Decaying relevance of clinical data towards future decisions in data-driven inpatient clinical order sets.

PubMed

Chen, Jonathan H; Alagappan, Muthuraman; Goldstein, Mary K; Asch, Steven M; Altman, Russ B

2017-06-01

Determine how varying longitudinal historical training data can impact prediction of future clinical decisions. Estimate the "decay rate" of clinical data source relevance. We trained a clinical order recommender system, analogous to Netflix or Amazon's "Customers who bought A also bought B..." product recommenders, based on a tertiary academic hospital's structured electronic health record data. We used this system to predict future (2013) admission orders based on different subsets of historical training data (2009 through 2012), relative to existing human-authored order sets. Predicting future (2013) inpatient orders is more accurate with models trained on just one month of recent (2012) data than with 12 months of older (2009) data (ROC AUC 0.91 vs. 0.88, precision 27% vs. 22%, recall 52% vs. 43%, all P<10 -10 ). Algorithmically learned models from even the older (2009) data was still more effective than existing human-authored order sets (ROC AUC 0.81, precision 16% recall 35%). Training with more longitudinal data (2009-2012) was no better than using only the most recent (2012) data, unless applying a decaying weighting scheme with a "half-life" of data relevance about 4 months. Clinical practice patterns (automatically) learned from electronic health record data can vary substantially across years. Gold standards for clinical decision support are elusive moving targets, reinforcing the need for automated methods that can adapt to evolving information. Prioritizing small amounts of recent data is more effective than using larger amounts of older data towards future clinical predictions. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Trends in substance use admissions among older adults.

PubMed

Chhatre, Sumedha; Cook, Ratna; Mallik, Eshita; Jayadevappa, Ravishankar

2017-08-22

Substance abuse is a growing, but mostly silent, epidemic among older adults. We sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Treatment Episode Data Set - Admissions (TEDS-A) for period between 2000 and 2012 was used. The trends in admission for primary substances, demographic attributes, characteristics of substance abused and type of admission were analyzed. While total number of substance abuse treatment admissions between 2000 and 2012 changed slightly, proportion attributable to older adults increased from 3.4% to 7.0%. Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. Majority of the admissions were for alcohol as the primary substance. However there was a decreasing trend in this proportion (77% to 64%). The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics. Also, admissions for older adults increased between 2000 and 2012 for African Americans (21% to 28%), females (20% to 24%), high school graduates (63% to 75%), homeless (15% to 19%), unemployed (77% to 84%), and those with psychiatric problems (17% to 32%).The proportion of admissions with prior history of substance abuse treatment increased from 39% to 46% and there was an increase in the admissions where more than one problem substance was reported. Ambulatory setting continued to be the most frequent treatment setting, and individual (including self-referral) was the most common referral source. The use of medication assisted therapy remained low over the years (7% - 9%). The changing demographic and substance use pattern of older adults implies that a wide array of psychological, social, and physiological needs will arise. Integrated, multidisciplinary and tailored policies for prevention and treatment are necessary to

[Philanthropic general hospitals: a new setting for psychiatric admissions].

PubMed

Larrobla, Cristina; Botega, Neury José

2006-12-01

To understand the process that led Brazilian philanthropic general hospitals to implement psychiatric units and to describe the main characteristics and therapeutic approaches of these services. Ten institutions in three Brazilian states (Minas Gerais, São Paulo e Santa Catarina) were assessed in 2002. Forty-three semi-structured interviews were carried out with health professionals who worked at the hospitals to collect data on service implementation process, therapeutic approaches and current situation. The interviews were audio-recorded and their content was analyzed. There was no mental hospital in the cities where the institutions were located. In five hospitals, psychiatric patients were admitted to general medical wards because there was no psychiatric unit. The therapeutic approach in six hospitals was based on psychopharmacological treatment. Due to lack of resources and more appropriate therapeutic planning, the admission of patients presenting psychomotor agitation increases resistance against psychiatric patients in general hospitals. Financial constraints regarding laboratory testing is still a challenge. There is no exchange between local authorities and hospital administrators of these institutions that are compelled to exceed the allowed number of admissions to meet the demand of neighboring cities. The need for mental health care to local populations combined with individual requests of local authorities and psychiatrists made possible the implementation of psychiatric units in these localities. In spite of the efforts and flexibility of health professional working in these institutions, there are some obstacles to be overcome: resistance of hospital community against psychiatric admissions, financial constraints, limited professional training in mental health and the lack of a therapeutic approach that goes beyond psychopharmacological treatment alone.

Decaying Relevance of Clinical Data Towards Future Decisions in Data-Driven Inpatient Clinical Order Sets

PubMed Central

Chen, Jonathan H; Alagappan, Muthuraman; Goldstein, Mary K; Asch, Steven M; Altman, Russ B

2017-01-01

Objective Determine how varying longitudinal historical training data can impact prediction of future clinical decisions. Estimate the “decay rate” of clinical data source relevance. Materials and Methods We trained a clinical order recommender system, analogous to Netflix or Amazon’s “Customers who bought A also bought B…” product recommenders, based on a tertiary academic hospital’s structured electronic health record data. We used this system to predict future (2013) admission orders based on different subsets of historical training data (2009 through 2012), relative to existing human-authored order sets. Results Predicting future (2013) inpatient orders is more accurate with models trained on just one month of recent (2012) data than with 12 months of older (2009) data (ROC AUC 0.91 vs. 0.88, precision 27% vs. 22%, recall 52% vs. 43%, all P<10−10). Algorithmically learned models from even the older (2009) data was still more effective than existing human-authored order sets (ROC AUC 0.81, precision 16% recall 35%). Training with more longitudinal data (2009–2012) was no better than using only the most recent (2012) data, unless applying a decaying weighting scheme with a “half-life” of data relevance about 4 months. Discussion Clinical practice patterns (automatically) learned from electronic health record data can vary substantially across years. Gold standards for clinical decision support are elusive moving targets, reinforcing the need for automated methods that can adapt to evolving information. Conclusions and Relevance Prioritizing small amounts of recent data is more effective than using larger amounts of older data towards future clinical predictions. PMID:28495350

Modeling Preferential Admissions at Elite Liberal Arts Colleges

ERIC Educational Resources Information Center

Cockburn, Sally; Hewitt, Gordon; Kelly, Timothy

2013-01-01

This paper presents the results of a model that simulates the effects of varying preferential admissions policies on the academic profile of a set of 35 small liberal arts colleges. An underlying assumption is that all schools in the set use the same ratio of preferential to non-preferential admissions. The model predicts that even drastic changes…

Statistical Criteria for Setting Thresholds in Medical School Admissions

ERIC Educational Resources Information Center

Albanese, Mark A.; Farrell, Philip; Dottl, Susan

2005-01-01

In 2001, Dr. Jordan Cohen, President of the AAMC, called for medical schools to consider using an Medical College Admission Test (MCAT) threshold to eliminate high-risk applicants from consideration and then to use non-academic qualifications for further consideration. This approach would seem to be consistent with the recent Supreme Court ruling…

Admissions Policies: Side Effects and their Implications

ERIC Educational Resources Information Center

Campbell, David P.

1971-01-01

Examines the effects of using standardized achievement test scores as primary admission criteria for college admission on the birth order composition of the professions and the range of vocational interests in the general educated public. (JM)

Paving the COWpath: data-driven design of pediatric order sets

PubMed Central

Zhang, Yiye; Padman, Rema; Levin, James E

2014-01-01

Objective Evidence indicates that users incur significant physical and cognitive costs in the use of order sets, a core feature of computerized provider order entry systems. This paper develops data-driven approaches for automating the construction of order sets that match closely with user preferences and workflow while minimizing physical and cognitive workload. Materials and methods We developed and tested optimization-based models embedded with clustering techniques using physical and cognitive click cost criteria. By judiciously learning from users’ actual actions, our methods identify items for constituting order sets that are relevant according to historical ordering data and grouped on the basis of order similarity and ordering time. We evaluated performance of the methods using 47 099 orders from the year 2011 for asthma, appendectomy and pneumonia management in a pediatric inpatient setting. Results In comparison with existing order sets, those developed using the new approach significantly reduce the physical and cognitive workload associated with usage by 14–52%. This approach is also capable of accommodating variations in clinical conditions that affect order set usage and development. Discussion There is a critical need to investigate the cognitive complexity imposed on users by complex clinical information systems, and to design their features according to ‘human factors’ best practices. Optimizing order set generation using cognitive cost criteria introduces a new approach that can potentially improve ordering efficiency, reduce unintended variations in order placement, and enhance patient safety. Conclusions We demonstrate that data-driven methods offer a promising approach for designing order sets that are generalizable, data-driven, condition-based, and up to date with current best practices. PMID:24674844

Physicians' perceptions and attitudes regarding inappropriate admissions and resource allocation in the intensive care setting.

PubMed

Giannini, A; Consonni, D

2006-01-01

Physicians' perceptions regarding intensive care unit (ICU) resource allocation and the problem of inappropriate admissions are unknown. We carried out an anonymous, self-administered questionnaire survey to assess the perceptions and attitudes of ICU physicians at all 20 ICUs in Milan, Italy, regarding inappropriate admissions and resource allocation. Eighty-seven percent (225/259) of physicians responded. Inappropriate admissions were acknowledged by 86% of respondents. The reasons given were clinical doubt (33%); limited decision time (32%); assessment error (25%); pressure from superiors (13%), referring clinician (11%) or family (5%); threat of legal action (5%); and an economically advantageous 'Diagnosis Related Group' (1%). Respondents reported being pressurized to make more 'productive' use of ICU beds by Unit heads (frequently 16%), hospital management (frequently 10%) and colleagues (frequently 4%). Five percent reported refusing appropriate admissions following 'indications' not to admit financially disadvantageous cases. Admissions after elective surgery prioritized patients from profitable surgical departments: frequently for 6% of respondents and occasionally for 15%. Sixty-seven percent said they frequently received requests for appropriate admissions when no beds were available. This was considered sufficient reason to withdraw treatment from patients with lower survival probability (sometimes 21%) or for whom nothing more could be done (sometimes 51%, frequently 11%). Inappropriate ICU admissions were perceived as a common event but were mainly attributed to difficulties in assessing suitability. Physicians were aware that their decisions were often influenced by factors other than medical necessity. Economic influences were perceived as limited but not negligible. Decisions to forgo treatment could be influenced by the need to admit other patients.

15 CFR 904.243 - Admissions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures Discovery § 904.243 Admissions. (a) Request. If ordered by the Judge, any party...

15 CFR 904.243 - Admissions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Hearing and Appeal Procedures Discovery § 904.243 Admissions. (a) Request. If ordered by the Judge, any party...

Construction of Weak and Strong Similarity Measures for Ordered Sets of Documents Using Fuzzy Set Techniques.

ERIC Educational Resources Information Center

Egghe, L.; Michel, C.

2003-01-01

Ordered sets (OS) of documents are encountered more and more in information distribution systems, such as information retrieval systems. Classical similarity measures for ordinary sets of documents need to be extended to these ordered sets. This is done in this article using fuzzy set techniques. The practical usability of the OS-measures is…

Higher-order risk preferences in social settings.

PubMed

Heinrich, Timo; Mayrhofer, Thomas

2018-01-01

We study prudence and temperance (next to risk aversion) in social settings. Previous experimental studies have shown that these higher-order risk preferences affect the choices of individuals deciding privately on lotteries that only affect their own payoff. Yet, many risky and financially relevant decisions are made in the social settings of households or organizations. We elicit higher-order risk preferences of individuals and systematically vary how an individual's decision is made (alone or while communicating with a partner) and who is affected by the decision (only the individual or the partner as well). In doing so, we can isolate the effects of other-regarding concerns and communication on choices. Our results reveal that the majority of choices are risk averse, prudent, and temperate across social settings. We also observe that individuals are influenced significantly by the preferences of a partner when they are able to communicate and choices are payoff-relevant for both of them.

Weather, season, and daily stroke admissions in Hong Kong

NASA Astrophysics Data System (ADS)

Goggins, William B.; Woo, Jean; Ho, Suzanne; Chan, Emily Y. Y.; Chau, P. H.

2012-09-01

Previous studies examining daily temperature and stroke incidence have given conflicting results. We undertook this retrospective study of all stroke admissions in those aged 35 years old and above to Hong Kong public hospitals from 1999 through 2006 in order to better understand the effects of meteorological conditions on stroke risk in a subtropical setting. We used Poisson Generalized Additive Models with daily hemorrhagic (HS) and ischemic stroke (IS) counts separately as outcomes, and daily mean temperature, humidity, solar radiation, rainfall, air pressure, pollutants, flu consultation rates, day of week, holidays, time trend and seasonality as predictors. Lagged effects of temperature, humidity and pollutants were also considered. A total of 23,457 HS and 107,505 IS admissions were analyzed. Mean daily temperature had a strong, consistent, negative linear association with HS admissions over the range (8.2-31.8°C) observed. A 1°C lower average temperature over the same day and previous 4 days (lags 0-4) being associated with a 2.7% (95% CI: 2.0-3.4%, P < .0.0001) higher admission rate after controlling for other variables. This association was stronger among older subjects and females. Higher lag 0-4 average change in air pressure from previous day was modestly associated with higher HS risk. The association between IS and temperature was weaker and apparent only below 22°C, with a 1°C lower average temperature (lags 0-13) below this threshold being associated with a 1.6% (95% CI:1.0-2.2%, P < 0.0001) higher IS admission rate. Pollutant levels were not associated with HS or IS. Future studies should examine HS and IS risk separately.

Setting up pre-admission visits for children undergoing day surgery: a practice development initiative.

PubMed

O'Shea, Maria; Cummins, Ann; Kelleher, Ann

2010-06-01

The hospital experience can bring about a range of negative emotions for children. The literature clearly states that children who are prepared for surgery recover faster and have fewer negative effects. Pre-admission programmes seek to prepare children (and their parents) for surgery. This paper describes in detail how a pre-admission programme was established for children and their families who were scheduled for day case surgery.

Routine admission laboratory testing for general medical patients.

PubMed

Hubbell, F A; Frye, E B; Akin, B V; Rucker, L

1988-06-01

We evaluated the usefulness of commonly ordered routine admission laboratory tests in 301 patients admitted consecutively to the internal medicine wards of a university teaching hospital. Using a consensus analysis approach, three Department of Medicine faculty members reviewed the charts of admitted patients to determine the impact of the test results on patient care. The evaluated tests were the urinalysis, hematocrit, white blood cell count, platelet count, six-factor automated multiple analysis (serum sodium, potassium, chloride, bicarbonate, glucose, and blood urea nitrogen), prothrombin time, partial thromboplastin time, chest x-ray, and electrocardiogram. Forty-five percent of the 3,684 tests were ordered for patients without recognizable medical indications. Twelve percent of these routine tests were abnormal, 5% led to additional laboratory testing, but only 0.5% led to change in the treatment of patients. We conclude that the impact of routine admission laboratory testing on patient care is very small and that there is little justification for ordering tests solely because of hospital admission.

Using intranet-based order sets to standardize clinical care and prepare for computerized physician order entry.

PubMed

Heffner, John E; Brower, Kathleen; Ellis, Rosemary; Brown, Shirley

2004-07-01

The high cost of computerized physician order entry (CPOE) and physician resistance to standardized care have delayed implementation. An intranet-based order set system can provide some of CPOE's benefits and offer opportunities to acculturate physicians toward standardized care. INTRANET CLINICIAN ORDER FORMS (COF): The COF system at the Medical University of South Carolina (MUSC) allows caregivers to enter and print orders through the intranet at points of care and to access decision support resources. Work on COF began in March 2000 with transfer of 25 MUSC paper-based order set forms to an intranet site. Physician groups developed additional order sets, which number more than 200. Web traffic increased progressively during a 24-month period, peaking at more than 6,400 hits per month to COF. Decision support tools improved compliance with Centers for Medicare & Medicaid Services core indicators. Clinicians demonstrated a willingness to develop and use order sets and decision support tools posted on the COF site. COF provides a low-cost method for preparing caregivers and institutions to adopt CPOE and standardization of care. The educational resources, relevant links to external resources, and communication alerts will all link to CPOE, thereby providing a head start in CPOE implementation.

Admissions Testing & Institutional Admissions Processes

ERIC Educational Resources Information Center

Hossler, Don; Kalsbeek, David

2009-01-01

The array of admissions models and the underlying, and sometimes conflicting goals people have for college admissions, create the dynamics and the tensions that define the contemporary context for enrollment management. The senior enrollment officer must ask, for example, how does an institution try to assure transparency, equality of access,…

Admission Volunteer Programs: Are They Really Worth the Effort?

ERIC Educational Resources Information Center

Symmonds, Ian

2002-01-01

Developing and using volunteers in the admission process is an age-old topic for those in the admission field. A good volunteer program allows an institution to provide more audience-based marketing messages rather than institutional-based marketing messages. Such programs can mean a more engaged, supportive, and enthusiastic set of key…

Making Sense of Clinical Practice: Order Set Design Strategies in CPOE

PubMed Central

Novak, Laurie L.

2007-01-01

A case study was conducted during the customization phase of a commercial CPOE system at a multi-hospital, academic health system. The study focused on the development of order sets. Three distinct approaches to order set development were observed: Empirical, Local Consensus and Departmental. The three approaches are first described and then examined using the framework of sensemaking. Different approaches to sensemaking in the context of order set development reflect variations in sources of knowledge related to the standardization of care. PMID:18693900

Using lean methodology to improve efficiency of electronic order set maintenance in the hospital.

PubMed

Idemoto, Lori; Williams, Barbara; Blackmore, Craig

2016-01-01

Order sets, a series of orders focused around a diagnosis, condition, or treatment, can reinforce best practice, help eliminate outdated practice, and provide clinical guidance. However, order sets require regular updates as evidence and care processes change. We undertook a quality improvement intervention applying lean methodology to create a systematic process for order set review and maintenance. Root cause analysis revealed challenges with unclear prioritization of requests, lack of coordination between teams, and lack of communication between producers and requestors of order sets. In March of 2014, we implemented a systematic, cyclical order set review process, with a set schedule, defined responsibilities for various stakeholders, formal meetings and communication between stakeholders, and transparency of the process. We first identified and deactivated 89 order sets which were infrequently used. Between March and August 2014, 142 order sets went through the new review process. Processing time for the build duration of order sets decreased from a mean of 79.6 to 43.2 days (p<.001, CI=22.1, 50.7). Applying Lean production principles to the order set review process resulted in significant improvement in processing time and increased quality of orders. As use of order sets and other forms of clinical decision support increase, regular evidence and process updates become more critical.

Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

PubMed

Hawken, Steven; Kwong, Jeffrey C; Deeks, Shelley L; Crowcroft, Natasha S; Ducharme, Robin; Manuel, Douglas G; Wilson, Kumanan

2013-01-01

We investigated the association between a child's birth order and emergency room (ER) visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. We included all children born in Ontario between April 1(st), 2006 and March 31(st), 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI) of events among 1(st)-born and later-born children using relative incidence ratios (RIR). For the 2-month vaccination, the RIR for 1(st)-borns versus later-born children was 1.37 (95% CI: 1.19-1.57), which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st)-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99), representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st) vs. later-borns was 1.27 (95% CI: 1.09-1.48), or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21), or 249 excess events/100,000 vaccinated. Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st)-born children had significantly higher relative incidence of events compared to later-born children.

Impact of rotavirus vaccine introduction and post-introduction etiology of diarrhea requiring hospital admission in Haydom, Tanzania, a rural African setting.

PubMed

Platts-Mills, James A; Amour, Caroline; Gratz, Jean; Nshama, Rosemary; Walongo, Thomas; Mujaga, Buliga; Maro, Athanasia; McMurry, Timothy L; Liu, Jie; Mduma, Estomih; Houpt, Eric R

2017-05-29

No data are available on the etiology of diarrhea requiring hospitalization after rotavirus vaccine introduction in Africa. The monovalent rotavirus vaccine was introduced in Tanzania on January 1, 2013. We performed a vaccine impact and effectiveness study as well as a qPCR-based etiology study at a rural Tanzanian hospital. We obtained data on admissions among children under 5 years to Haydom Lutheran Hospital between January 1, 2010 and December 31, 2015, and estimated the impact of vaccine introduction on all-cause diarrhea admissions. We then performed a vaccine effectiveness study using the test-negative design. Finally, we tested diarrheal specimens during 2015 by qPCR for a broad range of enteropathogens and calculated pathogen-specific attributable fractions. Vaccine introduction was associated with a 44.9% (95% CI 17.6 - 97.4) reduction in diarrhea admissions in 2015, as well as delay of the rotavirus season. The effectiveness of two doses of vaccine was 74.8% (-8.2 - 94.1) using an enzyme immunoassay-based case definition and 85.1% (26.5 - 97.0) using a qPCR-based case definition. Among 146 children enrolled in 2015, rotavirus remained the leading etiology of diarrhea requiring hospitalization (AF 25.8%, 95% CI: 24.4 - 26.7), followed by heat-stabile enterotoxin-producing E. coli (18.4%, 12.9 - 21.9), Shigella/enteroinvasive E. coli (14.5%, 10.2 - 22.8), and Cryptosporidium (7.9%, 6.2 - 9.3). Despite the clear impact of vaccine introduction in this setting, rotavirus remained the leading etiology of diarrhea requiring hospitalization. Further efforts to maximize vaccine coverage and improve vaccine performance in these settings are warranted. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Psychiatric Inpatient Admissions of Adults with Intellectual Disabilities: Predictive Factors

ERIC Educational Resources Information Center

Cowley, Amy; Newton, Jonathan; Sturmey, Peter; Bouras, Nick; Holt, Geraldine

2005-01-01

Information on admission to psychiatric inpatient units is lacking from the literature on contemporary services for people with intellectual disability and mental health needs. Here we report on predictors of admission for a cohort of 752 adults from this population living in community settings; 83 were admitted. We also report on two subsamples…

Analysis of Unplanned Intensive Care Unit Admissions in Postoperative Pediatric Patients.

PubMed

Landry, Elizabeth K; Gabriel, Rodney A; Beutler, Sascha; Dutton, Richard P; Urman, Richard D

2017-03-01

Currently, there are only a few retrospective, single-institution studies that have addressed the prevalence and risk factors associated with unplanned admissions to the pediatric intensive care unit (ICU) after surgery. Based on the limited amount of studies, it appears that airway and respiratory complications put a child at increased risk for unplanned ICU admission. A more extensive and diverse analysis of unplanned postoperative admissions to the ICU is needed to address risk factors that have yet to be revealed by the current literature. To establish a rate of unplanned postoperative ICU admissions in pediatric patients using a large, multi-institution data set and to further characterize the associated risk factors. Data from the National Anesthesia Clinical Outcomes Registry were analyzed. We recorded the overall risk of unplanned postoperative ICU admission in patients younger than 18 years and performed univariate and multivariate logistic regression analysis to identify the associated patient, surgical, and anesthetic-related characteristics. Of the 324 818 cases analyzed, 211 reported an unexpected ICU admission. There was an increased likelihood of unplanned postoperative ICU in infants (age <1 year) and children who were classified as American Society of Anesthesiologists physical status classification of III or IV. Likewise, longer case duration and cases requiring general anesthesia were also associated with unplanned ICU admissions. This study establishes a rate of unplanned ICU admission following surgery in the heterogeneous pediatric population. This is the first study to utilize such a large data set encompassing a wide range of practice environments to identify risk factors leading to unplanned postoperative ICU admissions. Our study revealed that patient, surgical, and anesthetic complexity each contributed to an increased number of unplanned ICU admissions in the pediatric population.

Admissions: The Higher Education Sector's Plans for Change. Policy Briefing

ERIC Educational Resources Information Center

Universities UK, 2008

2008-01-01

With the increase in student numbers and political concern to ensure fair access to higher education, universities have been reviewing their admissions processes in order to improve their transparency, efficiency and effectiveness. The process contains relatively discrete activities--applications and admissions--in which both the applicants and…

Adaptive Admissions Process for Effective and Fair Graduate Admission

ERIC Educational Resources Information Center

Zimmermann, Judith; von Davier, Alina; Heinimann, Hans Rudolf

2017-01-01

Purpose: Graduate admission has become a critical process for quality assurance in tertiary education. Hitherto, most research has investigated the validity of admissions instruments. However, surprisingly little work has been conducted on the overall organization of admission, which often remains "informal, ad hoc, and lacking in…

Opening College Doors: How To Make the Admissions Process Work for You.

ERIC Educational Resources Information Center

Ordovensky, Pat; Thornton, Robert

This book offers detailed information on college admissions designed to demystify the process for student applicants. Part I opens by arguing that the college admissions process is a mystery to many applicants because in large part admissions officers would prefer to have it that way in order to retain greater control. Other chapters in this…

Improving admission medication reconciliation compliance using the electronic tool in admitted medical patients.

PubMed

Taha, Haytham; Abdulhay, Dana; Luqman, Neama; Ellahham, Samer

2016-01-01

Sheikh Khalifa Medical City (SKMC) in Abu Dhabi is the main tertiary care referral hospital in the United Arab Emirates (UAE) with 560 bed capacity that is fully occupied most of the time. SKMC senior management has made a commitment to make quality and patient safety a top priority. Our governing body Abu Dhabi Health Services Company has identified medication reconciliation as a critical patient safety measure and key performance indicator (KPI). The medication reconciliation electronic form a computerized decision support tool was introduced to improve medication reconciliation compliance on transition of care at admission, transfer and discharge of patients both in the inpatient and outpatient settings. In order to improve medication reconciliation compliance a multidisciplinary task force team was formed and led this quality improvement project. The purpose of this publication is to indicate the quality improvement interventions implemented to enhance compliance with admission medication reconciliation and the outcomes of those interventions. We chose to conduct the pilot study in general medicine as it is the busiest department in the hospital, with an average of 390 patients admitted per month during the study period. The study period was from April 2014 till October 2015 and a total of 8576 patients were evaluated. The lessons learned were disseminated throughout the hospital. Our aim was to improve admission medication reconciliation compliance using the electronic form in order to ensure patient safety and reduce preventable harm in terms of medication errors. Admission medication reconciliation compliance improved in general medicine from 40% to above 85%, and this improvement was sustained for the last four months of the study period.

32 CFR 228.3 - Restrictions on admission to protected property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Restrictions on admission to protected property... property. Access to protected property shall be restricted to ensure the orderly and secure conduct of Agency business. Admission to protected property will be restricted to employees and other persons with...

32 CFR 228.3 - Restrictions on admission to protected property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Restrictions on admission to protected property... property. Access to protected property shall be restricted to ensure the orderly and secure conduct of Agency business. Admission to protected property will be restricted to employees and other persons with...

32 CFR 228.3 - Restrictions on admission to protected property.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Restrictions on admission to protected property... property. Access to protected property shall be restricted to ensure the orderly and secure conduct of Agency business. Admission to protected property will be restricted to employees and other persons with...

32 CFR 228.3 - Restrictions on admission to protected property.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Restrictions on admission to protected property... property. Access to protected property shall be restricted to ensure the orderly and secure conduct of Agency business. Admission to protected property will be restricted to employees and other persons with...

Admission, Heal Thyself: A Prescription for Reclaiming College Admission as a Profession

ERIC Educational Resources Information Center

Jump, Jim

2004-01-01

Is college admission a business or a profession? This question is timeless because no issue (with possible exception of the perennial debate about whether admission(s) is singular or plural) sparks as much passion among admission practitioners, and it is timely because many of the controversial issues found in college admission today beg the…

Association between Birth Order and Emergency Room Visits and Acute Hospital Admissions following Pediatric Vaccination: A Self-Controlled Study

PubMed Central

Hawken, Steven; Kwong, Jeffrey C.; Deeks, Shelley L.; Crowcroft, Natasha S.; Ducharme, Robin; Manuel, Douglas G.; Wilson, Kumanan

2013-01-01

Objective We investigated the association between a child's birth order and emergency room (ER) visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. Methods We included all children born in Ontario between April 1st, 2006 and March 31st, 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI) of events among 1st-born and later-born children using relative incidence ratios (RIR). Results For the 2-month vaccination, the RIR for 1st-borns versus later-born children was 1.37 (95% CI: 1.19–1.57), which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1st-borns vs. later-borns was 1.70 (95% CI: 1.45–1.99), representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1st vs. later-borns was 1.27 (95% CI: 1.09–1.48), or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02–1.21), or 249 excess events/100,000 vaccinated. Conclusions Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1st-born children had significantly higher relative incidence of events compared to later-born children. PMID:24324662

Strong Similarity Measures for Ordered Sets of Documents in Information Retrieval.

ERIC Educational Resources Information Center

Egghe, L.; Michel, Christine

2002-01-01

Presents a general method to construct ordered similarity measures in information retrieval based on classical similarity measures for ordinary sets. Describes a test of some of these measures in an information retrieval system that extracted ranked document sets and discuses the practical usability of the ordered similarity measures. (Author/LRW)

Profile of neurological admissions at the University of Nigeria Teaching Hospital Enugu.

PubMed

Ekenze, O S; Onwuekwe, I O; Ezeala Adikaibe, B A

2010-01-01

The burden of Neurological diseases may be on the increase especially in developing countries. Improved outcome in these settings may require appreciation of the spectrum of Neurological diseases and the impediments to their management. We aim to determine the profile of neurological admissions and the challenges of managing these diseases at the University of Nigeria Teaching Hospital Enugu South East Nigeria. Analysis of Neurological admissions into the medical wards of the University of Nigeria Teaching Hospital Enugu from January 2003 to December 2007. Neurological admissions comprise about 14.8% of medical admissions. There were 640 (51%) males and 609 (49%) females. The spectrum of neurological diseases were stroke 64.9%, central nervous system infections (21.8% ), HIV related neurological diseases 3.5%, hypertensive encephalopathy (3.4%), dementia (3%), subarachnoid haemorrhage (2.2%), Guillian Barre syndrome (1.2%), Parkinson's disease (1.1%), myasthenia gravis (1.0%), motor neurone disease and peripheral neuropathy and accounted for 0.8% and 0.6% respectively. Overall, noninfectious disease accounted for 78.2% of neurological admissions while infectious diseases accounted for 11.8%. A wide spectrum of neurological diseases occurs in our setting. The high incidence of CNS infections indicates that efforts should be geared towards preventive measures. A major challenge to be addressed in the management of neurological diseases in our setting is the lack of specialized facilities.

Improved vitamin D supplementation in hospitalized breastfed infants through electronic order modification and targeted provider education.

PubMed

Watnick, Caroline S; Binns, Helen J; Greenberg, Robert S

2015-03-01

To examine effectiveness of an intervention promoting vitamin D supplementation in hospitalized breastfed infants. Our urban tertiary care hospital instituted a 2-part intervention: brief education for providers on vitamin D guidelines and insertion of an opt-in order for vitamin D supplements into electronic admission order sets. Data downloads on admissions of patients aged <1 year were obtained. We excluded those not breastfed, with a dietary restriction, or admitted to intensive care. Intervention effects were compared from 6 months postintervention to the 6 same months 1 year earlier. We applied χ2 and logistic regression, including the patient as a random effect to adjust for repeated admissions. Data on 471 exclusively or partially breastfed admissions (441 infants) were analyzed (221 preintervention, 250 postintervention). Admission characteristics did not differ by period: 55.0% boys; 40.6% Medicaid; 63.7% hospitalized ≤2 days; 72.0% on a general medical service; 16.6% received nutritionist consultation. In-hospital vitamin D prescribing rates significantly increased postintervention (19.5% vs 44.4%; P<.001). Postintervention admissions were more than twice as likely to receive vitamin D supplementation (adjusted odds ratio 2.3, 95% confidence interval 1.6-3.2). Other associated factors included vitamin D as a medication used before admission (adjusted odds ratio 14.3, 95% confidence interval 4.9-41.6), nutritionist consultation during admission, hospitalization≥3 days, and admission to a general medical service. Prescribing of vitamin D at discharge increased significantly (9.0% vs 19.6%; P<.001). Medical provider education and modification of electronic ordering templates significantly increased use of vitamin D supplementation in hospitalized breastfed infants. Copyright © 2015 by the American Academy of Pediatrics.

Simple measurement-based admission control for DiffServ access networks

NASA Astrophysics Data System (ADS)

Lakkakorpi, Jani

2002-07-01

In order to provide good Quality of Service (QoS) in a Differentiated Services (DiffServ) network, a dynamic admission control scheme is definitely needed as an alternative to overprovisioning. In this paper, we present a simple measurement-based admission control (MBAC) mechanism for DiffServ-based access networks. Instead of using active measurements only or doing purely static bookkeeping with parameter-based admission control (PBAC), the admission control decisions are based on bandwidth reservations and periodically measured & exponentially averaged link loads. If any link load on the path between two endpoints is over the applicable threshold, access is denied. Link loads are periodically sent to Bandwidth Broker (BB) of the routing domain, which makes the admission control decisions. The information needed in calculating the link loads is retrieved from the router statistics. The proposed admission control mechanism is verified through simulations. Our results prove that it is possible to achieve very high bottleneck link utilization levels and still maintain good QoS.

Tempering pediatric hospitalist supervision of residents improves admission process efficiency without decreasing quality of care.

PubMed

Biondi, Eric A; Leonard, Michael S; Nocera, Elizabeth; Chen, Rui; Arora, Jyoti; Alverson, Brian

2014-02-01

Many academic pediatric hospital medicine (PHM) divisions have recently increased in-house supervision of residents, often providing 24/7 in-house attending coverage. Contrary to this trend, we removed mandated PHM attending input during the admission process. We present an evaluation of this process change. This cohort study compared outcomes between patients admitted to the PHM service before (July 1, 2011-September 30, 2011) and after (July 1, 2012-September 30, 2012) the process change. We evaluated time from admission request to inpatient orders, length of stay (LOS), frequency of change in antibiotic choice, and rapid response team (RRT) calls within 24 hours of admission. Data were obtained via chart abstraction and from administrative databases. Wilcoxon rank sum and Fisher exact tests were used for analysis. We identified 182 and 210 admissions in the before and after cohorts, respectively. Median time between emergency department admission request and inpatient orders was significantly shorter after the change (123 vs 62 minutes, P < 0.001). We found no significant difference in LOS, the number of changes to initial resident antibiotic choice, standard of care, or RRTs called within the first 24 hours of admission. Removing mandated attending input in decision making for PHM admissions significantly decreased time to inpatient resident admission orders without a change in measurable clinical outcomes. © 2013 Society of Hospital Medicine.

Test Takers' Attitudes and Beliefs about the Graduate Management Admission Test

ERIC Educational Resources Information Center

Stricker, Lawrence J.; Wilder, Gita Z.; Bridgeman, Brent

2006-01-01

The aim of this study was to assess test takers' attitudes and beliefs about an admissions test used extensively in graduate schools of business in the United States, the Graduate Management Admission Test (GMAT), and the relationships of these attitudes and beliefs to test performance. A set of attitude and belief items was administered by…

Racial disparities in primary prevention of incontinence among older adults at nursing home admission.

PubMed

Bliss, Donna Z; Gurvich, Olga V; Eberly, Lynn E; Savik, Kay; Harms, Susan; Wyman, Jean F; Mueller, Christine; Virnig, Beth; Wiltzen, Kjerstie

2017-04-01

Maintaining continence of nursing home (NH) residents promotes dignity and well-being and may reduce morbidity and healthcare treatment costs. To determine the prevalence of older continent adults who received primary prevention of incontinence at NH admission, assess whether there were racial or ethnic disparities in incontinence prevention, and describe factors associated with any disparities. The design was an observational cross-sectional study of a nation-wide cohort of older adults free of incontinence at NH admission (n = 42,693). Four US datasets describing NH and NH resident characteristics, practitioner orders for NH treatment/care, and socioeconomic and sociodemographic status of the community surrounding the NHs were analyzed. Disparities were analyzed for four minority groups identified on the minimum data set using the Peters-Belson method and covariates at multiple levels. Twelve percent of NH admissions received incontinence prevention. There was a significant disparity (2%) in incontinence prevention for Blacks (P < 0.05): Fewer Black admissions (8.6%) were observed to receive incontinence prevention than was expected had they been part of the White group (10.6%). The percentage of White admissions receiving incontinence prevention was 10.6%. Significant factors associated with disparity in receiving incontinence prevention were having greater deficits in ADL function and cognition and more comorbidities. No disparity disadvantaging the other minority groups was found. Greater efforts for instituting incontinence prevention at the time of NH admission are needed. Eliminating racial disparities in incontinence prevention seems an attainable goal. Appropriate staff training, organizational commitment, and monitoring progress toward equitable outcomes can help achieve this goal. Neurourol. Urodynam. 36:1124-1130, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Characteristics of Pregnant Teen Substance Abuse Treatment Admissions

MedlinePlus

... Set (TEDS) is an administrative data system providing descriptive information about the national flow of admissions aged ... Management Decisions, Inc., Arlington, VA; and RTI International, Research Triangle Park, NC. Information and data for this ...

The Structured Interview and Interviewer Training in the Admissions Process

PubMed Central

Cox, Wendy C.; White-Harris, Carla; Blalock, Susan J.

2007-01-01

Objectives To determine the extent to which the structured interview is used in the PharmD admissions process in US colleges and schools of pharmacy, and the prevalence and content of interviewer training. Methods A survey instrument consisting of 7 questions regarding interviews and interviewer training was sent to 92 colleges and schools of pharmacy in the United States that were accredited or seeking accreditation. Results Sixty survey instruments (65% response rate) were returned. The majority of the schools that responded (80%) used interviews as part of the PharmD admissions process. Of the schools that used an interview as part of the admissions process, 86% provided some type of interviewer training and 13% used a set of predefined questions in admissions interviews. Conclusions Most colleges and schools of pharmacy use some components of the structured interview in the PharmD admissions process; however, training for interviewers varies widely among colleges and schools of pharmacy. PMID:17998980

A multi-centre randomised trial to compare the effectiveness of geriatrician-led admission avoidance hospital at home versus inpatient admission.

PubMed

Shepperd, Sasha; Cradduck-Bamford, Andrea; Butler, Chris; Ellis, Graham; Godfrey, Mary; Gray, Alastair; Hemsley, Anthony; Khanna, Pradeep; Langhorne, Peter; McCaffrey, Patricia; Mirza, Lubena; Pushpangadan, Maj; Ramsay, Scott; Schiff, Rebekah; Stott, David; Young, John; Yu, Ly-Mee

2017-10-23

There is concern that existing models of acute hospital care will become unworkable as the health service admits an increasing number of frail older people with complex health needs, and that there is inadequate evidence to guide the planning of acute hospital level services. We aim to evaluate whether geriatrician-led admission avoidance to hospital at home is an effective alternative to hospital admission. We are conducting a multi-site randomised open trial of geriatrician-led admission avoidance hospital at home, compared with admission to hospital. We are recruiting older people with markers of frailty or prior dependence who have been referred to admission avoidance hospital at home for an acute medical event. This includes patients presenting with delirium, functional decline, dependence, falls, immobility or a background of dementia presenting with physical disease. Participants are randomised using a computerised random number generator to geriatrician-led admission avoidance hospital at home or a control group of inpatient admission in a 2:1 ratio in favour of the intervention. The primary endpoint 'living at home' (the inverse of death or living in a residential care setting) is measured at 6 months follow-up, and we also collect data on this outcome at 12 months. Secondary outcomes include the incidence of delirium, mortality, new long-term residential care, cognitive impairment, activities of daily living, quality of life and quality-adjusted survival, length of stay, readmission or transfer to hospital. We will conduct a parallel economic evaluation, and a process evaluation that includes an interview study to explore the experiences of patients and carers. Health systems around the world are examining how to provide acute hospital-level care to older adults in greater numbers with a fixed or shrinking hospital resource. This trial is the first large multi-site randomised trial of geriatrician-led admission avoidance hospital at home, and will

Does user-centred design affect the efficiency, usability and safety of CPOE order sets?

PubMed Central

Chan, Julie; Shojania, Kaveh G; Easty, Anthony C

2011-01-01

Background Application of user-centred design principles to Computerized provider order entry (CPOE) systems may improve task efficiency, usability or safety, but there is limited evaluative research of its impact on CPOE systems. Objective We evaluated the task efficiency, usability, and safety of three order set formats: our hospital's planned CPOE order sets (CPOE Test), computer order sets based on user-centred design principles (User Centred Design), and existing pre-printed paper order sets (Paper). Participants 27staff physicians, residents and medical students. Setting Sunnybrook Health Sciences Centre, an academic hospital in Toronto, Canada. Methods Participants completed four simulated order set tasks with three order set formats (two CPOE Test tasks, one User Centred Design, and one Paper). Order of presentation of order set formats and tasks was randomized. Users received individual training for the CPOE Test format only. Main Measures Completion time (efficiency), requests for assistance (usability), and errors in the submitted orders (safety). Results 27 study participants completed 108 order sets. Mean task times were: User Centred Design format 273 s, Paper format 293 s (p=0.73 compared to UCD format), and CPOE Test format 637 s (p<0.0001 compared to UCD format). Users requested assistance in 31% of the CPOE Test format tasks, whereas no assistance was needed for the other formats (p<0.01). There were no significant differences in number of errors between formats. Conclusions The User Centred Design format was more efficient and usable than the CPOE Test format even though training was provided for the latter. We conclude that application of user-centred design principles can enhance task efficiency and usability, increasing the likelihood of successful implementation. PMID:21486886

Trends in hospital admission rates for whooping cough in England across five decades: database studies

PubMed Central

Hoang, Uy; Goldacre, Michael J

2014-01-01

Objectives Our aim was to report on trends in hospitalisation rates for pertussis in England from the 1960s to 2011; and to provide context for the recent unexpected activity of Bordetella pertussis in the UK. Design A retrospective analysis of English national Hospital Episode Statistics (HES, 1968–2011) and the Oxford Record Linkage Study (ORLS, 1963–2011) for people admitted to hospital with whooping cough. Setting England and the Oxford Record Linkage Study area. Main outcome measures Age- and gender-specific hospital admission rates, and summary age- and sex-standardised rates, for people aged under 25 years per 100,000 population in each age group. Results Admission rates declined from the 1960s to the early 1970s. For example, the standardised rates were 12.8 (95% confidence interval 11.2–14.5) per 100,000 in England in 1968 and 4.0 (3.0–4.9) per 100,000 in 1973. They then increased to reach 45.0 (41.4–48.6) per 100,000 in 1978 and 47.4 (43.7–51.1) in 1982. From the late 1980s, admission rates continued to decline, falling to between 1 and 4 per 100,000 in each of the years between 2003 and 2011. While the trend in hospital admissions closely followed that in notifications, the annual ratio between these two measures was not consistent ranging from 1.07 (95% confidence interval 1.00–1.14) to 4.03 (3.79–4.27) notifications per admission over the last 10 years. Conclusions Epidemics of whooping cough in the late 1970s and early 1980s were associated with a significant rise in hospital admission rates. Current admission rates are low, by historical comparison. Vaccine programmes must continue to be fully implemented in order to improve control of pertussis activity. PMID:24526463

High-order time-marching reinitialization for regional level-set functions

NASA Astrophysics Data System (ADS)

Pan, Shucheng; Lyu, Xiuxiu; Hu, Xiangyu Y.; Adams, Nikolaus A.

2018-02-01

In this work, the time-marching reinitialization method is extended to compute the unsigned distance function in multi-region systems involving arbitrary number of regions. High order and interface preservation are achieved by applying a simple mapping that transforms the regional level-set function to the level-set function and a high-order two-step reinitialization method which is a combination of the closest point finding procedure and the HJ-WENO scheme. The convergence failure of the closest point finding procedure in three dimensions is addressed by employing a proposed multiple junction treatment and a directional optimization algorithm. Simple test cases show that our method exhibits 4th-order accuracy for reinitializing the regional level-set functions and strictly satisfies the interface-preserving property. The reinitialization results for more complex cases with randomly generated diagrams show the capability our method for arbitrary number of regions N, with a computational effort independent of N. The proposed method has been applied to dynamic interfaces with different types of flows, and the results demonstrate high accuracy and robustness.

Does user-centred design affect the efficiency, usability and safety of CPOE order sets?

PubMed

Chan, Julie; Shojania, Kaveh G; Easty, Anthony C; Etchells, Edward E

2011-05-01

Application of user-centred design principles to Computerized provider order entry (CPOE) systems may improve task efficiency, usability or safety, but there is limited evaluative research of its impact on CPOE systems. We evaluated the task efficiency, usability, and safety of three order set formats: our hospital's planned CPOE order sets (CPOE Test), computer order sets based on user-centred design principles (User Centred Design), and existing pre-printed paper order sets (Paper). 27 staff physicians, residents and medical students. Sunnybrook Health Sciences Centre, an academic hospital in Toronto, Canada. Methods Participants completed four simulated order set tasks with three order set formats (two CPOE Test tasks, one User Centred Design, and one Paper). Order of presentation of order set formats and tasks was randomized. Users received individual training for the CPOE Test format only. Completion time (efficiency), requests for assistance (usability), and errors in the submitted orders (safety). 27 study participants completed 108 order sets. Mean task times were: User Centred Design format 273 s, Paper format 293 s (p=0.73 compared to UCD format), and CPOE Test format 637 s (p<0.0001 compared to UCD format). Users requested assistance in 31% of the CPOE Test format tasks, whereas no assistance was needed for the other formats (p<0.01). There were no significant differences in number of errors between formats. The User Centred Design format was more efficient and usable than the CPOE Test format even though training was provided for the latter. We conclude that application of user-centred design principles can enhance task efficiency and usability, increasing the likelihood of successful implementation.

Interval-Valued Rank in Finite Ordered Sets

DOE Office of Scientific and Technical Information (OSTI.GOV)

Joslyn, Cliff; Pogel, Alex; Purvine, Emilie

We consider the concept of rank as a measure of the vertical levels and positions of elements of partially ordered sets (posets). We are motivated by the need for algorithmic measures on large, real-world hierarchically-structured data objects like the semantic hierarchies of ontolog- ical databases. These rarely satisfy the strong property of gradedness, which is required for traditional rank functions to exist. Representing such semantic hierarchies as finite, bounded posets, we recognize the duality of ordered structures to motivate rank functions which respect verticality both from the bottom and from the top. Our rank functions are thus interval-valued, and alwaysmore » exist, even for non-graded posets, providing order homomorphisms to an interval order on the interval-valued ranks. The concept of rank width arises naturally, allowing us to identify the poset region with point-valued width as its longest graded portion (which we call the “spindle”). A standard interval rank function is naturally motivated both in terms of its extremality and on pragmatic grounds. Its properties are examined, including the relation- ship to traditional grading and rank functions, and methods to assess comparisons of standard interval-valued ranks.« less

National Survey of Emergency Physicians Concerning Home-Based Care Options as Alternatives to Emergency Department-Based Hospital Admissions.

PubMed

Stuck, Amy R; Crowley, Christopher; Killeen, James; Castillo, Edward M

2017-11-01

Emergency departments (EDs) in the United States play a prominent role in hospital admissions, especially for the growing population of older adults. Home-based care, rather than hospital admission from the ED, provides an important alternative, especially for older adults who have a greater risk of adverse events, such as hospital-acquired infections, falls, and delirium. The objective of the survey was to understand emergency physicians' (EPs) perspectives on home-based care alternatives to hospitalization from the ED. Specific goals included determining how often EPs ordered home-based care, what they perceive as the barriers and motivators for more extensive ordering of home-based care, and the specific conditions and response times most appropriate for such care. A group of 1200 EPs nationwide were e-mailed a six-question survey. Participant response was 57%. Of these, 55% reported ordering home-based care from the ED within the past year as an alternative to hospital admission or observation, with most doing so less than once per month. The most common barrier was an "unsafe or unstable home environment" (73%). Home-based care as a "better setting to care for low-acuity chronic or acute disease exacerbation" was the top motivator (79%). Medical conditions EPs most commonly considered for home-based care were cellulitis, urinary tract infection, diabetes, and community-acquired pneumonia. Results suggest that EPs recognize there is a benefit to providing home-based care as an alternative to hospitalization, provided they felt the home was safe and a process was in place for dispositioning the patient to this setting. Better understanding of when and why EPs use home-based care pathways from the ED may provide suggestions for ways to promote wider adoption. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Representations of S{sub {infinity}} admissible with respect to Young subgroups

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nessonov, Nikolai I

2012-03-31

Let N be the set of positive integers and S{sub {infinity}} the set of finite permutations of N. For a partition {Pi} of the set N into infinite parts A{sub 1},A{sub 2},... we denote by S{sub {Pi}} the subgroup of S{sub {infinity}} whose elements leave invariant each of the sets A{sub j}. We set S{sub {infinity}}{sup (N)}={l_brace}s element of S{sub {infinity}:} s(i)=i for any i=1,2,...,N{r_brace}. A factor representation T of the group S{sub {infinity}} is said to be {Pi}-admissible if for some N it contains a nontrivial identity subrepresentation of the subgroup S{sub {Pi}} intersection S{sub {infinity}}{sup (N)}. In themore » paper, we obtain a classification of the {Pi}-admissible factor representations of S{sub {infinity}}. Bibliography: 14 titles.« less

Orders on Intervals Over Partially Ordered Sets: Extending Allen's Algebra and Interval Graph Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zapata, Francisco; Kreinovich, Vladik; Joslyn, Cliff A.

