R-intrusion in british hospitals

Introduction: The utilization of the post-traumatic stress disorder PTSD diagnostic spectrum is currently being debated to categorize psychological adjustment in cancer patients.

The aims of this study were to: 1 evaluate the presence of cancer-related traumatic dissociative symptomatology in a sample of cancer patients; 2 examine the correlation of cancer-related dissociation and sociodemographic and medical variables, anxiety, depression, and post-traumatic stress symptomatology; 3 investigate the predictors of cancer-related dissociation.

Methods: Ninety-two mixed cancer patients mean age: Results: A stepwise regression analysis was performed in order to find the predictors of cancer-related traumatic dissociative symptomatology. Conclusion: These findings allow us to hypothesize a specific psychological reaction which may be ascribed to the traumatic spectrum within the context of cancer, emphasizing the close relationship between the origin of dissociative constituents which, according to the scientific literature, compose the traumatic experience.

Our results have implications for understanding dissociative symptomatology in a cancer population and can help develop clinical programs of prevention and support for patients.

Keywords: cancer; dissociative symptoms; peritraumatic dissociation; post traumatic stress disorder; psychoncology.

Abstract Introduction: The utilization of the post-traumatic stress disorder PTSD diagnostic spectrum is currently being debated to categorize psychological adjustment in cancer patients.Lauren Frayer. Protesters marched in London on Feb. When Erich McElroy takes the stage at comedy clubs in London, his routine includes a joke about the first time he went to see a doctor in Britain. Originally from Seattle, McElroy, 45, has lived in London for almost 20 years.

A stand-up comedian, he's made a career out of poking fun at the differences in the ways Americans versus Britons see the world — and one of the biggest differences is their outlook on health care. But I still hadn't really done any paperwork.

I was like, 'This isn't right! McElroy acknowledges it doesn't sound like much of a joke. He's just recounting his first experience at a U.

But Britons find it hilarious, he says, that an American would be searching for a cash register, trying to find how to pay for treatment at a doctor's office or hospital. It's a foreign concept here, McElroy explains.

Onstage, McElroy recounts how, when the hospital receptionist instructed him to go home, he turned to her and exclaimed, "This is amazing! Amazing, he says, because he didn't have to pay — at least not at the point of service. That means everything from ambulance rides and emergency room visits to long hospital stays, complex surgery, radiation and chemotherapy — are all free. They're paid for with payroll taxes. In addition, any medication you get during a hospital visit is free, and the cost of most prescription drugs at a pharmacy are cheap — a few dollars.

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Private health care also exists in the U. Since the financial crisis, the U. Its expenditure on the National Health Service has still grown, but at a slower pace than before. That means drugs are now being rationed. Tens of thousands of operations have been postponed this winter. Wait times at the emergency room are up, says Richard Murraypolicy director at the King's Fund, a health care think tank.

In recent months, there have been several "Save the NHS" marches across Britain, where thousands have demonstrated to demand improved care and more funding for the health system. One such march, on Feb. Two days later, Trump tweeted that the NHS is "going broke and not working. No thanks! The Democrats are pushing for Universal HealthCare while thousands of people are marching in the UK because their U system is going broke and not working.

Dems want to greatly raise taxes for really bad and non-personal medical care. That tweet offended many in Britain. The U.Metrics details. Prior reports suggest that restrictive ICU visitation policies can negatively impact patients and their loved ones.

However, visitation practices in US ICUs, and the hospital factors associated with them, are not well described. A telephone survey was made of ICUs, stratified by US region and hospital type community, federal, or universitybetween and Hospital characteristics were self-reported and included the hospitals' bed number, critical care unit number, and presence of ICU leadership.

Hospital and ICU visitation restrictions were based on five criteria: visiting hours; visit duration; number of visitors; age of visitors; and membership in the patient's immediate family. Hospitals or ICUs without restrictions had open visitation policies; those with any restriction had restrictive policies.

