Background: The requirements for a comprehensive stroke center (CSC) include the capability to perform endovascular stroke therapy (EST). EST is a complex process requiring early identification of appropriate patients and effective delivery of intervention. In order to provide prompt intervention for stroke, CSCs have been established away from large academic centers in community-based hospitals. We hypothesized that quantifiable improvements would occur during the first 2 years of a community-based CSC as the processes and personnel evolved. We report the results over time of EST at a new community-based CSC. Methods: We have retrospectively analyzed demographic data and outcome metrics of EST from the initiation phase of a new community-based CSC. Data was divided into year 1 and year 2. Statistical analysis (Student’s t test and Fisher’s exact test) was performed to compare the patient population and outcomes across the two time periods. Outcome variables included the thrombolysis in cerebral infarction (TICI) score, a change in the NIH stroke scale score and the modified Rankin Scale (mRS) score. Analysis of variance (ANOVA) was used to statistically analyze the relationship between population variables and outcome. Computed tomography (CT) angiography and CT perfusion analysis were used to select patients for EST. Approximately half of the patients undergoing EST were excluded from receiving intravenous recombinant tissue plasminogen activator (IV rt-PA) by standard criteria, while the other half showed no sign of improvement following 1 h of IV rt-PA treatment. Mechanical thrombolysis with a stentriever was performed in the majority of cases with or without intra-arterial medication. The majority of treated occlusions were in the middle cerebral artery. Results: A total of 18 patients underwent EST during year 1 and year 2. A statistically significant increase in good

/pdf/endovascular-stroke-therapy-results-improve-over-time-the-3snusbvahz.pdf

Endovascular Stroke Therapy Results Improve over Time: The ‘Learning Curve' at a New Comprehensive Stoke Center

For many couples the inability to bear children is a tragedy. The conflux of personal interpersonal social and religious expectations brings a sense of failure loss and exclusion to those who are infertile. Relationships between couples can become very strained when children are not forthcoming. One partner may seek to blame the other as being defective or unwilling. Socially most societies are organized especially in the developing countries such that children are necessary for care and maintenance of older parents. Even in developed countries with social support systems children and family are expected to provide much of the care for the elderly. Childless couples are also excluded from taking leading roles in important family functions and events such as birthdays christenings confirmations bar mitzvahs and weddings of their children. Moreover many religions assign important ceremonial tasks to the couple’s children. The incidence of infertility in a population has important demographic and health implications as well. Because high infertility has a dampening effect on overall fertility and the rate of population growth improvements in the ability to bear children may impede efforts to lower the fertility rate. For example it has been estimated that a reduction in infertility in sub-Saharan Africa to “normal” levels would increase fertility in that region by 15 percent. Similarly Bongaarts Frank and Lesthaeghe (1984) found that infertility accounts for 60 percent of the variation in total fertility in 18 sub-Saharan countries and that fertility decreases by one birth for each increase in 9 percentage points in the proportion of women age 45 to 49 who have no children. In Cameroon a country with an unusually high level of infertility Larsen and Menken estimated that the then current total fertility rate of 5.5 children would rise to 7.3 in the absence of sterility. Reports from Demographic and Health Surveys (DHS) data have provided up-to-date measurements of levels and trends in fertility in conjunction with data on important fertility determinants such as first marriage and union first birth contraception breastfeeding and infant and child mortality. Outside of sub-Saharan Africa no major attention has been paid to the DHS data relating to infecundity although there is no doubt that infecundity is also an important determinant of fertility there. (excerpt)

/pdf/infecundity-infertility-and-childlessness-in-developing-4yg4pmo9mg.pdf

Infecundity, infertility, and childlessness in developing countries

Aim This paper reports a review of the empirical literature on factors that contribute to medication errors.

Background  Medication errors are a significant cause of morbidity and mortality in hospitalized patients. This creates an imperative to reduce medication errors to deliver safe and ethical care to patients.

Method  The databases CINAHL, PubMed, Science Direct and Synergy were searched from 1988 to 2007 using the keywords medication errors, medication management, medication reconciliation, medication knowledge and mathematical skills, and reporting medication errors.

Results  Contributory factors to nursing medication errors are manifold, and include both individual and systems issues. These include medication reconciliation, the types of drug distribution system, the quality of prescriptions, and deviation from procedures including distractions during administration, excessive workloads, and nurse’s knowledge of medications.

Implications for nursing management  It is imperative that managers implement strategies to reduce medication errors including the establishment of reporting mechanisms at international and national levels to include the evaluation and audit of practice at a local level. Systematic approaches to medication reconciliation can also reduce medication error significantly. Promoting consistency between health care professionals as to what constitutes medication error will contribute to increased accuracy and compliance in reporting of medication errors, thereby informing health care policies aimed at reducing the occurrence of medication errors. Acquisition and maintenance of mathematical competency for nurses in practice is an important issue in the prevention of medication error. The health care industry can benefit from learning from other high-risk industries such as aviation in the prevention and management of systems errors.