2013-08-01

To make a decision, we need to compare the values of quantities. In many practical situations, we know the values with interval uncertainty. In such situations, we need to compare intervals. Allen’s algebra describes all possible relations between intervals on the real line, and ordering relations between such intervals are well studied. In this paper, we extend this description to intervals in an arbitrary partially ordered set (poset). In particular, we explicitly describe ordering relations between intervals that generalize relation between points. As auxiliary results, we provide a logical interpretation of the relation between intervals, and extend the results aboutmore » interval graphs to intervals over posets.« less

Characteristics of Young Adult (Aged 18-25) and Youth (Aged 12-17) Admissions: 2004. The DASIS Report. Issue 21

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration, 2006

2006-01-01

This report compares young adult admissions to admissions of youths aged 12 to 17, who accounted for 8 percent of Treatment Episode Data Set (TEDS) admissions in 2004. The report further breaks down the young adult admissions into two subgroups: those aged 18 to 21 (9 percent of all admissions); and those aged 22 to 25 (12 percent of all…

The Landscape of Graduate Admissions: Surveying Physics Programs about Doctoral Admissions Practices

NASA Astrophysics Data System (ADS)

Potvin, Geoff

2014-03-01

Sustaining or improving the best graduate programs as well as increasing the diversity of the physics community requires us to better understand the critical gatekeeping role played by graduate admissions. Admissions processes determine not only who is allowed to begin graduate study but can also influence who chooses to even consider applying. Recently, in concert with some of the activities of the APS Bridge Program, a survey was conducted of directors of graduate admissions and associated faculty in doctoral-granting departments about their admissions practices. Receiving responses from over 75% of departments that award PhDs in physics, respondents were probed about their admissions decisions with special attention on the criteria used in admissions and their relative importance, and how student representation considerations are dealt with in the admissions process (if at all). Results indicate a number of important issues for future students, faculty, and administrators to consider including the importance placed on GRE scores. Results also indicate a sizable number of departments express a latent demand for greater numbers of students from traditionally-underrepresented backgrounds (including women) but simultaneously report a dearth of such students who even apply to their doctoral programs. Implications of these and other findings will be discussed.

Shocking Admission

ERIC Educational Resources Information Center

Hoover, Eric; Millman, Sierra

2007-01-01

Marilee Jones's career had been a remarkable success. She joined Massachusetts Institute of Technology's (MIT's) admissions office in 1979, landing a job in Cambridge at a time when boys ruled the sandbox of the admissions profession. Her job was to help MIT recruit more women, who then made up less than one-fifth of the institute's students. She…

45 CFR 618.300 - Admission.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 618.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by any...

Considerations for setting up an order entry system for nuclear medicine tests.

PubMed

Hara, Narihiro; Onoguchi, Masahisa; Nishida, Toshihiko; Honda, Minoru; Houjou, Osamu; Yuhi, Masaru; Takayama, Teruhiko; Ueda, Jun

2007-12-01

Integrating the Healthcare Enterprise-Japan (IHE-J) was established in Japan in 2001 and has been working to standardize health information and make it accessible on the basis of the fundamental Integrating Healthcare Enterprise (IHE) specifications. However, because specialized operations are used in nuclear medicine tests, online sharing of patient information and test order information from the order entry system as shown by the scheduled workflow (SWF) is difficult, making information inconsistent throughout the facility and uniform management of patient information impossible. Therefore, we examined the basic design (subsystem design) for order entry systems, which are considered an important aspect of information management for nuclear medicine tests and needs to be consistent with the system used throughout the rest of the facility. There are many items that are required by the subsystem when setting up an order entry system for nuclear medicine tests. Among these items, those that are the most important in the order entry system are constructed using exclusion settings, because of differences in the conditions for using radiopharmaceuticals and contrast agents and appointment frame settings for differences in the imaging method and test items. To establish uniform management of patient information for nuclear medicine tests throughout the facility, it is necessary to develop an order entry system with exclusion settings and appointment frames as standard features. Thereby, integration of health information with the Radiology Information System (RIS) or Picture Archiving Communication System (PACS) based on Digital Imaging Communications in Medicine (DICOM) standards and real-time health care assistance can be attained, achieving the IHE agenda of improving health care service and efficiently sharing information.

Admission to women's crisis houses or to psychiatric wards: women's pathways to admission.

PubMed

Howard, Louise M; Rigon, Elena; Cole, Laura; Lawlor, Caroline; Johnson, Sonia

2008-12-01

This study compared the sociodemographic and clinical characteristics and pathways to admission for women admitted to women's crisis houses and to psychiatric hospitals. A women's crisis house is a residential mental health crisis facility for women who would otherwise be considered for voluntary hospital admission. A survey of all 388 female admissions to women's crisis houses and psychiatric hospitals in four boroughs of London during a 12-week period in 2006 was conducted with questionnaires administered to key workers involved in the admissions. Pathways to admission were significantly less complex for women admitted to the crisis houses (fewer preadmission contacts with police, emergency departments, and other services). Women admitted to psychiatric wards were more likely to require supervision or observation. A multivariate analysis of data for the 245 voluntary admissions indicated that women admitted to women's crisis houses were significantly less likely to have a care coordinator (odds ratio [OR]=.528) or to have gone to an accident and emergency department (OR=.214) before admission. No other differences were found between the two groups. Pathways to admission were somewhat different for women admitted to women's crisis houses, but few clinical or sociodemographic differences were found between the two groups. Women's crisis houses may be a viable alternative to traditional wards for voluntary patients not needing intensive supervision and observation. Research should examine whether women's crisis houses are as effective as traditional inpatient services in treating women with acute psychiatric problems.

Seeking the Admission Hybrid

ERIC Educational Resources Information Center

Lucido, Jerome A.

2012-01-01

When one thinks of seminal publications in college admission, the first piece that comes to mind is B. Alden Thresher's "College Admissions in the Public Interest" (1966). Thresher's work, relevant to this day, is credited with being the foundational document of the admission profession. McDonough and Robertson's 1995 study, commissioned by NACAC,…

How Do Children Behave Regarding Their Birth Order in Dental Setting?

PubMed

Ghaderi, Faezeh; Fijan, Soleiman; Hamedani, Shahram

2015-12-01

Prediction of child cooperation level in dental setting is an important issue for a dentist to select the proper behavior management method. Many psychological studies have emphasized the effect of birth order on patient behavior and personality; however, only a few researches evaluated the effect of birth order on child's behavior in dental setting. This study was designed to evaluate the influence of children ordinal position on their behavior in dental setting. A total of 158 children with at least one primary mandibular molar needing class I restoration were selected. Children were classified based on the ordinal position; first, middle, or last child as well as single child. A blinded examiner recorded the pain perception of children during injection based on Visual Analogue Scale (VAS) and Sound, Eye and Movement (SEM) scale. To assess the child's anxiety, the questionnaire known as "Dental Subscale of the Children's Fear Survey Schedule" (CFSS-DS) was employed. The results showed that single children were significantly less cooperative and more anxious than the other children (p<0.001). The middle children were significantly more cooperative in comparison with the other child's position (p< 0.001). Single child may behave less cooperatively in dental setting. The order of child birth must also be considered in prediction of child's behavior for behavioral management.

How Do Children Behave Regarding Their Birth Order in Dental Setting?

PubMed Central

Ghaderi, Faezeh; Fijan, Soleiman; Hamedani, Shahram

2015-01-01

Statement of the Problem Prediction of child cooperation level in dental setting is an important issue for a dentist to select the proper behavior management method. Many psychological studies have emphasized the effect of birth order on patient behavior and personality; however, only a few researches evaluated the effect of birth order on child’s behavior in dental setting. Purpose This study was designed to evaluate the influence of children ordinal position on their behavior in dental setting. Materials and Method A total of 158 children with at least one primary mandibular molar needing class I restoration were selected. Children were classified based on the ordinal position; first, middle, or last child as well as single child. A blinded examiner recorded the pain perception of children during injection based on Visual Analogue Scale (VAS) and Sound, Eye and Movement (SEM) scale. To assess the child's anxiety, the questionnaire known as “Dental Subscale of the Children's Fear Survey Schedule” (CFSS-DS) was employed. Results The results showed that single children were significantly less cooperative and more anxious than the other children (p<0.001). The middle children were significantly more cooperative in comparison with the other child's position (p< 0.001). Conclusion Single child may behave less cooperatively in dental setting. The order of child birth must also be considered in prediction of child’s behavior for behavioral management. PMID:26636121

A simple tool to predict admission at the time of triage.

PubMed

Cameron, Allan; Rodgers, Kenneth; Ireland, Alastair; Jamdar, Ravi; McKay, Gerard A

2015-03-01

To create and validate a simple clinical score to estimate the probability of admission at the time of triage. This was a multicentre, retrospective, cross-sectional study of triage records for all unscheduled adult attendances in North Glasgow over 2 years. Clinical variables that had significant associations with admission on logistic regression were entered into a mixed-effects multiple logistic model. This provided weightings for the score, which was then simplified and tested on a separate validation group by receiving operator characteristic (ROC) analysis and goodness-of-fit tests. 215 231 presentations were used for model derivation and 107 615 for validation. Variables in the final model showing clinically and statistically significant associations with admission were: triage category, age, National Early Warning Score (NEWS), arrival by ambulance, referral source and admission within the last year. The resulting 6-variable score showed excellent admission/discharge discrimination (area under ROC curve 0.8774, 95% CI 0.8752 to 0.8796). Higher scores also predicted early returns for those who were discharged: the odds of subsequent admission within 28 days doubled for every 7-point increase (log odds=+0.0933 per point, p<0.0001). This simple, 6-variable score accurately estimates the probability of admission purely from triage information. Most patients could accurately be assigned to 'admission likely', 'admission unlikely', 'admission very unlikely' etc., by setting appropriate cut-offs. This could have uses in patient streaming, bed management and decision support. It also has the potential to control for demographics when comparing performance over time or between departments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Admissible Strategies in Infinite Games over Graphs

NASA Astrophysics Data System (ADS)

Faella, Marco

We consider games played on finite graphs, whose objective is to obtain a trace belonging to a given set of accepting traces. We focus on the states from which Player 1 cannot force a win. We compare several criteria for establishing what is the preferable behavior of Player 1 from those states, eventually settling on the notion of admissible strategy.

Forecasting paediatric malaria admissions on the Kenya Coast using rainfall.

PubMed

Karuri, Stella Wanjugu; Snow, Robert W

2016-01-01

Malaria is a vector-borne disease which, despite recent scaled-up efforts to achieve control in Africa, continues to pose a major threat to child survival. The disease is caused by the protozoan parasite Plasmodium and requires mosquitoes and humans for transmission. Rainfall is a major factor in seasonal and secular patterns of malaria transmission along the East African coast. The goal of the study was to develop a model to reliably forecast incidences of paediatric malaria admissions to Kilifi District Hospital (KDH). In this article, we apply several statistical models to look at the temporal association between monthly paediatric malaria hospital admissions, rainfall, and Indian Ocean sea surface temperatures. Trend and seasonally adjusted, marginal and multivariate, time-series models for hospital admissions were applied to a unique data set to examine the role of climate, seasonality, and long-term anomalies in predicting malaria hospital admission rates and whether these might become more or less predictable with increasing vector control. The proportion of paediatric admissions to KDH that have malaria as a cause of admission can be forecast by a model which depends on the proportion of malaria admissions in the previous 2 months. This model is improved by incorporating either the previous month's Indian Ocean Dipole information or the previous 2 months' rainfall. Surveillance data can help build time-series prediction models which can be used to anticipate seasonal variations in clinical burdens of malaria in stable transmission areas and aid the timing of malaria vector control.

Hospital and Community Characteristics Associated With Pediatric Direct Admission to Hospital.

PubMed

Leyenaar, JoAnna K; Shieh, Meng-Shiou; Lagu, Tara; Pekow, Penelope S; Lindenauer, Peter K

2017-10-27

One quarter of pediatric hospitalizations begin as direct admissions, defined as hospitalization without receiving care in the hospital's emergency department (ED). Direct admission rates are highly variable across hospitals, yet previous studies have not examined reasons for this variation. We aimed to determine the relationships between hospital and community factors and pediatric direct admission rates, and to evaluate the degree to which these characteristics explain variation in risk-adjusted direct admission rates. We conducted a cross-sectional study of the Healthcare Cost and Utilization Project's Kids Inpatient Database, American Hospital Association Database, and Area Health Resource File, including children <18 years of age who were admitted for a medical hospitalization in states contributing data to all data sets. Using hierarchical generalized linear modeling, we generated risk-adjusted direct admission rates and used generalized linear models to assess the association of hospital and community characteristics with these risk-adjusted rates. We included 211,458 children discharged from 933 hospitals and 26 states; 20.2% were admitted directly. One-fifth of the variance in risk-adjusted direct admission rates was attributed to observed hospital and community factors. The greatest proportion of this explained variance was related to ED volume (37%), volume of pediatric hospitalizations (27%), and size of the pediatrician workforce (12%). Direct admission rates were associated with several hospital and community characteristics, but the majority of variation in hospitals' direct admission rates was not explained by these factors. These findings suggest opportunities for diverse hospital types to develop the infrastructure and communication systems necessary to support pediatric direct admissions. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Modelling the Costs and Effects of Selective and Universal Hospital Admission Screening for Methicillin-Resistant Staphylococcus aureus

PubMed Central

Hubben, Gijs; Bootsma, Martin; Luteijn, Michiel; Glynn, Diarmuid; Bishai, David

2011-01-01

Background Screening at hospital admission for carriage of methicillin-resistant Staphylococcus aureus (MRSA) has been proposed as a strategy to reduce nosocomial infections. The objective of this study was to determine the long-term costs and health benefits of selective and universal screening for MRSA at hospital admission, using both PCR-based and chromogenic media-based tests in various settings. Methodology/Principal Findings A simulation model of MRSA transmission was used to determine costs and effects over 15 years from a US healthcare perspective. We compared admission screening together with isolation of identified carriers against a baseline policy without screening or isolation. Strategies included selective screening of high risk patients or universal admission screening, with PCR-based or chromogenic media-based tests, in medium (5%) or high nosocomial prevalence (15%) settings. The costs of screening and isolation per averted MRSA infection were lowest using selective chromogenic-based screening in high and medium prevalence settings, at $4,100 and $10,300, respectively. Replacing the chromogenic-based test with a PCR-based test costs $13,000 and $36,200 per additional infection averted, and subsequent extension to universal screening with PCR would cost $131,000 and $232,700 per additional infection averted, in high and medium prevalence settings respectively. Assuming $17,645 benefit per infection averted, the most cost-saving strategies in high and medium prevalence settings were selective screening with PCR and selective screening with chromogenic, respectively. Conclusions/Significance Admission screening costs $4,100–$21,200 per infection averted, depending on strategy and setting. Including financial benefits from averted infections, screening could well be cost saving. PMID:21483492

Applicability of internet search index for asthma admission forecast using machine learning.

PubMed

Luo, Li; Liao, Chengcheng; Zhang, Fengyi; Zhang, Wei; Li, Chunyang; Qiu, Zhixin; Huang, Debin

2018-04-15

This study aimed to determine whether a search index could provide insight into trends in asthma admission in China. An Internet search index is a powerful tool to monitor and predict epidemic outbreaks. However, whether using an internet search index can significantly improve asthma admissions forecasts remains unknown. The long-term goal is to develop a surveillance system to help early detection and interventions for asthma and to avoid asthma health care resource shortages in advance. In this study, we used a search index combined with air pollution data, weather data, and historical admissions data to forecast asthma admissions using machine learning. Results demonstrated that the best area under the curve in the test set that can be achieved is 0.832, using all predictors mentioned earlier. A search index is a powerful predictor in asthma admissions forecast, and a recent search index can reflect current asthma admissions with a lag-effect to a certain extent. The addition of a real-time, easily accessible search index improves forecasting capabilities and demonstrates the predictive potential of search index. Copyright © 2018 John Wiley & Sons, Ltd.

Medical school dropout--testing at admission versus selection by highest grades as predictors.

PubMed

O'Neill, Lotte; Hartvigsen, Jan; Wallstedt, Birgitta; Korsholm, Lars; Eika, Berit

2011-11-01

Very few studies have reported on the effect of admission tests on medical school dropout. The main aim of this study was to evaluate the predictive validity of non-grade-based admission testing versus grade-based admission relative to subsequent dropout. This prospective cohort study followed six cohorts of medical students admitted to the medical school at the University of Southern Denmark during 2002-2007 (n=1544). Half of the students were admitted based on their prior achievement of highest grades (Strategy 1) and the other half took a composite non-grade-based admission test (Strategy 2). Educational as well as social predictor variables (doctor-parent, origin, parenthood, parents living together, parent on benefit, university-educated parents) were also examined. The outcome of interest was students' dropout status at 2 years after admission. Multivariate logistic regression analysis was used to model dropout. Strategy 2 (admission test) students had a lower relative risk for dropping out of medical school within 2 years of admission (odds ratio 0.56, 95% confidence interval 0.39-0.80). Only the admission strategy, the type of qualifying examination and the priority given to the programme on the national application forms contributed significantly to the dropout model. Social variables did not predict dropout and neither did Strategy 2 admission test scores. Selection by admission testing appeared to have an independent, protective effect on dropout in this setting. © Blackwell Publishing Ltd 2011.

Increasing malaria hospital admissions in Uganda between 1999 and 2009

PubMed Central

2011-01-01

Background Some areas of Africa are witnessing a malaria transition, in part due to escalated international donor support and intervention coverage. Areas where declining malaria rates have been observed are largely characterized by relatively low baseline transmission intensity and rapid scaling of interventions. Less well described are changing patterns of malaria burden in areas of high parasite transmission and slower increases in control and treatment access. Methods Uganda is a country predominantly characterized by intense, perennial malaria transmission. Monthly pediatric admission data from five Ugandan hospitals and their catchments have been assembled retrospectively across 11 years from January 1999 to December 2009. Malaria admission rates adjusted for changes in population density within defined catchment areas were computed across three time periods that correspond to periods where intervention coverage data exist and different treatment and prevention policies were operational. Time series models were developed adjusting for variations in rainfall and hospital use to examine changes in malaria hospitalization over 132 months. The temporal changes in factors that might explain changes in disease incidence were qualitatively examined sequentially for each hospital setting and compared between hospital settings Results In four out of five sites there was a significant increase in malaria admission rates. Results from time series models indicate a significant month-to-month increase in the mean malaria admission rates at four hospitals (trend P < 0.001). At all hospitals malaria admissions had increased from 1999 by 47% to 350%. Observed changes in intervention coverage within the catchments of each hospital showed a change in insecticide-treated net coverage from <1% in 2000 to 33% by 2009 but accompanied by increases in access to nationally recommended drugs at only two of the five hospital areas studied. Conclusions The declining malaria disease

Influence of exposure to perinatal risk factors and parental mental health related hospital admission on adolescent deliberate self-harm risk.

PubMed

Hu, Nan; Li, Jianghong; Glauert, Rebecca A; Taylor, Catherine L

2017-07-01

Adolescent deliberate self-harm (DSH) has been found to be associated with a range of bio-psycho-social factors. Simultaneous investigations of these factors enable more robust estimation of the independent effect of a specific risk factor by adjusting for a more complete set of covariates. However, few studies have had the ability to examine all of these factors together. This study used the linkage of population-level de-identified data collections from government agencies to investigate a range of biological, psychological, and social risk factors and their effects on adolescent risk of DSH (with or without suicidal intent). The investigation was undertaken by progressively adjusting for plausible covariates, including fetal growth status and birth order, early familial social factors, parental hospital admissions due to psychiatric disorders or DSH, and parental all-cause death. Conditional logistic regression was used for data analysis. Children's psychiatric history was analysed to examine the extent to which it may account for the link between the risk factors and adolescent DSH risk. This study identified significant biological and perinatal social risk factors for adolescent DSH risk, including overdue birth, high birth order (≥2), single or teen/young motherhood, high neighbourhood socioeconomic disadvantage, and parental psychiatric and/or DSH-related hospital admissions. Further, parental psychiatric and/or DSH-related admissions, and children's psychiatric admissions in particular, largely attenuated the effects of the perinatal social risk factors but not the biological factors on adolescent DSH risk. These results highlight the importance of taking joint actions involving both health and social services in the prevention of adolescent DSH.

A Review of Legal Decisions Relevant to Technical Standards Used in Pharmacy School Admissions

PubMed Central

2017-01-01

The implementation of an effective and legally sound technical standards procedure for pharmacy schools requires a proactive approach by admissions officers. Applicants with disabilities are accorded significant rights that must not be infringed during the admissions process in order to ensure compliance with applicable law. This article provides a review of applicable state cases, federal cases, and OCR decisions and guidance to help pharmacy schools identify procedures and implement technical standards into their admissions processes as required by ACPE Standards 2016. PMID:28381897

Hypogonadism on admission to acute rehabilitation is correlated with lower functional status at admission and discharge.

PubMed

Carlson, N E; Brenner, L A; Wierman, M E; Harrison-Felix, C; Morey, C; Gallagher, S; Ripley, D

2009-04-01

To investigate the association between hormone levels and functional status during acute TBI rehabilitation. Retrospective cohort study of 43 men with moderate-to-severe TBI admitted to an acute rehabilitation unit during a 1 year period. Labs were drawn on admission, including total and free testosterone (T), prolactin, adrenocorticotropin hormone (ACTH), cortisol, thyroid stimulating hormone (TSH), free thyroxine (fT4) and insulin-like growth factor (IGF-1). Functional Independence Measure (FIM) scores were obtained at admission and discharge. Associations between admission hormone levels and the main outcomes, admission and discharge FIM scores, were assessed using linear regression. Lower total and free T-levels at admission were associated with lower total FIM scores at admission (p < 0.038) and discharge (p < 0.046). Higher cortisol levels at admission were significantly associated with lower admission (p = 0.012) and discharge (p = 0.036) scores on the cognitive-FIM. Prolactin, TSH, fT4 and IGF-1 were not correlated with functional status. In men, lower total and free T-levels at admission to acute rehabilitation correlate with lower admission and discharge FIM scores. These data support the need for studies to investigate the impact of physiological testosterone therapy on outcomes during and post-rehabilitation.

Reviewing RAWP. Variations in admission rates: implications for equitable allocation of resources.

PubMed Central

Bevan, G; Ingram, R

1987-01-01

The review of the Resource Allocation Working Party (RAWP) formula by the National Health Service Management Board has considered the method used to account for cross boundary flows between health authorities. There is no consensus on how this should be done subregionally, as it raises the unresolved problem of the best method of estimating the size of catchment populations. Different methods produce different population sizes when the admission rates of individuals living in different districts vary. The National Health Service/Department of Health and Social Security acute services working group on performance indicators recently considered the assumptions made by different methods in terms of admission thresholds set by hospital clinicians. More complicated methods of assessing catchment areas seem to offer little advantage over the simplest method, but none of the methods answer the underlying questions of what truly determines admission rates and whether higher admission rates are better than lower ones. Empirical research into variations in admission rates and their relation to outcomes is important for determining the fair allocation of resources in future. PMID:3120865

Adaptation and implementation of standardized order sets in a network of multi-hospital corporations in rural Ontario.

PubMed

Meleskie, Jessica; Eby, Don

2009-01-01

Standardized, preprinted or computer-generated physician orders are an attractive project for organizations that wish to improve the quality of patient care. The successful development and maintenance of order sets is a major undertaking. This article recounts the collaborative experience of the Grey Bruce Health Network in adapting and implementing an existing set of physician orders for use in its three hospital corporations. An Order Set Committee composed of primarily front-line staff was given authority over the order set development, approval and implementation processes. This arrangement bypassed the traditional approval process and facilitated the rapid implementation of a large number of order sets in a short time period.

An arbitrary-order Runge–Kutta discontinuous Galerkin approach to reinitialization for banded conservative level sets

DOE PAGES

Jibben, Zechariah Joel; Herrmann, Marcus

2017-08-24

Here, we present a Runge-Kutta discontinuous Galerkin method for solving conservative reinitialization in the context of the conservative level set method. This represents an extension of the method recently proposed by Owkes and Desjardins [21], by solving the level set equations on the refined level set grid and projecting all spatially-dependent variables into the full basis used by the discontinuous Galerkin discretization. By doing so, we achieve the full k+1 order convergence rate in the L1 norm of the level set field predicted for RKDG methods given kth degree basis functions when the level set profile thickness is held constantmore » with grid refinement. Shape and volume errors for the 0.5-contour of the level set, on the other hand, are found to converge between first and second order. We show a variety of test results, including the method of manufactured solutions, reinitialization of a circle and sphere, Zalesak's disk, and deforming columns and spheres, all showing substantial improvements over the high-order finite difference traditional level set method studied for example by Herrmann. We also demonstrate the need for kth order accurate normal vectors, as lower order normals are found to degrade the convergence rate of the method.« less

Level set methods for detonation shock dynamics using high-order finite elements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dobrev, V. A.; Grogan, F. C.; Kolev, T. V.

Level set methods are a popular approach to modeling evolving interfaces. We present a level set ad- vection solver in two and three dimensions using the discontinuous Galerkin method with high-order nite elements. During evolution, the level set function is reinitialized to a signed distance function to maintain ac- curacy. Our approach leads to stable front propagation and convergence on high-order, curved, unstructured meshes. The ability of the solver to implicitly track moving fronts lends itself to a number of applications; in particular, we highlight applications to high-explosive (HE) burn and detonation shock dynamics (DSD). We provide results for two-more » and three-dimensional benchmark problems as well as applications to DSD.« less

Current Legislation on Admission of Mentally Ill Patients in China

PubMed Central

Shao, Yang; Xie, Bin; Good, Mary-Jo DelVecchio; Good, Byron J.

2009-01-01

Objective To date, there is no systematic analysis of mental health laws and their implementation across the People’s Republic of China. This article aims to describe and analyze current legal frameworks for voluntary and involuntary admissions of mentally ill patients in the five cities of China that currently have municipal mental health regulations. Methods Information on the legislation and practice of involuntary admission in the five cities was gathered and assessed using the “WHO Checklist on Mental Health Legislation.” The checklist was completed for each city by a group of psychiatrists trained in mental health legislation. Results Although the mental health regulations in these five cities cover the basic principles needed to meet international standards of mental health legislation, some defects in the legislation remain. In particular, these regulations lack detail in specifying procedures for dealing with admission and treatment and lack oversight and review mechanisms and procedures for appeal of involuntary admission and treatment. Conclusions A more comprehensive and enforceable national mental health act is needed in order to ensure the rights of persons suffering mental illness in terms of admission and treatment procedures. In addition, more research is needed to understand how the current municipal regulations of mental health services in these cities are implemented in routine practice. PMID:19913300

Outpatient 'Acute Gynaecology Clinic' - a novel admission avoidance model to improve women care.

PubMed

Ewies, A A A

2016-05-01

This article presents to the gynaecologists, general practitioners, accident and emergency doctors and the policy makers the concept, proposed set-up and the benefits of the outpatient consultant-delivered 'Acute Gynaecology Clinic' as a novel admission avoidance model to improve women care and satisfaction. The service caters for women who present with urgent benign non-pregnancy-related gynaecological conditions not severe enough to necessitate admission or immediate assessment.

Practices of Whiteness: Racialization in College Admissions Viewbooks

ERIC Educational Resources Information Center

Osei-Kofi, Nana; Torres, Lisette E.; Lui, Joyce

2013-01-01

US colleges and universities today intensively market themselves in order to compete for prospective students. One of the most widespread marketing tools used to attract students are admissions viewbooks, which are designed to provide potential students with favorable impressions of the many institutions to which they may apply. In this study, we…

44 CFR 68.9 - Admissible evidence.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Admissible evidence. 68.9 Section 68.9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... admissible. (b) Documentary and oral evidence shall be admissible. (c) Admissibility of non-expert testimony...

A retrospective study describing the characteristics of one Mental Health Trust's admissions under sections 47 and 48 of the Mental Health Act 1983.

PubMed

Neeilan, Ravindran; O'Brien, Aileen

2017-01-01

Sections 47 and 48 of the Mental Health Act 1983 allow prisoners to be transferred from prison to an appropriate health-care setting in order to be treated. There is an awareness that delays exist when transferring prisoners to hospital. However, literature regarding the delay in returning these patients from hospital is limited. The admissions from prison to a Psychiatric Intensive Care Unit (PICU) in South West London were compared to non-offenders on the PICU in order to compare the average length of stay for both groups and the time taken for the discharge from PICU once felt clinically appropriate. The study also compared demographic profiles, reason for admissions, psychiatric diagnosis and index offences. Over six years, there were 18 admissions from prison to a PICU. The control group comprised 37 non-offenders admitted to the same PICU. On average the prison group took longer to be deemed clinically ready for discharge and, even once clinically ready, then took longer to be discharged. The average length of stay in PICU was 77.83 days for prisoners, and 16.46 days for non-offenders. All 55 admissions were between 1 January 2008 and 31 December 2014. The offender pathway and the difference in the length of stay between prisoners and non-offenders in a PICU warrants further exploration. Possible recommendations to reduce the length of stay of prisoners include improved information sharing between prisons and hospital, and clearer guidelines regarding the level of security required.

Decreased rates of hypoglycemia following implementation of a comprehensive computerized insulin order set and titration algorithm in the inpatient setting.

PubMed

Sinha Gregory, Naina; Seley, Jane Jeffrie; Gerber, Linda M; Tang, Chin; Brillon, David

2016-12-01

More than one-third of hospitalized patients have hyperglycemia. Despite evidence that improving glycemic control leads to better outcomes, achieving recognized targets remains a challenge. The objective of this study was to evaluate the implementation of a computerized insulin order set and titration algorithm on rates of hypoglycemia and overall inpatient glycemic control. A prospective observational study evaluating the impact of a glycemic order set and titration algorithm in an academic medical center in non-critical care medical and surgical inpatients. The initial intervention was hospital-wide implementation of a comprehensive insulin order set. The secondary intervention was initiation of an insulin titration algorithm in two pilot medicine inpatient units. Point of care testing blood glucose reports were analyzed. These reports included rates of hypoglycemia (BG < 70 mg/dL) and hyperglycemia (BG >200 mg/dL in phase 1, BG > 180 mg/dL in phase 2). In the first phase of the study, implementation of the insulin order set was associated with decreased rates of hypoglycemia (1.92% vs 1.61%; p < 0.001) and increased rates of hyperglycemia (24.02% vs 27.27%; p < 0.001) from 2010 to 2011. In the second phase, addition of a titration algorithm was associated with decreased rates of hypoglycemia (2.57% vs 1.82%; p = 0.039) and increased rates of hyperglycemia (31.76% vs 41.33%; p < 0.001) from 2012 to 2013. A comprehensive computerized insulin order set and titration algorithm significantly decreased rates of hypoglycemia. This significant reduction in hypoglycemia was associated with increased rates of hyperglycemia. Hardwiring the algorithm into the electronic medical record may foster adoption.

10 CFR 1042.300 - Admission.

Code of Federal Regulations, 2012 CFR

2012-01-01

... ENERGY (GENERAL PROVISIONS) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1042.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or...

10 CFR 1042.300 - Admission.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ENERGY (GENERAL PROVISIONS) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1042.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or...

29 CFR 36.300 - Admission.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 36.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be...

29 CFR 36.300 - Admission.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 36.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be...

7 CFR 501.2 - Admission.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Admission. 501.2 Section 501.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to the...

Partial admission effect on the performance and vibration of a supersonic impulse turbine

NASA Astrophysics Data System (ADS)

Lee, Hang Gi; Shin, Ju Hyun; Choi, Chang-Ho; Jeong, Eunhwan; Kwon, Sejin

2018-04-01

This study experimentally investigates the effects of partial admission on the performance and vibration outcomes of a supersonic impulse turbine with circular nozzles. The turbine of a turbopump for a gas-generator-type liquid rocket engine in the Korea Space Launch Vehicle-II is of the supersonic impulse type with the partial admission configuration for obtaining a high specific power. Partial admission turbines with a low-flow-rate working gas exhibit benefits over turbines with full admission, such as loss reduction, ease of controllability of the turbine power output, and simple turbine configurations with separate starting sections. However, the radial force of the turbine rotor due to the partial admission causes an increase in turbine vibration. Few experimental studies have previously been conducted regarding the partial admission effects on supersonic impulse turbines with circular nozzles. In the present study, performance tests of supersonic impulse turbines with circular nozzles were conducted for various partial admission ratios using a turbine test facility with high-pressure air in order to investigate the resulting aerodynamic performance and vibration. Four types of turbines with partial admission ratios of 0.17, 0.42, 0.75 and 0.83 were tested. Results show that the efficiencies at the design point increase linearly as the partial admission ratios increase. Moreover, as the velocity ratios increase, the difference in efficiency from the reference turbine with a partial admission ratio of 0.83 becomes increasingly significant, and the magnitudes of these differences are proportional to the square of the velocity ratios. Likewise, the decrease in the partial admission ratio results in an increase in the turbine vibration level owing to the increase in the radial force.

Perceptions of the Benefits to Using a Secondary Admissions Process in Professional Bachelor's Athletic Training Programs

ERIC Educational Resources Information Center

Bowman, Thomas G.; Mazerolle, Stephanie M.; Dodge, Thomas M.

2016-01-01

Context: Some athletic training program (ATP) directors use direct admit, where students are admitted into the ATP directly out of high school. Other ATP directors admit students into the program after a set time period on campus through a secondary admissions process. It remains unknown why ATP directors use various admissions practices.…

The Probabilistic Admissible Region with Additional Constraints

NASA Astrophysics Data System (ADS)

Roscoe, C.; Hussein, I.; Wilkins, M.; Schumacher, P.

The admissible region, in the space surveillance field, is defined as the set of physically acceptable orbits (e.g., orbits with negative energies) consistent with one or more observations of a space object. Given additional constraints on orbital semimajor axis, eccentricity, etc., the admissible region can be constrained, resulting in the constrained admissible region (CAR). Based on known statistics of the measurement process, one can replace hard constraints with a probabilistic representation of the admissible region. This results in the probabilistic admissible region (PAR), which can be used for orbit initiation in Bayesian tracking and prioritization of tracks in a multiple hypothesis tracking framework. The PAR concept was introduced by the authors at the 2014 AMOS conference. In that paper, a Monte Carlo approach was used to show how to construct the PAR in the range/range-rate space based on known statistics of the measurement, semimajor axis, and eccentricity. An expectation-maximization algorithm was proposed to convert the particle cloud into a Gaussian Mixture Model (GMM) representation of the PAR. This GMM can be used to initialize a Bayesian filter. The PAR was found to be significantly non-uniform, invalidating an assumption frequently made in CAR-based filtering approaches. Using the GMM or particle cloud representations of the PAR, orbits can be prioritized for propagation in a multiple hypothesis tracking (MHT) framework. In this paper, the authors focus on expanding the PAR methodology to allow additional constraints, such as a constraint on perigee altitude, to be modeled in the PAR. This requires re-expressing the joint probability density function for the attributable vector as well as the (constrained) orbital parameters and range and range-rate. The final PAR is derived by accounting for any interdependencies between the parameters. Noting that the concepts presented are general and can be applied to any measurement scenario, the idea

Implementation of an evidence-based order set to impact initial antibiotic time intervals in adult febrile neutropenia.

PubMed

Best, Janie T; Frith, Karen; Anderson, Faye; Rapp, Carla Gene; Rioux, Lisa; Ciccarello, Christina

2011-11-01

To evaluate the impact of the implementation of a standardized order set on the time interval in initiation of antibiotic therapy for adult patients with cancer and febrile neutropenia. Practice change. The oncology unit of an urban hospital in the south-eastern United States. Adult patients with cancer and febrile neutropenia admitted six months prior to (n = 30) or during the three months following (n = 23) implementation of the order set. Literature regarding febrile neutropenia, use of order sets, and change process was reviewed. In addition, a retrospective and concurrent chart review was conducted for adult patients admitted with febrile neutropenia. Time intervals were analyzed using SPSS® software, version 18. Initial antibiotic times, order-set use, and length of stay. An overall reduction in time intervals for initiation of antibiotic therapy was observed for presentation (t = 2.25; degrees of freedom [df] = 37; p = 0.031) and order (t = 2.67; df = 40.17; p = 0.012) to antibiotic administration, with an order-set usage of 31% in the inpatient unit and 71% in the emergency department. Findings in the presence of low order-set usage suggest that staff education and placement of the order-set antibiotics in unit-based medication dispensing machines helped reduce time intervals for initial antibiotic therapy. The use of an evidence-based approach to nursing care is essential to achieving the best outcomes for patients with febrile neutropenia. Incorporation of current evidence into an order set to guide clinical practice and comprehensive nurse, pharmacy, and physician education are needed for the successful implementation of evidence-based practice changes.

Admission to Women’s Crisis Houses or to Psychiatric Wards: Women’s Pathways to Admission

PubMed Central

Howard, Louise M.; Rigon, Elena; Cole, Laura; Lawlor, Caroline; Johnson, Sonia

2009-01-01

Objective This study compared the sociodemographic and clinical characteristics and pathways to admission for women admitted to women’s crisis houses and to psychiatric hospitals. A women’s crisis house is a residential mental health crisis facility for women who would otherwise be considered for voluntary hospital admission. Methods A survey of all 388 female admissions to women’s crisis houses and psychiatric hospitals in four boroughs of London during a 12-week period in 2006 was conducted with questionnaires administered to key workers involved in the admissions. Results Pathways to admission were significantly less complex for women admitted to the crisis houses (fewer preadmission contacts with police, emergency departments, and other services). Women admitted to psychiatric wards were more likely to require supervision or observation. A multivariate analysis of data for the 245 voluntary admissions indicated that women admitted to women’s crisis houses were significantly less likely to have a care coordinator (odds ratio [OR]=.528) or to have gone to an accident and emergency department (OR=.214) before admission. No other differences were found between the two groups. Conclusions Pathways to admission were somewhat different for women admitted to women’s crisis houses, but few clinical or sociodemographic differences were found between the two groups. Women’s crisis houses may be a viable alternative to traditional wards for voluntary patients not needing intensive supervision and observation. Research should examine whether women’s crisis houses are as effective as traditional inpatient services in treating women with acute psychiatric problems. PMID:19033172

Professional perspectives on systemic barriers to admission avoidance: learning from a system dynamics study of older people's admission pathways.

PubMed

Walsh, Bronagh; Lattimer, Valerie; Wintrup, Julie; Brailsford, Sally

2015-06-01

There is debate worldwide about the best way to manage increased healthcare demand within ageing populations, particularly rising rates of unplanned and avoidable hospital admissions. To understand health and social care professionals' perspectives on barriers to admission avoidance throughout the admissions journey, in particular: the causes of avoidable admissions in older people; drivers of admission and barriers to use of admission avoidance strategies; and improvements to reduce unnecessary admissions. A qualitative framework analysis of interview data from a System dynamics (SD) modelling study. Semi-structured interviews were conducted with twenty health and social care professionals with experience of older people's admissions. The interviews were used to build understanding of factors facilitating or hindering admission avoidance across the admissions system. Data were analysed using framework analysis. Three overarching themes emerged: understanding the needs of the patient group; understanding the whole system; and systemwide access to expertise in care of older people. There were diverse views on the underlying reasons for avoidable admissions and recognition of the need for whole-system approaches to service redesign. Participants recommended system redesign that recognises the specific needs of older people, but there was no consensus on underlying patient needs or specific service developments. Access to expertise in management of older and frailer patients was seen as a barrier to admission avoidance throughout the system. Providing access to expertise and leadership in care of frail older people across the admissions system presents a challenge for service managers and nurse educators but is seen as a prerequisite for effective admission avoidance. System redesign to meet the needs of frail older people requires agreement on causes of avoidable admission and underlying patient needs. © 2014 John Wiley & Sons Ltd.

The Effect of Automated Alerts on Provider Ordering Behavior in an Outpatient Setting

PubMed Central

Steele, Andrew W; Eisert, Sheri; Witter, Joel; Lyons, Pat; Jones, Michael A; Gabow, Patricia; Ortiz, Eduardo

2005-01-01

Background Computerized order entry systems have the potential to prevent medication errors and decrease adverse drug events with the use of clinical-decision support systems presenting alerts to providers. Despite the large volume of medications prescribed in the outpatient setting, few studies have assessed the impact of automated alerts on medication errors related to drug–laboratory interactions in an outpatient primary-care setting. Methods and Findings A primary-care clinic in an integrated safety net institution was the setting for the study. In collaboration with commercial information technology vendors, rules were developed to address a set of drug–laboratory interactions. All patients seen in the clinic during the study period were eligible for the intervention. As providers ordered medications on a computer, an alert was displayed if a relevant drug–laboratory interaction existed. Comparisons were made between baseline and postintervention time periods. Provider ordering behavior was monitored focusing on the number of medication orders not completed and the number of rule-associated laboratory test orders initiated after alert display. Adverse drug events were assessed by doing a random sample of chart reviews using the Naranjo scoring scale. The rule processed 16,291 times during the study period on all possible medication orders: 7,017 during the pre-intervention period and 9,274 during the postintervention period. During the postintervention period, an alert was displayed for 11.8% (1,093 out of 9,274) of the times the rule processed, with 5.6% for only “missing laboratory values,” 6.0% for only “abnormal laboratory values,” and 0.2% for both types of alerts. Focusing on 18 high-volume and high-risk medications revealed a significant increase in the percentage of time the provider stopped the ordering process and did not complete the medication order when an alert for an abnormal rule-associated laboratory result was displayed (5.6% vs

Is Contextualised Admission the Answer to the Access Challenge?

ERIC Educational Resources Information Center

Mountford-Zimdars, Anna; Moore, Joanne; Graham, Janet

2016-01-01

This article reviews the idea of contextualising applicants to higher education in order to widen access. First, the meaning of contextualised admissions (CAs) is discussed before laying out the rationale for contextualising applicants and the beneficiaries of the policy. The final sections discuss key critiques of CA and conclude by arguing that…

Equilibrium Tuition, Applications, Admissions and Enrollment in the College Market

ERIC Educational Resources Information Center

Fu, Chao

2010-01-01

I develop and structurally estimate an equilibrium model of the college market. Students, who are heterogeneous in both abilities and preferences, make college application decisions, subject to uncertainty and application costs. Colleges observe only noisy measures of student ability and set up tuition and admissions policies to compete for more…

Meeting a Forensic Podiatry Admissibility Challenge: A Daubert Case Study.

PubMed

Nirenberg, Michael

2016-05-01

This article is an introduction to the United States Supreme Court's standard of admissibility of forensic evidence and testimony at trial, known as the Daubert standard, with emphasis on how this standard applies to the field of forensic podiatry. The author, a forensic podiatrist, provided law enforcement with evidence tying a bloody sock-clad footprint found at the scene of a homicide to the suspect. In 2014, the author testified at a pretrial hearing, known as "a Daubert hearing," to address the admissibility of this evidence in court. This was the first instance of forensic podiatry being the primary subject of a Daubert hearing. The hearing resulted in the court ordering this evidence admissible. The expert's testimony contributed to the suspect's conviction. This article serves as a reference for forensic podiatrists and experts in similar fields that involve impression evidence, providing evidentiary standards and their impact on expert evidence and testimony. © 2016 American Academy of Forensic Sciences.

Technology in International Admissions

ERIC Educational Resources Information Center

White, Elizabeth

2012-01-01

In a relatively short time, technology applications have become an essential feature of the admissions business. They make the jobs of international admissions professionals easier in many ways, allowing for more robust communication with applicants and counselors, a streamlined application process, and quicker access to information about…

Pre-admission antibiotics for suspected cases of meningococcal disease.

PubMed

Sudarsanam, Thambu D; Rupali, Priscilla; Tharyan, Prathap; Abraham, Ooriapadickal Cherian; Thomas, Kurien

2013-08-02

= 477; 29 with sequelae; low-quality evidence). No adverse effects of treatment were reported. Estimated treatment costs were similar. No data were available on disease burden due to sequelae. We found no reliable evidence to support or refute the use of pre-admission antibiotics for suspected cases of non-severe meningococcal disease. Evidence of moderate quality from one RCT indicated that single intramuscular injections of ceftriaxone and long-acting chloramphenicol were equally effective, safe and economical in reducing serious outcomes. The choice between these antibiotics would be based on affordability, availability and patterns of antibiotic resistance.Further RCTs comparing different pre-admission antibiotics, accompanied by intensive supportive measures, are ethically justifiable in participants with severe illness, and are needed to provide reliable evidence in different clinical settings.

Implementing competency based admissions at the Albert Einstein College of Medicine.

PubMed

Kerrigan, Noreen; Akabas, Myles H; Betzler, Thomas F; Castaldi, Maria; Kelly, Mary S; Levy, Adam S; Reichgott, Michael J; Ruberman, Louise; Dolan, Siobhan M

2016-01-01

The Albert Einstein College of Medicine (Einstein) was founded in 1955 during an era of limited access to medical school for women, racial minorities, and many religious and ethnic groups. Located in the Bronx, NY, Einstein seeks to educate physicians in an environment of state-of-the-art scientific inquiry while simultaneously fulfilling a deep commitment to serve its community by providing the highest quality clinical care. A founding principle of Einstein, the basis upon which Professor Einstein agreed to allow the use of his name, was that admission to the student body would be based entirely on merit. To accomplish this, Einstein has long used a 'holistic' approach to the evaluation of its applicants, actively seeking a diverse student body. More recently, in order to improve its ability to identify students with the potential to be outstanding physicians, who will both advance medical knowledge and serve the pressing health needs of a diverse community, the Committee on Admissions reexamined and restructured the requirements for admission. These have now been categorized as four 'Admissions Competencies' that an applicant must demonstrate. They include: 1) cocurricular activities and relevant experiences; 2) communication skills; 3) personal and professional development; and 4) knowledge. The purpose of this article is to describe the process that resulted in the introduction and implementation of this competency based approach to the admission process.

Assessing the economic value of avoiding hospital admissions by shifting the management of gram+ acute bacterial skin and skin-structure infections to an outpatient care setting.

PubMed

Ektare, V; Khachatryan, A; Xue, M; Dunne, M; Johnson, K; Stephens, J

2015-01-01

To estimate, from a US payer perspective, the cost offsets of treating gram positive acute bacterial skin and skin-structure infections (ABSSSI) with varied hospital length of stay (LOS) followed by outpatient care, as well as the cost implications of avoiding hospital admission. Economic drivers of care were estimated using a literature-based economic model incorporating inpatient and outpatient components. The model incorporated equal efficacy, adverse events (AE), resource use, and costs from literature. Costs of once- and twice-daily outpatient infusions to achieve a 14-day treatment were analyzed. Sensitivity analyses were performed. Costs were adjusted to 2015 US$. Total non-drug medical cost for treatment of ABSSSI entirely in the outpatient setting to avoid hospital admission was the lowest among all scenarios and ranged from $4039-$4924. Total non-drug cost for ABSSSI treated in the inpatient setting ranged from $9813 (3 days LOS) to $18,014 (7 days LOS). Inpatient vs outpatient cost breakdown was: 3 days inpatient ($6657)/11 days outpatient ($3156-$3877); 7 days inpatient ($15,017)/7 days outpatient ($2495-$2997). Sensitivity analyses revealed a key outpatient cost driver to be peripherally inserted central catheter (PICC) costs (average per patient cost of $873 for placement and $205 for complications). Drug and indirect costs were excluded and resource use was not differentiated by ABSSSI type. It was assumed that successful ABSSSI treatment takes up to 14 days per the product labels, and that once-daily and twice-daily antibiotics have equal efficacy. Shifting ABSSSI care to outpatient settings may result in medical cost savings greater than 53%. Typical outpatient scenarios represent 14-37% of total medical cost, with PICC accounting for 28-43% of the outpatient burden. The value of new ABSSSI therapies will be driven by eliminating the need for PICC line, reducing length of stay and the ability to completely avoid a hospital stay.

Hospital admission avoidance through the introduction of a virtual ward.

PubMed

Jones, Joanne; Carroll, Andrea

2014-07-01

The ageing British population is placing increased demands on the delivery of care in mainstream health-care institutions. While people are living longer, a significant percentage is also living with one or more long-term conditions. These issues, alongside continuing financial austerity measures, require a radical improvement in the care of patients away from hospitals. The Wyre Forest Clinical Commissioning Group introduced a virtual ward model for two main purposes: to save on spiralling costs of hospital admissions, and, secondly, to ensure the preferred wishes of most patients to be cared for and even die at home were achieved. This commentary describes how the virtual ward model was implemented and the impact of preventing unplanned emergency admissions to hospitals. The setting up of enhanced care services and virtual wards in one county is discussed, aiming to highlight success points and potential pitfalls to avoid. The results from the implementation of the virtual ward model show a significant reduction in emergency and avoidable patient admissions to hospital. The success of virtual wards is dependent on integrated working between different health-care disciplines.

32 CFR 575.2 - Admission; general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... MILITARY ACADEMY § 575.2 Admission; general. (a) In one major respect, the requirements for admission to the United States Military Academy differ from the normal requirements for admission to a civilian college or university; each candidate must obtain an official nomination to the Academy. The young person...

