Academic literature on the topic 'Gippsland Base Hospital History'

The Longtom gas field was discovered in 1995, when the Longtom–1/ST1 wildcat well in the northern part of the offshore Gippsland Basin encountered dry gas in tight sandstones towards the base of the Latrobe Group, in what is now called the Admiral Formation of the Emperor Subgroup. In 2004 the Longtom–2/ST1 exploration well confirmed significant vertical and lateral extension of these prospective gas sands, and also provided very encouraging production test and core data. The recent Longtom–3 wells have demonstrated the viability of this new play by confirming significant lateral continuity of the thicker gas sands and demonstrating high gas flow rates. The history of the field’s discovery and appraisal illustrates how a multi-disciplinary and interactive approach, guided by innovative seismic inversion techniques and real-time petrophysical data, resulted in the successful planning and execution of the Longtom–3 drilling and evaluation program. The results of the wells and the outline of the field development plan illustrate how Longtom represents new production potential in this mature basin.

[pt] O nosso estudo analisa o hospital da Misericórdia de Vila Viçosa em 1870 com base na descrição elaborada pelo administrador do concelho nessa data. Os elementos fornecidos procuram conhecer a instituição a que está ligado –a Misericórdia–, e contribuir para uma melhor administração. Com base nesta fonte é possível conhecer o hospital, bem como a política seguida pela confraria no tocante à saúde. O seu estudo dá a conhecer o funcionamento da instituição, desde os seus espaços aos doentes, apresentando um hospital Municipal de traça quinhentista, embora adaptado às necessidades do século XIX. Integra ainda as sugestões do administrador do concelho, embora estas não sejam implementadas devido à escassez de receitas com que o hospital se debatia, as quais eram as responsáveis pelo estado de degradação em que alguns dos seus espaços se encontravam, mas sobretudo pelo corte no internamento de doentes e da assistência aos que se curavam em suas casas.

Neste artigo, inicialmente apresentaremos o conceito de degeneração desenvolvido por Benedict-Augustin Morel, Valentin Magnan e Emil Kraepelin, bem como suas repercussões na psiquiatria brasileira nos primeiros anos do século XX. Com base nesses pressupostos, discorreremos sobre a trajetória de vida de pessoas consideradas portadoras de transtornos mentais e do saber psiquiátrico no Hospital de Doenças Nervosas e Mentais do Recife, através da análise de alguns prontuários dos anos de 1920 com pacientes diagnosticados como portadores de Episódio Delirante de Degeneração. O suporte desta pesquisa está no trabalho desenvolvido no acervo do Hospital Ulysses Pernambucano, em que foi realizado o resgate da documentação, a catalogação e a edição de um inventário de todos os livros entre os anos de 1926 a 1970, no total de 1013 volumes, cada um com cinquenta prontuários. A análise dessas importantes fontes, juntamente com o aporte teórico, permitiu a elaboração desse artigo. Palavras-chave: Hospital; psiquiatria; degenerados; eugenia.

CONTEXT AND OBJECTIVE: Chordoma is a rare tumor with a high risk of locoregional recurrences. The aim of this study was analyze the long-term results from treating this pathological condition.DESIGN AND SETTING: Cohort study in a single hospital in São Paulo, Brazil.METHODS: This was a retrospective cohort study on 42 patients with chordoma who were treated at Hospital A. C. Camargo between 1980 and 2006. The hospital records were reviewed and a descriptive analysis was performed on the clinical-pathological variables. Survival curves were estimated using the Kaplan-Meier method and these were compared using the log-rank test.RESULTS: Nineteen patients were men and 23 were women. Twenty-five tumors (59.5%) were located in the sacrum, eleven (26.2%) in the skull base and six (14.3%) in the mobile spine. Surgery was performed on 28 patients (66.7%). The resection was considered to have negative margins in 14 cases and positive margins in 14 cases. The five-year overall survival (OS) was 45.4%. For surgical patients, the five-year OS was 64.3% (82.2% for negative margins and 51.9% for positive margins). In the inoperable group, OS was 37.7% at 24 months and 0% at five years.CONCLUSION: Complete resection is related to local control and definitively has a positive impact on long-term survival.

