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Period I (period + i)
Selected AbstractsFusion of dispatching centres into one entity: effects on performanceACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2010T. MÄÄTTÄ Background: Dispatching centres were fused into one of the 112 entity, which caused concerns regarding whether the medical calls could be processed effectively also in the new centre. We evaluated the effects of the reform on key performance criteria in medical calls. Methods: This observational study in the Helsinki Dispatching Centre consisted of two periods: Period I 2 years before the reform and Period II 2 years after. The main outcome measures were answering and call processing times, accuracy of risk assessment and appropriate use of ambulances. Results: In Period I (n=574,276), 92.2% of all incoming phone calls were answered within 10 s and in Period II (n=758,022) 82.8% (P<0.0001). Time to dispatch a first responding fire unit increased from 98 to 113 s (P<0.0001) and an advanced life support unit in category A calls increased from 73 to 84 s (P<0.0001). In Period I 47.7%, 34.8% and 17.5% of phone calls were completed in <3, 3,5 and >5 min and in Period II 29.8%, 36.1% and 34.1% (P<0.0001). The number of three studied non-transportation call types and unnecessary lights-and-siren responses increased significantly (P<0.0001 and 0.0001, respectively). Neither the accuracy of risk assessment in the three studied call types nor the rate of telephone-guided cardiopulmonary resuscitation changed. Conclusions: The reform increased the total number of ambulance dispatches, prolonged answering and call processing times and had a negative effect on the appropriate use of ambulances. The accuracy of risk assessment was not affected. Evidence-based data should be the basis for the future as dispatching centre processes are shown to be vulnerable during organisational reforms. [source] Safety of medications prescribed before and during early pregnancy in a cohort of 81,975 mothers from the UK General Practice Research Database,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 8 2006Janet R. Hardy PhD Abstract Purpose To demonstrate a linkage methodology for mother and baby automated medical records, and describe frequency, type, and pregnancy risk level of medications prescribed during pregnancy in a GPRD cohort, 1991,1999. Methods We linked records using a two-stage algorithm and selected pairs with ,7 months prenatal records and ,2 records in baby's first year of life. Periods of interest were: 90 days prior to a woman's earliest identified pregnancy record (Period I), and this record plus 70 days (Period II, approximate early pregnancy). Medications were classified using the British National Formulary and US Food and Drug Administration Pregnancy Risk Categories. Results We achieved over 80% record linkage and defined a cohort of 81,975. Sixty-five per,cent of mothers had ,1 prescription during both periods combined. Most frequent medications in Period I were anti-bacterial, contraceptive, topical steroid, and bronchodilator. In Period II, they were folic acid, anti-bacterial, antacid, and gynecological anti-infective. In Period I, 4% were FDA category A (considered safest), 34% B, and 49% C and D combined. By Period II, prescription of category A medications increased (folic acid, iron) while other categories declined. Category X medications, with potential teratogenic risk that outweighs maternal benefit, were prescribed to 5714 (7%) women in Period I, and 501 (0.6%) women in Period II (46% progesterone). Conclusions One in every 164 women received a category X prescription in early pregnancy. The visit when pregnancy is first medically recognized represents an opportunity to review prescribed medications in light of contraindication and/or fetal risk. Copyright © 2006 John Wiley & Sons, Ltd. [source] Corticolous arthropods under climatic fluctuations: compensation is more important than migrationECOGRAPHY, Issue 1 2005Andreas Prinzing Animals can cope with fluctuating climates by physiological tolerance, tracking of climatic fluctuations (migration) and compensatory redistribution among (micro)habitats (compensation). Compensation is less demanding and thus more important than migration at large geographic scales. It is not clear however which strategy is more important at the small scale of a microhabitat landscape. I investigated how six arthropod species (Collembola, Oribatei, Psocoptera, Isopoda) respond to microclimatic fluctuations at the surface of exposed tree trunks. Across a nine-month period I characterized the microclimatic zonation of 299 trunks, and focally sampled the arthropods from different microhabitat types (different cryptogam species and bark crevices) within different microclimatic zones. I found that compensatory microhabitat-use was a general phenomenon. The distribution of all species across microhabitats was influenced significantly by ambient microclimate. Also, the arthropods' microhabitat use changed throughout their ontogeny, and microhabitats were used even if they were rare. Most interestingly, the arthropods responded to microclimatic fluctuations primarily by redistribution among microhabitats and less by fluctuations of overall abundances across all microhabitats. Hence compensation was more important than migration. The animals moved for centimeters to decimeters rather than for decimeters to meters; they perceived and utilized their environment primarily at the finest, but also most complex scale. This has implications for the resilience of arthropod populations, their interactions with cryptogams and the turnover of species between macrohabitats. [source] Supplementation of xylanase and phospholipase to wheat-based diets for weaner pigsJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 9-10 2005G. Diebold Summary The effects of supplementing a wheat-based diet for weaner pigs with exogenous xylanase and phospholipase on ileal and faecal nutrient digestibilities and on the level of microbial metabolites in ileal digesta were examined. Fourteen piglets, weaned at 11 days, were fitted with a simple T-cannula at the distal ileum. The pigs were offered a control diet or diets supplemented with xylanase and phospholipase individually or in combination, in a two period crossover design. The combination of xylanase and phospholipase tended to increase the ileal recovery of the amino sugar galactosamine, whereas the concentration expressed in mg/kg dry matter intake of glucosamine was slightly decreased (p < 0.10). There was neither an effect of enzyme supplementation on ileal and faecal digestibility of the other nutrients and energy, nor was there an effect on pH and on the level of microbial metabolites in ileal digesta. However, an increase in ileal and faecal nutrient and energy digestibility with increasing age was observed. The ileal and faecal digestibility coefficients (except for ether extract) were significantly (p < 0.05) higher in experimental period I than in period II. These higher values may be attributed to a lower feed intake during period I. Since a lower level of feed intake is generally associated with a slower rate of passage and a longer retention time of digesta, a positive impact on digestion and absorption of nutrients can be assumed, which, on the other hand, limits the potential of additional enzyme effects. [source] | |||||||||||||