Debris Object Orbit Initialization Using the Probabilistic Admissible Region with Asynchronous Heterogeneous Observations

NASA Astrophysics Data System (ADS)

Zaidi, W. H.; Faber, W. R.; Hussein, I. I.; Mercurio, M.; Roscoe, C. W. T.; Wilkins, M. P.

One of the most challenging problems in treating space debris is the characterization of the orbit of a newly detected and uncorrelated measurement. The admissible region is defined as the set of physically acceptable orbits (i.e. orbits with negative energies) consistent with one or more measurements of a Resident Space Object (RSO). Given additional constraints on the orbital semi-major axis, eccentricity, etc., the admissible region can be constrained, resulting in the constrained admissible region (CAR). Based on known statistics of the measurement process, one can replace hard constraints with a Probabilistic Admissible Region (PAR), a concept introduced in 2014 as a Monte Carlo uncertainty representation approach using topocentric spherical coordinates. Ultimately, a PAR can be used to initialize a sequential Bayesian estimator and to prioritize orbital propagations in a multiple hypothesis tracking framework such as Finite Set Statistics (FISST). To date, measurements used to build the PAR have been collected concurrently and by the same sensor. In this paper, we allow measurements to have different time stamps. We also allow for non-collocated sensor collections; optical data can be collected by one sensor at a given time and radar data collected by another sensor located elsewhere. We then revisit first principles to link asynchronous optical and radar measurements using both the conservation of specific orbital energy and specific orbital angular momentum. The result from the proposed algorithm is an implicit-Bayesian and non-Gaussian representation of orbital state uncertainty.

Impact of a crisis assessment and treatment service on admissions into an acute psychiatric unit.

PubMed

Adesanya, Adesina

2005-06-01

To assess the impact of a regional/rural crisis assessment and treatment service (CAT) on admissions into an acute adult inpatient psychiatric facility. Relevant data for admissions into an acute adult inpatient psychiatric facility in the 18 month periods before and after the establishment of a CAT were compared. Data extracted from available clinical records were transferred into an appropriately structured pro forma for statistical analysis. There were 69 and 53 index inpatient unit admissions in the two time periods. The majority of these were for single, unemployed men aged in their 30s. Although statistically non-significant, the results appear to suggest that there were proportionately fewer readmissions and that admissions were likely to be influenced by illness severity and diagnostic considerations in the period following the establishment of the CAT. The establishment of CAT did not appear to have had much impact on the duration of psychiatric hospitalization. Crisis assessment and treatment services operating within a regional/rural integrated mental health setting appear to have only limited impact on hospitalization for psychiatric crisis presentations. There is a need for further studies looking at a broader range of outcome variables in the assessment of the impact of CAT on psychiatric hospitalization in such settings.

A brief report on Hispanic youth marijuana use: Trends in substance abuse treatment admissions in the United States.

PubMed

Marzell, Miesha; Sahker, Ethan; Pro, George; Arndt, Stephan

2017-01-01

Increases in Hispanic youth admissions to substance abuse treatment programs for marijuana use are a growing public health concern. In this study, we investigated trends in Hispanic youth from 1995 to 2012 utilizing the Treatment Episode Data Set-Admissions of the Substance Abuse Mental Health Services Administration. Hispanic youth marijuana admissions are associated with youth 15-17 years old, in high school, and living in a dependent situation. Notably, female admissions increased at greater rates than males. Results also point to decreasing tolerance of minor marijuana use by schools and community agencies. Findings highlight the need for targeted, culturally specific, and cost-effective treatment and prevention efforts.

An Admissions Officer's Credentials

ERIC Educational Resources Information Center

Chronicle of Higher Education, 2007

2007-01-01

Marilee Jones has resigned as a dean of admissions at the Massachusetts Institute of Technology after admitting that she had misrepresented her academic degrees when first applying to work at the university in 1979. As one of the nation's most prominent admissions officers--and a leader in the movement to make the application process less…

College Admissions Policies for the 1970's.

ERIC Educational Resources Information Center

College Entrance Examination Board, New York, NY.

The papers included in this collection are (1) "Problems and Issues Confronting the Admissions Community" by Clyde Vroman; (2) "Frozen Assumptions in Admissions" by B. Alden Thresher; (3) "The Effect of Federal Programs on Admissions Policies" by John F. Morse; (4) "State Plans for Higher Education and Their Influence on Admissions" by Charles W.…

Emergency department presentation and readmission after index psychiatric admission: a data linkage study

PubMed Central

Li, Xue; Srasuebkul, Preeyaporn; Reppermund, Simone

2018-01-01

Objective To use linked administrative datasets to assess factors associated with emergency department (ED) presentation and psychiatric readmission in three distinctive time intervals after the index psychiatric admission. Design A retrospective data-linkage study. Setting Cohort study using four linked government minimum datasets including acute hospital care from July 2005 to June 2012 in New South Wales, Australia. Participants People who were alive and aged ≥18 years on 1 July 2005 and who had their index admission to a psychiatric ward from 1 July 2007 to 30 June 2010. Outcome measures ORs of factors associated with psychiatric admission and ED presentation were calculated for three intervals: 0–1 month, 2–5 months and 6–24 months after index separation. Results Index admission was identified in 35 056 individuals (51% -males) with a median age of 42 years. A total of 12 826 (37%) individuals had at least one ED presentation in the 24 months after index admission. Of those, 3608 (28%) presented within 0–1 month, 6350 (50%) within 2–5 months and 10 294 (80%) within 6–24 months after index admission. A total of 14 153 (40%) individuals had at least one psychiatric readmission in the first 24 months. Of those, 6808 (48%) were admitted within 0–1 month, 6433 (45%) within 2–5 months and 7649 (54%) within 6–24 months after index admission. Principal diagnoses and length of stay at index admission, sociodemographic factors, Charlson Comorbidity Index score, drug and alcohol comorbidity, intellectual disability and other inpatient service use were significantly associated with ED presentations and psychiatric readmissions, and these relationships varied somewhat over the intervals studied. Conclusion Social determinants of service use, drug and alcohol intervention, addressing needs of individuals with intellectual disability and recovery-oriented whole-person approaches at index admission are key areas for investment to improve

Blood cultures in emergency medical admissions: a key patient cohort.

PubMed

Chotirmall, Sanjay H; Callaly, Elizabeth; Lyons, Judith; O'Connell, Brian; Kelleher, Mary; Byrne, Declan; O'Riordan, Deirdre; Silke, Bernard

2016-02-01

Blood cultures are performed in the emergency room when sepsis is suspected, and a cohort of patients is thereby identified. The present study investigated the outcomes (mortality and length of hospital stay) in this group following an emergency medical admission. Prospective assessment of all emergency medical admissions presenting to the emergency department at St James's Hospital, Dublin, over an 11-year period (2002-2012) was carried out. Outcomes including 30-day in-hospital mortality and length of stay were explored in the context of an admission blood culture. Generalized estimating equations, logistic or zero-truncated Poisson multivariate models were used, with adjustment for confounding variables including illness severity, comorbidity, and chronic disabling disease, to assess the effect of an urgent blood culture on mortality and length of stay. A total of 60 864 episodes were recorded in 35 168 patients admitted over the time period assessed. Patients more likely to undergo blood cultures in the emergency department were male, younger, and had more comorbidity. Univariate and multivariate analyses showed that those who had a blood culture, irrespective of result, had increased mortality and a longer in-hospital stay. This was highest for those with a positive culture, irrespective of the organism isolated. A clinical decision to request a blood culture identified a subset of emergency admissions with markedly worse outcomes. This patient cohort warrants close monitoring in the emergency setting.

Clinical associations of delirium in hospitalized adult patients and the role of on admission presentation.

PubMed

Lin, Robert Y; Heacock, Laura C; Bhargave, Geeta A; Fogel, Joyce F

2010-10-01

To describe clinical associations of delirium in hospitalized patients and relationships to on admission presentation. Retrospective analysis of an administrative hospitalization database 1998-2007. Acute care hospitalizations in the New York State (NYS). Four categories of diagnosis related group (DRG) hospitalizations were extracted from a NYS administrative database: pneumonia, congestive heart failure, urinary tract/kidney infection (UTI), and lower extremity orthopedic surgery (LEOS) DRGs. These hospitalizations were examined for clinical associations with delirium coding both on and after admission. Delirium was coded in 0.8% of the cohort, of which an on admission diagnosis was present in 59%. On admission delirium was strongly associated with dementia (adjusted odds ratio 0, 95%CI 5.8-6.3) and with adverse drug effects (ADEs) (adjusted odds ratio 4.6, 95%CI 4.3, 5.0). After admission delirium was even more highly associated with ADEs (adjusted odds ratio 22.2, 95%CI 20.7-23.7). The UTI DRG category had the greatest proportion of on admission delirium. However after admission delirium was more common in the LEOS DRG category. Over time, there was a greater increase in delirium proportions in the UTI DRG category, and an overall increase in coding for encephalopathy states (potential alternative delirium descriptors). ADEs play an important role in delirium regardless of whether or not it is present on admission. While the finding that most delirium hospitalizations presented on admission suggests that delirium impacts more as a clinical admitting determinant, in-hospital prevention strategies may still have benefit in targeted settings where after admission delirium is more frequent, such as patients with LEOS. Copyright © 2010 John Wiley & Sons, Ltd.

Playing the Private College Admissions Game.

ERIC Educational Resources Information Center

Moll, Richard

Truths and myths involved with student admission to Ivy League colleges are revealed by a director of admissions whose experience includes admission work at Vassar, Bowdoin, Harvard and Yale. Several basic concepts are offered as fact: most private colleges in America today are not highly selective; many colleges pose as being more selective than…

Pre-admission antibiotics for suspected cases of meningococcal disease.

PubMed

Sudarsanam, Thambu D; Rupali, Priscilla; Tharyan, Prathap; Abraham, Ooriapadickal Cherian; Thomas, Kurien

2017-06-14

2.15; N = 477; 18 clinical failures; moderate-quality evidence), or neurological sequelae (RR 1.29, 95% CI 0.63 to 2.62; N = 477; 29 with sequelae; low-quality evidence). No adverse effects of treatment were reported. Estimated treatment costs were similar. No data were available on disease burden due to sequelae. We found no reliable evidence to support the use pre-admission antibiotics for suspected cases of non-severe meningococcal disease. Moderate-quality evidence from one RCT indicated that single intramuscular injections of ceftriaxone and long-acting chloramphenicol were equally effective, safe, and economical in reducing serious outcomes. The choice between these antibiotics should be based on affordability, availability, and patterns of antibiotic resistance.Further RCTs comparing different pre-admission antibiotics, accompanied by intensive supportive measures, are ethically justified in people with less severe illness, and are needed to provide reliable evidence in different clinical settings.

Unanticipated Admission Following Outpatient Rotator Cuff Repair: An Analysis of 18,061 Cases.

PubMed

Gil, Joseph A; Durand, Wesley M; Johnson, Joey P; Goodman, Avi D; Owens, Brett D; Daniels, Alan H

2018-05-01

The objective of this investigation was to examine the characteristics that place patients at risk for unanticipated inpatient admission after outpatient arthroscopic rotator cuff repair. This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program data sets from years 2012 to 2015. Patients were included in the study based on the presence of a primary Current Procedural Terminology code for rotator cuff repair (23410, 23412, 23420, and 29827). Only outpatient, nonemergent, and elective procedures performed on patients with American Society of Anesthesiologists classification of 4 or less were considered. The primary outcome variable was admission after outpatient surgery (defined as length of initial hospital stay >0). This study examined risk factors for unanticipated admission following rotator cuff repair, finding that age of 65 years or older, female sex, hypertension, body mass index of 35 kg/m 2 or greater, American Society of Anesthesiologists classification of 2 or greater, and open surgical technique were significant predictors of admission, whereas monitored anesthesia care and regional anesthesia were associated with decreased odds of admission. Identifying patients with these characteristics will be critical in risk adjusting the anticipated cost of the episode of care in outpatient rotator cuff repair. [Orthopedics. 2018; 41(3):164-168.]. Copyright 2018, SLACK Incorporated.

Per capita increase in hospital presentations and admissions among children since the 1990s.

PubMed

Hardy, Andrew; Fuller, David G; Forrester, Mike; Anderson, Kym P; Cooper, Chris; Jenner, Bernard; Marshall, Isaac; Mccloskey, Kate; Sanderson, Christine; Standish, Jane; Vuillermin, Peter

2016-10-01

Data regarding temporal trends in per capita paediatric hospital presentations and admissions are required to inform health system and workforce planning. Emergency Department (ED) presentations and admissions to the University Hospital Geelong among patients aged 0 to 16 years over a 12-month period (2012-2013) were determined by review of hospital records and then compared with similar data collected during 1996/1997. 1 During each period, the Geelong region was serviced by a single ED, enabling us to estimate per capita presentation and admission rates. Since 1996/1997, per capita paediatric presentations to the ED increased from 643 to 1837 per 10 000 (186%; 95% confidence interval 181% to 191%). Moreover, the proportion of paediatric ED presentations resulting in hospital admission increased from 12.3% to 18.3% (49%; 95% confidence interval 39% to 59%). There has been a substantial absolute and per capita increase in paediatric ED presentations and hospital admissions since the 1990s. These trends place an increasing burden on the public hospital system, and strategies are required to promote paediatric acute care in the ambulatory setting. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission.

PubMed

Bliss, Donna Z; Gurvich, Olga; Savik, Kay; Eberly, Lynn E; Harms, Susan; Mueller, Christine; Garrard, Judith; Cunanan, Kristen; Wiltzen, Kjerstie

2017-09-01

Pressure ulcers increase the risk of costly hospitalization and mortality of nursing home residents, so timely healing is important. Disparities in healthcare have been identified in the nursing home population but little is known about disparities in the healing of pressure ulcers. To assess racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission. Multi-levels predictors, at the individual resident, nursing home, and community/Census tract level, were examined in three large data sets. Minimum Data Set records of older individuals admitted to one of 439 nursing homes of a national, for-profit chain over three years with a stages 2-4 pressure ulcer (n=10,861) were searched to the 90-day assessment for the first record showing pressure ulcer healing. Predictors of pressure ulcer healing were analyzed for White admissions first using logistic regression. The Peters-Belson method was used to assess racial or ethnic disparities among minority group admissions. A significantly smaller proportion of Black nursing home admissions had their pressure ulcer heal than expected had they been part of the White group. There were no disparities in pressure ulcer healing disadvantaging other minority groups. Significant predictors of a nonhealing of pressure ulcer were greater deficits in activities of daily living and pressure ulcer severity. Reducing disparities in pressure ulcer healing is needed for Blacks admitted to nursing homes. Knowledge of disparities in pressure ulcer healing can direct interventions aiming to achieve equity in healthcare for a growing number of minority nursing home admissions. Copyright © 2017 Elsevier B.V. All rights reserved.

A confidential enquiry into emergency hospital admissions on the Isle of Wight, UK.

PubMed Central

Denman-Johnson, M; Bingham, P; George, S

1997-01-01

OBJECTIVES: To quantify the proportion of potentially avoidable emergency short term admissions to hospital and to identify ways in which they could have been avoided. DESIGN: Confidential enquiry by peer review group. SETTING: St Mary's Hospital, Newport, Isle of Wight. SUBJECTS: All emergency, short term admissions (discharged home within five days) to medicine, general surgery, orthopaedics, gynaecology, ENT, and ophthalmology specialties for 28 (24 hour) days over a six month period in 1994. MAIN OUTCOME MEASURES: Appropriateness of admissions decided by the peer group, the peer group's opinion of ideal management, and the patients' views on the appropriateness of their admission. RESULTS: Altogether 139 cases satisfied the inclusion criteria. Complete data were collected on 123 cases and the peer group considered 81 in the time available. Twenty one of the 81 cases were judged "potentially avoidable". These represent 9.5% (95% CI 6.3%, 13.5%) of short term admissions to the specialties studied. The peer group considered that seven of 10 patients referred by a general practitioner (GP) could have been managed by the GP alone and that the remaining three had been referred appropriately but need not have been admitted had a consultant opinion been available in the accident and emergency (A&E) department. Two of the 10 would have required home support to avoid hospital admission. Five of 11 patients who referred themselves to A&E could have been discharged home without admission and without recourse to a specialist opinion. The remaining six could have been discharged had a consultant opinion been available in A&E. CONCLUSIONS: Urgent consultant opinion, either in A&E or in an outpatient clinic, would have prevented most of these inappropriate admissions, and home support would have expedited the ability to discharge some patients. Further research into the costs and benefits of methods for providing these services is needed urgently. PMID:9328544

Equivalences between nonuniform exponential dichotomy and admissibility

NASA Astrophysics Data System (ADS)

Zhou, Linfeng; Lu, Kening; Zhang, Weinian

2017-01-01

Relationship between exponential dichotomies and admissibility of function classes is a significant problem for hyperbolic dynamical systems. It was proved that a nonuniform exponential dichotomy implies several admissible pairs of function classes and conversely some admissible pairs were found to imply a nonuniform exponential dichotomy. In this paper we find an appropriate admissible pair of classes of Lyapunov bounded functions which is equivalent to the existence of nonuniform exponential dichotomy on half-lines R± separately, on both half-lines R± simultaneously, and on the whole line R. Additionally, the maximal admissibility is proved in the case on both half-lines R± simultaneously.

Using "Relationship Marketing" Theory To Develop a Training Model for Admissions Recruiters.

ERIC Educational Resources Information Center

Gyure, James F.; Arnold, Susan G.

2001-01-01

Addresses a critical aspect of enrollment management by providing a "conceptual training outline" based on relationship marketing and management principles for admissions recruiters and other appropriate enrollment staff. Provides a set of "Attitude Tools" to suggest how various training methods might benefit from a consistent…

Medical residencies and increased admissions in rural hospitals with fewer than 200 beds.

PubMed

Connor, R A

2000-01-01

Medical education programs in general, and rural residency programs in particular, can be beneficial for rural hospitals. This study of 1,792 non-metropolitan statistical area, acute general hospitals with fewer than 200 beds from 1993 to 1996 was designed to help rural hospitals and communities to quantify the likely effects of rural residency programs on hospital admissions. Data came from the hospital Prospective Payment System minimum data set. The results show that additional residents at rural hospitals with fewer than 200 beds generally result in an increase of approximately 100 to 200 admissions per resident--more for smaller hospitals and fewer for larger hospitals. Because increased admissions generally improve the financial health and continued operation of rural hospitals, this study confirms the importance of education-based strategies in ensuring access to care in rural communities.

Characterizing emergency admissions of patients with sickle cell crisis in NHS brent: observational study

PubMed Central

Green, Stuart A; AlJuburi, Ghida; Majeed, Azeem; Okoye, Ogo; Amobi, Carole; Banarsee, Ricky; Phekoo, Karen J

2012-01-01

Objectives To characterize emergency admissions for patients with sickle cell crisis in NHS Brent and to determine which patients and practices may benefit most from primary care intervention. Design Observational study Setting Emergency departments attended by residents of the London borough of Brent Participants Patients with sickle cell disease registered with a general practitioner (GP) in the borough of Brent Main outcome measures Analysis of admissions between January 2008 and July 2010 that included length of stay (average and <2 days versus ≥2 days) by age group and registered GP practice. Results Thirty six percent of sickle cell disease admission spells resulted in a length of stay of less than two days. Seventy four percent of total bed days are associated with patients with more than one admission during the period of analysis, i.e. multiple admissions. Two general practices in Brent were identified as having the highest number of patients admitted to the emergency department for sickle cell crisis and may benefit most from primary care intervention. Discussion Patients with short length of stay and multiple admissions may be potentially amenable to primary care intervention. The practices which have the highest numbers of sickle cell disease patients who frequently seek emergency care will be earmarked for an education intervention designed to help further engage general practitioners in the care and management of their sickle cell patients. PMID:22768371

Appraising the Dimensionality of the Medical College Admission Test. MCAT Monograph.

ERIC Educational Resources Information Center

Meara, Kevin; Sireci, Stephen G.

To provide a better understanding of the structure of the Medical College Admission Test (MCAT) and to determine if there are structural differences across selected groups of MCAT examinees, several dimensionality analyses were conducted on data from recent administrations of the MCAT. The first set of analyses focused on the global structure of…

Primary path reservation using enhanced slot assignment in TDMA for session admission.

PubMed

Koneri Chandrasekaran, Suresh; Savarimuthu, Prakash; Andi Elumalai, Priya; Ayyaswamy, Kathirvel

2015-01-01

Mobile ad hoc networks (MANET) is a self-organized collection of nodes that communicates without any infrastructure. Providing quality of service (QoS) in such networks is a competitive task due to unreliable wireless link, mobility, lack of centralized coordination, and channel contention. The success of many real time applications is purely based on the QoS, which can be achieved by quality aware routing (QAR) and admission control (AC). Recently proposed QoS mechanisms do focus completely on either reservation or admission control but are not better enough. In MANET, high mobility causes frequent path break due to the fact that every time the source node must find the route. In such cases the QoS session is affected. To admit a QoS session, admission control protocols must ensure the bandwidth of the relaying path before transmission starts; reservation of such bandwidth noticeably improves the admission control performance. Many TDMA based reservation mechanisms are proposed but need some improvement over slot reservation procedures. In order to overcome this specific issue, we propose a framework-PRAC (primary path reservation admission control protocol), which achieves improved QoS by making use of backup route combined with resource reservation. A network topology has been simulated and our approach proves to be a mechanism that admits the session effectively.

40 CFR 5.300 - Admission.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to...

45 CFR 86.21 - Admission.

Code of Federal Regulations, 2012 CFR

2012-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to...

45 CFR 86.21 - Admission.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to...

45 CFR 86.21 - Admission.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Department of Health and Human Services GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to...

Racial and ethnic comparisons of nursing home residents at admission.

PubMed

Buchanan, Robert J; Rosenthal, Mark; Graber, David R; Wang, Suojin; Kim, Myung Suk

2008-10-01

To present racial/ethnic comparisons of comprehensive profiles of nursing home residents at admission, including whites, African Americans, Hispanics, Asians/Pacific Islanders, and American Indians/Alaska Natives. More than 885,000 admission assessments recorded in the national Minimum Data Set (MDS) were analyzed. Racial and ethnic analyses of the MDS admission assessments were conducted using the software package SAS. There were significant racial/ethnic differences in gender and age, with minority residents more likely to be male and younger. African American, Hispanic, and Asian/Pacific Islanders were significantly more likely than white residents to exhibit total dependence in the self-performance of the ADLs and to have greater cognitive impairments, with Asian/Pacific Islanders the most physically dependent and cognitively impaired. The results illustrate significant and substantive differences among the racial/ethnic groups for many demographic characteristics, as well as health-related indicators and conditions. This analysis suggests that the general perspective that economically disadvantaged minorities enter nursing homes in worse condition than whites is too simplistic. More research, particularly qualitative studies of specific minority groups, will advance our understanding of why members of some racial/ethnic groups require nursing home placement sooner than other groups.

Reduction in myocardial infarction admissions in Liverpool after the smoking ban: potential socioeconomic implications for policymaking

PubMed Central

Liu, Andrew; Guzman Castillo, Maria; Capewell, Simon; Lucy, John; O'Flaherty, Martin

2013-01-01

Objectives To analyse the trends and trend changes in myocardial infraction (MI) and coronary heart disease (CHD) admissions, to investigate the effects of the 2007 smoke-free legislation on these trends, and to consider the policy implications of any findings. Design setting Liverpool (city), UK. Participants Hospital episode statistics data on all 56 995 admissions for CHD in Liverpool between 2004 and 2012 (International Classification of Diseases codes I20–I25 coded as an admission diagnosis within the defined dates). Primary and secondary outcome measures Trend gradient and change points (by trend regressions analysis) in age-standardised MI admissions in Liverpool between 2004 and 2012; by sex and by socioeconomic status. Secondary analysis on CHD admissions. Results A significant and sustained reduction was seen in MI admissions in Liverpool beginning within 1 year of the smoking ban. Comparing 2005/2006 and 2010/2011, the age-adjusted rates for MI admissions fell by 42% (39–45%) (41.6% in men and by 42.6% in women). Trend analysis shows that this is significantly greater than the background trend of decreasing admissions. These reductions appeared consistent across all socioeconomic groups. Interestingly, admission rates for total CHD (including mild to severe angina) increased by 10% (8–12%). Conclusions A dramatic reduction in MI admissions in Liverpool has been observed coinciding with the smoking ban in 2007. Furthermore, the benefits were apparent across the socioeconomic spectrum. Health inequalities were not affected and may even have been reduced. The rapid effects observed with this top-down, environmental policy may further increase its value to policymakers. PMID:24282240

Substance Abuse Treatment Admissions Aged 12 to 14. The TEDS Report

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration, 2011

2011-01-01

This report uses data from the Treatment Episode Data Set (TEDS) for 2008 to provide information on the characteristics of youths aged 12 to 14 admitted to substance abuse treatment. In 2008, approximately 23,770 substance abuse treatment admissions were adolescents aged 12 to 14. The two most frequently reported primary substances of abuse among…

Acute hospital admissions among nursing home residents: a population-based observational study

PubMed Central

2011-01-01

Background Nursing home residents are prone to acute illness due to their high age, underlying illnesses and immobility. We examined the incidence of acute hospital admissions among nursing home residents versus the age-matched community dwelling population in a geographically defined area during a two years period. The hospital stays of the nursing home population are described according to diagnosis, length of stay and mortality. Similar studies have previously not been reported in Scandinavia. Methods The acute hospitalisations of the nursing home residents were identified through ambulance records. These were linked to hospital patient records for inclusion of demographics, diagnosis at discharge, length of stay and mortality. Incidence of hospitalisation was calculated based on patient-time at risk. Results The annual hospital admission incidence was 0.62 admissions per person-year among the nursing home residents and 0.26 among the community dwellers. In the nursing home population we found that dominant diagnoses were respiratory diseases, falls-related and circulatory diseases, accounting for 55% of the cases. The median length of stay was 3 days (interquartile range = 4). The in-hospital mortality rate was 16% and 30 day mortality after discharge 30%. Conclusion Acute hospital admission rate among nursing home residents was high in this Scandinavian setting. The pattern of diagnoses causing the admissions appears to be consistent with previous research. The in-hospital and 30 day mortality rates are high. PMID:21615911

Imperfect physician assistant and physical therapist admissions processes in the United States

PubMed Central

2014-01-01

We compared and contrasted physician assistant and physical therapy profession admissions processes based on the similar number of accredited programs in the United States and the co-existence of many programs in the same school of health professions, because both professions conduct similar centralized application procedures administered by the same organization. Many studies are critical of the fallibility and inadequate scientific rigor of the high-stakes nature of health professions admissions decisions, yet typical admission processes remain very similar. Cognitive variables, most notably undergraduate grade point averages, have been shown to be the best predictors of academic achievement in the health professions. The variability of non-cognitive attributes assessed and the methods used to measure them have come under increasing scrutiny in the literature. The variance in health professions students’ performance in the classroom and on certifying examinations remains unexplained, and cognitive considerations vary considerably between and among programs that describe them. One uncertainty resulting from this review is whether or not desired candidate attributes highly sought after by individual programs are more student-centered or graduate-centered. Based on the findings from the literature, we suggest that student success in the classroom versus the clinic is based on a different set of variables. Given the range of positions and general lack of reliability and validity in studies of non-cognitive admissions attributes, we think that health professions admissions processes remain imperfect works in progress. PMID:24810020

Dust storms and the risk of asthma admissions to hospitals in Kuwait.

PubMed

Thalib, Lukman; Al-Taiar, Abdullah

2012-09-01

Arid areas in the Arabian Peninsula are one of the largest sources of global dust, yet there is no data on the impact of this on human health. This study aimed to investigate the impact of dust storms on hospital admissions due to asthma and all respiratory diseases over a period of 5 years in Kuwait. A population-based retrospective time series study of daily emergency asthma admissions and admissions due to respiratory causes in public hospitals in Kuwait was analyzed in relation to dust storm events. Dust storm days were defined as the mean daily PM(10)>200 μg/m(3) based on measurements obtained from all six monitoring sites in the country. During the five-year study period, 569 (33.6%) days had dust storm events and they were significantly associated with an increased risk of same-day asthma and respiratory admission, adjusted relative risk of 1.07 (95% CI: 1.02-1.12) and 1.06 (95% CI: 1.04-1.08), respectively. This was particularly evident among children. Dust storms have a significant impact on respiratory and asthma admissions. Evidence is more convincing and robust compared to that from other geographical settings which highlights the importance of public health measures to protect people's health during dust storms and reduce the burden on health services due to dust events. Copyright © 2012 Elsevier B.V. All rights reserved.

7 CFR 501.2 - Admission.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to the Research Center during “off duty” hours shall be restricted to the main arteries and any deviation...

7 CFR 501.2 - Admission.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to the Research Center during “off duty” hours shall be restricted to the main arteries and any deviation...

7 CFR 501.2 - Admission.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to the Research Center during “off duty” hours shall be restricted to the main arteries and any deviation...

7 CFR 501.2 - Admission.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to the Research Center during “off duty” hours shall be restricted to the main arteries and any deviation...

43 CFR 41.300 - Admission.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Lands: Interior Office of the Secretary of the Interior NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to...

28 CFR 54.300 - Admission.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 54.300 Admission. (a) General. No person shall, on the basis of sex, be denied...

43 CFR 41.300 - Admission.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Lands: Interior Office of the Secretary of the Interior NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient to...

Student System, On-Line Admissions.

ERIC Educational Resources Information Center

White, Stephen R.

This report provides technical information on an on-line admissions system developed by Montgomery College. Part I, Systems Development, describes the background, objectives and responsibilities, system design, and reports generated by the system. Part II, Operating Instructions, describes input forms and controls, admission system functions, file…

The frequency of adverse drug reaction related admissions according to method of detection, admission urgency and medical department specialty

PubMed Central

Brvar, Miran; Fokter, Nina; Bunc, Matjaz; Mozina, Martin

2009-01-01

Background Adverse Drug Reactions (ADRs) have been regarded as a major public health problem since they represent a sizable percentage of admissions. Unfortunately, there is a wide variation of ADR related admissions among different studies. The aim of this study was to evaluate the frequency of ADR related admissions and its dependency on reporting and method of detection, urgency of admissions and included medical departments reflecting department/hospital type within one study. Methods The study team of internal medicine specialists retrospectively reviewed 520 randomly selected medical records (3%) of patients treated in the medical departments of the primary city and tertiary referral governmental hospital for certain ADRs causing admissions regarding WHO causality criteria. All medical records were checked for whether the treating physicians recognised and documented ADRs causing admissions. The hospital information system was checked to ensure ADR related diagnoses were properly coded and the database of a national spontaneous reporting system was searched for patients with ADRs included in this study. Results The established frequency of admissions due to certain ADRs recognised by the study team and documented in medical records by the treating physicians was the same and represented 5.8% of all patients (30/520). The frequency of ADR causing admissions detected by employing a computer-assisted approach using an ICD-10 coding system was 0.2% (1/520), and no patient admitted due to ADRs was reported to the national reporting system (0/520). The recognized frequency of ADR related admissions also depends on the department's specialty (p = 0.001) and acceptance of urgently admitted patients (p = 0.001). Patients admitted due to ADRs were significantly older compared to patients without ADRs (p = 0.025). Gastrointestinal bleeding due to NSAID, acetylsalicylic acid and warfarin was the most common ADR that resulted in admission and represented 40% of all

Predicting outcome on admission and post-admission for acetaminophen-induced acute liver failure using classification and regression tree models.

PubMed

Speiser, Jaime Lynn; Lee, William M; Karvellas, Constantine J

2015-01-01

Assessing prognosis for acetaminophen-induced acute liver failure (APAP-ALF) patients often presents significant challenges. King's College (KCC) has been validated on hospital admission, but little has been published on later phases of illness. We aimed to improve determinations of prognosis both at the time of and following admission for APAP-ALF using Classification and Regression Tree (CART) models. CART models were applied to US ALFSG registry data to predict 21-day death or liver transplant early (on admission) and post-admission (days 3-7) for 803 APAP-ALF patients enrolled 01/1998-09/2013. Accuracy in prediction of outcome (AC), sensitivity (SN), specificity (SP), and area under receiver-operating curve (AUROC) were compared between 3 models: KCC (INR, creatinine, coma grade, pH), CART analysis using only KCC variables (KCC-CART) and a CART model using new variables (NEW-CART). Traditional KCC yielded 69% AC, 90% SP, 27% SN, and 0.58 AUROC on admission, with similar performance post-admission. KCC-CART at admission offered predictive 66% AC, 65% SP, 67% SN, and 0.74 AUROC. Post-admission, KCC-CART had predictive 82% AC, 86% SP, 46% SN and 0.81 AUROC. NEW-CART models using MELD (Model for end stage liver disease), lactate and mechanical ventilation on admission yielded predictive 72% AC, 71% SP, 77% SN and AUROC 0.79. For later stages, NEW-CART (MELD, lactate, coma grade) offered predictive AC 86%, SP 91%, SN 46%, AUROC 0.73. CARTs offer simple prognostic models for APAP-ALF patients, which have higher AUROC and SN than KCC, with similar AC and negligibly worse SP. Admission and post-admission predictions were developed. • Prognostication in acetaminophen-induced acute liver failure (APAP-ALF) is challenging beyond admission • Little has been published regarding the use of King's College Criteria (KCC) beyond admission and KCC has shown limited sensitivity in subsequent studies • Classification and Regression Tree (CART) methodology allows the

Admission plasma glucose and diabetes mellitus in elderly admissions to hospital.

PubMed

Croxson, S C; Keir, S L; Ibbs, L

1997-05-01

Over 6 months, all admissions to three geriatric wards were studied to define an admission plasma glucose level (APG) that identified previously undiagnosed diabetes mellitus. Subjects with APG> or =7.0 mmol l(-1) had a modified oral glucose tolerance test (OGTT) when well before discharge if their dose of steroid and/or thiazide was constant, and they were neither terminally ill nor dead; excluded were 1 subject on reducing steroid doses, and 9 moribund admissions without APG. If the first 2 h OGTT result was > or =11.1 mmol l(-1), a second OGTT was performed 6 weeks later to fulfil 1985 WHO criteria. Subjects with APG<7.0 mmol l(-1) did not have OGTT. Seventy had a previous diagnosis of diabetes; scrutiny of records and OGTT refuted the diagnosis in 5, who were excluded from further analysis. Diabetes was only commonly found among those with APG> or =8.0 mmol l(-1), and the proportion was small until APG> or =13 mmol l(-1), although even then only 47% (95% CI 21-73%) had diabetes. Fourteen of 28 subjects with initial OGTT results suggesting diabetes were not diabetic on retesting. Inpatient mortality was higher if APG> or =7.0 (Odds ratio 2.82; CI 1.63-4.89) or the subject had known diabetes (Odds ratio 2.43; CI 1.15-4.97) compared to APG<7; there was no age or sex difference between these three groups. We conclude that, unless overtly diabetic, diagnosis of diabetes in elderly medical admissions needs later confirmation.

HYPOTHESIS SETTING AND ORDER STATISTIC FOR ROBUST GENOMIC META-ANALYSIS.

PubMed

Song, Chi; Tseng, George C

2014-01-01

Meta-analysis techniques have been widely developed and applied in genomic applications, especially for combining multiple transcriptomic studies. In this paper, we propose an order statistic of p-values ( r th ordered p-value, rOP) across combined studies as the test statistic. We illustrate different hypothesis settings that detect gene markers differentially expressed (DE) "in all studies", "in the majority of studies", or "in one or more studies", and specify rOP as a suitable method for detecting DE genes "in the majority of studies". We develop methods to estimate the parameter r in rOP for real applications. Statistical properties such as its asymptotic behavior and a one-sided testing correction for detecting markers of concordant expression changes are explored. Power calculation and simulation show better performance of rOP compared to classical Fisher's method, Stouffer's method, minimum p-value method and maximum p-value method under the focused hypothesis setting. Theoretically, rOP is found connected to the naïve vote counting method and can be viewed as a generalized form of vote counting with better statistical properties. The method is applied to three microarray meta-analysis examples including major depressive disorder, brain cancer and diabetes. The results demonstrate rOP as a more generalizable, robust and sensitive statistical framework to detect disease-related markers.

45 CFR 672.10 - Default order.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND..., an admission of all facts alleged in the complaint and a waiver of respondent's right to a hearing on... with the Hearing Clerk. (c) Contents of a default order. A default order shall include findings of fact...

45 CFR 672.10 - Default order.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND..., an admission of all facts alleged in the complaint and a waiver of respondent's right to a hearing on... with the Hearing Clerk. (c) Contents of a default order. A default order shall include findings of fact...

45 CFR 672.10 - Default order.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND..., an admission of all facts alleged in the complaint and a waiver of respondent's right to a hearing on... with the Hearing Clerk. (c) Contents of a default order. A default order shall include findings of fact...

45 CFR 672.10 - Default order.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND..., an admission of all facts alleged in the complaint and a waiver of respondent's right to a hearing on... with the Hearing Clerk. (c) Contents of a default order. A default order shall include findings of fact...

45 CFR 672.10 - Default order.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION ENFORCEMENT AND..., an admission of all facts alleged in the complaint and a waiver of respondent's right to a hearing on... with the Hearing Clerk. (c) Contents of a default order. A default order shall include findings of fact...

49 CFR 25.300 - Admission.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Office of the Secretary of Transportation NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 25.300 Admission. (a) General. No person shall, on the basis of sex, be denied...

22 CFR 146.300 - Admission.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 146.300 Admission. (a) General. No person shall, on the basis of sex, be denied...

The Changing College Admissions Scene.

ERIC Educational Resources Information Center

Sjogren, Cliff

1983-01-01

Discusses the status of college admissions and some of the forces that influenced college admissions policies during each of four three-year periods: the Sputnik Era (1957-60), the Postwar Baby Boom Era (1964-67), the "New Groups" Era (1971-74), and the Stable Enrollment Era (1978-81). (PGD)

[Classification and monitoring of the appropriateness of emergency admissions in a tertiary hospital].

PubMed

López-Picazo Ferrer, J J; Tomás García, N; Cubillana Herrero, J D; Gómez Company, J A; de Dios Cánovas García, J

2014-01-01

To measure the appropriateness of hospital admissions, to classify its Clinical Services (CS) according to the level of inappropriateness, and to determine the usefulness of applying rapid assessment techniques (lot quality assurance sampling) in these types of measurements. A descriptive, retrospective study was conducted in a tertiary hospital to assess the clinical records of emergency admissions to the 12 CS with a higher volume of admissions, using the Appropriateness Evaluation Protocol (AEP). A four-level («A» to «D») increasingly inadequate admissions scale was constructed setting both standard and threshold values in every stratum. Every CS was classified in one of them using lot quality assurance sampling (LQAS). A total of 156 cases (13 cases from every CS) were assessed. The assessment effort (devoted time) was also estimated. There were 22.4±6.3% of inadequate admissions. In the CS classification, 9 (75%) got a good or acceptable appropriateness level, and only 1 (8%) got an inacceptable level. The time devoted was estimated at 17 hours. AEP is useful to assess the admission appropriateness and may be included in the «Emergencies» process management, although its variability prevents the use for external comparisons. If both LQAS and the appropriateness classification level and the global estimation (by unifying lot samples) are combined, the monitoring is affordable without a great effort. To extend these tools to other quality indicators requiring direct observation or clinical records, manual assessment could improve the monitoring efficiency. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Assessing Personal Qualities in Medical School Admissions.

ERIC Educational Resources Information Center

Albanese, Mark A.; Snow, Mikel H.; Skochelak, Susan E.; Huggett, Kathryn N.; Farrell, Philip M.

2003-01-01

Analyzes the challenges to using academic measures (MCAT scores and GPAs) as thresholds for medical school admissions and, for applicants exceeding the threshold, using personal qualities for admission decisions; reviews the literature on using the medical school interview and other admission data to assess personal qualities of applicants;…

Admission Policy Impact Study, 1993.

ERIC Educational Resources Information Center

Oklahoma State Regents for Higher Education, Oklahoma City.

In 1993, a second annual review was conducted of the 1990 State Regents admission policy for the Oklahoma State System of higher education. The review was intended to assure institutional policy compliance, ascertain the effects of increased admission standards on institutional student profiles, and evaluate whether the ultimate goal of maximizing…

The Economic Consequences of Hospital Admissions

PubMed Central

Dobkin, Carlos; Finkelstein, Amy; Kluender, Raymond; Notowidigdo, Matthew J.

2017-01-01

We use an event study approach to examine the economic consequences of hospital admissions for adults in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance, hospital admissions increase out-of-pocket medical spending, unpaid medical bills and bankruptcy, and reduce earnings, income, access to credit and consumer borrowing. The earnings decline is substantial compared to the out-of-pocket spending increase, and is minimally insured prior to age-eligibility for Social Security Retirement Income. Relative to the insured non-elderly, the uninsured non-elderly experience much larger increases in unpaid medical bills and bankruptcy rates following a hospital admission. Hospital admissions trigger less than 5 percent of all bankruptcies. PMID:29445246

Holistic Admissions in Nursing: We Can Do This

PubMed Central

GLAZER, GREER; CLARK, ANGELA; BANKSTON, KAREN; DANEK, JENNIFER; FAIR, MALIKA; MICHAELS, JULIA

2016-01-01

Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs. A biphasic qualitative research study was conducted with nursing deans from across the United States. Qualitative data collection consisted of two phases of focus group discussions conducted over a 3-month period. The qualitative data were analyzed using content analysis. The categories and subcategories identified in Phase 1 informed the discussion in Phase 2. One overarching category from Phase 1 was identified, which was the lack of nursing schools’ knowledge regarding holistic admissions review. Four subcategories also identified in Phase 1 included the need for better dissemination of evidence, the need for additional support from university leaders and administrators, the need for legal guidance to facilitate implementation of holistic admissions review, and ensuring appropriate resources to support the holistic admissions review process. Three categories emerged in Phase 2, which included everyone’s buy-in is required, the need for a model, and a need for training. The adoption of holistic admissions review in nursing may be feasible. However, certain barriers need to be overcome so that nursing schools can successfully take on this process. Therefore, five recommendations have been developed to assist nursing schools in the implementation of holistic admissions review. These recommendations include increasing knowledge and understanding of

Holistic Admissions in Nursing: We Can Do This.

PubMed

Glazer, Greer; Clark, Angela; Bankston, Karen; Danek, Jennifer; Fair, Malika; Michaels, Julia

2016-01-01

Research shows that holistic admissions review practices can increase diversity across students without decreasing the workforce preparedness and academic success of students. Therefore, many disciplines have readily adopted the widespread use of holistic admissions review. Despite its proven effectiveness in addressing student diversity, nursing has been slow to implement holistic admissions review. The purpose of this study was to gain a better understanding of the barriers to implementing holistic admissions review in nursing and the feasibility of adopting holistic admissions review across nursing programs. A biphasic qualitative research study was conducted with nursing deans from across the United States. Qualitative data collection consisted of two phases of focus group discussions conducted over a 3-month period. The qualitative data were analyzed using content analysis. The categories and subcategories identified in Phase 1 informed the discussion in Phase 2. One overarching category from Phase 1 was identified, which was the lack of nursing schools' knowledge regarding holistic admissions review. Four subcategories also identified in Phase 1 included the need for better dissemination of evidence, the need for additional support from university leaders and administrators, the need for legal guidance to facilitate implementation of holistic admissions review, and ensuring appropriate resources to support the holistic admissions review process. Three categories emerged in Phase 2, which included everyone's buy-in is required, the need for a model, and a need for training. The adoption of holistic admissions review in nursing may be feasible. However, certain barriers need to be overcome so that nursing schools can successfully take on this process. Therefore, five recommendations have been developed to assist nursing schools in the implementation of holistic admissions review. These recommendations include increasing knowledge and understanding of holistic

Epidemiology of Obstetric-Related Intensive Care Unit Admissions in Maryland: 1999–2008

PubMed Central

Wanderer, Jonathan P.; Leffert, Lisa R.; Mhyre, Jill M.; Kuklina, Elena V.; Callaghan, William M.; Bateman, Brian T.

2013-01-01

Objective To define the incidence, indications, and temporal trends in obstetric-related intensive care unit (ICU) admissions Design Descriptive analysis of utilization patterns Setting All hospitals within the State of Maryland Patients All antepartum, delivery and postpartum patients who were hospitalized between 1999 and 2008 Interventions None Measurements and Main Results We identified 2,927 ICU admissions from 765,598 admissions for antepartum, delivery, or postpartum conditions using appropriate International Classification of Diseases, 9th revision-Clinical Modification (ICD-9 CM) codes. The overall rate of ICU utilization was 419.1 per 100,000 deliveries, with rates of 162.5, 202.6 and 54.0 per 100,000 deliveries for the antepartum, delivery and postpartum periods, respectively. The leading diagnoses associated with ICU admission were pregnancy-related hypertensive disease (present in 29.9% of admissions), hemorrhage (18.8%), cardiomyopathy or other cardiac disease (18.3%), genitourinary infection (11.5%), complications from ectopic pregnancies and abortions (10.3%), non-genitourinary infection (10.1%), sepsis (7.1%), cerebrovascular disease (5.8%) and pulmonary embolism (3.7%). We assessed for changes in the most common diagnoses in the ICU population over time and found rising rates of sepsis (10.1 per 100,000 deliveries to 16.6 per 100,000 deliveries, p=0.003) and trauma (9.2 per 100,000 deliveries to 13.6 per 100,000 deliveries, p=0.026) with decreasing rates of anesthetic complications (11.3 per 100,000 to 4.7 per 100,000, p=0.006). The overall frequency of obstetric-related ICU admission and the rates for other indications remained relatively stable. Conclusions Between 1999 and 2008, 419.1 per 100,000 deliveries in Maryland were complicated by ICU admission. Hospitals providing obstetric services should plan for appropriate critical care management and/or transfer of women with severe morbidities during pregnancy. PMID:23648568

Use of MCAT Data in Admissions. A Guide for Medical School Admissions Officers and Faculty.

ERIC Educational Resources Information Center

Mitchell, Karen J.

A description of the standardized, multiple-choice Medical College Admission Test (MCAT) and how to use it is offered. Medical school admissions officers medical educators, college faculty members, and practicing physicians are active participants in selecting content, drafting test specifications, and authoring questions for the exam. The MCAT is…

Socioeconomic inequalities in neonatal intensive care admission rates.

PubMed

Jenkins, J; McCall, E; Gardner, E; Casson, K; Dolk, H

2009-11-01

To examine socioeconomic inequalities in neonatal intensive care (NIC) admissions relating to preterm birth, intrauterine growth restriction (IUGR), multiple births and other conditions. Retrospective review of all NIC admissions from 1996 to 2001 throughout a geographically defined region. Area deprivation indices were grouped into quintiles from least (1) to most (5) deprived. Admissions were classified by predefined hierarchical criteria. The rate of admissions was 31.4 per 1000 births. There was a J-shaped relation with socioeconomic group (28.1 NIC admissions per 1000 in quintile 1, 34.0 in quintile 5 and below 28 in the other quintiles). The most deprived areas had a rate 19% above the regional average. The relation with socioeconomic group differed significantly according to primary reason for admission. The rates of admissions with significant prematurity (34% of all admissions) and IUGR as primary reason were highest in quintile 5 (18% and 41% above the regional average, respectively). This contrasted with the rate of admission for multiple birth which was highest in quintile 1 (45% above average). These differences provided the main explanation for the J-shaped overall curve. Measures to alleviate deprivation and to improve the preterm birth and IUGR rates in deprived groups would have the greatest potential to reduce inequality in need for NIC admission. Efforts to achieve targets for reduction in infant mortality need to take account of the different effects of socioeconomic inequalities for different conditions and groups of infants.

The Role of Nursing Home Admission and Dementia Status on Care for Diabetes Mellitus

PubMed Central

Quinn, Charlene C.; Gruber-Baldini, Ann L.; Port, Cynthia L.; May, Conrad; Stuart, Bruce; Hebel, J. Richard; Zimmerman, Sheryl; Burton, Lynda; Zuckerman, Ilene H.; Fahlman, Cheryl; Magaziner, Jay

2010-01-01

Objectives To study the role of nursing home (NH) admission and dementia status on the provision of five procedures related to diabetes mellitus. Design Retrospective cohort study using data from a large prospective study in which an expert panel determined the prevalence of dementia. Setting Fifty-nine Maryland NHs. Participants Three hundred ninety-nine new admission NH patients with diabetes mellitus. Measurements Medicare administrative claims records matched to the NH medical record data were used to measure procedures related to diabetes mellitus received in the year before NH admission and up to a year after admission (and before discharge). Procedures included glycosylated hemoglobin, fasting blood glucose, dilated eye examination, lipid profile, and serum creatinine. Results For all but dilated eye examinations, higher rates of procedures related to diabetes mellitus were seen in the year after NH admission than in the year before. Residents without dementia received more procedures than those with dementia, although this was somewhat attenuated after controlling for demographic, health, and healthcare utilization variables. Persons without dementia experience greater increases in procedure rates after admission than those with dementia. Conclusion The structured environment of care provided by the NH may positively affect monitoring procedures provided to elderly persons with diabetes mellitus, especially those without dementia. Medical decisions related to the risks and benefits of intensive treatment for diabetes mellitus to patients of varying frailty and expected longevity may lead to lower rates of procedures for residents with dementia. PMID:19682125

[Central Patients Admission (CPA) unit--connecting inpatient and outpatient care].

