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51. On the Raman spectrum of a single crystal of K2SeO4: Corrections to earlier spectra and assignments

Author

C. Caville, V. Fawcett, and D. A. Long

Subjects
symbols.namesake, Quality (physics), Chemistry, Analytical chemistry, symbols, General Materials Science, Raman spectroscopy, Single crystal, Spectroscopy, Spectral line
Abstract

Improved room temperature Raman spectra obtained from oriented single crystals of K2SeO4 of high quality are reported and discussed. The new results show that some of the earlier spectra contained spurious bands and that some genuine bands were incorrectly assigned.

Published
1978
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54. ChemInform Abstract: RAMAN SPECTROSCOPIC STUDY OF SEMICARBAZIDE HYDROCHLORIDE ABOVE AND BELOW THE FERROELECTRIC PHASE TRANSITION

Author

V. Fawcett and D. A. Long

Subjects
Phase transition, Semicarbazide, Chemistry, Infrared, Hydrochloride, Analytical chemistry, General Medicine, Atmospheric temperature range, Ferroelectricity, chemistry.chemical_compound, symbols.namesake, Phase (matter), symbols, Raman spectroscopy
Abstract

Crystals of semicarbazide hydrochloride, NH2CONHNH+3Cl– are paraelectric above 294 K and ferroelectric below. The Raman spectra in the region 0–1800 cm–1 of oriented single crystals of semicarbazide hydrochloride and its perdeutero analogue have been recorded over the temperature range 298–87 K. In addition the infrared spectrum of semicarbazide hydrochloride in a KBr disc at 298 K has been recorded in the range 250–1700 cm–1. The Raman spectra have been analysed in relation to the structural changes occurring with the change of phase. The spectroscopic results support the X-ray evidence that the transition to the ferroelectric phase is second order and involves no major structural change. Comparison of the infrared and Raman spectra suggest that LO–TO splitting is unimportant.

Published
1976
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57. The enigma of copper(III) in YBCO superconductors

Author

R. I. Bickley, V. Fawcett, and L. Shields

Subjects
Superconductivity, Oxide ceramics, Materials science, High-temperature superconductivity, chemistry, law, Inorganic chemistry, Metallurgy, chemistry.chemical_element, General Materials Science, Electroceramics, Copper, law.invention
Published
1989
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58. Raman spectroscopic study of semicarbazide hydrochloride above and below the ferroelectric phase transition

Author

V. Fawcett and D. A. Long

Subjects
Phase transition, Semicarbazide, Infrared, Hydrochloride, Analytical chemistry, Atmospheric temperature range, Photochemistry, Ferroelectricity, chemistry.chemical_compound, symbols.namesake, chemistry, Phase (matter), symbols, Raman spectroscopy
Abstract

Crystals of semicarbazide hydrochloride, NH2CONHNH+3Cl– are paraelectric above 294 K and ferroelectric below. The Raman spectra in the region 0–1800 cm–1 of oriented single crystals of semicarbazide hydrochloride and its perdeutero analogue have been recorded over the temperature range 298–87 K. In addition the infrared spectrum of semicarbazide hydrochloride in a KBr disc at 298 K has been recorded in the range 250–1700 cm–1. The Raman spectra have been analysed in relation to the structural changes occurring with the change of phase. The spectroscopic results support the X-ray evidence that the transition to the ferroelectric phase is second order and involves no major structural change. Comparison of the infrared and Raman spectra suggest that LO–TO splitting is unimportant.

Published
1976
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60. Some reactions of tin oxide chloride and titanium oxide chloride

Author

I. R. Beattie and V. Fawcett

Subjects
chemistry.chemical_classification, Double bond, Acetylacetone, Inorganic chemistry, Infrared spectroscopy, equipment and supplies, Tin oxide, Chloride, Titanium oxide, Inorganic Chemistry, chemistry.chemical_compound, Monomer, chemistry, Pyridine, medicine, Physical and Theoretical Chemistry, medicine.drug
Abstract

Some reactions of tin oxide chloride with pyridine and with tetrahydrothiophen are reported, and it is suggested that products are normally of the form SnO2 and SnCl4,L2. Reaction of tin oxide chloride or titanium oxide chloride with acetylacetone appears to lead to the known compounds MCl2(acac)2(where Hacac = acetylacetone, M = Sn or Ti). Several preparations of “TiO(acac)2” did not (with the present authors) lead to a monomeric species. The nature of the cation TiOCl42– is discussed as is the characterisation of “metal–oxygen double bonds” using vibrational spectroscopy.

