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At least 433 records · Page 24Linked to original sources
PubMed2005

Tennessee trauma care system plan, Part 1.

Tennessee implemented a statewide trauma care system in 1988. This system serves the state of Tennessee and supports eight neighboring states. The demographics and geography of Tennessee have ensured that nearly all residents have rapid access to the trauma care system. However, since 1988, many changes have occurred in healthcare in general, and trauma care in particular, that point out problems and issues with the Tennessee trauma care system. Therefore, the Tennessee Trauma Care Advisory Council has developed this Trauma Care System Plan to look at needs and opportunities for the future of trauma care in Tennessee. This plan will be presented in four segments: History, Administrative Components, Operational Components, and Clinical Components.

Health Services Accessibility↗
PubMed2004

Addressing the cancer control needs of Pacific Islanders: experience of the Pacific Islander Cancer Control Network.

PURPOSE: This paper describes the accomplishments of the Pacific Islander Cancer Control Network (PICCN). PICCN's objectives fall under two broad categories: increasing cancer awareness and enhancing cancer control research among Samoans, Tongans, and Chamorros. METHODS: PICCN established an infrastructure for addressing the goals that include the University of California, Irvine; the UCI Chao Family Comprehensive Cancer Center; and community-based organizations (CBOs) in areas where large numbers of Pacific Islanders live. Activities that increase cancer awareness include assessing existing cancer education materials, developing new culturally-sensitive materials, and distributing the materials in a culturally-sensitive manner. Activities that enhance cancer control research include training Pacific Islander investigators and providing them with mentors to help with the development of research projects. RESULTS: During the four project years, PICCN has conducted more than 180 cancer awareness activities in its six study sites: Carson, CA; San Mateo, CA; San Diego, CA; Salt Lake City, UT; American Samoa; and Guam. PICCN members have also participated in conferences and lead discussions about the importance of clinical trials for Pacific Islanders. In addition, the Network has trained nine Pacific Islander investigators (three individuals from each ethnic group) in its cancer control academy. Finally, PICCN investigators are conducting pilot research projects that will answer important questions regarding the cancer control needs of these Pacific Islanders and set the stage for interventions aimed at addressing the needs. CONCLUSION: PICCN is advancing the national goal of eliminating cancer-related health disparities through its cancer awareness and research activities for Pacific Islanders.

American Samoa↗
PubMed2005

Best practices in stroke care.

In 2001, the Ontario Ministry of Health and Long-Term Care introduced the Ontario Stroke Strategy by designating regional stroke centres across the province. The primary role of these centres is to coordinate stroke care within the region and across the care continuum in keeping with best practices. Concurrently, Trillium Health Centre was identifying best practice projects to support its ongoing quest for excellence. With Trillium designated as a regional stroke centre, acute ischemic stroke care was an obvious choice for a best practice project. The aim of the project was to improve access to care and quality of care for stroke patients from emergency through acute care to in-patient rehabilitation. The team chose the rapid cycle change methodology. This approach to quality improvement advocates the testing of a series of small changes (i.e., process improvement ideas) in tandem with measurements to assess the impact of the change to drive further process improvements. The project was deemed a success, resulting in significant improvements in the timeliness and quality of care.

Benchmarking↗
PubMed1992

Ten years of maternal-fetal transport.

One maternal-fetal transport system and the public health policies that supported its development are presented. System development, the components necessary for successful two-way maternal-fetal transports, and growth between 1981 and 1991 are summarized.

Equipment and Supplies↗
PubMed1994

[Effectiveness of a programme to improve housing conditions for elderly requiring supportive care in Edogawa-ku, Tokyo].

The programme in Edogawa-ku, Tokyo, for improvement of housing conditions for the elderly requiring supportive care, is unique in Japan in that it offers unlimited amount of benefits regardless of income status of beneficiaries. Between October, 1990, when the programme started, to March, 1992, total of 447 people utilized the programme. These 18 months were divided into three periods for comparative analysis of characteristics of users, details of improvement in housing conditions and cost (amount of benefits). The proportion of bed-ridden cases decreased during the later periods, with a corresponding increase in those who had improvements made to entrances and approaches to their residence. However, average cost of changes in housing features decreased in the later periods because there was less demand for expensive changes such as bathtub remodeling or installation of lifts on stairs. A survey by mail was conducted to find out the effect from the users' viewpoint. Valid responses were collected from 290 cases. Three aspects of improvement in housing conditions were assessed: improvement in daily activities, reduction in the care taker's burden, and reduction in the need for long-term institutional care. More than one-third of the users reported improvement in each of three aspects, and two-thirds had improvements in at least one out of the three items. There were intercorrelation among the three items, especially between improvement in daily activities and reduction of the care taker's burden. Analysis showed that improvements were reported in a greater proportion of those living alone or in a two-person household, those who utilized the programme following discharge from inpatient care, those who had their bathroom or bathtub remodeled, and those who had the more expensive changes made. Changes in entrances and approaches to the residence was correlated to an improvement in daily activities. Reduction in care-taker's burden was seen where stroke was the cause of being dependent and where a specially equipped bed was provided. Reduction in the need for long-term institutional care is related to family structure and number of rooms in the home, which are barriers to continuing home care.

Aged↗
PubMed1996

SEOPF high-grade match algorithm: the effect of HLA matching with ROP trays in transplanting highly sensitized patients. Southern Organ Procurement Foundation.

The SEOPF high-grade match (HGM) algorithm for sharing kidneys was designed to increase utilization of kidneys for excellent HLA matches, decrease sharing for poor HLA matches, and improve the chances for highly sensitized patients to receive a kidney transplant through the use of ROP crossmatch trays. All retrieved kidneys from participating centers were offered to the system to be shared for high-grade HLA matches after six-antigen match obligations were satisfied with UNOS. Kidneys were shared according to HLA matches in the following priority: 1) 0-ABDR mismatch six - Antigen Matches. 2) 0-AB mismatch PRA > 40%, ROP tray negative crossmatch. 3) 0-BDR mismatch PRA > 40%, ROP tray negative crossmatch. 4) 0-BDR mismatch PRA < 40%. All patients with PRA's > 40% must be represented on the ROP tray to be considered for a shared kidney. Preliminary ROP tray crossmatch results must have been known for these patients in order to access the system. Here we report results of 126 shared kidneys using the HGM algorithm from January 1994 to September 1995. HLA typing concordance between the initial typing of cadaver donors by the donor center and repeat typing by recipient center was 94.7%. There were six (5.3%) typing discrepancies: HLA-A, no typing discrepancies; HLA-B, 2 (1.8%) typing discrepancies; and HLA-DR, 4 (3.5%) discrepancies. A total of 34 of 126 (27%) kidneys were shared for patients with high grade HLA matches, PRA's > 40% and a negative ROP tray. Twenty-eight of 34 (82.4%) shared kidneys were final crossmatch negative and transplanted into the intended recipient. Six of 34 (17.6%) shared kidneys were transplanted into backup recipients. All six of the intended recipients had positive final crossmatches using enhanced crossmatch procedures, such as antiglobulin and flow cytometry. In conclusion, the HLA concordance rate for shared kidneys within SEOPF was 94.7%. Kidney sharing using the HGM algorithm was very effective in transplanting highly sensitized patients when good HLA matching was combined with a negative ROP tray result.

Algorithms↗