PubMed

Fleck, Martin; Zeuner, Martin; Schölmerich, Jürgen

2009-12-15

Due to the novel reimbursement policies, hospitals face substantial conflicts regarding best patient care and optimal utilization of resources. In order to optimize patient treatment, a central patients admission (CPA) unit has been established. All patients electively referred to the hospital were primarily treated by a medical specialist at the CPA unit. According to an appropriateness evaluation protocol established with the medical service of the health insurances of Bavaria ("MDK-Bayern"), patients were treated as inpatients or outpatients. The impact of this novel admission procedure was assessed for a period of 30 months. Within 30 months following establishment of the CPA unit, 10% of the patients were treated as outpatients, whereas 90% of referred patients were admitted as inpatients. Nonetheless, numbers of inpatients increased by 20.7% after 24 months compared to 12 months following establishment of the CPA unit with a substantial increase of patients referred by external medical specialists. In addition, there were no cases of inappropriate admission. The CPA unit is an ideal instrument for treating patients cross-sectorally as well as more effectively and economically advocating reorganization. Establishment of a CPA unit leads to greater satisfaction among patients, referring physicians, and medical staff.

Optimal Admission to Higher Education

ERIC Educational Resources Information Center

Albaek, Karsten

2017-01-01

This paper analyses admission decisions when students from different high school tracks apply for admission to university programmes. I derive a criterion that is optimal in the sense that it maximizes the graduation rates of the university programmes. The paper contains an empirical analysis that documents the relevance of theory and illustrates…

Black Clouds vs Random Variation in Hospital Admissions.

PubMed

Ong, Luei Wern; Dawson, Jeffrey D; Ely, John W

2018-06-01

Physicians often accuse their peers of being "black clouds" if they repeatedly have more than the average number of hospital admissions while on call. Our purpose was to determine whether the black-cloud phenomenon is real or explainable by random variation. We analyzed hospital admissions to the University of Iowa family medicine service from July 1, 2010 to June 30, 2015. Analyses were stratified by peer group (eg, night shift attending physicians, day shift senior residents). We analyzed admission numbers to find evidence of black-cloud physicians (those with significantly more admissions than their peers) and white-cloud physicians (those with significantly fewer admissions). The statistical significance of whether there were actual differences across physicians was tested with mixed-effects negative binomial regression. The 5-year study included 96 physicians and 6,194 admissions. The number of daytime admissions ranged from 0 to 10 (mean 2.17, SD 1.63). Night admissions ranged from 0 to 11 (mean 1.23, SD 1.22). Admissions increased from 1,016 in the first year to 1,523 in the fifth year. We found 18 white-cloud and 16 black-cloud physicians in simple regression models that did not control for this upward trend. After including study year and other potential confounding variables in the regression models, there were no significant associations between physicians and admission numbers and therefore no true black or white clouds. In this study, apparent black-cloud and white-cloud physicians could be explained by random variation in hospital admissions. However, this randomness incorporated a wide range in workload among physicians, with potential impact on resident education at the low end and patient safety at the high end.

Caring for women in early labor: can we delay admission and meet women's needs?

PubMed

Marowitz, Amy

2014-01-01

Early labor poses challenges for women and their health care providers. Qualitative research shows that women may have a hard time determining when labor begins and when to seek care, are unprepared for the realities of this part of labor, find it difficult to manage early labor at home, and often desire admission before active labor. Yet a primary clinical management goal in early labor is the delay of admission until active labor. This is based on evidence that admission before active labor is associated with higher rates of cesarean birth and interventions such as oxytocin augmentation and epidural analgesia. The reasons for the higher rates of intervention are not known, but may include the effect of the hospital environment, inherent problems with the labor, misdiagnosis of active labor, provider impatience, and institutional policies not compatible with the care of women in early labor. Programs to decrease early admission have had mixed results. Thus, a tension exists between the goal of delaying admission until active labor in order to decrease the incidence of unnecessary interventions and women's difficulty with managing this part of labor at home. In this case report, the midwife provides a significant amount of care and support before admission through phone calls and outpatient visits; however, admission occurred prior to active labor. Supportive care continued in the hospital, and the labor and birth occurred with little intervention. Strategies that can be used to optimize the management and experience of early labor are presented. © 2014 by the American College of Nurse-Midwives.

The Role of Noncognitive Assessment in Admissions

ERIC Educational Resources Information Center

Hoerle, Heather

2014-01-01

Confident that understanding and employing new approaches to assessment is a top priority for admissions professionals, the Secondary School Admission Test Board (SSATB) recently launched a Think Tank on the Future of Admission Assessment, with a two-year timeline and a charge to educate its membership and inspire greater innovation in admissions…

Assessing Practical Intelligence in Business School Admissions: A Supplement to the Graduate Management Admissions Test

ERIC Educational Resources Information Center

Hedlund, Jennifer; Wilt, Jeanne M.; Nebel, Kristina L.; Ashford, Susan J.; Sternberg, Robert J.

2006-01-01

The Graduate Management Admission Test (GMAT) is the most widely used measure of managerial potential in MBA admissions. GMAT scores, although predictive of grades in business school, leave much of the variance in graduate school performance unexplained. The GMAT also produces disparities in test scores between groups, generating the potential for…

Prevention of hospital payment errors and implications for case management: a study of nine hospitals with a high proportion of short-term admissions over time.

PubMed

Hightower, Rebecca E

2008-01-01

medical advice) occurring during the baseline and remeasurement time frames was examined. The baseline period consisted of 1 month's claims-the complete month just prior to the start of approved project activities. Remeasurement was performed by each hospital and reported to the Quality Improvement Organization on a monthly basis following implementation of the hospital's quality improvement plan. Each hospital was required to provide a monthly remeasurement report by indicator until it had met its stated goal(s) for improvement for 2 consecutive months; therefore, each hospital completed its required monthly reporting for a specific indicator in a different month. Results were calculated for the following indicators: INDICATOR 1: Proportion of unnecessary short-term admissions = number of unnecessary short-term inpatient admissions/total short-term inpatient admissions in time frame. INDICATOR 2: Proportion of errors in billed treatment setting, that is, outpatient observation billed as inpatient = number of errors in billed treatment setting/total short-term admissions in time frame.Six of the 9 hospitals were able to accomplish reduction of their error rates within 6 months from the beginning of the study. The seventh hospital reached its goals in the 7th month, with the 2 remaining hospitals making progress toward their goals by the conclusion of the study. 1 Case managers must be up-to-date with payor requirements regarding medical record documentation for medical necessity of services and timing of inpatient admission, e.g., for Medicare, the date and time of the written physician's order for admission to the inpatient care setting is the date and time of inpatient admission. 2 The balancing of clinical decisions and financial considerations required of case managers in hospital settings remains an ongoing challenge. 3 Senior leadership must be engaged in ensuring the success of the case management program by providing the resources required. 4 Managers of case

High-Order Discontinuous Galerkin Level Set Method for Interface Tracking and Re-Distancing on Unstructured Meshes

NASA Astrophysics Data System (ADS)

Greene, Patrick; Nourgaliev, Robert; Schofield, Sam

2015-11-01

A new sharp high-order interface tracking method for multi-material flow problems on unstructured meshes is presented. The method combines the marker-tracking algorithm with a discontinuous Galerkin (DG) level set method to implicitly track interfaces. DG projection is used to provide a mapping from the Lagrangian marker field to the Eulerian level set field. For the level set re-distancing, we developed a novel marching method that takes advantage of the unique features of the DG representation of the level set. The method efficiently marches outward from the zero level set with values in the new cells being computed solely from cell neighbors. Results are presented for a number of different interface geometries including ones with sharp corners and multiple hierarchical level sets. The method can robustly handle the level set discontinuities without explicit utilization of solution limiters. Results show that the expected high order (3rd and higher) of convergence for the DG representation of the level set is obtained for smooth solutions on unstructured meshes. High-order re-distancing on irregular meshes is a must for applications were the interfacial curvature is important for underlying physics, such as surface tension, wetting and detonation shock dynamics. This work was performed under the auspices of the U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344. Information management release number LLNL-ABS-675636.

Relationship between Admission Criteria and Program Completion in a Radiation Therapy Program

ERIC Educational Resources Information Center

Dougherty, Adrienne M.

2017-01-01

Poor completion rates in the radiation therapy associate's degree program offered through a community college did not meet the standards set by the college and damaged the program's reputation. The relationship between admission criteria and program completion was not known. The purpose of this study was to determine if there were any…

Admission to Medical Education in Ten Countries.

ERIC Educational Resources Information Center

Burn, Barbara B., Ed.

As part of a study of access and admission to higher education in Germany and the United States, a group of papers on medical admissions in various countries was commissioned. The papers presented in this book reveal wide differences in admissions policies and procedures. Barbara Burn examines some of the major issues in a foreword: representation…

Analysis of 2014 Post UTME Score of Candidates in the University of Ibadan with Two Methods of Standard Setting to Set Cut Off Points

ERIC Educational Resources Information Center

Oladele, Babatunde

2017-01-01

The aim of the current study is to analyse the 2014 Post UTME scores of candidates in the university of Ibadan towards the establishment of cut off using two methods of standard settings. Prospective candidates who seek admission to higher institution are often denied admission through the Post UTME exercise. There is no single recommended…

The Predictive Validity of Using Admissions Testing and Multiple Mini-Interviews in Undergraduate University Admissions

ERIC Educational Resources Information Center

Makransky, Guido; Havmose, Philip; Vang, Maria Louison; Andersen, Tonny Elmose; Nielsen, Tine

2017-01-01

The aim of this study was to evaluate the predictive validity of a two-step admissions procedure that included a cognitive ability test followed by multiple mini-interviews (MMIs) used to assess non-cognitive skills, compared to grade-based admissions relative to subsequent drop-out rates and academic achievement after one and two years of study.…

Scheduling admissions and reducing variability in bed demand.

PubMed

Bekker, René; Koeleman, Paulien M

2011-09-01

Variability in admissions and lengths of stay inherently leads to variability in bed occupancy. The aim of this paper is to analyse the impact of these sources of variability on the required amount of capacity and to determine admission quota for scheduled admissions to regulate the occupancy pattern. For the impact of variability on the required number of beds, we use a heavy-traffic limit theorem for the G/G/∞ queue yielding an intuitively appealing approximation in case the arrival process is not Poisson. Also, given a structural weekly admission pattern, we apply a time-dependent analysis to determine the mean offered load per day. This time-dependent analysis is combined with a Quadratic Programming model to determine the optimal number of elective admissions per day, such that an average desired daily occupancy is achieved. From the mathematical results, practical scenarios and guidelines are derived that can be used by hospital managers and support the method of quota scheduling. In practice, the results can be implemented by providing admission quota prescribing the target number of admissions for each patient group.

Full glowworm swarm optimization algorithm for whole-set orders scheduling in single machine.

PubMed

Yu, Zhang; Yang, Xiaomei

2013-01-01

By analyzing the characteristics of whole-set orders problem and combining the theory of glowworm swarm optimization, a new glowworm swarm optimization algorithm for scheduling is proposed. A new hybrid-encoding schema combining with two-dimensional encoding and random-key encoding is given. In order to enhance the capability of optimal searching and speed up the convergence rate, the dynamical changed step strategy is integrated into this algorithm. Furthermore, experimental results prove its feasibility and efficiency.

Reliability and acceptability of six station multiple mini-interviews: past-behavioural versus situational questions in postgraduate medical admission.

PubMed

Yamada, Toru; Sato, Juichi; Yoshimura, Hiroshi; Okubo, Tomoya; Hiraoka, Eiji; Shiga, Takashi; Kubota, Tadao; Fujitani, Shigeki; Machi, Junji; Ban, Nobutaro

2017-03-16

The multiple mini-interview (MMI) is increasingly used for postgraduate medical admissions and in undergraduate settings. MMIs use mostly Situational Questions (SQs) rather than Past-Behavioural Questions (PBQs). A previous study of MMIs in this setting, where PBQs and SQs were asked in the same order, reported that the reliability of PBQs was non-inferior to SQs and that SQs were more acceptable to candidates. The order in which the questions are asked may affect reliability and acceptability of an MMI. This study investigated the reliability of an MMI using both PBQs and SQs, minimising question order bias. Acceptability of PBQs and SQs was also assessed. Forty candidates applying for a postgraduate medical admission for 2016-2017 were included; 24 examiners were used. The MMI consisted of six stations with one examiner per station; a PBQ and a SQ were asked at every station, and the order of questions was alternated between stations. Reliability was analysed for scores obtained for PBQs or SQs separately, and for both questions. A post-MMI survey was used to assess the acceptability of PBQs and SQs. The generalisability (G) coefficients for PBQs only, SQs only, and both questions were 0.87, 0.96, and 0.80, respectively. Decision studies suggested that a four-station MMI would also be sufficiently reliable (G-coefficients 0.82 and 0.94 for PBQs and SQs, respectively). In total, 83% of participants were satisfied with the MMI. In terms of face validity, PBQs were more acceptable than SQs for candidates (p = 0.01), but equally acceptable for examiners (88% vs. 83% positive responses for PBQs vs. SQs; p = 0.377). Candidates preferred PBQs to SQs when asked to choose one, though this difference was not significant (p = 0.081); examiners showed a clear preference for PBQs (p = 0.007). Reliability and acceptability of six-station MMI were good among 40 postgraduate candidates; modelling suggested that four stations would also be reliable. SQs were more

A Role for Marketing in College Admissions. Papers Presented at the Colloquium on College Admissions, May 16-l8, 1976.

ERIC Educational Resources Information Center

College Entrance Examination Board, New York, NY.

This collection stresses the need for informed and more sophisticated marketing techniques for college admissions officers to help them cope with the decreasing number of prospective college students. The importance of the college admissions office is increasing as admissions becomes a more crucial element to the colleges' financial well-being.…

32 CFR 776.66 - Bar admission and disciplinary matters.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Bar admission and disciplinary matters. 776.66... ADVOCATE GENERAL Rules of Professional Conduct § 776.66 Bar admission and disciplinary matters. (a) Bar admission and disciplinary matters. A covered attorney, in connection with any application for bar admission...

8 CFR 235.4 - Withdrawal of application for admission.

Code of Federal Regulations, 2010 CFR

2010-01-01

... right to withdraw his or her application for admission. Permission to withdraw an application for... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Withdrawal of application for admission... INSPECTION OF PERSONS APPLYING FOR ADMISSION § 235.4 Withdrawal of application for admission. The Attorney...

[How medical students perform academically by admission types?].

PubMed

Kim, Se-Hoon; Lee, Keumho; Hur, Yera; Kim, Ji-Ha

2013-09-01

Despite the importance of selecting students whom are capable for medical education and to become a good doctor, not enough studies have been done in the category. This study focused on analysing the medical students' academic performance (grade point average, GPA) differences, flunk and dropout rates by admission types. From 2004 to 2010, we gathered 369 Konyang University College of Medicine's students admission data and analyzed the differences between admission method and academic achievement, differences in failure and dropout rates. Analysis of variance (ANOVA), ordinary least square, and logistic regression were used. The rolling students showed higher academic achievement from year 1 to 3 than regular students (p < 0.01). Using admission type variable as control variable in multiple regression model similar results were shown. But unlike the results of ANOVA, GPA differences by admission types were shown not only in lower academic years but also in year 6 (p < 0.01). From the regression analysis of flunk and dropout rate by admission types, regular admission type students showed higher drop out rate than the rolling ones which demonstrates admission types gives significant effect on flunk or dropout rates in medical students (p < 0.01). The rolling admissions type students tend to show lower flunk rate and dropout rates and perform better academically. This implies selecting students primarily by Korean College Scholastic Ability Test does not guarantee their academic success in medical education. Thus we suggest a more in-depth comprehensive method of selecting students that are appropriate to individual medical school's educational goal.

Index Blood Tests and National Early Warning Scores within 24 Hours of Emergency Admission Can Predict the Risk of In-Hospital Mortality: A Model Development and Validation Study

PubMed Central

Mohammed, Mohammed A.; Rudge, Gavin; Watson, Duncan; Wood, Gordon; Smith, Gary B.; Prytherch, David R.; Girling, Alan; Stevens, Andrew

2013-01-01

Background We explored the use of routine blood tests and national early warning scores (NEWS) reported within ±24 hours of admission to predict in-hospital mortality in emergency admissions, using empirical decision Tree models because they are intuitive and may ultimately be used to support clinical decision making. Methodology A retrospective analysis of adult emergency admissions to a large acute hospital during April 2009 to March 2010 in the West Midlands, England, with a full set of index blood tests results (albumin, creatinine, haemoglobin, potassium, sodium, urea, white cell count and an index NEWS undertaken within ±24 hours of admission). We developed a Tree model by randomly splitting the admissions into a training (50%) and validation dataset (50%) and assessed its accuracy using the concordance (c-) statistic. Emergency admissions (about 30%) did not have a full set of index blood tests and/or NEWS and so were not included in our analysis. Results There were 23248 emergency admissions with a full set of blood tests and NEWS with an in-hospital mortality of 5.69%. The Tree model identified age, NEWS, albumin, sodium, white cell count and urea as significant (p<0.001) predictors of death, which described 17 homogeneous subgroups of admissions with mortality ranging from 0.2% to 60%. The c-statistic for the training model was 0.864 (95%CI 0.852 to 0.87) and when applied to the testing data set this was 0.853 (95%CI 0.840 to 0.866). Conclusions An easy to interpret validated risk adjustment Tree model using blood test and NEWS taken within ±24 hours of admission provides good discrimination and offers a novel approach to risk adjustment which may potentially support clinical decision making. Given the nature of the clinical data, the results are likely to be generalisable but further research is required to investigate this promising approach. PMID:23734195

32 CFR 242.5 - Admission procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... HEALTH SCIENCES § 242.5 Admission procedures. (a) Application—(1) Civilians. Civilians seeking admission..., physical examinations, and National Agency Checks, as required, consistent with § 242.4(a)(5)) to determine whether or not the selected candidates are acceptable for commissioning. (Physical examinations for...

32 CFR 242.5 - Admission procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... HEALTH SCIENCES § 242.5 Admission procedures. (a) Application—(1) Civilians. Civilians seeking admission..., physical examinations, and National Agency Checks, as required, consistent with § 242.4(a)(5)) to determine whether or not the selected candidates are acceptable for commissioning. (Physical examinations for...

32 CFR 242.5 - Admission procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... HEALTH SCIENCES § 242.5 Admission procedures. (a) Application—(1) Civilians. Civilians seeking admission..., physical examinations, and National Agency Checks, as required, consistent with § 242.4(a)(5)) to determine whether or not the selected candidates are acceptable for commissioning. (Physical examinations for...

32 CFR 242.5 - Admission procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... HEALTH SCIENCES § 242.5 Admission procedures. (a) Application—(1) Civilians. Civilians seeking admission..., physical examinations, and National Agency Checks, as required, consistent with § 242.4(a)(5)) to determine whether or not the selected candidates are acceptable for commissioning. (Physical examinations for...

Effect of air pollution on pediatric respiratory emergency room visits and hospital admissions.

PubMed

Farhat, S C L; Paulo, R L P; Shimoda, T M; Conceição, G M S; Lin, C A; Braga, A L F; Warth, M P N; Saldiva, P H N

2005-02-01

In order to assess the effect of air pollution on pediatric respiratory morbidity, we carried out a time series study using daily levels of PM10, SO2, NO2, ozone, and CO and daily numbers of pediatric respiratory emergency room visits and hospital admissions at the Children's Institute of the University of Sao Paulo Medical School, from August 1996 to August 1997. In this period there were 43,635 hospital emergency room visits, 4534 of which were due to lower respiratory tract disease. The total number of hospital admissions was 6785, 1021 of which were due to lower respiratory tract infectious and/or obstructive diseases. The three health end-points under investigation were the daily number of emergency room visits due to lower respiratory tract diseases, hospital admissions due to pneumonia, and hospital admissions due to asthma or bronchiolitis. Generalized additive Poisson regression models were fitted, controlling for smooth functions of time, temperature and humidity, and an indicator of weekdays. NO2 was positively associated with all outcomes. Interquartile range increases (65.04 microg/m3) in NO2 moving averages were associated with an 18.4% increase (95% confidence interval, 95% CI = 12.5-24.3) in emergency room visits due to lower respiratory tract diseases (4-day moving average), a 17.6% increase (95% CI = 3.3-32.7) in hospital admissions due to pneumonia or bronchopneumonia (3-day moving average), and a 31.4% increase (95% CI = 7.2-55.7) in hospital admissions due to asthma or bronchiolitis (2-day moving average). The study showed that air pollution considerably affects children's respiratory morbidity, deserving attention from the health authorities.

Relationship of academic success of medical students with motivation and pre-admission grades.

PubMed

Luqman, Muhammad

2013-01-01

To determine predictive validity of pre-admission scores of medical students, evaluate correlation between level of motivation and later on academic success in a medical college. Analytical study. Foundation University Medical College, Islamabad, from June to August 2011. A non-probability convenience sampling of students of 1st to final year MBBS classes was done after obtaining informed consent. These students filled out 'Strength of Motivation for Medical School' (SMMS) questionnaire. The data of pre-admission grades of these students along with academic success in college according to examination results in different years were collected. The correlation between the pre-admission grades and score of SMMS questionnaire with their academic success in medical college was found by applying Pearson co-efficient of correlation in order to determine the predictive validity. Only 46% students revealed strong motivation. A significant, moderate correlation was found between preadmission scores and academic success in 1st year modular examination (0.52) which became weaker in various professional examinations in higher classes. However, no significant correlation was observed between motivation and academic success of medical students in college. Selecting medical students by pre-admission scores or motivation level alone may not be desirable. A combination of measures of cognitive ability criteria (FSc/pre-admission test scores) and non-cognitive skills (personality traits) is recommended to be employed with the use of right tools for selection of students in medical schools.

Non-uniqueness of admissible weak solutions to the Riemann problem for isentropic Euler equations

NASA Astrophysics Data System (ADS)

Chiodaroli, Elisabetta; Kreml, Ondřej

2018-04-01

We study the Riemann problem for multidimensional compressible isentropic Euler equations. Using the framework developed in Chiodaroli et al (2015 Commun. Pure Appl. Math. 68 1157–90), and based on the techniques of De Lellis and Székelyhidi (2010 Arch. Ration. Mech. Anal. 195 225–60), we extend the results of Chiodaroli and Kreml (2014 Arch. Ration. Mech. Anal. 214 1019–49) and prove that it is possible to characterize a set of Riemann data, giving rise to a self-similar solution consisting of one admissible shock and one rarefaction wave, for which the problem also admits infinitely many admissible weak solutions.

[Violent and intimidating behavior of psychiatric patients at admission].

PubMed

Moamaï, J; Moamaï, N

1994-05-01

The dangerousness of the mentally ill patient is still unknown. This study assesses the actual prevalence of violent and intimidating behaviours in psychiatric patients at the time of their admission, or in the days leading up to their admission to a Quebec hospital. These behaviours have been measured on a six-point scale whose reliability for this population is appropriate. The consecutive sample consists of 383 adult admissions, and the results show that 83.0 percent of the involuntary admissions and 40.7 percent of the voluntary admissions manifested violent or intimidating behaviours at the time of hospitalization. The results support the clinical experience that psychiatric patients often exhibit this type of behaviour on admission.

Quality Assessment of College Admissions Processes.

ERIC Educational Resources Information Center

Fisher, Caroline; Weymann, Elizabeth; Todd, Amy

2000-01-01

This study evaluated the admissions process for a Master's in Business Administration Program using such quality improvement techniques as customer surveys, benchmarking, and gap analysis. Analysis revealed that student dissatisfaction with the admissions process may be a factor influencing declining enrollment. Cycle time and number of student…

Complexity in College Admission: Fact or Urban Myth. Research Findings of Parent and Student Perceptions of Complexity in College Admission

ERIC Educational Resources Information Center

College Board Advocacy & Policy Center, 2010

2010-01-01

In September 2007, the College Board formed the Task Force on Admissions in the 21st Century in response to a request from the Guidance and Admission Assembly Council (GAA Council) to more closely examine the high-school-to-college transition process. Each spring, at the conclusion of the college admission cycle, there is much discussion in the…

43 CFR 4.116 - Interrogatories to parties; inspection of documents; admission of facts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... applications for permission to serve written interrogatories upon the opposing party, applications for an order to produce and permit the inspection of designated documents, and applications for permission to serve upon the opposing party a request for the admission of specified facts. Such applications shall be...

Seasonality of Admissions for Mania: Results From a General Hospital Psychiatric Unit in Pondicherry, India

PubMed Central

Sarkar, Siddharth

2015-01-01

Introduction: Bipolar disorder is affected by variables that modulate circadian rhythm, including seasonal variations. There is evidence of a seasonal pattern of admissions of mania in various geographical settings, though its timing varies by region and climate. Variables such as age and gender have been shown to affect seasonality in some studies. Methodology: Data on monthly admission patterns for mania at a general hospital psychiatry unit in Pondicherry, India, were collected for 4 years (2010–2013) and analyzed for seasonality and seasonal peaks. The effects of age and gender were analyzed separately. Results: There was overall evidence of a seasonal pattern of admissions for mania (P < .01, Friedman test for seasonality), with a peak beginning during the rainy season and ending before summer (P < .0.1, Ratchet circular scan test). Male sex (P < .005, Ratchet circular scan test) and age > 25 years (P < .005, Ratchet circular scan test) were specifically associated with this seasonal peak. Discussion: The effect of seasons on mania is complex and is modulated by a variety of variables. Our study is consistent with earlier research findings: a greater degree of seasonality for mania in men. It is possible that climatic and individual variables interact to determine seasonal patterns in bipolar disorder in a given setting. PMID:26644962

The Impact of Special Admissions Programs on General Admissions Policies in Five San Francisco Bay Area Public Institutions of Higher Education 1966-1971.

ERIC Educational Resources Information Center

Alford, Howard Lee

This study researched the impact of special admissions programs on general admission policies in 5 San Francisco Bay area colleges and universities during a period of 5 years ending June 1971. The study was conducted to determine more specifically: (1) what general admissions policies were waived for special admissions students; (2) what was the…

38 CFR 17.365 - Admission priorities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of § 17...

38 CFR 17.365 - Admission priorities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of § 17...

38 CFR 17.365 - Admission priorities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of § 17...

38 CFR 17.365 - Admission priorities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of § 17...

38 CFR 17.365 - Admission priorities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of § 17...

Organ donation in the ICU: A document analysis of institutional policies, protocols, and order sets.

PubMed

Oczkowski, Simon J W; Centofanti, John E; Durepos, Pamela; Arseneau, Erika; Kelecevic, Julija; Cook, Deborah J; Meade, Maureen O

2018-04-01

To better understand how local policies influence organ donation rates. We conducted a document analysis of our ICU organ donation policies, protocols and order sets. We used a systematic search of our institution's policy library to identify documents related to organ donation. We used Mindnode software to create a publication timeline, basic statistics to describe document characteristics, and qualitative content analysis to extract document themes. Documents were retrieved from Hamilton Health Sciences, an academic hospital system with a high volume of organ donation, from database inception to October 2015. We retrieved 12 active organ donation documents, including six protocols, two policies, two order sets, and two unclassified documents, a majority (75%) after the introduction of donation after circulatory death in 2006. Four major themes emerged: organ donation process, quality of care, patient and family-centred care, and the role of the institution. These themes indicate areas where documented institutional standards may be beneficial. Further research is necessary to determine the relationship of local policies, protocols, and order sets to actual organ donation practices, and to identify barriers and facilitators to improving donation rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends in neonatal and post-neonatal tetanus admissions at a Nigerian teaching hospital.

PubMed

Oyedeji, Olusola Adetunji; Fadero, Francis; Joel-Medewase, Victor; Elemile, Peter; Oyedeji, Gabriel Ademola

2012-12-15

Tetanus accounts for high morbidity and case fatality rates in developing countries. This study therefore aimed to identify reasons for the persistence of this disease. Paediatric admissions at Ladoke Akintola University Teaching Hospital between 1 January 2006 and 31 December 2008 diagnosed with tetanus were studied. Data was analyzed with SPSS 18 and statistical significance was set at p < 0.05. Of the total 1,681 paediatric admissions, 30 (1.8%) had tetanus. Of the 878 neonatal admissions, 8 (0.9%) had tetanus, while 22 (2.7%) of the total 803 post-neonatal admissions had tetanus. Neonatal tetanus admissions were significantly higher in 2006 compared to 2007 and 2008 (7 [2.3%] versus 1 [0.2%] [χ²= 7.50, P=0.01]). Of the eight mothers whose neonates had tetanus, seven did not receive tetanus toxoids in pregnancy and five (62.5%) were secondary school dropouts. Post-neonatal tetanus cases admitted in the years 2006, 2007, and 2008 were 4, 12, and 6 children respectively. Most of these 22 children did not receive tetanus toxoid immunization in their first year of life. None of the 22 children received booster doses of tetanus toxoids after their first years of life. Mothers at risk of their babies having tetanus, such as secondary school dropouts, must be identified antenatally and vaccinated with tetanus toxiod. Their babies should also receive good care post-delivery. Completion of routine tetanus toxoid schedule in the first year and booster doses in the post-neonatal age should be ensured.

Medication reconciliation in acute care: ensuring an accurate drug regimen on admission and discharge.

PubMed

Rodehaver, Claire; Fearing, Deb

2005-07-01

Several factors contribute to the potential for patient confusion regarding his or her medication regimen, including multiple names for a single drug and formulary variations when the patient receives medications from more than one pharmacy. A 68-year-old woman was discharged from the hospital on a HMG-CoA reductase inhibitor (statin) and resumed her home statin. Eleven days later she returned to the hospital with a diagnosis of severe rhabdomyolysis due to statin overdose. IMPLEMENTING SOLUTIONS: Miami Valley Hospital, Dayton, Ohio, implemented a reconciliation process and order form at admission and discharge to reduce the likelihood that this miscommunication would recur. Initial efforts were trialed on a 44-bed orthopedic unit, with spread of the initiative to the cardiac units and finally to the remaining 22 nursing units. The team successfully implemented initiation of the order sheet, yet audits indicated the need for improvement in reconciling the medications within 24 hours of admission and in reconciling the home medications at the point of discharge. Successful implementation of the order sheet to drive reconciliation takes communication, perseverance, and a multidisciplinary team approach.

Fracture admissions after burns: A retrospective longitudinal study.

PubMed

Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; Wood, Fiona M

2017-09-01

Severe burn triggers systemic responses that result in reduced muscle mass and changes in bone formation, with recent evidence also suggesting systemic effects on bone after minor burns. The aim of this study was to assess if people hospitalised with a burn have increased admissions for fractures after discharge. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalised for a first burn (n=30,997) during the period 1980-2012. Australian population-based annual rates for fracture admissions for the period 1993-2012 were obtained from the Australian Institute of Health and Welfare. Rates of hospital admissions for fractures in the burn cohort and the Australian population were standardised, using the direct method, to the age and gender structure of the Western Australian population at the 2006. Annual standardised fracture admission rates for the period 1993-2012 were graphed with estimated 95% confidence intervals. Age and gender specific fracture rates were also examined. A total of 4004 members of the burn cohort had at least one fracture admission for a total of 6096. The median (IQR) time to the first fracture admission after burn was 6.9 years (2.8-13.6) and the median age (IQR) at first fracture admission was 31 years (20-49). The burn cohort experienced admissions for fractures at a rate approximately twice that of the Australian population. While rates were generally higher for males in the burn cohort when compared with males in the Australian population, female burn patients had significantly higher rates over the entire study period when compared with the female Australian population. Elevated rates were observed for those younger than 20 years at the time of the burn admission; however, rates were significantly and consistently elevated during the study period for those 20 years and older at the time of the burn. Burn patients experienced significantly higher

Rethinking Dental School Admission Criteria: Correlation Between Pre-Admission Variables and First-Year Performance for Six Classes at One Dental School.

PubMed

Rowland, Kevin C; Rieken, Susan

2018-04-01

Admissions committees in dental schools are charged with the responsibility of selecting candidates who will succeed in school and become successful members of the profession. Identifying students who will have academic difficulty is challenging. The aim of this study was to determine the predictive value of pre-admission variables for the first-year performance of six classes at one U.S. dental school. The authors hypothesized that the variables undergraduate grade point average (GPA), undergraduate science GPA (biology, chemistry, and physics), and Dental Admission Test (DAT) scores would predict the level of performance achieved in the first year of dental school, measured by year-end GPA. Data were collected in 2015 from school records for all 297 students in the six cohorts who completed the first year (Classes of 2007 through 2013). In the results, statistically significant correlations existed between all pre-admission variables and first-year GPA, but the associations were only weak to moderate. Lower performing students at the end of the first year (lowest 10% of GPA) had, on average, lower pre-admission variables than the other students, but the differences were small (≤10.8% in all categories). When all the pre-admission variables were considered together in a multiple regression analysis, a significant association was found between pre-admission variables and first-year GPA, but the association was weak (adjusted R 2 =0.238). This weak association suggests that these students' first-year dental school GPAs were mostly determined by factors other than the pre-admission variables studied and has resulted in the school's placing greater emphasis on other factors for admission decisions.

Unintended Medication Discrepancies Associated with Reliance on Prescription Databases for Medication Reconciliation on Admission to a General Medical Ward

PubMed Central

Kalb, Kelli; Shalansky, Stephen; Legal, Michael; Khan, Nadia; Ma, Irene; Hunte, Garth

2009-01-01

Background: In a recent study, 50% of the patients who were admitted to a hospital’s general medicine ward had at least one error in medication orders at the time of admission related to inaccuracies in the medication history. The use of computerized prescription databases has been suggested as a way to improve medication reconciliation at the time of admission. Objective: To quantify and describe unintended discrepancies between a best possible medication history and medications ordered on admission to the general medicine ward in a hospital with routine access to a provincial outpatient prescription database (British Columbia’s PharmaNet). Methods: This prospective study involved 20 patients who were regularly using at least 4 prescription medications before admission to hospital. The best possible medication history for each patient (based on a review of the medical chart and the PharmaNet record and an interview with the patient) was compared with the physician’s admission orders to identify any discrepancies. The frequency and perceived severity of discrepancies, graded independently by 3 physicians, were compared with observations from a similar study conducted at a hospital where a prescription database was not available. Results: The 20 patients were recruited between September 2005 and January 2006. For 8 patients (40%), information in the PharmaNet database was consistent with the prescription medication list obtained during the best possible medication history at the time of admission. For the other 12 patients, a total of 30 unintended discrepancies were identified, 13 (43%) of which were classified as having potential for moderate or severe harm. The proportion of patients with unintended discrepancies was similar to that for the comparison cohort (60% versus 54%). Although the percentage of discrepancies involving omissions was lower than in the comparison population (37% versus 46%), these results were offset by a higher proportion of

A second-order cell-centered Lagrangian ADER-MOOD finite volume scheme on multidimensional unstructured meshes for hydrodynamics

NASA Astrophysics Data System (ADS)

Boscheri, Walter; Dumbser, Michael; Loubère, Raphaël; Maire, Pierre-Henri

2018-04-01

In this paper we develop a conservative cell-centered Lagrangian finite volume scheme for the solution of the hydrodynamics equations on unstructured multidimensional grids. The method is derived from the Eucclhyd scheme discussed in [47,43,45]. It is second-order accurate in space and is combined with the a posteriori Multidimensional Optimal Order Detection (MOOD) limiting strategy to ensure robustness and stability at shock waves. Second-order of accuracy in time is achieved via the ADER (Arbitrary high order schemes using DERivatives) approach. A large set of numerical test cases is proposed to assess the ability of the method to achieve effective second order of accuracy on smooth flows, maintaining an essentially non-oscillatory behavior on discontinuous profiles, general robustness ensuring physical admissibility of the numerical solution, and precision where appropriate.

Reducing admissions with patient group directions.

PubMed

Wat, Dennis; Glossage, Elaine; Hampson, Onnor; Sibley, Sarah

In times of financial restrictions and reform impediments, health services need to invest in resources that provide value for money and reduce hospital admissions. Improving disease management in the community is a primary target for those trying to reduce costs. The second most common cause of emergency admissions to hospital is chronic obstructive pulmonary disease and it has been suggested that more effective treatments and better management of the condition would likely result in an estimated 5% fewer admissions to hospital, saving around pound 15.5m each year. This article discusses how savings could be made by improving care provided in the community.

Reclaiming the Educational Role of Chief Admission Officers.

ERIC Educational Resources Information Center

McDonough, Patricia; Robertson, Larry

1995-01-01

Describes changes that have occurred in high schools, colleges, and the entrepreneurial admission sector. Relates the evolution of the admission officer's job since the early 1960s and the profession's rapid growth. Details the hybrid role of marketer and educator for chief admissions officers, and issues a call for professional standards. (RJM)

Admission to Law School: New Measures

ERIC Educational Resources Information Center

Shultz, Marjorie M.; Zedeck, Sheldon

2012-01-01

Standardized tests have been increasingly controversial over recent years in high-stakes admission decisions. Their role in operationalizing definitions of merit and qualification is especially contested, but in law schools this challenge has become particularly intense. Law schools have relied on the Law School Admission Test (LSAT) and an INDEX…

The Acceptability of Online Courses as Criteria for Admission to Medical School

PubMed Central

Adams, Jonathan

2009-01-01

A national survey of medical school admissions administrators was used to assess the acceptability of applicants' qualifications that included degrees earned partly online, partly in a community college, or in a traditional program. A questionnaire was sent from The Florida State University in 2007 to admissions administrators in the 125 accredited allopathic medical schools in the United States. In each of three situations, the respondents were asked to select one of two hypothetical applicants to invite for an interview. The applicants with their coursework taken in a traditional-residential setting were overwhelmingly preferred over the applicant holding the degree earned partly online. Further analysis indicated that online courses were perceived as not presenting sufficient opportunity for students to develop important social skills through interaction with other students and mentors. PMID:21603401

Are Residents Losing Their Edge in Public University Admissions? The Case at the University of Washington. Schools in Crisis: Making Ends Meet

ERIC Educational Resources Information Center

Blume, Grant; Roza, Marguerite

2012-01-01

This case study examines admissions data at the University of Washington (UW) in order to quantify the effect on admissions standards for residents versus nonresidents. Like many other state flagship universities, the UW has suffered from constrained state revenues during the recent recessionary years. The findings suggest that Washington…

Heat and emergency room admissions in the Netherlands.

PubMed

van Loenhout, Joris Adriaan Frank; Delbiso, Tefera Darge; Kiriliouk, Anna; Rodriguez-Llanes, Jose Manuel; Segers, Johan; Guha-Sapir, Debarati

2018-01-05

Due to a global warming-related increase in heatwaves, it is important to obtain detailed understanding of the relationship between heat and health. We assessed the relationship between heat and urgent emergency room admissions in the Netherlands. We collected daily maximum temperature and relative humidity data over the period 2002-2007. Daily urgent emergency room admissions were divided by sex, age group and disease category. We used distributed lag non-linear Poisson models, estimating temperature-admission associations. We estimated the relative risk (RR) for urgent hospital admissions for a range of temperatures compared to a baseline temperature of 21 °C. In addition, we compared the impact of three different temperature scenarios on admissions using the RR. There is a positive relationship between increasing temperatures above 21 °C and the RR for urgent emergency room admissions for the disease categories 'Potential heat-related diseases' and 'Respiratory diseases'. This relationship is strongest in the 85+ group. The RRs are strongest for lag 0. For admissions for 'circulatory diseases', there is only a small significant increase of RRs within the 85+ age group for moderate heat, but not for extreme heat. The RRs for a one-day event with extreme heat are comparable to the RRs for multiple-day events with moderate heat. Hospitals should adjust the capacity of their emergency departments on warm days, and the days immediately thereafter. The elderly in particular should be targeted through prevention programmes to reduce harmful effects of heat. The fact that this increase in admissions already occurs in temperatures above 21 °C is different from previous findings in warmer countries. Given the similar impact of three consecutive days of moderate heat and one day of extreme heat on admissions, criteria for activation of national heatwave plans need adjustments based on different temperature scenarios.

Combining the Best of Two Standard Setting Methods: The Ordered Item Booklet Angoff

ERIC Educational Resources Information Center

Smith, Russell W.; Davis-Becker, Susan L.; O'Leary, Lisa S.

2014-01-01

This article describes a hybrid standard setting method that combines characteristics of the Angoff (1971) and Bookmark (Mitzel, Lewis, Patz & Green, 2001) methods. The proposed approach utilizes strengths of each method while addressing weaknesses. An ordered item booklet, with items sorted based on item difficulty, is used in combination…

49 CFR 1114.3 - Admissibility of business records.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 8 2012-10-01 2012-10-01 false Admissibility of business records. 1114.3 Section... § 1114.3 Admissibility of business records. Any writing or record, whether in the form of an entry in a... be admissible as evidence thereof if it appears that it was made in the regular course of business...

49 CFR 1114.3 - Admissibility of business records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Admissibility of business records. 1114.3 Section... § 1114.3 Admissibility of business records. Any writing or record, whether in the form of an entry in a... be admissible as evidence thereof if it appears that it was made in the regular course of business...

Analysis of failed discharge after ambulatory surgery: unanticipated admission.

PubMed

Van Caelenberg, Els; De Regge, Melissa; Eeckloo, Kristof; Coppens, Marc

2018-05-30

Advantages of ambulatory surgery are lost when patients need an unplanned admission. This retrospective cohort study investigated reasons for failed discharge and unanticipated admission of adult patients after day surgery. Ambulatory patients (n = 145) requiring unanticipated admission were compared to patients (n = 4980) not requiring admission and timely discharged from a total of 5156 ambulatory surgical procedures. Demographic data, organisational data, reason for admission, type of anesthesia, surgical discipline, length of procedure, ASA classification, surgical completion time and severity of illness score were collected from both groups. Reason for admission was classified according to four subtypes. Logistic regression analysis was used. Incidence of unanticipated admission following day care surgery was 2.89%. The reasons for admission were mainly organisational issues (45.52%), time of completion surgery in the afternoon between 12 pm and 3 pm (OR 1.73; 95% CI 1.05-2.86) and surgery that ends after 3 pm (OR 6.52; 95% CI 4.11-10.34). Surgical factors associated with unanticipated admission (38.62%) were length of surgery of one to three hours (OR 2.05; 95% CI 1.27-3.29), length of surgery more than three hours (OR 8.31; 95% CI 3.56-19.40). Additionally, anaesthetic (10.34%) and medical (5.52%) reasons were found, e.g. ASA class II (OR 1.61; 95% CI 1.06-2.44), ASA class III (OR 2.19; 95% CI 1.10-4.34); moderate severity of illness score (OR 1.72; 95% CI 1.03-2.88) and major of severity of illness score (OR 7.85; 95% CI 2.31-26.62). Unanticipated admissions following day surgery occur mainly due to social/organisational and surgical reasons. However, medical and anaesthetic reasons also explain 15.86% of the unanticipated admissions.

Potentially preventable complications in epilepsy admissions: The "weekend effect".

PubMed

Ho, Lianne; Kramer, Daniel R; Wen, Timothy; Moalem, Alimohammad S; Millett, David; Heck, Christianne N; Mack, William J; Liu, Charles Y

2017-05-01

Epilepsy affects approximately 1% of the population in the United States with frequent hospital admissions accounting for a significant burden on patients and society as a whole. Weekend admissions have generally been found to have poorer outcomes compared to weekday admissions with increased rates of preventable complications, such as nationally identified "hospital-acquired conditions" (HAC). This study aimed to assess the impact of weekend admission on HACs and mortality in the adult epilepsy population. All adult patients with epilepsy hospitalized in the U.S. from 2000 to 2010 in the Nationwide Inpatient Sample. There were 12,997,181 admissions for epilepsy with 10,106,152 (78%) weekday, 2,891,019 (22%) weekend, and 10 (<0.1%) missing admissions. Weekend admissions saw a 10% increased likelihood of both HACs (RR=1.10, 95% CI:1.09, 1.11, p<0.01) and mortality (RR=1.10, 95% CI: 1.09, 1.11, p<0.01) compared to weekday admissions. The occurrence of HAC was associated with higher inpatient charges (RR=1.36, 95% CI: 1.35, 1.36, p<0.01), pLOS (RR=1.21, 95% CI: 1.21, 1.22, p<0.01), and higher mortality (RR=1.13, 95% CI: 1.12, 1.14, p<0.01). Prior studies have shown weekend admissions are usually associated with higher rates of complications leading to higher costs and a longer hospital stay. Likewise, weekend admissions for epilepsy were associated with increased rates of HACs and mortality; however, they were also negatively associated with LOS and total charge. Thus, weekend admissions for epilepsy should be considered high risk with greater effort made to mitigate these risks. Copyright © 2017 Elsevier Inc. All rights reserved.

Traumatic Brain Injury Rehabilitation in Riyadh, Saudi Arabia: Time to Rehabilitation Admission, Length of Stay, and Functional Outcome

PubMed Central

Mahmoud, Husam; Qannam, Hazem; Mortenson, Ben

2017-01-01

Objectives 1) To describe trends in time to rehabilitation admission and rehabilitation length of stay (LOS), and functional status, 2) To identify independent predictors of functional outcomes following rehabilitation. Design Retrospective cohort study. Setting Traumatic brain injuries rehabilitation unit of King Fahad Medical City, Riyadh, Saudi Arabia. Participants Adult patients with TBI discharged from inpatient rehabilitation between 2009–2014. Methods We collected information on time from injury to rehabilitation admission, rehabilitation LOS, Functional Independence Measure (FIM) score (admission and discharge), and demographic variables by chart review. Hierarchical regression was employed to investigate variables associated with FIM score at rehabilitation discharge. Results Data from 208 patients were obtained. Mean time from injury to rehabilitation admission was 263±274 days. Rehabilitation LOS was 66±43 days. FIM scores improved significantly during rehabilitation. After controlling for other variables, increasing time from injury to rehabilitation admission was associated with lower FIM score at discharge from rehabilitation. Conclusions Time from injury to rehabilitation admission is notably longer than reported elsewhere. Decreasing this time may improve functional outcome at discharge from rehabilitation. Ensuring that information regarding TBI severity is included throughout the continuum of care would benefit patients and provide insight into TBI aetiology in Saudi Arabia. PMID:28362120

Perceptions of admission committee members: some aspects on individual admission to dental education at Karolinska Institutet.

PubMed

Röding, Karin

2005-08-01

The aim of the study was to generate an overall impression of the admission committee's (AC) perspective on individualised admission procedures, derived from some perceived experience of the individual committee members using semi-structured interviews. Qualitative research was used and data were collected by use of interviews. The results show that the committee members are highly committed to the task and try to identify desirable, non-cognitive attributes in the applicants, such as motivation, empathy, drive, and tenacity: 'emotional intelligence'. The committee members were of the opinion that it was possible to identify these attributes in an applicant. The AC further believes that the admissions procedure influences academic achievements because students regard themselves as specially selected and therefore aspire to higher achievements.

Factors Associated with the Time of Admission among Notified Dengue Fever Cases in Region VIII Philippines from 2008 to 2014

PubMed Central

Gil Cuesta, Julita; Cerro, Boyd Roderick; Guha-Sapir, Debarati

2016-01-01

In cases of Dengue fever, late hospital admission can lead to treatment delay and even death. In order to improve early disease notification and management, it is essential to investigate the factors affecting the time of admission of Dengue cases. This study determined the factors associated with the time of admission among notified Dengue cases. The study covered the period between 2008 and 2014 in Region VIII, Philippines. The factors assessed were age, sex, hospital sector, hospital level, disease severity based on the 1997 WHO Dengue classification, and period of admission (distinguishing between the 2010 Dengue epidemic and non-epidemic time). We analysed secondary data from the surveillance of notified Dengue cases. We calculated the association through chi-square test, ordinal logistic regression and linear regression at p value < 0.05. The study included 16,357 admitted Dengue cases. The reported cases included a majority of children (70.09%), mild cases of the disease (64.00%), patients from the public sector (69.82%), and non-tertiary hospitals (62.76%). Only 1.40% of cases had a laboratory confirmation. The epidemic period in 2010 comprised 48.68% of all the admitted cases during this period. Late admission was more likely among adults than children (p<0.05). The severe type of the disease was more likely to be admitted late than the mild type (p<0.05). Late admission was also more likely in public hospitals than in private hospitals (p<0.05); and within tertiary level hospitals than non-tertiary hospitals (p<0.05). Late admission was more likely during the non-epidemic period than the 2010 epidemic period (p<0.05). A case fatality rate of 1 or greater was significantly associated with children, severe diseases, tertiary hospitals and public hospitals when admitted late (p<0.05). Data suggests that early admission among child cases was common in Region VIII. This behavior is encouraging, and should be continued. However, further study is needed on the

Unethical Admissions: Academic Integrity in Question.

PubMed

Ansah, Richard Hannis; Aikhuele, Daniel O; Yao, Liu

2017-08-01

The increasing unethical practices of graduates' admissions have heightened concerns about the integrity of the academy. This article informs this important subject that affects the students, admission systems, and the entire scientific community, thus, representing an approach against scholarly black market activities including falsified documents and unethical practices by consultants and students' recruitment agencies.

