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Search Results: 1 - 10 of 10602 matches for " Merritt-Charles Lorna "
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Evaluation of the utilization of the preanaesthetic clinics in a University teaching hospital
Seetharaman Hariharan, Deryk Chen, Lorna Merritt-Charles
BMC Health Services Research , 2006, DOI: 10.1186/1472-6963-6-59
Abstract: All patients scheduled to have elective surgery during the period of twelve weeks were enrolled for prospective collection of data including demographics, the admitting diagnoses, surgical procedure, category of surgery and specialty, and the patients' attendance to preanaesthetic clinics. Cancellations on the day of surgery along with reasons were recorded. The difference between patients who attended and did not attend the clinic was analysed.Of 424 patients scheduled for procedures during the study period, 213 were adults and 211 were children. Overall 39% of adults and 46% of the children scheduled for surgery had previously attended the preanaesthetic clinic. Among adults, general surgery patients were the largest majority to attend the preanaesthetic clinic. The paediatric preanaesthetic clinic was mostly utilized by paediatric general surgery. Overall 30% of procedures in adults and 26% of those in children were cancelled. There was a statistically significant difference in cancellations between patients who attended and did not attend the preanaesthetic clinic (p = 0.004). There was a 52% more chance of the procedure getting cancelled if the patient did not attend the clinic.The study highlights the inadequate use of the preanaesthetic clinics and the impact of the clinics on last-minute cancellations.Preanaesthetic assessment of a surgical patient is done differently in various settings. In an outpatient setting this may be done by administering a questionnaire by the nursing or medical staff, or assessing the patient in a dedicated preanaesthetic out-patient clinic. In an in-patient setting the patient on the ward may be referred to the anaesthetist preoperatively for preoperative evaluation and optimization. Although in many institutions the anaesthetists get to see the patient on the day of the procedure in the patient-waiting room, there is evidence that a preanaesthetic assessment well before the procedure plays a vital role in avoiding last-minute can
The utilities of the therapeutic intervention scoring system (TISS-28)
Hariharan Seetharaman,Chen Deryk,Merritt-Charles Lorna,Bobb Nahmorah
Indian Journal of Critical Care Medicine , 2007,
Abstract: Background and Aims: The study evaluates the utility of therapeutic intervention scoring system (TISS-28) in quantifying the resource utilization, costs and predicting outcome of critically ill patients. Materials and Methods: TISS-28 was prospectively applied to patients consecutively admitted to the intensive care units (ICU) of three public teaching hospitals and two private hospitals in Trinidad on a daily basis for a period of eight weeks. Demographic data, diagnoses on admission, nurse-patient ratio, ICU length of stay and hospital outcomes were recorded. Simplified acute physiology score (SAPS)-II was applied for all adult patients. Costs were calculated from data collected from the public hospitals in relation to TISS-28 score. Results : TISS-28 scores of five hundred and ninety-five patient-days were analyzed. The median daily TISS-28 per patient was 27 [24.5, 30.6 quartiles (IQR)]; the median day-1 TISS-28 score was 29 (25, 33 IQR) and the median last day TISS-28 score was 25 (21, 30 IQR). The overall average TISS per nurse was 26.2 per day. The mean cost per patient per day was 414 US dollars. The discriminatory function of day-1 TISS-28 as a prognostic scoring system was less compared to SAPS II as shown by the area under the receiver operating characteristic curve (0.65 compared to 0.71). Conclusions: TISS-28 is useful for evaluating the resource utilization and costs and may not be useful as a prognostic scoring system
No Supermassive Black Hole in M33?
David Merritt,Laura Ferrarese,Charles L. Joseph
Physics , 2001, DOI: 10.1126/science.1063896
Abstract: We analyze optical long-slit spectroscopy of the nucleus of M33 obtained from the Space Telescope Imaging Spectrograph aboard the Hubble Space Telescope. Rather than the steep rise expected within the radius of influence of a supermassive black hole, the velocity dispersion drops significantly within the inner parsec. Dynamical modelling yields an estimated upper limit of 3000 solar masses for the mass of a central compact object. This upper limit is however consistent within the uncertainties with the mass predicted by the M-sigma relation, which is between 2000 and 20,000 solar masses. We therefore can not conclude that the presence of a massive black hole in the nucleus of M33 would require a different formation mechanism from that of the black holes detected in galaxies with more luminous bulges.
