The Ice Storm in Eastern Canada 1998 KAMEDO-Report No. 74

2001 ◽  
Vol 16 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Louis Riddex ◽  
Uno Dellgar
Keyword(s):  
Emergency Services ◽  
Electrical Power ◽  
Emergency Department Visits ◽  
Ice Storm ◽  
Structured Interviews ◽  
Eastern Canada ◽  
Essential Services ◽  
Generating Equipment ◽  
Tract Infections ◽  
The Impact

AbstractThis is a report of the impact of the ice storm that struck eastern Canada on 04–09 January 1998. The storm deposited ice some 100 mm thick on the ground and on the electric power lines and eventually left 1.4 million households and much of the infrastructure without electrical power.Data were obtained through non-structured interviews of those involved. Most of the larger hospitals were equipped with emergency generating equipment and were able to provide most essential services. For most hospitals, non-emergency services were compromised. Many other medical facilities, including clinics had to be shut down, and smaller hospitals were forced to transfer some patients to larger institutions. In addition, hospitals experienced a marked increase in the number of emergency department visits including an increase in the number of persons with injuries, respiratory tract infections, or heart problems. A marked increase in carbon-monoxide intoxication was observed: 50 persons required the use of hyperbaric oxygen and six persons died of CO poisoning.Prehospital services not only experienced a marked increase in the number of emergency responses, but also were utilized to provide transportation of non-ill or injured persons, equipment, and supplies. Home care was interrupted and many patients dependent upon power had to be transported to hospitals. Many hospitals opened their buildings to provide shelter to the families of many of their employees and medical staff. This helped to keep staffing at a better level than if they had to find shelter and essential services elsewhere.The transmission and sharing of information was severely limited due in part to the loss of power and inability to access television. This led to the distribution of misleading or incorrect information.This storm was exemplary of our dependence upon electrical power and that we are not prepared to cope with the loss of electricity.

scholarly journals Emergency department visits for children with acute asthma: discharge instructions, parental plans, and follow-through of care—a prospective study

CJEM ◽  
2014 ◽  
Vol 16 (06) ◽  
pp. 467-476 ◽  
Author(s):  
Pat G. Camp ◽  
Seamus P. Norton ◽  
Ran D. Goldman ◽  
Salomeh Shajari ◽  
M. Anne Smith ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Family Doctor ◽  
Emergency Department Visits ◽  
Upper Respiratory Tract ◽  
Asthma Exacerbations ◽  
Initial Care ◽  
Children With Asthma ◽  
Tract Infections ◽  
The Impact

Abstract Objective: Communication between emergency department (ED) staff and parents of children with asthma may play a role in asthma exacerbation management. We investigated the extent to which parents of children with asthma implement recommendations provided by the ED staff. Method: We asked questions on asthma triggers, ED care (including education and discharge recommendations), and asthma management strategies used at home shortly after the ED visit and again at 6 months. Results: A total of 148 children with asthma were recruited. Thirty-two percent of children were not on inhaled corticosteroids prior to their ED visit. Eighty percent of parents identified upper respiratory tract infections (URTIs) as the primary trigger for their child’s asthma. No parent received or implemented any specific asthma strategies to reduce the impact of URTIs; 82% of parents did not receive any printed asthma education materials. Most (66%) parents received verbal instructions on how to manage their child’s future asthma exacerbations. Of those, one-third of families were told to return to the ED. Parents were rarely advised to bring their child to their family doctor in the event of a future exacerbation. At 6 months, parents continued to use the ED services for asthma exacerbations in their children, despite reporting feeling confident in managing their child’s asthma. Conclusion: Improvements are urgently needed in developing strategies to manage pediatric asthma exacerbations related to URTIs, communication with parents at discharge in acute care, and using alternate acute care services for parents who continue to rely on EDs for the initial care of mild asthma exacerbations.

scholarly journals An Assessment of Inappropriate Antibiotic Use and Guideline Adherence for Uncomplicated Urinary Tract Infections