An Admissions Race that's Already Won

ERIC Educational Resources Information Center

Stevens, Mitchell L.

2008-01-01

The author recently spent a year and a half in the admissions office of a highly selective Eastern college as an ethnographer, seeking to understand just how admissions officers make their decisions. He accompanied them on recruitment trips to high schools and college fairs, helped manage their offices' relentless current of visitors and mail, and…

False confessions, expert testimony, and admissibility.

PubMed

Watson, Clarence; Weiss, Kenneth J; Pouncey, Claire

2010-01-01

The confession of a criminal defendant serves as a prosecutor's most compelling piece of evidence during trial. Courts must preserve a defendant's constitutional right to a fair trial while upholding the judicial interests of presenting competent and reliable evidence to the jury. When a defendant seeks to challenge the validity of that confession through expert testimony, the prosecution often contests the admissibility of the expert's opinion. Depending on the content and methodology of the expert's opinion, testimony addressing the phenomenon of false confessions may or may not be admissible. This article outlines the scientific and epistemological bases of expert testimony on false confession, notes the obstacles facing its admissibility, and provides guidance to the expert in formulating opinions that will reach the judge or jury. We review the 2006 New Jersey Superior Court decision in State of New Jersey v. George King to illustrate what is involved in the admissibility of false-confession testimony and use the case as a starting point in developing a best-practice approach to working in this area.

Orbit Determination with Very Short Arcs: Admissible Regions

NASA Astrophysics Data System (ADS)

Gronchi, G. F.; Milani, A.; de'Michieli Vitturi, M.; Knezevic, Z.

2004-05-01

Contemporary observational surveys provide a huge number of detections of small solar system bodies, in particular of asteroids. These have to be reduced in real time in order to optimize the observational strategy and to select the targets for the follow-up and for the subsequent determination of an orbit. Typically, reported astrometry consists of few positions over a short time span, and this information is often not enough to compute a preliminary orbit and perform an identification. Classical methods for preliminary orbit determination based on three observations fail in such cases, and a new approach is necessary to cope with the problem. We introduce the concept of attributable, which is a vector composed by two angles and two angular velocities at a given time. It is then shown that the missing values (geocentric range and range rate), necessary for the computation of an orbit, can be constrained to a compact set that we call admissible region (AR). The latter is defined on the basis of requirements that the body belongs to the solar system, that it is not a satellite of the Earth, and that it is not a "shooting star" (very close and very small). A mathematical description of the AR is given, together with the proof of its topological properties: it turns out that the AR cannot have more than two connected components. A sampling of the AR can be performed by means of a Delaunay triangulation. A finite number of six-parameter sets of initial conditions are thus defined, with each node of triangulation representing a Virtual Asteroid for which it is possible to propagate the corresponding orbit and to predict ephemerides.

Time series model for forecasting the number of new admission inpatients.

PubMed

Zhou, Lingling; Zhao, Ping; Wu, Dongdong; Cheng, Cheng; Huang, Hao

2018-06-15

Hospital crowding is a rising problem, effective predicting and detecting managment can helpful to reduce crowding. Our team has successfully proposed a hybrid model combining both the autoregressive integrated moving average (ARIMA) and the nonlinear autoregressive neural network (NARNN) models in the schistosomiasis and hand, foot, and mouth disease forecasting study. In this paper, our aim is to explore the application of the hybrid ARIMA-NARNN model to track the trends of the new admission inpatients, which provides a methodological basis for reducing crowding. We used the single seasonal ARIMA (SARIMA), NARNN and the hybrid SARIMA-NARNN model to fit and forecast the monthly and daily number of new admission inpatients. The root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) were used to compare the forecasting performance among the three models. The modeling time range of monthly data included was from January 2010 to June 2016, July to October 2016 as the corresponding testing data set. The daily modeling data set was from January 4 to September 4, 2016, while the testing time range included was from September 5 to October 2, 2016. For the monthly data, the modeling RMSE and the testing RMSE, MAE and MAPE of SARIMA-NARNN model were less than those obtained from the single SARIMA or NARNN model, but the MAE and MAPE of modeling performance of SARIMA-NARNN model did not improve. For the daily data, all RMSE, MAE and MAPE of NARNN model were the lowest both in modeling stage and testing stage. Hybrid model does not necessarily outperform its constituents' performances. It is worth attempting to explore the reliable model to forecast the number of new admission inpatients from different data.

Grade Inflation and Law School Admissions

ERIC Educational Resources Information Center

Wongsurawat, Winai

2008-01-01

Purpose: The purpose of this paper is to evaluate the evidence on whether grade inflation has led to an increasing emphasis on standardized test scores as a criterion for law school admissions. Design/methodology/approach: Fit probabilistic models to admissions data for American law schools during the mid to late 1990s, a period during which…

Impact of order set design on urine culturing practices at an academic medical centre emergency department.

PubMed

Munigala, Satish; Jackups, Ronald R; Poirier, Robert F; Liang, Stephen Y; Wood, Helen; Jafarzadeh, S Reza; Warren, David K

2018-01-20

Urinalysis and urine culture are commonly ordered tests in the emergency department (ED). We evaluated the impact of removal of order sets from the 'frequently ordered test' in the computerised physician order entry system (CPOE) on urine testing practices. We conducted a before (1 September to 20 October 2015) and after (21 October to 30 November 2015) study of ED patients. The intervention consisted of retaining 'urinalysis with reflex to microscopy' as the only urine test in a highly accessible list of frequently ordered tests in the CPOE system. All other urine tests required use of additional order screens via additional mouse clicks. The frequency of urine testing before and after the intervention was compared, adjusting for temporal trends. During the study period, 6499 (28.2%) of 22 948 ED patients had ≥1 urine test ordered. Urine testing rates for all ED patients decreased in the post intervention period for urinalysis (291.5 pre intervention vs 278.4 per 1000 ED visits post intervention, P=0.03), urine microscopy (196.5vs179.5, P=0.001) and urine culture (54.3vs29.7, P<0.001). When adjusted for temporal trends, the daily culture rate per 1000 ED visits decreased by 46.6% (-46.6%, 95% CI -66.2% to -15.6%), but urinalysis (0.4%, 95% CI -30.1 to 44.4%), microscopy (-6.5%, 95% CI -36.0% to 36.6%) and catheterised urine culture rates (17.9%, 95% CI -16.9 to 67.4) were unchanged. A simple intervention of retaining only 'urinalysis with reflex to microscopy' and removing all other urine tests from the 'frequently ordered' window of the ED electronic order set decreased urine cultures ordered by 46.6% after accounting for temporal trends. Given the injudicious use of antimicrobial therapy for asymptomatic bacteriuria, findings from our study suggest that proper design of electronic order sets plays a vital role in reducing excessive ordering of urine cultures. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article

How Admission Policy Shapes College Access: Evidence from Two Sectors

ERIC Educational Resources Information Center

Gentsch, Kerstin

2016-01-01

This dissertation illustrates how admission policies shape access to postsecondary education. Evidence comes from two sectors, each with a distinct type of admission system: highly selective institutions that practice holistic admission (chapters 2 and 3) and less selective public four-year colleges that use admission thresholds (chapter 4). The…

Evaluating acute medical admissions through emergency departments in Hong Kong: can one adjust for case-mix variation?

PubMed

Rainer, T H; Sollich, P; Piotrowski, T; Coolen, A C C; Cheng, B; Graham, C A

2012-12-01

Healthcare systems are under pressure to efficiently and safely reduce acute care admissions to hospital. There is a need to develop a standardised system for assessing emergency department performance which takes into account case-mix variation. The objective of this study was to derive and validate a standardised tool for assessing variations in medical admissions through emergency departments in Hong Kong. Retrospective study of patients attending emergency departments of 14 acute hospitals in Hong Kong. Data were retrieved from a centralised administrative database. Of 2,531,225 patients who attended emergency departments between 1 January 2001 and 31 December 2003, 780,444 (30.8%) were admitted to medical wards. A model derived from 2001 data shows well-calibrated admission probabilities, with an area under the receiver operating characteristic curve for probability of admission of 90.3 (95% CI ±0.11). The areas under the receiver operating characteristic curves for 2002 and 2003 validation sets were 89.9 (95% CI ±0.11) and 89.0 (95% CI ±0.12), respectively. With an averaged benchmark, reductions in medical admissions of up to 19% could be achieved, while under the most optimistic assumption, reductions of up 36% could be achieved. A tool for benchmarking hospital medical admissions and minimising case-mix variation has been derived and validated in Hong Kong, but it requires further validation in other healthcare systems given the wide variations in admission thresholds internationally. This may be used as one potential method to evaluate the performance of emergency departments against a common standard.

A Connection Admission Control Method for Web Server Systems

NASA Astrophysics Data System (ADS)

Satake, Shinsuke; Inai, Hiroshi; Saito, Tomoya; Arai, Tsuyoshi

Most browsers establish multiple connections and download files in parallel to reduce the response time. On the other hand, a web server limits the total number of connections to prevent from being overloaded. That could decrease the response time, but would increase the loss probability, the probability of which a newly arriving client is rejected. This paper proposes a connection admission control method which accepts only one connection from a newly arriving client when the number of connections exceeds a threshold, but accepts new multiple connections when the number of connections is less than the threshold. Our method is aimed at reducing the response time by allowing as many clients as possible to establish multiple connections, and also reducing the loss probability. In order to reduce spending time to examine an adequate threshold for web server administrators, we introduce a procedure which approximately calculates the loss probability under a condition that the threshold is given. Via simulation, we validate the approximation and show effectiveness of the admission control.

Who Gets In and Why: A Former Admissions Officer Tells All.

ERIC Educational Resources Information Center

Gose, Ben

1997-01-01

A former Dartmouth College (New Hampshire) admissions officer has written a book about the college admissions process at Ivy League and other selective colleges. She details factors in admissions decision making that contradict stated policies and admissions principles. Admissions professionals at Dartmouth and other colleges criticize the book as…

Review of admission of MBBS students at KMC.

PubMed

Dixit, H; Maharjan, S

2003-01-01

This is an account regarding the intake of the 7th batch of MBBS students at Kathmandu Medical College (KMC) for the academic session 2003-2004. A total of 257 admission forms had been issued to Nepali students. Of these, 252 admission forms were filled up and were submitted to KMC together with the completed questionnaire by the Nepali students. Seven students (approximately 2.7%) did not attend interview. After the interview, out of the 245 interviewed students, the names of only 50 were brought out in the 1st list for admission. The paper presents the system for admission of MBBS students and has made recommendations for future action.

Optimal control problem for linear fractional-order systems, described by equations with Hadamard-type derivative

NASA Astrophysics Data System (ADS)

Postnov, Sergey

2017-11-01

Two kinds of optimal control problem are investigated for linear time-invariant fractional-order systems with lumped parameters which dynamics described by equations with Hadamard-type derivative: the problem of control with minimal norm and the problem of control with minimal time at given restriction on control norm. The problem setting with nonlocal initial conditions studied. Admissible controls allowed to be the p-integrable functions (p > 1) at half-interval. The optimal control problem studied by moment method. The correctness and solvability conditions for the corresponding moment problem are derived. For several special cases the optimal control problems stated are solved analytically. Some analogies pointed for results obtained with the results which are known for integer-order systems and fractional-order systems describing by equations with Caputo- and Riemann-Liouville-type derivatives.

Analysis of National Trends in Admissions for Pulmonary Embolism.

PubMed

Smith, Sean B; Geske, Jeffrey B; Kathuria, Parul; Cuttica, Michael; Schimmel, Daniel R; Courtney, D Mark; Waterer, Grant W; Wunderink, Richard G

2016-07-01

Pulmonary embolism (PE) remains a significant cause of hospital admission and health-care costs. Estimates of PE incidence came from the 1990s, and data are limited to describe trends in hospital admissions for PE over the past decade. We analyzed Nationwide Inpatient Sample data from 1993 to 2012 to identify patients admitted with PE. We included admissions with International Classification of Diseases, 9th revision, codes listing PE as the principal diagnosis as well as admissions with PE listed secondary to principal diagnoses of respiratory failure or DVT. Massive PE was defined by mechanical ventilation, vasopressors, or nonseptic shock. Outcomes included hospital lengths of stay, adjusted charges, and all-cause hospital mortality. Linear regression was used to analyze changes over time. Admissions for PE increased from 23 per 100,000 in 1993 to 65 per 100,000 in 2012 (P < .001). The percent of admissions meeting criteria for massive PE decreased (5.3% to 4.4%, P = .002), but the absolute number of admissions for massive PE increased (from 1.5 to 2.8 per 100,000, P < .001). Median length of stay decreased from 8 (interquartile range [IQR], 6-11) to 4 (IQR, 3-6) days (P < .001). Adjusted hospital charges increased from $16,475 (IQR, $10,748-$26,211) in 1993 to $25,728 (IQR, $15,505-$44,493) in 2012 (P < .001). All-cause hospital mortality decreased from 7.1% to 3.2% (P < .001), but population-adjusted deaths during admission for PE increased from 1.6 to 2.1 per 100,000 (P < .001). Total admissions and hospital charges for PE have increased over the past two decades. However, the population-adjusted admission rate has increased disproportionately to the incidence of patients with severe PE. We hypothesize that these findings reflect a concerning national movement toward more admissions of less severe PE. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Predictors of care home and hospital admissions and their costs for older people with Alzheimer's disease: findings from a large London case register

PubMed Central

Knapp, Martin; Chua, Kia-Chong; Broadbent, Matthew; Chang, Chin-Kuo; Fernandez, Jose-Luis; Milea, Dominique; Romeo, Renee; Lovestone, Simon; Spencer, Michael; Thompson, Gwilym; Stewart, Robert; Hayes, Richard D

2016-01-01

Objectives To examine links between clinical and other characteristics of people with Alzheimer's disease living in the community, likelihood of care home or hospital admission, and associated costs. Design Observational data extracted from clinical records using natural language processing and Hospital Episode Statistics. Statistical analyses examined effects of cognition, physical health, mental health, sociodemographic factors and living circumstances on risk of admission to care home or hospital over 6 months and associated costs, adjusting for repeated observations. Setting Catchment area for South London and Maudsley National Health Service Foundation Trust, provider for 1.2 million people in Southeast London. Participants Every individual with diagnosis of Alzheimer's disease seen and treated by mental health services in the catchment area, with at least one rating of cognition, not resident in care home at time of assessment (n=3075). Interventions Usual treatment. Main outcome measures Risk of admission to, and days spent in three settings during 6-month period following routine clinical assessment: care home, mental health inpatient care and general hospital inpatient care. Results Predictors of probability of care home or hospital admission and/or associated costs over 6 months include cognition, functional problems, agitation, depression, physical illness, previous hospitalisations, age, gender, ethnicity, living alone and having a partner. Patterns of association differed considerably by destination. Conclusions Most people with dementia prefer to remain in their own homes, and funding bodies see this as cheaper than institutionalisation. Better treatment in the community that reduces health and social care needs of Alzheimer's patients would reduce admission rates. Living alone, poor living circumstances and functional problems all raise admission rates, and so major cuts in social care budgets increase the risk of high-cost admissions which older

Multi-Stakeholder Informed Guidelines for Direct Admission of Children to Hospital.

PubMed

Leyenaar, JoAnna K; Shevenell, Megan; Rizzo, Paul A; Hill, Vanessa L; Lindenauer, Peter K

2018-04-25

To develop pediatric direct admission guidelines and prioritize outcomes to evaluate the safety and effectiveness of hospital admission processes. We conducted deliberative discussions at 1 children's hospital and 2 community hospitals, engaging parents of hospitalized children and inpatient, outpatient, and emergency department physicians and nurses to identify shared and dissenting perspectives regarding direct admission processes and outcomes. Discussions were audio-recorded, professionally transcribed, and analyzed using a general inductive approach. We then convened a national panel to prioritize guideline components and outcome measures using a RAND/UCLA Modified Delphi approach. Forty-eight stakeholders participated in 6 deliberative discussions. Emergent themes related to effective multistakeholder communication, resources needed for high quality direct admissions, written direct admission guidelines, including criteria to identify children appropriate for and inappropriate for direct admission, and families' needs. Building on these themes, Delphi panelists endorsed 71 guideline components as both appropriate and necessary at children's hospitals and community hospitals and 13 outcomes to evaluate hospital admission systems. Guideline components include (1) pre-admission communication, (2) written guidelines, (3) hospital resources to optimize direct admission processes, (4) special considerations for pediatric populations that may be at particular risk of nosocomial infection and/or stress in emergency departments, (5) communication with families referred for direct admission, and (6) quality reviews to evaluate admission systems. These direct admission guidelines can be adapted by hospitals and health systems to inform hospital admission policies and protocols. Multistakeholder engagement in evaluation of hospital admission processes may improve transitions of care and health system integration. Copyright © 2018 Elsevier Inc. All rights reserved.

Trends in hospital admission rates for whooping cough in England across five decades: database studies.

PubMed

Haslam, Nick; Hoang, Uy; Goldacre, Michael J

2014-04-01

Our aim was to report on trends in hospitalisation rates for pertussis in England from the 1960s to 2011; and to provide context for the recent unexpected activity of Bordetella pertussis in the UK. A retrospective analysis of English national Hospital Episode Statistics (HES, 1968-2011) and the Oxford Record Linkage Study (ORLS, 1963-2011) for people admitted to hospital with whooping cough. England and the Oxford Record Linkage Study area. Age- and gender-specific hospital admission rates, and summary age- and sex-standardised rates, for people aged under 25 years per 100,000 population in each age group. Admission rates declined from the 1960s to the early 1970s. For example, the standardised rates were 12.8 (95% confidence interval 11.2-14.5) per 100,000 in England in 1968 and 4.0 (3.0-4.9) per 100,000 in 1973. They then increased to reach 45.0 (41.4-48.6) per 100,000 in 1978 and 47.4 (43.7-51.1) in 1982. From the late 1980s, admission rates continued to decline, falling to between 1 and 4 per 100,000 in each of the years between 2003 and 2011. While the trend in hospital admissions closely followed that in notifications, the annual ratio between these two measures was not consistent ranging from 1.07 (95% confidence interval 1.00-1.14) to 4.03 (3.79-4.27) notifications per admission over the last 10 years. Epidemics of whooping cough in the late 1970s and early 1980s were associated with a significant rise in hospital admission rates. Current admission rates are low, by historical comparison. Vaccine programmes must continue to be fully implemented in order to improve control of pertussis activity.

Hospital costs estimation and prediction as a function of patient and admission characteristics.

PubMed

Ramiarina, Robert; Almeida, Renan Mvr; Pereira, Wagner Ca

2008-01-01

The present work analyzed the association between hospital costs and patient admission characteristics in a general public hospital in the city of Rio de Janeiro, Brazil. The unit costs method was used to estimate inpatient day costs associated to specific hospital clinics. With this aim, three "cost centers" were defined in order to group direct and indirect expenses pertaining to the clinics. After the costs were estimated, a standard linear regression model was developed for correlating cost units and their putative predictors (the patients gender and age, the admission type (urgency/elective), ICU admission (yes/no), blood transfusion (yes/no), the admission outcome (death/no death), the complexity of the medical procedures performed, and a risk-adjustment index). Data were collected for 3100 patients, January 2001-January 2003. Average inpatient costs across clinics ranged from (US$) 1135 [Orthopedics] to 3101 [Cardiology]. Costs increased according to increases in the risk-adjustment index in all clinics, and the index was statistically significant in all clinics except Urology, General surgery, and Clinical medicine. The occupation rate was inversely correlated to costs, and age had no association with costs. The (adjusted) per cent of explained variance varied between 36.3% [Clinical medicine] and 55.1% [Thoracic surgery clinic]. The estimates are an important step towards the standardization of hospital costs calculation, especially for countries that lack formal hospital accounting systems.

Increased admissions for diabetes mellitus after burn.

PubMed

Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; O'Halloran, Emily; Rea, Suzanne; Wood, Fiona M

2016-12-01

Currently, limited long-term data on hyperglycaemia and insulin sensitivity in burn patients are available and the data that do exist are primarily related to paediatric severe burns. The aim of this study was to assess if burn is associated with increased post-burn admissions for diabetes mellitus. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalized for a first burn (n=30,997) in 1980-2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia's birth registrations and electoral roll (n=123,399). Crude admission rates and summed length of stay for diabetes mellitus were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. After adjustment for socio-demographic factors and pre-existing health status, the burn cohort had 2.21 times (95% Confidence Interval (CI): 1.36-1.56) as many admissions and almost three times the number of days in hospital with a diabetes mellitus diagnosis (IRR, 95% CI: 2.94, 2.12-4.09) than the uninjured cohort. Admission rates were significantly elevated for those burned during childhood (<18 years, IRR, 95% CI: 2.65, 1.41-4.97) and adulthood (≥18 years, IRR, 95% CI: 2.12, 1.76-2.55). Incident admissions were significantly elevated in the burn cohort during the first 5 years post-burn when compared with the uninjured (HR, 95% CI: 1.96, 1.46-2.64); no significant difference was found beyond 5 years post-burn (HR, 95% CI: 1.08, 0.82-1.41). Findings of increased hospital admission rates and prolonged length of hospital stay for diabetes mellitus in the burn cohort provide evidence that burns have longer term effects on blood glucose and insulin regulation after wound healing. The first five years after burn discharge appears to be a critical period with significantly elevated incident

Asians in Higher Education: Conflicts over Admissions.

ERIC Educational Resources Information Center

Hoachlander, E. Gareth; Brown, Cynthia L.

1989-01-01

Many Asian Americans believe that the admissions policies of many selective colleges are unfair to them. Demographic trends and the resultant political activity are discussed. The admissions policies and practices that Asian Americans consider objectionable are examined and some policy options are offered. (MLW)

42 CFR 93.519 - Admissibility of evidence.

Code of Federal Regulations, 2011 CFR

2011-10-01

... RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions Hearing Process § 93.519 Admissibility of evidence. (a) The ALJ decides the admissibility of... of Witness). (i) Evidence about offers of compromise or settlement made in this action is...

42 CFR 93.519 - Admissibility of evidence.

Code of Federal Regulations, 2010 CFR

2010-10-01

... RESEARCH MISCONDUCT Opportunity To Contest ORI Findings of Research Misconduct and HHS Administrative Actions Hearing Process § 93.519 Admissibility of evidence. (a) The ALJ decides the admissibility of... of Witness). (i) Evidence about offers of compromise or settlement made in this action is...

Do hospital admission rates increase in colder winters? A decadal analysis from an eastern county in England.

PubMed

Patterson, Stephen

2017-07-05

The aim of the study was to measure the effect of colder winters compared to warmer winters on hospital admission rates in Suffolk County. The setting of this study was Suffolk County in eastern England. The period of the study was financial years 2003/04-2012/13. The study was an analytic ecological study. Analysis involved calculation of rate ratios of hospital admission rates in colder winters compared to warmer winters, in all persons and the elderly. The main finding of the study was that all rate ratios for hospital admission rates in colder winters compared to warmer winters were significantly raised with effects of 2-5%. Rate ratios for all admissions in persons of all ages and persons aged 65 years and over were, respectively, 1.02 (99% confidence interval (CI): 1.01, 1.03; P < 0.001) and 1.02 (99% CI: 1.01, 1.04; P < 0.001). Rate ratios for emergency admissions in persons of all ages and persons aged 65 years and over were, respectively, 1.05 (99% CI: 1.03, 1.06; P < 0.001) and 1.04 (99% CI: 1.01, 1.06; P < 0.001). In Suffolk County, hospital admission rates are significantly raised in colder winters compared to warmer winters. This evidence may be useful in planning hospital services. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Childhood Malaria Admission Rates to Four Hospitals in Malawi between 2000 and 2010

PubMed Central

Okiro, Emelda A.; Kazembe, Lawrence N.; Kabaria, Caroline W.; Ligomeka, Jeffrey; Noor, Abdisalan M.; Ali, Doreen; Snow, Robert W.

2013-01-01

Introduction The last few years have witnessed rapid scaling-up of key malaria interventions in several African countries following increases in development assistance. However, there is only limited country-specific information on the health impact of expanded coverage of these interventions. Methods Paediatric admission data were assembled from 4 hospitals in Malawi reflecting different malaria ecologies. Trends in monthly clinical malaria admissions between January 2000 and December 2010 were analysed using time-series models controlling for covariates related to climate and service use to establish whether changes in admissions can be related to expanded coverage of interventions aimed at reducing malaria infection. Results In 3 of 4 sites there was an increase in clinical malaria admission rates. Results from time series models indicate a significant month-to-month increase in the mean clinical malaria admission rates at two hospitals (trend P<0.05). At these hospitals clinical malaria admissions had increased from 2000 by 41% to 100%. Comparison of changes in malaria risk and ITN coverage appear to correspond to a lack of disease declines over the period. Changes in intervention coverage within hospital catchments showed minimal increases in ITN coverage from <6% across all sites in 2000 to maximum of 33% at one hospital site by 2010. Additionally, malaria transmission intensity remained unchanged between 2000–2010 across all sites. Discussion Despite modest increases in coverage of measures to reduce infection there has been minimal changes in paediatric clinical malaria cases in four hospitals in Malawi. Studies across Africa are increasingly showing a mixed set of impact results and it is important to assemble more data from more sites to understand the wider implications of malaria funding investment. We also caution that impact surveillance should continue in areas where intervention coverage is increasing with time, for example Malawi, as decline may

Fixed and growth mindsets in physics graduate admissions

NASA Astrophysics Data System (ADS)

Scherr, Rachel E.; Plisch, Monica; Gray, Kara E.; Potvin, Geoff; Hodapp, Theodore

2017-12-01

Considering the evidence that standard physics graduate admissions practices tend to exclude women and traditionally marginalized racial and ethnic groups from the discipline, we investigate (a) the characteristics of students that physics graduate admissions committee members seek to admit to their programs and (b) the practices associated with these admissions goals. The data for this investigation are interviews with 18 faculty who chair graduate admissions committees in programs that prioritize diversity in their graduate admissions practices. We find that some express elements of an implicit theory of intelligence known as a "fixed mindset," in which intelligence is understood as an inherent capacity or ability primarily measured by standardized test scores and grades. Some also express elements of a "growth mindset," in which intelligence is understood in terms of acquired knowledge and effort. Overall, most faculty interviewed expressed elements of both mindsets. A fixed mindset in physics graduate admissions is consistent with research identifying physics as a "brilliance-required" field, whose members tend to believe that raw, innate talent is a primary requirement for success in the discipline. Such a mindset directly affects the participation of women and some racial or ethnic groups, who are stereotyped as lacking such high-level intellectual ability.

Combining Different Privacy-Preserving Record Linkage Methods for Hospital Admission Data.

PubMed

Stausberg, Jürgen; Waldenburger, Andreas; Borgs, Christian; Schnell, Rainer

2017-01-01

Record linkage (RL) is the process of identifying pairs of records that correspond to the same entity, for example the same patient. The basic approach assigns to each pair of records a similarity weight, and then determines a certain threshold, above which the two records are considered to be a match. Three different RL methods were applied under privacy-preserving conditions on hospital admission data: deterministic RL (DRL), probabilistic RL (PRL), and Bloom filters. The patient characteristics like names were one-way encrypted (DRL, PRL) or transformed to a cryptographic longterm key (Bloom filters). Based on one year of hospital admissions, the data set was split randomly in 30 thousand new and 1,5 million known patients. With the combination of the three RL-methods, a positive predictive value of 83 % (95 %-confidence interval 65 %-94 %) was attained. Thus, the application of the presented combination of RL-methods seem to be suited for other applications of population-based research.

Periodical capacity setting methods for make-to-order multi-machine production systems

PubMed Central

Altendorfer, Klaus; Hübl, Alexander; Jodlbauer, Herbert

2014-01-01

The paper presents different periodical capacity setting methods for make-to-order, multi-machine production systems with stochastic customer required lead times and stochastic processing times to improve service level and tardiness. These methods are developed as decision support when capacity flexibility exists, such as, a certain range of possible working hours a week for example. The methods differ in the amount of information used whereby all are based on the cumulated capacity demand at each machine. In a simulation study the methods’ impact on service level and tardiness is compared to a constant provided capacity for a single and a multi-machine setting. It is shown that the tested capacity setting methods can lead to an increase in service level and a decrease in average tardiness in comparison to a constant provided capacity. The methods using information on processing time and customer required lead time distribution perform best. The results found in this paper can help practitioners to make efficient use of their flexible capacity. PMID:27226649

Information Retrieval Performance of Probabilistically Generated, Problem-Specific Computerized Provider Order Entry Pick-Lists: A Pilot Study

PubMed Central

Rothschild, Adam S.; Lehmann, Harold P.

2005-01-01

Objective: The aim of this study was to preliminarily determine the feasibility of probabilistically generating problem-specific computerized provider order entry (CPOE) pick-lists from a database of explicitly linked orders and problems from actual clinical cases. Design: In a pilot retrospective validation, physicians reviewed internal medicine cases consisting of the admission history and physical examination and orders placed using CPOE during the first 24 hours after admission. They created coded problem lists and linked orders from individual cases to the problem for which they were most indicated. Problem-specific order pick-lists were generated by including a given order in a pick-list if the probability of linkage of order and problem (PLOP) equaled or exceeded a specified threshold. PLOP for a given linked order-problem pair was computed as its prevalence among the other cases in the experiment with the given problem. The orders that the reviewer linked to a given problem instance served as the reference standard to evaluate its system-generated pick-list. Measurements: Recall, precision, and length of the pick-lists. Results: Average recall reached a maximum of .67 with a precision of .17 and pick-list length of 31.22 at a PLOP threshold of 0. Average precision reached a maximum of .73 with a recall of .09 and pick-list length of .42 at a PLOP threshold of .9. Recall varied inversely with precision in classic information retrieval behavior. Conclusion: We preliminarily conclude that it is feasible to generate problem-specific CPOE pick-lists probabilistically from a database of explicitly linked orders and problems. Further research is necessary to determine the usefulness of this approach in real-world settings. PMID:15684134

Integrated model for pricing, delivery time setting, and scheduling in make-to-order environments

NASA Astrophysics Data System (ADS)

Garmdare, Hamid Sattari; Lotfi, M. M.; Honarvar, Mahboobeh

2018-03-01

Usually, in make-to-order environments which work only in response to the customer's orders, manufacturers for maximizing the profits should offer the best price and delivery time for an order considering the existing capacity and the customer's sensitivity to both the factors. In this paper, an integrated approach for pricing, delivery time setting and scheduling of new arrival orders are proposed based on the existing capacity and accepted orders in system. In the problem, the acquired market demands dependent on the price and delivery time of both the manufacturer and its competitors. A mixed-integer non-linear programming model is presented for the problem. After converting to a pure non-linear model, it is validated through a case study. The efficiency of proposed model is confirmed by comparing it to both the literature and the current practice. Finally, sensitivity analysis for the key parameters is carried out.

Effects of air pollution on respiratory hospital admissions in İstanbul, Turkey, 2013 to 2015.

PubMed

Çapraz, Özkan; Deniz, Ali; Doğan, Nida

2017-08-01

We examined the associations between the daily variations of air pollutants and hospital admissions for respiratory diseases in İstanbul, the largest city of Turkey. A time series analysis of counts of daily hospital admissions and outdoor air pollutants was performed using single-pollutant Poisson generalized linear model (GLM) while controlling for time trends and meteorological factors over a 3-year period (2013-2015) at different time lags (0-9 days). Effects of the pollutants (Excess Risk, ER) on current-day (lag 0) hospital admissions to the first ten days (lag 9) were determined. Data on hospital admissions, daily mean concentrations of air pollutants of PM 10 , PM 2.5 and NO 2 and daily mean concentrations of temperature and humidity of İstanbul were used in the study. The analysis was conducted among people of all ages, but also focused on different sexes and different age groups including children (0-14 years), adults (35-44 years) and elderly (≥65 years). We found significant associations between air pollution and respiratory related hospital admissions in the city. Our findings showed that the relative magnitude of risks for an association of the pollutants with the total respiratory hospital admissions was in the order of: PM 2.5 , NO 2 , and PM 10 . The highest association of each pollutant with total hospital admission was observed with PM 2.5 at lag 4 (ER = 1.50; 95% CI = 1.09-1.99), NO 2 at lag 4 (ER = 1.27; 95% CI = 1.02-1.53) and PM 10 at lag 0 (ER = 0.61; 95% CI = 0.33-0.89) for an increase of 10 μg/m3 in concentrations of the pollutants. In conclusion, our study showed that short-term exposure to air pollution was positively associated with increased respiratory hospital admissions in İstanbul during 2013-2015. As the first air pollution hospital admission study using GLM in İstanbul, these findings may have implications for local environmental and social policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Implementation of a Goal-Directed Mechanical Ventilation Order Set Driven by Respiratory Therapists Improves Compliance With Best Practices for Mechanical Ventilation.

PubMed

Radosevich, Misty A; Wanta, Brendan T; Meyer, Todd J; Weber, Verlin W; Brown, Daniel R; Smischney, Nathan J; Diedrich, Daniel A

2017-01-01

Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice. We evaluated 1302 patients undergoing invasive mechanical ventilation (1693 separate episodes of invasive mechanical ventilation) prior to and after institution of a standardized, goal-directed mechanical ventilation order set using a controlled before-and-after study design. Patient-specific goals for oxygenation partial pressure of oxygen in arterial blood (Pao 2 ), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio 2 ] table use) and ventilation (pH, partial pressure of carbon dioxide) were selected by prescribers and implemented by RTs. Compliance with the new mechanical ventilation order set was high: 88.2% compliance versus 3.8% before implementation of the order set ( P < .001). Adherence to the PEEP/Fio 2 table after implementation of the order set was significantly greater (86.0% after vs 82.9% before, P = .02). There was no difference in duration of mechanical ventilation, intensive care unit (ICU) length of stay, and in-hospital or ICU mortality. A standardized best practice mechanical ventilation order set can be implemented by a multidisciplinary team and is associated with improved compliance to written orders and adherence to the ARDSNet PEEP/Fio 2 table.

Secondary School Admissions: The Choice for Black Parents in the London Borough of Hackney, United Kingdom

ERIC Educational Resources Information Center

McCalman, Lionel

2008-01-01

In the UK, the law places a lot of emphasis on parental rights and choice--the right to choose the school that suits the needs of your child. Parents can list in order of preference and this ranked order is lodged with the education authority (through one common application form), and hope that within the complexities of the admissions process,…

Text mining electronic hospital records to automatically classify admissions against disease: Measuring the impact of linking data sources.

PubMed

Kocbek, Simon; Cavedon, Lawrence; Martinez, David; Bain, Christopher; Manus, Chris Mac; Haffari, Gholamreza; Zukerman, Ingrid; Verspoor, Karin

2016-12-01

Text and data mining play an important role in obtaining insights from Health and Hospital Information Systems. This paper presents a text mining system for detecting admissions marked as positive for several diseases: Lung Cancer, Breast Cancer, Colon Cancer, Secondary Malignant Neoplasm of Respiratory and Digestive Organs, Multiple Myeloma and Malignant Plasma Cell Neoplasms, Pneumonia, and Pulmonary Embolism. We specifically examine the effect of linking multiple data sources on text classification performance. Support Vector Machine classifiers are built for eight data source combinations, and evaluated using the metrics of Precision, Recall and F-Score. Sub-sampling techniques are used to address unbalanced datasets of medical records. We use radiology reports as an initial data source and add other sources, such as pathology reports and patient and hospital admission data, in order to assess the research question regarding the impact of the value of multiple data sources. Statistical significance is measured using the Wilcoxon signed-rank test. A second set of experiments explores aspects of the system in greater depth, focusing on Lung Cancer. We explore the impact of feature selection; analyse the learning curve; examine the effect of restricting admissions to only those containing reports from all data sources; and examine the impact of reducing the sub-sampling. These experiments provide better understanding of how to best apply text classification in the context of imbalanced data of variable completeness. Radiology questions plus patient and hospital admission data contribute valuable information for detecting most of the diseases, significantly improving performance when added to radiology reports alone or to the combination of radiology and pathology reports. Overall, linking data sources significantly improved classification performance for all the diseases examined. However, there is no single approach that suits all scenarios; the choice of the

Helmet legislation and admissions to hospital for cycling related head injuries in Canadian provinces and territories: interrupted time series analysis

PubMed Central

Ramsay, Tim; Turgeon, Alexis F; Zarychanski, Ryan

2013-01-01

Objective To investigate the association between helmet legislation and admissions to hospital for cycling related head injuries among young people and adults in Canada. Design Interrupted time series analysis using data from the National Trauma Registry Minimum Data Set. Setting Canadian provinces and territories; between 1994 and 2003, six of 10 provinces implemented helmet legislation. Participants All admissions (n=66 716) to acute care hospitals in Canada owing to cycling related injury between 1994 and 2008. Main outcome measure Rate of admissions to hospital for cycling related head injuries before and after the implementation of provincial helmet legislation. Results Between 1994 and 2008, 66 716 hospital admissions were for cycling related injuries in Canada. Between 1994 and 2003, the rate of head injuries among young people decreased by 54.0% (95% confidence interval 48.2% to 59.8%) in provinces with helmet legislation compared with 33.1% (23.3% to 42.9%) in provinces and territories without legislation. Among adults, the rate of head injuries decreased by 26.0% (16.0% to 36.3%) in provinces with legislation but remained constant in provinces and territories without legislation. After taking baseline trends into consideration, however, we were unable to detect an independent effect of legislation on the rate of hospital admissions for cycling related head injuries. Conclusions Reductions in the rates of admissions to hospital for cycling related head injuries were greater in provinces with helmet legislation, but injury rates were already decreasing before the implementation of legislation and the rate of decline was not appreciably altered on introduction of legislation. While helmets reduce the risk of head injuries and we encourage their use, in the Canadian context of existing safety campaigns, improvements to the cycling infrastructure, and the passive uptake of helmets, the incremental contribution of provincial helmet legislation to reduce

42 CFR 456.125 - Time limits for admission review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for admission review. 456.125 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.125 Time limits for admission review. Except as required under § 456...

42 CFR 456.125 - Time limits for admission review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for admission review. 456.125 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.125 Time limits for admission review. Except as required under § 456...

Early and Late Recurrent Epistaxis Admissions: Patterns of Incidence and Risk Factors.

PubMed

Cohen, Oded; Shoffel-Havakuk, Hagit; Warman, Meir; Tzelnick, Sharon; Haimovich, Yaara; Kohlberg, Gavriel D; Halperin, Doron; Lahav, Yonatan

2017-09-01

Objective Epistaxis is a common complaint, yet few studies have focused on the incidence and risk factors of recurrent epistaxis. Our objective was to determine the patterns of incidence and risk factors for recurrent epistaxis admission (REA). Study Design Case series with chart review. Settings Single academic center. Subjects and Methods The medical records of patients admitted for epistaxis between 1999 and 2015 were reviewed. The follow-up period was defined as 3 years following initial admission. REAs were categorized as early (30 days) and late (31 days to 3 years) following initial admission. Logistic regression was used to identify potential predictors of REAs. Results A total of 653 patients were included. Eighty-six patients (14%) had REAs: 48 (7.5%) early and 38 (6.5%) late. Nonlinear incidence curve was demonstrated for both early and late REAs. Based on logistic regression, prior nasal surgery and anemia were independent risk factors for early REAs. According to multivariate analysis, thrombocytopenia was significantly associated with late REAs. Conclusion Early and late REAs demonstrate different risk predictors. Knowledge of such risk factors may help in risk stratification for this selected group of patients. All patients at risk should be advised on possible preventive measures. Patients at risk for early REA may benefit from a more proactive approach.

43 CFR 41.305 - Preference in admission.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 41.305 Preference in admission. A recipient to... or predominantly members of one sex, if the giving of such preference has the effect of...

43 CFR 41.305 - Preference in admission.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 41.305 Preference in admission. A recipient to... or predominantly members of one sex, if the giving of such preference has the effect of...

28 CFR 54.305 - Preference in admission.

Code of Federal Regulations, 2013 CFR

2013-07-01

... SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 54.305 Preference in admission. A recipient to... or predominantly members of one sex, if the giving of such preference has the effect of...

19 CFR 210.31 - Requests for admission.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Requests for admission. 210.31 Section 210.31 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Discovery and Compulsory Process § 210.31 Requests for admission. (a...

Comparison of clock drawing with Mini Mental State Examination as a screening test in elderly acute hospital admissions.

PubMed Central

Death, J.; Douglas, A.; Kenny, R. A.

1993-01-01

Clock drawing is a quick, easy to remember test that is well received by patients. It is a good screening test for Alzheimer's disease in the outpatient setting. We evaluated its usefulness compared with the standard Mini Mental State Examination (MMSE) in elderly acute medical and surgical hospital admissions. Within 48 hours of admission, 117 patients over 70 years old were administered the MMSE and asked to draw a clock. Using the MMSE as the standard, clock drawing had a sensitivity of 77% and a specificity of 87%. Patients with discrepant scores were then further evaluated. The findings suggest that normal clock drawing ability reasonably excludes cognitive impairment or other causes of an abnormal MMSE in elderly acute medical and surgical hospital admissions, where cognitive impairment is common and frequently missed. PMID:8255833

Developing a customized multiple interview for dental school admissions.

PubMed

Gardner, Karen M

2014-04-01

From the early 1980s until recently, the University of British Columbia Faculty of Dentistry had employed the Canadian Dental Association (CDA) Structured Interview in its Phase 2 admissions process (with those applicants invited for interviews). While this structured interview had demonstrated reliability and validity, the Faculty of Dentistry came to believe that a multiple interview process using scenarios would help it better identify applicants who would match its mission. After a literature review that investigated such interview protocols as unstructured, semi-structured, computerized, and telephone formats, a multiple interview format was chosen. This format was seen as an emerging trend, with evidence that it has been deemed fairer by applicants, more reliable by interviewers, more difficult for applicants to provide set answers for the scenarios, and not to require as many interviewers as other formats. This article describes the process undertaken to implement a customized multiple interview format for admissions and reports these outcomes of the process: a smoothly running multiple interview; effective training protocols for staff, interviewers, and applicants; and reports from successful applicants and interviewers that they felt the multiple interview was a more reliable and fairer recruiting tool than other models.

Geographic distribution of burn in an Australian setting.

PubMed

Randall, Sean M; Wood, Fiona M; Boyd, James H; Duke, Janine M

2017-11-01

To investigate the geographic distribution and temporal trends of burn admissions in an Australian setting. Health administrative data of all persons hospitalised for a first burn in Western Australia for the period 2000-2012 were used. Crude and standardised incident rates were generated for each region. Maps of crude rates were generated for state regions and postcode-suburbs of Perth, the capital city. Standardised incidence rates were generated for Western Australia, total and regions, and for sub-cohorts defined by age (<20years; ≥20 years), TBSA burn severity and major causes of burns (fire, scalds and contact). Negative binomial regression was used to examine temporal changes and generate incidence rate ratios (IRR) with 95% confidence intervals (CI). Perth had the lowest burn admission rate per population; clusters of suburbs of lower social advantage and higher immigrant settlement were identified as being at high risk. While the highest observed admission rates were found in Kimberley and Goldfields (remote) regions, after adjustment for the regional demographic structures, the Wheatbelt and Mid-West (rural) regions were found to have the highest adjusted rates of burn admissions. Significant annual declines in admission rates were found for the Kimberley, Pilbara and Goldfields (remote regions); however, stable admission rates were identified for all other regions. The Mid-West and Wheatbelt rural regions were found to have the highest risk of burn admissions raising concerns about farming-related injury. Safety awareness and burn prevention strategies need to be continued, with specific attention to these high risk areas, to reduce burn admissions in Western Australia. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

8 CFR 1235.4 - Withdrawal of application for admission.

Code of Federal Regulations, 2010 CFR

2010-01-01

... construed as to give an alien the right to withdraw his or her application for admission. Permission to... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Withdrawal of application for admission... application for admission. The Attorney General may, in his or her discretion, permit any alien applicant for...

An Introduction to the Surveys of Applicants Who Accepted or Declined Admission to UMCP.

ERIC Educational Resources Information Center

Ott, Mary Diederich

Surveys of admitted students (N=309) at the University of Maryland College Park (UMCP) were conducted in order to obtain admitted applicants' views of the functioning of the Admission Office and to assess differences in responses of certain subgroups of applicants. The four classification variables defining the subgroups were: acceptance status…

Racial variation in the use of do-not-resuscitate orders.

PubMed

Shepardson, L B; Gordon, H S; Ibrahim, S A; Harper, D L; Rosenthal, G E

1999-01-01

To compare the use of do-not-resuscitate (DNR) orders in African-American and white patients using a large, multisite, community-based sample. Our sample included 90,821 consecutive admissions to 30 hospitals in a large metropolitan region with six nonsurgical conditions from 1993 through 1995. Demographic and clinical data were abstracted from medical records. Admission severity of illness was measured using multivariate risk-adjustment models with excellent discrimination (receiver-operating characteristic curve areas, 0.82-0.88). Multiple logistic regression analysis was used to determine the independent association between race and use of DNR orders, adjusting for age, admission severity, and other covariates. In all patients, the rate of DNR orders was lower in African Americans than whites (9% vs 18%; p <.001). Rates of orders were also lower ( p <. 001) among African Americans in analyses stratified by age, gender, diagnosis, severity of illness, and in-hospital death. After adjusting for severity and other important covariates, the odds of a DNR order remained lower ( p <.001) for African-Americans relative to whites for all diagnoses, ranging from 0.38 for obstructive airway disease to 0.71 for gastrointestinal hemorrhage. Results were similar in analyses limited to orders written by the first, second, or seventh hospital day. Finally, among patients with DNR orders, African Americans were less likely to have orders written on the first hospital day and more likely to have orders written on subsequent days. The use of DNR orders was substantially lower in African Americans than in whites, even after adjusting for severity of illness and other covariates. Identification of factors underlying such differences will improve our understanding of the degree to which expectations for care differ in African American and white patients.

Lexical Profiles of Thailand University Admission Tests

ERIC Educational Resources Information Center

Cherngchawano, Wirun; Jaturapitakkul, Natjiree

2014-01-01

University Admission Tests in Thailand are important documents which reflect Thailand's education system. To study at a higher education level, all students generally need to take the University Admission Tests designed by the National Institute of Educational Testing Service (NIETS). For the English test, vocabulary and reading comprehension is…

45 CFR 86.22 - Preference in admission.

Code of Federal Regulations, 2010 CFR

2010-10-01

... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 86.22 Preference in admission. A... predominantly members of one sex, if the giving of such preference has the effect of discriminating on the basis...

45 CFR 86.22 - Preference in admission.

Code of Federal Regulations, 2014 CFR

2014-10-01

... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 86.22 Preference in admission. A... predominantly members of one sex, if the giving of such preference has the effect of discriminating on the basis...

40 CFR 5.305 - Preference in admission.

Code of Federal Regulations, 2010 CFR

2010-07-01

... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 5.305 Preference in admission. A... students only or predominantly members of one sex, if the giving of such preference has the effect of...

45 CFR 86.22 - Preference in admission.

Code of Federal Regulations, 2012 CFR

2012-10-01

... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 86.22 Preference in admission. A... predominantly members of one sex, if the giving of such preference has the effect of discriminating on the basis...

10 CFR 590.308 - Admissions of facts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Admissions of facts. 590.308 Section 590.308 Energy DEPARTMENT OF ENERGY (CONTINUED) NATURAL GAS (ECONOMIC REGULATORY ADMINISTRATION) ADMINISTRATIVE PROCEDURES WITH RESPECT TO THE IMPORT AND EXPORT OF NATURAL GAS Procedures § 590.308 Admissions of facts. (a) At...

Understanding the Bologna Process for Admissions Officers

ERIC Educational Resources Information Center

Baxton, Mary; Johnson, Johnny Kent; Nathanson, Gloria; Paver, William; Watkins, Robert

2009-01-01

In Spring 2008, senior members of the international admission and credential evaluation community met to deliberate over the admission and placement of Bologna Compliant degree holders into U.S. graduate programs. This group comprised several individuals holding top leadership positions in NAFSA, AACRAO, and closely allied groups involved in…

Beyond Standardized Tests: Admissions Alternatives That Work.

ERIC Educational Resources Information Center

Allina, Amy; And Others

Seven schools that have re-evaluated their needs for standardized college admissions examinations were studied to explore their admissions and innovative testing policies. The schools include: (1) Bates College in Lewiston, Maine; (2) Bowdoin College in Brunswick, Maine; (3) Harvard Graduate School of Business Administration in Cambridge,…

40 CFR 5.305 - Preference in admission.

Code of Federal Regulations, 2013 CFR

2013-07-01

... BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 5.305 Preference in admission. A... students only or predominantly members of one sex, if the giving of such preference has the effect of...

Exploring unplanned ICU admissions: a systematic review.

