Commonplace book of Clement Weeks

Commonplace book containing a transcription of the "The Book of Harvard," a satirical account of the Butter Rebellion of 1766 followed with supplementary text of "The Arguments in Defence of the Proceedings of the Scholars" and "The Confession that was made after all was done." The above occupies pp. 1-14; pp. 15-18 missing. Pages 19-23 hold excerpts from Edward Young's Conjectures on Original Composition. Pages 24-62 hold excerpts from Saint Augustine's Heresies. Finally pages 62-64 hold an excerpt of Druidical maxims from the introduction of the first volume of Paul Rapin de Thoyras' The History of England (1724).

Chef Wyman's daily health menus /

Includes index.

Manual for managers of rural and other small school lunchrooms /

"Recipes": p. 71-226.

Hearty dishes for one hundred : suitable for hotels, boarding houses, institutions /

Mode of access: Internet.

Private school lunch management manual /

Cover title.

Foodservice cluster /

"Printed by the Authority of the State of Illinois, July 1997, 1.5M 022-41 No. 705".

Illinois pneumonia hospitalizations, 1998.

Provides hospitals, health plans, and citizens with meaningful comparative data about hospital-related illnesses and provides pruchasers with information they can use to obtain greater value for their health care purchasing decisions as they relate to pneumonia hospitalizations by presenting information and statistics on such hospitalizations for calendar year 1998 by age group, gender, payer type, hospital health service area, and trend section, covering the years 1991 through 1998.

Organizational and direct support maintenance repair parts and special tools list : kitchen, field, trailer mounted, MKT-75 (NSN 7360-00-138-7782) ... MKT-85S (NSN 7360-01-246-4646).

Includes indexes.

Equipment guide for on-site school kitchens.

Supersedes PA No. 292, "A Guide for Planning and Equipping School Lunchrooms."

Special summer program for children : site handbook.

"PA-1041."

Proceedings

Ceased publication with vol. 5. Thereafter, papers appear in Hospital social service quarterly

Development of career progression systems for employees in the foodservice industry,

"Prepared for the Manpower Administration, U.S. Department of Labor, under contract no.82-17-71-19."

The information specialist in the clinical team: Building expertise in evidence-based healthcare

The Clinician Development Program (CDP) is an initiative of Queensland Health’s Quality Improvement and Enhancement Program. At the Royal Brisbane & Royal Women's Hospital Health Service Districts, evidence-base practice (EBP) is an important CDP area in which several projects were carried out in 2002. This paper describes one such project. A medical librarian was invited to accompany the clinical team on morning rounds in the Medical Assessment & Planning Unit (MAPU). The librarian conducted information skills training in the ward and helped clinicians to answer questions directly related to patient care. Questions not answered during the round were followed-up, usually within 48 hours, and responses emailed to the consultant who led the rounds. At the project’s conclusion the librarian was invited to continue as a member of the MAPU clinical team, thus acknowledging the valuable role an information specialist can play in incorporating research evidence into patient care. Clinical librarianship (CL) creates a space, albeit a contentious one, for the health librarian at the bedside. This paper describes an Australian CL project and attempts to demystify the role of an information specialist in EBP. It also highlights some of the challenges facing librarians and clinicians attempting to embed EBP in clinical settings.

Optic disc haemorrhage audit

Poster section INTRODUCTION. Retrospective Analysis PURPOSE. To evaluate the morphology and location of optic disc haemorrhages (ODH) identified at diabetic retinopathy (DR) screening to establish whether particular ODH are predictive of ocular disease (e.g. glaucoma). METHODS. Retrospective analysis of 77 patients who presented with ODH at DR screening in the Birmingham and Black Country screening programme between June 2009-March 2010. Mean age was 71 years (range 39-89). Cup/disc ratio (CDR), location and morphology of the haemorrhage were recorded. The outcome of the referral and the status of the ODH were followed up a year later. RESULTS. Of the 77 referred, 34 patients were unassessed for possible glaucoma. Of the 43 patients that were assessed in the hospital eye service for glaucoma, 11 (26%) were diagnosed with glaucoma. These glaucoma patients mostly presented with flame haemorrhages (64%) and blot haemorrhages (36%). Haemorrhages tended to adjoin the margin of the OD (64%), and were more commonly flame shaped (64%). They less commonly occurred in the optic disc itself (36%), and were all blot shaped. The OD Cup/disc ratio (CDR) of the patients with glaucoma (n=11) ranged from 0.33-0.57. It is interesting to note the highest CDR was 0.68 in the 77 patients referred. 32 patients were confirmed as not having glaucoma. 24 (75%) of these patients presented with an ODH adjoining the margin, of which 20 (83%) were flame, and 4 blot (17%) shaped. Only 8 (25%) presented with an ODH in the OD, of which 6 (75%) were blot shaped. One year follow up of the 77 referred cases revealed that the ODH resolved in 45 (57%) patients while 10 (13%) still had an ODH present. 15 (21%) were still under ophthalmology hence digital retinal photos were not available for assessment. Six patients (8%) (age range 71-91 years) died within the year, and one lost to follow up. CONCLUSIONS. The results suggest that a significant number of patients with ODH have glaucoma and that the differing morphology of the haemorrhage is not a major predictor i.e. blot versus flame shaped, adjoining or in the optic disc. The cup/disc ratio did not predict glaucoma either.

The significance of microaneurysms and haemorrhages within one optic disc diameter of the fovea

Free paper session INTRODUCTION. Microaneurysms and haemorrhages within the macula area are a poor predictor of macular oedema as shown by optical coherence tomography (OCT). Our research suggests that it is safe and cost effective to screen patients who present with these surrogate markers annually. PURPOSE. To determine whether microaneurysms (ma) and haemorrhages (hm) within one optic disc diameter of the fovea (ma/hm<1DD) are significant predictors of macular oedema. METHODS. Data were collected over a one-year period from patients attending digital diabetic retinopathy screening. Patients who presented with ma/hm<1DD also had an OCT scan. The fast macula scan on the Stratus OCT was used and an ophthalmologist reviewed the scans to determine whether macular oedema was present. Macular oedema was identified by thickening on the OCT cross-sections. Patients were split into two groups. Group one (325 eyes) included those with best VA?6/9 and group two (30 eyes) with best VA =6/12. Only patients who had no other referable features of diabetic retinopathy were selected. RESULTS. In group one, 6 (1.8%) out of 325 eyes showed thickening on the OCT and were referred to hospital eye service (HES) for further investigation. In group two, 6 (20%) out of 30 eyes showed thickening and were referred to HES. CONCLUSIONS. Ma/hm<1DD become more significant predictors of macular oedema when VA is reduced. Results confirm the grading criteria concerning microaneurysms predicting macular oedema for referable maculopathy in the English national screening programme. OCT is a useful method to accurately identify patients requiring referral to HES.