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Major Hospitals (major + hospital)
Selected AbstractsAge Recognition in Adults with Intellectual Disabilities: a Literature Review and an Exploratory StudyJOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES, Issue 3 2000Dorothy M. Bell The ability of children to classify accurately their own ages and the ages of others has been the subject of very limited research. However, the literature is largely in agreement on there being progressive increases in skill with chronological age, although there is disagreement on the age at which this ability becomes well developed. The processes look similar in the field of intellectual disabilities, although this area is extremely under-researched. Key factors may include age, the amount of time spent in institutions (e.g. long-term hospitals for people with intellectual disabilities), developmental level and IQ. The present paper provides a review of the relevant literature and an exploratory study investigating the age recognition of self and colleagues in a group of 20 adults with intellectual disability, some from within what has been a major hospital for people with intellectual disabilities and some from the wider community. Measures of age recognition using photographs, as well as standardized measures of intellectual ability and social adaptive behaviour, were administered, and correlations were found between the ability to recognize age in others and developmental age, and also IQ. Success on the task of age discrimination appears to be more likely if the IQ of the individual is around 60,65 or above, and if the person shows social adaptive behaviour equivalent to 8 or 9 years of age and over. Also included in the study was a task in which only the discrimination of whether the photographs were of adults or children was required, and this proved to be a simpler process for the participants. The present study also demonstrates some of the discriminative stimuli used by adults with intellectual disabilities to ascertain the approximate age of a person. [source] Renal failure and bacterial infections in patients with cirrhosis: Epidemiology and clinical features,HEPATOLOGY, Issue 1 2007Silvano Fasolato The aim of the study was to investigate the prevalence and clinical course of renal failure that was induced by the various types of bacterial infections in patients with cirrhosis and ascites. Three hundred and nine patients, who were consecutively admitted to the 3 major hospitals of Padova, Italy, during the first 6 months of 2005, were studied prospectively. Of these, 233 patients (75.4%) had evidence of ascites. In 104 patients with cirrhosis and ascites (44.6%) a bacterial infection was diagnosed. A bacterial infection-induced renal failure was observed in 35 of 104 patients (33.6%). The prevalence of renal failure was higher in biliary or gastrointestinal tract infections and in spontaneous bacterial peritonitis (SBP) and in than in other types of infections. In addition, the progressive form of renal failure was only precipitated by biliary or gastrointestinal tract infections, SBP, and urinary tract infections (UTI). In a multivariate analysis only MELD score (P = 0.001), the peak count of neutrophil leukocyte in blood (P = 0.04), and the lack of resolution of infection (P = 0.03) had an independent predictive value on the occurrence of renal failure. Conclusion: The results of the study show that the development of bacterial-induced renal failure in patients with cirrhosis and ascites is related to the MELD score, and to both the severity and the lack of resolution of the infection. A progressive form of renal failure occurs only as a consequence of biliary or gastrointestinal tract infections, SBP, and UTI. (HEPATOLOGY 2007;45:223,229.) [source] New immunochemical fecal occult blood test with two-consecutive stool sample testing is a cost-effective approach for colon cancer screening: Results of a prospective multicenter study in Chinese patientsINTERNATIONAL JOURNAL OF CANCER, Issue 12 2006Shirong Li Abstract The purpose of the study is to evaluate a new immunochemical fecal occult blood test method (Hemosure IFOBT), and compare it to the Guaiac-based chemical method (CFOBT) for colorectal cancer detection. A hypothetical sequential method (SFOBT), in which IFOBT was used only as a confirmatory test for CFOBT, was also evaluated. A total of 324 patients were recruited from 5 major hospitals in Beijing, China. For each patient, 3 consecutive stool samples were collected for simultaneous CFOBT and IFOBT tests, followed by colonoscopic examination. We compared the sensitivity and specificity of the 3 methods (CFOBT, IFOBT and SFOBT) in two