Published
1967
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61. The vibrational spectra of some chloro-complexes of germanium, tin, phosphorus, arsenic, and antimony

Author

V. Fawcett, I. R. Beattie, K. M. S. Livingston, G. A. Ozin, and T. R. Gilson

Subjects
Inorganic Chemistry, chemistry.chemical_classification, chemistry, Antimony, Phosphorus, Inorganic chemistry, chemistry.chemical_element, Salt (chemistry), Germanium, Physical and Theoretical Chemistry, Tin, Arsenic, Vibrational spectra
Abstract

Complete vibrational spectra and assignments are reported for the following species: PCl5, PCl6–, AsCl4+, AsCl6– SbCl5, SbCl6–, and GeCl62–. Partial data are reported for the species GeCl5–, SnCl5–, and SnCl62–. It is suggested that the compound AsCl5,SbCl5 is correctly formulated as AsCl4+SbCl6– while the related compound PCl5,AsCl5(although not obtained pure) is probably the salt PCl4+AsCl6–. Calculated and observed data are compared for all the MCl5 species mentioned above.

Published
1967
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62. A quality-improvement approach to effective trauma team activation

Author

Verhoeff K, Saybel R, Fawcett V, Tsang B, Mathura P, and Widder S

Subjects
Canada, Guideline Adherence organization & administration, Guideline Adherence standards, Guideline Adherence statistics & numerical data, Health Plan Implementation, Humans, Patient Care Team standards, Practice Guidelines as Topic, Program Evaluation, Retrospective Studies, Stakeholder Participation, Trauma Centers standards, Trauma Centers statistics & numerical data, Triage standards, Triage statistics & numerical data, Patient Care Team organization & administration, Quality Improvement statistics & numerical data, Trauma Centers organization & administration, Triage organization & administration, Wounds and Injuries therapy
Abstract

Background: Appropriate, timely trauma team activation (TTA) can directly affect outcomes for patients with trauma. A review of quality-performance indicators at our Canadian level 1 trauma centre showed a high level of undertriage, with TTA compliance rates less than 60% for major trauma. A quality-improvement project was undertaken, targeting a sustained goal of at least 90% TTA compliance based on Accreditation Canada guidelines., Methods: Quality-improvement action followed a well-defined process. Baseline data collection was performed, and, in keeping with the Donabedian approach, we brought together stakeholders to collectively review and understand the reasons behind poor TTA compliance; and root-cause analysis. This was followed by rapid change cycles that focused on structure and processes with ongoing audits to support and sustain change., Results: Trauma team activation compliance improved from 58.8% to more than 90% over 2 years. Quality indicators showed a statistically significant reduction in the time to computed tomography scanner, time in the acute care region of the emergency department and total time in the emergency department, with improved TTA compliance., Conclusion: Compliance with TTA protocols improved to more than 90% over a 2-year period, which shows the benefit of having a clearly outlined qualityimprovement process. This well-defined quality-improvement method provides a framework for use by other institutions that seek to improve their processes of trauma care, including activation rates., Competing Interests: V. Fawcett and S. Widder are members of the CJS editorial board, but they were not involved in the review or acceptance of this manuscript. No other competing interests declared., (© 2019 Joule Inc. or its licensors)

Published
2019
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63. High-risk medications in older patients with trauma: a cross-sectional study of risk mitigation

Author

Lester E, Dykstra M, Grant C, Fawcett V, Tsang B, and Widder S

Subjects
Aged, Alberta epidemiology, Cross-Sectional Studies, Female, Hospital Mortality, Hospitalization statistics & numerical data, Humans, Male, Prevalence, Prospective Studies, Quality Improvement, Registries statistics & numerical data, Retrospective Studies, Risk Factors, Wounds and Injuries mortality, Drug Prescriptions statistics & numerical data, Polypharmacy, Potentially Inappropriate Medication List, Wounds and Injuries therapy
Abstract

Background: The Beers Criteria for Potentially Inappropriate Medication Use inOlder Adults is a framework that can assess the nature of high-risk medication use. The objective of this study was to use the Beers Criteria to assess the prevalence and nature of polypharmacy, the magnitude of medication changes during the hospital stay and the impact of Beers Criteria medications on outcomes in older patients with trauma., Methods: We used the Alberta Trauma Registry to conduct a retrospective review of patients aged 65 years or older with major trauma (Injury Severity Score ≥ 12) who were admitted to a level 1 trauma centre between January 2013 and December 2014. We analyzed changes in medication prescriptions during the hospital stay using descriptive statistics and assessed the association between Beers Criteria medications and relevant outcomes using multivariable regression analysis., Results: There was no significant change in the number of Beers Criteria medications prescribed before and after admission. The adjusted odds ratio for 30-day mortality for each additional Beers Criteria medication prescribed was 2.02 (95% confidence interval [CI] 1.16–3.51) versus 1.24 (95% CI 1.04–1.59) for each additional medication of any type. The corresponding adjusted incidence rate ratios for length of stay were 1.15 (95% CI 1.03–1.30) versus 1.05 (95% CI 1.01–1.10)., Conclusion: Beers Criteria medications were not discontinued during trauma admissions. Using the Beers Criteria as a process indicator for quality improvement in trauma care may provide interdisciplinary trauma teams an opportunity to audit patient medications and stop potentially harmful medications in a vulnerable population., Competing Interests: V. Fawcett and S. Widder are CJS associate editors, but they were not involved in the review or the decision to publish this paper. None declared by E. Lester, M. Dykstra, C. Grant and B. Tsang., (© 2019 Joule Inc. or its licensors)

Published
2019
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64. Canadian Surgery Forum 2018: St. John's, NL Sept. 13-15, 2018.

