day mortality for five common elective operations. A wide range of answers was given for operations by all groups. Estimates of 24-h mortality after unilateral inguinal herniorrhaphy differed between staff grades by a factor of 3, but estimates of 24-h mortality after thyroidectomy differed by a factor of 100 between consultant surgeons and staff nurses. Our findings suggest that some members of the surgical team have insufficient knowledge about common operations to obtain properly informed consent from patients. | Aims This study aimed to identify how di ierent trusts in England were utilising lay involvement through their clinical governance committees. Method It considered the perspectives of both the trust and the lay members. Twenty-three clinical governance chairs and lay participants returned a questionnaire. Results This study found that the lay participants were far from representative of the local population in terms of socio-demographics and special interests, and highlighted dee ciencies in their recruitment and training. Conclusions The conclusions point to successful approaches that could be applied by trusts. | eng_Latn | 27,088 |
[Dynamic sliding screw in the treatment of fractures of the proximal femur in the traumatological research institute in 1987-1991.]. | The authors present the retrospective evaluation of a group of 20 patients with fractures of the proximal femur who were treated in 1987-1991 by synthesis with a sliding conpressive screw. The authors used implants POLDI, OSTEO and AESCULAP. Women predominated at a ratio of 3 : 2. The mean age at the time of the injury was 57 years. The operations were made soon after the injury - 13 times on the day of the injury, the longest interval was three days after the injury. Mediocolic fractures predominated - 10 times. An exchange operation had to be performed 5 times, five patients died and three patients were lost from the records. Of the remaining seven patients six were cured with excellent results and one female patient, the only one who developed posttraumatic necrosis of the head, recovered with good results. The basis of success remains correct indication of the operation and its implementation, perfect from the technical aspect. Key words: fractures of the neck of the femur, dynamic sliding screw. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,089 |
SUDDEN DEATH DUE TO CARDIAC RUPTURE - A CASE REPORT | Every autopsy expert has to deal with many kind of cases like road traffic accidents, poisoning, insect bites, hanging, drowning, burns etc., but sometimes some cases made us think twice, to give perfect opinion regarding the cause of death which otherwise might be missed and injustice might occur. A case of 55 years old, Muslim, female with history of coronary artery bypass graft 7 years back, met with road traffic accident followed by head injury and admitted in hospital for the same. After complete careful examination and investigations, doctors came to know that she had subarachnoid and subpial hemorrhage along with fracture of left forearm bones and treated accordingly. She survived for 10 days in hospital under treatment and died suddenly without any significant cause. On autopsy examination, haemopericardium as a result of cardiac rupture was found to be the cause of sudden death. | BACKGROUND/OBJECTIVE ::: The goal of this update in hospice and palliative care is to summarize and critique research published between January 1 and December 31, 2014 that has a high potential for impact on clinical practice. ::: ::: ::: DESIGN ::: To identify articles we hand searched 22 leading journals, the Cochrane Database of Systematic Reviews, and Fast Article Critical Summaries for Clinicians in Palliative Care. We also performed a PubMed keyword search using the terms "hospice" and "palliative care." ::: ::: ::: MEASUREMENTS ::: We ranked candidate articles based on study quality, appeal to a breadth of palliative care clinicians, and potential for impact on clinical practice. ::: ::: ::: RESULTS ::: In this manuscript we have summarized the findings of eight articles with the highest ratings and make recommendations for clinical practice based on the strength of the resulting evidence. | yue_Hant | 27,090 |
Multistage Evaluation of Measurement Error in a Reliability Study | SUMMARY. We introduce sequential testing procedures for the planning and analysis of reliability studies to assess an exposure's measurement error. The designs allow repeated evaluation of reliability of the measurements and stop testing if early evidence shows the measurement error is within the level of tolerance. Methods are developed and critical values tabulated for a number of two-stage designs. The methods are exemplified using an example evaluating the reliability of biomarkers associated with oxidative stress. | Medical quality is the key to the hospital survival and development,is also the life engineering of the patient health.Increasingly improving medical quality is the important course discussed by medical managers and workers,which is easy to see from the reassessment of hospital grade.Patient- oriented mode has been deeply in people's heart and in action.Making the hospital's grade reassessment as fine opportunity,our hospital followed continuous improving medical quality way and process,exploring a series of effective management. | eng_Latn | 27,091 |
Forensic record-keeping and documentation of samples | Record-keeping is an essential part of any forensic investigation. Cases involving reptiles and amphibians are no exception. All such records are to be considered as evidence and must be fully accountable in a chain of custody. Equally, the documentation of samples is vital, from the earliest point of entry into an investigation. Strict adherence to these basic principles will ensure that the evidence, when presented, will withstand scrutiny of both its integrity and transparency. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,092 |
[Diagnosis of ischemic heart disease in an organized population]. | In a simultaneous cardiological examination of the workers and employees of an electronics plant, a total of 3183 ECGs at the 12 standard leads were recorded with the help of the automatic ECG analysis system HP5600C. Parallelly, the ECGs were coded by the Minnesota Code. A group of high risk for coronary heart disease was identified on the basis of the questionnaire data and ECG findings and comprised 7.8% of the population studied. Pathological ECGs were registered in only 27.1% of the high risk group. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,093 |
New measure of hospital deaths will act as trigger “to ask hard questions” | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | Objectives. We examined the efficiency of country-specific health care spending in improving life expectancies for men and women.Methods. We estimated efficiencies of health care spending for 27 Organisation for Economic Co-operation and Development (OECD) countries during the period 1991 to 2007 using multivariable regression models, including country fixed-effects and controlling for time-varying levels of national social expenditures, economic development, and health behaviors.Results. Findings indicated robust differences in health-spending efficiency. A 1% annual increase in health expenditures was associated with percent changes in life expectancy ranging from 0.020 in the United States (95% confidence interval [CI] = 0.008, 0.032) to 0.121 in Germany (95% CI = 0.099, 0.143). Health-spending increases were associated with greater life expectancy improvements for men than for women in nearly every OECD country.Conclusions. This is the first study to our knowledge to estimate the effect of country-spe... | eng_Latn | 27,094 |
The Correction of the Explanation for The Brief Excavation Report of the Tomb of the Princess Living in Shangluo County of the Ming Dynasty | The Brief Excavation Report of the Tomb of the Princess Living in Shangluo County of the Ming Dynasty publishes the rubbings of the land certificate and the epitaph,and also offers the explanation of the rubbings,but many parts of the explanation are wrong.By correcting some parts of the explanation,and analyzing the error cause to avoid conveying erroneous information,so that this valuable material can be utilized scientifically. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,095 |
Developing harmonious medical-patient relationship with fo-cus-on-persons | The letterpress summarizes the meanings and causations of building a socialistic harmonious society, consanguineous connection between building a harmonious society and harmonious medical- patient relationship. The paper analyzes the flux of medical-patient relationship currently, primary reasons of problems and expounds the realistic significance of developing harmonious medical-patient relationship. It puts forward countermeasures about it. These include government's leading, community's being concerned with it, focus-on-persons, strengthening communication between medical workers and patients, strict medical quality control in order to developing harmonious medical-patient relationship. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,096 |
Standard life: Scientific advancement is not the be all and end all of nursing | When Neil Armstrong stepped on to the moon 30 years ago, I was up a tree. If he thought he was taking a giant leap, he obviously hadn't straddled the large gap between forking boughs half way up the big yew in our garden. The Sea of Tranquility? Easy. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | eng_Latn | 27,097 |
Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010 | Introduction ::: Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. | Abstract Interactions between a set of polluting and non-polluting sectors are analyzed using a form of decomposition analysis first proposed by Miyazawa and subsequently modified by Sonis and Hewings. The analysis is applied to a time series set of input–output tables for the Chicago region in an attempt to generate assessments of the internal and external multipliers and their changes over time. The results revealed the important role that structural change will play in determining pollution levels in the region in the future. In addition, significant variations were noted across sectors in terms of the direct and indirect contributions to pollution. | eng_Latn | 27,098 |
DIARRHEA RATES AND RISK FACTORS FOR DEVELOPING CHRONIC DIARRHEA IN INFANT AND JUVENILE RHESUS MONKEYS | Abstract Ten independent risk factors were evaluated in an effort to identify predictors of problem diarrhea at weaning and chronic diarrhea in infant and juvenile rhesus monkeys (Macaca mulatta) at the California Primate Research Center. None of the variables proved to be a significant predictor of problem diarrhea at weaning; however, two of the variables were significant predictors for developing chronic diarrhea. Odds ratios, adjusted for other variables in the logistic regression model, showed that compared with females, males were nearly three times more likely to develop chronic diarrhea, and nursery-reared animals were 7.5 times more likely to develop chronic diarrhea than were breast-fed animals. The annual incidence rates for problem diarrhea at weaning for 1978, 1979, and 1980 were 49%, 37%, and 41%, respectively. A weighted average annual incidence rate for problem diarrhea at weaning for the 3-year period was 39%. The incidence rate for chronic diarrhea for the 3-year period was 49%. | From April next year the NHS in England is to have a new measure of hospitals’ performance, a regular report on the numbers of patients dying in hospital in each trust. ::: ::: Called the summary hospital level mortality indicator (SHMI), the measure draws on experience gathered by companies such as Dr Foster and Caspe Healthcare Knowledge Systems (CHKS) in comparing hospitals by how many patients die. The Dr Foster measure, the hospital standardised mortality ratio, originally developed by Brian Jarman at Imperial College London, forms an important part of Dr Foster’s annual Good Hospital Guide ( BMJ 2009;339:b5242, doi:10.1136/bmj.b5242). ::: ::: Discrepancies between the ratings given by Dr Foster and those derived from inspections by the Care Quality Commission (Dr Foster rated Mid Staffordshire NHS Foundation Trust among its “most improved” at a time when it was branded “appalling” … | yue_Hant | 27,099 |
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