settings, with the first 2 consecutive samples versus all 3 samples. Although the sensitivity for the detection of cancer and large (>20 mm) or multiple adenoma was similar for all 3 methods in the three-sample setting, in the two-sample setting IFOBT had higher sensitivity than SFOBT for detecting cancer (87.8% vs. 75.5%, respectively, p < 0.05) and large (>20 mm) or multiple adenomas (65.4% vs. 42.3%, respectively, p < 0.05). The IFOBT also had a higher specificity than the CFOBT (89.2% vs. 75.5%, respectively, p < 0.01) in "normal" individuals defined by colonoscopy in the three-sample setting. Comparing two-sample setting to the three-sample setting, both CFOBT and SFOBT showed significant loss of sensitivity for the detection of cancer as well as adenoma, whereas the sensitivity for IFOBT did not change significantly. Overall, IFOBT with two-sample testing showed compatible sensitivity and specificity to the three-sample testing, and had a lower relative cost per cancer detected than the three-sample testing. In conclusion, the new Hemosure IFOBT with two consecutive stool samples appears to be the most cost-effective approach for colon cancer screening. © 2006 Wiley-Liss, Inc. [source] Integrating clinical psychology into primary care settingsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 10 2006Larry C. James The primary care setting offers a mostly new and exciting opportunity for clinical psychology. Historically, psychology has been relegated to the "back forty," distant and far removed from mainstream medicine in most major hospitals. The primary care integration possibilities for clinical psychology are many. The present article will highlight these opportunities as well as provide the reader with an understanding as to why this conceptual paradigm and practical shift is needed as well as how to integrate clinical psychology services into the primary care setting. © 2006 Wiley Periodicals, Inc. J Clin Psychol 62: 1207,1212, 2006. [source] Intrauterine growth standards in a developing country: a study of singleton livebirths at 28,42 weeks' gestationPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 5 2007Khalid A. Yunis Summary This study aimed to develop fetal growth charts for the population of Greater Beirut, Lebanon, and compare them with previously established references. A survey of consecutive singleton livebirths admitted to normal nurseries and neonatal intensive care units of major hospitals, through the database project of the National Collaborative Perinatal Neonatal Network was used as a design. The study was conducted in nine major healthcare institutions serving the population of Beirut and its suburbs. A total of 24 767 singleton livebirths delivered between 28 and 42 weeks' gestation, with known data on gender, gestational age and anthropometric characteristics were recorded between 1 April 1999 and 31 March 2002. Growth charts were developed by plotting birthweight, length and head circumference percentiles against gestational age for male and female infants separately. Overall, 1348 (5.4%) pregnancies were delivered before 37 weeks' gestation and 1227 (4.9%) were low birthweight. Male infants were delivered slightly earlier than their female counterparts and the mean birthweight, length and head circumference were consistently higher in males. A total of 2247 (9.1%) infants were small-for-gestational-age, with a male-to-female sex ratio of 1.03. Using previously established growth references that overestimated small-for-gestational-age prevalence resulted in a greater proportion of false positives. The opposite was true for growth references that underestimated small-for-gestational-age prevalence. The current growth charts present useful tools for assessing the general health status of newborn infants delivered at sea level in the urban areas of Lebanon and other East Mediterranean countries. [source] Antibiotic susceptibility of blood culture isolates of Enterobacteriaceae,APMIS, Issue 10 2001A Norwegian multicenter study From May to November 1997 each of six major hospitals throughout Norway collected 72 to 104 consecutive blood culture isolates of Enterobacteriaceae, altogether 563 isolates. Escherichia coli was the predominating organism (69%), followed by Klebsiella spp. (15%), Enterobacter spp. (6%), and Proteus mirabilis (4%). The susceptibility of the isolates to ampicillin, cefuroxime, ceftazidime, imipenem, tobramycin, and ciprofloxacin was determined by the E-test. 37% and 7% of the isolates were resistant to ampicillin and cefuroxime, respectively, and 1% were resistant to ceftazidime and tobramycin. Only one isolate of P. mirabilis was imipenem resistant. All isolates were susceptible to ciprofloxacin. The