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4. Supporting home care for the dying: an evaluation of healthcare professionals' perspectives of an individually tailored hospice at home service

Author

Jack, Barbara A, Baldry, C R, Groves, K E, Whelan, Alison, Sephton, J, Gaunt, K, Jack, Barbara A, Baldry, C R, Groves, K E, Whelan, Alison, Sephton, J, and Gaunt, K

Abstract

Aims and objectives To explore health care professionals' perspective of hospice at home service that has different components, individually tailored to meet the needs of patients. Background Over 50% of adults diagnosed with a terminal illness and the majority of people who have cancer, prefer to be cared for and to die in their own home. Despite this, most deaths occur in hospital. Increasing the options available for patients, including their place of care and death is central to current UK policy initiatives. Hospice at home services aim to support patients to remain at home, yet there are wide variations in the design of services and delivery. A hospice at home service was developed to provide various components (accompanied transfer home, crisis intervention and hospice aides) that could be tailored to meet the individual needs of patients. Design An evaluation study. Methods Data were collected from 75 health care professionals. District nurses participated in one focus group (13) and 31 completed an electronic survey. Palliative care specialist nurses participated in a focus group (9). One hospital discharge co-ordinator and two general practitioners participated in semi-structured interviews and a further 19 general practitioners completed the electronic survey. Results Health care professionals reported the impact and value of each of the components of the service, as helping to support patients to remain at home, by individually tailoring care. They also positively reported that support for family carers appeared to enable them to continue coping, rapid access to the service was suggested to contribute to faster hospital discharges and the crisis intervention service was identified as helping patients remain in their own home, where they wanted to be. Conclusions Health care professionals perceived that the additional individualised support provided by this service contributed to enabling patients to continue be cared for and to die at home in their place

Published
2013

5. Supporting home care for the dying: an evaluation of healthcare professionals' perspectives of an individually tailored hospice at home service.

Author

Jack, BA, Baldry, CR, Groves, KE, Whelan, A, Sephton, J, Gaunt, K, Jack, BA, Baldry, CR, Groves, KE, Whelan, A, Sephton, J, and Gaunt, K

Abstract

AIMS AND OBJECTIVES: To explore health care professionals' perspective of hospice at home service that has different components, individually tailored to meet the needs of patients. BACKGROUND: Over 50% of adults diagnosed with a terminal illness and the majority of people who have cancer, prefer to be cared for and to die in their own home. Despite this, most deaths occur in hospital. Increasing the options available for patients, including their place of care and death is central to current UK policy initiatives. Hospice at home services aim to support patients to remain at home, yet there are wide variations in the design of services and delivery. A hospice at home service was developed to provide various components (accompanied transfer home, crisis intervention and hospice aides) that could be tailored to meet the individual needs of patients. DESIGN: An evaluation study. METHODS: Data were collected from 75 health care professionals. District nurses participated in one focus group (13) and 31 completed an electronic survey. Palliative care specialist nurses participated in a focus group (9). One hospital discharge co-ordinator and two general practitioners participated in semi-structured interviews and a further 19 general practitioners completed the electronic survey. RESULTS: Health care professionals reported the impact and value of each of the components of the service, as helping to support patients to remain at home, by individually tailoring care. They also positively reported that support for family carers appeared to enable them to continue coping, rapid access to the service was suggested to contribute to faster hospital discharges and the crisis intervention service was identified as helping patients remain in their own home, where they wanted to be. CONCLUSIONS: Health care professionals perceived that the additional individualised support provided by this service contributed to enabling patients to continue be cared for and to die at home in their