2018 ◽  
Vol 5 (9) ◽  
Author(s):  
Michael J Durkin ◽  
Matthew Keller ◽  
Anne M Butler ◽  
Jennie H Kwon ◽  
Erik R Dubberke ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antibiotic Use ◽  
Emergency Department Visits ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Duration Of Treatment ◽  
Minimal Impact ◽  
Tract Infections ◽  
The Impact

Abstract Background In 2011, The Infectious Diseases Society of America released a clinical practice guideline (CPG) that recommended short-course antibiotic therapy and avoidance of fluoroquinolones for uncomplicated urinary tract infections (UTIs). Recommendations from this CPG were rapidly disseminated to clinicians via review articles, UpToDate, and the Centers for Disease Control and Prevention website; however, it is unclear if this CPG had an impact on national antibiotic prescribing practices. Methods We performed a retrospective cohort study of outpatient and emergency department visits within a commercial insurance database between January 1, 2009, and December 31, 2013. We included nonpregnant women aged 18–44 years who had an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for a UTI with a concurrent antibiotic prescription. We performed interrupted time series analyses to determine the impact of the CPG on the appropriateness of the antibiotic agent and duration. Results We identified 654 432 women diagnosed with UTI. The patient population was young (mean age, 31 years) and had few comorbidities. Fluoroquinolones, nonfirstline agents, were the most commonly prescribed antibiotic class both before and after release of the guidelines (45% vs 42%). Wide variation was observed in the duration of treatment, with >75% of prescriptions written for nonrecommended treatment durations. The CPG had minimal impact on antibiotic prescribing behavior by providers. Conclusions Inappropriate antibiotic prescribing is common for the treatment of UTIs. The CPG was not associated with a clinically meaningful change in national antibiotic prescribing practices for UTIs. Further interventions are necessary to improve outpatient antibiotic prescribing for UTIs.

scholarly journals 2094. Acceptability of Antibiotic Substitutions for Fluoroquinolones and Third and Fourth-generation Cephalosporins: A Report from the VA-CDC Practice-Based Research Network (PBRN)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S708-S708
Author(s):  
Matthew B Goetz ◽  
Stacey Hockett Sherlock ◽  
Cassie Goedken ◽  
Erin C Balkenende ◽  
Charlesnika T Evans ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Antimicrobial Stewardship ◽  
Empiric Therapy ◽  
Research Network ◽  
Fourth Generation ◽  
Structured Interviews ◽  
Practice Based Research ◽  
Tract Infections ◽  
The Impact

Abstract Background Studies suggest fluoroquinolones (FQ), and third (3C) and fourth (4C) generation cephalosporins, agents often used for empiric therapy, place patients at higher risk for C. difficile infection. Substituting alternative antibiotics for empiric therapy might reduce risk. We surveyed inpatient physician (MD) and pharmacist (PharmD) antimicrobial stewardship champions to evaluate their preferred FQ, 3C and 4C substitutions for empiric therapy. Methods Semi-structured interviews were conducted with the antimicrobial stewardship MD and the PharmD champion from each of the 15 VA-CDC Practice Based Research Network (PBRN) sites. Interviewees were asked what empiric antibiotics for pneumonia and urinary tract infections would be recommended in local guidelines if all 3C, 4C and FQ were restricted. Respondents could list multiple antibiotics. Templated data collection and analysis were used to assist in rapid analysis of interviews. Results Narrow β-lactams were identified as appropriate options for CAP by 8 MD and 9 PharmD (table). Piperacillin/tazobactam was the preferred choice by MDs and PharmDs for HCAP (7 and 12, respectively) and HAP (10 and 12, respectively). For community-onset urinary tract infections (cUTI), numerous alternatives to FQ, 3C and 4C were identified. For hospital-onset (hUTI), piperacillin/tazobactam was most frequently mentioned by MD and PharmDs (7 and 9, respectively). 4 of 5 MDs and 5 of 7 PharmDs who chose 3C for CAP indicated that 3C were preferred over all other choices for CAP, few stewards indicated that 3C were the sole preferred agents for other conditions. Conclusion Antimicrobial stewardship MD and PharmD champions were readily able to find FQ substitutions for all indications; 3C and 4C substitutions were found for all indications with a notable exception of treatment of CAP. These results suggest considerable opportunity to reduce use of these antibiotic classes. Future studies should examine the appropriateness and acceptability of the substitutions identified by stewardship champions to providers and the impact of restriction of FQ, 3C and 4C on clinical outcomes. Disclosures All authors: No reported disclosures.

