RESUMEN
The Senior Friendly Hospital Accelerating Change Together in Ontario program linked the Collaborative Network Model and the Senior Friendly Hospital Framework in a unique multi-hospital knowledge-to-practice initiative to improve care for hospitalized older adults. The design enabled teams from 78 Ontario hospitals to close a shared skills and knowledge gap while meeting the varied needs of their diverse contexts. Results suggest that this design meant to reduce unnecessary redundancy, while preserving requisite diversity, was successful in achieving its specific objectives: to build a collaborative network and increase the confidence, knowledge, and skills of its members sufficient to lead sustainable improvements in their unique hospital settings. Findings with special relevance to process improvement specialists, health system leaders, and hospital administrators and managers are discussed.
Asunto(s)
Hospitalización , Hospitales , Humanos , Anciano , OntarioRESUMEN
In this article, we report the design, synthesis, and characterization of a series of cyclometalated iridium(III) polypyridine complexes containing a perfluorobiphenyl (PFBP) moiety [Ir(N^C)2(bpy-PFBP)](PF6) (bpy-PFBP = 4-(S-(perfluoro-(1,1'-biphenyl)-4-yl)-N-mercaptoethylaminocarbonyloxymethyl)-4'-methyl-2,2'-bipyridine; HN^C = 2-phenylpyridine (Hppy) (1a), 2-(4-hydroxymethylphenyl)pyridine (Hppy-CH2OH) (2a), 2-((1,1'-biphenyl)-4-yl)pyridine (Hpppy) (3a), 2-((4'-hydroxymethyl-1,1'-biphenyl)-4-yl)pyridine (Hpppy-CH2OH) (4a), 2-phenylquinoline (Hpq) (5a), 2-(4-hydroxymethylphenyl)quinoline (Hpq-CH2OH) (6a)). Their PFBP-free counterparts [Ir(N^C)2(bpy-C4)](PF6) (bpy-C4 = 4-(N-n-butylaminocarbonyloxymethyl)-4'-methyl-2,2'-bipyridine; HN^C = Hppy (1b), Hppy-CH2OH (2b), Hpppy (3b), Hpppy-CH2OH (4b), Hpq (5b), Hpq-CH2OH (6b)) were also prepared for comparison studies. Upon irradiation, all the complexes displayed intense and long-lived greenish-yellow to orange luminescence in solutions under ambient conditions and in low-temperature alcohol glass. Reactions of the PFBP complexes with peptides containing the FCPF sequence via the π-clamp-mediated cysteine conjugation afforded luminescent peptide conjugates that exhibited rich photophysical properties. Using complex 3a as an example, we demonstrated that the conjugation of complexes to organelle-targeting peptides is an effective means to modulate their intracellular localization behavior, which was further shown to be important to their performance in photodynamic therapy. The results of this work will contribute to the development of photofunctional transition metal complexes as theranostic agents.
Asunto(s)
Compuestos de Bifenilo/farmacología , Complejos de Coordinación/farmacología , Sustancias Luminiscentes/farmacología , Piridinas/farmacología , Fármacos Sensibilizantes a Radiaciones/farmacología , Compuestos de Bifenilo/metabolismo , Compuestos de Bifenilo/efectos de la radiación , Núcleo Celular/metabolismo , Complejos de Coordinación/metabolismo , Complejos de Coordinación/efectos de la radiación , Retículo Endoplásmico/metabolismo , Células HeLa , Humanos , Iridio/química , Iridio/efectos de la radiación , Luz , Sustancias Luminiscentes/metabolismo , Sustancias Luminiscentes/efectos de la radiación , Microscopía Confocal , Péptidos/metabolismo , Péptidos/farmacología , Medicina de Precisión , Piridinas/metabolismo , Piridinas/efectos de la radiación , Fármacos Sensibilizantes a Radiaciones/metabolismo , Fármacos Sensibilizantes a Radiaciones/efectos de la radiación , Oxígeno Singlete/metabolismoRESUMEN
Since 2011, Ontario hospitals have been engaged in the Senior Friendly Hospital (SFH) Strategy led by the Regional Geriatric Program (RGP) of Toronto, in partnership with Ontario's Local Health Integration Networks (LHINs) and the RGPs of Ontario. Using the SFH Framework as a foundation, improvement in Ontario hospitals has been driven by the identification of common priorities, sharing of resources and best practices, and the development of quality indicators. We document this progress through a second environmental scan of hospitals conducted in 2014 that highlights significant advancement in all five domains of the SFH Framework. Key learnings will be shared on how this framework and its self-assessment tool helped drive practice change.