prevalence of ampicillin-resistant isolates at each hospital varied from 21 to 45%, and of cefuroxime-resistant isolates from 3 to 9%. The results were compared with those of a similar study performed in 1991,1992. No significant changes in the susceptibility to the various agents could be demonstrated. The high frequency of isolates resistant to ampicillin has clearly limited the usefulness of this agent in the treatment of septicemia and other serious infections caused by Enterobacteriaceae. [source] A study of natural rubber latex allergens in gloves used by healthcare workers in SingaporeBRITISH JOURNAL OF DERMATOLOGY, Issue 5 2005D. Koh Summary Background, Allergy to natural rubber latex (NRL) proteins is a well-recognized health problem among subjects using protective gloves and products made of NRL. There is currently no information on NRL allergen levels in gloves used in Singapore. Objectives, This study aims to quantify the amount of specific allergens (Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02) found in rubber gloves used in Singapore. It also aims to determine if these levels are above thresholds that may cause NRL allergy. It also compares the levels of these specific allergens in gloves used for different purposes, namely gloves used for examination purposes or for surgical procedures. Methods, Forty-nine rubber gloves were obtained from major hospitals and healthcare departments in Singapore and were analysed for their NRL allergen levels. FITkitTM, based on the enzyme immunometric assay technique, was used to determine the specific allergen levels of Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02 in the gloves. Results, Examination gloves had higher NRL allergen content compared with surgical gloves, and powdered gloves had higher allergen content compared with nonpowdered gloves. Among the various allergens, Hev b 5 and Hev b 6.02 were present in larger quantities than Hev b 1 and Hev b 3. Only two of 19 (11%) surgical gloves had the sum of the four allergens (Hev b 1, Hev b 3, Hev b 5, Hev b 6.02) in excess of 1 µg g,1, which is believed to be a clinically relevant threshold. Among the examination gloves, 25 of 30 (83%) exceeded this level. Conclusions, This study shows that NRL allergen levels are present in the majority of examination gloves used by healthcare workers in Singapore at levels high enough to cause NRL allergy among sensitized persons. The information can serve as evidence for a possible requirement for manufacturers to produce gloves with low NRL allergen levels and to state the allergen level in gloves in the product information. [source] The pattern of self-poisoning among Lebanese children and adolescents in two tertiary care centres in LebanonACTA PAEDIATRICA, Issue 6 2009Durriyah Sinno Abstract Aim: Self-poisoning in childhood and adolescence is a major problem for health authorities all over the world. The objective of this study was to determine the pattern of self-poisoning in Lebanese children and adolescents. Materials and methods: This prospective study included all cases of poisoning in individuals aged 0,18 years who presented to the emergency department of two major hospitals in Beirut, Lebanon over a period of 1 year. Participants were divided into two age groups (0,12 years and 12,18 years). These cases were followed to record the applied treatment and whether the patient was admitted or discharged. Results: There were 110 self-poisoning incidents, of which 74 (67%) were in female patients. The predominant type of poisoning was with pharmaceutical products (68.2%). Accidental self-poisoning was significantly more common in the younger age group among both genders compared with the older age group (p < 0.0001). There were significantly more poisoned male children (72%) than male adolescents (28%) (p = 0.003); whereas among females, poisoned adolescents were significantly more common (64%) than poisoned children (36%) (p = 0.009). Moreover, poisoning with pharmaceuticals was significantly higher in the young male group compared to the older age group and older female group compared to the younger age group (p = 0.0007 and p = 0.01, respectively). In total, 78% of patients were discharged home following basic observation, charcoal or gastric lavage. Conclusion: Female adolescents are more at risk of deliberate self-intoxication after the age of 12 years compared to males, whereas males younger than 12 years are more likely to suffer from accidental poisoning. Preventative strategies include screening adolescents at high risk of self-harm in order to offer adequate counselling, while providing anticipatory guidance for parents of children in the younger age group. [source] | ||||||||||