PubMed

Vlayen, Annemie; Verelst, Sandra; Bekkering, Geertruida E; Schrooten, Ward; Hellings, Johan; Claes, Nerée

anesthetic procedures (UIA). 2) Only a few studies examined patients on general wards being at risk for clinical deterioration. The overall incidence of surgical and medical adverse events compared with ICU admissions ranged from 1.1% to 37.2%. 3) The third category of studies examined patients that were readmitted on ICUs. ICU readmission rates varied from 0% to 18.3%. Nine studies explicitly reported on the preventability of adverse outcomes. The preventability rates of the adverse events varied from 17% to 76.5%. Preventable adverse events are further synthesized by type of event and patterns of preventability are being formulated. Consequences of the adverse events included a mean length of ICU stay that ranged from 1.5 days to 10.4 days for the patient's first stay in ICU. Mortality rates varied between 0% and 58%. Adverse events are a persistent and an important reason for admission to the ICU. However, there is relatively weak evidence to estimate an overall incidence and preventability rate of these events. In addition, estimates on preventability are prone to subjective judgments. Variability in methodology and definitions, and poor reporting in studies may be the main reasons for study heterogeneity. Unplanned intensive care admission within 24 hours of a procedure with an anesthetist in attendance (UIA) is a recommended clinical indicator in surgical patients. Several authors recommend early detection of patients with clinical instability on general wards and the implementation of rapid response teams. Step-down or intermediate care units could be a useful strategy for patients that require monitoring to avoid ICU readmissions. There is a need for further studies on the detection of adverse events. The poor quality of current research evidence and the heterogeneity across studies requires that planning of future studies should aim to standardize measures of outcomes to allow for comparisons across studies. This area of research is important in order to identify

Pediatric intensive care unit admission tool: a colorful approach.

PubMed

Biddle, Amy

2007-12-01

This article discusses the development, implementation, and utilization of our institution's Pediatric Intensive Care Unit (PICU) Color-Coded Admission Status Tool. Rather than the historical method of identifying a maximum number of staffed beds, a tool was developed to color code the PICU's admission status. Previous methods had been ineffective and led to confusion between the PICU leadership team and the administration. The tool includes the previously missing components of staffing and acuity, which are essential in determining admission capability. The PICU tool has three colored levels: green indicates open for admissions; yellow, admission alert resulting from available beds or because staffing is not equal to the projected patient numbers or required acuity; and red, admissions on hold because only one trauma or arrest bed is available or staffing is not equal to the projected acuity. Yellow and red designations require specific actions and the medical director's approval. The tool has been highly successful and significantly impacted nursing with the inclusion of the essential component of nurse staffing necessary in determining bed availability.

Care provider allocation on admissions to acute mental health wards: The development and validation of the Admission Team Score List.

PubMed

van den Berg, Sjobha R N; Stringer, Barbara; van de Sande, Roland; Draisma, Stasja

2018-05-18

Currently, support tools are lacking to prioritize steps in the care coordination process to enable safe practice and effective clinical pathways in the first phase of acute psychiatric admissions. This study describes the development, validity, and reliability of an acute care coordination support tool, the Admission Team Score List (ATSL). The ATSL assists in care provider allocation during admissions. Face validity and feasibility of the ATSL were tested in 77 acute admissions. Endscores of filled out ATSL's were translated to recommended team compositions. These ATSL team (ATSL-T) compositions were compared to the actually present team (AP-T) and the most preferred team (MP-T) composition in hindsight. Consistency between the ATSL-T and the MP-T was substantial; K w  = 0.70, P < 0.001, 95% CI [0.55-0.84]. The consistency between the ATSL-T and AP-T was moderate; K w  = 0.43, P < 0.001, 95% CI [0.23-0.62]. The ATSL has an adequate (inter-rater) reliability; ICC = 0.90, P < 0.001, 95% CI [0.65-0.91]. The ATSL study is an important step to promote safety and efficient care based on care provider allocation, for service users experiencing an acute admission. The ATSL may stimulate structured clinical decision-making during the hectic process around acute psychiatric admissions. © 2018 Australian College of Mental Health Nurses Inc.

45 CFR 618.305 - Preference in admission.

Code of Federal Regulations, 2014 CFR

2014-10-01

... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 618.305 Preference in admission. A... students only or predominantly members of one sex, if the giving of such preference has the effect of...

29 CFR 2200.54 - Requests for admissions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 9 2011-07-01 2011-07-01 false Requests for admissions. 2200.54 Section 2200.54 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION RULES OF PROCEDURE... complexity of the case or the number of citation items necessitates a greater number of requested admissions...

Physician organization care management capabilities associated with effective inpatient utilization management: a fuzzy set qualitative comparative analysis.

PubMed

Sheehy, Thomas J; Thygeson, N Marcus

2014-12-03

We studied the relationship between physician organization (PO) care management capabilities and inpatient utilization in order to identify PO characteristics or capabilities associated with low inpatient bed-days per thousand. We used fuzzy-set qualitative comparative analysis (fsQCA) to conduct an exploratory comparative case series study. Data about PO capabilities were collected using structured interviews with medical directors at fourteen California POs that are delegated to provide inpatient utilization management (UM) for HMO members of a California health plan. Health plan acute hospital claims from 2011 were extracted from a reporting data warehouse and used to calculate inpatient utilization statistics. Supplementary analyses were conducted using Fisher's Exact Test and Student's T-test. POs with low inpatient bed-days per thousand minimized length of stay and surgical admissions by actively engaging in concurrent review, discharge planning, and surgical prior authorization, and by contracting directly with hospitalists to provide UM-related services. Disease and case management were associated with lower medical admissions and readmissions, respectively, but not lower bed-days per thousand. Care management methods focused on managing length of stay and elective surgical admissions are associated with low bed-days per thousand in high-risk California POs delegated for inpatient UM. Reducing medical admissions alone is insufficient to achieve low bed-days per thousand. California POs with high bed-days per thousand are not applying care management best practices.

Seven-days-ahead forecasting of childhood asthma admissions using artificial neural networks in Athens, Greece.

PubMed

Moustris, Kostas P; Douros, Konstantinos; Nastos, Panagiotis T; Larissi, Ioanna K; Anthracopoulos, Michael B; Paliatsos, Athanasios G; Priftis, Kostas N

2012-01-01

Artificial Neural Network (ANN) models were developed and applied in order to predict the total weekly number of Childhood Asthma Admission (CAA) at the greater Athens area (GAA) in Greece. Hourly meteorological data from the National Observatory of Athens and ambient air pollution data from seven different areas within the GAA for the period 2001-2004 were used. Asthma admissions for the same period were obtained from hospital registries of the three main Children's Hospitals of Athens. Three different ANN models were developed and trained in order to forecast the CAA for the subgroups of 0-4, 5-14-year olds, and for the whole study population. The results of this work have shown that ANNs could give an adequate forecast of the total weekly number of CAA in relation to the bioclimatic and air pollution conditions. The forecasted numbers are in very good agreement with the observed real total weekly numbers of CAA.

Daily weather variables and affective disorder admissions to psychiatric hospitals

NASA Astrophysics Data System (ADS)

McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

2014-12-01

Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables—namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature—influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed.

Trend Analysis of Substance Abuse Treatment Admissions in New Orleans From 2000-2012: A Population-Based Comparison Pre- and Post-Hurricane Katrina.

PubMed

Shuler, Monique N; Wallington, Sherrie F; Qualls-Hampton, Raquel Y; Podesta, Arwen E; Suzuki, Sumihiro

2016-10-14

Substance abuse treatment following a natural disaster is often met with challenges. If treatment is available, facilities may be unequipped to service an influx of patients or provide specialized care for unique populations. This paper seeks to evaluate trends in substance abuse treatment over time and assess changes pre- and post-Hurricane Katrina. Substance abuse treatment admission data (N = 42,678) from New Orleans, Louisiana, for years 2000 through 2012 were obtained from the Treatment Episode Data Set. Admissions were examined to evaluate demographic, socioeconomic, psychiatric, and criminality trends in substance abuse treatment and assess changes following Hurricane Katrina. Treatment admissions have decreased from 2000 to 2012. About one in five admissions had a psychiatric illness in addition to a substance abuse problem. A staggering 76% of admissions with a psychiatric illness were referred by the criminal justice system post-Katrina as compared to pre-Katrina. Rates of alcohol and marijuana admissions have remained stable from 2000 to 2012. Cocaine/crack admissions have declined and admissions who abused heroin have increased over time. Treatment admissions stabilized following Hurricane Katrina; however, since 2009, they have begun to decline. Targeted exploration of factors affecting admission to treatment in New Orleans with populations such as the homeless, those with a psychiatric illness in addition to a substance abuse problem, and those referred by the criminal justice system is essential. The results of this study assist in identifying variations in substance abuse treatment characteristics for those admitted to treatment in New Orleans.

Handbook for the College Admissions Profession. The Greenwood Educators' Reference Collection.

ERIC Educational Resources Information Center

Swann, Claire C., Ed.; Henderson, Stanley E., Ed.

The 19 chapters of this book on college admissions are divided into six sections on: (1) perspectives and history, (2) the admissions officer, (3) understanding enrollment management, (4) admissions tools, (5) admissions programs, and (6) perspectives on the twenty-first century. The papers are: "Perspectives on Educational Reform" (Donald…

Assessing the Need for Hospitalization in Order to Conduct a Psychiatric Evaluation as part of Criminal Law Procedure.

PubMed

Olmer, Ahikam; Greenberg, Binyamin; Strous, Rael D

2015-09-01

In criminal law, psychiatrists are consulted regarding the "insanity defense" and the defendant's competency to stand trial. Court-ordered hospital admissions for such evaluations are on the increase, creating a major burden on the health system. To assess, in a hospital setting, whether hospitalization of the defendant is necessary for conducting a psychiatric evaluation. A 6 month prospective observational study exploring the phenomenon was conducted at the Beer Yaakov Mental Health Center. The psychiatrist was asked both at the initiation and at the end of the assessment process whether the subject was competent to stand trial and responsible for his/her actions and if hospitalization was necessary in order to conduct the evaluation. During the study period there were 112 admissions with a court request for a psychiatric evaluation. In 73 of the cases (65.2%) the evaluating psychiatrist believed there was no need for hospitalization. This assessment did not change by the end of the hospitalization in all cases. Employment and alcohol use were the only factors associated with a lower need for hospitalization (OR 0.24, 95% CI 0.07-0.77, and OR 0.34, 95% CI 0.13-0.90, respectively). In the majority of cases, based on the evaluating psychiatrist's responses, the evaluation could have been conducted without need for hospitalization. The findings indicate that an outpatient unit designated to write court-requested psychiatric evaluations could significantly reduce the rates of hospital admissions for this purpose.

The relationship between thermal sensation and the rate of hospital admissions for cardiovascular disease in Kermanshah, Iran

NASA Astrophysics Data System (ADS)

Mohammadi, Bakhtiyar; Karimi, Shilan

2017-11-01

Climate and weather conditions are the most important factors that influence activities and human health. Bioclimatology/biometeorology are concerned with the study of weather effects on living creatures, including humans, plants, and animals. This research was prepared in order to understand the bioclimatic condition of Kermanshah and its relation to the level of hospital admissions of cardiovascular patients in this city. In addition to the climatic variables, the statistics on the number of daily admissions of cardiovascular patients in Kermanshah during March 27, 2009 to April 30, 2015 was prepared. First, Kermanshah's bioclimatic conditions were identified on a daily basis. Then, the relationship between each of the thermal sensations with the level of hospital admissions of cardiovascular patients in Kermanshah using Levene's test, univariate analysis of variance (ANOVA), Scheffe and Games-Howell post hoc tests was investigated. The results of this study showed that in each index, only very few bioclimatic conditions have had an impact on the increase of hospital admissions of cardiovascular diseases. For example, based on the equivalent temperature index (Tek or EqT), there is a significant relationship between extreme conditions and the rate of cardiovascular admissions. But, however, in the effective temperature index (TE), a significant correlation between warm/hot conditions and an increase in the number of cardiovascular admissions was seen. Based on the predicted mean vote (PMV) and physiological equivalent temperature (PET) indices, cool and cold conditions more than warm and comfort conditions have an effect on the number of hospital admissions of cardiovascular patients. Overall, the obtained results showed that the extreme climatic conditions were directly related to an increase in cardiovascular disease in Kermanshah.

Intensive care unit admission in chronic obstructive pulmonary disease: patient information and the physician's decision-making process.

PubMed

Schmidt, Matthieu; Demoule, Alexandre; Deslandes-Boutmy, Emmanuelle; Chaize, Marine; de Miranda, Sandra; Bèle, Nicolas; Roche, Nicolas; Azoulay, Elie; Similowski, Thomas

2014-06-04

ICU admission is required in more than 25% of patients with chronic obstructive pulmonary disease (COPD) at some time during the course of the disease. However, only limited information is available on how physicians communicate with COPD patients about ICU admission. COPD patients and relatives from 19 French ICUs were interviewed at ICU discharge about their knowledge of COPD. French pulmonologists self-reported their practices for informing and discussing intensive care treatment preferences with COPD patients. Finally, pulmonologists and ICU physicians reported barriers and facilitators for transfer of COPD patients to the ICU and to propose invasive mechanical ventilation. Self-report questionnaires were filled in by 126 COPD patients and 102 relatives, and 173 pulmonologists and 135 ICU physicians were interviewed. For 41% (n = 39) of patients and 54% (n = 51) of relatives, ICU admission had never been expected prior to admission. One half of patients were not routinely informed by their pulmonologist about possible ICU admission at some time during the course of COPD. Moreover, treatment options (that is, non-invasive ventilation, intubation and mechanical ventilation or tracheotomy) were not explained to COPD patients during regular pulmonologist visits. Pulmonologists and ICU physician have different perceptions of the decision-making process pertaining to ICU admission and intubation. The information provided by pulmonologists to patients and families concerning the prognosis of COPD, the risks of ICU admission and specific care could be improved in order to deliver ICU care in accordance with the patient's personal values and preferences. Given the discrepancies in the decision-making process between pulmonologists and intensivists, a more collaborative approach should probably be discussed.

Patient subjective experience and satisfaction during the perioperative period in the day surgery setting: a systematic review.

PubMed

Rhodes, Lenore; Miles, Gail; Pearson, Alan

2006-08-01

This systematic review used the Joanna Briggs Institute Qualitative Assessment and Review Instrument to manage, appraise, analyse and synthesize textual data in order to present the best available information in relation to how patients experience nursing interventions and care during the perioperative period in the day surgery setting. Some of the significant findings that emerged from the systematic review include the importance of pre-admission contact, provision of relevant, specific education and information, improving communication skills and maintaining patient privacy throughout their continuum of care.

Banding and Ballots: Secondary School Admissions in England: Admissions in 2012/13 and the Impact of Growth of Academies

ERIC Educational Resources Information Center

Noden, Philip; West, Anne; Hind, Audrey

2014-01-01

This report provides key findings from a two part research project funded by the Sutton Trust and the London School of Economics & Political Science, (LSE) focusing on secondary school admissions in England. The research analyses secondary schools' admissions criteria and practices in England in 2012/13 and illustrative examples of how some…

[Effect of maximum blood pressure fluctuation on prognosis of patients with acute ischemic stroke within 24 hours after hospital admission].

PubMed

Wang, H; Tang, Y; Zhang, Y; Xu, K; Zhao, J B

2018-05-10

Objective: To investigate the relationship between the maximum blood pressure fluctuation within 24 hours after admission and the prognosis at discharge. Methods: The patients with ischemic stroke admitted in Department of Neurology of the First Affiliated Hospital of Harbin Medical University within 24 hours after onset were consecutively selected from April 2016 to March 2017. The patients were grouped according to the diagnostic criteria of hypertension. Ambulatory blood pressure of the patients within 24 hours after admission were measured with bedside monitors and baseline data were collected. The patients were scored by NIHSS at discharge. The relationships between the maximum values of systolic blood pressure (SBP) or diastolic blood pressure (DBP) and the prognosis at discharge were analyzed. Results: A total of 521 patients with acute ischemic stroke were enrolled. They were divided into normal blood pressure group (82 cases) and hypertension group(439 cases). In normal blood pressure group, the maximum values of SBP and DBP were all in normal distribution ( P >0.05). The maximum value of SBP fluctuation was set at 146.6 mmHg. After adjustment for potential confounders, the OR for poor prognosis at discharge in patients with SBP fluctuation ≥146.6 mmHg was 2.669 (95 %CI : 0.594-11.992) compared with those with SBP fluctuation <146.6 mmHg. The maximum value of DBP fluctuation was set at 90.0 mmHg, and the adjusted OR for poor prognosis at discharge in patients with DBP fluctuation ≥90.0 mmHg was 0.416 (95 %CI : 0.087-1.992) compared with those with DBP fluctuation <90.0 mmHg. In hypertension group, the maximum values of SBP and DBP were not in normal distribution ( P <0.05). The maximum value of SBP fluctuation was set at median 171.0 mmHg. After adjustment for the confounders, the greater the maximum of SBP, the greater the risk of poor prognosis at discharge was, the OR was 1.636 (95 %CI : 1.014-2.641). The maximum value of DBP fluctuation was set at

[Involuntary admission of addict during early pregnancy].

PubMed

Hondius, Adger J K; Stikker, Tineke E; Wennink, J M B Hanneke; Honig, Adriaan

2012-01-01

A 30-year-old cocaine-dependent woman was 16 weeks pregnant. Because of possible endangerment of the fetus, an involuntary provisional admission was authorized. Of particular interest is the application of the Dutch Act on Formal Admissions to Psychiatric Hospitals for the primary diagnosis 'addiction' and the fact that the fetus was regarded as a legal 'other'. In severe cases of addiction combined with pregnancy an earlier intervention is needed and arrangement of accelerated legal custody of the newborn before birth should be considered. For the protection of the unborn, we advocate a stricter application of the United Nations Convention on the Rights of the Child. Information for addicted women with preconception counselling can help prevent a compulsory admission.

[Influence of postcode on paediatric admissions in Seville].

PubMed

Tornero Patricio, Sebastián; Charris-Castro, Liliana; Granero Asencio, Mercedes; Daponte Codina, Antonio

2017-12-01

The postcode (where the home is situated) is an indicator of socioeconomic status and is associated with morbidity, mortality, and the use of health services. The aim of this study was to analyse its effects on paediatric admissions and to determine the rates of the most common causes of paediatric admissions in Seville. An observational cross-sectional study with two analysis units: under 15 year-old "admissions" in public hospitals in Seville (n=2,660) and "city districts" of Seville (n=11). The independent variable analysed was whether the postcode of the admitted patients was within a Regional Government designated "area with social transformation needs". The analysis of the admissions was performed using X 2 -test, Fisher test and Student-t test, with the description of rates using the calculation of crude and specific rates, and by rate ratio. Children living in districts with a lower socioeconomic status were on average 7 months younger (P<.001), and they were significantly more likely to be admitted via the emergency department (P<.001). There was no statistical difference detected in either the length of hospital stay or mortality. The crude admission rate ratio was higher in districts with a lower socioeconomic status (1.8), with a higher specific rate ratio detected in admissions due to asthma, respiratory infections, inguinal hernia, and epilepsy/convulsions. Paediatric hospital admission rates of the main diagnoses were higher in districts with a lower socioeconomic status. Children living in these districts were more likely to be admitted younger and via the emergency department. Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Hospital admissions and school dropout: a retrospective cohort study of the 'selection hypothesis'.

PubMed

van Heesch, Mirjam M J; Bosma, Hans; Traag, Tanja; Otten, Ferdy

2012-08-01

School dropout is an important predictor of poor health and of high relevance for public health (in accord with the 'causation hypothesis'). Rather than examining how dropout affects health, we set out to examine how poor health might affect school dropout (in accord with the 'selection hypothesis'). Hospital admissions are potentially indicative of more serious disease and might be expected to result in learning backlogs. Longitudinal data of the Dutch Secondary Education Pupil Cohort 1993 (VOCL'93) and the National Medical Registration (LMR) were combined. The study population consisted of 16,239 pupils who were followed from first grade at secondary school until they left fulltime education. Pupils were monitored regarding both their educational careers and their hospital admissions. Nine percent had a hospital admission and 10% became a school dropout. Hospital admissions were only predictive of later school dropout for pupils starting in the highest type of secondary education (pre-university education) [OR 1.54 (95% CI 1.05-2.26)], not for pupils with lower educational levels. Pre-university pupils who had been hospitalized for more than 9 days [OR 2.34 (95% CI 1.08-5.09)] or who were hospitalized more than three times [OR 4.20 (95% CI 1.75-10.04)] had particularly heightened odds of school dropout. Our findings further support the 'selection hypothesis' and confirm the relevance of dropout for public health. Public health workers and educational professionals should probably aim at intensified monitoring of children who have been hospitalized and simultaneously aim at improving accessibility to (higher quality) education in the hospital.

[Intelligence, socio-economic status and hospital admissions of young adults].

PubMed

Bosma, H; Traag, T; Berger-van Sijl, M; van Eijk, J; Otten, F

2007-05-12

To determine whether socio-economic differences in hospital admissions of adolescents and young adults are related to differences in intelligence. . Retrospective cohort study. The data were derived from a group of 10,231 young adults and adolescents who were followed for a total of 47,212 person years with regard to their hospital admissions. Intelligence was measured in the first year of secondary school by 2 non-verbal intelligence tests for fluid intelligence. Data from hospital admissions were matched to a large-scale educational and occupational cohort. Data were analysed with Cox proportional hazards analysis. Intelligence was not found to be related to hospital admissions. However, a low occupational and educational level of the young adults or their parents, was strongly related to heightened risk for hospital admissions. In particular, the low socio-economic status of a respondent was associated with heightened risk for hospital admissions due to accidents (relative risk: 3.49; 95% confidence interval: 1.91-6.39). The small extent to which the socio-economic differences in hospital admissions seem to be based upon fluid intelligence, at least in adolescents and young adults, as well as the heightened risks of hospital admissions in lower socio-economic status groups and the associated high costs for health care legitimise further study of the determinants of these differences.

Correlating weather and trauma admissions at a level I trauma center.

PubMed

Rising, William R; O'Daniel, Joseph A; Roberts, Craig S

2006-05-01

Popular emergency room wisdom touts higher temperatures, snowfall, weekends, and evenings as variables that increase trauma admissions. This study analyzed the possible correlation between trauma admissions and specific weather variables, and between trauma admissions and time of day or season. Trauma admission data from a Level I trauma center database from July 1, 1996 to January 31, 2002 was downloaded and linked with local weather data from the Archives of the National Oceanic and Atmospheric Administration website, and then analyzed. There were 8,269 trauma admissions over a total of 48,984 hours for an average of one admission every 6 hours. Daily high temperature and precipitation were valid predictors of trauma admission volume, with a 5.25% increase in hourly incidents for each 10-degree difference in temperature, and a 60% to 78% increase in the incident rate for each inch of precipitation in the previous 3 hours. Weather and seasonal variations affect admissions at a Level I trauma center. Data from this study could be useful for determining staffing requirements and resource allocation.

Effects of post-discharge management on rates of early re-admission and death after hospitalisation for heart failure.

PubMed

Huynh, Quan; Negishi, Kazuaki; De Pasquale, Carmine; Hare, James; Leung, Dominic; Stanton, Tony; Marwick, Thomas H

2018-06-18

To investigate whether enrolment of patients in management programs after hospitalisation for heart failure (HF) reduces the likelihood of post-hospital adverse outcomes. Cohort study in which associations between adverse outcomes at 30 and 90 days for people hospitalised for HF and baseline clinical, socio-demographic and blood pathology factors, and with post-discharge management strategies, were assessed. Setting, participants: 906 patients with HF were prospectively enrolled in five Australian states at cardiology departments with expertise in treating people with HF. All-cause re-admissions and deaths at 30 and 90 days after discharge from the index admission. 58% of patients were men; the mean age was 72.5 years (SD, 13.9 years). By hospital, 30-day re-admission rates ranged from 17% to 33%, and 90-day rates from 40% to 55%; 30-day mortality rates were 0-13%, 90-day rates 4-24%. Factors associated with increased odds of re-admission or death at 30 or 90 days included living alone, cognitive impairment, depression, NYHA classification, left atrial volume index, and Charlson index score. Nurse-led disease management programs and reviews within 7 days were associated with reduced odds of re-admission (but not of death) at 30 and 90 days; exercise programs were associated with reduced odds at 90 days. Significant between-hospital differences in re-admission rates were reduced after adjustment for post-discharge management programs, and abolished by further adjustment for echocardiography findings. Between-hospital differences in mortality were largely explained by differences in echocardiographic findings. Differences in early re-admission rates after hospitalisation for HF are primarily explained by differences in post-discharge management.

[Appropriateness of direct admissions to acute care geriatric unit for nursing home patients: an adaptation of the AEPf GRID].

PubMed

Abdoulhadi, Dalia; Chevalet, Pascal; Moret, Leila; Fix, Marie-Hélène; Gégu, Marine; Jaulin, Philippe; Berrut, Gilles; de Decker, Laure

2015-03-01

The patient population staying in nursing homes is increasingly vulnerable and dependent and should benefit from a direct access to an acute care geriatric unit. Nevertheless, the easy access by a simple phone call from the general practitioner to the geriatrician, as well as the lack of orientation of these patients by emergency units, might lead to inappropriate admissions. This work studied the appropriateness of direct admissions of 40 patients living in nursing home in an acute care geriatric unit. Based on the AEPf assessment grid, 82.5% of these admissions were considered as appropriate (52.5%) or justified (30% based on an expert panel decision), and 17.5% were inappropriate. In conclusion, the process of direct admission does not seem to increase the rate of inappropriate admissions. Some actions could decrease this rate: implementation of geriatric mobile teams or psychogeriatric mobile teams intervening in nursing home, a better and more adapted use of ambulatory structures, a better information to the general practitioners. In order to reduce the intervention of the panel of experts, an adaptation of the AEPf assessment grid to these geriatric patients has been proposed. The "AEPg" assessment grid should benefit from a validation study.

Trends in hospital admissions, re-admissions, and in-hospital mortality among HIV-infected patients between 1993 and 2013: Impact of hepatitis C co-infection.

PubMed

Meijide, Héctor; Mena, Álvaro; Rodríguez-Osorio, Iria; Pértega, Sonia; Castro-Iglesias, Ángeles; Rodríguez-Martínez, Guillermo; Pedreira, José; Poveda, Eva

2017-01-01

New patterns in epidemiological characteristics of people living with HIV infection (PLWH) and the introduction of Highly Active Antiretroviral Therapy (HAART) have changed the profile of hospital admissions in this population. The aim of this study was to evaluate trends in hospital admissions, re-admissions, and mortality rates in HIV patients and to analyze the role of HCV co-infection. A retrospective cohort study conducted on all hospital admissions of HIV patients between 1993 and 2013. The study time was divided in two periods (1993-2002 and 2003-2013) to be compared by conducting a comparative cross-sectional analysis. A total of 22,901 patient-years were included in the analysis, with 6917 hospital admissions, corresponding to 1937 subjects (75% male, mean age 36±11 years, 37% HIV/HCV co-infected patients). The median length of hospital stay was 8 days (5-16), and the 30-day hospital re-admission rate was 20.1%. A significant decrease in hospital admissions related with infectious and psychiatric diseases was observed in the last period (2003-2013), but there was an increase in those related with malignancies, cardiovascular, gastrointestinal, and chronic respiratory diseases. In-hospital mortality remained high (6.8% in the first period vs. 6.3% in the second one), with a progressive increase of non-AIDS-defining illness deaths (37.9% vs. 68.3%, P<.001). The admission rate significantly dropped after 1996 (4.9% yearly), but it was less pronounced in HCV co-infected patients (1.7% yearly). Hospital admissions due to infectious and psychiatric disorders have decreased, with a significant increase in non-AIDS-defining malignancies, cardiovascular, and chronic respiratory diseases. In-hospital mortality is currently still high, but mainly because of non-AIDS-defining illnesses. HCV co-infection increased the hospital stay and re-admissions during the study period. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y

Report of the Survey of Admissions Officers in Selected Black Colleges (in the Moton Consortium on Admissions and Financial Aid).

ERIC Educational Resources Information Center

Morris, Eddie W.

Questionnaires sent to 60 black colleges were designed to provide information concerning characteristics of the chief officers, including salaries by size of institution and by level of education, experience of selected admissions officers, supporting staff, student recruitment duties, admissions procedures, space and facilities, and budgeting and…

Age and admission times as predictive factors for failure of admissions to discharge-stream short-stay units.

PubMed

Shetty, Amith L; Shankar Raju, Savitha Banagar; Hermiz, Arsalan; Vaghasiya, Milan; Vukasovic, Matthew

2015-02-01

Discharge-stream emergency short-stay units (ESSU) improve ED and hospital efficiency. Age of patients and time of hospital presentations have been shown to correlate with increasing complexity of care. We aim to determine whether an age and time cut-off could be derived to subsequently improve short-stay unit success rates. We conducted a retrospective audit on 6703 (5522 inclusions) patients admitted to our discharge-stream short-stay unit. Patients were classified as appropriate or inappropriate admissions, and deemed successful if discharged out of the unit within 24 h; and failures if they needed inpatient admission into the hospital. We calculated short-stay unit length of stay for patients in each of these groups. A 15% failure rate was deemed as acceptable key performance indicator (KPI) for our unit. There were 197 out of 4621 (4.3%, 95% CI 3.7-4.9%) patients up to the age of 70 who failed admission to ESSU compared with 67 out of 901 (7.4%, 95% CI 5.9-9.3%, P < 0.01) of patients over the age of 70, reflecting an increased failure rate in geriatric population. When grouped according to times of admission to the ESSU (in-office 06.00-22.00 hours vs out-of-office 22.00-06.00 hours) no significant difference rates in discharge failure (4.7% vs 5.2%, P = 0.46) were noted. Patients >70 years of age have higher rates of failure after admission to discharge-stream ESSU. Although in appropriately selected discharge-stream patients, no age group or time-band of presentation was associated with increased failure rate beyond the stipulated KPI. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Moral dilemmas in medical school admission.

PubMed

Self, D J

1990-03-01

The wide range of complex moral and ethical issues of medical school admission committees are seldom publicly acknowledged, reflected upon, analyzed, or discussed, although they are faced regularly. Three cases are presented that illustrate some of the common and unusual moral dilemmas in the admission process. These issues and several practical strategies for ethical decision making are discussed, along with their limitations and weaknesses. These practical strategies are applied to the three cases to see what solutions might be offered.

Nursing Admission Practices to Discern "Fit": A Case Study Exemplar

ERIC Educational Resources Information Center

Sinutko, Jaime M.

2014-01-01

Admission to a baccalaureate nursing school in the United States is currently a challenging proposition for a variety of reasons. This research explored a holistic nursing school admission process at a small, private, baccalaureate college using a retrospective, mixed-method, approach. The holistic method included multiple admission criteria, both…

Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network

PubMed Central

2012-01-01

Background Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare. Method We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN). We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops. Results We identified three types of intervention: pre-hospital; within the emergency department (ED); and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR – Patients at risk of readmission and ACG – Adjusted Clinical Groups) sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP) within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission. Conclusions Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don’t change. PMID:22682525

Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network.

PubMed

Woodhams, Victoria; de Lusignan, Simon; Mughal, Shakeel; Head, Graham; Debar, Safia; Desombre, Terry; Hilton, Sean; Al Sharifi, Houda

2012-06-10

Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare. We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN). We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops. We identified three types of intervention: pre-hospital; within the emergency department (ED); and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR - Patients at risk of readmission and ACG - Adjusted Clinical Groups) sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP) within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission. Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don't change.

Faculty and students' perception about aptitude of professionalism in admission process of medical college.

PubMed

Waheed, Gulfreen; Mengal, Mohammad Amin; Shah, Syed Shaukat Ali; Sheikh, Abdul Waheed

2011-01-01

Historically, knowledge and skill were of prime focus in medical education, where as professionalism was perceived as an attribute to be acquired during their MBBS studies. In the past decade, trends have changed and graduating medical students are expected to competently deliver care in a professional manner. The selection of applicants with professional attributes at the time of admission is a stepping stone for the formation of a good doctor. This study was conducted to determine the students' and faculty's perception about aptitude of professionalism in the admission process in our setting. In this descriptive cross-sectional study an interactive/scenario-based conversation regarding institutional values, contribute to personal reflection of what will be expected of them in the medical profession and inclusion of such discussion in admission process was made to assess the aptitude of Professionalism of 100 students and 100 faculty members of Avicenna Medical College Lahore. After this conversation the questionnaires were filled by both the groups to record their responses on the aptitude of professionalism. The data was analysed to determine the response patterns of both the groups by using Pearson Chi-Square analysis through crosstabs. All analyses were carried out using SPSS-18. The response of students to professionalism discussion was more positively influenced (91%) compared to the faculty (59%), (p < 0.05). The students agreed that such scenarios do indicate what our institution values in its students and contribute to personal reflection of what will be expected of them in the medical profession. However, faculty agreed more (85%) than the students (67%) for inclusion of such scenarios in admission process, p < 0.05. Medical Colleges should include some form of assessment regarding aptitude of professionalism in the admission process to identify future medical students' capacity for professional behaviour. Future studies are needed to determine

Do-not-resuscitate orders in an extended-care study group.

PubMed

Meyers, R M; Lurie, N; Breitenbucher, R B; Waring, C J

1990-09-01

We examined the charts of 911 nursing home patients in Hennepin County, Minnesota, to determine the prevalence of written do-not-resuscitate (DNR) orders. Information regarding demographic characteristics, and whether a surrogate decisionmaker was available and participated in the decision, was also collected. Twenty-seven percent of patients had DNR orders. Ninety percent of all patients had potentially available surrogate decisionmakers. However, for 31% of patients with DNR orders, there was no documentation of patient or surrogate participation in the DNR decision. Univariate analysis identified female sex; increased age, level of care (skilled versus intermediate), presence of a potential surrogate decisionmaker, and increasing length of time since nursing home admission as factors associated with presence of DNR orders. When a logistic regression model was used, increased age, increased length of time since nursing home admission, skilled versus intermediate level of care, and presence of a surrogate decisionmaker were independently associated with presence of DNR status. Several variables are independently associated with written DNR orders; their relationship to the factors physicians use in decision making requires further study.

Somnambulism: Emergency Department Admissions Due to Sleepwalking-Related Trauma.

PubMed

Sauter, Thomas C; Veerakatty, Sajitha; Haider, Dominik G; Geiser, Thomas; Ricklin, Meret E; Exadaktylos, Aristomenis K

2016-11-01

Somnambulism is a state of dissociated consciousness, in which the affected person is partially asleep and partially awake. There is pervasive public opinion that sleepwalkers are protected from hurting themselves. There have been few scientific reports of trauma associated with somnambulism and no published investigations on the epidemiology or trauma patterns associated with somnambulism. We included all emergency department (ED) admissions to University Hospital Inselspital, Berne, Switzerland, from January 1, 2000, until August 11, 2015, when the patient had suffered a trauma associated with somnambulism. Demographic data (age, gender, nationality) and medical data (mechanism of injury, final diagnosis, hospital admission, mortality and medication on admission) were included. Of 620,000 screened ED admissions, 11 were associated with trauma and sleepwalking. Two patients (18.2%) had a history of known non-rapid eye movement parasomnias. The leading cause of admission was falls. Four patients required hospital admission for orthopedic injuries needing further diagnostic testing and treatment (36.4%). These included two patients with multiple injuries (18.2%). None of the admitted patients died. Although sleepwalking seems benign in the majority of cases and most of the few injured patients did not require hospitalization, major injuries are possible. When patients present with falls of unknown origin, the possibility should be evaluated that they were caused by somnambulism.

Emergency Physician Risk Estimates and Admission Decisions for Chest Pain: A Web-Based Scenario Study.

PubMed

Schriger, David L; Menchine, Michael; Wiechmann, Warren; Carmelli, Guy

2018-04-20

We conducted this study to better understand how emergency physicians estimate risk and make admission decisions for patients with low-risk chest pain. We created a Web-based survey consisting of 5 chest pain scenarios that included history, physical examination, ECG findings, and basic laboratory studies, including a negative initial troponin-level result. We administered the scenarios in random order to emergency medicine residents and faculty at 11 US emergency medicine residency programs. We randomized respondents to receive questions about 1 of 2 endpoints, acute coronary syndrome or serious complication (death, dysrhythmia, or congestive heart failure within 30 days). For each scenario, the respondent provided a quantitative estimate of the probability of the endpoint, a qualitative estimate of the risk of the endpoint (very low, low, moderate, high, or very high), and an admission decision. Respondents also provided demographic information and completed a 3-item Fear of Malpractice scale. Two hundred eight (65%) of 320 eligible physicians completed the survey, 73% of whom were residents. Ninety-five percent of respondents were wholly consistent (no admitted patient was assigned a lower probability than a discharged patient). For individual scenarios, probability estimates covered at least 4 orders of magnitude; admission rates for scenarios varied from 16% to 99%. The majority of respondents (>72%) had admission thresholds at or below a 1% probability of acute coronary syndrome. Respondents did not fully differentiate the probability of acute coronary syndrome and serious outcome; for each scenario, estimates for the two were quite similar despite a serious outcome being far less likely. Raters used the terms "very low risk" and "low risk" only when their probability estimates were less than 1%. The majority of respondents considered any probability greater than 1% for acute coronary syndrome or serious outcome to be at least moderate risk and warranting

Open Admissions: A Bibliography for Research and Application.

ERIC Educational Resources Information Center

Shrier, Irene; Lavin, David E.

This bibliography presents materials for research and application of open admissions policies in higher education. Sections cover: open admissions; factors influencing high school graduates to attend college; disadvantaged and minority students; precollege and special programs; English and reading skills; general compensatory programs; dropouts;…

Eliminating Standardized Tests in College Admissions: The New Affirmative Action?

ERIC Educational Resources Information Center

Zwick, Rebecca

1999-01-01

Eliminating the Scholastic Aptitude Test for college admissions might seem a form of covert affirmative action. Although it is possible to design a workable admissions policy that excludes standardized tests (as 15 percent of colleges have done), banishing admissions tests to further a social-policy goal indirectly is unsound policy. (Contains 25…

Early Admissions at Selective Colleges. NBER Working Paper No. 14844

ERIC Educational Resources Information Center

Avery, Christopher; Levin, Jonathan D.

2009-01-01

Early admissions is widely used by selective colleges and universities. We identify some basic facts about early admissions policies, including the admissions advantage enjoyed by early applicants and patterns in application behavior, and propose a game-theoretic model that matches these facts. The key feature of the model is that colleges want to…

Is integrated care associated with service costs and admission rates to institutional settings? An observational study of community mental health teams for older people in England.

PubMed

Wilberforce, Mark; Tucker, Sue; Brand, Christian; Abendstern, Michele; Jasper, Rowan; Challis, David

2016-11-01

To evaluate the association between the degree of integration in community mental health teams (CMHTs) and: (i) the costs of service provision; (ii) rates of mental health inpatient and care home admission. An observational study of service use and admissions to institutional care was undertaken for a prospectively-sampled cohort of patients from eight CMHTs in England. Teams were chosen to represent 'high' or 'low' levels of integrated working practice and patients were followed-up for seven months. General linear models were used to estimate service costs and the likelihood of institutional admission. Patients supported by high integration teams received services costing an estimated 44% more than comparable patients in low integration teams. However, after controlling for case mix, no significant differences were found in the likelihood of admission to mental health inpatient wards or care homes between team types. Integrated mental health and social care teams appeared to facilitate greater access to community care services, but no consequent association was found with community tenure. Further research is required to identify the necessary and sufficient components of integrated community mental health care, and its effect on a wider range of outcomes using patient-reported measures. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd. © 2016 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

Intensive care unit admission in chronic obstructive pulmonary disease: patient information and the physician’s decision-making process

PubMed Central

2014-01-01

Introduction ICU admission is required in more than 25% of patients with chronic obstructive pulmonary disease (COPD) at some time during the course of the disease. However, only limited information is available on how physicians communicate with COPD patients about ICU admission. Methods COPD patients and relatives from 19 French ICUs were interviewed at ICU discharge about their knowledge of COPD. French pulmonologists self-reported their practices for informing and discussing intensive care treatment preferences with COPD patients. Finally, pulmonologists and ICU physicians reported barriers and facilitators for transfer of COPD patients to the ICU and to propose invasive mechanical ventilation. Results Self-report questionnaires were filled in by 126 COPD patients and 102 relatives, and 173 pulmonologists and 135 ICU physicians were interviewed. For 41% (n = 39) of patients and 54% (n = 51) of relatives, ICU admission had never been expected prior to admission. One half of patients were not routinely informed by their pulmonologist about possible ICU admission at some time during the course of COPD. Moreover, treatment options (that is, non-invasive ventilation, intubation and mechanical ventilation or tracheotomy) were not explained to COPD patients during regular pulmonologist visits. Pulmonologists and ICU physician have different perceptions of the decision-making process pertaining to ICU admission and intubation. Conclusions The information provided by pulmonologists to patients and families concerning the prognosis of COPD, the risks of ICU admission and specific care could be improved in order to deliver ICU care in accordance with the patient’s personal values and preferences. Given the discrepancies in the decision-making process between pulmonologists and intensivists, a more collaborative approach should probably be discussed. PMID:24898342

Quantifying alcohol-related emergency admissions in a UK tertiary referral hospital: a cross-sectional study of chronic alcohol dependency and acute alcohol intoxication

PubMed Central

Vardy, J; Keliher, T; Fisher, J; Ritchie, F; Bell, C; Chekroud, M; Clarey, F; Blackwood, L; Barry, L; Paton, E; Clark, A; Connelly, R

2016-01-01

Objectives Alcohol is responsible for a proportion of emergency admissions to hospital, with acute alcohol intoxication and chronic alcohol dependency (CAD) implicated. This study aims to quantify the proportion of hospital admissions through our emergency department (ED) which were thought by the admitting doctor to be (largely or partially) a result of alcohol consumption. Setting ED of a UK tertiary referral hospital. Participants All ED admissions occurring over 14 weeks from 1 September to 8 December 2012. Data obtained for 5497 of 5746 admissions (95.67%). Primary outcome measures Proportion of emergency admissions related to alcohol as defined by the admitting ED clinician. Secondary outcome measures Proportion of emergency admissions due to alcohol diagnosed with acute alcohol intoxication or CAD according to ICD-10 criteria. Results 1152 (21.0%, 95% CI 19.9% to 22.0%) of emergency admissions were thought to be due to alcohol. 74.6% of patients admitted due to alcohol had CAD, and significantly greater than the 26.4% with ‘Severe’ or ‘Very Severe’ acute alcohol intoxication (p<0.001). Admissions due to alcohol differed to admissions not due to alcohol being on average younger (45 vs 56 years, p<0.001) more often male (73.4% vs 45.1% males, p<0.001) and more likely to have a diagnosis synonymous with alcohol or related to recreational drug use, pancreatitis, deliberate self-harm, head injury, gastritis, suicidal ideation, upper gastrointestinal bleeds or seizures (p<0.001). An increase in admissions due to alcohol on Saturdays reflects a surge in admissions with acute alcohol intoxication above the weekly average (p=0.003). Conclusions Alcohol was thought to be implicated in 21% of emergency admissions in this cohort. CAD is responsible for a significantly greater proportion of admissions due to alcohol than acute intoxication. Interventions designed to reduce alcohol-related admissions must incorporate measures to tackle CAD. PMID:27324707

Admissions Decisions, the Law, and Students with Disabilities

ERIC Educational Resources Information Center

Kutnak, Michael J.; Janosik, Steven M.

2015-01-01

This article explores the legal implications for U.S. higher education administrators who make admissions decisions regarding students with disabilities. A review of federal legislation, case law, and government agency rulings pertaining to higher education admissions and students with disabilities informs administrators of current law.…

Effectiveness of Student Admission Essays in Identifying Attrition.

ERIC Educational Resources Information Center

Sadler, Judith

2003-01-01

From a longitudinal sample of nursing students, 193 completers and 43 noncompleters were compared, revealing significant differences in the groups' mean scores on admission essays but not admission grade point averages. Content analysis revealed how completers had internalized the role of nurse. (Contains 12 references.) (SK)

Nationwide Chains May Shake Up Admissions-Counseling Industry.

ERIC Educational Resources Information Center

Gose, Ben

1999-01-01

For-profit college-admissions counseling and college-preparation companies are expanding, and existing test-preparation centers are planning to begin offering admissions-counseling services. One company envisions a national chain. Some educators welcome the trend, while others feel the commercial enterprises may take an inappropriate approach to…

GRACE score predicts heart failure admission following acute coronary syndrome.

PubMed

McAllister, David A; Halbesma, Nynke; Carruthers, Kathryn; Denvir, Martin; Fox, Keith A

2015-04-01

Congestive heart failure (CHF) is a common and preventable complication of acute coronary syndrome (ACS). Nevertheless, ACS risk scores have not been shown to predict CHF risk. We investigated whether the at-discharge Global Registry of Acute Coronary Events (GRACE) score predicts heart failure admission following ACS. Five-year mortality and hospitalization data were obtained for patients admitted with ACS from June 1999 to September 2009 to a single centre of the GRACE registry. CHF was defined as any admission assigned WHO International Classification of Diseases 10 diagnostic code I50. The hazard ratio (HR) for CHF according to GRACE score was estimated in Cox models adjusting for age, gender and the presence of CHF on index admission. Among 1,956 patients, CHF was recorded on index admission in 141 patients (7%), and 243 (12%) were admitted with CHF over 3.8 median years of follow-up. Compared to the lowest quintile, patients in the highest GRACE score quintile had more CHF admissions (116 vs 17) and a shorter time to first admission (1.2 vs 2.0 years, HR 9.87, 95% CI 5.93-16.43). Per standard deviation increment in GRACE score, the instantaneous risk was more than two-fold higher (HR 2.28; 95% CI 2.02-2.57), including after adjustment for CHF on index admission, age and gender (HR 2.49; 95% CI 2.06-3.02). The C-statistic for CHF admission at 1-year was 0.74 (95% CI 0.70-0.79). The GRACE score predicts CHF admission, and may therefore be used to target ACS patients at high risk of CHF with clinical monitoring and therapies. © The European Society of Cardiology 2014.

Prehospital antiplatelet use and functional status on admission of patients with non-haemorrhagic moyamoya disease: a nationwide retrospective cohort study (J-ASPECT study)

PubMed Central

Onozuka, Daisuke; Hagihara, Akihito; Nishimura, Kunihiro; Kada, Akiko; Nakagawara, Jyoji; Ogasawara, Kuniaki; Ono, Junichi; Shiokawa, Yoshiaki; Aruga, Toru; Miyachi, Shigeru; Nagata, Izumi; Toyoda, Kazunori; Matsuda, Shinya; Suzuki, Akifumi; Kataoka, Hiroharu; Nakamura, Fumiaki; Kamitani, Satoru; Nishimura, Ataru; Kurogi, Ryota; Sayama, Tetsuro; Iihara, Koji

2016-01-01

Objectives To elucidate the association between antiplatelet use in patients with non-haemorrhagic moyamoya disease before hospital admission and good functional status on admission in Japan. Design Retrospective, multicentre, non-randomised, observational study. Setting Nationwide registry data in Japan. Participants A total of 1925 patients with non-haemorrhagic moyamoya disease admitted between 1 April 2012 and 31 March 2014 in Japan. Main outcome measure We performed propensity score-matched analysis to examine the association between prehospital antiplatelet use and no significant disability on hospital admission, as defined by a modified Rankin Scale score of 0 or 1. Results Propensity-matched patients who received prehospital antiplatelet drugs were associated with a good outcome on hospital admission (OR adjusted for all covariates, 3.82; 95% CI 1.22 to 11.99) compared with those who did not receive antiplatelet drugs prior to hospital admission. Conclusions Prehospital antiplatelet use was significantly associated with good functional status on hospital admission among patients with non-haemorrhagic moyamoya disease in Japan. Our results suggest that prehospital antiplatelet use should be considered when evaluating outcomes of patients with non-haemorrhagic moyamoya disease. PMID:27008684

Edinburgh Emergency Asthma Admission Service: report on 10 years' experience.

PubMed Central

Crompton, G K; Grant, I W; Bloomfield, P

1979-01-01

In December 1968 an emergency service was begun in Edinburgh to expedite admission to hospital of patients with severe acute asthma. During the first 10 years requests were made to admit 112 patients to a respiratory unit with provision for intensive care on 360 occasions. Four of the patients died of their disease, one in hospital and three before admission. It was thought that the death rate would have been much higher had conventional admission procedures been observed. Owing to ethical objections to a controlled trial it was not possible to obtain substantive proof that the service reduced deaths from asthma. Nevertheless, there was strong circumstantial evidence that organised facilities for the immediate admission to hospital of patients with a history of life-threatening attacks would result in fewer deaths at home. Earlier admission also apparently reduced hospital mortality and the number of patients requiring tracheal intubation and mechanical ventilation. It is concluded that there is a prima facie case for an emergency asthma admission serivce similar to that operating in Edinburgh to be established in all cities and large towns. PMID:519358

Preventable complications in epilepsy admissions: The "July effect".