Author

Jayaraman S, Lee L, Mata J, Droeser R, Kaneva P, Liberman S, Charlebois P, Stein B, Fried G, Feldman L, Schellenberg M, Inaba K, Cheng V, Bardes J, Lam L, Benjamin E, Matsushima K, Demetriades D, Schellenberg M, Inaba K, Cho J, Strumwasser A, Grabo D, Bir C, Eastman A, Demetriades D, Schellenberg M, Inaba K, Bardes J, Orozco N, Chen J, Park C, Kang T, Demetriades D, Jung J, Elfassy J, Grantcharov T, Jung J, Grantcharov T, Jung J, Grantcharov T, Taylor J, Stem M, Yu D, Chen S, Fang S, Gearhart S, Safar B, Efron J, Serrano P, Parpia S, McCarty D, Solis N, Valencia M, Jibrael S, Wei A, Gallinger S, Simunovic M, Hummadi A, Rabie M, Al Skaini M, Shamshad H, Shah S, Verhoeff K, Glen P, Taheri A, Min B, Tsang B, Fawcett V, Widder S, Yang M, Wanis K, Gilani O, Vogt K, Ott M, VanKoughnett J, Vinden C, Balvardi S, St Louis E, Yousef Y, Toobaie A, Guadagno E, Baird R, Poenaru D, Kleiman A, Mador B, Widder S, Serrano P, Moulton C, Lee E, Li C, Beyfuss K, Solomon H, Sela N, McAlister V, Ritter A, Gallinger S, Hallet J, Tsang M, Martel G, Jalink D, Husien M, Gu C, Levine M, Otiti S, Nginyangi J, Yeo C, Ring J, Holden M, Ungi T, Fichtinger G, Zevin B, Fang B, Dang J, Karmali S, Serrano P, Kim M, Zhang B, Duceppe E, Rieder S, Maeda A, Okrainec A, Jackson T, Kegel F, Lachance S, Landry T, Feldman L, Fried G, Mueller C, Lee L, Kegel F, Kegel F, Lachance S, Lee L, Joharifard S, Nyiemah E, Howe C, Dobboh C, Kortimai LG, Kabeto A, Beste J, Garraway N, Riviello R, Hameed S, Shinde S, Marcil G, Prasad S, Arminan J, Debru E, Church N, Gill R, Mitchell P, Delisle M, Chernos C, Park J, Hardy K, Vergis A, Guez M, Hong D, Guez M, Hong D, Koichopolos J, Hilsden R, Thompson D, Myslik F, Vandeline J, Leeper R, Doumouras A, Govind S, Hong D, Govind S, Valanci S, Alhassan N, Lee L, Feldman L, Fried G, Mueller C, Wong T, Nadkarni N, Chia S, Seow D, Carter D, Li C, Valencia M, Ruo L, Parpia S, Simunovic M, Levine O, Serrano P, Vogt K, Allen L, Murphy P, van Heest R, Saleh F, Widder S, Minor S, Engels P, Joos E, Wang C, Nenshi R, Meschino M, Laane C, Parry N, Hameed M, Lacoul A, Lee L, Chrystoja C, Ramjist J, Sutradhar R, Lix L, Simunovic M, Baxter N, Urbach D, Ahlin J, Patel S, Nanji S, Merchant S, Lajkosz K, Brogly S, Groome P, Sutherland J, Liu G, Crump T, Bair M, Karimuddin A, Sutherland J, Peterson A, Karimuddin A, Liu G, Crump T, Koichopolos J, Hawel J, Shlomovitz E, Habaz I, Elnahas A, Alkhamesi N, Schlachta C, Akhtar-Danesh G, Doumouras A, Hong D, Daodu T, Nguyen V, Dearden R, Datta I, Hampton L, Kirkpatrick A, McKee J, Regehr J, Brindley P, Martin D, LaPorta A, Park J, Vergis A, Gillman L, DeGirolamo K, Hameed M, D'Souza K, Hartford L, Gray D, Murphy P, Hilsden R, Clarke C, Vogt K, Wigen R, Allen L, Garcia-Ochoa C, Gray S, Maciver A, Parry N, Van Koughnett J, Leslie K, Zwiep T, Ahn S, Greenberg J, Balaa F, McIsaac D, Musselman R, Raiche I, Williams L, Moloo H, Nguyen M, Naidu D, Karanicolas P, Nadler A, Raskin R, Khokhotva V, Poirier R, Plourde C, Paré A, Marchand M, Leclair M, Deshaies J, Hebbard P, Ratnayake I, Decker K, MacIntosh E, Najarali Z, Valencia M, Zhang B, Alhusaini A, Solis N, Duceppe E, Parpia S, Ruo L, Simunovic M, Serrano P, Murphy P, Murphy P, McClure A, Dakouo M, Vogt K, Vinden C, Behman R, Nathens A, Hong NL, Pechlivanoglou P, Karanicolas P, Lung K, Leslie K, Parry N, Vogt K, Leeper R, Simone P, Leslie