Enhancing pnemonia surveillance in acute care facilities in post SARS era : a Canadian hospital surveillance study, 2003-2004 influenza season

A retrospective study of patients hospitalized with influenza and/or pneumonia in a Niagara area community hospital for the influenza season 2003-04 was designed with the main goal of enhancing pneumonia surveillance in acute care facilities and the following specific objectives: 1) identify etiologies, factors, and clinical presentation associated with pneumonia; 2) assess the ODIN score on ICU patients to predict outcomes of severe pneumonia; 3) identify the frequency of pneumonia and influenza in a hospital setting; and 4) develop a hospital pneumonia electronic surveillance tool. A total of 172 patients' charts (50% females) were reviewed and classified into two groups: those with diagnosis of pneumonia (n=132) and those without pneumonia (n=40). The latter group consisted mainly of patients with influenza (85%). Most patients were young (<10yrs) or elderly (>71yrs). Presenting body temperature <38°C, cough symptoms, respiratory and cardiac precomorbidities were common in both groups. Pneumonia was more frequent in males (p= .032) and more likely community-acquired (98%) than nosocomial (2%). No evidence of ventilator-associated pneumonia was found. Microbiology testing in 72% of cases detected 19 different pathogens. In pneumonia patients the most common organisms were Streptococcus pneumoniae (3%), Respiratory syncytial virus (4%), and Influenza A virus (2%). Conversely, Influenza A virus was identified in 73% of non-pneumonia patients. Community-acquired influenza was more common (80%) than nosocomial influenza (20%). The ODIN score was a good predictor of mortality and the new electronic surveillance tool was an effective prototype to monitor patients in acute care, especially during influenza season. The results of this study provided baseline data on respiratory illness surveillance and demonstrated that future research, including prospective studies, is warranted in acute care facilities.

Heidegger's tragic Greeks : the relation between presence and deinon

Martin Heidegger's interpretation of the ancients was born out of something like a crisis in the interpretation of the Greeks, which can be characterized as nothing other than the realization of the idea that the Greek philosophers put a serious question mark over existence. This idea, which had its germination in Prussia with Jakob Burckhart and his teacher, but first came to be seriously cultivated in the Philosophy of Friedrich Nietzsche, was the first in depth investigation into whether the Greeks, on the one hand, questioned existence or, on the other hand, put a question mark over existence. To question existence is rather innocuous, since it amounts to little more, in the end, than a child looking up at the stars and asking what it all means. To put a question mark over existence, however, is another business entirely. For the Greeks, as the life work of Martin Heidegger amply demonstrates, the nature of Greek thinking and the objects towards which it is directed follows so absolutely from the tragic view of the human person that, in a certain sense, philosophy is Greek and could only have developed in Greece. Perhaps stating it a little less categorically, philosophy could have developed elsewhere at least to the extent that something like they way the Greeks understood life was at the forefront: presence, in other words. This thesis deals with the problem ofHeidegger's relation to the Greeks, specifically in terms of his understanding of the Greeks and presence. It is the position of this dissertation that the Greek notion of presence is, as Heidegger understands it, the homeliness of the hearth that radiates through all the things that humans concern themselves with. This is thought by Heidegger, as the Greeks did, specifically in contrast with the uncanninesslunhomeliness of the hqrnan apart from his or her concern with things. Therefore, the thesis is an attempt at exposing the relation between presence and the unhomely by situating it withing Greek existence and the meaning of the Greek Philosopher. In order to support this position, the thesis has been divided into five parts. The first two chapters deal with Heidegger's explanation of the relation between Greek notion of physics (Phusis), metaphysics (specifically in relation to an analysis of time and motion in Greek thought), and what Heidegger calls the fundamental attunement of Dasein (boredom). More exactly, it deals with these issues only so far as they allow us to bring out something like the notion of 'presence' in relation to things and homelessness or restlessness in relation to the human being. The rationale for these two chapters in relation to the central problem of the paper is that in Heidegger's elucidation of physics and metaphysics, he conducts his analysis in such a way that he explicitly uncovers that dimension of human existence that he calls the fundamental attunement of Dasein. This fundamental attunement is, in tum, similar to what the Greeks understood as the deinon, the uncanninesslunhomeliness of the human. The third and fourth chapters take as their explicit themes the problem of the Greek understanding of the assertion and the ways in which the person can comport himlherself toward things, two issues which are not separable. The rationale for these two chapters in relation to the central theme of the paper is that Heidegger's analysis of these two areas in Greek thought brings out precisely why the philosopher and the philosophical way of life is the highest mode of existence for the Greeks and how this is thought specifically in tenns of the uncanniness of humans. The final cijapter gives a complete elucidation of presence as the homeliness of the hearth and shows specifically how this is thought of in contradistinction to the uncanny/unhomely for the Greeks. 1I1 This last chapter also explains Martin Heidegger's reaction to the Greek's interpretation of the highest mode of existence, and what he posited as a counter-thought. The essay as a whole is an attempt to fully concertize an important dimension of Heidegger' s understanding of the Greeks, that is, the relation between presence and the deinon or Greek notion ofunhomely, which, to my la)owledge, has not been offered anywhere in commentaries on Heidegger.