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At least 19 recordsLinked to original sources
PubMed2003

Executive insights. John J. Gantner, treasurer, Robert Wood Johnson University Hospital, New Brunswick, New Jersey.

Sometimes a CFO has to make a leap of faith that he or she is making the right decisions, because those decisions can involve intangibles that reach far beyond financial data. According to John J. Gantner, treasurer of Robert Wood Johnson University Hospital in New Brunswick, N.J., if your decisions are guided by what is best for patient care, they will likely benefit the hospital over the long term. Gantner's hospital has taken a leadership role in adopting standards relating to patient safety, fiscal accountability, and ethics. Gantner spoke with HFM about what has guided some of the recent major initiatives undertaken at his hospital.

Decision Making, Organizational↗
PubMed2005

[Integration of research into the dietetic practice of New Brunswick].

In New Brunswick, we have very little information that describes practice-based research in dietetics. To encourage and promote research in this province, it is crucial to describe the place that research has in dietetic practice and determine the number of dietician in New Brunswick that received an education in research methodology. A validated questionnaire was distributed to all the members of the New Brunswick Association of Dietitians; 76% of the members filled out the questionnaire. For 85% of them, their highest level of education is the internship; 15% have a postgraduate degree, and 55% have completed a research methodology course. The dietitians having completed graduate studies perceived fewer barriers to the integration of practice-based research. The Barrier that 81% of the dietitians in the province agreed was most influential in discouraging the implementation of research to daily practice was the time allowed for research at work. Nearly two-thirds (63%) agreed that it is very improbable that they will pursue graduate studies. The probability of pursuing graduate studies decreased with the age of the dietitians: 85% agreed that "family and personal obligations" and "lack of time" were the most important barriers in pursuing graduate studies. The attitude of New Brunswick dietitians towards research was nonetheless positive.

Adult↗
PubMed1995

Health service regionalization in New Brunswick, Canada: a bold move.

New Brunswick moved swiftly in 1992 to regionalize hospital and physician services along with the reform and expansion of other health care services. The dissolution of 51 hospital and community health services center boards and the establishment of eight region hospital corporations to oversee services in the seven health regions set the tone for regionalization in the province. The plan provides the flexibility to meet specific regional needs. The initial regionalization of hospital services was followed by the determination of the appropriate number, mix, and distribution of physician resources for each region, also to be managed by the region hospital corporation. The provincial government's central role not only guides the regions, but also uses incentives and disincentives to ensure that regional goals are.met. While regionalization is not new and some components of the New Brunswick plan have been used elsewhere, the effort offers an integrated model for the regionalization of hospital and physician services, with the expansion of complementary services.

Community Health Centers↗
PubMed1982

Antibodies to the California group of arboviruses in animal populations of New Brunswick.

Wild and domestic animals of New Brunswick were tested serologically for antibodies to the California group (CAL) of arboviruses. Deer (Odocoileus virginianus) blood collected during 1976 showed 6 of 129 (4.7%) sera with neutralizing antibodies to the snowshoe hare strain (SSH) of CAL. Neutralization tests on moose (Alces alces americana Clinton) sera collected during 1979 indicated 94 of 127 (74%) with antibodies to SSH, 4 of 127 (3.2%) with antibodies to the Jamestown Canyon Strain (JC) of CAL, and 17 of 127 (13.4%) with equal antibody titers to SSH and JC. Hemagglutination inhibition tests on house blood collected during 1977 showed 54 of 204 (26.5%) with antibodies to SSH; of these, 36 also had neutralizing antibodies to SSH. This study is the first indication of CAL activity in New Brunswick and supports evidence of JC activity in northeastern North America.

Animals↗
PubMed1994

Relation between physician characteristics and prescribing for elderly people in New Brunswick.

OBJECTIVE: To determine whether there is a relation between physician characteristics and prescribing for elderly patients. DESIGN: Descriptive study linking two provincial databases. SETTING: New Brunswick. PARTICIPANTS: All general practitioners (GPs) in New Brunswick who ordered at least 200 prescriptions for elderly beneficiaries of the New Brunswick Prescription Drug Program between Apr. 1, 1990, and Mar. 31, 1991; eligible GPs accounted for 376 (40%) of all physicians with a general licence in New Brunswick. MAIN OUTCOME MEASURES: GPs' personal and professional characteristics (age, sex, family practice accreditation, country of training and number of years in practice), practice characteristics (number of practice days, number of patients seen and medical services provided per day, average amount of billing per patient, total number of patients seen and their average age, and total amount of billings) and number of prescriptions by category of drug. RESULTS: High prescribers and low prescribers did not differ significantly in age, number of years in practice, mean practice size or patient age. Compared with the low prescribers the high prescribers were more likely to be male, have been trained in Canada and be qualified by the Canadian College of Family Physicians. Also, they had more practice days, saw more patients per day, performed more services per day, billed more per patient and billed on average 30% more during the study period. Overall, the high prescribers ordered on average 45% more prescriptions than the low prescribers. CONCLUSION: There is a significant relation between certain physician characteristics and prescribing behaviour. Further study is required to examine the relation between these variables and patient outcomes.