Share and share alike: encouraging the reuse of academic resources through the Scottish electronic Staff Development Library
Lorna M. Campbell,Allison Littlejohn,Charles Duncan
Research in Learning Technology , 2001, DOI: 10.3402/rlt.v9i2.12027
Abstract: The Scottish electronic Staff Development Library (http://www.sesdl.scotcit.acuk) is an ongoing collaborative project involving the Universities of Edinburgh, Paisley and Strathclyde which has been funded by SHEFC as part of their current ScotCIT Programme (http:llwww.scotcit.ac.uk). This project is being developed in response to the increasing demand for flexible, high-quality staff development materials.
Trendelenburg chest optimization prolongs spontaneous breathing trials in ventilator-dependent patients with low cervical spinal cord injury
Charles J. Gutierrez, PhD, RRT, FAARC,Cathy Stevens, RRT,John Merritt, MD, FACP,Cecille Pope, MD
Journal of Rehabilitation Research and Development , 2010,
Abstract: Chest optimization, an evidence-based protocol-guided multimodal chest physiotherapy consisting of body positioning, sputum mobilization, bronchodilation, and lung hyperinflation, may be routinely administered to ventilator-dependent patients with low cervical spinal cord injury (CSCI) for improving pulmonary functional outcomes that facilitate weaning from mechanical ventilation. We undertook this study to determine whether position-specific chest optimization was associated with changes in spontaneous breathing trial (SBT) duration. Cardiac output (CO), alveolar minute volume (MValv), carbon dioxide elimination (VCO2), and static chest compliance (Cst) were measured during chest optimization; then MValv and rapid shallow breathing index (RSBI) were measured during SBT. Study participants (N = 12) were clinically stable ventilator-dependent patients with low CSCI. Trendelenburg chest optimization (TCO) was associated with significant increases in SBT (p < 0.001), CO (p < 0.001), MValv (p < 0.003), VCO2 (p < 0.001), and Cst (p < 0.002). SBT following TCO was associated with significant increases in MValv (p < 0.03) and RSBI (p < 0.002). These preliminary findings suggest the importance of proper recumbent body positioning during evidence-based, protocol-guided multimodal chest physiotherapy for ventilator-dependent patients with low CSCI.
Supermassive Black Holes in Active Galactic Nuclei. I. The Consistency of Black Hole Masses in Quiescent and Active Galaxies
Laura Ferrarese,Richard W. Pogge,Bradley M. Peterson,David Merritt,Amri Wandel,Charles L. Joseph
Physics , 2001, DOI: 10.1086/322528
Abstract: We report the first results of a program to measure accurate stellar velocity dispersions in the bulges of the host galaxies of active galactic nuclei (AGNs) for which accurate black hole (BH) masses have been determined via reverberation mapping. We find good agreement between BH masses obtained from reverberation mapping, and from the M(BH) - sigma relation as defined by quiescent galaxies, indicating a common relationship between active and quiescent black holes and their large-scale environments.