Published
2013

6. Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review

Author

Hoit, G., primary, Hinkewich, C., primary, Tiao, J., primary, Porgo, V., primary, Moore, L., primary, Wang, C., primary, Moffatt, B., primary, Wheeler, S., primary, Gillman, L., primary, Bartens, K., primary, Lysecki, P., primary, Pallister, I., primary, Patel, S., primary, Bradford, P., primary, Kidane, B., primary, Holmes, A., primary, Trajano, A., primary, March, J., primary, Lyons, R., primary, Kao, R., primary, Rezende-Neto, J., primary, Leblanc, Y., primary, Vogt, K., primary, Alzaid, S., primary, Jansz, G., primary, Andrusiek, D., primary, Bailey, K., primary, Livingston, M., primary, Calthorpe, S., primary, Hsu, J., primary, Lubbert, P., primary, Boitano, M., primary, Leeper, W., primary, Williamson, O., primary, Reid, S., primary, Alonazi, N., primary, Lee, C.M., primary, Aleassa, E., primary, Jennings, P., primary, Mador, B., primary, Hoffman, K., primary, Riley, J., primary, Vu, E., primary, Alburakan, A., primary, Mckee, J., primary, Bobrovitz, N., primary, Gabbe, B.J., primary, Hodgkinson, J., primary, Ali, J., primary, Grant, M., primary, Roberts, D., primary, Holodinsky, J., primary, Cooper, C., primary, Santana, M.J., primary, Kruger, K., primary, Waggott, M., primary, Da Luz, L.T., primary, Banfield, J., primary, Dorigatti, A., primary, Birn, K., primary, Zakirova, R., primary, Davies, D., primary, Das, D., primary, Gamme, G., primary, Pervaiz, F., primary, Almarhabi, Y., primary, Brainard, A., primary, Brown, R., primary, Bell, N., primary, Jowett, H., primary, Bressan, S., primary, Hogan, A., primary, Watson, I., primary, Woodford, S., primary, Boulay, R., primary, Howlett, M., primary, Atkinson, P., primary, Chesters, A., primary, Hamadani, F., primary, Azzam, M., primary, Fraser, J., primary, Doucet, J., primary, Muakkassa, F., primary, Sathivel, N., primary, Chadi, S., primary, Joseph, B., primary, Takeuchi, L., primary, Bradley, N., primary, Al Bader, B., primary, Harrington, A., primary, Nixon, K., primary, Veigas, P., primary, O’Keeffe, T., primary, Bracco, D., primary, Lin, Y., primary, Nash, N., primary, Alhabboubi, M., primary, Slobogean, G., primary, Spicer, J., primary, Heidary, B., primary, Joos, E., primary, Berg, R., primary, Sankarankutty, A., primary, Zakrison, T., primary, Babul, S., primary, Lockhart, S., primary, Faux, S., primary, Jackson, A., primary, Lee, T., primary, Bailey, K., additional, Pemberton, J., additional, Green, R., additional, Tallon, J., additional, Moore, L., additional, Turgeon, A., additional, Boutin, A., additional, Reinartz, D., additional, Lapointe, G., additional, Stelfox, H.T., additional, Nathens, A., additional, Neveu, X., additional, Bratu, I., additional, Gladwin, C., additional, Voaklander, D., additional, Lewis, M., additional, Vogt, K., additional, Eckert, K., additional, Williamson, J., additional, Stewart, T. Charyk, additional, Parry, N., additional, Gray, D., additional, L’Heureux, R., additional, Ziesmann, M., additional, Kortbeek, J., additional, Brindley, P., additional, Hicks, C., additional, Fata, P., additional, Engels, P., additional, Ball, C., additional, Paton-Gay, D., additional, Widder, S., additional, Hernandez-Alejandro, R., additional, Vanderbeek, L., additional, Forrokhyar, F., additional, Anatharajah, R., additional, Howatt, N., additional, Lamb, S., additional, Sne, N., additional, Kahnamoui, K., additional, Lyons, R., additional, Walters, A., additional, Brooks, C., additional, Pinder, L., additional, Rahman, S., additional, Kidane, B., additional, Donnelly, E., additional, Lewell, M., additional, Mellow, R., additional, Hedges, C., additional, Morassutti, P., additional, Bulatovic, R., additional, Galbraith, E., additional, McKenzie, S., additional, Bradford, D., additional, Peddle, M., additional, Dukelow, A., additional, Eby, D., additional, McLeod, S., additional, Bradford, P., additional, Williamson, O., additional, Fraga, G., additional, Pereira, B., additional, Sareen, J., additional, Doupe, M., additional, Gawaziuk, J., additional, Chateau, D., additional, Logsetty, S., additional, Pallister, I., additional, Lewis, J., additional, O’Doherty, D., additional, Hopkins, S., additional, Griffiths, S., additional, Palmer, S., additional, Gabbe, B.J., additional, Xu, X., additional, Martin, C., additional, Xenocostas, A., additional, Mele, T., additional, Rui, T., additional, Abreu, E., additional, Andrade, M., additional, Cruz, F., additional, Pires, R., additional, Carreiro, P., additional, Andrade, T., additional, Lampron, J., additional, Balaa, F., additional, Fortuna, R., additional, Issa, H., additional, Dias, P., additional, Marques, M., additional, Fernandes, T., additional, Sousa, T., additional, Inaba, K., additional, Smith, J., additional, Okoye, O., additional, Joos, E., additional, Shulman, I., additional, Nelson, J., additional, Rhee, P., additional, Demetriades, D., additional, Ostrofsky, R., additional, Butler-Laporte, G., additional, Chughtai, T., additional, Khwaja, K., additional, Mulder, D., additional, Razek, T., additional, Deckelbaum, D., additional, Evans, D., additional, Anton, H., additional, Wei, J., additional, Randall, E., additional, Sobolev, B., additional, Scott, B. Ballantyne, additional, van Heest, R., additional, Frankfurter, C., additional, McKerracher, S., additional, Merritt, N., additional, Barber, L., additional, Kimmel, L., additional, Hodgson, C., additional, Webb, M., additional, Holland, A., additional, Gruen, R., additional, Harrison, K., additional, Hwang, M., additional, Hsee, L., additional, Civil, I., additional, Muizelaar, A., additional, Baillie, F., additional, Leeper, T., additional, Sutherland, A., additional, Hart, M., additional, Tuma, F., additional, Coates, A., additional, Farrokhyar, F., additional, Faidi, S., additional, Gastaldo, F., additional, Paskar, D., additional, Reid, S., additional, Petrisor, B., additional, Bhandari, M., additional, Loh, W-L, additional, Ho, C.D., additional, Chong, C.K., additional, Rodrigues, G., additional, Gissoni, M., additional, Martins, M., additional, Cunha-Melo, J., additional, Rizoli, S., additional, Abu-Zidan, F., additional, Cameron, P., additional, Bernard, S., additional, Walker, T., additional, Jolley, D., additional, Fitzgerald, M., additional, Masci, K., additional, Simpson, P., additional, Smith, K., additional, Cox, S., additional, West, A., additional, Barratt, L., additional, Rozmovits, L., additional, Livingstone, B., additional, Vu, M., additional, Griesdale, D., additional, Schlamp, R., additional, Wand, R., additional, Alhabboubi, M., additional, Alrowaili, A., additional, Alghamdi, H., additional, Essbaiheen, F., additional, Chankowsky, J., additional, Stephens, M., additional, Vis, C., additional, Belton, K., additional, Dufresne, B., additional, Guilfoyle, J., additional, Ibbotson, G., additional, Martin, K., additional, Matheson, D., additional, Parks, P., additional, Thomas, L., additional, Kirkpatrick, A., additional, Santana, M.J., additional, Kline, T., additional, Macey, S., additional, Judson, R., additional, Morgan, M., additional, McLellan, S., additional, Wilson, K., additional, Sorvari, A., additional, Chaudhry, Z., additional, Khawaja, K., additional, Ali, A., additional, Akhtar, J., additional, Zubair, M., additional, Nickow, J., additional, Holodinsky, J., additional, Jaeschke, R., additional, Blaser, A. Reintam, additional, Starkopf, J., additional, Zygun, D., additional, Roberts, D., additional, Tanenbaum, B., additional, Redondano, B. Ribeiro, additional, Jimenez, L. Simakawa, additional, Zago, T., additional, de