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Washe A.P.,Rovira i Virgili University | Lozano-Sanchez P.,Integrated Quality | Bejarano-Nosas D.,Rovira i Virgili University | Katakis I.,Rovira i Virgili University
Electrochimica Acta | Year: 2013

Screen printed carbon electrodes provide attractive opportunity for the development of miniaturized low cost electrochemical sensors. However, the electrodes display very low level of electrochemical performance due to the nonelectroactive components in the ink formulation and relatively low graphitic carbon content imposed by the constraints of screen-printing. In this work, selective etching action of a judiciously selected organic solvent was envisaged to improve the electrochemical characteristics of the electrodes. The procedure involves soaking the electrode strips in N,N-dimethylformamide (DMF) for just minutes of etching followed by drying. Five minutes DMF treated electrode, for instance, showed a 100-fold increase in the heterogeneous charge transfer kinetics compared to the untreated electrodes. The effective area of the solvent treated electrode was 57-fold of its apparent geometric area. The solvent treated electrodes also showed a dramatically decreased charge transfer resistance from ca. 18,000 Ω to 180 Ω. The results of surface examination using scanning probe microscopy and electrochemical impedance spectroscopy revealed enhancement in the porosity of the solvent treated electrodes. The procedure is versatile and applicable to other screen-printed electrodes such as gold, silver or silver/silver chloride to improve the performances characteristics including stability. The ability to activate several electrodes simultaneously and multiple re-usability of the solvent makes this approach cost effective and very promising to facilitate mass production of miniaturized and disposable electrochemical sensors. © 2012 Elsevier Ltd. All rights reserved.

Freeman E.,University of Southern Maine | McGuire C.A.,Integrated Quality | McGuire C.A.,University of Southern Maine | Thomas J.W.,University of Southern Maine | Thayer D.A.,University of Michigan
Medical Care | Year: 2014

Background: Persons with behavioral disorders incur higher healthcare costs. Although they utilize behavioral health (BH) services others do not, they also have higher utilization of medical services Objectives: To determine the degree to which higher costs for persons with BH disorders are attributable to utilization of BH services, multiple chronic medical conditions (CMCs) or other issues specific to populations with BH disorders. Research Design: Data base consisted of claims for 63,141 Medicaid beneficiaries, 49% of whom had one of 5 categories of BH disorder. Generalized linear models were used to identify relative impact of demographics, BH status, multiple CMCs and primary care access on total, behavioral, nonbehavioral, and medical/surgical costs. Results: Number of CMCs was associated with significant increases in all cost categories, including behavioral costs. Presence of any BH disorder significantly influenced these same costs, including those not associated with BH care. Effect size in each cost category varied by BH group. Conclusions: BH status has a large impact on all healthcare costs, including costs of medical and other non-BH services. The number of CMCs affects BH costs independent of BH disorder. Results suggest that costs might be reduced through better integration of behavioral and medical health services. © 2014 by Lippincott Williams & Wilkins.

Davies D.,John Dossetor Health Ethics Center | Davies D.,University of Alberta | Hartfield D.,University of Alberta | Hartfield D.,Integrated Quality | Wren T.,Stollery Childrens Hospital
Paediatrics and Child Health (Canada) | Year: 2014

OBJECTIVE: To describe the clinical course of all infants and children hospitalized for six consecutive months (180 days) or longer at a tertiary/quaternary children's hospital in Western Canada.METHODS: A retrospective review of medical records for all eligible patients from January 1, 2007 to December 31, 2012 at Stollery Children's Hospital (Edmonton, Alberta) was performed.RESULTS: A total of 61 patients experienced 64 eligible hospitalizations. The mean length of stay was 326 days, corresponding to a cumulative 20,892 hospital days (57.2 patient-years). Prevalent procedures resulting in long hospitalization were long-term tracheostomy ± ventilation in 32 (52%) patients, need for organ transplantation in 24 (39%) with completed transplantation in 15 (25%), and ventricu- lar-assist devices (VADs) in seven (11%). Sixteen (26%) patients in the study group died, and 16 (26%) were placed in long-term care or out-of-home care at the end of their long hospitalization. Of children displaced from their family home, 14 (88%) were Aboriginal.CONCLUSION: Infants and children who experience very long hospitalizations have complex illnesses, with substantial risk for mortality and a high rate of displacement from their families after discharge. Aboriginal children appear to be particularly vulnerable to displacement and problem solving for this population must be undertaken, involving a variety of stakeholders. © 2014 Pulsus Group Inc. All rights reserved.

Phillips I.D.,Integrated Quality | Phillips I.D.,University of Saskatchewan | Parker D.,AquaTax Consulting and 1204 Main Street | Hoemsen B.M.,University of Saskatchewan | And 2 more authors.
Western North American Naturalist | Year: 2013

During research on brook trout (Salvelinus fontinalis [Mitchill]), we collected larval and pupal specimens of the midge Odontomesa fulva (Kieffer) (Diptera: Chironomidae) from Pine Cree Creek, in the Cypress Hills area of the Northern Great Plains of Saskatchewan, Canada. This record is the first observation of O. fulva from the province. The larvae of the population of O. fulva in this study prefer shallow pools in this first-order, cold water stream. The species displays a univoltine emergence phenology. This range extension of O. fulva highlights and reinforces the importance of the Cypress Hills to the unique aquatic faunal biodiversity and ecology of Saskatchewan and the Northern Great Plains.

McAlister F.A.,University of Alberta | Bakal J.A.,University of Alberta | Majumdar S.R.,University of Alberta | Dean S.,Data Integration Measurement and Reporting | And 4 more authors.
BMJ Quality and Safety | Year: 2014

Purpose: Whether improving the efficiency of hospital care will worsen post-discharge outcomes is unclear. We designed this study to evaluate the General Internal Medicine (GIM) Care Transformation Initiative implemented at one of the seven teaching hospitals in the Canadian province of Alberta. Methods: Controlled before-after study of GIM patients hospitalised at the University of Alberta Hospital (UAH, intervention site, n=1896) or the six other teaching hospitals in Alberta - three in Edmonton (intra-regional controls (IRC), n=4550) and three in Calgary (extra-regional controls (ERC), n=4095). The primary effectiveness outcome was risk-adjusted length of stay (LOS) and the primary safety outcome was 'mortality during index hospitalisation or all-cause readmission or death within 30-days of discharge'. Results: LOS for GIM patients decreased by 0.68 days at Alberta teaching hospitals between 2009 and 2012; GIM patients hospitalised at the UAH exhibited a further 20%relative decline in adjusted LOS (total reduction=1.43 days, 95% CI 0.94 to 1.92 days) from PRE to POST. Interrupted time series (ITS) confirmed that the 1.43 day reduction at the UAH was statistically significant (level change p=0.003), while the declines at the IRC (p=0.37) and ERC (p=0.45) were not. Our safety outcome did not change for UAH patients (18.4% PRE-intervention vs 17.8%POST-intervention, adjusted OR 1.02 (95%CI 0.80 to 1.31), p=0.42 on ITS), nor for those hospitalised at the IRC (p=0.33) or the ERC (p=0.73) sites. Conclusions: The Care Transformation Initiative was associated with substantial reductions in LOS without increasing post-discharge events commonly quoted as proxies for quality.

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