Radiation Retinopathy: Case report and review
Abha Gupta, Felipe Dhawahir-Scala, Amy Smith, Lorna Young, Steve Charles
BMC Ophthalmology , 2007, DOI: 10.1186/1471-2415-7-6
Abstract: A 55 year old male was referred from the oncology department with epiphora. His medical history included Type 2 Insulin treated Diabetes Mellitus and hypertension. One year prior to presentation he had undergone a total rhinectomy with a 4 week course of post-operative radiotherapy for an aggressive sqaumous cell carcinoma of the nose. On examination the visual acuity was noted to be 6/36 left eye and 6/9 right eye. Posterior segment examination revealed marked retinal ischaemia present in the posterior pole and macular region of both eyes. The appearance was not thought to be typical of diabetic changes, radiation retinopathy being the more likely diagnosis especially in view of his history. Over the next four months the vision in both eyes rapidly deteriorated to 3/60 left eye and 1/60 right eye. Bilateral pan retinal photocoagulation was thought to be appropriate treatment at this point.This case highlights the importance for ophthalmologists and oncologists to be aware of the close relationship between diabetes and radiation treatment and the profound rapid impact this combination of factors may have on visual function. Radiation is being used with increasing frequency for ocular and orbital disease, because of this more cases of radiation retinopathy may become prevalent. Factors which may potentiate radiation retinopathy should be well known including, increased radiation dosage, increased fraction size, concomitant systemic vascular disease and use of chemotherapy. Counselling should be offered in all cases at risk of visual loss. As no effective treatment currently exists to restore visual function, monitoring of visual acuity in all cases and early referral to the ophthalmologist as appropriate is warranted.Ocular damage from radiation treatment is a well established phenomenon. Many factors are now known to influence the incidence of radiation retinopathy, including total dosage and daily fraction size. Patients who are diabetic, hypertensive or who have r
Academic Success in College: Socioeconomic Status and Parental Influence as Predictors of Outcome  [PDF]
Devin L. Merritt, Walter Buboltz
Open Journal of Social Sciences (JSS) , 2015, DOI: 10.4236/jss.2015.35018
Abstract: Bandura (1986) postulated that beliefs about one’s ability (self-efficacy) were better predictors of achievement than ability itself [1]. Therefore, in academics, the higher the beliefs that a student develops regarding his or her ability to succeed in school, the greater the likelihood that he or she will attain academic success. Although academic goals vary among students, academic self-efficacy appears to be essential in order for academic aspirations to be achieved. Multiple factors, including socioeconomic status (SES) are related to academic self-efficacy. Past research has noted that SES influences academic attainment [2] [3]. Familial backgrounds, such as SES [4] and parental influence [5], have been found to impact academic achievement. This study examined the relationship between socioeconomic status, academic self-efficacy, and perceived success in college. A total of 298 undergraduate students from a southern university completed self-report measures that consisted of sociodemographic questions, the Multidimensional Scales of Perceived Self-Efficacy (MSPSE), and the Perceptions of Parental and Teacher Academic Involvement. Results indicated that SES was significantly related to self-efficacy, and parental influence was a significant predictor of academic self-efficacy. Results also showed that parental involvement mediated the relationship between familial SES and self-efficacy.
Information technologies and the evolution of the digital divide in Mexico: a public policy approach
Humberto Merritt
Análisis Económico , 2011,
Abstract: The rapid diffusion of Information Technologies (ITs) has noticeably influenced the ability of societies to stimulate economic growth and development. Among these technologies, the Internet stands out due to its contribution to the advancement of education, learning and knowledge. Hence, the commitment of some developing nations like Mexico to the diffusion of the Internet has become a top issue in their policy agendas. However, the country's promotion of this technology has undergone a number of setbacks, mainly due to a misinterpretation of the factors causing the so-called 'digital divide'. Hence, the purpose of this paper is to analyze the rationale for governmental intervention regarding the diffusion of the Internet in Mexico.
The Dynamical Inverse Problem for Axisymmetric Stellar Systems
David Merritt
Physics , 1996, DOI: 10.1086/118080
Abstract: The standard method of modelling axisymmetric stellar systems begins from the assumption that mass follows light. The gravitational potential is then derived from the luminosity distribution, and a unique two-integral distribution function f(E,Lz) that generates the stellar density in this potential is found. We show that the gravitational potential can instead be generated directly from the velocity data in a two-integral galaxy, thus allowing one to drop the assumption that mass follows light. The rotational velocity field can also be recovered in a model-independent way. We present regularized algorithms for carrying out the inversions and test them by application to pseudo-data from a family of oblate models.
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