Carvalho, R. Barros, additional, Calderan, T. Araujo, additional, Campbell, S., additional, Ferri, M., additional, Lashoher, A., additional, McFarlan, A., additional, Ahmed, N., additional, Booy, J., additional, McDowell, D., additional, Nasr, A., additional, Wales, P., additional, Mercado, M., additional, Lall, R., additional, Niven, D., additional, Dixon, E., additional, Kaplan, G., additional, Hameed, M., additional, Qadura, M., additional, Veenstra, J., additional, Hennecke, P., additional, Gardner, R., additional, Appleton, L., additional, Simons, R., additional, Palmer, C., additional, Bevan, C., additional, Crameri, J., additional, Hogan, D., additional, Grealy, L., additional, Jowett, H., additional, Boulay, R., additional, Chisholm, A., additional, Beairsto, E., additional, Goulette, E., additional, Martin, M., additional, Benjamin, S., additional, Watson, I., additional, Savoie, J., additional, Hogan, A., additional, Woodford, S., additional, Ondiveeran, H., additional, Atkinson, P., additional, Doody, K., additional, Fraser, J., additional, Leblanc-Duchin, D., additional, Strack, B., additional, Naveed, A., additional, vanRensburg, L., additional, Madan, R., additional, Boulva, K., additional, Verheul, G., additional, Parks, A., additional, Milne, J., additional, Nemeth, J., additional, Correa, J., additional, Bernardin, B., additional, Al Bader, B., additional, Sproul, E., additional, Mehta, A., additional, Galarneau, M., additional, Mahadevan, P., additional, Bansal, V., additional, Dye, J., additional, Hollingsworth-Fridlund, P., additional, Stout, P., additional, Potenza, B., additional, Coimbra, R., additional, Marley, R., additional, Salvator, A., additional, Pisciotta, D., additional, Bridge, J., additional, Lin, S., additional, Ovens, H., additional, Abdo, H., additional, Dencev-Bihari, R., additional, Lawendy, A., additional, Ibrahim-Zada, I., additional, Pandit, V., additional, Tang, A., additional, O’Keeffe, T., additional, Wynne, J., additional, Gries, L., additional, Friese, R., additional, Taulu, T., additional, Wong, H., additional, Saleem, A., additional, Azzam, M., additional, Plourde, M., additional, Chadi, S., additional, Forbes, T., additional, Martin, G., additional, Gaunt, K., additional, Bandiera, G., additional, Bawazeer, M., additional, MacKinnon, D., additional, Spence, J., additional, Sankarankutty, A., additional, Nascimento, B., additional, Aziz, H., additional, O’keeffe, T., additional, Vercruysse, G., additional, Kulvatunyou, N., additional, Sakles, J., additional, Mosier, J., additional, Joseph, B., additional, Bracco, D., additional, Norman, D., additional, Li, J., additional, Al-Oweis, J., additional, Albuz, O., additional, Karamanos, E., additional, Talving, P., additional, Elhusseini, M., additional, Sudarshan, M., additional, MacPherson, C., additional, Sun, T., additional, Pelletier, M., additional, Khalil, M. Abou, additional, Valenti, D., additional, Brown, R., additional, Gelbard, R., additional, Moe, D., additional, Grabo, D., additional, Pasley, J., additional, Teixeira, P., additional, Fung, S.Y., additional, Alababtain, I., additional, Brnjac, E., additional, Luz, L., additional, Parikh, P., additional, Proctor, K., additional, Murtha, M., additional, Schulman, C., additional, Namias, N., additional, Goldman, R., additional, Pike, I., additional, Korn, P., additional, Flett, C., additional, Jackson, T., additional, Keith, J., additional, Joseph, T., additional, Giddins, E., additional, Ouellet, J.F., additional, Cook, M., additional, and Schreiber, M., additional

