116 research outputs found
Nurse To Patient Ratios: Government Mandated Or Evidence Based?
No full textNurse to patient ratios are currently controversial in health care. The central issue is what is a safe limit to the number of patients for whom an RN is responsible in the acute care setting? Some states require a committee at each facility to determine ratios whereas in other states, the legislature has established what the ratio must be. A systematic review of the literature was conducted using CINAHL to identify the major factors being used to determine a safe nurse to patient ratio. Criteria for inclusion in this study were (a) published between 2013 and September 2018; (b) peer reviewed; (c) published in English and (d) had at least one nurse as an author. A combination of the following keywords were nurse to patient ratios, safety, patient outcomes and quality of care. Thirteen studies qualified for inclusion in this systematic review. Five major factors identified as determining nurse to patient ratios are the educational levels of the nursing staff, patient acuity, patient outcomes, cost and the staffing method of the institution based upon cost/budget, nurse to patient ratio or patient acuity. The staffing method chosen is a decision between administrators and the nursing leadership. Cost is more heavily weighted by administrators than by the nursing leadership. These five factors are not constants and the dynamic environment of acute care nursing does not lend itself to staffing that does not consider these factors. Government mandated nurse to patient staffing ratios cannot provide the work environment that provides for the nursing needs of today’s patient populations.Nursin
Impact du programme de dépistage néonatal universel sur l’évolution des enfants atteints d’anémie falciforme à l’Hôpital Sainte-Justine de 2000 à 2020
No full textL'objectif de ce travail est d'évaluer l'impact du programme de dépistage néonatal universel chez de l’anémie falciforme (AF) chez les enfants.
Méthode : Nous avons procédé à une étude de cohorte rétrospective sur 600 dossiers d’enfants atteints d’AF suivis au CHU Saint-Justine sur une période de janvier 2000 à décembre 2019. Nous avons divisé la durée de suivi en deux grandes périodes, avant 2013 (pré-dépistage néonatal, pré-DN) et après 2013 (post-dépistage néonatal, post-DN) et avons retenu 410 enfants et le logiciel R version 4.2.1 a été utilisé pour les analyses de différentes variables retenues.
Résultats : Alors que 42.6% des enfants avant novembre 2013 étaient diagnostiqués pour une première manifestation de l’AF, tous les enfants nés au Québec après 2013 qui nous ont été référés ont bénéficié d’une prise en charge précoce. Nous observons ainsi une diminution de l’âge médian lors du diagnostic de 10.8 mois (EI, 1.2-52.8) en pré-DN à 1.2 mois (EI, 1.2-43.2) en post-DN, p0.9). De même, le délai moyen d’introduction de l’HU depuis la première visite a diminué de 4.5 ans avant 2013 à 0.8 mois après 2013 (p<0.001). Le taux moyen d’hospitalisation par patient année (hospit/pt-an) a diminué en post-DN de moitié passant de 2 hospit/pt-an pré-DN (1st Qu.1.0 et 3rd Qu.3.0) à 1.0 hospit/pt-an (1st Qu.0.6 et 3rd Qu.1.4) avec un p (<0.001).
Conclusion : L’universalisation du programme de dépistage néonatal de l’AF a permis une détection et une référence précoces des enfants dans les centres de prise en charge, associée à une diminution du taux d’hospitalisation.The aim of this work is to evaluate the impact of the universal neonatal screening program with sickle cell disease (SCD) in children
Method: We conducted a retrospective cohort study of 600 records of children with SCD followed at the CHU Saint-Justine over a period from January 2000 to December 2019. We divided the duration of follow-up into two main periods, before 2013 (pre-neonatal screening, pre-DN) and after 2013 (post-neonatal screening, post-DN) and retained 410 children. R software version 4.2.1 was used for the analyses of different retained variables.