PubMed

Pierson, Natalie S; Kramer, Daniel R; Wen, Timothy; Ho, Lianne; Patel, Arati; Donoho, Daniel; Mehta, Vivek; Heck, Christianne; Lee, Brian; Mack, William J; Liu, Charles Y

2017-11-01

Inpatient hospital stays for patients with epilepsy represent a significant burden on patients and society. Identifying factors that contribute to such costs aides in developing effective strategies to address this burden. July admissions have been associated with higher rates of complications and worse outcomes, attributed to the presence of new physicians. This study aims to evaluate whether epilepsy patients admitted in July have higher preventable complication rates and mortality than during the rest of the year. Data was derived from the Nationwide Inpatient Sample (NIS) for epilepsy admissions for the years 2000-2010. Multivariable analyses assessed the effect of July against non-July admission on "hospital acquired complications" (HAC), which are complications identified as owing to preventable causes and mortality. Additionally, the total adjusted charges and prolonged length of stay (pLOS) for July admissions were compared to the 50th percentile. A total of 12,997,181 admissions for epilepsy were identified with 993,619 (8%) occurring in July, 10,810,900 (83%) were non-July months, and 1,192,662 (9%) were missing data. Patients admitted in July showed an increased association for HAC events (RR=1.02, [1.01,1.03], p<0.01), but a decrease in mortality (RR=0.96, [0.95,0.97], p<0.01). There was no difference in rates of higher total adjusted charges for July admissions (RR=1.00, [1.00,1.00], p<0.01) and a decrease in rates of pLOS (RR=0.99, [0.98,0.99], p<0.01). In the epilepsy population, although July admissions were associated with a slight increase in HAC events, there was a non-significant or decreased rate of mortality, LOS, and total charge. Our results suggest that although complications were increased in July, possibly due to new staff, supervision is sufficient to prevent significant burden on patients and hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

The Economics of an Admissions Holding Unit.

PubMed

Schreyer, Kraftin E; Martin, Richard

2017-06-01

With increasing attention to the actual cost of delivering care, return-on-investment calculations take on new significance. Boarded patients in the emergency department (ED) are harmful to clinical care and have significant financial opportunity costs. We hypothesize that investment in an admissions holding unit for admitted ED patients not only captures opportunity cost but also significantly lowers direct cost of care. This was a three-phase study at a busy urban teaching center with significant walkout rate. We first determined the true cost of maintaining a staffed ED bed for one patient-hour and compared it to alternative settings. The opportunity cost for patients leaving without being seen was then conservatively estimated. Lastly, a convenience sample of admitted patients boarding in the ED was observed continuously from one hour after decision-to-admit until physical departure from the ED to capture a record of every interaction with a nurse or physician. Personnel costs per patient bed-hour were $58.20 for the ED, $24.80 for an inpatient floor, $19.20 for the inpatient observation unit, and $10.40 for an admissions holding area. An eight-bed holding unit operating at practical capacity would free 57.4 hours of bed space in the ED and allow treatment of 20 additional patients. This could yield increased revenues of $27,796 per day and capture opportunity cost of $6.09 million over 219 days, in return for extra staffing costs of $218,650. Analysis of resources used for boarded patients was determined by continuous observation of a convenience sample of ED-boarded patients, which found near-zero interactions with both nursing and physicians during the boarding interval. Resource expense per ED bed-hour is more than twice that in non-critical care inpatient units. Despite the high cost of available resources, boarded non-critical patients receive virtually no nursing or physician attention. An admissions holding unit is remarkably effective in avoiding the

A New Era in Admissions. Focus 7, 1980.

ERIC Educational Resources Information Center

Westoff, Leslie Aldridge

1980-01-01

In this issue on admissions in colleges and universities, the history of the admissions process and trends are outlined, and the current situation of declining enrollments reviewed. The place of testing is discussed briefly, and other factors in selection listed: student background (educational, extracurricular, and ethnic), and student…

Fixed and Growth Mindsets in Physics Graduate Admissions

ERIC Educational Resources Information Center

Scherr, Rachel E.; Plisch, Monica; Gray, Kara E.; Potvin, Geoff; Hodapp, Theodore

2017-01-01

Considering the evidence that standard physics graduate admissions practices tend to exclude women and traditionally marginalized racial and ethnic groups from the discipline, we investigate (a) the characteristics of students that physics graduate admissions committee members seek to admit to their programs and (b) the practices associated with…

Admission rates and costs associated with emergency presentation of urolithiasis: analysis of the Nationwide Emergency Department Sample 2006-2009.

PubMed

Eaton, Samuel H; Cashy, John; Pearl, Jeffrey A; Stein, Daniel M; Perry, Kent; Nadler, Robert B

2013-12-01

We sought to examine a large nationwide (United States) sample of emergency department (ED) visits to determine data related to utilization and costs of care for urolithiasis in this setting. Nationwide Emergency Department Sample was analyzed from 2006 to 2009. All patients presenting to the ED with a diagnosis of upper tract urolithiasis were analyzed. Admission rates and total cost were compared by region, hospital type, and payer type. Numbers are weighted estimates that are designed to approximate the total national rate. An average of 1.2 million patients per year were identified with the diagnosis of urolithiasis out of 120 million visits to the ED annually. Overall average rate of admission was 19.21%. Admission rates were highest in the Northeast (24.88%), among teaching hospitals (22.27%), and among Medicare patients (42.04%). The lowest admission rates were noted for self-pay patients (9.76%) and nonmetropolitan hospitals (13.49%). The smallest increases in costs over time were noted in the Northeast. Total costs were least in nonmetropolitan hospitals; however, more patients were transferred to other hospitals. When assessing hospital ownership status, private for-profit hospitals had similar admission rates compared with private not-for-profit hospitals (16.6% vs 15.9%); however, costs were 64% and 48% higher for ED and inpatient admission costs, respectively. Presentation of urolithiasis to the ED is common, and is associated with significant costs to the medical system, which are increasing over time. Costs and rates of admission differ by region, payer type, and hospital type, which may allow us to identify the causes for cost discrepancies and areas to improve efficiency of care delivery.

Predictive validity of the Biomedical Admissions Test: an evaluation and case study.

PubMed

McManus, I C; Ferguson, Eamonn; Wakeford, Richard; Powis, David; James, David

2011-01-01

There has been an increase in the use of pre-admission selection tests for medicine. Such tests need to show good psychometric properties. Here, we use a paper by Emery and Bell [2009. The predictive validity of the Biomedical Admissions Test for pre-clinical examination performance. Med Educ 43:557-564] as a case study to evaluate and comment on the reporting of psychometric data in the field of medical student selection (and the comments apply to many papers in the field). We highlight pitfalls when reliability data are not presented, how simple zero-order associations can lead to inaccurate conclusions about the predictive validity of a test, and how biases need to be explored and reported. We show with BMAT that it is the knowledge part of the test which does all the predictive work. We show that without evidence of incremental validity it is difficult to assess the value of any selection tests for medicine.

Auxiliary basis sets for density-fitting second-order Møller-Plesset perturbation theory: weighted core-valence correlation consistent basis sets for the 4d elements Y-Pd.

PubMed

Hill, J Grant

2013-09-30

Auxiliary basis sets (ABS) specifically matched to the cc-pwCVnZ-PP and aug-cc-pwCVnZ-PP orbital basis sets (OBS) have been developed and optimized for the 4d elements Y-Pd at the second-order Møller-Plesset perturbation theory level. Calculation of the core-valence electron correlation energies for small to medium sized transition metal complexes demonstrates that the error due to the use of these new sets in density fitting is three to four orders of magnitude smaller than that due to the OBS incompleteness, and hence is considered negligible. Utilizing the ABSs in the resolution-of-the-identity component of explicitly correlated calculations is also investigated, where it is shown that i-type functions are important to produce well-controlled errors in both integrals and correlation energy. Benchmarking at the explicitly correlated coupled cluster with single, double, and perturbative triple excitations level indicates impressive convergence with respect to basis set size for the spectroscopic constants of 4d monofluorides; explicitly correlated double-ζ calculations produce results close to conventional quadruple-ζ, and triple-ζ is within chemical accuracy of the complete basis set limit. Copyright © 2013 Wiley Periodicals, Inc.

Predicting Nursing Home Admissions among Incontinent Older Adults: A Comparison of Residential Differences across Six Years.

ERIC Educational Resources Information Center

Coward, Raymond T.

1995-01-01

Uses data from the Longitudinal Studies on Aging (1984-90) to examine a sample who at baseline lived in community settings and reported problems with urinary incontinence (n=719). Analyses indicate that residents of less urbanized and more thinly populated nonmetropolitan counties were more likely to have a nursing home admission than others. (JPS)

Somnambulism: Emergency Department Admissions Due to Sleepwalking-Related Trauma

PubMed Central

Sauter, Thomas C.; Veerakatty, Sajitha; Haider, Dominik G.; Geiser, Thomas; Ricklin, Meret E.; Exadaktylos, Aristomenis K.

2016-01-01

Introduction Somnambulism is a state of dissociated consciousness, in which the affected person is partially asleep and partially awake. There is pervasive public opinion that sleepwalkers are protected from hurting themselves. There have been few scientific reports of trauma associated with somnambulism and no published investigations on the epidemiology or trauma patterns associated with somnambulism. Methods We included all emergency department (ED) admissions to University Hospital Inselspital, Berne, Switzerland, from January 1, 2000, until August 11, 2015, when the patient had suffered a trauma associated with somnambulism. Demographic data (age, gender, nationality) and medical data (mechanism of injury, final diagnosis, hospital admission, mortality and medication on admission) were included. Results Of 620,000 screened ED admissions, 11 were associated with trauma and sleepwalking. Two patients (18.2%) had a history of known non-rapid eye movement parasomnias. The leading cause of admission was falls. Four patients required hospital admission for orthopedic injuries needing further diagnostic testing and treatment (36.4%). These included two patients with multiple injuries (18.2%). None of the admitted patients died. Conclusion Although sleepwalking seems benign in the majority of cases and most of the few injured patients did not require hospitalization, major injuries are possible. When patients present with falls of unknown origin, the possibility should be evaluated that they were caused by somnambulism. PMID:27833677

Confidential inquiry into quality of care before admission to intensive care

PubMed Central

McQuillan, Peter; Pilkington, Sally; Allan, Alison; Taylor, Bruce; Short, Alasdair; Morgan, Giles; Nielsen, Mick; Barrett, David; Smith, Gary

1998-01-01

Objective: To examine the prevalence, nature, causes, and consequences of suboptimal care before admission to intensive care units, and to suggest possible solutions. Design: Prospective confidential inquiry on the basis of structured interviews and questionnaires. Setting: A large district general hospital and a teaching hospital. Subjects: A cohort of 100 consecutive adult emergency admissions, 50 in each centre. Main outcome measures: Opinions of two external assessors on quality of care especially recognition, investigation, monitoring, and management of abnormalities of airway, breathing, and circulation, and oxygen therapy and monitoring. Results: Assessors agreed that 20 patients were well managed (group 1) and 54 patients received suboptimal care (group 2). Assessors disagreed on quality of management of 26 patients (group 3). The casemix and severity of illness, defined by the acute physiology and chronic health evaluation (APACHE II) score, were similar between centres and the three groups. In groups 1, 2, and 3 intensive care mortalities were 5 (25%), 26 (48%), and 6 (23%) respectively (P=0.04) (group 1 versus group 2, P=0.07). Hospital mortalities were 7 (35%), 30 (56%), and 8 (31%) (P=0.07) and standardised hospital mortality ratios (95% confidence intervals) were 1.23 (0.49 to 2.54), 1.4 (0.94 to 2.0), and 1.26 (0.54 to 2.48) respectively. Admission to intensive care was considered late in 37 (69%) patients in group 2. Overall, a minimum of 4.5% and a maximum of 41% of admissions were considered potentially avoidable. Suboptimal care contributed to morbidity or mortality in most instances. The main causes of suboptimal care were failure of organisation, lack of knowledge, failure to appreciate clinical urgency, lack of supervision, and failure to seek advice. Conclusions: The management of airway, breathing, and circulation, and oxygen therapy and monitoring in severely ill patients before admission to intensive care units may frequently be suboptimal

Spinal cord injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional independence

PubMed Central

Mahmoud, Husam; Qannam, Hazem; Mortenson, Ben

2017-01-01

Objectives 1) To describe functional status, length of stay (LOS), and time to rehabilitation admission trends. 2) To identify independent predictors of motor function following rehabilitation for traumatic and nontraumatic spinal cord injury (SCI). Participants Adult patients with SCI discharged from inpatient rehabilitation between 2009–2014. Design Retrospective cohort study. Setting Spinal injury rehabilitation unit at the King Fahad Medical City, Riyadh, Saudi Arabia. Methods From retrospective chart reviews of 312 traumatic and 106 nontraumatic SCI, we extracted information on time from injury to rehabilitation admission, rehabilitation LOS, and Functional Independence Measure (FIM) score (admission and discharge). Additionally we collected information on SCI patients’ demographics and injury characteristics. Hierarchical regression was employed to investigate variables associated with FIM motor score at discharge for traumatic SCI and nontraumatic SCI. Outcome measures FIM motor score measured at discharge. Results Mean and median days from injury to rehabilitation admission were not significantly different for traumatic SCI (377±855, 150) and nontraumatic SCI (288±403, 176). Mean and median days for rehabilitation LOS were significantly longer for traumatic SCI (85±60, 70) compared to nontraumatic SCI (64±59, 49) (p=…..). FIM scores improved significantly from admission to discharge in both groups. For individuals with traumatic SCI, after accounting for admission FIM motor score, tetraplegia and time from injury to rehabilitation, admission had a significant but small negative association with discharge FIM motor score. For individuals with nontraumatic SCI, increasing age and AIS score of A or B had a significant negative association with discharge FIM motor score. LOS in rehabilitation was not a significant contributor for either model. Conclusions Decreasing the time from injury to rehabilitation admission may improve outcomes for those with

Hospital admissions for non-cystic fibrosis bronchiectasis in New Zealand.

PubMed

Bibby, Susan; Milne, Richard; Beasley, Richard

2015-09-04

To investigate hospital admissions for non-cystic fibrosis bronchiectasis during July 1, 2008 to June 30, 2013; and to describe their distribution and annual cost in New Zealand. Admissions with a principal diagnosis of bronchiectasis (ICD10 J47), excluding cystic fibrosis, and length of stay <90 days were analysed by age, sex, ethnicity, socioeconomic deprivation, DHB, re-admissions and seasonality. There were 5,494 admissions with a mean annual rate of 25.7 (age adjusted rate 20.4) per 100,000. Admission rates peaked in childhood and in the elderly, and increased steeply with socioeconomic deprivation. Age-adjusted rates were 38% higher for women, 4.9-fold higher for Māori and 9.1-fold higher for Pacific peoples. Counties Manukau had the highest unadjusted rate for any DHB (49.4 per 100,000). The overall 30 day readmission rate was 12.4%. Admissions peaked in winter and spring. The estimated cost in financial year 2012/13 was NZD 5.34M. Hospital admissions for bronchiectasis are concentrated in socioeconomically disadvantaged young and elderly Māori and Pacific peoples; are more common in winter and spring, and incur a high annual cost. Evidence-based interventions to reduce the disproportionate burden of bronchiectasis in Māori and Pacific children and the elderly is a public health priority.

Risk factors for readmission in schizophrenia patients following involuntary admission.

PubMed

Hung, Yu-Yuan; Chan, Hung-Yu; Pan, Yi-Ju

2017-01-01

Individuals with schizophrenia who are involuntarily admitted may have poorer prognosis, including higher readmission rates, than those voluntarily admitted. However, little is known about the risk factors for readmission in those schizophrenia patients who are involuntarily admitted. We aim to explore the risk factors for readmission in this population. We enrolled 138 schizophrenia patients with involuntary admission from July 2008 to June 2013 and followed those patients for readmission outcomes at 3 months and at 1 year. The one-year and 3-months readmission rates were 33.3% and 15.2%, respectively. Unmarried status (adjusted odds ratio (aOR) = 6.28, 95% CI: 1.48-26.62), previous history of involuntary admission (aOR = 4.08, 95% CI: 1.19-14.02), longer involuntary admission days (aOR = 1.04, 95% CI: 1.01-1.07) and shorter total admission days (aOR = 1.03, 95% CI: 1.01-1.05) were associated with increased risk for 1-year readmission. Younger age (aOR = 1.10, 95% CI 1.02-1.18) was associated with increased risk for 3-months readmission. Unmarried status, prior history of involuntary admission, longer involuntary admission days and shorter total admission days were associated with increased risk for 1-year readmission. Healthcare providers may need to focus on patients with these risk factors to reduce subsequent readmissions.

Evaluation of the Special Tertiary Admissions Test (STAT)

ERIC Educational Resources Information Center

Coates, Hamish; Friedman, Tim

2010-01-01

This paper reports findings from the first national Australian study of the predictive validity of the Special Tertiary Admissions Test (STAT). Background on tertiary admissions procedures in Australia is presented, followed by information on STAT and the research methods. The results affirm that STAT, through the provision of baseline and…

42 CFR 32.86 - Admissions to Service facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Admissions to Service facilities. 32.86 Section 32.86 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND... Hansen's Disease § 32.86 Admissions to Service facilities. Any person with Hansen's disease who presents...

14 CFR 121.547 - Admission to flight deck.

Code of Federal Regulations, 2013 CFR

2013-01-01

... is directly related to the conduct or planning of flight operations or the in-flight monitoring of... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Admission to flight deck. 121.547 Section... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.547 Admission to flight deck...

14 CFR 121.547 - Admission to flight deck.

Code of Federal Regulations, 2012 CFR

2012-01-01

... is directly related to the conduct or planning of flight operations or the in-flight monitoring of... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Admission to flight deck. 121.547 Section... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.547 Admission to flight deck...

14 CFR 121.547 - Admission to flight deck.

Code of Federal Regulations, 2011 CFR

2011-01-01

... is directly related to the conduct or planning of flight operations or the in-flight monitoring of... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Admission to flight deck. 121.547 Section... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.547 Admission to flight deck...

14 CFR 121.547 - Admission to flight deck.

Code of Federal Regulations, 2014 CFR

2014-01-01

... is directly related to the conduct or planning of flight operations or the in-flight monitoring of... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Admission to flight deck. 121.547 Section... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.547 Admission to flight deck...

14 CFR 121.547 - Admission to flight deck.

Code of Federal Regulations, 2010 CFR

2010-01-01

... is directly related to the conduct or planning of flight operations or the in-flight monitoring of... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Admission to flight deck. 121.547 Section... REQUIREMENTS: DOMESTIC, FLAG, AND SUPPLEMENTAL OPERATIONS Flight Operations § 121.547 Admission to flight deck...

Student Incentives and Preferential Treatment in College Admissions

ERIC Educational Resources Information Center

Pastine, Ivan; Pastine, Tuvana

2012-01-01

We consider a framework in which the optimal admissions policy of a purely academic-quality oriented college implements preferential treatment in favor of the student from the deprived socioeconomic background which maximizes the competition between candidates. We find that the exact form of the preferential treatment admissions policy matters for…

Using Social Media "Smartly" in the Admissions Process

ERIC Educational Resources Information Center

Parrot, Teresa Valerio; Tipton, Stacia

2010-01-01

Admissions officers around the country are hearing consistent calls to enhance their social media presence. Whether the pressure is from administrators, influential alumni, or peers across institutions, social media are touted as the next big thing in admissions marketing. But are social media strategies truly "strategic," or are they merely…

N-Acetylcysteine (NAC)-Induced Hyponatremia Caused by an Electronic Medical Record (EMR) Order Error.

PubMed

Furmaga, Jakub; Wax, Paul; Kleinschmidt, Kurt

2015-09-01

Intravenous N-acetylcysteine (NAC) causes few adverse drug events, with mild anaphylactoid reactions being the most common. Hyponatremia as a complication of hypoosmolar NAC solution has been reported. We describe how a locally constructed electronic medical record (EMR) order set for IV NAC resulted in a seizure from hyponatremia due to excess free water administration. A 13-month-old female with no past medical history presented to a hospital after ingesting an unknown number of acetaminophen 500 mg tablets. The 4-h acetaminophen concentration was 343 mcg/mL, and she was started on IV NAC. 8.2 h into her 21-h IV NAC protocol, she developed a tonic-clonic seizure. Repeat serum sodium was 124 mEq/L, a decrease from 142 mEq/L at the time of admission. She was treated with hypertonic saline, lorazepam, and levetiracetam and had no further seizures. A brain MRI and EEG were both normal. After the seizure was stabilized, the providers noticed that the patient had receive a total of 900 mL of D5W (112.5 mL/kg) in the first 9 h of hospitalization. This was caused by a poorly constructed, restrictive, EMR order set that did not allow customization of the IV NAC preparation. Because the 21-h IV NAC administration involves preparation of 3 different doses infused over 3 different time intervals, an order set was developed to reduce ordering errors. However, error in its construction caused the pharmacist to prepare a solution containing too much free water, decreasing patient's intravascular sodium and resulting in a seizure. The purposes of our case report were to highlight the dangers of overreliance on EMR order sets and to recognize hyponatremic seizures as an adverse reaction of an inappropriately prepared IV NAC.

How many schools adopt interviews during the student admission process across the health professions in the United States of America?

PubMed Central

2016-01-01

Health profession schools use interviews during the admissions process to identify certain non-cognitive skills that are needed for success in diverse, inter-professional settings. This study aimed to assess the use of interviews during the student admissions process across health disciplines at schools in the United States of America in 2014. The type and frequency of non-cognitive skills assessed were also evaluated. Descriptive methods were used to analyze a sample of interview rubrics collected as part of a national survey on admissions in the health professions, which surveyed 228 schools of medicine, dentistry, pharmacy, nursing, and public health. Of the 228 schools, 130 used interviews. The most desirable non-cognitive skills from 34 schools were identified as follows: communication skills (30), motivation (22), readiness for the profession (17), service (12), and problem-solving (12). Ten schools reported using the multiple mini-interview format, which may indicate potential for expanding this practice. Disparities in the use of interviewing across health professions should be verified to help schools adopt interviews during student admissions processes. PMID:26924541

How many schools adopt interviews during the student admission process across the health professions in the United States of America?

PubMed

Glazer, Greer; Startsman, Laura F; Bankston, Karen; Michaels, Julia; Danek, Jennifer C; Fair, Malika

2016-01-01

Health profession schools use interviews during the admissions process to identify certain non-cognitive skills that are needed for success in diverse, inter-professional settings. This study aimed to assess the use of interviews during the student admissions process across health disciplines at schools in the United States of America in 2014. The type and frequency of non-cognitive skills assessed were also evaluated. Descriptive methods were used to analyze a sample of interview rubrics collected as part of a national survey on admissions in the health professions, which surveyed 228 schools of medicine, dentistry, pharmacy, nursing, and public health. Of the 228 schools, 130 used interviews. The most desirable non-cognitive skills from 34 schools were identified as follows: communication skills (30), motivation (22), readiness for the profession (17), service (12), and problem-solving (12). Ten schools reported using the multiple mini-interview format, which may indicate potential for expanding this practice. Disparities in the use of interviewing across health professions should be verified to help schools adopt interviews during student admissions processes.

Effect of pentavalent rotavirus vaccine introduction on hospital admissions for diarrhoea and rotavirus in children in Rwanda: a time-series analysis.

PubMed

Ngabo, Fidele; Tate, Jacqueline E; Gatera, Maurice; Rugambwa, Celse; Donnen, Philippe; Lepage, Philippe; Mwenda, Jason M; Binagwaho, Agnes; Parashar, Umesh D

2016-02-01

In May, 2012, Rwanda became the first low-income African country to introduce pentavalent rotavirus vaccine into its routine national immunisation programme. Although the potential health benefits of rotavirus vaccination are huge in low-income African countries that account for more than half the global deaths from rotavirus, concerns remain about the performance of oral rotavirus vaccines in these challenging settings. We conducted a time-series analysis to examine trends in admissions to hospital for non-bloody diarrhoea in children younger than 5 years in Rwanda between Jan 1, 2009, and Dec 31, 2014, using monthly discharge data from the Health Management Information System. Additionally, we reviewed the registries in the paediatric wards at six hospitals from 2009 to 2014 and abstracted the number of total admissions and admissions for diarrhoea in children younger than 5 years by admission month and age group. We studied trends in admissions specific to rotavirus at one hospital that had undertaken active rotavirus surveillance from 2011 to 2014. We assessed changes in rotavirus epidemiology by use of data from eight active surveillance hospitals. Compared with the 2009-11 prevaccine baseline, hospital admissions for non-bloody diarrhoea captured by the Health Management Information System fell by 17-29% from a pre-vaccine median of 4051 to 2881 in 2013 and 3371 in 2014, admissions for acute gastroenteritis captured in paediatric ward registries decreased by 48-49%, and admissions specific to rotavirus captured by active surveillance fell by 61-70%. The greatest effect was recorded in children age-eligible to be vaccinated, but we noted a decrease in the proportion of children with diarrhoea testing positive for rotavirus in almost every age group. The number of admissions to hospital for diarrhoea and rotavirus in Rwanda fell substantially after rotavirus vaccine implementation, including among older children age-ineligible for vaccination, suggesting

42 CFR 418.25 - Admission to hospice care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Admission to hospice care. 418.25 Section 418.25... (CONTINUED) MEDICARE PROGRAM HOSPICE CARE Eligibility, Election and Duration of Benefits § 418.25 Admission to hospice care. (a) The hospice admits a patient only on the recommendation of the medical director...

Millennials Invading: Building Training for Today's Admissions Counselors

ERIC Educational Resources Information Center

Barnds, W. Kent

2009-01-01

As chief admissions officer at two small colleges, the author has been responsible, in part, for ensuring that entry-level admissions counselors are trained properly. He learned through trial and error, and has adapted his methods to be increasingly sensitive to the learning curve of new employees. His thoughts about training new admissions…

Evaluating Admission Criteria Effects for Under-Represented Groups

ERIC Educational Resources Information Center

Childs, Ruth A.; Ferguson, Amanda K.; Herbert, Monique B.; Broad, Kathryn; Zhang, Jingshun

2016-01-01

The effects that admission criteria may have for under-represented groups are an important concern for programs seeking to improve access to post-secondary education. Using data from a large preservice teacher education program in the Canadian province of Ontario, we demonstrate two approaches to evaluating the effects of admission criteria. The…

Communications Is from Mars, Admissions Is from Venus

ERIC Educational Resources Information Center

Scully, Maura King

2010-01-01

Marketing communications and admissions often have very different needs, priorities, and ways of conducting business, but the two units work toward the same end goal. Brad Ward of BlueFuego, a marketing company that specializes in social Web tools for educational institutions, explains that admissions doesn't necessarily need to [talk] to…

University Exceptional Admission during the Republic of China

ERIC Educational Resources Information Center

Tao, Li

2014-01-01

The stories of many universities' exceptive admission during the republic period of China were widely circulated. The typical example of these universities' exceptional admission was the very product of special historical condition, which had its own characteristics, but also conforms to the general rule, so it can be cited. To select special…

Size and clustering of ethnic groups and rates of psychiatric admission in England.

PubMed

Venkatesan, Gayathri; Weich, Scott; McBride, Orla; Twigg, Liz; Parsons, Helen; Scott, Jan; Bhui, Kamaldeep; Keown, Patrick

2018-05-11

Aims and methodTo compare rates of admission for different types of severe mental illness between ethnic groups, and to test the hypothesis that larger and more clustered ethnic groups will have lower admission rates. This was a descriptive study of routinely collected data from the National Health Service in England. There was an eightfold difference in admission rates between ethnic groups for schizophreniform and mania admissions, and a fivefold variation in depression admissions. On average, Black and minority ethnic (BME) groups had higher rates of admission for schizophreniform and mania admissions but not for depression. This increased rate was greatest in the teenage years and early adulthood. Larger ethnic group size was associated with lower admission rates. However, greater clustering was associated with higher admission rates.Clinical implicationsOur findings support the hypothesis that larger ethnic groups have lower rates of admission. This was a between-group comparison rather than within each group. Our findings do not support the hypothesis that more clustered groups have lower rates of admission. In fact, they suggest the opposite: groups with low clustering had lower admission rates. The BME population in the UK is increasing in size and becoming less clustered. Our results suggest that both of these factors should ameliorate the overrepresentation of BME groups among psychiatric in-patients. However, this overrepresentation continues, and our results suggest a possible explanation, namely, changes in the delivery of mental health services, particularly the marked reduction in admissions for depression.Declaration of interestNone.

Hospital admissions due to norovirus in adult and elderly patients in England.

PubMed

Haustein, Thomas; Harris, John P; Pebody, Richard; Lopman, Ben A

2009-12-15

Norovirus generally causes a mild illness in the community. However, modeling routine hospital admission statistics, we estimate that approximately 3000 norovirus admissions to English hospitals occur per year, accounting for 0.3% and 0.1% of emergency admissions among elderly and adult patients, respectively, at times of peak activity. These admissions pose a risk for subsequent nosocomial infection outbreaks.

Comparing Indications for Cardiovascular Admissions into a Nigerian and an Israeli Hospital

PubMed Central

Ukpabi, Ogba Joseph; Uwanurochi, Kelechukwu

2017-01-01

Background: Changing epidemiologic profile with increase in cardiovascular risk factors is well documented in literature. Our study sought to see how this is reflected in cardiovascular admissions into medical wards of a Nigerian and an Israeli hospital. Objective: To compare the range and pattern of cardiovascular admissions encountered in a Nigerian hospital and an Israel hospital. Methods: This was a retrospective study of admission records of patients admitted into both Federal Medical Centre (FMC), Umuahia, Abia State, Nigeria, and Sheba Medical Centre, Israel. Results: Ischemic heart disease (IHD) was the most prevalent among the Israeli hospital's admissions but ranks very low as an indication for admission in Nigeria. The most common causes of admission in Nigeria were hypertension and heart failure (HF). The spectrum of cardiovascular diseases (CVDs) was very limited in the Nigerian hospital, indicating disparity in diagnostic capacity. Conclusion: There were more patients with CVD as a cause of medical admission in the Israel hospital as compared to the Nigerian hospital. Hypertension and HF were prevalent indications for CVD in FMC, Umuahia, Nigeria, while hypertension and IHD were the prevalent indications for admission in Sheba Medical Centre, Israel. Future studies are needed to monitor spectrum and frequency of cardiovascular admissions in view of evolving epidemiological transition in developing countries. PMID:28469120

Exercise order affects the total training volume and the ratings of perceived exertion in response to a super-set resistance training session

PubMed Central

Balsamo, Sandor; Tibana, Ramires Alsamir; Nascimento, Dahan da Cunha; de Farias, Gleyverton Landim; Petruccelli, Zeno; de Santana, Frederico dos Santos; Martins, Otávio Vanni; de Aguiar, Fernando; Pereira, Guilherme Borges; de Souza, Jéssica Cardoso; Prestes, Jonato

2012-01-01

The super-set is a widely used resistance training method consisting of exercises for agonist and antagonist muscles with limited or no rest interval between them – for example, bench press followed by bent-over rows. In this sense, the aim of the present study was to compare the effects of different super-set exercise sequences on the total training volume. A secondary aim was to evaluate the ratings of perceived exertion and fatigue index in response to different exercise order. On separate testing days, twelve resistance-trained men, aged 23.0 ± 4.3 years, height 174.8 ± 6.75 cm, body mass 77.8 ± 13.27 kg, body fat 12.0% ± 4.7%, were submitted to a super-set method by using two different exercise orders: quadriceps (leg extension) + hamstrings (leg curl) (QH) or hamstrings (leg curl) + quadriceps (leg extension) (HQ). Sessions consisted of three sets with a ten-repetition maximum load with 90 seconds rest between sets. Results revealed that the total training volume was higher for the HQ exercise order (P = 0.02) with lower perceived exertion than the inverse order (P = 0.04). These results suggest that HQ exercise order involving lower limbs may benefit practitioners interested in reaching a higher total training volume with lower ratings of perceived exertion compared with the leg extension plus leg curl order. PMID:22371654

Soft learning vector quantization and clustering algorithms based on ordered weighted aggregation operators.

PubMed

Karayiannis, N B

2000-01-01

This paper presents the development and investigates the properties of ordered weighted learning vector quantization (LVQ) and clustering algorithms. These algorithms are developed by using gradient descent to minimize reformulation functions based on aggregation operators. An axiomatic approach provides conditions for selecting aggregation operators that lead to admissible reformulation functions. Minimization of admissible reformulation functions based on ordered weighted aggregation operators produces a family of soft LVQ and clustering algorithms, which includes fuzzy LVQ and clustering algorithms as special cases. The proposed LVQ and clustering algorithms are used to perform segmentation of magnetic resonance (MR) images of the brain. The diagnostic value of the segmented MR images provides the basis for evaluating a variety of ordered weighted LVQ and clustering algorithms.

3 CFR - Refugee Admissions for Fiscal Year 2014

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Refugee Admissions for Fiscal Year 2014 Presidential Documents Other Presidential Documents Presidential Determination No. 2014-1 of October 2, 2013 Refugee Admissions for Fiscal Year 2014 Memorandum for the Secretary of State In accordance with section 207 of the Immigration and Nationality Act (the...

Environmental Scan of BC Post-Secondary Admissions: 2009

ERIC Educational Resources Information Center

Heath, Nick

2009-01-01

In 2008, British Columbia Council on Admissions and Transfer (BCCAT) commissioned an environmental scan on the possible need for system-wide work on institutional admissions processes and practices. This scan is intended to seek system input and to provide guidance on the choice of research projects and other related work in the coming year. This…

Admission blood glucose predicted haemorrhagic shock in multiple trauma patients.

PubMed

Kreutziger, Janett; Rafetseder, Andreas; Mathis, Simon; Wenzel, Volker; El Attal, René; Schmid, Stefan

2015-01-01

Admission blood glucose is known to be a predictor for outcome in several disease patterns, especially in critically ill trauma patients. The underlying mechanisms for the association of hyperglycaemia and poor outcome are still not proven. It was hypothesised that hyperglycaemia upon hospital admission is associated with haemorrhagic shock and in-hospital mortality. Data was extracted from an observational trauma database of the level 1 trauma centre at Innsbruck Medical University hospital. Trauma patients (≥18 years) with multiple injuries and an Injury Severity Score ≥17 were included and analysed. In total, 279 patients were analysed, of which 42 patients (15.1%) died. With increasing blood glucose upon hospital admission, the rate of patients with haemorrhagic shock rose significantly [from 4.4% (glucose 4.1-5.5mmol/L) to 87.5% (glucose >15mmol/L), p<0.0001]. Mortality was also associated with initial blood glucose [≤5.50mmol/L 8.3%; 5.51-7.50mmol/L 10.9%, 7.51-10mmol/L 12.4%; 10.01-15mmol/L 32.0%; ≥15.01mmol/L 12.5%, p=0.008]. Admission blood glucose was a better indicator for haemorrhagic shock (cut-off 9.4mmol/L, sensitivity 67.1%, specificity 83.9%) than haemoglobin, base excess, bicarbonate, pH, lactate, or vital parameters. Regarding haemorrhagic shock, admission blood glucose is more valuable during initial patient assessment than the second best predictive parameter, which was admission haemoglobin (cut-off value 6.5mmol/L (10.4g/dL): sensitivity 61.3%, specificity 83.9%). In multiple trauma, non-diabetic patients, admission blood glucose predicted the incidence of haemorrhagic shock. Admission blood glucose is an inexpensive, rapidly and easily available laboratory value that might help to identify patients at risk for haemorrhagic shock during initial evaluation upon hospital admission. Copyright © 2014 Elsevier Ltd. All rights reserved.

Solar radiation is inversely associated with inflammatory bowel disease admissions.

PubMed

Jaime, Francisca; Riutort, Maria C; Alvarez-Lobos, Manuel; Hoyos-Bachiloglu, Rodrigo; Camargo, Carlos A; Borzutzky, Arturo

To explore the associations between latitude and solar radiation with inflammatory bowel disease admission rates in Chile, the country with the largest variation in solar radiation in the world. This is an ecological study, which included data on all hospital-admitted population for inflammatory bowel disease between 2001 and 2012, according to different latitudes and solar radiation exposures in Chile. The data were acquired from the national hospital discharge database from the Department of Health Statistics and Information of the Chilean Ministry of Health. Between 2001 and 2012 there were 12,869 admissions due to inflammatory bowel disease (69% ulcerative colitis, 31% Crohn's disease). Median age was 36 years (IQR: 25-51); 57% were female. The national inflammatory bowel disease admission rate was 6.52 (95% CI: 6.40-6.63) per 100,000 inhabitants with increasing rates over the 12-year period. In terms of latitude, the highest admission rates for pediatric ulcerative colitis and Crohn's disease, as well as adult ulcerative colitis, were observed in the southernmost region with lowest annual solar radiation. Linear regression analysis showed that regional solar radiation was inversely associated with inflammatory bowel disease admissions in Chile (β: -.44, p = .03). Regional solar radiation was inversely associated with inflammatory bowel disease admission rates in Chile; inflammatory bowel disease admissions were highest in the southernmost region with lowest solar radiation. Our results support the potential role of vitamin D deficiency on inflammatory bowel disease flares.

Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring.

PubMed

Lay, Barbara; Salize, Hans Joachim; Dressing, Harald; Rüsch, Nicolas; Schönenberger, Thekla; Bühlmann, Monika; Bleiker, Marco; Lengler, Silke; Korinth, Lena; Rössler, Wulf

2012-09-05

The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients' perceived coercion and to increase patient satisfaction, their quality of life and empowerment. This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care procedures (control group

Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring

PubMed Central

2012-01-01

Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care

Trends in hospital admissions for hypoglycaemia in England: a retrospective, observational study.

PubMed

Zaccardi, Francesco; Davies, Melanie J; Dhalwani, Nafeesa N; Webb, David R; Housley, Gemma; Shaw, Dominic; Hatton, James W; Khunti, Kamlesh

2016-08-01

Studies in the USA and Canada have reported increasing or stable rates of hospital admissions for hypoglycaemia. Some data from small studies are available for other countries. We aimed to gather information about long-term trends in hospital admission for hypoglycaemia and subsequent outcomes in England to help widen understanding for the global burden of hospitalisation for hypoglycaemia. We collected data for all hospital admissions listing hypoglycaemia as primary reason of admission between Jan 1, 2005, and Dec 31, 2014, using the Hospital Episode Statistics database, which contains details of all admissions to English National Health Service (NHS) hospital trusts. We calculated trends in crude and adjusted (for age, sex, ethnic group, social deprivation, and Charlson comorbidity score) admissions for hypoglycaemia; in admissions for hypoglycaemia per total hospital admissions and per diabetes prevalence in England; and in length of stay, in-hospital mortality, and 1 month readmissions for hypoglycaemia. 79 172 people had 101 475 admissions for hypoglycaemia between 2005 and 2014, of which 72 568 (72%) occurred in people aged 60 years or older. 13 924 (18%) people had more than one admission for hypoglycaemia during the study period. The number of admissions increased steadily from 7868 in 2005, to 11 756 in 2010 (49% increase) and then remained more stable until 2014 (10 977; 39% increase from baseline, range across English regions 11-89%); the trend was similar after adjustment for risk factors, with a rate ratio of 1·53 (95% CI 1·29-1·81) for 2014 versus 2005. Admissions for hypoglycaemia per 100 000 total hospital admissions increased from 63·6 to 78·9 between 2005-06 and 2010-11 (24% increase), and then fell to 72·3 per 100 000 in 2013-14 (14% overall increase). Accounting for diabetes prevalence data, rates declined from 4·64 to 3·86 admissions per 1000 person-years with diabetes between 2010-11 and 2013-14. We were unable to

14 CFR 125.315 - Admission to flight deck.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Admission to flight deck. 125.315 Section...,000 POUNDS OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Flight Operations § 125.315 Admission to flight deck. (a) No person may admit any person to the flight deck of an airplane unless the...

14 CFR 125.315 - Admission to flight deck.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Admission to flight deck. 125.315 Section...,000 POUNDS OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Flight Operations § 125.315 Admission to flight deck. (a) No person may admit any person to the flight deck of an airplane unless the...

14 CFR 125.315 - Admission to flight deck.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Admission to flight deck. 125.315 Section...,000 POUNDS OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT Flight Operations § 125.315 Admission to flight deck. (a) No person may admit any person to the flight deck of an airplane unless the...

A new medical image segmentation model based on fractional order differentiation and level set

NASA Astrophysics Data System (ADS)

Chen, Bo; Huang, Shan; Xie, Feifei; Li, Lihong; Chen, Wensheng; Liang, Zhengrong

2018-03-01

Segmenting medical images is still a challenging task for both traditional local and global methods because the image intensity inhomogeneous. In this paper, two contributions are made: (i) on the one hand, a new hybrid model is proposed for medical image segmentation, which is built based on fractional order differentiation, level set description and curve evolution; and (ii) on the other hand, three popular definitions of Fourier-domain, Grünwald-Letnikov (G-L) and Riemann-Liouville (R-L) fractional order differentiation are investigated and compared through experimental results. Because of the merits of enhancing high frequency features of images and preserving low frequency features of images in a nonlinear manner by the fractional order differentiation definitions, one fractional order differentiation definition is used in our hybrid model to perform segmentation of inhomogeneous images. The proposed hybrid model also integrates fractional order differentiation, fractional order gradient magnitude and difference image information. The widely-used dice similarity coefficient metric is employed to evaluate quantitatively the segmentation results. Firstly, experimental results demonstrated that a slight difference exists among the three expressions of Fourier-domain, G-L, RL fractional order differentiation. This outcome supports our selection of one of the three definitions in our hybrid model. Secondly, further experiments were performed for comparison between our hybrid segmentation model and other existing segmentation models. A noticeable gain was seen by our hybrid model in segmenting intensity inhomogeneous images.

Effective admissions practices to achieve greater student diversity in dental schools.

PubMed

Price, Shelia S; Grant-Mills, Donna

2010-10-01

In this chapter we describe the institutional and policy-level strategies that dental schools in the Pipeline, Profession, and Practice: Community-Based Dental Education program used to modify their admissions practices to increase the diversity of their student bodies. Schools developed and used clear statements recognizing the value of diversity. They incorporated recent U.S. Supreme Court rulings regarding educational diversity into their revised admissions practices; these rulings cited diversity as both a "compelling interest" and its use in only "narrowly tailored" circumstances. We make a case for admissions decisions based on a comprehensive evaluation that balances the quantitative and qualitative qualities of a candidate. It refutes the practice of overreliance on standardized tests by detailing the whole-file review process to measure merit and professional promise. Also described is a range of noncognitive variables (e.g., leadership, ability to sustain academic achievement with competing priorities, volunteerism, communication, social background, and disadvantaged status) that schools can take into consideration in admissions decisions. Admissions committees can tie this comprehensive review of candidates into the case for promoting cross-cultural understanding and enhanced competence to provide care to patients from diverse backgrounds. In addition, the chapter reviews the challenges schools face in developing admissions policies and procedures that reflect the university's mission for diversity. It addresses the importance of a diverse composition of the admissions committee. It also describes how tailored workshops and technical assistance for admissions committees can help schools improve their student diversity and how admissions committees can engage in a process of periodic review of their diversity objectives in relationship to the school's mission.

Trends in hospital admissions involving suicidal behaviour in the Northern Territory, 2001-2013.

PubMed

Leckning, Bernard A; Li, Shu Qin; Cunningham, Teresa; Guthridge, Steven; Robinson, Gary; Nagel, Tricia; Silburn, Sven

2016-06-01

To investigate trends in hospital admissions involving suicidal behaviour in the Northern Territory (NT) resident population over the period 2001-2013. Estimates of age-standardised rates and average changes in the annual rate of hospital admissions involving suicidal behaviour were calculated by socio-demographic characteristics and types of suicidal behaviour. Overall rates for Indigenous admissions were 2.7 times higher than non-Indigenous admissions and had increased by almost twice as much. While male and female rates of admission were similar for both Indigenous and non-Indigenous residents, the average annual change in rates was greater for Indigenous females (13.4%) compared to males (8.8%) and for non-Indigenous males (7.7%) compared to females (5.2%). Younger and middle-aged Indigenous admissions experienced increasing rates of admissions, whilst trends were similar across age groups for non-Indigenous admissions. Admissions with a diagnosis of suicidal ideation increased the most across all groups. Trends in intentional self-harm admissions differed according to Indigenous status and sex. There have been substantial increases in hospital admissions involving suicidal behaviour in the NT, most markedly for Indigenous residents. Indigenous females and youth appear to be at increasing risk. The steep increase in suicidal ideation across all groups warrants further investigation. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Cause-Specific Hospital Admissions on Hot Days in Sydney, Australia

PubMed Central

Vaneckova, Pavla; Bambrick, Hilary

2013-01-01

Background While morbidity outcomes for major disease categories during extreme heat have received increasing research attention, there has been very limited investigation at the level of specific disease subcategories. Methodology/Principal Findings We analyzed daily hospital admissions for cardiovascular (CVD), respiratory (RD), genitourinary (GU) and mental diseases (MD), diabetes (DIA), dehydration (DEH) and ‘the effects of heat and light’ (HEAT) in Sydney between 1991 and 2009. We further investigated the sensitivity to heat of subcategories within the major disease groups. We defined hot days as those with temperatures in the 95th and 99th percentiles within the study period. We applied time-stratified case-crossover analysis to compare the hospital admissions on hot days with those on non-hot days matched by day of the week. We calculated the odds ratios (OR) of admissions between the two types of days, accounting for other environmental variables (relative humidity, ozone and particulate matter) and non-environmental trends (public and school holidays). On hot days, hospital admissions increased for all major categories except GU. This increase was not shared homogeneously across all diseases within a major category: within RD, only ‘other diseases of the respiratory system’ (includes pleurisy or empyema) increased significantly, while admissions for asthma decreased. Within MD, hospital admissions increased only for psychoses. Admissions due to some major categories increased one to three days after a hot day (e.g., DIA, RD and CVD) and on two and three consecutive days (e.g., HEAT and RD). Conclusions/Significance High ambient temperatures were associated with increased hospital admissions for several disease categories, with some within-category variation. Future analyses should focus on subgroups within broad disease categories to pinpoint medical conditions most affected by ambient heat. PMID:23408986

An algorithm for minimum-cost set-point ordering in a cryogenic wind tunnel

NASA Technical Reports Server (NTRS)

Tripp, J. S.

1981-01-01

An algorithm for minimum cost ordering of set points in a cryogenic wind tunnel is developed. The procedure generates a matrix of dynamic state transition costs, which is evaluated by means of a single-volume lumped model of the cryogenic wind tunnel and the use of some idealized minimum-costs, which is evaluated by means of a single-volume lumped model of the cryogenic wind tunnel and the use of some idealized minimum-cost state-transition control strategies. A branch and bound algorithm is employed to determine the least costly sequence of state transitions from the transition-cost matrix. Some numerical results based on data for the National Transonic Facility are presented which show a strong preference for state transitions that consume to coolant. Results also show that the choice of the terminal set point in an open odering can produce a wide variation in total cost.

At Admissions Conference, Talk of Standardized Tests, Early Decisions, and Swag

ERIC Educational Resources Information Center

Farrell, Elizabeth F.; Hoover, Eric

2007-01-01

At the annual conference of the National Association for College Admission Counseling (Nacac), admissions deans and high-school counselors gathered in September 2007 to grapple with questions such as: (1) Rethinking the role of standardized tests in admissions (many attendees predict that psychometric giants ACT and SAT, will not always dominate…

The Admissions Profession: A Guide for Staff Development and Program Management.

ERIC Educational Resources Information Center

American Association of Collegiate Registrars and Admissions Officers, Washington, DC.

This guide is designed to assist in college admissions staff development and program management, but is also suggested for use in training and accrediting efforts, presentations on admissions tasks, internal or external evaluations, preparation of periodic reports, and as a self-paced workbook when preparing for the admission profession, or for…

Exploring social media and admissions decision-making - friends or foes?

PubMed

Law, Marcus; Mylopoulos, Maria; Veinot, Paula; Miller, Daniel; Hanson, Mark D

2016-10-01

Despite the ever-increasing use of social media (e.g., Facebook, Twitter) little is known about its use in medical school admissions. This qualitative study explores whether and how social media (SM) is used in undergraduate admissions in Canada, and the attitudes of admissions personnel towards such use. Phone interviews were conducted with admissions deans and nominated admissions personnel. A qualitative descriptive analysis was performed using iterative coding and comparing, and grouping data into themes. Personnel from 15 of 17 Canadian medical schools participated. A sizeable proportion had, at some point, examined social media (SM) profiles to acquire information on applicants. Participants did not report using it explicitly to screen all applicants (primary use); however, several did admit to looking at SM to follow up on preliminary indications of misbehaviour (secondary use). Participants articulated concerns, such as validity and equity, about using SM in admissions. Despite no schools having existing policy, participants expressed openness to future use. While some of the 15 schools had used SM to acquire information on applicants, criteria for formulating judgments were obscure, and participants expressed significant apprehension, based on concerns for fairness and validity. Findings suggest participant ambivalence and ongoing risks associated with "hidden" selection practices.

Reasons for refusal of admission to intensive care and impact on mortality.