scholarly journals Theory-based electronic learning intervention to support appropriate antibiotic prescribing by nurses and pharmacists: intervention development and feasibility study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028326 ◽  
Author(s):  
Molly Courtenay ◽  
Rosemary Lim ◽  
Rhian Deslandes ◽  
Rebecca Ferriday ◽  
David Gillespie ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Feasibility Study ◽  
Intervention Development ◽  
Antibiotic Prescribing ◽  
Structured Interviews ◽  
Step Method ◽  
Ethical Approval ◽  
Prescribing Behaviour ◽  
Tract Infections ◽  
The Impact

IntroductionNurse and pharmacist independent prescribers manage patients with respiratory tract infections and are responsible for around 8% of all primary care antibiotic prescriptions. A range of factors influence the prescribing behaviour of these professionals, however, there are no interventions available specifically to support appropriate antibiotic prescribing behaviour by these groups. The aims of this paper are to describe (1) the development of an intervention to support appropriate antibiotic prescribing by nurse and pharmacist independent prescribers and (2) an acceptability and feasibility study designed to test its implementation with these prescribers.Method and analysisDevelopment of intervention: a three-stage, eight-step method was used to identify relevant determinants of behaviour change and intervention components based on the Behaviour Change Wheel. The intervention is an online resource comprising underpinning knowledge and an interactive animation with a variety of open and closed questions to assess understanding. Acceptability and feasibility of intervention: nurse and pharmacist prescribers (n=12–15) will use the intervention. Evaluation includes semi-structured interviews to capture information about how the user reacts to the design, delivery and content of the intervention and influences on understanding and engagement, and a pre-post survey to assess participants’ perceptions of the impact of the intervention on knowledge, confidence and usefulness in terms of application to practice. Taking an initial inductive approach, data from interview transcripts will be coded and then analysed to derive themes. These themes will then be deductively mapped to the Capability, Opportunity, Motivation-Behaviour model. Descriptive statistics will be used to analyse the survey data, and trends identified.Ethics and disseminationEthical approval for the study has been provided by the School of Healthcare Sciences Research Governance and Ethics Committee, Cardiff University. The findings will be disseminated via publication in peer-reviewed journals and through conference presentations.

scholarly journals Quantitative and qualitative effects of a severe ice storm on an old-growth beech–maple forest

2007 ◽  
Vol 37 (3) ◽  
pp. 598-606 ◽  
Author(s):  
Koichi Takahashi ◽  
Ken Arii ◽  
Martin J. Lechowicz
Keyword(s):  
Detrended Correspondence Analysis ◽  
Basal Area ◽  
Forest Composition ◽  
Permanent Plots ◽  
Stem Density ◽  
Ice Storm ◽  
Eastern Canada ◽  
Old Growth ◽  
The Impact ◽  
Stand Basal Area

Comparing permanent plots censused in 1997 and again in 2005, we quantified the impact of a severe ice storm on forest composition and dynamics in an old-growth beech–maple forest in eastern Canada. Acer saccharum Marsh. and Fagus grandifolia Ehrh. accounted for 78% of stand basal area immediately before the January 1998 ice storm. By 2005, eight growing seasons after the ice storm, stand basal area had dropped from 49.1 m2/ha to 31.5 m2/ha, and total tree density (>1 cm diameter at breast height (DBH)) decreased from 6350 stems/ha to 3875 stems/ha. However, A. saccharum and F. grandifolia remained dominant, accounting for 74% of stand basal area. Detrended correspondence analysis of relative dominance ratios at each plot in 1997 and 2005 showed that community composition did not change much during this period for either understory (1 cm ≤ DBH < 10 cm) or canopy trees (DBH ≥ 10 cm). The ice storm did not lead to significant recruitment of saplings (DBH ≥ 1 cm), but appears to have only contributed more to the growth of already-established saplings. We conclude that the ice storm of 1998 substantially decreased stand basal area and stem density but did not act to change the overall species composition or tree diversity in this old-growth beech–maple forest.

