Numerous systems have been proposed to grade the severity of mucositis in an effort to standardize the reporting of clinical findings. To date, no single scale is universally accepted for reporting mucositis. The scale developed by the National Cancer Institute according to common toxicity criteria is: 0 1 2 None Painless ulcers, erythema, or mild soreness Painful erythema, edema, or ulcers, but patient can eat solids Painful erythema, edema, or ulcers, patient cannot eat solids Requires parenteral or enteral support Mucositis is very common with head and neck radiation therapy. Virtually all patients will get some degree of mucositis. Oral rinsing may be helpful to soothe tissues See Table 6 ; . Hydrogen peroxide can be used for debridement of ulcerated areas but should be avoided as a part of a daily rinse, as it can interfere with collagen formation and thus wound healing. Any removable prosthetic appliances should be removed during periods of mucositis. Oral lesions should be evaluated for Candida by Gram stain or KOH preparation when yeast infection is suspected. Use topical anesthetics and or systemic pain medication for pain control. This is covered under Management of Oral Mucositis Pain.
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72 Heart Study, it was shown that smoking significantly increased the risk associated with markers of chronic C. pneumoniae infection, and its effect at high levels of CRP was more than multiplicative, showing a high degree of synergy Roivainen et al. 2000 ; . On the other hand, Yudkin et al. 1999 ; found that smoking did not affect the level of CRP in a healthy population. Adipose tissue, especially abdominal fat deposition, is strongly associated with CRP in healthy, middle-aged women. Given that inflammatory mediators may be directly involved in atherogenesis, these results suggest an important mechanism through which obesity might affect the risk of CHD. Hak et al. 1999 ; Higher BMI is associated with higher CRP concentrations, even among young adults, suggesting a state of low-grade systemic inflammation in overweight persons Visser et al. 1999, Yudkin et al. 1999 ; . One shortcoming in the study population of the Helsinki Heart Study was that some serum samples were lacking, making the numbers too small for further analysis. Most missing samples were related to coronary events that had occurred very early during the follow-up period, with only the baseline samples available. Moreover, sufficient volumes of sera were no longer available in all cases. Some ORs would probably have reached statistical significance in a larger population. The participants with only one sample available, and therefore excluded from the analyses, did not differ from those included in this study with respect to age, body mass index, serum total cholesterol or blood pressure. However, this group of participants involved a larger number of smokers 53% ; than the group included in the study 42% ; . The strong interaction between CRP and smoking observed by Roivainen et al. 2000 ; suggests a higher risk in the total study population compared with the risk found in this study. In addition, the case-control status is naturally time-dependent, as some of the current controls are likely to be future cases, and the same process may well be ongoing in both groups, but only to different extents. Another shortcoming is that the test of the post hoc hypothesis is based on dyslipidemic, middleaged, white men. Thus, the findings of this study should not be generalised to normocholesterolemic men or women or to other races.
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First Nations House has been involved with a number of faculties, looking at the outreach strategies to the Aboriginal community in Toronto and throughout the country. STEPS to Education: First Nations House, along with the Transitional Year Program and the Toronto District School Board are developing a program that will offer an university course to Aboriginal high school students. Enrolled students will receive one university credit upon the successful completion of the program. The course will be the Introduction to Aboriginal Studies, and is anticipated to begin in September 2004. Faculty of Social Work: First Nations House, along with the Faculty of Social Work U of T ; , the School of Social Work Ryerson ; and the Transitional Year Program have established the Aboriginal Advanced Practitioners Initiative AAPI ; . This two-year pilot provides a number of educational paths to the staff of Native Child and Family Services to continue or upgrade their education. This access program enrolled six students at U of and two students at Ryerson University. After the pilot, the program will explore the possibility of making it available to more Aboriginal agencies in the city and throughout the province. Faculty of Arts and Science: First Nations House has a representative on the Arts and Science Recruitment Advisory Council Outreach Sub-Committee. This committee identifies the populations that are underrepresented in the faculty and short and long term strategies are developed.
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Appendix B, Page 3 Med 5 Local Medical Coordination - Assigned on a real time basis Med 6 Local Medical Coordination - Assigned on a real time basis Med 7 Local Medical Coordination - Assigned on a real time basis Med 8 Statewide Medical Coordination Med 9 Bayflite Dispatch Med 10 Pinellas County Hailing Channel Paging UHF Alphanumeric Pagers and a Paging Transmitter allow the Contractor's CAD software the ability to encode personnel and units through the County's paging terminal Zetron ; connected to the County's paging transmitter. 9-1-1 Data Transfer A data link from the 9-1-1 Center's mainframe computer is routed via leased telephone line, T-1 line, or microwave link, as determined by the Authority, to the EMS Communications Center. It facilitates sending emergency call data between the Contractor's CAD and the 9-1-1 CAD. This allows each center to "ship" the call location of an emergency to the other communications center. Additionally, it allows for shared notes of the call to be continuously updated. The County provides the data link and the Contractor provides the interface server that is connected to the Contractor's CAD system. Billing Data Transfer A data link between the Contractor's CAD and the Authority's Ambulance Billing System. It facilitates sending dispatch data from the Contractor's CAD to the Authority's Ambulance Billing System. The County provides the data link and the Contractor provides the interface server and software that connects to the Contractor's CAD system. Audio Recording of Telephone and Radio A digital audio recording system is in place. It records every operator console telephone and all radio channels relating to Medical Direction and Sunstar. Fire Rescue radio channels are recorded by the 9-1-1 Center. The Authority shall ensure such audio recording equipment is reliable and proper archives are maintained. 9-1-1 Fire Dispatch Consoles The 9-1-1 Center has backup consoles located within the EMS Communications Center. In the event of an equipment failure or evacuation of the 9-1-1 Center, Contractor personnel may be called upon to operate those consoles while dispatch personnel are in transit to the EMS Communications Center from the 9-1-1 Center.