A literature review of the individual and systems factors that contribute to medication errors in nursing practice.

Innovation in healthcare: Issues and future trends☆

Gender differences in predictors of initiation, retention, and completion in an HMO-based substance abuse treatment program.

Ongoing efforts to reduce medical errors and enhance quality of patient care focus primarily on technological innovations. However, important management issues that underlie about two-thirds of adverse events have commanded insufficient attention. This article examines two alternative management philosophies—control-based and commitment-based—premised on opposite sets of assumptions about human motivation, and it develops a model linking the overall management philosophy with medical errors and quality of care. The current control-based culture and management systems in health care organizations are inherently inadequate in delivering high quality of patient care and safety. Consequently, there is a need to transform them for bringing further improvements in clinical outcomes. Implementing commitment-based management will foster collaboration, communication, coordination, and teamwork, the essential mechanisms for reducing medical errors and rendering high-quality health care.

Medical Errors and Quality of Care: From Control to Commitment

Even though clients treated in an outpatient setting have been documented to have very high dropout rates, evidences of the factors that influence dropping out are fragmentary and are based on small-scale studies. In our attempt to distinguish such factors, outpatient and intensive outpatient alcoholism admissions for the State of New Jersey were analyzed. Our findings indicated that females, the young and the unskilled are at a higher risk of dropping out. We also documented that drinking status of patients, occupational status, health insurance coverage, educational status, living arrangement, duration of stay in treatment and the number of sessions of service were important factors that influenced the likelihood of dropping out. Controlling for the number of sessions revealed that the relationship between the odds of dropping out and duration in treatment was mixed. Primary drug abusers in our cohort had the highest likelihood of dropping out followed by the dually addicted. It is argued that dropping ...

Some factors that influence dropping out from outpatient alcoholism treatment facilities.

The 1981 Rural Demographic Survey focused on current and retrospective fertility mortality and migration information collecting data at 50000 households in 12 provinces of Ethiopia. Patterns of primary and secondary infertility by province and cohort showed a clear decline of women never having a child; having a 1st child but not a 2nd; having a 2nd child but not a 3rd. Childlessness dropped from 12% of the earliest cohort to 5%; 2nd birth declined from 16% to 6%. Childlessness varied from 20% to 3% in the earliest cohorts (women aged 59 or older) compared to 12% to 2% in the most recent cohorts (women aged 30-39). Almost all provinces showed a decline across cohorts. Infertility is commonly attributed to gonorrhea with high prevalence in Ethiopia and other sexually transmitted diseases (STD) although antibiotics (penicillin chloramphenicol and tetracycline) have reduced their incidence. A maximum of 2.2% increase of fertility was observed in a 5-year period by eradication of excess childlessness. In Ethiopia changes in primary fertility increased fertility by 1.5% between 1970 and 1980; and cohort trends in primary and secondary infertility increased total fertility by 4.5% during this period. In Arsi province the odds of childlessness increased by a factor of 2.3 if the woman was Christian and not Muslim. Christians also had a higher rate of childlessness in 2 of the 12 provinces. Ethnicity also played a role: in 5 provinces the Amara had a higher rate of childlessness than the Oromo indicated by an odds ratio of greater than 1.0. The Amara had 1.5 to 2.7 times the Oromo childlessness levels. Patterns of childlessness were attributable to STDs whose recent decline was caused by the availability of antibiotics. The implication of STDs only in infertility is not entirely plausible in view of the traditional structure of Ethiopian society. Therefore more research is needed on sexuality marriage and the family.

Childlessness in Rural Ethiopia

The Social Dysfunction Scale, originally framed by Simeone et al., is a major first step in the introduction of objectivity to a complex subject often guided by political concerns rather than empirical findings. However, it is too heavily influenced by population sizes of the geographic units. The Relative Needs Assessment Scale proposed here is more flexible and corrects that problem by using weights that set a balance between the burden of the substance use(r) problem and the size of the “population at risk” in the geographic unit. Assuming that a fairly good mix of indicators is identified for substance use(r) problems, the alternative scale provides a better estimate of relative needs for resources.

On the Construction of a Relative Needs Assessment Scale

Because of cost and other constraints, states often find it difficult to estimate need for treatment of alcohol-related problems from routine surveys. The social undesirability of illegal drug use makes the assessment of need for treatment of their use even more difficult. This paper uses independently obtained treatment need estimates to provide parameters for short-term prediction. We obtained the parameters by regressing the proportions of people addicted to alcohol (or drugs) in counties on social-indicator-based relative treatment need estimates for alcohol (or drugs). In addition to integrating estimates coming from independent sources, our approach presents an important tool for planning and resource allocation.

Using Social Indicators to Predict Addiction

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Abate Mammo

Author Tools

Chat about Author