The study surveyed hospitals in the Northeast Among restrictive ICUs, the bed size, hospital type, number of critical care units, and ICU leadership were not associated with the number of restrictions. On average, hospitals in the Midwest had the least restrictive policies, while those in the Northeast had the most restrictive. Wide variability in visitation policies suggests that further study into the impact of ICU visitations on care and outcomes remains necessary to standardize practice.

Critical illness and intensive care have a profound and traumatic impact on the health and well-being of patients and their loved ones [ 1 — 3 ]. Previous reports suggest that many patients in the ICU are separated from their families and loved ones by widespread restrictive visitation policies that can negatively impact care and recovery [ 3 — 6 ].

However, limited data exist about the scope and variability of ICU visitation policies and practices across the United States as well as the hospital factors that influence them [ 7 — 10 ]. We further aimed to evaluate whether key hospital characteristics were associated with visitation restrictions. Based on the American Hospital Association Hospital Survey Database, we grouped hospitals as either university-affiliated hospitals, federal government Veterans Health Administration hospitals, or nonfederal and nonuniversity community hospitals.

We aimed to survey all university and government hospitals with an ICU. For each hospital, we contacted the ICU leadership, if available, or ICU nursing staff familiar with visitation policies to conduct the telephone survey from to If a hospital's ICU personnel could not be identified or declined survey participation, the next hospital in the randomly generated sample by strata was surveyed.

The question survey ascertained hospital characteristics including each hospital's self-reported number of beds total and ICU and critical care units; if numbers were reported as a range for example, 25 to 30 bedswe selected the mean value 28 beds.

We calculated the percentage of critical care beds within each hospital ICU bed percentage. We also ascertained the presence or absence of ICU leadership medical director or clinical nurse specialist.

r-intrusion in british hospitals

Clinical nurse specialists typically have received training at the level of a master's degree and often take a lead role in staff education, protocol development, and standardizing nursing care based on current evidence.

We assessed visitation policies based on whether the hospital or ICU placed restrictions based on a total of five criteria: visiting hours; visit duration; number of visitors; age of visitors; and membership in the patient's immediate family. We designated hospitals with zero restrictions as having open visitation policies and those with any restriction as having a restricted policy.

Visitation policies and practices in US ICUs

We also determined whether exceptions to the visitation policies were allowed within the ICU. We used Spearman's correlation coefficient to assess the intra-hospital correlation between the number of hospital and ICU visitation restrictions.By cclark healthleadersmedia. The spotlight is shining on infection control chiefs. It's a big responsibility, especially with continued pressure from federal reports that remind inpatients that one in 20 of them will contract a hospital-acquired infection, with annual direct medical costs to U.

On Monday, 4, such professionals are expected to discuss the issues on their minds and perhaps share some solutions as the Association of Professionals in Infection Control and EpidemiologyAPIC kicks off its annual conference in Baltimore.

What's uppermost on their minds? What do they think are the most pressing problems, issues and concerns they hope to address? Infection control experts shared their toughest challenges:. Parodi said that C. An important undertaking within Kaiser hospitals and many other facilities across the country is how to empower nurses to recognize patients with diarrhea as potentially harboring C.

It's almost one-sixth of the people are not alive in a year. And remember, it's not the thing the patient originally came in with. But experts agree that improving and then sustaining good hand-washing practices is an ever-present challenge. To make it easier, patient units can be revamped at minimal expense so that dispensers are placed as conveniently as possible to patient care practices, and become an automatic step for the care provider entering and leaving the room.

But next up is to create a system to monitor healthcare workers' handwashing practices without creating a system in which workers instinctively wash their hands only when the monitors — whose identities will quickly become known — are present. And some workers will object to a big-brother intrusion on their practices.

We don't tolerate unsterile conditions in the operating room, and that's audited I don't see this as any different just because a patient on a regular hospital floor, why shouldn't we expect the same standards? Parodi and others discussed technology that uses electronic means to conduct hand hygiene surveillance, perhaps with a radiofrequency tag. Some of these products have yet to be thoroughly tested.

View the discussion thread.

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Scott Jensen, R-Minn. Healthcare creatednew jobs inup fromjobs in The figures includejobs in ambulatory services andhospital jobs. Extracorporeal membrane oxygenation provides life support for coronavirus patients suffering respiratory failure.