K, Schemitsch E, Laane C, Chen L, Rosenkrantz L, Schuurman N, Hameed M, Joos E, George R, Shavit E, Pawliwec A, Rana Z, Laane C, Joos E, Evans D, Dawe P, Brown R, Hameed M, Lefebvre G, Devenny K, Héroux D, Bowman C, Mimeault R, Calder L, Baker L, Winter R, Cahill C, Fergusson D, Williams L, Schroeder T, Kahnamoui K, Elkheir S, Farrokhyar F, Wainman B, Hershorn O, Lim S, Hardy K, Vergis A, Arora A, Wright F, Nadler A, Escallon J, Gotlib L, Allen M, Gawad N, Raîche I, Jeyakumar G, Li D, Aarts M, Meschino M, Giles A, Dumitra T, Alam R, Fiore J, Mata J, Fried G, Vassiliou M, Mueller C, Lee L, Feldman L, Al Busaidi O, Brobbey A, Stelfox T, Chowdhury T, Kortbeek J, Ball C, AlShahwan N, Fraser S, Gawad N, Tran A, Martel A, Baxter N, Allen M, Manhas N, Balaa F, Mannina D, Khokhotva V, Tran A, Gawad N, Martel A, Manhas N, Allen M, Balaa F, Behman R, Behman A, Haas B, Hong NL, Pechlivanoglou P, Karanicolas P, Gawad N, Fowler A, Mimeault R, Raiche I, Findlay-Shirras L, Decker K, Singh H, Biswanger N, Park J, Gosselin-Tardif A, Khalil MA, Gutierrez JM, Guigui A, Feldman L, Lee L, Mueller C, Ferri L, Roberts D, Stelfox T, Moore L, Holcomb J, Harvin J, Sadek J, Belanger P, Nadeau K, Mullen K, Aitkens D, Foss K, MacIsaac D, Williams L, Musselman R, Raiche I, Moloo H, Zhang S, Ring J, Methot M, Zevin B, Yu D, Hookey L, Patel S, Yates J, Perelman I, Saidenberg E, Khair S, Taylor J, Lampron J, Tinmouth A, Lim S, Hammond S, Park J, Hochman D, Lê M, Rabbani R, Abou-Setta A, Zarychanski R, Patel S, Yu D, Elsoh B, Goldacre B, Nash G, Trepanier M, Alhassan N, Wong-Chong N, Sabapathy C, Chaudhury P, Liberman S, Charlebois P, Stein B, Feldman L, Lee L, Bradley N, Dakin C, Holm N, Henderson W, Roche M, Sawka A, Tang E, Murphy P, Allen L, Huang B, Vogt K, Gimon T, Rochon R, Lipson M, Buie W, MacLean A, Lau E, Alkhamesi N, Schlachta C, Mocanu V, Dang J, Tavakoli I, Switzer N, Tian C, de Gara C, Birch D, Karmali S, Young P, Chiu C, Meneghetti A, Warnock G, Meloche M, Panton O, Istl A, Gan A, Colquhoun P, Habashi R, Stogryn S, Abou-Setta A, Metcalfe J, Hardy K, Clouston K, Vergis A, Zondervan N, McLaughlin K, Springer J, Doumouras A, Lee J, Amin N, Caddedu M, Eskicioglu C, Hong D, Cahill C, Fowler A, Warraich A, Moloo H, Musselman R, Raiche I, Williams L, Keren D, Kloos N, Gregg S, MacLean A, Mohamed R, Dixon E, Rochan R, Ball C, Taylor J, Stem M, Yu D, Chen S, Fang S, Gearhart S, Safar B, Efron J, Yu D, Stem M, Taylor J, Chen S, Fang S, Gearhart S, Safar B, Efron J, Domouras A, Springer J, Elkheir S, Eskicioglu C, Kelly S, Yang I, Forbes S, Wong-Chong N, Khalil MA, Garfinkle R, Bhatnagar S, Ghitulescu G, Vasilevsky C, Morin N, Boutros M, Garfinkle R, Wong-Chong N, Petrucci A, Sylla P, Wexner S, Bhatnagar S, Morin N, Boutros M, Garfinkle R, Sigler G, Morin N, Ghitulescu G, Bhatnagar S, Faria J, Gordon P, Vasilevsky C, Boutros M, Garfinkle R, Khalil MA, Bhatnagar S, Wong-Chong N, Azoulay L, Morin N, Vasilevsky C, Boutros M, Alhassan N, Wong-Chong N, Trepanier M, Chaudhury P, Liberman A, Charlebois P, Stein B, Lee L, Alhassan N, Yang M, Wong-Chong N, Liberman A, Charlebois P, Stein B, Fried G, Lee L, Khorasani S, de Buck van Overstraeten A, Kennedy E, Hong NL, Mata J, Fiore J, Pecorelli N, Mouldoveanu D, Gosselin-Tardiff A, Lee L, Liberman S, Stein B, Charlebois P, Feldman L, Chau J, Bhatnagar S, Khalil MA, Morin N, Vasilevsky C, Ghitulescu