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7 results

  • Understanding hospital and emergency department congestion: an examination of inpatient admission trends and bed resources

  • Hannah J. Wong, Dante Morra, Michael Caesar, Michael W. Carter, Howard Abrams
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 12 / Issue 1 / January 2010
    Published online by Cambridge University Press:
    21 May 2015, pp. 18-26
    Print publication:
    January 2010
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  • Objective:

    Patients in the emergency department (ED) who have been admitted to hospital (inpatient “boarders”) are associated with ED overcrowding. They are also a symptom of a hospital-wide imbalance between demand and supply of resources. We analyzed the trends of inpatient admissions, ED boarding volumes, lengths of stay and bed resources of 3 major admitting services at our teaching institution.

    Methods:

    We used hospital databases from Jan. 1, 2004, to Dec. 31, 2007, to analyze ED visits that resulted in admission to hospital.

    Results:

    During the study period, 21 986 ED patients were admitted to hospital. The percentage of cancer-related admissions to the oncology admitting service decreased from 48% in 2004 to 24% in 2007, and admissions to general internal medicine (GIM) increased nearly 2-fold, from 28% in 2004 to 54% in 2007. In addition, GIM admitted about 10% more myocardial infarction and heart failure patients than did cardiology. General internal medicine constituted the majority of ED boarders and had a median boarding length of stay of approximately 15 hours. Inpatient beds on oncology and cardiology services remained static.

    Conclusion:

    Without bed capacity to admit more patients, our specialty services relied on GIM to serve as a safety net. At the same time, GIM was cited as a main source of ED congestion as their patients occupied more ED beds for longer periods than any other admitting service. The data presented in this study has helped effect positive change within our institution. Other hospitals running at or near capacity and faced with similar ED congestion may apply the methods we used in this study to analyze the cause and nature of their situation.

  • 9 - Eco and Joyce

  • Edited by Peter Bondanella, Indiana University
  • Book:
    New Essays on Umberto Eco
    Published online:
    26 January 2010
    Print publication:
    02 July 2009, pp 141-156

  • Summary

    Umberto Eco's career as a writer, scholar and philosopher reflects a lifelong engagement with the writings of James Joyce. Eco's encounters with Joyce in his “pre-semiotic” phase were both critical and creative, occasional as well as substantial. Eco also made very specific semiotic uses of Joyce. Early in his career, Eco examined Joyce in an important essay that formed part of the original Italian edition of his Open Work: Form and Indeterminancy in Contemporary Poetics (1962), now entitled in English as The Aesthetics of Chaosmos: The Middle Ages of James Joyce (1989). The young Eco found aspects of Joyce's character Stephen Dedalus congenial, but the interaction of medievalism and modernism in the mature Joyce constitutes a model to which Eco constantly returns. Indeed, the patterning of cultural history discernible in Eco's first three novels, foreshadowed in his reading of Joyce's medievalism, lends a character of hesitancy to the history that is narrated there.

    1954–68: CRITIAL AND CREATIVE ENCOUNTERS WITH JOYCE

    Eco worked on Joyce during the 1950s. There are allusions to the Irish writer in his degree thesis of 1954 on Saint Thomas Aquinas (first published in 1956 in Italian, revised in 1970, and now available in English as The Aesthetics of Thomas Aquinas [1988]). Eco's principal points of reference in his thesis – understandably, in view of his focus on Thomas Aquinas – were the abandoned autobiographical novel Stephen Hero and its successor, Portrait of the Artist as a Young Man. Their use is evidence of Eco's interest in the Thomist, and more generally Aristotelian, foundations of Joyce's poetics.

  • Manzoni and Leopardi—Kenelm Foster's Interpretation

  • Michael Caesar
  • Journal:
    New Blackfriars / Volume 67 / Issue 798 / October 1986
    Published online by Cambridge University Press:
    02 April 2024, pp. 432-435
    Print publication:
    October 1986
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  • To a former student like myself, to whom Kenelm’s conversation about the Italian Ottocento was as stimulating over the years as his teaching on the subject had been sure and authoritative in undergraduate and postgraduate days, it was always something of a shock to remember how relatively little he had published in this area of Italian literature. Two major essays, both of which started life as lectures, two invaluable translations, a scattering of lesser articles and reviews—these, combined with his presence as teacher and talker, were enough to ensure his status as an indispensable point of reference in any discussion of the early nineteenth century in Italy.

    The two lecture-essays—on the idea of truth in Manzoni and Leopardi (1967) and in commemoration of Manzoni on the centenary of his death (1973)—are not so much the report of specific pieces of research as syntheses, dense and sometimes tense, of what Kenelm judged to be the most important things he had to say about the subject. And the subject mattered to him a lot. Manzoni was important because, as he put it in the centenary lecture, he was ‘that uncommon thing, a considerable Christian artist’—adding in pen to his own copy the word ‘very’ before ‘considerable’—and Leopardi was in some sense his antithesis. What Kenelm had in mind when he thought about Christian art is discussed elsewhere in this issue.