Objective: Urinary catheterization is associated with urinary tract infection, a common complication of stroke. We aimed to investigate the incidence and risk factors associated with urinary catheterization following acute stroke, and its impact on stroke outcome. Method: We prospectively studied a cohort of stroke patients hospitalized within 10 days after onset from August 2006 to December 2008. Kaplan-Meier method was used to estimate the cumulative incidence of Foley catheter insertion over time, and Cox proportional hazards regression analysis to evaluate the independent predictors. The impact of urinary catheterization on poor stroke outcome (modified Rankin Scale >2 or dead) at 3 months was analyzed by logistic regression. Results: Of 2789 study patients, 761 (27%) received Foley catheter insertion. Most urinary catheterization was carried out within two days of admission, with estimated cumulative incidence of 23% (95% CI, 22% to 25%) at 2 days, and 27% (25% to 29%) at 7 days. Predictors of urinary catheterization were advanced age (HR 1.01 per year; 95% CI, 1.00-1.01), increased National Institutes of Health Stroke Scale score (HR 1.08 per point; 1.07-1.09), and hemorrhagic (versus ischemic) stroke (HR 2.03; 1.69-2.44), after adjustment for gender, diabetes mellitus and previous stroke/transient ischemic attack. The influence of urinary catheterization on poor outcome at 3 months remained significant (OR 2.43; 1.65-3.58) after adjustment for relevant covariates. Conclusion: Urinary catheterization was common among hospitalized acute stroke patients, and associated with poor outcome at 3 months. Judicious use of urinary catheter in acute stroke patients is crucial to improve quality of care.

The medical quality becomes a very important issue of a scholar and the public opinion. The high quality medical service of patients center and customer direction already has been necessarily prepare conditions to get the best competition advantage of all levels hospital in Taiwan, now.¡CTherefore, all hospital manager believe that promote medical quality is the very important issue¡CThe medical service quality of Emergency Department plays the very important role in the whole hospital. The medical service quality indicator is acknowledged well trusty medical quality measurement tool. Donabedian point out that medical quality measurement is compose of structure¡Bprocess and outcome, and that the outcome quality indicator measurement is the trend¡CAsthma is one of the most common diseases among children. Because of rising morbidity, mortality and medical costs all over the world, asthma becomes a very important issue. So, The purpose of this study is to identify the key factors associated with the of outcomes quality. The example of Pediatric Asthma in a Teaching Hospital. Data take from the Teaching Hospital¡¦s TQIP database through 2003. There are 534 Pediatric asthma patients who are research samples and care take by 25 physicians. The research analyze patient¡¦s and physician¡¦s characteristic to described data, Correlation and Regression with SPSS software. Look for the characteristic what influence the outcome quality of Emergency Department. The outcome quality include that patient¡¦s state after the treatment, patient¡¦s stay time and unscheduled revisit to Emergency Department.¡CRegression analysis showed that. 1.patient¡¦s state after the treatment trend to be inpatient who care by experienced physician, younger, illness serious and reach on day shift. 2.patient¡¦s stay time longer who care by experienced physician, so that the consultations effectiveness should promote to reduce .patient¡¦s stay time¡C3.patient¡¦s stay time longer who younger, so that the staff take care more careful and pay attention to patient¡¦s condition change frequently¡Ato reduce uneasy of long-term stay in Emergency Department. 4.unscheduled revisit ratio in the study is 4.7%¡Abut not discover the correlation factor¡C Integrate above-mentioned¡Athe study find that ¡Aphysician¡¦s and patient¡¦s characteristic will influence medical outcome quality. The project hospital should with different influence factor to draw quality manage policy and stratagem, and improve Emergency Department quality will raise the satisfied degree.