G, Faria J, Boutros M, Fournier FR, Bouchard P, Khalil MA, Bhatnagar S, Khalil JA, Vasilevsky C, Morin N, Ghitulescu G, Faria J, Boutros M, Khalil MA, Morin N, Vasilevsky C, Ghitulescu G, Motter J, Boutros M, Wong-Chong N, Mottl J, Hwang G, Kelly J, Nassif G, Albert M, Lee L, Monson J, Wong-Chong N, Lee L, Kelly J, Nassif G, Albert M, Monson J, McLeod J, Cha J, Raval M, Phang T, Brown C, Karimuddin A, Karimuddin A, Robertson R, Letarte F, Karimuddin A, Raval M, Phang T, Brown C, Antoun A, Sigler G, Garfinkle R, Morin N, Vasilevsky C, Pelsser V, Ghitulescu G, Boutros M, Hyun E, Clouston-Chambers K, Hochman D, Helewa R, Park J, Candy S, Mir Z, Hanna N, Zevin B, Patel S, Azin A, Hirpara D, Quereshy F, Jackson T, Okrainec A, O'Brien C, Chadi S, Punnen S, Raval M, Karimuddin A, Phang T, Brown C, Yoon H, Brown C, Karimuddin A, Raval M, Phang T, Xiong W, Stuart H, Andrews J, Selvam R, Wong S, Hopman W, MacDonald P, Patel S, Dossa F, Medeiros B, Keng C, Acuna S, Hamid J, Baxter N, Ghuman A, Kasteel N, Brown C, Karimuddin A, Raval M, Phang T, Dossa F, Baxter N, Buie D, McMullen T, Elwi A, MacLean T, Wang H, Coutinho F, Le Q, Shack L, Roy H, Kennedy R, Hanna N, Zevin B, Bunn J, Mir Z, Chung W, Elmi M, Wakeam E, Azin A, Presutti R, Keshavjee S, Cil T, McCready D, Cheung V, Schieman C, Bailey J, Nelson G, Batchelor T, Grondin S, Graham A, Safieddine N, Johnson S, Hanna W, Cheung V, Schieman C, Bailey J, Nelson G, Low D, Safieddine N, Grondin S, Seely A, Bedard E, Finley C, Nayak R, Brogly S, Lajkosz K, Lougheed D, Petsikas D, Kinio A, Resende VF, Anstee C, Seely A, Maziak D, Gilbert S, Shamji F, Sundaresan S, Villeneuve P, Ojah J, Ashrafi A, Najjar A, Yamani I, Sersar S, Batouk A, Parente D, Laliberte A, McInnis M, McDonald C, Hasnain Y, Yasufuku K, Safieddine N, Waddell T, Chopra N, Nicholson-Smith C, Malthaner R, Patel R, Doubova M, Robaidi H, Anstee C, Delic E, Fazekas A, Gilbert S, Maziak D, Shamji F, Sundaresan S, Villeneuve P, Seely A, Taylor J, Hanna W, Hughes K, Pinkney P, Lopez-Hernandez Y, Coret M, Schneider L, Agzarian J, Finley C, Tran A, Shargall Y, Mehta M, Pearce K, Hanna W, Schneider L, Farrokhyar F, Agzarian J, Finley C, Shargall Y, Gupta V, Coburn N, Kidane B, Hess K, Compton C, Ringash J, Darling G, Mahar A, Gupta V, Kidane B, Ringash J, Sutradhar R, Darling G, Coburn N, Thomas P, Vernon J, Shargall Y, Schieman C, Finley C, Agzarian J, Hanna W, Spicer J, Renaud S, Seitlinger J, Al Lawati Y, Guerrera F, Falcoz P, Massard G, Ferri L, Hylton D, Huang J, Turner S, French D, Wen C, Masters J, Kidane B, Spicer J, Taylor J, Finley C, Shargall Y, Fahim C, Farrokhyar F, Yasufuku K, Agzarian J, Hanna W, Spicer J, Renaud S, Seitlinger J, St-Pierre D, Garfinkle R, Al Lawati Y, Guerrera F, Ruffini E, Falcoz P, Massard G, Ferri L, Agzarian J, Inra M, Abdelsattar Z, Allen M, Cassivi S, Nichols F 3rd, Wigle D, Blackmon S, Shen K, Gowing S, Robaidi H, Anstee C, Seely A, Beigee FS, Sheikhy K, Dezfouli AA, Shargall Y, Lopez-Hernandez Y, Schnurr T, Schneider L, Linkins L, Crowther M, Agzarian J, Hanna W, Finley C, Waddell T, de Perrot M, Uddin S, Douketis J, Taylor J, Finley C, Shargall Y, Agzarian J, Hanna W, Martel A, Angka L, Jeong A, Sadiq M, Kilgour M, de Souza CT, Baker L, Kennedy M, Auer R, Hallet J, Adam R, Karanicolas P, Memeo R, Goéré D, Piardi T, Lermite E, Turrini O, Lemke M, Li J, Dixon E, Tun-Abraham