OBJECTIVE: Selecting controls is one of the most difficult tasks in the design of case-control studies. Hospital controls may be inadequate and random controls drawn from the base population may be unavailable. The aim was to assess the use of hospital visitors as controls in a case-control study on the association of organochlorinated compounds and other risk factors for breast cancer conducted in the main hospital of the "Instituto Nacional de Câncer" -- INCA (National Cancer Institute) in Rio de Janeiro (Brazil). METHODS: The study included 177 incident cases and 377 controls recruited among female visitors. Three different models of control group composition were compared: Model 1, with all selected visitors; Model 2, excluding women visiting relatives with breast cancer; and Model 3, excluding all women visiting relatives with any type of cancer. Odds ratios (OR) and 95% confidence intervals were calculated to test the associations. RESULTS: Age-adjusted OR for breast cancer associated with risk factors other than family history of cancer, except smoking and breast size, were similar in the three models. Regarding family history of all cancers, except for breast cancer, there was a decreased risk in Models 1 and 2, while in Model 3 there was an increased risk, but not statistically significant. Family history of breast cancer was a risk factor in Models 2 and 3, but no association was found in Model 1. In multivariate analysis a significant risk of breast cancer was found when there was a family history of breast cancer in Models 2 and 3 but not in Model 1. CONCLUSIONS: These results indicate that while investigating risk factors unrelated to family history of cancer, the use of hospital visitors as controls may be a valid and feasible alternative.

OBJECTIVE To increase the knowledge base on the frequency, causality, and avoidability of adverse drug events (ADEs) as a cause for admission in internal medicine or when occurring during hospitalization. METHODS A prospective study was performed for 6 periods of 8 days each. Epidemiologic data (e.g., age, gender, medical history), drug utilization, and adverse drug reactions on patients hospitalized during these periods were collected by a pharmacy student. RESULTS A total of 156 patients (70 men and 86 women) were included in the study. The patients’ mean age ± SD was 66.5 ± 18.1 years and mean length of stay was 13.2 ± 9 days. Renal and hepatic insufficiency and previous history of drug intolerance were observed in 17.9%, 10.2%, and 2% of the hospitalized patients, respectively. Thirty-eight ADEs occurred in 32 patients; in 15 cases, ADEs were identified as the reason for admission, 10 cases occurred during hospitalization, and 13 cases were present at admission, but were not the cause of admission. The most frequent ADEs involved the neurologic (23.6%), renal (15.7%), and hematologic (13.1%) systems. Among these 38 ADEs, 22 were considered avoidable (57.9%); 20 of these were associated with therapeutic errors (inappropriate administration, drug–drug interactions, dosage error, drug not stopped despite the onset of ADEs). Patients with ADEs stayed longer in the hospital and took more drugs both before and during their hospital stay (p < 0.05). CONCLUSIONS Most of the ADEs observed in this study were avoidable. The risk/benefit ratio of administered drugs could be improved with better knowledge of the patients’ medical history and the risk factors of ADEs.

Based on archival data and literary sources, the article presents the history of the Kazan psychophysiological laboratory of V.M. Bekhterev during the years of his work in Kazan (18851893). The circumstances of the creation of the psychophysiological laboratory, its locations (during the years of Bekhterevs work, it changed two rooms) and equipment are described. The main scientific directions of V.M. Bekhterev and his students during the Kazan period of activity, the history of their appointment to the positions of residents and assistants of the Department of Psychiatry are analysed. The reasons and history of creation of a psychophysiological laboratory at the clinical base of the University in the Kazan District Hospital are described.