scholarly journals Covid-19 and public service media: Impact of the pandemic on public television in Europe

2020 ◽  
Author(s):  
Miguel Túñez-López ◽  
Martín Vaz-Álvarez ◽  
César Fieiras-Ceide
Keyword(s):  
Public Service ◽  
Public Information ◽  
Public Television ◽  
Structured Interviews ◽  
Technical Standards ◽  
Convenience Sample ◽  
Media Impact ◽  
European Public ◽  
Essential Services ◽  
The Impact

This article analyses the response of European Public Service Media to the crisis caused by Covid-19, especially the impact of the pandemic on Europe’s major public broadcasters, with a particular focus on technical and professional constraints, alterations in audience volume and habits, production strategies, type of broadcast content and journalists’ routines. The research is based on public information from the European Broadcasting Union (EBU) and 19 in-depth, structured interviews with a convenience sample of innovation and strategy managers from public broadcasters in Austria (ORF), Belgium (VRT and RTBF), Denmark (DR), Finland (YLE), France (France TV), Germany (ARD and ZDF), Great Britain (BBC), Ireland (RTÉ), Italy (RAI), Netherlands (NPO), Portugal (RTP), Spain (RTVE), Sweden (SVT), Switzerland (RTS) and the European Broadcasting Union (EBU). The results indicate that the corporate projection of PSM was increased by emphasising their role as essential services and their defence of the values that characterise them. The pandemic forced the adaptation of programme production from technical standards to an emotional approach, accelerating a formal hybridisation with native online contents. Dependence on software grew and newsmaking processes were altered towards ‘remote journalism’. Changes are drawn that may be maintained in the future.

An influence of social isolation on the level of physical activity as well as on well-being and mental state of people during the coronavirus COVID-19 pandemic

2019 ◽  
Vol 129 (4) ◽  
pp. 127-131
Author(s):  
Agnieszka Parfin ◽  
Krystian Wdowiak ◽  
Marzena Furtak-Niczyporuk ◽  
Jolanta Herda
Keyword(s):  
Physical Activity ◽  
Social Isolation ◽  
Small Sample Size ◽  
Statistical Tests ◽  
Population Group ◽  
Well Being ◽  
Small Sample ◽  
Subjective Well Being ◽  
Tract Infections ◽  
The Impact

AbstractIntroduction. The COVID-19 is the name of an infectious disease caused by a new strain of coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). It was first diagnosed in December 2019 in patients in Wuhan City, Hubei Province, China. The symptoms are dominated by features of respiratory tract infections, in some patients with a very severe course leading to respiratory failure and, in extreme cases to death. Due to the spread of the infection worldwide, the WHO declared a pandemic in March 2020.Aim. An investigation of the impact of social isolation introduced due to the coronavirus pandemic on selected aspects of life. The researchers focused on observing changes in habits related to physical activity and their connections with people’s subjective well-being and emotional state.Material and methods. The study was carried out within the international project of the group „IRG on COVID and exercise”. The research tool was a standardized questionnaire.Results. Based on the data collected and the analysis of the percentage results, it can be observed that the overwhelming majority of people taking up physical activity reported a better mood during the pandemic. However, statistical tests do not confirm these relationships due to the small sample size.Conclusions. Isolation favours physical activity. Future, in-depth studies, by enlarging the population group, are necessary to confirm the above observations.

