66 research outputs found
"They Said the Course Would Be Wasted On Me Because I Was A Girl": Mothers, Daughters, And Shifting Forms Of Female Activism in the Ukrainian Left in Twentieth-Century Canada
A generation divided progressive Ukrainian mothers and daughters. Nonetheless, they shared cultural and political lessons learned at the Ukrainian labour temples, in their neighbourhoods, and on picket lines. They absorbed, transformed and put these ideas to work in a variety of ways to build, challenge, change, or leave the Ukrainian left.Une géneration séparait les mères et les filles ukréniennes. Néanmoins elle partageaient des lessons culturelles et politiques apprises aux Temples du travail ukréniens, dans leurs voisinnages, sur les lignes de piquetage. Elles ont absorbé, transformé, et mis ces idées en marche dans une variétés de façons de bâtir, de mettre au défi, de changer ou de laisser l'Ukraine qu'elles ont laissée
Review of "Labouring Feminisms and Feminist Working-Class History in North America and Beyond," 29 September-2 October 2005, Munk Centre for International Studies at the University of Toronto
Tensile Strength of Malosma Laurina Leaves in Wet and Dry Conditions
Pepperdine University is one located in one of the most diverse places of the world. It is located in the Mediterranean which occupies less than 5% of the earth\u27s landmass and is only found in five areas which includes California. On the campus there are several canyons. One of the canyons is called Winter Canyon. The canyon contained a plant called Malosma laurina which is located in a riparian environment and a chaparral environment. The plant grows in both areas however, our hypothesis was that the dry plants\u27 leaves would demonstrate more plasticity. The soil humidity was also measured to compare the difference between the two and there was a significant difference. The average humidity for the wet soil was 43.5% and the dry was 22.5%. Our hypothesis was proven to be true after analyzing the results of the instron machine. The tensile strength was higher among dry leaves
Chronic opioid use following surgery for head and neck cancer patients undergoing free flap reconstruction
Abstract
Background
Physician opioid-prescribing patterns have significant impacts on the current opioid crisis. Patients who use opioids in the postoperative period are at risk of developing chronic postoperative opioid use. This study determined the rate of chronic postoperative opioid use among head and neck cancer patients undergoing primary surgery with free-flap reconstruction. Additionally, this study identified major risk factors associated with the development of chronic postoperative opioid use.
Methods
A retrospective chart review was performed for all adults (age ≥ 18 years) undergoing primary head and neck surgical resection with free-flap reconstruction between January 2008 and December 2015. Patients were identified from a prospectively collected database, Otobase™. Data from the provincial drug insurance program were used to capture drug dispensing information to determine chronic opioid use at 3- and 12-months postoperatively. Data extracted from Otobase™ included patient demographics, social habits, clinical stage, pathological stage, type of surgery, and adjuvant treatment.
Results
The total cohort was comprised of 212 patients. Chronic opioid use at 3- and 12- months postoperatively was observed in 136 (64%) and 116 (55%) patients, respectively. Of the 212 patients, 85 patients (40%) were identified as preoperative opioid users and 127 were opioid naïve (60%). Of the 85 patients who were preoperative opioid users, 70 (82%) and 63 (77%) patients continued to use opioids 3- and 12-months postoperatively, respectively. The proportion of opioid-naïve patients who were using opioids at 3- and 12-months postoperatively was 52% (66 patients) and 42% (53 patients), respectively. Identified risk factors included preoperative opioid use, prior tobacco use, advanced pathologic T-stage, and adjuvant treatment.
Conclusions
Among head and neck cancer patients that have undergone major resection with free-flap reconstruction, the prevalence of chronic postoperative opioid users was considerable. Identified risk factors included preoperative opioid use, prior tobacco use, tumor stage, and adjuvant treatment.
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Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700
BSAP: Language and Psychosocial Outcomes for Stroke Survivors
Aphasia is an acquired impairment of language resulting from a focal brain lesion that impacts speaking, listening, reading, and writing (Papathanasiou & Coppens, 2013). More than 200,000 individuals in the United States acquire aphasia every year (National Aphasia Association, 2014). Intensive comprehensive aphasia programs (ICAPS) are specialized therapy protocols designed to help individuals who suffer from aphasia secondary to stroke. These emerging programs help clients improve their quality of life and daily functioning by building communication skills. The Big Sky Aphasia Program (BSAP) is an ICAP housed in the RiteCare Speech, Language, and Hearing Clinic at the University of Montana. This program has been under development since the summer of 2011. Currently, BSAP runs twice per year, for five weeks at a time. This model incorporates weekly caregiver counseling, and strives for client/caregiver satisfaction. The purpose of this study is to contribute to the ICAP evidence base by examining outcome measures from the perspectives of researchers, clinicians, and clients. Student clinician feedback, caregiver perspectives, and participant communication outcomes will be reported and discussed with an emphasis on socio functional skill improvement
Efficacy of postoperative pain management in head and neck cancer patients
Abstract Background Our study quantifies the effectiveness of perioperative pain control in a cohort of patients undergoing major head and neck surgery with free flap reconstruction. Our long-term goal is to improve pain control and thereby increase mobility, decrease postoperative complications and decrease hospital stay. Methods A retrospective analysis was performed at a tertiary, academic head and neck surgical oncology program in Calgary, Alberta, Canada from January 1, 2015 – December 31, 2015. Pain scores were recorded prospectively. Primary outcomes were frequency of postoperative pain assessments and pain intensity using the numeric rating scale. Results The cohort included 41 patients. Analysis was limited to pain scores recorded from postoperative days 1–14. There was an average of 7.3 pain measurements per day (SD 4.6, range 1–24) with the most frequent monitoring on postoperative days 1–4. Median pain scores ranged from 0 to 4.5 with the highest median score on postoperative day 6. The daily maximum pain scores recorded ranged from 8 to 10 with scores of 10 recorded on postoperative days 1, 2, 3, 5, 7, 8, and 10. Patients most frequently had inadequate pain control on postoperative days 1, 2, 4, and 5 with the majority occurring on postoperative day 1. Conclusions Postoperative pain control could be improved at our centre. The frequency of pain assessments is also highly variable. Ongoing measurement, audit, and feedback of analgesic protocol effectiveness is an excellent first step in improving perioperative pain management in patients undergoing major head and neck cancer surgery with free flap reconstruction
The impact of close surgical margins on recurrence in oral squamous cell carcinoma
Abstract
Background
Close margins influence treatment and outcome in patients with oral squamous cell carcinoma (OSCC). This study evaluates 187 cases of surgically treated OSCC regarding the impact of close margins on recurrence-free survival (RFS) and disease-specific survival (DSS).
Methods
Predictors of worsened outcome were identified using Kaplan-Meier analysis and multivariate Cox regression analysis.
Results
Tumour size [HR:1.70(0.95–3.08)], nodal status [HR:2.15(1.00–4.64)], presence of extracapsular spread (ECS) [HR:6.36(2.41–16.74)] and smoking history [HR:2.87(1.19–6.86)] were associated with worsened RFS. Similar factors were associated with worsened DSS. Close margins did not influence RFS or DSS.
Conclusions
While most conventional risk factors for OSCC conferred a worsened outcome, close margins did not. One explanation for this would be that close margins (< 5 mm) are equivalent to clear margins and the cutoff definition for a close margin should be re-evaluated. Lack of standardized pathology could also reduce accuracy of reporting of close surgical margins.
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Period prevalence (SPP) of patients presenting with VS to the National Health Services of West of Scotland a) by NHS Health Boards with board names for reference and b) by postcode districts with settlements named within text.
<p>Note the different scales for period prevalence between a and b.</p
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