OBJECTIVE The objective of this study was to identify the natural history and clinical predictors of postoperative recurrence of skull base and non–skull base meningiomas. METHODS The authors performed a retrospective hospital-based study of all patients with meningioma referred to their institution from September 1993 to January 2014. The cohort constituted both patients with a first-time presentation and those with evidence of recurrence. Kaplan-Meier curves were constructed for analysis of recurrence and differences were assessed using the log-rank test. Cox proportional hazard regression was used to identify potential predictors of recurrence. RESULTS Overall, 398 intracranial meningiomas were reviewed, including 269 (68%) non–skull base and 129 (32%) skull base meningiomas (median follow-up 30.2 months, interquartile range [IQR] 8.5–76 months). The 10-year recurrence-free survival rates for patients with gross-total resection (GTR) and subtotal resection (STR) were 90% and 43%, respectively. Skull base tumors were associated with a lower proliferation index (0.041 vs 0.062, p = 0.001), higher likelihood of WHO Grade I (85.3% vs 69.1%, p = 0.003), and younger patient age (55.2 vs 58.3 years, p = 0.01). Meningiomas in all locations demonstrated an average recurrence rate of 30% at 100 months of follow-up. Subsequently, the recurrence of skull base meningiomas plateaued whereas non–skull base lesions had an 80% recurrence rate at 230 months follow-up (p = 0.02). On univariate analysis, a prior history of recurrence (p < 0.001), initial WHO grade following resection (p < 0.001), and the inability to obtain GTR (p < 0.001) were predictors of future recurrence. On multivariate analysis a prior history of recurrence (p = 0.02) and an STR (p < 0.01) were independent predictors of a recurrence. Assessing only patients with primary presentations, STR and WHO Grades II and III were independent predictors of recurrence (p < 0.001 for both). CONCLUSIONS Patients with skull base meningiomas present at a younger age and have less aggressive lesions overall. Extent of resection is a key predictor of recurrence and long-term follow-up of meningiomas is necessary, especially for non–skull base tumors. In skull base meningiomas, recurrence risk plateaus approximately 100 months after surgery, suggesting that for this specific cohort, follow-up after 100 months can be less frequent.

Hospital infection control practices known as Contact Precautions are recommended for the management of people with pathogens such as methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococci. Background: The patient is isolated, and staff are required to wear gloves, and a gown or apron when providing care. A notice is displayed to remind staff of these requirements and an ‘alert’ message is placed in the patient’s medical record. Objective: The aim of this article is to discuss and explore whether practices used in hospitals to reduce the transmission of endemic antibiotic-resistant organisms are ethically justified in today’s healthcare environment in the developed world. In order to do this, the history of the development of these practices is summarised, and the evidence base for their effectiveness is reviewed. Key bioethics principles are then discussed and contextualised from the perspective of hospital infection prevention and control, and an ethically superior model for the prevention and control of healthcare associated infection is proposed.

[pt] O presente trabalho tem como objetivos principais analisar a génese, as dinâmicas e as funcionalidades do Asilo António Almeida da Costa, fundado no início do século XX em Vila Nova de Gaia, localidade perto da cidade do Porto, no norte de Portugal, na assistência na velhice, inicialmente idealizada para os velhos operários do complexo industrial de Cerâmica e de Fundição das Devesas, e na sua iniciativa pontual: a transformação num hospital dos Tifosos aquando a epidemia que se fez sentir na cidade. Para responder a estes objetivos efectuou-se um exercício de reconstrução histórica através do acervo do benemérito, nomeadamente com base nas atas da comissão administrativa, nos regulamentos e estatutos internos e, também, no livro de inválidos internados no Asilo. Com base na informação encontrada foi possível descrever as dinâmicas da instituição na assistência à velhice, em especial no lugar das Devesas em Vila Nova de Gaia, enquadrando o importante contributo da mesma na causa pública do combate à epidemia do tifo exantemático.

