64 research outputs found
Towards a Cavity-Free Future for Infants and Children in Canada:Given recent developments in oral health care policy and practice in Canada and Internationally, what else is needed in terms of investments or other conditions to maximize caries prevention and care amongst infants and children?
Urban Political Ecology Beyond Methodological Cityism
The concept of planetary urbanization has emerged in recent years amongst neo-
Lefebvrian urban scholars who see urbanization as a process taking place at all spatial
scales. This article analyses recent critiques of the urban political ecology (UPE) literature
which argue that much of the work in the field has been guilty of focusing exclusively on
the traditional bounded city unit rather than urbanization as a process. In response, the
article reviews various strands of the UPE literature which have (always) moved beyond
‘the city’ to consider the various metabolisms and circulations of humans and non-humans
connecting cities with places outside of their borders at a variety of scales. Furthermore,
it suggests how these approaches can productively work with the insights of the planetary
urbanization literature, in considering both the changing nature of urbanization and also
the socio-ecological and political implications of these changes. Finally, the article suggests
how the methodological approach of the ‘site multiple’ and its focus on everyday practices
and lived experiences can be useful for researching diverse urban phenomena and their
more-than-urban connections
Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy
Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial
Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme
Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial
BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme
Towards Oral and Dental Health through Partnership:How can the oral health and dental industries benefit from enabling positive behaviour in caries prevention and control amongst patients and the public?
Sediment Distribution in the Hawaiian Archipelago
Four sediment types were differentiated in 125 samples of marine
sediments taken from the sea floor around the Hawaiian Islands. These were:
shallow-water carbonates and detritus around the islands, calcareous oozes on
bathymetric highs distant from shore, brown clay on the Hawaiian Arch, and
siliceous ooze in the Hawaiian Deep and west of the island of Hawaii
Towards paying for health in dentistry:How can we create and implement acceptable prevention-based dental payment systems to achieve and maintain health outcomes?
Effects of lipopolysaccharide on glial phenotype and activity of glutamate transporters: Evidence for delayed up-regulation and redistribution of GLT-1
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