Results: Whereas 42.6% of children before November 2013 were diagnosed with a first manifestation of SCD, all children born in Quebec after 2013 who were referred to us benefited from early management. We observed a reduction in median age at diagnosis from 10.8 months (AR, 1.2-52.8) pre-DN to 1.2 months (range, 1.2-43.2) post-DN, p0.9). Similarly, the median time to introduction of HU since the first visit decreased from 4.5 years pre-2013 to 0.8 months post-2013 (p<0.001). The mean hospitalization rate per patient year (hosp/pt-year) decreased post-DN by half from 2 hosp/pt-year pre-DN (1st Qu.1.0 and 3rd Qu.3.0) to 1.0 hosp/pt-year (1st Qu.0.6 and 3rd Qu.1.4) with a p (<0.001).
Conclusion: Universalization of the neonatal SCD screening program has resulted in early detection and referral of children to care centers, associated with a decrease in the rate of hospitalizatio
Responsibility to report : the role of the media in the Rwanda genocide
No full textFrench version available in IDRC Digital Library: Responsabilité de rendre compte : le rôle des médias dans le génocide au Rwanda“The Media and the Rwanda Genocide” (2007), edited by Allan Thompson, was co-published by Canada’s International Development Research Centre (IDRC). Rather than being front page news, the horrendous events unfolding in Rwanda were largely ignored by the North American press. Thompson and his colleagues at Carleton University have set up a media internship program in Rwanda for Canadian journalism students. The internship program is part of The Rwanda Initiative, a capacity building project headed by Thompson. What was getting media attention in North America during the genocide? The O.J. Simpson trial; the winter Olympics; the bizarre rivalry between figure skaters Tonya Harding and Nancy Kerrigan
Diagnosis and management of transfusion‐associated circulatory overload in adults and children
No full textLa Leçon (1977)
No full text1. Cover page 2. Program [Attached] 3. Slides of scenes from La Leçon. 4. Unidentified Author. (1977, Feb.) La Leçon par/The Lesson by Eugène Ionesco. Pro Tem. 5. Robitaille, Pierre. (1977, Mar. 10). La Leçon: Critique (?!: ) neo--espagnole. Pro Tem. 6. Unidentified Author. (1977, Feb. 24). La Leçon. Pro Tem. 7. Unidentified Author. (1977, Feb. 10). La Leçon: Une expérience illuminante. Pro Tem. [Attached] 8. Scene from La Leçon.Archival file for the Glendon College production of La Leçon, produced and directed by John Van Burek. The play was performed March 2 to 6, 1977
Key factors influencing First Nation youth perspectives on forest management and capacity development in northern Ontario, Canada
No full textFirst Nation youth often play a central, though indirect, role in Ontario’s forest sector as the beneficiaries of capacity-building arrangements, employment opportunities and cultural-retention initiatives. Correspondingly, recent peer-reviewed literature has emphasized the need to engage First Nation youth directly regarding the forestry-related issues that affect them. Such steps will help to ensure that forest policy and youth-focused capacity development initiatives fully realize their intended benefits and remain relevant into the future. Despite this imperative, the direct engagement of First Nation youth remains a major outstanding gap in the research. This exploratory study endeavoured to fill the current knowledge gap by directly engaging First Nations youth participants in the First Nations Natural Resources Youth Employment Program through semi-structured interviews and focus group activities. Using inductive, qualitative grounded theory analysis, four key perspective-influencing factors were identified: relationship; natural and socioeconomic cycles; intergenerational equity; and the resource trap. These explanatory factors indicate that participants’ thought processes and worldviews are deeply grounded in and affected by the unique historical experiences, sociocultural traditions and contemporary lived realities of their First Nation communities. Forest sector relationships, policies and capacity development initiatives in Ontario could thus be supported through the adoption of several specific policy directions, including: mandating comprehensive social impact analysis as a component of forest management planning; including specific funding for education and employment supports within broader capacity development initiatives; and supporting additional opportunities for culturally-rooted, land-based, experiential learning for First Nation youth
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