Este artículo consiste en analizar una nueva alternativa de control antisísmico de alta tecnología para la construcción de hospitales en el Perú, que en su normativa exige el uso de aislamiento de base para edificaciones esenciales. Para ello, se opta por la evaluación estructural de una edificación construida con aisladores sísmicos y la misma con implementación del sistema de disipación de energía SLB (Shear Link Bozzo). Los resultados analizados, para cada técnica estudiada de control antisísmico, son: derivas de entrepiso, aceleraciones de piso, balance energético y análisis de rotulas plásticas, en base a la filosofía de funcionalidad continua.
This article consists of analyzing a new high-tech anti-seismic control alternative for the construction of hospitals in Peru, which in its regulations requires the use of base insulation for essential buildings. For this, the structural evaluation of a building constructed with seismic isolators is chosen and the same with the implementation of the SLB (Shear Link Bozzo) energy dissipation system. The results analyzed for each anti-seismic control technique studied are: mezzanine drifts, floor accelerations, energy balance and analysis of plastic hinges, based on the philosophy of continuous functionality.
Trabajo de investigación

A 71-year-old woman of Caribbean descent with a 15-year history of type 2 diabetes, hypertension, and hyperlipidemia is sent to the emergency room of a large academic medical center by her podiatrist. The podiatrist correctly suspects that a draining ulcer at the base of her left third toe indicates underlying osteomyelitis. Under the care of a primary care physician, the patient’s home diabetes regimen has been the same since diagnosis 15 years earlier: glyburide 10 mg twice daily and metformin 850 mg twice daily. The patient is admitted to a general medicine floor with a blood glucose (BG) level of 201 mg/dL (11.2 mmol/L) and is started on basal/bolus insulin therapy, intravenous (i.v.) antibiotics, and wound care. Her HbA1c is 12.2%.

Objective: to describe the profile of individuals residing in Montes Claros with oral cancer in the 2015/2019 historical series. Method: descriptive study with a quantitative approach. Clinical and epidemiological data of individuals with oral cancer residing in Montes Claros, Minas Gerais were evaluated. Inclusion criteria were data available in the system and incomplete data were excluded. An analysis of the data available in the hospital records of the Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) was carried out in the most recent historical series, and a descriptive analysis of the data was performed. The study was carried out during the month of June 2022. Results: in the analysis of the years 2015 to 2019, 312 diagnoses of oral cancer were recorded. 17.2% of individuals were female and 82.8% were male, the predominant age ranged from 50 to 69 years (55.6%), family history of cancer was negative in 37.7% of those investigated . 48.4% of the patients used tobacco or derivatives, the combined use of tobacco and alcoholic beverages was present in 83.4 of the cases. Regarding the clinicopathological variables, the highest rate corresponded to squamous cell carcinoma (97.4%), with TNM staging classified as 4 A (46.4%) more frequently and with primary location in the tongue or base of it (51, 7%). Conclusion: the data predominantly indicate male patients, aged between 50 and 69 years and without a family history of cancer, alcoholism and positive smoking, in addition to advanced carcinogenesis.

This chapter explores in detail using the examples of optometry and radiography the early development of the well-established and more mature allied health professions who have had to negotiate their professional boundaries with the state and the medical profession. In many ways, it is these early disputes and negotiations that are responsible for shaping the modern health workforce and the allied health division of labour. Optometry and radiology constitute two clear examples of professions that may be regarded as established within contemporary mainstream healthcare. One has a long pre-modern history, with a degree of autonomy built on its claim to a unique knowledge base that is independent of medicine and a track record of retail business success; the other emerged firmly rooted in hospital practice comprising technicians competing with medicine within a medical sphere of practice. Optometry, historically male-dominated, was established prior to the advent of full medical hegemony and power; radiography, mainly female, arose within it. Yet, both continue to operate within limits to a scope of practice defined by the presence of two major medical specialities with which they closely interface: ophthalmology and radiology. Both groups have a clearly limited and subordinate role in the provision of healthcare within their own spheres, and both had to concede the right to make diagnoses within their fields of expertise. It is the latter that has so clearly influenced the limitations set on the prescribing of medicines for both groups, even in the current policy climate of workforce redesign and role flexibility.

Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.