A system is a collection of entities (ie, widgets, molecules, people, businesses) that interact in such a way that their resulting collective behavior is not immediately apparent by viewing the collected items separately. Hospital-based health care meets the definition of a system, but further specification is helpful to describe the value of components in the system. Complexity science offers a chance to reconceptualize our understanding of health care to an environment of connected parts operating together and adapting on the basis of inputs and outputs. The purpose of this conceptual article is to apply complexity science principles to acute care physical therapy in order to provide perspective on the value of the physical therapist in the hospital environment and on the contextual factors that influence the profession's value. We present a model, the Socio-Ecological Model for Acute Care, and apply this model to physical therapy in order to describe the interrelated factors influencing the profession's value to individual patients, to the hospital units on which they practice, to the hospital system as a whole, and how they contribute to policy discussions. Yet, this value is difficult to distinguish due to the multifarious inputs into the system. Providing a clear description of the value of physical therapy in hospital settings is essential in our current health care environment that is increasingly cost-conscious. We provide perspective for clinicians and health care leaders while suggesting needs for future research.
From 1964 to 1966, live-trapping was conducted in a mixed hardwood-cedar swamp forest located 24 kilometer’s from Quebec city, Canada, to measure density and home range of the snowshoe hare. In 1964-1965, a classic square grid with traps at 100-meter intervals was used on 24 hectares, and 17 different individuals were caught at least four times. In 1966, this grid was replaced by an hexagonal grid where each trap is equidistant from all its neighbours (100 meters). Fifteen hares were captured at least four times on a 30 hectares area. With both methods, the population density was estimated at one hare per hectare and the home range at 4.4 hectares. No significant relationship was detected between the size of the home range and the sex of the animals, the type of habitat or the number of recaptures.
Introduction The purpose of this study was to identify the timing and nature of complications associated with distal femur fracture surgery in patients aged 65 and older using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Methods The ACS NSQIP database was queried for adults aged 65 and older who received surgical treatment for a distal femur fracture between 01 January 2015 and 31 December 2021. Cox regression models and risk tables adjusted for baseline clinical characteristics were created for 14 complications (Superficial Surgical Site Infection (SSI), Deep SSI, Organ/Space SSI, Pneumonia, Pulmonary Embolism (PE), Deep Venous Thrombosis (DVT), Urinary Tract Infection (UTI), Stroke/Cerebrovascular accident (CVA), Myocardial Infarction (MI), Renal Failure, Cardiac Arrest (CA), Re-operation, Sepsis, and Death within 30 days of surgery). Model summaries were used to identify significant variables with a Bonferroni correction applied. Results A total of 3956 adults met inclusion criteria and were included in analysis. The most common complications were UTI (5.2%), death (4.1%), and pneumonia (3.4%). Complications typically occurred within 14 days after surgery, except for SSI, which occurred between post-op days 11 and 24. Conclusions Distal femur fractures are a substantial source of morbidity and mortality in the older adult population. Our findings underscore the need for comprehensive preoperative risk assessment and patient management strategies to mitigate the impact of identified risk factors in this vulnerable population.
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