The purpose of this project was to design an algorithm for the management of Dermatofibrosarcom Protuberans (DFSP.) The National Cancer Center Network guidelines suggest immediate reconstruction in most cases after DFSP resection. We believe this algorithm is inadequate. Due to the infiltrating nature of DFSP, tumor margins are often positive after resection. Immediate reconstruction in the context of residual tumor is problematic because of the risk for spreading microscopic disease and the potential to compromise reconstructive options. At our institution we examined the prevalence of positive margins on permanent pathology after immediate closure following surgical resection of DFSP. Forty-one patients were identified; 25 had received treatment with surgical excision and 16 with Mohs surgery. Of the 25 patients that were treated with surgical excision, 20 underwent immediate closure and 5 underwent delayed closure after tumor resection. Eight out of 19 (40%) of patients who underwent immediate closure were found to have positive margins on permanent pathology. Given these findings, we propose a treatment algorithm focused on more conservative surgical management of DFSP in which negative margins are established before closure. Mohs surgery, which allows for immediate identification of pathology, plays a central role.

Thesis (M. Med. Sc.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 83-93).

Thesis (Ph. D.)--University of Washington, 2001. / Vita. Includes bibliographical references (leaves 44-49).

Today’s technological development has shed new light upon the management practiceproduct management and it is considered more important than ever to manage products.Moreover, organisations to a growing extent face external bodies that evaluate them andimpose organisational structures that they need to comply with. Product management isnevertheless characterised with ambiguity, broad definitions and various depictions. Ascattered research field together with practitioners struggle to define the area stress the needto clarify product management structuring. This thesis uses a sensemaking perspective and akaleidoscopic approach in order to capture product management structuring in a fragmentedarea. It means that we investigate what the sensemaking outcome of product management isand why organisational members make sense this way. This thesis has found that productmanagement is understood on two main levels and that the practice comprises bothconsistency and inconsistency on an inter-organisational level. Findings suggest that sharedidentity, strong commitment, cues, metaphors and expectations have influenced consistentunderstandings and crystallised the sensemaking outcome. In addition, product governanceinfluences product management and therefore the sensemaking outcome are inconsistent inseveral structuring elements. The thesis concludes that our contemporary productmanagement practice is comprised with general components that can be structured similarlybut also components that require a customised structuring due to the product governance trait.

published_or_final_version / Paediatrics and Adolescent Medicine / Master / Master of Medical Sciences

This research provides an analysis of the relationship between demographic information and between specific vocational rehabilitation services and employment outcome in RSA consumers with traumatic brain injury (TBI). The findings suggest that these is a relationship between a consumers' race (i.e., White, Black, Hispanic, and Hawaiian), level of education, and presence of substance abuse. No relationship was identified between a consumers' gender, age, or race of Asian or American Indian consumers. When specific services of assessment, job placement, job search, and diagnosis/treatment were provided consumers were more likely to obtain employment. The specific services of job placement, job search and diagnosis/treatment also predicted consumers' employment outcome. Only three of these services, job placement, job search, and diagnosis/treatment were significantly related to consumers' weekly earnings at case closure. Diagnosis/Treatment was positively related, while job placement and job search were negatively associated.

No description available.

The present study examined the emotional responses of 112 dyads of same-sex friends in early and middle childhood as they competed against each other on 3 identical games, enabling each child in the pair to experience 3 outcome conditions: winning, losing, and tying. Emotional reactions were videotaped and rated for degree of enjoyment and discomfort. In addition, following the 3 games, children were individually interviewed and asked to report their levels of happiness regarding winning, losing, and tying. The social context of a dyad is more closely associated with female social interaction which tends to be egalitarian. It was hypothesized that boys' well-documented greater comfort with competition relative to girls would be attenuated in the context of a dyad. Results indicated that boys showed more comfort and enjoyment throughout the competitive process than did girls. However, both boys and girls showed equal levels of comfort and enjoyment for the win and tie outcomes, indicating boys, like girls, were also concerned with doing the same as their friend. A developmental difference was also seen as the children in middle childhood reported less happiness than the kindergarten children when they experienced the win outcome. The results are discussed in terms of the necessity of considering the social context in which competition occurs when investigating gender differences in competition.