Accounting↗
PubMed1988

Seroepidemiology of Q fever in New Brunswick and Manitoba.

A seroepidemiological survey, using an indirect immunofluorescence test, was carried out on serum samples obtained from New Brunswick and Manitoba blood donors during 1986. The antigens were Coxiella burnetii phase I and phase II from strain Nine Mile. Eighty of the 503 (15.9%) Manitoba blood donors had a phase II antibody titer of greater than or equal to 1:8, while 41 (4.2%) of the 966 New Brunswick blood donors had such antibodies. We have recently diagnosed three cases of Q fever in New Brunswick but none have been diagnosed in Manitoba. Our data suggest that Q fever may be increasing in New Brunswick and repeated seroepidemiological studies are indicated. It is likely that undetected cases of Q fever are occurring in Manitoba.

Antibodies, Bacterial↗
PubMed2003

The changing division of labour between nurses and nursing assistants in New Brunswick.

BACKGROUND: In 1989, the professional nursing organization that represents nurses in New Brunswick adopted baccalaureate entry to practice in nursing. This decision coincided with a major restructuring of provincial health care. Consequently, there has been a reorganization of health care worker roles which affects nurses and nursing assistants. AIM: This paper explores the changing division of labour between nurses and nursing assistants in the province of New Brunswick, Canada. METHODS: The study used archival material, from the period 1978-1990, of three nursing organizations that played a significant role in initiating baccalaureate entry to practice. Interviews with 19 key people involved in the decision to upgrade nurse education were conducted. Data from the archival material and interviews were analysed jointly. FINDINGS: There are ongoing tensions between nurses and nursing assistants. Although nurses would like a support worker, they remain ambiguous about the role of nursing assistants in health care and which tasks should be delegated to this group. Nursing leaders are concerned about the ease with which some patient-related tasks are moved to nursing assistants. In the past, these concerns have led nursing leaders to attempt to limit nursing assistant responsibilities through both legislative means and ways of organizing nursing labour (primary nursing). As a result of health care reforms and baccalaureate entry to practice for nurses, nursing assistant responsibilities are currently expanding. CONCLUSION: Upgrading nurse education, which came into effect in 1996 with the closure of diploma schools in New Brunswick, is likely to entrench the role of nursing assistants in health care because of the economic value of their work during a period of restructuring and rationalization of health care.

Education, Nursing, Baccalaureate↗
PubMed1996

For "the honor and dignity of the profession": organized medicine in colonial New Brunswick, 1793-1860.

This article discusses the several attempts to organize and regulate the medical profession in New Brunswick, Canada, between 1793 and 1860. It examines medical legislation during the colonial era, culminating in the creation of the Medical Faculty of New Brunswick in 1859. Also, it explores the desire within the profession itself for increased protection and recognition. This desire inspired the formation of several medical societies in the years following 1827. A central figure in professional organization was Robert Bayard (1788-1868), who graduated from Edinburgh in 1809. The article examines his relationship with his colleagues, notably Thomas Paddock, John Boyd, and Alexander Boyle, to identify personal tensions affecting the development of the medical profession. The article concludes that the medical profession acquired a significant degree of authority in New Brunswick only following the enlistment of legislative support. The search for greater authority stemmed from the advent of sectarian doctors in the province. Although sectarian practitioners never flourished in New Brunswick, the law of 1859 gave the province's regular doctors a sense of identitiy that facilitated the establishment of medical societies and the province's first general public hospital, in Saint John.

Canada↗
PubMed1987

The earliest ether anaesthetic in British North America--a first for Saint John, New Brunswick?

Literature relating the early history of ether anaesthesia in New Brunswick which, as part of British North America was a British colony until 1867, is reviewed. There is documentary evidence that the first ether anaesthetic for dental surgery in what is now Canada, was administered in 1844 in St. John, New Brunswick. There is also documentary evidence that the first ether anaesthetic for general surgery was administered in St. John on Monday, January 18, 1847, rather than in Montreal in March, 1847.

Anesthesia, Inhalation↗
PubMed2000

Comparison of CMA joint statement on resuscitative interventions and New Brunswick hospital corporations' policies on end-of-life treatments.

Why do most physicians have so much difficulty respecting the wishes of their terminally ill patients who refuse treatment? The normative pluralism model is introduced to answer this question. Comparative content analysis serves as the theoretical framework for evaluating the Canadian Medical Association Joint Statement on Resuscitative Interventions against the corresponding administrative policies of New Brunswick hospital corporations and relevant New Brunswick law. Despite protection afforded patients by law, fully 75% of New Brunswick hospital corporations' administrative policies permit physicians to ignore patients' expressed objection to treatments. The futility-of-treatment criteria in the CMA joint statement and in all provincial hospital corporations' policies authorize physicians to substitute their judgment for patients' expressed refusal of CPR. The author concludes that when medical professional norms conflict with the law, physicians tend to follow their professional normative order.