Published
2013
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8. A terminal deletion of the long arm of chromosome 4 [46,XX,del(4)(q33)] in an infant with phenotypic features of Williams syndrome.

Author

Jefferson, R D, Burn, J, Gaunt, K L, Hunter, S, and Davison, E V

Abstract

A female infant with peripheral pulmonary artery stenosis, growth retardation, and developmental delay was noticed to have facial features consistent with a diagnosis of Williams syndrome. Chromosome analysis revealed a deletion of the terminal portion of the long arm of chromosome 4 (4q33----qter). This is the seventh reported case of this chromosome disorder. It is possible that this chromosome region is specific for the Williams syndrome phenotype but it is more likely that the syndrome is heterogeneous. Chromosome analysis should be performed in all suspected cases with particular attention to the long arm of chromosome 4. [ABSTRACT FROM PUBLISHER]

Published
1986

9. High-flow nasal cannula therapy for patients with blunt thoracic injury: A retrospective study

Author

Halub Meghan E, Spilman Sarah K, Gaunt Kristina A, Lamb Keith D, Jackson Julie A, Oetting Trevor W, and Sahr Sheryl M

Subjects
Diseases of the respiratory system, RC705-779
Abstract

OBJECTIVE High-flow nasal cannula (HFNC) has been shown to reduce the need for mechanical ventilation (MV) and to decrease hospital and ICU days for patients with severe respiratory compromise. HFNC has not been evaluated in trauma patients, thus the goal of this study is to describe the use of HFNC in a chest-injured population. METHODS A retrospective study examined trauma patients with moderate to severe thoracic injury admitted to the ICU at a tertiary hospital between March 2012 and August 2015. HFNC was delivered by the Fisher & Paykel Optiflow system. Primary outcomes were the need for intubation after HFNC for respiratory failure, length of hospitalization, and mortality. RESULTS During the study period, 105 patients with blunt chest trauma were admitted to the ICU and received HFNC therapy. Eighteen percent received MV prior to HFNC. Overall, 69% of patients who received HFNC never received MV, and 92% of patients were discharged alive. The intubation rate for respiratory failure after HFNC was 18%. For patients who did not receive MV prior to HFNC, delay to first HFNC was correlated with increased hospital days (r ~s~ = 0.41, p = 0.001) and ICU days (r ~s~ = 0.41, p \< 0.001). CONCLUSIONS Study results suggest that HFNC is comparable with other methods of noninvasive ventilation and may be beneficial for patients with thoracic injury. Additional investigation is warranted to determine if early use of HFNC can deliver effective respiratory support and prevent intubation in this population.

Published
2016

11. Emergency department overcrowding and long wait times: taking a corporate approach to improving patient flow.

Author

Bandiera G, Gaunt K, Sinclair D, and Trafford A

Subjects
Emergency Service, Hospital standards, Emergency Service, Hospital statistics & numerical data, Humans, Ontario, Patient Admission standards, Patient Admission statistics & numerical data, Waiting Lists, Crowding, Emergency Service, Hospital organization & administration, Quality Improvement organization & administration
Abstract

Emergency department (ED) overcrowding and long wait times are major concerns in health systems the world over. Many ED-focused innovations--such as revising staff mix, improving internal processes and exploiting decision-support software--have been implemented to address these complex problems, often with limited success. Beginning in 2008, St. Michael's Hospital in Toronto, which had some of the most challenging ED overcrowding and longest wait times in Ontario, has charted a different course. By taking an organization-wide corporate approach to the challenge of patient flow throughout the hospital, St. Michael's has significantly improved key ED flow metrics for both its admitted and non-admitted patients.

Published
2014
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12. Supporting home care for the dying: an evaluation of healthcare professionals' perspectives of an individually tailored hospice at home service.

