A quality improvement project was initiated on Ivory ward, a functional older adult psychiatric inpatient ward at Newham Centre for Mental Health, part of the East London NHS Foundation Trust. The project was started by staff on the ward after it had come to their attention that their ward had the highest bed occupancy and length of stay across similar wards in the trust. The mean bed occupancy...

The traditional model of acute medical care involves the admission of patients to hospital to be assessed by a consultant and facilitate access to investigation and treatment. This model has, however, led to a number of problems. Firstly, there is high bed occupancy which restricts access and increases the risk of healthcare-acquired infection. Secondly, only limited training opportunities are ...

This article presents a case study of how one health system-Health First, in Brevard County, Florida-addressed resource challenges by using Lean thinking enabled by information technology. Examining Health First provides an opportunity to learn about how one hospital system addressed these challenges by making fundamental changes in their operations, in advance of the shift toward accountable c...

Mediterranean rhodolith beds are priority marine benthic habitats for the European Community, because of their relevance as biodiversity hotspots and role in carbonate budget. Presently, typically occur within range 30–75 m water depth, generally located around islands capes, on flat or gently sloping areas. In framework a collaboration between University Milano-Bicocca Marine Protected Area “C...

The dynamics of river bedforms is still not well understood and detailed experimental investigation may provide significant insight into the process mechanisms. In this study, results are presented for a laboratory experiment that returned long time series sediment kinematics bed-load dunes. run was performed in closed conduit but, light prior literature, also representative dunes under open-ch...

In cases of pulmonary embolism, the visualization of a free-floating right heart thrombus on conventional transthoracic echocardiography is extremely rare. Even rarer is an echocardiographic recording of migration of a free-floating clot from the right heart into the pulmonary vasculature leading to pulmonary embolism. We present a unique case of an elderly man who presented with dyspnoea, in w...

is about 4000 each year; between 1911 and 1926 inclusive there were 66,421 deaths from these causes in England and Wales. Septic infection is by far the most important single cause. The official figures show the total maternal mortality in 1926 for England and Wales as 5-14, and the sepsis rate as i-6o, per 1000 live births. But this loss by death is in some ways not the gravest consequence of ...

Introduction The introduction of biological therapies (BT) has improve the management of patients with Juvenile Idiopathic Arthritis (JIA) in terms of relive of symptoms, enhancing the quality of live and reducing joint damage. Its pharmacological activity induces immunity transitory suppression that supposes an increased risk of acquire infectious diseases or a major severity of them. TB adver...

Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals.The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) ho...