M, Hernandez-Alejandro R, Bennett S, Martel G, Navarro F, Sa Cunha A, Pessaux P, Hallet J, Isenberg-Grzeda E, Kazdan J, Beyfuss K, Myrehaug S, Singh S, Chan D, Law C, Nessim C, Paull G, Ibrahim A, Sabri E, Rodriguez-Qizilbash S, Berger-Richardson D, Younan R, Hétu J, Wright F, Johnson-Obaseki S, Angarita F, Elmi M, Zhang Y, Hong NL, Govindarajan A, Taylor E, Bayat Z, Bischof D, McCart A, Elmi M, Wakeam E, Azin A, Presutti R, Keshavjee S, McCready D, Cil T, Elmi M, Sequeira S, Azin A, Elnahas A, McCready D, Cil T, Samman S, Cornacchi S, Foster G, Thabane L, Thomson S, Lovrics O, Martin S, Lovrics P, Latchana N, Davis L, Coburn N, Mahar A, Liu Y, Hammad A, Kagedan D, Earle C, Hallet J, Zhang Y, Elmi M, Angarita F, Hong NL, Pang G, Hong NL, Paull G, Kupper S, Kagedan D, Nessim C, Quan M, Wright F, Hsiao R, Bongers P, Lustgarten M, Goldstein D, Dhar P, Rotstein L, Pasternak J, Nostedt J, Gibson-Brokop L, McCall M, Schiller D, Park J, Ratnayake I, Hebbard P, Mukhi S, Mack L, Singh N, Chanco M, Hilchie-Pye A, Kenyon C, Mathieson A, Burke J, Nason R, Kupper S, Austin J, Brar M, Wright F, Quan M, Hurton S, Quan M, Kong S, Xu Y, Thibedeau M, Cheung W, Dort J, Karim S, Crump T, Bouchard-Fortier A, Jeong Y, Mahar A, Li Q, Bubis L, Gupta V, Coburn N, Hirpara D, O'Rourke C, Azin A, Quereshy F, Chadi S, Dharampal N, Smith K, Harvey A, Pashcke R, Rudmik L, Chandarana S, Buac S, Latosinsky S, Shahvary N, Gervais M, Leblanc G, Brackstone M, Guidolin K, Yaremko B, Gaede S, Lynn K, Kornecki A, Muscedere G, Shmuilovich O, BenNachum I, Mouawad M, Gelman N, Lock M, Jayaraman S, Jayaraman S, Daza J, Solis N, Parpia S, Gallinger S, Moulton C, Levine M, Serrano P, Horkoff M, Sutherland F, Dixon E, Ball C, Bathe O, Moser M, Shaw J, Beck G, Luo Y, Ahmed S, Wall C, Domes T, Jana K, Waugh E, Tsang M, Jayaraman S, Tang E, Baird J, Newell P, Hansen P, Gough M, Garcia-Ochoa C, McArthur E, Tun-Abraham M, Hawel J, Skaro A, Leslie K, Garcia-Ochoa C, McArthur E, Tun-Abraham M, Leslie K, Skaro A, Gauvin G, Goel N, Mutabdzic D, Lambreton F, Kilcoyne M, Nadler A, Ang K, Karachristos A, Cooper H, Hoffman J, Reddy S, Park L, Gilbert R, Shorr R, Workneh A, Bertens K, Abou-Khalil J, Balaa F, Martel G, Smith H, Bertens K, Levy J, Hammad A, Davis L, Gupta V, Jeong Y, Mahar A, Coburn N, Hallet J, Mahar A, Jayaraman S, Serrano P, Martel G, Beyfuss K, Coburn N, Piardi T, Pessaux P, Hallet J, Ellis J, Bakanisi B, Sadeghi M, Beyfuss K, Michaelson S, Karanicolas P, Law C, Nathens A, Coburn N, Giles A, Daza J, Doumouras A, Serrano P, Tandan V, Ruo L, Marcaccio M, Dath D, Connell M, Selvam R, Patel S, Kleiman A, Bennett A, Wasey N, Sorial R, Macdonald S, Johnson D, Klassen D, Leung C, Vergis A, Botkin C, Azin A, Hirpara D, Jackson T, Okrainec A, Elnahas A, Chadi S, Quereshy F, Bahasadri M, Saleh F, Bahasadri M, Saleh F, Saleh F, Bahasadri M, MacLellan S, Tan J, Jun H, Cheah H, Wong K, Harvey N, Smith A, Cassie S, Sun S, Vallis J, Twells L, Lester K, Gregory D, Vallis J, Lester K, Gregory D, Twells L, Dang J, Sun W, Switzer N, Raghavji F, Birch D, Karmali S, Dang J, Switzer N, Delisle M, Laffin M, Gill R, Birch D, Karmali S, Marcil G, Bourget-Murray J, Switzer N, Shinde S, Debru E, Church N, Reso A, Mitchell P, Gill R, Sun W, Dang J, Switzer N, Tian C, de Gara C, Birch D, Karmali S, Jarrar A, Eipe N, Budiansky A, Walsh C, Mamazza J, Rashid M, and Engels P