A team of Canadian scientists believes it has found strong strains of cannabis that could help prevent and then treat coronavirus infections, according to interviews and a study. Get the latest on healthcare leadership in your inbox. Tagged Under:. Read More.Saturday, 30 June Italian triphthongs? In a discussion on the history of the terms smoothing and compressionJack Windsor Lewis, in an article published on the 25 th of Junesaid:. The last sentence in the quote above I find a bit baffling.

Does Italian really have triphthongs? According to a traditional view shared by the majority of linguists in Italy, a true triphthong is a sequence of three vowel sounds belonging to the same syllable. Buoi is not a word 'containing' a true triphthong but just a sequence of sounds consisting of a semivowel plus a falling diphthong. Like buoiterms such as mieisuoiguaiaiuolacontinuiamoand quiete all exhibit similar phonetic features.

r-intrusion in british hospitals

Why then do most Italian writers consider these good examples of words 'containing' a triphthong? The answer, I think, is to be found in the fact that grammarians and linguists in Italy have always been traditionally too much 'attached' to the orthography of words and only rarely have they paid attention to the actual phonetic reality of the language.

A term like buoi DOES, of course, have three vowels but it's three vowel letters not sounds! The same can be said of all the other examples I gave above. It is perhaps not surprising to hear that some primary school teachers, when wanting to explain to their pupils how many vowels we use in Italian, often provide the noun aiuole 'hedges' as an example.

This, they claim, is an 'excellent' word as it contains all the vowels of Italian. But again they don't realise that they're talking about letters, not sounds! As I see it, triphthongs in Italian are a no-no, but you might disagree with me. Saturday, 23 June r-intrusion in British hospitals.

The answer is yes, at least in non-rhotic accents. In LPD3 p. The phrase, which at first sounded completely incomprehensible to them, only became clear when I gave my students the chance to look at the audioscript in the book. These examples show us once again that teaching English pronunciation in EFL is absolutely vital and that failing to do so may mean depriving our students 'of the right' to understand English as it is spoken by native speakers.

What this transcription also shows is that, according to the editors, the word in question is usually perceived as being disyllabic by British native speakers.

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If one looks up other varisyllabic words in the dictionary, words that is in which smoothing and compression are both possible and indeed extremely common in current RP, one finds a great deal of inconsistency:.

Why all this inconsistency? The answer is to be found in the introduction to the CEPD, pp. Some triphthongs are pronounced like single syllables, as in the example just given, while others are more likely to be divided into two syllables ….

We usually find the two-syllable pronunciation i when the schwa is a separate morpheme e.

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Where we feel a triphthong may be pronounced either as two syllables or as one, we give one pronunciation with a syllable division and an alternative with a one-syllable pronunciation.

What does "seems more likely" in the last sentence mean?

r-intrusion in british hospitals

A bit confusing for foreign learners of English, I think. What is the rationale behind these choices? Can word frequency be a valid reason for transcribing the above words as disyllabic in some cases and monosyllabic and smoothed in others?

Saturday, 2 June Ca p pannoni in Emilia Romagna.As they are attested as occurring in Spanish, Portuguese and Romanian it wdnt be at all surprising if triphthongs were found to occur in some dialects of Italian but as far as one knows, none have been claimed to exist other than the one attested by Jones.

Breaking Point: The Crisis in Britain’s Hospitals – BBC Newsnight

He no longer included that comment after his second edition of but we dont know why. He woudnt've been likely to take it on trust and the most likely person for him to have discust the matter with wd've praps been Amerindo Camilli a Marche native who published in under Jones's editorship An Italian Phonetic Reader.

Spanish has as many triphthongs as Italian does: none. Spanish words like buey contain the sequence of a consonant and a diphthong: [wei], which -- just like in Italian as Alex pointed out -- might become disyllabic in slow speech: [u'ei], which isn't a triphthong, either. The idea of analyzing a phonetic sequence of sounds that never make up a true triphthong as a phonemic triphthong doesn't sound reasonable to me. Is it because the vowel turns into a consonant in order to avoid a triphthong?