Impact and Challenges of Centres for Education and Community Action in Cameroon’s North West Region

2018 ◽  
Vol 8 (2) ◽  
pp. 51-74
Author(s):  
Fonteh Athanasius Amungwa
Keyword(s):  
Rural Development ◽  
Economic Crisis ◽  
Formal Education ◽  
Community Education ◽  
Sampling Technique ◽  
Community Action ◽  
Structured Interviews ◽  
North West ◽  
West Region ◽  
The Impact

This paper examines the impact of community education and challenges facing Centres for Education and Community Action as a rural development strategy in Cameroon. The study was conducted in the North-West Region of Cameroon, employing field observations, semi-structured interviews with key informants using a convenient sampling technique and through elaborate review of documents. These research instruments were blended into what is termed triangulation and the data collected was analysed descriptively. The main focus of qualitative analysis is to understand the ways in which people act and the accounts that people give for their actions. This paper posits that extreme dependence on the provision of Western formal education cannot solve the problems of a rapidly changing society like Cameroon, which is facing a long-term economic crisis and persistent unemployment issues of graduates. Consequently, education should be redefined in the context of the prevailing economic crisis to make it responsive to the aspirations of rural communities. Findings showed that community education had contributed towards rural development immensely but has suffered many challenges due to neglect of the field in the policy agenda. This paper recommends the integration of community education with formal education to facilitate group and community betterment in particular and rural transformation in general.

A general practice provider federation in a mixed health economy in England: a case study investigation

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696929
Author(s):  
Jill Mitchell
Keyword(s):  
General Practice ◽  
Shared Vision ◽  
Health Economy ◽  
Structured Interviews ◽  
The North ◽  
Common Strategy ◽  
Common Purpose ◽  
Collaborative Working ◽  
The Impact

BackgroundThere is an emerging debate that general practice in its current format is out-dated and there is a requirement to move to a federated model of provision where groups of Practices come together. The emergence of federations has developed over the past 5 years but the factors that influence how federations develop and the impact of this new model is an under researched area.AimThe study explored the rationale around why a group of independent GP practices opted to pursue an alternative business venture and the benefits that this strategy offered.MethodA single organisational case study of a federation in the North of England was conducted between 2011–2016. Mixed methods data collection included individual and group semi-structured interviews and quantitative surveys.ResultsFederations promote collaborative working, relying on strategic coherence of multiple individual GP practices through a shared vision and common purpose. Findings revealed many complexities in implementing a common strategy across multiple independent businesses. The ability of the federation to gain legitimacy was two dimensional – externally and internally. The venture had mixed successes, but their approach to quality improvement proved innovative and demonstrated outcomes on a population basis. The study identified significant pressures that practices were experiencing and the need to seek alternative ways of working but there was no shared vision or inclination to relinquish individual practice autonomy.ConclusionOrganisational development support is critical to reform General Practice. Whether central funding through the GP Five Year Forward View will achieve the scale of change required is yet to be evidenced.

Serving the People in Long Beach, California: Advancing Justice for Southeast Asian Youth through Community University Research Partnerships

2019 ◽  
Vol 16 (1-2) ◽  
pp. 1-34
Author(s):  
R. Varisa Patraporn
Keyword(s):  
Asian American ◽  
Research Work ◽  
Community Based Participatory Research ◽  
Youth Empowerment ◽  
Long Beach ◽  
Structured Interviews ◽  
Research Partnerships ◽  
Community Needs ◽  
The People ◽  
The Impact

Khmer Girl’s in Action is a nonprofit that successfully utilizes community-based participatory research (CBPR) with university partners to create social change for youth in Long Beach, CA. Based on semi-structured interviews and content analysis of news articles, I explore the impact and sustainability of this research work and the research partnerships. Findings highlight impacts such as youth empowerment, heightened awareness around community needs, policy change, and CBPR curriculum improvements in the field as impacts. Sustainability requires integrating research into program funding, utilizing a tailored training curriculum, building on community members prior relationships, and selecting partners that share common goals, levels of commitment, and flexibility. As funders demand more data to justify community needs, understanding more examples of such work in the Asian American community will be useful for informing future partnerships.

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