Guideline Adherence↗
PubMed1995

Physician characteristics and prescribing for elderly people in New Brunswick: relation to patient outcomes.

OBJECTIVE: To examine the relation between physician characteristics, prescribing behaviour and patient outcomes. DESIGN: Descriptive study linking four provincial databases. SETTING: New Brunswick. PARTICIPANTS: All 366 general practitioners (GPs) (accounting for 40% of all physicians with a general licence in New Brunswick) who ordered at least 200 prescriptions for elderly beneficiaries of the New Brunswick Prescription Drug Program and saw at least 20 elderly patients in an office setting between Apr. 1, 1990, and Mar. 31, 1991. Physicians with palliative care practices were excluded. OUTCOME MEASURES: GPs' personal, professional and practice characteristics, their prescribing patterns, and mortality, morbidity (number of days in hospital per patient) and hip-fracture rates among their elderly patients. RESULTS: Compared with the GPs who had a lower mortality rate, those with a higher mortality rate prescribed more drugs overall (p < 0.001), specifically antidepressants, bronchodilators, cholesterol-lowering agents, gastrointestinal drugs, neuroleptics and nonsteroidal anti-inflammatory drugs (NSAIDs). They also were more likely to be male (p < 0.01), had larger practices (p < 0.001), saw more patients per day (p < 0.05) and billed more per year (p < 0.001). Compared with the GPs who had a lower morbidity rate, those with a higher morbidity rate prescribed more drugs overall (p < 0.005), specifically bronchodilators, gastrointestinal drugs and NSAIDs. They also were more likely to be younger (p < 0.005) and male (p < 0.01), had fewer years in practice (p < 0.001), saw more patients per day (p < 0.05) and billed more per patient (p < 0.01). The GPs who had a higher hip-fracture rate prescribed more drugs overall (p < 0.001), notably antihypertensives, bronchodilators, cholesterol-lowering agents, gastrointestinal drugs and NSAIDs, than those who had a lower hip-fracture rate. They also had a larger practice (p < 0.001), practised more days per year (p < 0.005), had more patient visits per year (p < 0.05) and billed more per year (p < 0.001). Younger male GPs who practised with relatively more intensity and prescribed more drugs per patient had practices with higher morbidity, mortality and hip-fracture rates among their elderly patients than the other GPs. CONCLUSIONS: There is a significant relation between certain physician characteristics, their prescribing behaviour and patient outcomes. Further study is required to determine what physician characteristics and prescribing behaviours for specific illnesses contribute to patient outcomes. Regional differences should also be examined, as should incentives in this fee-for-service system. Linkage of these types of provincial databases may help in the evaluation of physicians' performance and in the development of strategic interventions and practice guidelines.

Adult↗
PubMed2003

Factor V New Brunswick: Ala221Val associated with FV deficiency reproduced in vitro and functionally characterized.

Factor V (FV) deficiency, also known as parahemophilia, is a rare bleeding disorder. Herein we investigate the first reported missense mutation associated with FV deficiency, Ala221Val, assigned as FV New Brunswick. To elucidate the molecular pathology associated with the Ala221Val substitution, the mutation was recreated in a recombinant system together with 3 FV mutants (Ala221Gly, Glu275Gln, and Cys220Ala/Cys301Ala) designed to help explain the Ala221Val phenotype. The expression pattern was analyzed by pulse-chase experiments and an FV-specific enzyme-linked immunosorbent assay (ELISA), the results suggesting the Ala221Val mutation not to interfere with the synthesis or secretion. The functional properties of the recombinant FV New Brunswick were evaluated in both plasma clotting and purified systems. The Ala221Val mutation did not affect the factor Xa (FXa) cofactor function; nor did it interfere with the activated protein C (APC)-mediated down-regulation of activated FV (FVa) activity. However, FV New Brunswick demonstrated reduced stability at 37 degrees C due to an increased rate of dissociation of light and heavy chains of FVa. In conclusion, this in vitro study of FV New Brunswick suggests the Ala221Val mutation not to impair synthesis and expression of procoagulant activity, indicating overall proper folding of the mutant molecule. Rather, the Ala221Val substitution appears to interfere with the stability of the activated FVa mutant, the reduced stability possibly explaining the deficiency symptoms associated with the mutation.

Amino Acid Substitution↗
PubMed1979

Early medicine and surgery in New Brunswick.

The author discusses some of the major events in medicine and surgery in New Brunswick prior to 1900. The influences of Indian medicine, of early French and Acadian surgeons, of the British colonial surgeons at the siege of Fort Beausejour, of the pre-Loyalist and Loyalist surgeons all led up to the building of marine hospitals and quarantine stations. The introduction of anesthesia with ether and chloroform hastened progress towards"modern surgery" which was carried out in the many general hospitals that were built following the opening, in 1865, of New Brunswick's first general hospital, the General Public Hospital (now the saint John General Hospital).

England↗