Norfolk General Hospital is a general hospital in Simcoe, Ontario, Canada; it is the only one in Norfolk County. The hospital was founded in 1925. It became an official teaching site for McMaster University's Faculty of Health Sciences in 2009. Like many hospitals, it has a charitable foundation which helps to fund its capital acquisitions and various programs.Norfolk General Hospital can support up to 3,719 patients; the average patient stay is nearly eight days. It takes about five hours for the average patient to be admitted to the emergency room. 13% of the beds are located in private rooms where people with private health insurance usually get them.
Background A previous single-center survey of trauma and general surgery faculty demonstrated perceived positive impact of trauma and surgical subspecialty service-based advanced practice providers (SB APPs). The aim of this multicenter survey was to further validate these findings. Methods Faculty surgeons on teams that employ SB APPs at 8 academic centers completed an electronic survey querying perception about advanced practice provider (APP) competency and impact. Results Respondents agreed that SB APPs decrease workload (88%), length of stay (72%), contribute to continuity (92%), facilitate care coordination (87%), enhance patient satisfaction (88%), and contribute to best practice/safe patient care (83%). Fewer agreed that APPs contribute to resident education (50%) and quality improvement (QI)/research (36%). Although 93% acknowledged variability in the APP level of function, 91% reported trusting their clinical judgment. Conclusion This study supports the perception that SB APPs have a positive impact on patient care and quality indicators. Areas for potential improvement include APP contribution to resident education and research/QI initiatives.
We rediscovered populations of Anacampsis lupinella Busck (Lepidoptera: Gelechiidae) in three remnant populations of sundial lupines (Lupinus perennis L. (Fabaceae)) in southern Ontario. Here we provide a detailed description of the species and illustrate it with figures of adult moths and both male and female genitalia. Photographs of the moths taken recently in High Park, Toronto, match photos of the type specimen that was collected at High Park in 1901. The male genitalia of contemporary males match those of a male from the original series of specimens collected in Toronto. CO1DNA barcodes of eight contemporary specimens were very similar to the CO1barcode recovered from a specimen from the original series. The CO1sequences demonstrated slight genetic differentiation of the three Ontario populations, but collectively were clearly delimited from the seven congeneric species known from Ontario.
In 2013, the Organ Procurement and Transplantation Network approved a new national kidney allocation scheme (KAS) for deceased donor (DD) transplantation. Among the many attributes of the new policy was the decision to proactively address organ allocation to highly sensitized patients, long recognized to be the most disadvantaged group on the waiting list. Beginning on December 4, 2014, the new KAS will be implemented and candidates with calculated panel reactive antibody (cPRA) values of 98%, 99% and 100% will have the highest priority for local, regional and national sharing, respectively. This approach is projected to improve the access of patients in this group to compatible organs. While the new KAS undoubtedly favors the highly sensitized candidate, antibodies to HLA-DPB and HLA-DQA antigens were not incorporated into the new allocation algorithm and they were not (and could not be) modeled in the simulation performed by the Scientific Registry of Transplant Recipients. The effect of omitting this immunological information may have unintended consequences depending on the frequency of DPB and DQA antibodies among candidates with cPRA of 98%. Under the current allocation schema, listing of unacceptable antigens combined with virtual crossmatching has facilitated the transplantation of many highly sensitized patients (1). Nonetheless, unexpected positive crossmatches still occur as a result of antibodies to DPB and DQA. In order to better understand the potential impact these antibodies may present under the new KAS, we assessed the frequency of antibodies to DPB and DQA among active candidates with cPRA 98%. Our findings show that these antibodies are quite prominent among this group of patients and we predict that their presence will result in a less-than-expected rate of transplantation.
National health surveys are sometimes used to provide estimates on risk factors for policy and program development at the regional/local level. However, as regional/local needs may differ from national ones, an important question is how to also enhance capacity for risk factor surveillance regionally/locally. A Think Tank Forum was convened in Canada to discuss the needs, characteristics, coordination, tools and next steps to build capacity for regional/local risk factor surveillance. A series of follow up activities to review the relevant issues pertaining to needs, characteristics and capacity of risk factor surveillance were conducted. Results confirmed the need for a regional/local risk factor surveillance system that is flexible, timely, of good quality, having a communication plan, and responsive to local needs. It is important to conduct an environmental scan and a gap analysis, to develop a common vision, to build central and local coordination and leadership, to build on existing tools and resources, and to use innovation. Findings of the Think Tank Forum are important for building surveillance capacity at the local/county level, both in Canada and globally. This paper provides a follow-up review of the findings based on progress over the last 4 years.
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