Published
2018
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65. Ensuring adequate vascular access in patients with major trauma: a quality improvement initiative.

Author

Verhoeff K, Saybel R, Mathura P, Tsang B, Fawcett V, and Widder S

Abstract

Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital. Background data were supported with a formal root cause analysis to outline the problems and generate plan, do, study and act (PDSA) rapid change cycles. These PDSA cycles were then implemented over the course of 2 months to alter system and personnel barriers to care, thereby ensuring that patients with major trauma received adequate vascular access for fluid resuscitation. This was followed by a 6-month sustainability assessment. The percentage of patients with major trauma who received adequate fluid access went from a mean of 55.5% to >90% in 2 months and was sustained at or greater than 90% for 6 consecutive months. The formal application of quality improvement processes is uncommon in trauma care but is much needed to ensure success and sustainability of quality initiatives. Planning including engagement and prechange awareness is crucial to staff engagement, change, and sustainment. Formal quality improvement and change management techniques can elicit rapid and sustainable changes in trauma care. We provide a framework for change to increase compliance with fluid access in patients with major trauma., Competing Interests: Competing interests: None declared.

Published
2018
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66. Intentional injury and violence in Cape Town, South Africa: an epidemiological analysis of trauma admissions data.

Author

Schuurman N, Cinnamon J, Walker BB, Fawcett V, Nicol A, Hameed SM, and Matzopoulos R

Subjects
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Female, Humans, Male, Middle Aged, Prospective Studies, Public Health Surveillance, Sex Factors, Social Environment, South Africa epidemiology, Substance-Related Disorders epidemiology, Time Factors, Hospitalization statistics & numerical data, Trauma Centers statistics & numerical data, Violence statistics & numerical data, Wounds and Injuries epidemiology
Abstract

Background: Injury is a truly global health issue that has enormous societal and economic consequences in all countries. Interpersonal violence is now widely recognized as important global public health issues that can be addressed through evidence-based interventions. In South Africa, as in many low- and middle-income countries (LMIC), a lack of ongoing, systematic injury surveillance has limited the ability to characterize the burden of violence-related injury and to develop prevention programmes., Objective: To describe the profile of trauma presenting to the trauma centre of Groote Schuur Hospital in Cape Town, South Africa - relating to interpersonal violence, using data collected from a newly implemented surveillance system. Particular emphasis was placed on temporal aspects of injury epidemiology, as well as age and sex differentiation., Design: Data were collected prospectively using a standardized trauma admissions form for all patients presenting to the trauma centre. An epidemiological analysis was conducted on 16 months of data collected from June 2010 to October 2011., Results: A total of 8445 patients were included in the analysis, in which the majority were violence-related. Specifically, 35% of records included violent trauma and, of those, 75% of victims were male. There was a clear temporal pattern: a greater proportion of intentional injuries occur during the night, while unintentional injury peaks late in the afternoon. In total, two-third of all intentional trauma is inflicted on the weekends, as is 60% of unintentional trauma. Where alcohol was recorded in the record, 72% of cases involved intentional injury. Sex was again a key factor as over 80% of all records involving alcohol or substance abuse were associated with males. The findings highlighted the association between violence, young males, substance use, and weekends., Conclusions: This study provides the basis for evidence-based interventions to reduce the burden of intentional injury. Furthermore, it demonstrates the value of locally appropriate, ongoing, systematic public health surveillance in LMIC.

