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This paper summarizes two studies conducted to improve the emergency service delivery in St. Albert, a small city near Edmonton, Alberta. The first study dealt with selecting the location of a new fire station. The goals of the study included an assessment of the performance of the current system, an identification of the area(s) with poor coverage, a selection of a site among a set of given candidate locations, and an assessment of the improvement in the system performance upon the addition of the new fire station. A geographical information system was used for storing and displaying the spatial data, computing service areas for given travel times, and for communicating the results of the study. The second study considered an evaluation of the resources available for emergency service. A probabilistic model was used to evaluate labor costs for different platoon sizes and a simulation model was used to evaluate the adequacy of the current staff and fleet sizes. Results were presented to EMS office...

This report describes cartilaginous regeneration in a cricoarytenoid joint affected by spondyloarthropathy using tumor necrosis factor-alpha (TNF-α) blockade, monitored by magnetic resonance (MR) and computed tomography (CT) imaging. This case is interesting for several reasons. It is only the eighth case of destructive ankylosing spondylitis-related cricoarytenoid arthritis published in the English language literature. It describes, for the first time, full recovery of vocal cord mobility following TNF-α blockade. It is also the first case to be published with MR imaging demonstrating regeneration of the cricoarytenoid cartilage following treatment. This case represents a landmark in the treatment of patients presenting with destructive arthritis involving the cricoarytenoid joint.

The purpose of this study was to determine the variability of laboratory nasal function tests in 26 patients (18 female) with seasonal allergic rhinitis (SAR) (mean age 38.1 years). Their usual medication for SAR was withheld for 2 separate one week washout periods, separated by at least 2 weeks, in order to produce clinically significant nasal airflow obstruction. Measurements were made on both occasions for nasal nitric oxide (NO), nasal peak inspiratory flow (nPIF), oral PIF (oPIF), nasal forced inspiratory flow rate in 1 second (nFIV1), oral FIV1 (oFIV1). The respective nasal-oral ratios for FIV1 and PIF were also determined. The intra-individual coefficient of variation was: NO = 14%, nFIV1 = 4%, nFIV1/oFIV1 ratio = 10%, nPIF = 8% and nPIF/oPIF ratio = 12%. Linear regression analysis showed significant (p0.05) correlations between nPIF and nFIV1 (R2 = 0.45) and between nPIF/oPIF and nFIV1/oFIV1 (R2 = 0.20). In conclusion, there was a good correlation between the two methods of nasal inspiratory flow, although FIV1 had a lesser degree of variability.

Paranoid states beginning in middle life were selected from a case register. A search among the sibs of those probands uncovered no paranoid states and schizophrenia was no more common than in the general population. The implications for the asteiology of paranoid states and for the relationship between these and schizophrenia are discussed.

The national cost of prescriptions for drugs for use in medical practice in the United Kingdome has risen progressively from £35,000,000 in 1949 to well over £100,000,000 a year now (Dunlop, 1965). The number of drugs taken by patients is vast, and the variety of drugs available for prescription is considerable. Prescribed in order to produce a specific therapeutic effect, few drugs, if any, are wholly free from the potential of producing undesirable side-effects. These vary from the trivial to the lethal, from the transient to the permanent. Methods for their accurate detection, qualitative evaluation and risk identification are vital prerequisites to therapeutic safety and refinement. Experimental techniques, using detailed observation on large samples of patients being treated by drugs, have been developed recently. A monitoring system which scans for side-effects of drugs represents a means whereby prospective and cumulative data on the frequency of occurrence and nature of these side-effects can accrue. This is referred to as drug monitoring.

Monitoring for untoward events associated with drug and other physical treatments was conducted on all patients admitted to a psychiatric teaching unit for one calendar year. The design and implementation of the monitoring system is described. Amongst the characteristics of the 307 patients who comprised the cohort was a low mean age of 37 years, a sex ratio of men to women 1:2, a low level of senile and degenerative disorders and a high level of morbidity from co-existing physical illness. The monitor revealed that 52 per cent of the cohort experienced at least one untoward-event. Multiple untoward-event experiences were common. The highest rates were associated with treatment by electroplexy, anti-depressant drugs and phenothiazines. Four-fifths of all untoward events occurred within seven days of starting treatment. Patients with major psychiatric illness and patients with severe concomitant physical illness experienced more untoward events associated with the use of drugs and electroplexy than did patients with minor psychiatric and physical illness. The incidence of untoward events increased as the number of drugs prescribed increased. Age, socio-economic status and intelligence did not influence untoward-event experience, but women experienced significantly more events than men. Length of stay in hospital was not influenced by the experience of untoward events.