PubMed

Iapichino, Gaetano; Corbella, Davide; Minelli, Cosetta; Mills, Gary H; Artigas, Antonio; Edbooke, David L; Pezzi, Angelo; Kesecioglu, Jozef; Patroniti, Nicolò; Baras, Mario; Sprung, Charles L

2010-10-01

To identify factors influencing triage decisions and investigate whether admission to the intensive care unit (ICU) could reduce mortality compared with treatment on the ward. A multicentre cohort study in 11 university hospitals from seven countries, evaluating triage decisions and outcomes of patients referred for admission to ICU who were either accepted, or refused and treated on the ward. Confounding in the estimation of the effect of ICU admission on mortality was controlled by use of a propensity score approach, which adjusted for the probability of being admitted. Variability across centres was accounted for in both analyses of factors influencing ICU admission and effect of ICU admission on mortality. Eligible were 8,616 triages in 7,877 patients referred for ICU admission. Variables positively associated with probability of being admitted to ICU included: ventilators in ward; bed availability; Karnofsky score; absence of comorbidity; presence of haematological malignancy; emergency surgery and elective surgery (versus medical treatment); trauma, vascular involvement, liver involvement; acute physiologic score II; ICU treatment (versus ICU observation). Multiple triages during patient's hospital stay and age were negatively associated with ICU admission. The area under the receiver operating characteristic (ROC) curve of the model was 0.83 [95% confidence interval (CI): 0.81-0.84], with Hosmer-Lemeshow test P = 0.300. ICU admission was associated with a statistically significant reduction of both 28-day mortality [odds ratio (OR): 0.73; 95% CI: 0.62-0.87] and 90-day mortality (0.79; 0.66-0.93). The benefit of ICU admission increased substantially in patients with greater severity of illness. We suggest that intensivists take great care to avoid ICU admission of patients judged not severe enough for ICU or with low performance status, and they tend to admit surgical patients more readily than medical patients. Interestingly, they do not judge age per se as

Generalized contractive mappings and weakly α-admissible pairs in G-metric spaces.

PubMed

Hussain, N; Parvaneh, V; Hoseini Ghoncheh, S J

2014-01-01

The aim of this paper is to present some coincidence and common fixed point results for generalized (ψ, φ)-contractive mappings using partially weakly G-α-admissibility in the setup of G-metric space. As an application of our results, periodic points of weakly contractive mappings are obtained. We also derive certain new coincidence point and common fixed point theorems in partially ordered G-metric spaces. Moreover, some examples are provided here to illustrate the usability of the obtained results.

Generalized Contractive Mappings and Weakly α-Admissible Pairs in G-Metric Spaces

PubMed Central

Hussain, N.; Parvaneh, V.; Hoseini Ghoncheh, S. J.

2014-01-01

The aim of this paper is to present some coincidence and common fixed point results for generalized (ψ, φ)-contractive mappings using partially weakly G-α-admissibility in the setup of G-metric space. As an application of our results, periodic points of weakly contractive mappings are obtained. We also derive certain new coincidence point and common fixed point theorems in partially ordered G-metric spaces. Moreover, some examples are provided here to illustrate the usability of the obtained results. PMID:25202742

Exploring Ethnic Inequalities in Admission to Russell Group Universities

PubMed Central

Boliver, Vikki

2015-01-01

This article analyses national university applications and admissions data to explore why ethnic minority applicants to Russell Group universities are less likely to receive offers of admission than comparably qualified white applicants. Contrary to received opinion, the greater tendency of ethnic minorities to choose highly numerically competitive degree subjects only partially accounts for their lower offer rates from Russell Group universities relative to white applicants with the same grades and ‘facilitating subjects’ at A-level. Moreover, ethnic inequalities in the chances of receiving an admissions offer from a Russell Group university are found to be greater in relation to courses where ethnic minorities make up a larger percentage of applicants. This latter finding raises the possibility that some admissions selectors at some Russell Group universities may be unfairly rejecting a proportion of their ethnic minority applicants in an attempt to achieve a more ethnically representative student body. PMID:27904229

Influences on hospital admission for asthma in south Asian and white adults: qualitative interview study

PubMed Central

Griffiths, Chris; Kaur, Gurmit; Gantley, Madeleine; Feder, Gene; Hillier, Sheila; Goddard, Jill; Packe, Geoff

2001-01-01

Objective To explore reasons for increased risk of hospital admission among south Asian patients with asthma. Design Qualitative interview study using modified critical incident technique and framework analysis. Setting Newham, east London, a deprived area with a large mixed south Asian population. Participants 58 south Asian and white adults with asthma (49 admitted to hospital with asthma, 9 not admitted); 17 general practitioners; 5 accident and emergency doctors; 2 out of hours general practitioners; 1 asthma specialist nurse. Main outcome measures Patients' and health professionals' views on influences on admission, events leading to admission, general practices' organisation and asthma strategies, doctor-patient relationship, and cultural attitudes to asthma. Results South Asian and white patients admitted to hospital coped differently with asthma. South Asians described less confidence in controlling their asthma, were unfamiliar with the concept of preventive medication, and often expressed less confidence in their general practitioner. South Asians managed asthma exacerbations with family advocacy, without systematic changes in prophylaxis, and without systemic corticosteroids. Patients describing difficulty accessing primary care during asthma exacerbations were registered with practices with weak strategies for asthma care and were often south Asian. Patients with easy access described care suggesting partnerships with their general practitioner, had better confidence to control asthma, and were registered with practices with well developed asthma strategies that included policies for avoiding hospital admission. Conclusions The different ways of coping with asthma exacerbations and accessing care may partly explain the increased risk of hospital admission in south Asian patients. Interventions that increase confidence to control asthma, confidence in the general practitioner, understanding of preventive treatment, and use of systemic corticosteroids in

Gatekeepers or Marketers: Reclaiming the Educational Role of Chief Admission Officers

ERIC Educational Resources Information Center

McDonough, Patricia; Robertson, Larry

2012-01-01

The U.S. college admission environment has changed enormously over the last three decades. What have those changes meant for the profession of college admission officers? In this paper, the authors will describe the enormous changes that have taken place in high schools, colleges, and the entrepreneurial admission sector. They will describe how…

28 CFR 522.13 - Relationship between existing civil contempt commitment orders and new criminal sentences imposed...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Relationship between existing civil contempt commitment orders and new criminal sentences imposed under the U.S. or D.C. Code. 522.13 Section 522.13 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INMATE ADMISSION, CLASSIFICATION, AND TRANSFER ADMISSION TO INSTITUTION Civi...

OrderRex: clinical order decision support and outcome predictions by data-mining electronic medical records.

PubMed

Chen, Jonathan H; Podchiyska, Tanya; Altman, Russ B

2016-03-01

To answer a "grand challenge" in clinical decision support, the authors produced a recommender system that automatically data-mines inpatient decision support from electronic medical records (EMR), analogous to Netflix or Amazon.com's product recommender. EMR data were extracted from 1 year of hospitalizations (>18K patients with >5.4M structured items including clinical orders, lab results, and diagnosis codes). Association statistics were counted for the ∼1.5K most common items to drive an order recommender. The authors assessed the recommender's ability to predict hospital admission orders and outcomes based on initial encounter data from separate validation patients. Compared to a reference benchmark of using the overall most common orders, the recommender using temporal relationships improves precision at 10 recommendations from 33% to 38% (P < 10(-10)) for hospital admission orders. Relative risk-based association methods improve inverse frequency weighted recall from 4% to 16% (P < 10(-16)). The framework yields a prediction receiver operating characteristic area under curve (c-statistic) of 0.84 for 30 day mortality, 0.84 for 1 week need for ICU life support, 0.80 for 1 week hospital discharge, and 0.68 for 30-day readmission. Recommender results quantitatively improve on reference benchmarks and qualitatively appear clinically reasonable. The method assumes that aggregate decision making converges appropriately, but ongoing evaluation is necessary to discern common behaviors from "correct" ones. Collaborative filtering recommender algorithms generate clinical decision support that is predictive of real practice patterns and clinical outcomes. Incorporating temporal relationships improves accuracy. Different evaluation metrics satisfy different goals (predicting likely events vs. "interesting" suggestions). Published by Oxford University Press on behalf of the American Medical Informatics Association 2015. This work is written by US Government

OrderRex: clinical order decision support and outcome predictions by data-mining electronic medical records

PubMed Central

Chen, Jonathan H; Podchiyska, Tanya

2016-01-01

Objective: To answer a “grand challenge” in clinical decision support, the authors produced a recommender system that automatically data-mines inpatient decision support from electronic medical records (EMR), analogous to Netflix or Amazon.com’s product recommender. Materials and Methods: EMR data were extracted from 1 year of hospitalizations (>18K patients with >5.4M structured items including clinical orders, lab results, and diagnosis codes). Association statistics were counted for the ∼1.5K most common items to drive an order recommender. The authors assessed the recommender’s ability to predict hospital admission orders and outcomes based on initial encounter data from separate validation patients. Results: Compared to a reference benchmark of using the overall most common orders, the recommender using temporal relationships improves precision at 10 recommendations from 33% to 38% (P < 10−10) for hospital admission orders. Relative risk-based association methods improve inverse frequency weighted recall from 4% to 16% (P < 10−16). The framework yields a prediction receiver operating characteristic area under curve (c-statistic) of 0.84 for 30 day mortality, 0.84 for 1 week need for ICU life support, 0.80 for 1 week hospital discharge, and 0.68 for 30-day readmission. Discussion: Recommender results quantitatively improve on reference benchmarks and qualitatively appear clinically reasonable. The method assumes that aggregate decision making converges appropriately, but ongoing evaluation is necessary to discern common behaviors from “correct” ones. Conclusions: Collaborative filtering recommender algorithms generate clinical decision support that is predictive of real practice patterns and clinical outcomes. Incorporating temporal relationships improves accuracy. Different evaluation metrics satisfy different goals (predicting likely events vs. “interesting” suggestions). PMID:26198303

Risk factors for admission at three urban emergency departments in England: a cross-sectional analysis of attendances over 1 month.

PubMed

Ismail, Sharif A; Pope, Ian; Bloom, Benjamin; Catalao, Raquel; Green, Emilie; Longbottom, Rebecca E; Jansen, Gwyneth; McCoy, David; Harris, Tim

2017-06-22

To investigate factors associated with unscheduled admission following presentation to emergency departments (EDs) at three hospitals in England. Cross-sectional analysis of attendance data for patients from three urban EDs in England: a large teaching hospital and major trauma centre (site 1) and two district general hospitals (sites 2 and 3). Variables included patient age, gender, ethnicity, deprivation score, arrival date and time, arrival by ambulance or otherwise, a variety of ED workload measures, inpatient bed occupancy rates and admission outcome. Coding inconsistencies in routine ED data used for this study meant that diagnosis could not be included. The primary outcome for the study was unscheduled admission. All adults aged 16 and older attending the three inner London EDs in December 2013. Data on 19 734 unique patient attendances were gathered. Outcome data were available for 19 721 attendances (>99%), of whom 6263 (32%) were admitted to hospital. Site 1 was set as the baseline site for analysis of admission risk. Risk of admission was significantly greater at sites 2 and 3 (adjusted OR (AOR) relative to site 1 for site 2 was 1.89, 95% CI 1.74 to 2.05, p<0.001) and for patients of black or black British ethnicity (AOR 1.29, 1.16 to 1.44, p<0.001). Deprivation was strongly associated with admission. Analysis of departmental and hospital-wide workload pressures gave conflicting results, but proximity to the "4-hour target" (a rule that limits patient stays in EDs to 4 hours in the National Health Service in England) emerged as a strong driver for admission in this analysis (AOR 3.61, 95% CI 3.30 to 3.95, p<0.001). This study found statistically significant variations in odds of admission between hospital sites when adjusting for various patient demographic and presentation factors, suggesting important variations in ED-level and clinician-level behaviour relating to admission decisions. The 4-hour target is a strong driver for emergency admission. �

Datagram: Medical College Admission Test

ERIC Educational Resources Information Center

Nelson, Bonnie C.

1974-01-01

Presents data concerning the Medical College Admission Test (MCAT): number of MCAT examinations, 1968-73; characteristics of examinee population; comparison of percentages; mean MCAT scores by sex; and mean score by undergraduate major. (Author/PG)

Weight bias in graduate school admissions.

PubMed

Burmeister, Jacob M; Kiefner, Allison E; Carels, Robert A; Musher-Eizenman, Dara R

2013-05-01

Whether weight bias occurs in the graduate school admissions process is explored here. Specifically, we examined whether body mass index (BMI) was related to letter of recommendation quality and the number of admissions offers applicants received after attending in-person interviews. Participants were 97 applicants to a psychology graduate program at a large university in the United States. They reported height, weight, and information about their applications to psychology graduate programs. Participants' letters of recommendation were coded for positive and negative statements as well as overall quality. Higher BMI significantly predicted fewer post-interview offers of admission into psychology graduate programs. Results also suggest this relationship is stronger for female applicants. BMI was not related to overall quality or the number of stereotypically weight-related adjectives in letters of recommendation. Surprisingly, higher BMI was related to more positive adjectives in letters. The first evidence that individuals interviewing applicants to graduate programs may systematically favor thinner applicants is provided here. A conscious or unconscious bias against applicants with extra body weight is a plausible explanation. Stereotype threat and social identity threat are also discussed as explanations for the relationship between BMI and interview success. Copyright © 2012 The Obesity Society.

Potential Utility of Non-Cognitive Constructs in Graduate Admissions

NASA Astrophysics Data System (ADS)

Miller, Casey

2015-03-01

It is becoming clear that the methods employed by many graduate admissions committees need updating. Regarding outcomes, we cannot select students that will actually graduate much better than would a coin toss. Further, the GRE is often misused. For example, the most recent GRE general test data (2006-2007) shows that for US citizens in the physical sciences, a cut-off score of ~64th percentile (700/155 on old/new test) would eliminate from eligibility: 63% of women vs 42% of men; 76% of all under-represented minorities vs 38% of Asian and 47% of White applicants. Fortunately, Organizational Psychologists have identified and validated several ``non-cognitive constructs'' for admissions: aspects of personality (conscientiousness); and self-management factors. Some intriguing facts about these parameters: they are measurable with the help of social scientists; they do not show race/ethnicity/gender performance differences; they are orthogonal to cognitive metrics measured by GPA and tests scores. These are proven to enhance both validity and diversity in admissions. My goals for this talk are to overview the non-cognitive constructs with the most potential for being used in physics graduate admissions, and to suggest example admissions protocols. Supported by the National Science Foundation.

Facilitators and barriers to the use of standing orders for vaccination in obstetrics and gynecology settings.

PubMed

Barnard, Juliana G; Dempsey, Amanda F; Brewer, Sarah E; Pyrzanowski, Jennifer; Mazzoni, Sara E; O'Leary, Sean T

2017-01-01

Many young and middle-aged women receive their primary health care from their obstetrician-gynecologists. A recent change to vaccination recommendations during pregnancy has forced the integration of new clinical processes at obstetrician-gynecology practices. Evidence-based best practices for vaccination delivery include the establishment of vaccination standing orders. As part of an intervention to increase adoption of evidence-based vaccination strategies for women in safety-net and private obstetrician-gynecology settings, we conducted a qualitative study to identify the facilitators and barriers experienced by obstetrician-gynecology sites when establishing vaccination standing orders. At 6 safety-net and private obstetrician-gynecology practices, 51 semistructured interviews were completed by trained qualitative researchers over 2 years with clinical staff and vaccination program personnel. Standardized qualitative research methods were used during data collection and team-based data analysis to identify major themes and subthemes within the interview data. All study practices achieved partial to full implementation of vaccine standing orders for human papillomavirus, tetanus diphtheria pertussis, and influenza vaccines. Facilitating factors for vaccine standing order adoption included process standardization, acceptance of a continual modification process, and staff training. Barriers to vaccine standing order adoption included practice- and staff-level competing demands, pregnant women's preference for medical providers to discuss vaccine information with them, and staff hesitation in determining HPV vaccine eligibility. With guidance and commitment to integration of new processes, obstetrician-gynecology practices are able to establish vaccine standing orders for pregnant and nonpregnant women. Attention to certain process barriers can aid the adoption of processes to support the delivery of vaccinations in obstetrician-gynecology practice setting, and

Free text adversity statements as part of a contextualised admissions process: a qualitative analysis.

PubMed

Owen, Lysa E; Anderson, Stephanie Ann; Dowell, Johnathan S

2018-04-02

Medical schools globally are encouraged to widen access and participation for students from less privileged backgrounds. Many strategies have been implemented to address this inequality, but much still needs to be done to ensure fair access for all. In the literature, adverse circumstances include financial issues, poor educational experience and lack of professional-status parents. In order to take account of adverse circumstances faced by applicants, The University of Dundee School of Medicine offers applicants the opportunity to report circumstances which may have resulted in disadvantage. Applicants do this by completing a free text statement, known as an 'adversity statement', in addition to the other application information. This study analysed adversity statements submitted by applicants during two admissions cycles. Analysis of content and theme was done to identify the information applicants wished to be taken into consideration, and what range of adverse circumstances individuals reported. This study used a qualitative approach with thematic analysis to categorise the adversity statements. The data was initially analysed to create a coding framework which was then applied to the whole data set. Each coded segment was then analysed for heterogeneity and homogeneity, segments merged into generated themes, or to create sub-themes. The data set comprised a total of 384 adversity statements. These showed a wide range of detail involving family, personal health, education and living circumstances. Some circumstances, such as geographical location, have been identified and explored in previous research, while others, such as long term health conditions, have had less attention in the literature. The degree of impact, the length of statement and degree of detail, demonstrated wide variation between submissions. This study adds to the debate on best practice in contextual admissions and raises awareness of the range of circumstances and impact applicants wish to

Trends in fall-related hospital admissions in older persons in the Netherlands.

PubMed

Hartholt, Klaas A; van der Velde, Nathalie; Looman, Caspar W N; van Lieshout, Esther M M; Panneman, Martien J M; van Beeck, Ed F; Patka, Peter; van der Cammen, Tischa J M

2010-05-24

Fall-related injuries, hospitalizations, and mortality among older persons represent a major public health problem. Owing to aging societies worldwide, a major impact on fall-related health care demand can be expected. We determined time trends in numbers and incidence of fall-related hospital admissions and in admission duration in older adults. Secular trend analysis of fall-related hospital admissions in the older Dutch population from 1981 through 2008, using the National Hospital Discharge Registry. All fall-related hospital admissions in persons 65 years or older were extracted from this database. Outcome measures were the numbers, and the age-specific and age-adjusted incidence rates (per 10,000 persons) of fall-related hospital admissions in each year of the study. From 1981 through 2008, fall-related hospital admissions increased by 137%. The annual age-adjusted incidence growth was 1.3% for men vs 0.7% for women (P < .001). The overall incidence rate increased from 87.7 to 141.2 per 10,000 persons (an increase of 61%). Age-specific incidence increased in all age groups, in both men and women, especially in the oldest old (>75 years). Although the incidence of fall-related hospital admissions increased, the total number of fall-related hospital days was reduced by 20% owing to a reduction in admission duration. In the Netherlands, numbers of fall-related hospital admissions among older persons increased drastically from 1981 through 2008. The increasing fall-related health care demand has been compensated for by a reduced admission duration. These figures demonstrate the need for implementation of falls prevention programs to control for increases of fall-related health care consumption.

Continuity of care of emergency surgical admissions: impact on SpR training.

PubMed

Ledwidge, S F C; Bryden, E; Halestrap, P; Galland, R B

2008-06-01

Continuity of patient care is an important component of surgical education. This study assesses continuity of care in the current working climate. Data were collected prospectively on consecutive emergency general surgical admissions during one month. Our SpR rota is a partial shift 24 hour on call with the SpR's own consultant. The SpR is free of commitments the next day following post-take work. The on call general surgery SpR was designated the 'assessor'. Data were analysed according to involvement of the 'assessor' at subsequent stages of the admission--consent, operation, review during admission and review on discharge. Data were also collected defining whether the 'assessor' and operator followed-up the patient. There were 200 admissions; 108 female and 92 male. Overall 23% admissions had the same 'assessor' for all stages of patient care. The 'assessor' dealt with an aspect of patient care in 11% of admissions who underwent an operation and 29% of admissions who were conservatively managed. SpR follow-up of admissions on whom they operated was 70% but only 41% of admissions who were conservatively managed were followed-up by the assessing SpR. Complete in-hospital continuity of care was poor, although SpR follow-up of patients on whom they had operated was better. Introduction of shift patterns has reduced continuity of patient care. This will have a negative impact on both surgical training and patient care.

Incapable adults and informal admission: lifting the veil of deceit.

PubMed

Griffith, R; Tengnah, C; Grey, R

Since 1959, informal admission has been used for the admission of non-resisting adults to hospital for treatment of their mental health problems. The Court of Appeal has ruled this practice unlawful. As a consequence, certain issues in relation to the admission and management of these patients will have to be reconsidered and while there will be positive repercussions for the management of patients there will also be some negative effects. This article considers the implications.

Equal Protection in Special Admissions Programs: Forward from Bakke.

ERIC Educational Resources Information Center

Stone, Julius

1979-01-01

Bakke's equal protection holding is analyzed and an assessment is offered of what the decisions mean for academic special admissions programs. Discussion focuses on how race may be used as a factor in admissions decisions consistently with the equal protection clause of the Federal Constitution. (Author/MSE)

An Appreciative Approach to Training Undergraduate Admissions Student Workers

ERIC Educational Resources Information Center

Fippinger, Alex

2009-01-01

In most admissions offices, the focus of training sessions for student telecounselors and tour guides is on transmitting information about the institution. Although this transmission of institutional knowledge is important, these training sessions are opportunities for student admissions employees to consider how their work relates to their…

Hospital Admissions for Childhood Asthma After Smoke-Free Legislation in England

PubMed Central

Lee, John Tayu; Laverty, Anthony A.; Glantz, Stanton A.; Majeed, Azeem

2013-01-01

OBJECTIVE: To assess whether the implementation of English smoke-free legislation in July 2007 was associated with a reduction in hospital admissions for childhood asthma. METHODS: Interrupted time series study using Hospital Episodes Statistics data from April 2002 to November 2010. Sample consisted of all children (aged ≤14 years) having an emergency hospital admission with a principle diagnosis of asthma. RESULTS: Before the implementation of the legislation, the admission rate for childhood asthma was increasing by 2.2% per year (adjusted rate ratio 1.02; 95% confidence interval [CI]: 1.02–1.03). After implementation of the legislation, there was a significant immediate change in the admission rate of −8.9% (adjusted rate ratio 0.91; 95% CI: 0.89–0.93) and change in time trend of −3.4% per year (adjusted rate ratio 0.97; 95% CI: 0.96–0.98). This change was equivalent to 6802 fewer hospital admissions in the first 3 years after implementation. There were similar reductions in asthma admission rates among children from different age, gender, and socioeconomic status groups and among those residing in urban and rural locations. CONCLUSIONS: These findings confirm those from a small number of previous studies suggesting that the well-documented population health benefits of comprehensive smoke-free legislation appear to extend to reducing hospital admissions for childhood asthma. PMID:23339216

Minority Group Status and Bias in College Admissions Criteria

ERIC Educational Resources Information Center

Silverman, Bernie I.; And Others

1976-01-01

Cleary's and Thorndike's definition of bias in college admissions criteria (ACT scores and high school percentile rank) were examined for black, white, and Jewish students. Use of the admissions criteria tended to overpredict blacks' performance, accurately predict whites' performance, and underpredict that of Jews. In light of Cleary's…

Pawns or Professionals: The 21st Century Admission Counselor

ERIC Educational Resources Information Center

Norris, Jean M.

2005-01-01

The National Association for College Admission Counseling (NACAC), originally established to serve as an advocate of ethical practices in the recruitment of students and awarding of scholarship dollars, now recognizes the ethical dilemmas admission counselors face in the current competitive marketplace. This article presents the details of a…

Consultant Input in Acute Medical Admissions and Patient Outcomes in Hospitals in England: A Multivariate Analysis

PubMed Central

Bell, Derek; Lambourne, Adrian; Percival, Frances; Laverty, Anthony A.; Ward, David K.

2013-01-01

Recent recommendations for physicians in the UK outline key aspects of care that should improve patient outcomes and experience in acute hospital care. Included in these recommendations are Consultant patterns of work to improve timeliness of clinical review and improve continuity of care. This study used a contemporaneous validated survey compared with clinical outcomes derived from Hospital Episode Statistics, between April 2009 and March 2010 from 91 acute hospital sites in England to evaluate systems of consultant cover for acute medical admissions. Clinical outcomes studied included adjusted case fatality rates (aCFR), including the ratio of weekend to weekday mortality, length of stay and readmission rates. Hospitals that had an admitting Consultant presence within the Acute Medicine Unit (AMU, or equivalent) for a minimum of 4 hours per day (65% of study group) had a lower aCFR compared with hospitals that had Consultant presence for less than 4 hours per day (p<0.01) and also had a lower 28 day re-admission rate (p<0.01). An ‘all inclusive’ pattern of Consultant working, incorporating all the guideline recommendations and which included the minimum Consultant presence of 4 hours per day (29%) was associated with reduced excess weekend mortality (p<0.05). Hospitals with >40 acute medical admissions per day had a lower aCFR compared to hospitals with fewer than 40 admissions per day (p<0.03) and had a lower 7 day re-admission rate (p<0.02). This study is the first large study to explore the potential relationships between systems of providing acute medical care and clinical outcomes. The results show an association between well-designed systems of Consultant working practices, which promote increased patient contact, and improved patient outcomes in the acute hospital setting. PMID:23613858

Consultant input in acute medical admissions and patient outcomes in hospitals in England: a multivariate analysis.

PubMed

Bell, Derek; Lambourne, Adrian; Percival, Frances; Laverty, Anthony A; Ward, David K

2013-01-01

Recent recommendations for physicians in the UK outline key aspects of care that should improve patient outcomes and experience in acute hospital care. Included in these recommendations are Consultant patterns of work to improve timeliness of clinical review and improve continuity of care. This study used a contemporaneous validated survey compared with clinical outcomes derived from Hospital Episode Statistics, between April 2009 and March 2010 from 91 acute hospital sites in England to evaluate systems of consultant cover for acute medical admissions. Clinical outcomes studied included adjusted case fatality rates (aCFR), including the ratio of weekend to weekday mortality, length of stay and readmission rates. Hospitals that had an admitting Consultant presence within the Acute Medicine Unit (AMU, or equivalent) for a minimum of 4 hours per day (65% of study group) had a lower aCFR compared with hospitals that had Consultant presence for less than 4 hours per day (p<0.01) and also had a lower 28 day re-admission rate (p<0.01). An 'all inclusive' pattern of Consultant working, incorporating all the guideline recommendations and which included the minimum Consultant presence of 4 hours per day (29%) was associated with reduced excess weekend mortality (p<0.05). Hospitals with >40 acute medical admissions per day had a lower aCFR compared to hospitals with fewer than 40 admissions per day (p<0.03) and had a lower 7 day re-admission rate (p<0.02). This study is the first large study to explore the potential relationships between systems of providing acute medical care and clinical outcomes. The results show an association between well-designed systems of Consultant working practices, which promote increased patient contact, and improved patient outcomes in the acute hospital setting.

Centre-related variability in hospital admissions of patients with spondyloarthritis.

PubMed

Andrés, Mariano; Sivera, Francisca; Pérez-Vicente, Sabina; Carmona, Loreto; Vela, Paloma

2016-09-01

The aim of this study was to explore the variability in hospital admissions of patients with spondyloarthritis (SpA) in Spain, and the centre factors that may influence that variability. Descriptive cross-sectional study, part of the emAR II study, performed in Spain (2009-2010). Health records of patients with a diagnosis of SpA and at least one visit to the rheumatology units within the previous 2 years were reviewed. Variables related to hospital admissions, to the SpA, and to the patient and centre were collected. A multilevel logistic regression analysis of random intercept with non-random slopes was performed to assess variability between centres. From 45 centres, 1168 patients' health records were reviewed. Main SpA forms were ankylosing spondylitis (55.2 %) and psoriatic arthritis (22.2 %). A total of 248 admissions were registered for 196 patients (19.2 %, n = 1020). An adjusted variability of 17.6 % in hospitalizations between centres was noted. The following hospital-related factors showed a significant association with admissions: the total number of admissions of the centre, the existence of electronic admission, and the availability of ultrasound in rheumatology. However, these factors only explained 42.9 % of the inter-centre variability. The risk of a patient with SpA of being admitted could double (median OR 2.09), depending on the hospital where the patient was being managed. Hospital admissions of patients with SpA varied between hospitals due to centre characteristics. Further studies are needed to ascertain which specific factors may be causing the variation, as studied variables explained less than half of the variability.

Predicting respiratory hospital admissions in young people with cerebral palsy.

PubMed

Blackmore, Amanda Marie; Bear, Natasha; Blair, Eve; Langdon, Katherine; Moshovis, Lisa; Steer, Kellie; Wilson, Andrew C

2018-03-19

To determine the early predictors of respiratory hospital admissions in young people with cerebral palsy (CP). A 3-year prospective cohort study using linked data. Children and young people with CP, aged 1 to 26 years. Self-reported and carer-reported respiratory symptoms were linked to respiratory hospital admissions (as defined by the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes) during the following 3 years. 482 participants (including 289 males) were recruited. They were aged 1 to 26 years (mean 10 years, 10 months; SD 5 years, 11 months) at the commencement of the study, and represented all Gross Motor Function Classification Scale (GMFCS) levels. During the 3-year period, 55 (11.4%) participants had a total of 186 respiratory hospital admissions, and spent a total of 1475 days in hospital. Statistically significant risk factors for subsequent respiratory hospital admissions over 3 years in univariate analyses were GMFCS level V, at least one respiratory hospital admission in the year preceding the survey, oropharyngeal dysphagia, seizures, frequent respiratory symptoms, gastro-oesophageal reflux disease, at least two courses of antibiotics in the year preceding the survey, mealtime respiratory symptoms and nightly snoring. Most risk factors for respiratory hospital admissions are potentially modifiable. Early identification of oropharyngeal dysphagia and the management of seizures may help prevent serious respiratory illness. One respiratory hospital admission should trigger further evaluation and management to prevent subsequent respiratory illness. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Implementation of an IT-guided checklist to improve the quality of medication history records at hospital admission.

PubMed

Huber, Tanja; Brinkmann, Franziska; Lim, Silke; Schröder, Christoph; Stekhoven, Daniel Johannes; Marti, Walter Richard; Egger, Richard Robert

2017-12-01

Background Medication discrepancies often occur at transition of care such as hospital admission and discharge. Obtaining a complete and accurate medication history on admission is essential as further treatment is based on it. Objective The goal of this study was to reduce the proportion of patients with at least one medication discrepancy in the medication history at admission by implementing an IT-guided checklist. Setting Surgery ward focused on vascular and visceral surgery at a Swiss Cantonal Hospital. Method The study was divided into two phases, before and after implementation of an IT-guided checklist. For both phases a pharmacist collected and compared the medication history (defined as gold standard) with that of the admitting physician. Medication discrepancies were subdivided in omissions and commissions, incorrect medications or dose changes, and incorrect dosage forms or strength. Main outcome measure The proportion of patients with at least one medication discrepancy in the medication history before and after intervention was assessed. Results Out of 415 admissions, 228 patients that met the inclusion criteria were enrolled in the study, 113 before and 115 patients after intervention. After intervention, medication discrepancies declined from 69.9 to 29.6% (p < 0.0001) of patients, the mean medication discrepancy per patient was reduced from 2.3 to 0.6 (p < 0.0001), and the most common error, omission of a regularly used medication, was reduced from 76.4 to 44.1% (p < 0.001). Conclusion The implementation of the IT-guided checklist is associated with a significant reduction of medication discrepancies at admission and potentially improves the medication safety for the patient.

64 Percent of Asian and Pacific Islander Treatment Admissions Name Alcohol as Their Problem

MedlinePlus

... 000 (1 percent) of the 1.8 million substance abuse admissions were APIs. Among all admissions, 60 percent ... AANHPI. aspx. Asian and Pacific Islander Admissions to Substance Abuse Treatment and Total Substance Abuse Treatment Admissions Reporting ...

Predicting the need for institutional care shortly after admission to rehabilitation: Rasch analysis and predictive validity of the BRASS Index.

PubMed

Panella, L; La Porta, F; Caselli, S; Marchisio, S; Tennant, A

2012-09-01

Effective discharge planning is increasingly recognised as a critical component of hospital-based Rehabilitation. The BRASS index is a risk screening tool for identification, shortly after hospital admission, of patients who are at risk of post-discharge problems. To evaluate the internal construct validity and reliability of the Blaylock Risk Assessment Screening Score (BRASS) within the rehabilitation setting. Observational prospective study. Rehabilitation ward of an Italian district hospital. One hundred and four consecutively admitted patients. Using classical psychometric methods and Rasch analysis (RA), the internal construct validity and reliability of the BRASS were examined. Also, external and predictive validity of the Rasch-modified BRASS (RMB) score were determined. Reliability of the original BRASS was low (Cronbach's alpha=0.595) and factor analyses showed that it was clearly multidimensional. A RA, based on a reduced 7-BRASS item set (RMB), satisfied model's expectations. Reliability was 0.777. The RMB scores strongly correlated with the original BRASS (rho=0.952; P<0.000) and with FIM™ admission scores (rho=-0.853; P<0.000). A RMB score of 12 was associated with an increased risk of nursing home admission (RR=2.1, 95%CI=1.7-2.5), whereas a score of 17 was associated to a higher risk of length of stay >28 days (RR=7.6, 95%CI=1.8-31.9). This study demonstrated that the original BRASS was multidimensional and unreliable. However, the RMB holds adequate internal construct validity and is sufficiently reliable as a predictor of discharge problems for group, but not individual use. The application of tools and methods (such as the BRASS Index) developed under the biomedical paradigm in a Physical and Rehabilitation Medicine setting may have limitations. Further research is needed to develop, within the rehabilitation setting, a valid measuring tool of risk of post-discharge problems at the individual level.

Implicit Racial Bias in Medical School Admissions.

PubMed

Capers, Quinn; Clinchot, Daniel; McDougle, Leon; Greenwald, Anthony G

2017-03-01

Implicit white race preference has been associated with discrimination in the education, criminal justice, and health care systems and could impede the entry of African Americans into the medical profession, where they and other minorities remain underrepresented. Little is known about implicit racial bias in medical school admissions committees. To measure implicit racial bias, all 140 members of the Ohio State University College of Medicine (OSUCOM) admissions committee took the black-white implicit association test (IAT) prior to the 2012-2013 cycle. Results were collated by gender and student versus faculty status. To record their impressions of the impact of the IAT on the admissions process, members took a survey at the end of the cycle, which 100 (71%) completed. All groups (men, women, students, faculty) displayed significant levels of implicit white preference; men (d = 0.697) and faculty (d = 0.820) had the largest bias measures (P < .001). Most survey respondents (67%) thought the IAT might be helpful in reducing bias, 48% were conscious of their individual results when interviewing candidates in the next cycle, and 21% reported knowledge of their IAT results impacted their admissions decisions in the subsequent cycle. The class that matriculated following the IAT exercise was the most diverse in OSUCOM's history at that time. Future directions include preceding and following the IAT with more robust reflection and education on unconscious bias. The authors join others in calling for an examination of bias at all levels of academic medicine.

42 CFR 483.12 - Admission, transfer and discharge rights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Admission, transfer and discharge rights. 483.12 Section 483.12 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Requirements for Long Term Care Facilities § 483.12 Admission, transfer and discharge rights. (a) Transfer and...

A Study of Undergraduate Admissions to Alabama Colleges and Universities, 1971-72.

ERIC Educational Resources Information Center

Alabama State Commission on Higher Education, Montgomery.

This study examines the undergraduate admission process at Alabama colleges and universities. A questionnaire mailed to officials directing admissions at the 54 public and private colleges and universities in Alabama was constructed to determine: the minimum requirements for undergraduate admission; routine extra-credential considerations; the…

Admission From Nursing Home Residence Increases Acute Mortality After Hip Fractures.

PubMed

van Dijk, Pim A D; Bot, Arjan G J; Neuhaus, Valentin; Menendez, Mariano E; Vrahas, Mark S; Ring, David

2015-09-01

Little is known about the effect of preinjury residence on inpatient mortality following hip fracture. This study addressed whether (1) admission from a nursing home residence and (2) admission from another hospital were associated with higher inpatient mortality after a hip fracture. Using the National Hospital Discharge Survey database, we analyzed an estimated 2 124 388 hip fractures discharges, from 2001 to 2007. Multivariable logistic regression analysis was performed to identify whether admission from a nursing home and admission from another hospital were independent risk factors for inpatient mortality. Our primary null hypothesis is that there is no difference in inpatient mortality rates after hip fracture in patients admitted from a nursing home, compared to other forms of admission. The secondary null hypothesis is that there is no difference in inpatient mortality after hip fracture in patients whose source of admission was another hospital, compared to other sources of admission. Almost 4% of the patients were admitted from a nursing home and 6% from another hospital. The mean age was 79 years and 71% were women. The majority of patients were treated with internal fixation. Admission from a nursing home residence (odds ratio [OR] of 2.1, confidence interval [CI] 1.9-2.3) and prior hospital stay (OR 3.4, CI 3.2-3.7) were associated with a higher risk of inpatient mortality after accounting for other comorbidities and type of treatment. Patients transferred to an acute care hospital from a long-term care facility or another acute care hospital are at particularly high risk of inpatient death. This subset of patients should be considered separately from patients admitted from other sources. Prognostic level II.

Admissions to Canadian hospitals for acute asthma: A prospective, multicentre study

PubMed Central

Rowe, Brian H; Villa-Roel, Cristina; Abu-Laban, Riyad B; Stenstrom, Rob; Mackey, Duncan; Stiell, Ian G; Campbell, Sam; Young, Bryan

2010-01-01

BACKGROUND: Asthma exacerbations constitute one of the most common causes of emergency department (ED) attendance in most developed countries. While severe asthma often requires hospitalization, variability in admission practices has been observed. OBJECTIVE: To describe the factors associated with admission to Canadian hospitals for acute asthma after ED treatment. METHODS: Subjects 18 to 55 years of age treated for acute asthma in 20 Canadian EDs prospectively underwent a structured ED interview (n=695) and telephone interview two weeks later. RESULTS: The median age of the patients was 30 years, and the majority were women (62.8%). The admission rate was 13.1% (95% CI 10.7% to 15.8%). Admitted patients were older, more often receiving oral or inhaled corticosteroids at presentation, and more frequently receiving systemic corticosteroids and magnesium sulphate in the ED. Similar proportions received beta-2 agonists and/or ipratropium bromide within 1 h of arrival. On multivariable analyses, factors associated with admission included age, previous admission in the past two years, more than eight beta-2 agonist puffs in the past 24 h, a Canadian Triage and Acuity Score of 1 to 2, a respiratory rate of greater than 22 breaths/min and an oxygen saturation of less than 95%. CONCLUSION: The admission rate for acute asthma from these Canadian EDs was lower than reported in other North American studies. The present study provides insight into practical factors associated with admission for acute asthma and highlights the importance of history and asthma severity markers on ED decision making. Further efforts to standardize ED management and expedite admission decision-making appear warranted. PMID:20186368

The Admission and Placement of Students From the Pacific-Asia Area. A Workshop Report. Australia, Ceylon, Hong Kong, India, Malaysia, New Zealand, Pakistan, Singapore, Okinawa, and Pacific Islands.

ERIC Educational Resources Information Center

Jameson, Sanford, Ed.

This is the report from the workshop for the admission and placement of students from the Pacific-Asia Area. The basic purpose of this workshop was to bring together a group of experienced admissions officers and resource persons with expertise in the particular countries to be covered, in order to study, in some depth, foreign educational systems…

43 CFR 4.1141 - Admissions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... readily obtainable by him is insufficient to enable him to admit or deny. (d) The party who has requested... pending action only and is not an admission by him for any other purpose nor may it be used against him in...

Admission time to hospital: a varying standard for a critical definition for admissions to an intensive care unit from the emergency department.

PubMed

Nanayakkara, Shane; Weiss, Heike; Bailey, Michael; van Lint, Allison; Cameron, Peter; Pilcher, David

2014-11-01

Time spent in the emergency department (ED) before admission to hospital is often considered an important key performance indicator (KPI). Throughout Australia and New Zealand, there is no standard definition of 'time of admission' for patients admitted through the ED. By using data submitted to the Australian and New Zealand Intensive Care Society Adult Patient Database, the aim was to determine the differing methods used to define hospital admission time and assess how these impact on the calculation of time spent in the ED before admission to an intensive care unit (ICU). Between March and December of 2010, 61 hospitals were contacted directly. Decision methods for determining time of admission to the ED were matched to 67,787 patient records. Univariate and multivariate analyses were conducted to assess the relationship between decision method and the reported time spent in the ED. Four mechanisms of recording time of admission were identified, with time of triage being the most common (28/61 hospitals). Reported median time spent in the ED varied from 2.5 (IQR 0.83-5.35) to 5.1 h (2.82-8.68), depending on the decision method. After adjusting for illness severity, hospital type and location, decision method remained a significant factor in determining measurement of ED length of stay. Different methods are used in Australia and New Zealand to define admission time to hospital. Professional bodies, hospitals and jurisdictions should ensure standardisation of definitions for appropriate interpretation of KPIs as well as for the interpretation of studies assessing the impact of admission time to ICU from the ED. WHAT IS KNOWN ABOUT THE TOPIC?: There are standards for the maximum time spent in the ED internationally, but these standards vary greatly across Australia. The definition of such a standard is critically important not only to patient care, but also in the assessment of hospital outcomes. Key performance indicators rely on quality data to improve decision

A Survey of International Practice in University Admissions Testing

ERIC Educational Resources Information Center

Edwards, Daniel; Coates, Hamish; Friedman, Tim

2012-01-01

This paper explores how admissions tests are used in different higher education systems around the world. This is a relatively new area of research, despite the fact that admissions processes are a key component of university practices and given the ever increasing globalisation of higher education. This paper shows that aptitude and achievement…

The Use of Tests in Admissions to Higher Education.

ERIC Educational Resources Information Center

Fruen, Mary

1978-01-01

There are both strengths and weaknesses of using standardized test scores as a criterion for admission to institutions of higher education. The relative importance of scores is dependent on the institution's degree of selectivity. In general, decision processes and admissions criteria are not well defined. Advantages of test scores include: use of…

Grading Standards, Student Ability and Errors in College Admission

ERIC Educational Resources Information Center

Moen, Jarle; Tjelta, Martin

2010-01-01

Grades are important for admission of students in most higher education programs. Analyzing admission and student performance data at a major Norwegian business school, we find that the grading practice of teachers at regional colleges sending students to the school is affected by the average performance of the students being graded. Teachers at…

Admission temperature of low birth weight infants: predictors and associated morbidities.

PubMed

Laptook, Abbot R; Salhab, Walid; Bhaskar, Brinda

2007-03-01

There is a paucity of information on the maintenance of body temperature at birth for low birth weight infants. We examined the distribution of temperatures in low birth weight infants on admission to the NICUs in the Neonatal Research Network centers and determined whether admission temperature was associated with antepartum and birth variables and selected morbidities and mortality. Infants without major congenital anomalies born during 2002 and 2003 with birth weights of 401 to 1499 g who were admitted directly from the delivery room to the NICU were included. Bivariate associations between antepartum/birth variables and admission temperature and selected morbidities/mortality and admission temperature were examined, followed by multivariable linear or logistic regressions to detect independent associations. There were 5277 study infants and the mean (+/-SD) birth weight and gestational age were 1036 +/- 286 g and 28 +/- 3 weeks, respectively. The distribution of admission temperatures was 14.3% at < 35 degrees C, 32.6% between 35 and 35.9 degrees C, 42.3% between 36 and 36.9 degrees C, and 10.8% at > or = 37 degrees C. The estimate of birth weight on admission temperature with and without intubation was +0.13 degrees C and +0.04 degrees C per 100-g increase in birth weight, respectively. The mean admission temperature for each center varied from 1.5 degrees C below to 0.3 degrees C above a reference center. On adjusted analyses, admission temperature was inversely related to mortality (28% increase per 1 degrees C decrease) and late-onset sepsis (11% increase per 1 degrees C decrease) but not to intraventricular hemorrhage, necrotizing enterocolitis, or duration of conventional ventilation. Preventing decreases in temperature at birth among low birth weight infants remains a challenge. Associations with intubation and center of birth suggest that assessment of temperature control for infants intubated in the delivery room may be beneficial. Whether the

Hospital admissions for anaphylaxis in Istanbul, Turkey.

PubMed

Cetinkaya, F; Incioglu, A; Birinci, S; Karaman, B E; Dokucu, A I; Sheikh, A

2013-01-01

There are very limited data characterizing the epidemiology of anaphylaxis from low- and middle-income country settings. We aimed to estimate the frequency of anaphylaxis admissions to hospitals in Istanbul. We obtained data from all 45 hospitals in Istanbul over a 12-month period and used ICD-10 codes to extract data on those admitted with a recorded primary diagnosis of anaphylaxis. Because of concerns about possible under-coding, we undertook an additional analysis to identify patients admitted with two or more clinical codes for symptoms and/or signs suggestive of, but not coded as having, anaphylaxis. A total of 114 cases (79 people with anaphylaxis codes and 35 with symptoms and signs suggestive of anaphylaxis) were identified, giving an overall estimate of 1.95 cases per 100 000 person-years. The novel two-stage identification approach employed suggests significant under-recording of anaphylaxis in those admitted to hospitals in Istanbul. © 2012 John Wiley & Sons A/S.

Degeneracy relations in QCD and the equivalence of two systematic all-orders methods for setting the renormalization scale

DOE PAGES

Bi, Huan -Yu; Wu, Xing -Gang; Ma, Yang; ...

2015-06-26

The Principle of Maximum Conformality (PMC) eliminates QCD renormalization scale-setting uncertainties using fundamental renormalization group methods. The resulting scale-fixed pQCD predictions are independent of the choice of renormalization scheme and show rapid convergence. The coefficients of the scale-fixed couplings are identical to the corresponding conformal series with zero β-function. Two all-orders methods for systematically implementing the PMC-scale setting procedure for existing high order calculations are discussed in this article. One implementation is based on the PMC-BLM correspondence (PMC-I); the other, more recent, method (PMC-II) uses the R δ-scheme, a systematic generalization of the minimal subtraction renormalization scheme. Both approaches satisfymore » all of the principles of the renormalization group and lead to scale-fixed and scheme-independent predictions at each finite order. In this work, we show that PMC-I and PMC-II scale-setting methods are in practice equivalent to each other. We illustrate this equivalence for the four-loop calculations of the annihilation ratio R e+e– and the Higgs partial width I'(H→bb¯). Both methods lead to the same resummed (‘conformal’) series up to all orders. The small scale differences between the two approaches are reduced as additional renormalization group {β i}-terms in the pQCD expansion are taken into account. In addition, we show that special degeneracy relations, which underly the equivalence of the two PMC approaches and the resulting conformal features of the pQCD series, are in fact general properties of non-Abelian gauge theory.« less

Understanding psychiatric nursing care with nonsuicidal self-harming patients in acute psychiatric admission units: the views of psychiatric nurses.

PubMed

O'Donovan, Aine; Gijbels, Harry

2006-08-01

Self-harm in the absence of suicidal intent is an underexplored area in psychiatric nursing research. This article reports on findings of a study undertaken in two acute psychiatric admission units in Ireland. The purpose of this study was to gain an understanding of the practices of psychiatric nurses in relation to people who self-harm but who are not considered suicidal. Semistructured interviews were held with eight psychiatric nurses. Content analysis revealed several themes, some of which will be presented and discussed in this article, namely, the participants' understanding of self-harm, their approach to care, and factors in the acute psychiatric admission setting, which impacted on their care. Recommendations for further research are offered.

Turning Over Patient Turnover: An Ethnographic Study of Admissions, Discharges, and Transfers

PubMed Central

Mowinski Jennings, Bonnie; Sandelowski, Margarete; Boshamer, Cary C.; Higgins, Melinda K.

2014-01-01

The impact on nursing work of patient turnover (admissions, discharges, and transfers) became evident in an ethnographic study of turbulence. The patient turnover data were generated from extensive observations, 21 formal interviews, and a year of admission and discharge records on one medical and one surgical unit. Timing of turnover events on the two units differed, but on both units admissions typically interrupted workflow more than did discharges, clustered admissions were more disruptive than staggered admissions, and patient turnover during change of shift was more disruptive than during medication administration. Understanding the complexity of patient turnover will elucidate the work involved and improve the evidence base for nurse staffing, a key determinant of quality and safety of care. PMID:24242196

7 CFR 503.2 - Admission.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC, into animal holding areas, specified restricted areas, laboratory compounds, or into laboratories without...

7 CFR 503.2 - Admission.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC, into animal holding areas, specified restricted areas, laboratory compounds, or into laboratories without...

7 CFR 503.2 - Admission.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC, into animal holding areas, specified restricted areas, laboratory compounds, or into laboratories without...

7 CFR 503.2 - Admission.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC, into animal holding areas, specified restricted areas, laboratory compounds, or into laboratories without...

7 CFR 503.2 - Admission.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC, into animal holding areas, specified restricted areas, laboratory compounds, or into laboratories without...

40 CFR 91.703 - Admission.

Code of Federal Regulations, 2010 CFR