Author

Jack BA, Baldry CR, Groves KE, Whelan A, Sephton J, and Gaunt K

Subjects
Humans, Attitude of Health Personnel, Health Personnel psychology, Home Care Services organization & administration, Hospices, Terminal Care
Abstract

Aims and Objectives: To explore health care professionals' perspective of hospice at home service that has different components, individually tailored to meet the needs of patients., Background: Over 50% of adults diagnosed with a terminal illness and the majority of people who have cancer, prefer to be cared for and to die in their own home. Despite this, most deaths occur in hospital. Increasing the options available for patients, including their place of care and death is central to current UK policy initiatives. Hospice at home services aim to support patients to remain at home, yet there are wide variations in the design of services and delivery. A hospice at home service was developed to provide various components (accompanied transfer home, crisis intervention and hospice aides) that could be tailored to meet the individual needs of patients., Design: An evaluation study., Methods: Data were collected from 75 health care professionals. District nurses participated in one focus group (13) and 31 completed an electronic survey. Palliative care specialist nurses participated in a focus group (9). One hospital discharge co-ordinator and two general practitioners participated in semi-structured interviews and a further 19 general practitioners completed the electronic survey., Results: Health care professionals reported the impact and value of each of the components of the service, as helping to support patients to remain at home, by individually tailoring care. They also positively reported that support for family carers appeared to enable them to continue coping, rapid access to the service was suggested to contribute to faster hospital discharges and the crisis intervention service was identified as helping patients remain in their own home, where they wanted to be., Conclusions: Health care professionals perceived that the additional individualised support provided by this service contributed to enabling patients to continue be cared for and to die at home in their place of choice., Relevance to Clinical Practice: This service offers various components of a hospice at home service, enabling a tailor made package to meet individual and local area needs. Developing an individually tailored package of care appears to be able to meet specific needs., (© 2013 Blackwell Publishing Ltd.)

Published
2013
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13. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part I: an historical and theoretical perspective.

Author

Khan KZ, Ramachandran S, Gaunt K, and Pushkar P

Subjects
Humans, Models, Educational, Clinical Competence, Education, Medical methods, Educational Measurement methods, Models, Theoretical
Abstract

The Objective Structured Clinical Examination (OSCE) was first described by Harden in 1975 as an alternative to the existing methods of assessing clinical performance (Harden et al. 1975). The OSCE was designed to improve the validity and reliability of assessment of performance, which was previously assessed using the long case and short case examinations. Since then the use of the OSCE has become widespread within both undergraduate and postgraduate clinical education. We recognise that the introduction of the OSCE into an existing assessment programme is a challenging process requiring a considerable amount of theoretical and practical knowledge. The two parts of this Guide are designed to assist all those who intend implementing the OSCE into their assessment systems. Part I addresses the theoretical aspects of the OSCE, exploring its historical development, its place within the range of assessment tools and its core applications. Part II offers more practical information on the process of implementing an OSCE, including guidance on developing OSCE stations, choosing scoring rubrics, training examiners and standardised patients and managing quality assurance processes. Together we hope these two parts will act as a useful resource both for those choosing to implement the OSCE for the first time and also those wishing to quality assure their existing OSCE programme.

Published
2013
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14. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part II: organisation & administration.

Author

Khan KZ, Gaunt K, Ramachandran S, and Pushkar P

Subjects
Humans, Clinical Competence, Education, Medical organization & administration, Educational Measurement methods
Abstract

The organisation, administration and running of a successful OSCE programme need considerable knowledge, experience and planning. Different teams looking after various aspects of OSCE need to work collaboratively for an effective question bank development, examiner training and standardised patients' training. Quality assurance is an ongoing process taking place throughout the OSCE cycle. In order for the OSCE to generate reliable results it is essential to pay attention to each and every element of quality assurance, as poorly standardised patients, untrained examiners, poor quality questions and inappropriate scoring rubrics each will affect the reliability of the OSCE. The validity will also be influenced if the questions are not realistic and mapped against the learning outcomes of the teaching programme. This part of the Guide addresses all these important issues in order to help the reader setup and quality assure their new or existing OSCE programmes.