Published
2015
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67. Trauma Surveillance in Cape Town, South Africa: An Analysis of 9236 Consecutive Trauma Center Admissions.

Author

Nicol A, Knowlton LM, Schuurman N, Matzopoulos R, Zargaran E, Cinnamon J, Fawcett V, Taulu T, and Hameed SM

Subjects
Adolescent, Adult, Aged, Feasibility Studies, Female, Glasgow Coma Scale, Humans, Male, Middle Aged, Population Surveillance, Prospective Studies, Registries, South Africa epidemiology, Hospitalization statistics & numerical data, Trauma Centers statistics & numerical data, Wounds and Injuries epidemiology, Wounds and Injuries therapy
Abstract

Importance: Trauma is a leading cause of death and disability worldwide. In many low- and middle-income countries, formal trauma surveillance strategies have not yet been widely implemented., Objective: To formalize injury data collection at Groote Schuur Hospital, the chief academic hospital of the University of Cape Town, a level I trauma center, and one of the largest trauma referral hospitals in the world., Design, Setting, and Participants: This was a prospective study of all trauma admissions from October 1, 2010, through September 30, 2011, at Groote Schuur Hospital. A standard admission form was developed with multidisciplinary input and was used for both clinical and data abstraction purposes. Analysis of data was performed in 3 parts: demographics of injury, injury risk by location, and access to and maturity of trauma services. Geographic information science was then used to create satellite imaging of injury "hot spots" and to track referral patterns. Finally, the World Health Organization trauma system maturity index was used to evaluate the current breadth of the trauma system in place., Main Outcomes and Measures: The demographics of trauma patients, the distribution of injury in a large metropolitan catchment, and the patterns of injury referral and patient movement within the trauma system., Results: The minimum 34-point data set captured relevant demographic, geographic, incident, and clinical data for 9236 patients. Data field completion rates were highly variable. An analysis of demographics of injury (age, sex, and mechanism of injury) was performed. Most violence occurred toward males (71.3%) who were younger than 40 years of age (74.6%). We demonstrated high rates of violent interpersonal injury (71.6% of intentional injury) and motor vehicle injury (18.8% of all injuries). There was a strong association between injury and alcohol use, with alcohol implicated in at least 30.1% of trauma admissions. From a systems standpoint, the data suggest a mature pattern of referral consistent with the presence of an inclusive trauma system., Conclusions and Relevance: The implementation of injury surveillance at Groote Schuur Hospital improved insights about injury risk based on demographics and neighborhood as well as access to service based on patterns of referral. This information will guide further development of South Africa's already advanced trauma system.

Published
2014
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68. Collecting injury surveillance data in low- and middle-income countries: the Cape Town Trauma Registry pilot.

Author

Schuurman N, Cinnamon J, Matzopoulos R, Fawcett V, Nicol A, and Hameed SM

Subjects
Adult, Age Factors, Data Collection, Female, Humans, Male, Middle Aged, Pilot Projects, Sentinel Surveillance, Sex Factors, South Africa epidemiology, Trauma Severity Indices, Wounds and Injuries prevention & control, Young Adult, Poverty, Public Health, Registries statistics & numerical data, Trauma Centers statistics & numerical data, Wounds and Injuries epidemiology
Abstract

Injury is a major public health issue, responsible for 5 million deaths each year, equivalent to the total mortality caused by HIV, malaria and tuberculosis combined. The World Health Organisation estimates that of the total worldwide deaths due to injury, more than 90% occur in low- and middle-income countries (LMIC). Despite the burden of injury sustained by LMIC, there are few continuing injury surveillance systems for collection and analysis of injury data. We describe a hospital-based trauma surveillance instrument for collection of a minimum data-set for calculating common injury scoring metrics including the Abbreviated Injury Scale and the Injury Severity Score. The Cape Town Trauma Registry (CTTR) is designed for injury surveillance in low-resource settings. A pilot at Groote Schuur Hospital in Cape Town was conducted for one month to demonstrate the feasibility of systematic data collection and analysis, and to explore challenges of implementing a trauma registry in a LMIC. Key characteristics of the CTTR include: ability to calculate injury severity, key minimal data elements, expansion to include quality indicators and minimal drain on human resources based on few fields. The CTTR provides a strategy to describe the distribution and consequences of injury in a high trauma volume, low-resource environment.

Published
2011
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