In any case, I have always been told that we have a triphthong in Spanish "buey" -Could we say, then, that a triphthong would be a sequence of a consonantal vowel followed by a diphthong? Those consonants necessarily become vowels, because [w] or [j] couldn't constitute a syllable nucleus: [bw'ei] is ill formed, so it turns into [bu'ei]. A diphthong by definition can consist of nothing but two vowels.

r-intrusion in british hospitals

Likewise, a triphthong can consist of nothing but three vowels. Since [w] and [j] are clearly not vowels and thus not at all interchangeable with [u] and [i], respectivelyno sequence containing them should be called legitimately a diphthong or a triphthong as doing so would violate the definitions.

Under no circumstances can we consider sequences like [we, je, aj, aw; wei, jei, aja, awa] valid diphthongs and triphthongs.

Coronavirus: Boris Johnson admitted to hospital over virus symptoms

At least we can't if we keep the definitions in mind. As a consequence, words like Spanish bueno or Italian buono do not have phonetic diphthongs, either.

A valid triphtong would be e. It is always the first member of a diphthong or triphthong that is the most prominent, since if the second or third vowel were more prominent, they'd be more stressed than the previous one sin other words: they'd start a new syllable [u'e, u'ei]which is obviously incompatible with the one-syllable concept of diphthongs and triphthongs. Unfortunately common practice too often disregards definitions I see what you mean, yes.

On the other hand, they are referred to as "semivocales" when "at the end of a diphthong: aire, aceite, causa, feudo". I think these articles use the word vocal in an orthographic sense rather than a phonetic one, because this word can be used also as an abbreviation for letra vocal 'vowel letter', i.

Misleading and confusing. Well, I understand that the mark "FON. Maybe the gentlemen were referring to the fact that the segment begins as something like a consonant and ends as a vowel, and vice versa; couldn't this make sense at a phonetic level? Yes, you're right: I overlooked "FON.Either your web browser doesn't support Javascript or it is currently turned off. In the latter case, please turn on Javascript support in your web browser and reload this page.

Two studies examined peritraumatic symptoms due to war-related stress among hospital personnel with different affect types. In Study 1, we examined 80 Israeli hospital personnel during the period they were exposed to frequent missile attacks in the Second Lebanon War. In both studies, hospital personnel completed measures of posttraumatic stress disorder symptoms as well as of positive- and negative-affect items PA and NA, respectively.

Exposed personnel with a positive congruent high PA and low NA or a deflated incongruent low PA and low NA affective types had a lower level of peritraumatic symptoms compared to those with a negative congruent low PA and high NA or an inflated incongruent high PA and NA affective types. Study 2 further showed that among non-exposed personnel, only personnel with a negative congruent affective type had a higher level of peritraumatic symptoms compared to personnel with other affective types.

Clinical implications and required future studies are discussed. A substantial amount of literature is available on the harmful effects of exposure to extreme traumatic stress.

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PTSD is related to impairment in major functioning facets physical, emotional, cognitive, and social as well as to other psychiatric conditions such as depression, anxiety, and somatic symptoms Kessler, ; Yehuda, Moreover, according to the dose—response model, repeated and continued extreme exposure to casualties and dead bodies is directly related to a worsened functioning March, However, although the previous studies examined mostly traumatic symptoms that predict well-being, the present studies refer to well-being as a mode of adaptation and therefore as an independent variable.

Subjective well-being SWB broadly refers to personal evaluations that people make about their lives. Recent findings indicate that different SWB dimensions e. Shmotkinsuggested that by cross-tabulating different SWB dimensions or intradimensional components, one can better capture the differential nature of SWB. Thus, the emotional affective typology has been delineated by cross-tabulating PA and NA as presented ahead. The present studies focuses on this typology.

The cross-tabulation of low and high PA and NA levels creates four affective types: two congruent cells 1 and 4 and two incongruent types cells 2 and 3 see Fig. Affect typology according to Shmotkin The congruent types reflect a dominance of one affect over the other and, therefore, can be characterized by a consistent affective valence.


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