Published
2013
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15. The effects of ageing and of DSP-4 administration on the micturition characteristics of male Wistar rats.

Author

Ranson RN, Gaunt K, Santer RM, and Watson AH

Subjects
Animals, Autonomic Fibers, Preganglionic drug effects, Central Nervous System drug effects, Circadian Rhythm, Drinking drug effects, Immunohistochemistry, Locus Coeruleus pathology, Male, Rats, Rats, Wistar, Tyrosine 3-Monooxygenase metabolism, Aging, Benzylamines pharmacology, Locus Coeruleus drug effects, Neurotoxins pharmacology, Tyrosine 3-Monooxygenase drug effects, Urination
Abstract

This study sought to determine the effects of ageing on the in vivo micturition characteristics of male Wistar rats and to assess whether they might be replicated in young rats by using the neurotoxin DSP-4 to lesion locus coeruleus-derived noradrenergic pathways projecting to spinal cord nuclei controlling micturition. Significant age-related changes in micturition patterns were observed. There was a loss of a diurnal rhythm in micturition patterns and a large increase in voided volume, maximal between 21 and 24 months, which was paralleled by an increased water intake. DSP-4 lesions neither altered micturition patterns nor water intake in the young adult rat. DSP-4 induced changes in the pattern of tyrosine hydroxylase-like immunoreactivity (TH-LI), most notably almost complete depletion of TH-LI in the dorsolateral nucleus and retention of TH-LI in lumbosacral autonomic preganglionic nuclei, did not mimic the changes in the pattern of TH-LI seen in aged rats.

Published
2003
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17. Karyotype abnormalities in non-Hodgkin lymphomas.

Author

Gaunt KL, Callaghan J, and Roberts DF

Subjects
Female, Humans, Karyotyping, Lymph Nodes pathology, Lymphocytes cytology, Lymphoma, Non-Hodgkin pathology, Male, Spleen pathology, Chromosome Aberrations, Chromosome Disorders, Lymphoma, Non-Hodgkin genetics
Abstract

Karyotype anomalies were found in 9 of 13 non-Hodgkin lymphomas. The observed non-random involvement of chromosomes was non-specific and was associated with chromosome breakpoints rather than recurrent markers. The recurrent markers which were found were similar to those of previously published studies. An attempt to correlate histological classification and chromosome anomalies in published series indicated that there were limited histological associations, the frequency of abnormalities of chromosomes 14 and 18 showing the largest disparity between disease types. Among the breakpoints and translocations found are those known to be associated with oncogene location, and the possibility is raised of an oncogene on 18.

Published
1986

18. Effect of ethyl alcohol on lonic calcium and prolactin in man.

Author

Earll JM, Gaunt K, Earll LA, and Djuh YY

Subjects
Adult, Humans, Male, Middle Aged, Osmolar Concentration, Calcium blood, Ethanol pharmacology, Prolactin blood
Abstract

Earlier animal studies suggested that there might be physiologically significant changes in serum calcium following administration of ethyl alcohol. Ionized and total calcium were measured in five normal male subjects following the oral ingestion of 200cm3 of 50% ethyl alcohol. Although blood alcohols reached intoxication levels in all subjects, no significant change in ionized calcium or total calcium occurred. It is unlikely that alcohol contributes to the risks of hypocalcemia or hyperventilation and anxiety in individuals performing in adverse environments, although there is little question it contributes to other risks. Even though two-fold elevations in plasma prolactin have been described in men with chronic alcoholism, no significant changes in plasma prolactin occurred during acute alcohol ingestion. Awareness of the significant increase in plasma osmolality, which has been demonstrated with alcohol, is important to avoid inappropriate therapy, since individuals performing in adverse environments are at risk of becoming dehydrated.

Published
1976

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