3,164 research outputs found

    Tertiary Hospitals Management of Patients with Acute

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    In the tertiary care setting, there is a gap in the recommended door-to-balloon time of less than 90 minutes when treating a patient with an acute myocardial infarction (AMI). Data show significantly decreased mortality when percutaneous coronary intervention (PCI) is initiated within 90 minutes of the onset of an AMI. According to an Institute of Healthcare Improvement (IHI) report, there are recommended interventions with goals for door-to-balloon times (Mayo Clinic, 2011 ). Tertiary hospitals frequently transport their AMI patients out to a specialty cardiac center. These patients typically do not receive the recommended PCI and the delay in treatment increases the risk for poor patient outcomes A comprehensive literature review was conducted with the goal of collecting evidencebased data for determination of best practices in the management of patients presenting with AMI at tertiary hospitals. A step-by-step guide was developed for the management of patients presenting with an AMI that reflects best practice, including expert consult by a cardiologist. A cardiologist also evaluated the guideline for accuracy and feasibility. Findings were presented to health care providers at a designated tertiary hospital to promote utilization of the step-by-step guidelines to achieve the recommended 90-minute door-to-balloon time The anticipated result of this project would be the development of a guideline for AMI patients who present to tertiary ERs with complaints of chest pain. Dissemination of this guideline to the health care providers responsible for triage of patients with acute chest pain at tertiary hospitals is anticipated to improve patient outcomes through the use of evidence based practice guideline

    The Stonecutters and Tomb Builders of Lafayette Cemetery No.1, New Orleans, Louisiana

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    This thesis explores the building history of Lafayette Cemetery No. 1, established 1833. The historic cemetery, located in what is now the Garden District of New Orleans, Louisiana, was listed on the National Register of Historic Places in 1972, but has continued to experience preservation issues concerning its traditional above-ground tombs and other landscape features. By investigating the building methods and background of the historic craftsmen who helped develop Lafayette No. 1, the cemetery will be better understood and, thus, better preserved. A combination of structural surveys and archival research, this thesis constructs a dimensional portrait not only of specific craftsmen, but also of their remaining tombs and carved tablets. Methods employed include a comprehensive database of all work signed by a tomb builder or stone cutter currently present in Lafayette No. 1, from which comparisons regarding construction method, style, materials, and clientele background were drawn. From the nearly three dozen names identified through research and survey, a number of individuals are elaborated upon through documentary research and in-depth study of remaining in situ work. These craftsmen include Gottlieb Huber, Hugh J. McDonald, James Hagan, and H. Lowenstein. Patterns in construction, style, materials, and clientele within different periods of the cemetery\u27s one hundred and eighty year history were distinguished in the course of research. Understanding such methods and traditions will equip preservation groups with a more substantial foundation from which to maintain these structures

    Effect of Henrik Ibsen's personality on the characters in his plays

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    This item was digitized by the Internet Archive. Thesis (M.A.)--Boston Universityhttps://archive.org/details/effectofhenrikib00for

    A study of mothers of acting out boys as seen at intake in a child guidance clinic.

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    Thesis (M.S.)--Boston Universit

    Complementary Alternative Medicine for Chronic Pain

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    Young women smokers' response to using plain cigarette packaging: Qualitative findings from a naturalistic study

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    Background: The aim of this study was to explore in-depth the response of young women smokers (18-35 years) to using dark brown ‘plain' cigarette packs in naturalistic settings. Methods: Participants were recruited in six towns and cities in Scotland to take part in a naturalistic study, where they used plain cigarette packs for a week. Participants completed a number of questionnaires during the study period (reported elsewhere), and a sub-sample participated in post-study telephone interviews to explore their experiences of using the plain packs. Of the 187 participants who completed the study, 23 were randomly selected to participate in the post-study interviews. Within the interviews a semi-structured topic guide was used to assess perceptions of the plain pack, feelings created by the pack, feelings about smoking, and avoidant and smoking behaviour. Results: The brown (plain) packs were perceived negatively due to the colour, the  undesirable image the pack conveyed, and the reaction from others. The plain packs were  also associated with negative feelings, such as embarrassment, discomfort and guilt. Some participants also commented that they felt differently about the product, considered to be less enjoyable or more harmful, when using the plain packs, and were less interested in, or felt more negatively about, smoking. A number of participants said that they had engaged in avoidant behavior with the plain packs, such as hiding it, due to their negative thoughts about the packs and the reaction of others. Some participants also mentioned cessation-related behaviours when using the plain packs, such as forgoing cigarettes, stubbing cigarettes out early and thinking about quitting, largely due to the decreased enjoyment of smoking. Conclusions: The experience of using cigarettes in plain packs prompted a range of negative responses from young women smokers, who are a crucial target group for tobacco control interventions

    How adolescents perceive cigarette packaging and possible benefits of plain packaging

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    Surveys in secondary schools in Scotland show 3% of 13 year olds to be regular smokers, i.e. smoke one or more cigarettes a week, with this number rising to 13% for 15 year olds (Black et al., 2011). While smoking prevalence is in long-term decline in Scotland, and indeed most of Europe, these figures are concerning given that trying a single cigarette increases the risk that an adolescent will become a later smoker, even after a gap of not smoking for up to three years (Fidler et al., 2006). Furthermore, the earlier that adolescents start smoking regularly, the greater the risk of developing tobaccorelated cancers and other diseases (International Agency for Research on Cancer, 2004; Muller, 2007). For smoking prevention to be effective a coordinated approach is required. This may include policy measures such as increasing taxation on tobacco products to keep prices high, and non-policy measures such as providing health advice to parents and carers, as well as promoting smoke-free domestic environments and encouraging smoking cessation (Muller, 2007). School-based interventions can also play a key role in helping prevention efforts (NICE, 2010)

    Adolescent girls and young adult women's perceptions of superslims cigarette packaging: a qualitative study

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    Objectives: To explore perceptions of superslims packaging, including compact ‘lipstick’ packs, in line with 3 potential impacts identified within the impact assessment of the European Union (EU) Tobacco Products Directive: appeal, harm perceptions and the seriousness of warning of health risks.  Design: Qualitative focus group study. SettingInformal community venues in Scotland, UK.  Participants: 75 female non-smokers and occasional smokers (age range 12–24).  Results: Compact ‘lipstick’-type superslims packs were perceived most positively and rated as most appealing. They were also viewed as less harmful than more standard sized cigarette packs because of their smaller size and likeness to cosmetics. Additionally, ‘lipstick’ packs were rated as less serious in terms of warning about the health risks associated with smoking, either because the small font size of the warnings was difficult to read or because the small pack size prevented the text on the warnings from being displayed properly. Bright pack colours and floral designs were also thought to detract from the health warning.  Conclusions: As superslims packs were found to increase appeal, mislead with respect to level of harm, and undermine the on-pack health warnings, this provides support for the decision to ban ‘lipstick’-style cigarette packs in the EU and has implications for policy elsewhere

    Chronicles of Oklahoma

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    Article details the exploits of Captain Bonneville as he explored the western frontier. Captain Bonneville was the focal point of Washington Irving's book "Adventures of Captain Bonneville." This article further explores his adventures
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